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Bills Digest No. 231 1997-98
Veterans' Entitlements Amendment (Gold Card) Bill 1998
WARNING:
This Digest was prepared for debate. It reflects the legislation as introduced
and does not canvass subsequent amendments. This Digest does not have
any official legal status. Other sources should be consulted to determine
the subsequent official status of the Bill.
CONTENTS
Passage History
Purpose
Background
Main Provisions
Endnotes
Contact Officer and Copyright Details
Veterans' Entitlements Amendment (Gold Card) Bill 1998
Date Introduced: 3
June 1998
House: House of Representatives
Portfolio: Veterans'
Affairs
Commencement: 1
January 1999
To extend full repatriation health
care benefits (the Gold Card) to Australian veterans who are aged 70 or
over and who have World War II qualifying service.
The Gold Card is the popular name for the 'Repatriation
Health Card - For All Conditions' which is issued by the Department of
Veterans' Affairs. This card enables the holder to access the full range
of repatriation health care benefits. The health care benefits available
to holders of the Gold Card are equivalent to top of the range cover in
a private health fund. The benefits include treatment as a private patient
in a public or private hospital, choice of doctor, pharmaceuticals at
the concessional rate, optical care, physiotherapy, dental care, podiatry
and chiropractic services. The benefits are for all medical conditions,
irrespective of whether the conditions resulted from war service. The
Gold Card also entitles veterans to transport to and from their medical
treatment.
There are 257 639 veterans and their dependants already
receiving the Gold Card,(1) of whom 135 000 are World War II veterans(2).
The Gold Card is not issued to all veterans. At present the following
groups are eligible:
- All veterans and nurses of World War I
- All prisoners of war
- All female World War II veterans
- All veterans receiving 100% or more disability pension
- All veterans receiving 50%+ disability pension and any amount of service
pension
- Veterans who receive a service pension and qualify for treatment under
the income and assets test
- War widows, war widowers and dependant children.
The Government estimates that this measure will make
a further 50 000 male World War II veterans eligible. It is anticipated
by the Department of Veterans Affairs that most of these veterans will
be self-funded retirees. At present some may be receiving a level of service
pension but have not qualified for health care under the current income
and assets test. The average age of World War II veterans is 76.5 years.
Who will miss out?
- Veterans of World War II who are under the age of 70 on 1 January
1999 will not be entitled to the Gold Card until their 70th
birthday. Given that it is almost 54 years since the end of World War
II, only those servicemen who enlisted at a very young age will miss
out. No numbers are available, but popular legend has it that a small
number of midshipmen enlisted at the age of 14 and served in an area
of hostile enemy action during World War II. However, the numbers are
expected to be extremely small. The imposition of an age limit is unusual.
When free medical treatment was provided to World War I veterans in
1973, no age barrier was imposed. Similarly, in 1988, the Gold Card
was provided to female veterans of World War II without an age limit.
Given the very small number of veterans involved, the age limit may
be unnecessary.
- Veterans who do not meet the service criteria. Qualifying service
is defined in Section 7A of the Veterans' Entitlements Act 1986.
The major test for qualifying service is that the veteran has, in operations
against the enemy, 'incurred danger from hostile forces of the enemy'.
Most World War II veterans have this qualifying service as a result
of their service outside Australia during the period of hostilities
from 3 September 1939 to 29 October 1945 inclusive. Certain World War
II service within Australia while in danger from hostile forces of the
enemy is also classified as qualifying service. Veterans who do not
meet the criteria for qualifying service include servicemen who enlisted
to serve but were not sent overseas and were not in an area of Australia
that came under hostile enemy action. Some veterans enlisted during
World War II, served within Australia and later served in Korea. These
people may now be aged more than 70 years, but they will not be eligible
for the Gold Card under these arrangements.
- Allied and Commonwealth veterans who served with a Commonwealth or
Allied force during World War II will not be eligible, unless they actually
lived in Australia before enlisting in Commonwealth or Allied forces.
Costs
It is estimated that to extend full repatriation health
care to eligible World War II veterans will cost an additional $480 million
over 4 years. $95.7 million is budgeted for 1998-1999. As a consequence
of this initiative, funding for some medical and pharmaceutical payments
currently being made to World War II veterans by the Department of Health
and Family Services will be reduced.(3)
Impact on private health insurance
Eligible veterans who presently have private health insurance
will find that the Gold Card provides comprehensive health care coverage,
and may decide to relinquish their private health insurance after 1 January
1999. World War II veterans on waiting lists for operations in public
hospitals will be eligible for private hospital care after 1 January 1999.
Comments
The extension of the Gold Card was announced by the Prime
Minister, Hon John Howard MP, on 27 April 1998.(4) It has received almost
universal approval. The RSL applauded the Government for its recognition
of the contribution made by World War II veterans, saying that:
Veterans of World War I received an automatic entitlement to the Gold
Card 55 years after the end of that war. It is now timely and fair that
our veterans of the Second World War be similarly recognised for their
outstanding commitment and sacrifice to Australia...
We would expect similar arrangements to apply to veterans of subsequent
conflicts as they reach their senior years.(5)
However, Peter Walsh, writing in the Australian Financial
Review on 26 May 1998 questioned whether Australia should be extending
coverage of the Gold Card to all eligible World War II veterans. He wrote
that:
Fifty thousand old diggers will get gold-plated medical services for nothing,
even if they are millionaires...Lest the RSL be annoyed by this criticism,
I remind it that affluent World War II soldiers who have already died
- about half I understand - did not receive such benefits.
If Australia could not afford them when it paid its way in the world,
we cannot afford them now, let alone the multitude of other claims they
will provoke.(6)
In supporting the extension of full repatriation health
care benefits to eligible World War II veterans, the Shadow Minister for
Veterans' Affairs, Laurie Ferguson MP, stated that:
Whilst the opposition is happy to consider sound proposals, it would be
unsustainable to constantly extend the gold card to more and more groups.
Apart from anything else, such an approach could soon endanger the continuation
of the level of benefits enjoyed by current cardholders.(7)
Philosophy behind providing repatriation benefits
to veterans
The basic principles which have governed Repatriation
legislation in Australia were stated by Justice Toose in his 1975 Report
of the Independent Enquiry into the Repatriation System.(8) They include:
- Australia is indebted to those who served it in time of war by enlisting
in the Armed Forces, thereby endangering their lives and health and
probably suffering economic loss
- As a consequence, the nation has a duty to ensure that those who have
served, together with their dependants, are properly cared for
- Those who have served overseas or in a proclaimed theatre of war,
are likely to have encountered greater danger and/or more arduous service
than those who had home service and, accordingly, they should have a
more extensive cover
- Compensation and other benefits should be available as a matter of
right and not as a welfare hand-out, and in cases of doubt, the doubt
should be resolved in favour of those claiming to be entitled.
Brief history of medical treatment cards for
returned service personnel
The Commonwealth's repatriation initiatives to provide
benefits and opportunities for service people and their dependants began
during World War I when it was recognised that returned soldiers, and
dependants of the dead and injured, would require continued assistance
in the form of pensions, medical care, allowances for dependants and many
other benefits.(9) Through 'repatriation'-a uniquely Australian use of
the word which came to mean all the assistance given to ex-service people,
the nation was able to recognise the sacrifice of the dead through assistance
to their families, and to help the living achieve an effective return
to civilian life. The provision of health care and benefits to older veterans
may be seen as part of Australia's ongoing obligation to honour and reward
those who served.
Entitlement to free medical treatment was initially confined
to service-related disabilities. However, from 1924 onwards, Commonwealth
governments have progressively expanded entitlement to treatment for non-service
related disabilities to certain prescribed categories of veterans and
their dependants, and to some civilians.
- In 1973 (55 years after the end of World War I) all Boer War and World
War I veterans were granted free universal medical care through the
provision of a Personal Treatment Entitlement Card (PTEC), a fore-runner
to the Gold Card.
- In 1974 free medical treatment was extended to all Australian ex-prisoners
of war, and to all ex-service personnel suffering from cancer, whether
or not their disease was related to their war service.
- From 1 January 1998 all World War II ex-servicewomen were provided
with full medical treatment entitlements. This was in response to a
government initiated inquiry that highlighted the disadvantages suffered
by female World War II veterans. In particular the review indicated
that women had been paid less than men throughout their war service
and had not been eligible for the same level of repatriation assistance
after the war.
The effect of Item 1 of Schedule 1 is to amend
Section 7A (which defines 'qualifying service') so that it also applies
to eligibility for a Gold Card (Section 85) and eligibility for a Seniors
Health Card (Section 118V). The Explanatory Memorandum states that
the amendment to section 118V corrects a 'minor technical deficiency'
in the Veterans' Entitlements Act 1986.
Item 2 adds a new subsection 85(4A) providing
the criteria that will be used to determine if a World War II veteran
is eligible for full repatriation health benefits. The criteria to be
used are:
- the veteran is aged 70 or more, and
- the veteran must meet the criterion of 'eligible service' as defined
in section 7A, and that service must have occurred between 3 September
1939 and 29 October 1945 inclusive (the 'period of hostilities' for
World War II as defined in subsection 5B(1) of the Principal Act).
New paragraph (4A)(c) provides that a veteran
is not eligible for treatment until he or she has applied for the Gold
Card or been notified by the Department of Veterans' Affairs of eligibility.
- The figure comes from the Department of Veterans' Affairs and is the
number at 30 March 1998.
- Dept of Veterans' Affairs, News release, 27 April 1998.
- Budget Measures 1998-99, (Budget paper No. 2, 1998-99), 1-111.
- John Howard, Press release, 27 April 1998, 'Gold Card boost
for Australian World War II veterans'.
- RSL, Media Release, 27 April 1998, 'RSL applauds grant of Gold
Card to World War II veterans'.
- Peter Walsh, 'The folly of an overkill', Australian Financial Review,
26 May 1998, 21.
- House of Representatives, Debates, 28 May 1998, 3915.
- Independent Enquiry into the Repatriation System, Report, AGPS,
Canberra, June 1975, Volume 3 Summary of report, 4-5.
- Australian Soldiers' Repatriation Act 1917-1918.
Rosemary Bell
18 June 1988
Bills Digest Service
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ISSN 1328-8091
© Commonwealth of Australia 1998
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