Thursday, October 09, 2014

Review Of The Ongoing Post - Budget Controversy 09th October 2014. It Just Rolls On!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
It is amazing how the discussion on the GP Co-Payment just runs and runs. Some more this week.
Here are some of the more interesting articles I have spotted this 19th week since it was released.
The big news from last week is a clear cut back-down on some of the more draconian changes proposed in May. The MYEFO - due December - will show us what other nasties have been dreamt up to replace the budget holes!
Laura Tingle put it is context:

“New spending to fund

When federal cabinet’s expenditure review committee of cabinet met this week to contemplate the mid-year review (MYEFO) of the budget in December, it faced the stark reality that revenue is once again looking weak, there is a whole range of new spending decisions to fund – most notably a new war – and a significant lack of progress in getting the May budget through the Parliament. On Thursday, the government split its budget social security measures bill into four separate new bills, but only put one up for debate.”


Budget negotiations remain in deadlock

Date September 30, 2014 - 7:42AM

Gareth Hutchens

More than $20 billion of budget measures remain deadlocked in the Senate, more than four weeks after the Abbott government tried to reboot the national argument by declaring the bulk of its budget measures locked-in.
The government is still negotiating with key cross-benchers on some of its most controversial policies – including the $14 billion social security bills and $2.2 billion fuel indexation changes – despite Treasurer Joe Hockey revealing last week that the 2013-14 budget deficit was $30 billion bigger than expected.
Mr Hockey said on Thursday the final budget deficit for the 2013-14 financial year had come in at $48.5 billion, $30 billion more than forecast, with 60 per cent of the $30 billion deterioration in the bottom line coming from the write-down of receipts, particularly tax receipts.

Hockey’s budget retreat

The Abbott government has raised the white flag on up to $30 billion of four-year budget savings, deciding to push the remaining few measures which have Senate ­support through the Parliament before recasting its budget strategy in December.
The Senate standoff, a slump in iron ore prices, the soft economic outlook and a potential multibillion-dollar bill for a new military commitment in the Middle East have put a cloud over the government’s forecast that the budget deficit will shrink from $48.5 billion to $30 billion deficit this financial year and over the shape of its structural savings into future years.
The government has started work on a new, alternate round of savings – to be unveiled in the mid-year review of the budget in December – although sources concede the options are very limited.

Cancer causes pain in hip pocket

Date October 1, 2014 - 12:15AM

Kate Hagan, Health Reporter

Almost two-thirds of women with advanced breast cancer experience financial difficulty as a result of their diagnosis, with average out-of-pocket costs of $687 each month.
A Breast Cancer Network Australia survey of 580 women found financial difficulties affected women in the private and public healthcare systems, and drugs not included on Australia's list of subsidised medicines caused the greatest burden.
Women reported average monthly out-of-pocket costs of $687 associated with their treatment, including costs of $817 in the private hospital system and $531 in the public system.

Government in humiliating retreat on budget

Date October 2, 2014 - 1:42AM

Mark Kenny

Chief political correspondent

The federal government has beaten a tactical retreat on welfare cuts in its budget in order to ring-fence nearly $4 billion in savings after it became clear it would lose its entire package of welfare changes worth in excess of $9 billion to the bottom line.
In closed-door talks with the opposition on Wednesday, the ministers in charge of the welfare reform package, finally conceded they cannot find the numbers and will need to split the omnibus legislation up to secure those aspects for which there is Labor or crossbench support - that is, proposed changes to the Family Tax Benefit (part B) threshold through lowering the upper income limit of the primary earner to $100,000 rather the current $150,000 cutoff.
In direct negotiations with the opposition's welfare spokeswoman, Jenny Macklin, on Wednesday, the relevant ministers, Social Services Minister Kevin Andrews and Assistant Social Services Minister Mitch Fifield, indicated they would divide the legislation, allowing those parts with opposition and/or Greens support to go forward while the rest would sit in abeyance.

Govt flags move to accept $3b welfare savings and discuss the rest later

Alexandra Kirk reported this story on Wednesday, October 1, 2014 12:14:00
ASHLEY HALL: It's been four months since the Federal Government handed down its controversial budget, and for the first time it may have a glimmer of hope in getting some of its more controversial measures passed by the Senate.
It's proposing to split its social security bill.
Labor and the Greens say they want to see new legislation that only covers the savings they support.
If passed, it would deliver almost $3 billion in budget savings for the Government, but the future of the remaining $27 billion in proposed savings measures remains in doubt.
2 October 2014, 5.39am AEST

Bludgers and battlers are back as Hockey takes aim at welfare state

Verity Archer

Lecturer in Sociology at Federation University Australia
Bludgers are back, and with them their traditional sparring partners, the battlers. The welfare changes in the Abbott government’s first budget have created fierce debate.
On the side of the government, Andrew Bolt wants to “separate the battlers from the bludgers” and end the “culture of welfare”.
Others, like Mission Australia CEO Catherine Yeomans and Labor’s Anthony Albanese, claim there are very few dole bludgers. They say the vast majority of unemployed “really do want to work” and demonising our most vulnerable can only add insult to injury.

Coalition flails against grip of budgetary tar baby

Laura Tingle
Things used to be more straightforward in the olden days. The economy would boom and then it would bust. Tax collections would slump then roar back. A new government would be elected having pledged big cuts to get the budget into shape and would then have a tough first budget to give it plenty of space between unpopular cuts and the next election.
But about 2008, things somehow went awry.
The economy had been booming. Then along came the GFC and we didn’t bust, thanks (depending on your perspective) on Labor’s stimulus package, or China, or some combination of both.

Abbott budget faces tough test as Senate blocks cause a rethink

Date October 3, 2014 - 11:45PM
When Jenny Macklin, Labor's inveterate social policy expert sat down with the government on Wednesday morning, she sensed a rare opposition win might be in the offing.
A long-running game of political brinkmanship had seen the government roll a clutch of welfare tightenings into an omnibus bill, gambling that the non-government majority in the Senate would eventually baulk at taking responsibility for blocking more than $10 billion in savings needed to help rebalance the budget.
Labor had steadfastly maintained it was not for turning and while there were a couple of items it would wave through, it would "never" back harsh changes to the dole to make the young wait six months for payments, lower indexation for pensions, and a two-year freeze on family payments.

Coalition budget battle plan falls apart

Laura Tingle Political editor
On Thursday, the House of Representatives passed a rather shrivelled little bill from the Abbott government, containing cuts to the welfare bill amounting to just $2.7 billion over the next four years.
To lock in these cuts, it had sliced about $10 billion of further welfare savings out of the legislation because it knew they would not get through the Senate.
Even cuts of this very scaled back magnitude will have an impact on people of course.
Many retirees, for example, who currently get the Commonwealth Seniors Health Card, will lose it because, from January 1, their untaxed superannuation earnings will be included in their eligibility for the card. Equally, families earning more than $100,000 but less than $150,000 will no longer be eligible for family tax benefits B.

Health cuts and education deregulation: critical issues for Indigenous doctors

Melissa Sweet | Oct 01, 2014 12:09PM |
Members of the Australian Indigenous Doctors’ Association are gathering in Melbourne today for the start of their annual conference, at a time of great uncertainty for Indigenous health and Indigenous doctors.
In previewing the conference, AIDA president Dr Tammy Kimpton raises concerns about the impact of the Federal Government’s plans for deregulation of higher education.
Dr Kimpton, a Palawa woman from the west coast of Tasmania, also highlights the importance of growing the number of Indigenous doctors – and how universities can do more to help this.

Medical Research.

Scary lack of funding for rare cancer research

Date September 27, 2014

Amy Corderoy

Health Editor, Sydney Morning Herald

They are three terrible words that change your life: "You have cancer."
They set you on a path that can become part of your identity: the "cancer patient", on a treadmill of doctors, treatments, hospitals, then, hopefully, the "cancer survivor".
But for some diagnoses, there is no set path.
Richard Vines, the director of Rare Cancers Australia, advocates for those who may be the only person, or one of a few, in Australia to have their type of cancer.
"There's absolutely nobody in Australia you can go to," he says. "There is not enough money and there is not enough research, so you don't have centres of expertise, you don't have that brilliant part-academic, part-clinician researcher who is the pick of the bunch for that particular tumour type."

GP Co-Payment.

Dutton puts GP co-payment legislation on hold

Joanna Heath
Plans to introduce legislation for the controversial $7 GP co-payment into Parliament this week were pulled at the last minute by Health Minister Peter Dutton, as the government refocuses its budget strategy on measures it has ­support for.
The co-payment has proven to be one of the least popular measures from the May budget and does not have the support of the Senate.
According to correspondence seen by The Australian Financial Review, Mr Dutton was set to brief the Coalition Policy Committee on Health on the legislation on Tuesday morning before a party room meeting. But late on Monday, Mr Dutton’s office cancelled the meeting and announced the legislation had been withdrawn until a later date with no explanation. Members were told only that the executive had made a decision not to proceed with the meeting.

Co-payment on hold

3 October, 2014 Amanda Davey
The controversial $7 GP co-payment is on hold after the Health Minister’s office announced the legislation had been withdrawn until a later date.
Mr Dutton was set to brief the Coalition Policy Committee on Health on the legislation on Tuesday morning before a party room meeting. But late on Monday, the Health Minister’s office cancelled the meeting with no explanation, according to a report in The Australian Financial Review.
A spokesman for Mr Dutton said that government was still committed to the measure.
“The government has a number of important pieces of legislation to pass. Legislation is normally brought forward in accordance with timing priority and there is plenty of time for this legislation to be debated before its commencement,” he told the Financial Review.

Pharmacy Related Articles.

Union calls for government intervention over 6CPA

29 September, 2014 Chris Brooker
Professional Pharmacists Australia (PPA) says the Federal Government needs to widen the base of Sixth Community Pharmacy Agreement negotiations beyond pharmacy owners.
Consumers and professional employee pharmacists should be invited to the 6CPA negotiating table, PPA CEO Chris Walton says in a letter to Prime Minister Tony Abbott (pictured).
“PPA asks that you invite consumers and professional employee pharmacists to the table as part of the negotiations for the Sixth Community Pharmacy Agreement,” Mr Walton said.

Be prepared for security threats: Guild

30 September, 2014 Christie Moffat
Community pharmacies should be mindful of national security concerns and take steps to ensure safety procedures are in place, the Pharmacy Guild of Australia says.
In a recent edition of Guild newsletter Forefront, the Guild highlighted the importance of remaining vigilant, following Prime Minister Tony Abbott’s decision to upgrade the National Threat Level from medium to high.

Price disclosure wave breaks today

1 October, 2014 Chris Brooker
Today (October 1) marks the kick-off of the Federal Governments ‘simplified’ price disclosure regime.
A series of accelerated price disclosure cuts will come into force, seeing 442 PBS items across 82 molecules experiencE large drops in their PBS price.
Among the key selling pharmaceuticals to be affected are atorvastatin, which will be subject to a 45.9% drop from today, and rosuvastatin, the price of which will decline by 36 per cent.

The Stalinism on Australia’s high streets

Terry Barnes
The competition review led by Ian Harper has tackled both the pharmacists’ near-monopoly ownership of Australia’s 5000-plus community pharmacies and the myriad rules controlling where a pharmacy can dispense medicines under the Pharmaceutical Benefits Scheme (PBS).
Stalinist location rules have been in place, with relatively minor modifications, ever since the Hawke government made the first five-year Community Pharmacy Agreement with the owners’ union, The Pharmacy Guild of Australia (PGA).
What is in place today remains a Kafkaesque bog of red tape and bureaucracy protecting the interests of the very few – pharmacist proprietors and guild members – from the great many – taxpayers, consumers and even non-proprietor fellow pharmacists.
In 2012, I wrote that location rules “protect the position of the relatively few retail pharmacists who have provider approvals in commercially desirable locations against the many who don’t”. Nothing has changed. Establishing a new pharmacy 1.501 kilometres in a straight line from an existing premise is OK, but establishing one 1.499km away is not. Establishing a pharmacy within a private hospital with 150 inpatient beds is fine, but if just one of those beds closes, no can do.

6CPA projections show PBS savings of $14b

2 October, 2014 Christie Moffat
PBS reforms will save the Federal Government nearly $14 billion over the five-year course of the Sixth Community Pharmacy Agreement (6CPA), according to the Pharmacy Guild of Australia.
David Quilty (pictured), Guild executive director, wrote in Forefront that Guild projections based on May’s Federal Budget showed that the Government was making far greater savings from PBS reforms than expected, and it was “beyond doubt” that PBS expenditures were contained and sustainable.
Following the release of the Final 2013-2014 Budget Outcome last week, Mr Quilty said the paper revealed a further write-down of $168 million in pharmaceutical expenditures since the release of the Budget, and had cost 14% less than predicted in 2011-2012.

Pharmacists display skills to parliamentarians

2 October, 2014 Chris Brooker
NSW pharmacists have recently demonstrated their clinical skills to state parliamentarians, showing the range of services pharmacists can offer.
State Guild branch committee members Rick Samimi, Mark Douglass and Mario Barone, and pharmacist officers Kim Tran, David Bryant and Alex Milne displayed their professional capabilities at a Parliament Health Check day held in collaboration with Optometry NSW/ACT.
Held on Wednesday 10 September, through the initiative of Dr Andrew McDonald, Member for Macquarie Fields, parliamentarians were able to have comprehensive health screenings, followed by counselling and appropriate referral by pharmacists and optometrists.

Consumers want pharmacy service expansion

3 October, 2014 Chris Brooker
Australia’s leading consumer group has given qualified support to expanding the role of pharmacists in providing primary care services, while continuing its criticism of the Community Pharmacy Agreement.
Commenting on recent AMA concerns about proposals by the Pharmacy Guild of Australia for an expanded role for pharmacy, the Consumers Health Forum (CHF) says it was “broadly supportive” of the service expansion.
However, the AMA had raised “some important questions about the optimum delivery of primary care in Australia and negotiations around the 6th community pharmacy agreement”, the CHF said.
“CHF agrees with AMA that the transparent Medical Services Advisory Committee (MSAC) process may be an appropriate place for the consideration of government funding for such services - not the secretive Community Pharmacy Agreement negotiations”.

Medibank Private Sale.

Medibank putting profits before patients: St Vincent's

Date October 1, 2014 - 6:56PM

Harriet Alexander

St Vincent's Health has accused Australia's largest health insurer of putting profits before patient welfare in a bristling retort to plans by Medibank Private to boycott hospitals that do not meet its conditions.
Medibank Private's managing director George Savvides threatened on Wednesday to use the insurer's market clout only to preference hospitals that agreed to its prices and quality standards and refuse to insure policyholders who went elsewhere.
But St Vincent's Health Australia, which is negotiating a new two-year contract with Medibank Private, is concerned this will lock high quality but more expensive providers out of Medibank contracts.

Doctors don’t know best, we do, says Medibank

Jessica Gardner and Joanna Heath
Whether it is to treat a stubborn sniffle, deliver a baby or replace an ageing hip, most patients trust their doctor to make decisions that will ensure them the best care. But faced with ballooning costs of medical care, health insurance companies argue this social contract has failed.
Medibank Private, the federal government-owned insurer looking for ways to increase profits ahead of a $4 billion-plus privatisation, and its nearest rival Bupa are spearheading a push to challenge the notion that “doctor knows best”.
The insurers argue they have a hip pocket incentive to keep their members healthy. By expanding into non-traditional spheres such as primary care and chronic illness ­prevention, they hope their members will stay fit. This, it is hoped, will put a lid on ­medical claims costs that have grown an average of 5.5 per cent annually in the past five years.

Medibank’s George Savvides has ‘good story’ to sell

Richard Gluyas

THE big swing factors in the ­performance of health insurers are the claims cost and management expenses, with premium ­adjustments subject to regulation and ministerial sign-off.
Medibank Private’s 2014 figures are under wraps until the release of its prospectus later this month.
However, in 2013, premium receipts came to $5.2 billion, with $4.6bn in claims.
Chief executive George Savvides says that, of the insurer’s $5bn-plus in total costs, about 87 per cent relates to claims, with the management expense accounting for only 9 per cent.

Medibank Private chief’s patient path to good health

Richard Gluyas

WHEN George Savvides became chief executive of Medibank Private in 2002 after leaving drug company Sigma Co, it was a case of out of the frying pan and into a blazing fire.
Savvides’ departure from Sigma in August 2000, accompanied by a profit downgrade, triggered a share price slump, with the friendless stock finally coming to rest 35 per cent below its listing price less than a year before. Medibank, at around the same time, was in dire straits.
After joining the board in September 2001, Savvides was elevated to CEO the following April — soon after, announcing a $176 million loss for financial 2002.
“It was embarrassing for the (government) shareholder, and the regulator was antsy because we were getting close to prudential risk,” he recalls.

Medicare Locals.

Health Alert

Medicare Locals – Are you solvent?

2 October 2014

With Commonwealth funding to Medicare Locals ceasing on 30 June 2015, now is the time for Boards of Medicare Locals to ensure that they are, and remain, solvent, now that a substantial part of their revenue flow is being terminated.

Boards of Medicare Locals will wish to ensure that revenue expected over the remaining 9 months will adequately cover all known expenses and liabilities, to the point where funding ends.  Some Medicare Locals may have already entered into leases, contracts and other commitments that extend beyond 30 June 2015.  If they were dependent on continued government funding, there is a substantial risk of insolvency.  Medicare Locals should also factor in the costs of wind-down, including termination and redundancy of staff, which will be in excess of ordinary recurrent expenditure up to 30 June 2015.  If a Medicare Local does not have sufficient reserves to cover all of these costs, then it raises the question of insolvency now.
I also have to say reading all the articles I still have no idea what is actually going to happen with the Budget at the end of the day. Now parliament was back for 2 weeks and, as noted above, some key changes have emerged .
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:

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