Thursday, December 18, 2014

Review Of The Ongoing Post - Budget Controversy 18th December 2014. It’s Gone Ballistic!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot. Indeed more than a few commentators are wondering out loud if the Abbot Government will last for a second term.
The modified co-payment - announced early last week - seems to have annoyed most other than the Government and we now wait till mid February 2015 to see what the Senate thinks of Plan B.
Otherwise the Budget seems to be in chaos with falling iron ore and now oil prices along with slowing growth and lots of commentary regarding the future of interest rates over 2015.
It also seems clear the Business Community is just utterly sick of the parliamentary shenanigans and really wants the Government to start behaving a adults as they promised.
See here:
Here are a few highlights of the vast number of articles I have seen.
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General.

Galaxy poll: Voters just about ready to ditch Tony Abbott

  • Samantha Maiden
  • Herald Sun
  • December 07, 2014 10:01AM
TONY Abbott risks becoming a one-term prime minister unless he lifts the Federal Government’s fortunes, with Labor opening up a 10-point 55-45 lead on a two-party-preferred basis.
After a week of confusion over the fate of the $7 GP fee and Mr Abbott’s confession that the Government had a “ragged” week, support for the Coalition has plunged again.
For the first time, Labor under Bill Shorten has also overtaken the Coalition on the primary vote since the election of the Government.
Support for the Labor Party has hit 41 per cent on primaries.
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Wealthy mothers earning more than $150,000 a year may NOT get maternity pay as Tony Abbott backflips to pay for childcare reform 

·         Working mothers will reportedly be denied access to paid parental leave
·         Women earning over $150,000 could potentially miss the scheme entirely
·         The prime minister believes the combination of PPL and affordable childcare could get more women into the workforce
·         Carers working in the family home would be eligible for 50 per cent rebate
Published: 00:58 AEST, 7 December 2014 | Updated: 09:35 AEST, 7 December 2014
Working mothers who are earning six-figure salaries may be denied access to the Abbott government's much-vaunted paid parental leave (PPL) scheme as it looks to review the policy over the summer.
The revelation comes as a new poll shows the Coalition continues to trail behind the Opposition on a two-party preferred basis.
On Sunday, Mr Abbott fronted media after mounting speculation he would dump the policy that would see women earning up to $150,000 receiving six months' pay - a scheme he touted in the lead up to last year's election. 
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Economy: Not good but not disastrous

Date: December 8, 2014 - 12:15AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Don't drop your bundle. It's not clear the economy has slowed to the snail's pace a literal reading of the latest national accounts suggests. As for the talk of a "technical income recession", it's just silly.
What is clear is that, at best, the economy continues to grow at the sub-par rate of about 2.5 per cent a year, a rate insufficient to stop unemployment continuing to edge up. This has been true for more than two years.
A literal reading of last week's national accounts from the Bureau of Statistics says the economy – real gross domestic product – grew by a mere 0.3 per cent in the September quarter, down from growth of 0.5 per cent in the previous quarter and 1 per cent in the quarter before that.
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Medicare Co-Payments.

Tony Abbott dumps $7 GP co-payment for $5 optional fee

Joanna Mather
Prime Minister Tony Abbott has revised downwards his proposed GP tax from $7 to $5 and announced exemptions for children, pensioners, veterans and aged care residents.
The “co-payment” would only apply to adults for consultations of 10 minutes or more and it would be up to doctors to decide who should be billed, Mr Abbott said.
Opposition from Labor and minor parties meant Mr Abbott could not get the original proposal of a $7 fee through the Senate.
Mr Abbott said it was a “new and improved proposal which indicates that this is a government which is always capable of listening, learning and improving”.
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Tony Abbott dumps Medicare copayment

Jared Owens

TONY Abbott has dumped plans to impose a $7 co-payment on Medicare services, instead using his executive power to cut payments to doctors and encouraging them to raise fees.
The Prime Minister’s new policy includes a price signal on doctors’ visits by cutting the rebate for doctors’ visits by $5, forcing doctors to consider imposing an “optional co-payment” to recover their loss.
The government will also impose a requirement for Medicare-funded doctors’ appointments to tackle 10-minute “sausage machine medicine” where patients are simply “churned through”.
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Medicare co-payment amended by Coalition in favour of 'optional' system

Government backs away from its controversial budget proposal to charge $7 upfront payment for visits to the GP
Tony Abbott has backed away from the budget policy to introduce a $7 co-payment on GP visits, announcing exemptions for children, pensioners and veterans.
The prime minister said after a cabinet meeting in Canberra on Tuesday the government would proceed with a revised policy that would allow GPs to charge an “optional” $5 fee for adults who did not hold concession cards.
The government would reduce the Medicare rebate paid to providers by $5 for non-concession card holders, and it would be up to the provider to decide whether to recoup the money from patients.
Abbott said there would be “no change to bulk billing for children under 16, for pensioners, for veterans, for people in nursing homes and other aged care institutions”.
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Government’s new co-payment model a ‘mixed bag’

09/12/2014
AMA President, A/Prof Brian Owler, said today that the Government’s reworked co-payment model is a mixed bag, with welcome exemptions for vulnerable patients but concerns remain about cuts to the Medicare patient rebate.
A/Prof Owler said the AMA has been calling for protection for the poor, the elderly, the chronically ill, and Indigenous Australians – and this has been delivered with the new co-payment model.
“The AMA has led the debate on the unfairness of the Government’s original co-payment model since Budget night, and the Government has today addressed a number of our concerns,” A/Prof Owler said.
“We are pleased that concession card holders, children under 16, and residents of aged care facilities will not be subject to reduced Medicare rebates for general practitioner services.
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Longer rebate freeze leaves GPs cold

Sean Parnell

Rachel Baxendale

HEALTH groups last night welcomed a belated decision to protect vulnerable patients and crucial tests from a reworked medical co-payment.
But doctors were still concerned they would be left to pay for the Abbott government’s concessions by way of an extension to the freeze on Medicare rebates to July 2018.
Seven months after the budget unveiled a $7 co-payment on all routine medical services, Tony Abbott and Health Minister Peter Dutton yesterday announced a reworked $5 co-payment for all but children, pensioners and veterans.
While the original model was set to free up $3.6 billion in government spending, initially to create a medical research future fund, the latest model will raise $3.5bn, through a $5 cut to standard Medicare rebates, changes to the rebate structure to incentivise longer consultations, and the extended freeze on Medicare rebates, each of which will contribute about $1bn.
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The GP co-payment trick that purports to save $3.5 billion

Date December 10, 2014 - 8:43AM

Peter Martin

EXPLAINER
How can a $5 GP co-payment that excludes the young and those on benefits save just as much as a $7 co-payment that applies to everyone?
That's what we'll be asked to believe when the budget update is published next week. We'll be told Prime Minister Tony Abbott's new health package will save $3.5 billion whereas his old package would have saved $3.6 billion.
Part of the trick is that it isn't the co-payment that saves the government money, it's the cut to the Medicare rebate. That cut was always going to be $5 per consultation. If doctors had had the ability to charge a $7 co-payment they would have got an extra $2 in their pockets. Now they won't.
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GP co-payment: Government prepares to woo Senate crossbenchers as doctors warn patients will pay more

By political correspondent Emma Griffiths
December 10, 2014, 10:18 am
The Federal Government has begun the sales job for its "better" GP co-payment proposal as it prepares for another round of crucial negotiations with the Senate crossbench to pass the measure.
Prime Minister Tony Abbott announced yesterday the original proposal to force patients to pay an extra $7 fee for GP visits had been dumped.
But the new plan cuts the Medicare rebate given to doctors by $5, putting pressure on GPs to charge patients the shortfall.
Mr Abbott denied the change was a backdown.
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Aged care spared government’s GP co-payment

By Darragh O'Keeffe on December 10, 2014 in Government, Industry
While acknowledging the exemptions for aged care residents and children, consumers, doctors and nurses have broadly criticised the government’s latest policy.
Residents of aged care facilities will be among those exempt from the Federal Government’s new $5 GP co-payment plan, to be introduced for all non-concessional patients aged over 16 from 1 July 2015.
The government yesterday announced it was amending its fraught GP co-payment policy, first set out in the Budget in May.
While some media yesterday erroneously reported the government had “dumped” the scheme, Prime Minister Tony Abbott announced that the Medicare rebate paid to doctors would be reduced by $5. Doctors could choose to recoup that rebate reduction by charging patients a co-payment, or continue to bulk bill non-concessional patients – but at their own expense.
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Patients could be paying $10 to see a doctor not $5 under Tony Abbott’s GP fee revamp

  • December 11, 2014 12:01AM
  • Sue Dunlevy National Health Reporter
  • News Corp Australia Network
PATIENTS could end up paying way more than $5 to see a doctor, with the AMA predicting a copayment of up to $10 under Tony Abbott’s revamped policy on GP fees.
Worse still, patients who were once bulk-billed may have to pay $42 upfront and then go to Medicare to claim a $32 rebate as doctors scramble to stop their income from general patients being cut in half.
Patients also could face increased wait times to see a doctor with medicos now required to see patients for a minimum of ten minutes, up from six minutes.
Costs rising...AMA GP spokesman Dr Brian Morton says patients could pay more than $45 to see a GP under Tony Abbott’s reforms. Picture: News Corp. Source: News Limited
“A lot of practices are saying if you are just to maintain the status quo, given the extra red tape and cost of administering the fee, why not make it $10,” Australian Medical Association GP spokesman Dr Brian Morton said.
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Co-payment will hit bulk billing, AMA predicts

Date December 10, 2014 - 10:35PM

Dan Harrison

Many medical practices will shift from bulk-billing to charging patients the full cost of their visit in advance in response to the Abbott Government's proposed GP co-payment, doctors have predicted.
Under proposals announced by Prime Minister Tony Abbott and Health Minister Peter Dutton on Tuesday, the Medicare rebates for standard GP visits will be cut by $5 for non-concessional patients, and doctors will be allowed to charge the patient a fee of up to $5. In addition, the fees paid by Medicare for all other services will be frozen until July 2018.
Australian Medical Association president Brian Owler predicted the changes would lead to a shift away from bulk-billing, where a doctor bills Medicare directly for the service, to private billing, where the doctor charges the patient the full cost of the visit in advance, and the patient claims a rebate for part of this cost from Medicare.
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Regular GP visits, not budget cuts, help keep health costs down

Date December 11, 2014 - 12:00AM

James Best

From an Australian patient's perspective, there are two things that matter in our country's health system: regardless of my financial situation I can see a doctor when I want to, and if something bad happens to me medically I will be looked after.
The first of these is looking shaky after this week. From next July, if the government has its way, many of us will have to look in our wallet and decide whether we can afford, this week, to go to the doctor. Another nail in the coffin of universal health care.
There will be four consequences of this, the first two the government wants. Individuals (i.e. you) will have to pay more to see a GP, and the government will save some money, at least initially. However, it is saving money in a very unintelligent way.  In the long run we will see the third and fourth consequences: health outcomes in the country will worsen, and finally, the health system will actually end up costing more.
How can this be?
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It gets harder to provide quality care each year. The GP co-payment could sink my practice

We have impersonal medicine because GPs have to churn patients to cover costs. The co-payment will make things much harder for smaller practices
My general practice is like the TV show Cheers: a place where everybody knows your name. My reception and nursing staff know the quirks of the majority our patients. We know Mrs Jones will need a taxi to take her to her appointment. It’s easier for our staff to book Mr Verona’s high resolution thoracic CT scan for him, because of his thick accent and poor hearing. I am grateful for having such good staff, pay them above the award and try to provide them with a yearly pay rise. Now I’m unsure if I can afford to keep them.
Each year it has become progressively harder to maintain a level of service at a time when the ageing population presents with complex, chronic conditions. To prevent an expensive hospitalisation, patients require more time and resources than ever. General practice sometimes seems like a death by a thousand cuts.
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Strong medicine for GPs

Adam Creighton

AMID the outrage this week over the supposed unaffordability of paying $5 to visit the doctor, it is worth noting that more than 60 per cent of GP visits in Melbourne’s up-market electorate of Kooyong are bulk-billed, and more than 67 per cent in the salubrious Wentworth seat of Sydney. That equates to tens of millions of dollars of taxpayer support each year for doctors’ visits for people who probably can afford to chip in.
Since May the Abbott government has been embroiled in a political battle to make all of the electors of Wentworth and Kooyong, along with every other Australian, pay $7 to visit the doctor — part of a set of health reforms to help return the budget to surplus by 2023. These were designed to save a government facing more than $100 billion of deficits over the next four years around $3.5bn across the same period.
Nationally, more than 80 per cent of the 130 million-plus general practitioner services each year are “free” for patients, courtesy of Medicare, up from about 67 per cent a decade ago thanks in part — somewhat ironically — to Tony Abbott’s policies as health minister aimed to boost rates of bulk-billing.
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$100 GP fees in two years?

Date December 14, 2014 - 12:15AM

Julia Medew

The average upfront cost of a 15-minute consultation with a GP could exceed $100 within two years under the federal government's proposed changes to Medicare, the Doctors Reform Society says.
The  society, a lobby group that supports publicly funded universal health care, says the Abbott government's plan to reduce the Medicare rebate for doctors by $5 and freeze it until 2018 is promoting a "return to a failed privatised system of the past" with doctors free to charge what the market will bear.
Society national president and GP Con Costa said extending the current two-year-long freeze on Medicare rebates for another four years would hit GP clinics' budgets hard, driving many doctors away from bulk-billing and  into increasing their fees for patients who do not have concession cards.
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9 reasons why GPs are being screwed by government

The government’s revised co-payment plan is a dog’s breakfast. Here are 9 reasons why the proposal has angered Australian GPs.

#1

Prime-minister Abbott’s reference to sausage machine medicine is insulting. If the government is unhappy about the way some clinics churn through patients, they should do something about it, but not punish all Australian GPs – and patients.
Besides, it looks like the government didn’t do their homework properly: A recent report debunked the myth that GP care is ‘6-minute medicine’. The authors of the report: “If people feel they must ignore the wide range, and refer to the length of GP consultations in one phrase, it would be far more accurate to call it ‘14 minute medicine’.”
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Pharmacy Related Articles.

Uncertain times: the year in review

9 December, 2014 Chris Brooker
How will pharmacy look back on 2014? Will it be remembered as a watershed year where the push for remunerated professional services finally reached a critical mass? Will it be remembered as the year the profession's financial position bottomed out? Will it be remembered as a year of bickering and sniping within the profession and from a range of critics?

If the cap fits

In 2013, proposals were first aired by the Pharmacy Guild of Australia for a cap on Home Medicines Reviews numbers to control what they claimed was exploitation and overuse of the system.
The deferring of this plan turned out to be only temporary, with the profession being jolted by the announcement on the eve of APP 2014 that the HMR program would indeed be capped, at 20 HMRs per accredited service provider per month.
Despite Guild claims that most would not be impacted by the caps, accredited pharmacists were outraged. In March, leading clinical pharmacist Debbie Rigby said she had heard lots of "open hostility and anger" about the decision.
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Editorial -Wednesday, December 10: Woolworths wants it all

Tim Howard | 10th Dec 2014 3:00 AM
NEWSAGENTS are the latest to face losing a key part of their business to the ever expanding reach of the supermarket giants.
Butchers and bakers have succumbed, and if there was a mass market for it, so would candlestick makers.
Already the poor newsagents have lost the attraction of being the sole place to buy newspapers and magazines. Now, the supermarkets are after the best attraction the agents have of luring customers into their shops.
While you might have sympathy for their plight, you should be worried about Woolworths' plans to sell pharmaceuticals from the supermarket shelf.
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Comment:
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.
As pointed out on Insiders a few weeks ago the next chance to have progress  in February, 2015 - and after MYEFO last Monday and  the next Budget!
One wonders for how much longer this will go on?
Enjoy.
David.

2 comments:

Bernard Robertson-Dunn said...

Here's something to think about:

AFP admits 'non-definitive' database used to brief PM on Monis gun licence

The Australian federal police used a database that is known by law enforcement agencies to be “non-definitive” to brief the prime minister Tony Abbott on whether Man Haron Monis had a New South Wales firearm licence.

...

The prime minister’s statement said the AFP was investigating how the National Police Reference System (NPRS), which is a central database for sharing information between state and federal law enforcement agencies, had given the wrong information.

http://www.theguardian.com/australia-news/2014/dec/18/afp-admits-non-definitive-database--brief-pm-monis-gun-licence

The parallels between NPRS and PECHR are worrying - to me, if no one else.

“NPRS remains a reference tool whose data is sourced from PAPJ systems but is not linked in a manner to reflect exactly PAPJ operational systems.”

".. the database was a “consolidation of person of interest information provided by all police agencies which is managed by Crimtrac on their behalf”.

"The authoritative source of data remains with the originating agency."

The mistakes made by Crimtrac did not seem to impact the police operation, however they did embarrassed the PM.

I do hope the people responsible for the PCEHR see the similarities and learn serious lessons from this sad event.

Errors and discrepancies in the data in the PCEHR and feeder system could have far more serious impacts on patients.

Karen Dearne said...

Good point, Bernard. Clearly they have got nowhere near the real-time exchange of information they envisaged in 2008. http://www.theaustralian.com.au/archive/news/user-friendly-system-aids-crime-fighters/story-e6frgao6-1111116912623

http://www.theaustralian.com.au/archive/news/green-light-for-national-dna-matching/story-e6frgal6-1225700549874

Pretty worrying if police systems like these are just as dysfunctional as the PCEHR