Thursday, January 15, 2015

Review Of The Ongoing Post - Budget Controversy 15th January 2015. It’s Getting Much Worse!

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 late last year  - 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.
Last week this appeared - so the ground may be shifting but the new regulations start on January 19th - Next Monday!

Coalition looks to dump optional GP co-payment

Joanna Heath
The Abbott government would keep the majority of planned ­savings in its revamped Medicare package if it dropped its $5 optional GP co-payment.
There is speculation the ­measure, which lacks support among the Senate crossbench at present, could be quietly ­abandoned as the government seeks to close off ­lingering political battles from last year’s May budget.
The co-payment is not due to come into force until July 1 this year. It will be introduced by ­cutting the Medicare rebate by $5, to prompt GPs to charge patients who can afford to pay.
The optional charge is only one of three measures announced by the government in December to replace its original mandatory $7 co-payment proposal, but is proving the most controversial among parliamentarians.
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Otherwise the Budget still 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 (flat to down seems to be consensus).
It 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:

CEOs call for Senate overhaul

Chanticleer
Tony Boyd and Michael Smith
Australia’s chief executives want urgent changes to how the Senate is elected and longer terms for the House of Representatives.
Morale among Australia’s business leaders, which peaked in late 2013 when Prime Minister Tony Abbott was elected after six years of Labor power, has been hit by the inability of the ­Coalition government to get major changes through the Senate that could lift the economy’s performance.
The rising business frustration at the impact of minor parties on policy and the inability of Mr Abbott to fulfil his electoral mandate is revealed in the 2015Chanticleer CEO Outlook survey.

Late Breaking News: The new Health Minister has bowed to the political inevitable and has just (Thursday 15/1 at midday) withdrawn the regulatory changes which were to start next week. She admits she does not presently have a plan and will consult widely over the next period. Watch this space!
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General.

Call to target health insurance rebate at private care

Sean Parnell

A PUSH to strip the health ­insurance rebate from policies covering unproven natural therapies has sparked a call for the ­Abbott government to go further and focus the subsidy on high-end private hospital care.
The Weekend Australian revealed health funds and their members had embraced the so-called alternatives to traditional medicine, with natural therapies responsible for the biggest ­increase in benefits paid to members outside of hospital services — a 345 per cent increase in 10 years.
As the government considers stripping the rebate from policies covering unproven therapies, such as homeopathy — from April 1 when premiums will rise again — market trends have exposed other problems for the industry and potential challenges for the government. The industry regulator, the Private Health Insurance Administration Council, has charted an increase in general insurance policies, which may cover natural therapies but not hospital treatments and still receive the rebate.
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4:39pm January 6, 2015

PM remains 'box office poison', says Labor

Federal Labor wants Queenslanders to send Tony Abbott a big message on January 31, even if it thinks Premier Campbell Newman is desperate to keep the prime minister away from his re-election campaign.
Acting opposition leader Tony Burke says the prime minister remains "box office poison", a term Victorian Liberal strategists used to describe Mr Abbott before their state election loss in late 2014.
"Campbell Newman is doing everything he can to try to time an election in a way that has people thinking about Tony Abbott as little as possible," he told reporters in Canberra.
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Redirect the subsidy to cure insurance headache

FOR an industry that attracts a government subsidy of more than $5 billion a year — more than the wildest aspirations of the carmakers — the private health insurance industry has escaped a serious look for almost 20 years.
The industry we see today is the linear descendant of the industry of the 1950s, with more than 30 funds, over-regulated, over-subsidised and over-protected. Two for-profit funds dominate the industry — BUPA (owned by a British not-for-profit) and newly listed Medibank Private. These dominant funds have about 80 per cent of all issued policies, with Medibank Private losing its position as market leader to BUPA in the past six months, continuing a slow decline that had been evident for years.
The latest tweak to industry regulation is apparently to be the withdrawal of subsidies for unproven natural therapies, a good move that will promote greater use of evidence in healthcare. There has also been a recent call to target subsidies only to those products that offer comprehensive coverage (The Australian, January 1), based on the argument that products which only cover public hospital care by definition don’t reduce demand on public hospitals, one of the arguments for the subsidy in the first place.
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Means testing free hospital care will make medicare sustainable

CONVERTING the private health insurance subsidy into a private hospital subsidy, as Stephen Duckett suggested on this page yesterday, is only half the solution to funding healthcare.
Unless a means test is employed, and so long as Medicare offers ‘‘free and universal’’ public hospital care paid for by taxes, consumers have scant incentive to take out private health cover regardless of the subsidy available for private hospital care. This is the chief lesson of the last half-century of health policy.
Public subsidies for public and private hospital care were a core feature of pre-1980s Australian health system. However, reviving this approach in the limited form of a publicly funded private hospital subsidy is unlikely to promote a more efficient, mixed public-private health system without reintroducing another key policy of that era — a means test for public hospital care.
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The Australian economy is in need of some medicine

By Stephen Koukoulas
December 18, 2014
"The policy prescription to a sick economy should be clear. Needed now in Australia is easier policy in the form of either stimulatory levels of interest rates or a relaxation of fiscal policy, or some mix of the two. "
In terms of some hard numbers, Australia should ideally be recording real economic growth a little above three percent, on average, over the course of the business cycle. This would translate to employment growth sufficiently strong to lock in an unemployment rate that is consistent with the Reserve Bank of Australia’s inflation target of two to three percent.
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Morgan Stanley eyes slow growth, $A slide

Stephen Cauchi
Australia’s economy will grow at the slowest rate since 2009 over the coming year, according to a pessimistic Morgan Stanley overview for 2015.
The Australian dollar will slide to US76¢ and the sharemarket will trade sideways to 5350, with a bear case of 4400, according to the predictions.
Morgan Stanley did not predict any quarters of negative growth over 2015, merely subdued growth leading to a total 2015 GDP figure of 1.5 per cent. But this is notably less than other predictions. A Bloomberg survey of 35 economists in December produced an average GDP prediction of 2.54 per cent for 2015.
Federal Treasury is tipping 2.5 per cent growth in 2015 and the Reserve Bank between 2.5 per cent and 3.5 per cent growth.
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Fair billing, not bulk-billing, a healthier choice

PRIME Minister Tony Abbott’s ministerial reshuffle last month, focused attention on hardhead Scott Morrison moving to Social Services. Yet the hottest social policy seat belongs to his newly-promoted cabinet colleague, Sussan Ley.
As the new Health Minister, Ley succeeds Peter Dutton, now the tough cop on the border protection beat. Dutton shifted after a tumultuous year in health, highlighted by the government’s difficulties selling a $7 co-payment on GP services.
Yet the budget policy had the right intention, imposing a modest and affordable price signal on GP services with a ceiling to protect the elderly, the poor, young families and the chronically ill. But its design was rushed, consultation non-existent, and it focused too much on bottom-line savings over sustaining the creaking Medicare edifice.
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Frydenberg appointment gives Abbott muscle to sell economic message

THE fact is Joe Hockey’s future as federal Treasurer is intimately tied to Tony Abbott’s success as Prime Minister. This means these two seasoned political warhorses have a mutual interest in turning around the opinion polls and cementing their jobs.
Importantly, Abbott’s appointment of the up-and-coming, hardworking and intelligent MP for Kooyong, Josh Frydenberg, as the new Assistant Treasurer has afforded Hockey (and also Mathias Cormann) an opportunity to combine their complementary skills to sell the government’s economic message more effectively.
Frydenberg will also join the frontline in question time and more than likely land some body blows on the federal ALP.
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6 questions for the new health minister

5 January, 2015 Paul Smith 25 comments
Australia’s new Federal Health Minister, Sussan Ley, is now tasked with defending the government's $3.5 billion worth of cuts to GP funding following the Christmas departure of her predecessor Peter Dutton.
Mr Dutton during his brief tenure had declared the government was “totally committed to rebuilding general practice”.
That claim looks to many to be simply untrue.
With rebates cuts for millions of consultations lasting less than 10 minutes being introduced in just two weeks’ time — the first of three Medicare cuts coming the way of general practice this year — Australian Doctor lists a few of the many questions Ms Ley (pictured) now needs to answer.
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Medicare Co-Payments.

Medicare Funding Cuts - Support Materials For Practices

2014 was a turbulent year for the future of Medicare.  The Government has pursued an agenda of fiscal policy – not health policy – to strip $3.5 billion out of Medicare and shift these costs on to patients.
The AMA’s strong and sustained advocacy resulted in a number of concessions by the Government. [click here to read more about the original Government proposals and AMA advocacy]
Instead, the Government will:
General practice will be hardest hit, with the first change already set in law that will start on 19 January 2015.  The AMA has developed material to assist general practices to implement the changes to the Medicare Level A and Level B consultation items.
Let the Government and your local MP know that you oppose these changes. [click here to access links to MPs
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New year, same approach: implications of the Fed Govt’s confidence trick on Medicare

Marie McInerney | Jan 05, 2015 12:03PM | EMAIL | PRINT
Much happened on the health front in the closing weeks of 2014, not least with the appointment of a new Health Minister Sussan Ley. See some interim advice to the new Minister and judgements on the contributions of former Minister Peter Dutton from Croakey contributors.
The Federal Government also finally came up with a Plan B to its proposed $7 GP co-payment that also raises significant concerns. Thanks to Tim Woodruff, Vice President of the Doctors Reform Society, for this clear and timely post that explains the implications of the latest changes, including the new requirement that a Level B consultation be a minimum of 10 minutes duration, which took effect on 1 January.
See also this article – GP co-payment 2.0: a triple whammy for patients – from The Conversation by Stephen Duckett and Peter Breadon from the Grattan Institute.
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GPs lobby MPs, patients ahead of looming rebate cut, AMA president Brian Owler says

Wed 7 Jan 2015, 1:00pm
Doctors are taking their fight against the Federal Government's changes to Medicare consultations to the waiting rooms of their practices.
GPs are soon expected to display posters in their surgeries explaining to patients why they will have to pay more under the Government's changes to consultation rebates.
Late last year Prime Minister Tony Abbott announced a revised healthcare policy which includes an optional $5 co-payment.
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Doctors to demonstrate in protest at 'plan B' proposed Medicare changes

AMA president says public rallies in Sydney, Brisbane and possibly Canberra will draw ‘hundreds if not thousands of doctors’
Lenore Taylor, political editor
Doctors are planning public demonstrations over the Abbott government’s proposed Medicare changes as they ramp up a lobbying campaign against a policy they claim is the greatest threat to general practice in a decade.
The Australian Medical Association’s president, Brian Owler, told Guardian Australia doctors were planning public rallies in Sydney, Brisbane and possibly Canberra in early February to demonstrate their “extreme unhappiness” with the government’s health “plan B” unveiled shortly before Christmas.
The “plan B” saves $3.5bn over the next four years – almost as much as the original budget policy to introduce a $7 GP co-payment which was blocked in the Senate. But it achieves the savings by reducing or freezing Medicare rebates paid to doctors, leaving it up to the GPs to decide whether to pass on the costs to patients.
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Federal Govt faces doctors rallying in waiting rooms, streets over Medicare co-payment Plan B

Marie McInerney | Jan 08, 2015 10:58AM | EMAIL | PRINT
The Federal Government is facing the prospect of doctors marching on the streets against its latest Medicare package – possibly ahead of the Queensland state election on January 31 where health cuts are already on the agenda.
The Australian Medical Association (AMA) yesterday signalled it was launching a campaign to put a stop to the changes.
AMA President Brian Owler tweeted (above left) confirmation of plans for doctors to rally in capital cities, in a bid to lobby new Health Minister Sussan Ley and Senate cross benchers. He told ABC Radio:
We have a new Health Minister, and obviously the new Minister’s getting across her portfolio at the moment, but we would hope that common sense will prevail. Now, these changes are due to come in on 19 January. Parliament can disallow them when they come back in early February, so they will be introduced before Parliament has the chance to make the disallowance, but when they come back, the AMA and the other groups will be campaigning very strongly to make sure that these changes are stopped.
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Changes to Medicare billing to cause rise to GP fees, Australian Medical Association says

Thu 8 Jan 2015, 12:33pm
The Australian Medical Association (AMA) has warned of a rise in medical fees due to new changes to the Medicare benefits schedule coming into effect on January 19.
The Federal Government scrapped its plan for a $7 Medicare co-payment before Christmas, but AMA national president Associate Professor Brian Owler said new changes had outraged general practitioners.
Under the new co-payment schedule, rebates for GP consultations lasting less than 10 minutes would be reduced.
"This has angered GPs more than any of the other proposals, even more than the initial proposal," Dr Owler said in an interview on 666 ABC Canberra Breakfast.
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Petitioning Federal Minister for Health The Hon. Sussan Ley
This petition will be delivered to:
Federal Minister for Health
The Hon. Sussan Ley

Quit targeting general practice and the health of all Australians

Royal Australian College of General Practitioners
From 19 January 2015, patient rebates from Medicare will be CUT by up to $25, meaning patients will pay more. Both patients and GPs have been unfairly targeted under the Government’s revised co-payment model.
GPs are vital to the health and wellbeing of every Australian. Don’t let yours be targeted.
The Royal Australian College of General Practitioners (RACGP) represents over 28,500 GPs working in or towards a career in general practice. The RACGP has been vocal with Government but it is falling on deaf ears. They haven’t listened to us but perhaps they will listen to you.
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7:13pm January 8, 2015

Patients could foot $20 shortfall for short GP visits

January 08, 2015: Changes have been quietly introduced to the Medicare rebate, placing limits on consultation times and forcing GPs to charge patients more.
Australians could be paying more for a visit to the doctor when changes to the Medicare rebate come into effect later this month.
Doctors have warned they will be forced to pass the difference on to patients when changes to consultation time limits are introduced on January 19.
“Patients would find it harder to get to a consultation to see their GP,” Sydney doctor Brian Morton said.
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Patients already avoiding doctor visits ahead of proposed Medicare cuts, says Broken Hill GP

By Gavin Coote
Posted yesterday at 10:19amThu 8 Jan 2015, 10:19am
A Broken Hill GP is joining the latest national push against the Federal Government's changes to consultation rebates.
Doctors will be putting up posters campaigning against the government's proposed $5 cut to the Medicare rebate, the plan which replaced the $7 GP co-payment proposal.
Local GP Ramu Nachiappan said the proposed funding changes were already putting patients off doctor visits.
He said he saw fewer patients book in over the New Year period compared with last year.
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Primary Health Care hit by ‘material’ funding cuts: analyst

Date January 9, 2015 - 2:46PM

Jessica Gardner

Tony Abbott also revealed a freeze on Medicare rebates to July 2018 and a $5 co-payment on doctor visits.
Cuts to Medicare funding of short visits to GPs, which are being fought by the powerful doctors' lobby, might  cost corporate medical giant Primary Health Care millions in revenue and significantly hit profit, a healthcare analyst has found.
A drop in the scheduled fee paid to doctors for visits that last less than 10 minutes from $37.05 to $16.95 is part of a revised Medicare funding plan put forward by Prime Minister Tony Abbott in December.
Mr Abbott also revealed a freeze on Medicare rebates to July 2018 and a $5 co-payment on doctor visits by adults and non-concessional patients under a plan that would save $3.4 billion over three years.
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Important changes to Medicare from 19 January

From January 19, 2015 important changes will be introduced regarding GP consultations. Additional changes will also come into effect from 1 July 2015.
Effective January 19, 2015 the following new time requirements will be applied to describe consultations.
  • Level A GP consultations (MBS item 3) will cover attendances less than 10 minutes (currently defined as straightforward consultations, without any reference to timing)
  • Level B consultations (MBS item 23) will cover attendances from at least 10 minutes to 20 minutes (currently defined as up to 20 minutes)
There is no change to item numbers used by non-vocationally registered medical practitioners as these are already time based.
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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 when Parliament comes back! Right now there is a lot of planning going on behind the scenes.
One wonders for how much longer this will go on?
Enjoy.
David.

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