Thursday, February 05, 2015

Review Of The Ongoing Post - Budget Controversy 5th February 2015. Beknighted!

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 now wondering out loud if the Abbot Government will last for a second term.
The modified Medicare co-payment plan - announced late last year  - has now gone very quiet with the Government disarray of the last 3 weeks. The Queensland election has hardly helped!
Now part of Co-payment Plan B is gone,  but some extreme nasties still remain, i.e. the rebate cut for short consults has been abandoned but the freezing of rebate levels until 2018 and a plan for a co-payment are still live.
Seems there are lots of broader problems also. See here:

Vulnerable: Abbott still standing, just

Date January 30, 2015 - 8:21PM

Peter Hartcher

The besieged leader of Australia's least popular government in 40 years has one unique advantage, writes Peter Hartcher.
Tony Abbott, under pressure, has an advantage no other Liberal leader has enjoyed in nearly two decades.
He has no rival for the leadership within his party. For this reason, Abbott's prime ministership is safe for now. The alternatives are not prepared to run against him.
Rather than collecting supporters, the two highest-polling members of the government are rebuffing them. Deputy Liberal leader and Minister for Foreign Affairs Julie Bishop told backbenchers that Abbott had to be given the opportunity to recover. 
Support for Abbott within his party room has collapsed. It has been more than a year since the government has consistently been ahead in the polls and the Liberal backbench has lost confidence in Abbott's ability to recover.
And here:

Samantha Maiden: Politics — it can all get very weird very quickly

  • Samantha Maiden
  • The Sunday Telegraph
  • February 01, 2015 12:00AM
TONY Abbott likes to tell the story that he accidentally downed a marijuana-laced lassi in India as a young man and spent 12 hours “off with the fairies’’.’
After the week that was, it’s easy to jump to the conclusion that someone has been incubating a very strong batch of hemp yoghurt in the Prime Minister’s office.
The truth is, Abbott is a self-saucing pudding when it comes to his madness for the monarchy. We shouldn’t be surprised that the bloke who ran the monarchists’ campaign is hurt and confused that we think it’s a national joke he would award Prince Philip a gong.
True, the PM’s decision is the political equivalent of ­setting fire to the Australian flag while smearing yourself in Marmite and delivering a one fingered salute to voters.
It is also amazing that with the 2014 Budget still not passed we are seeing submissions regarding the 2015 Budget.
Other articles this week.

General Budget Issues.

PM and Treasurer: start your brains

  • Terry McCrann
  • Herald Sun
  • January 28, 2015 12:00AM
IT is now less than 15 weeks to Budget night.
Self-evidently that means there has been something like 37 weeks since the last budget night — which was of course Joe Hockey’s first as treasurer and so easily could also have been his last.
Two critical points arise from these time frames.
Why is the Government still fighting — and mucking up — policy proposals from that budget? All that Hockey — and even more, Prime Minister Tony Abbott — have succeeded in doing is chewing up what was an already miserable store of political capital before they started.
Indeed they’ve gone well into the red so far as that capital is concerned. As I wrote some months ago, the Government — and that meant the Prime Minister, Tony Abbott, no one else — should have drawn a line on all the stalled measures.

Happy New Year! (Sort of)

  • Terry McCrann
  • Herald Sun
  • January 29, 2015 12:00AM
AFTER 18 months of keeping its official interest rate unchanged, the Reserve Bank will almost certainly cut the rate at its first meeting back for the year next Tuesday.
What is absolutely certain is that the key language in RBA governor Glenn Stevens’s post-meeting statement will change. That would obviously be the case if he’s announcing a 25-point cut, but it would change to “signalling a future cut” even in the now unlikely case the rate was left unchanged.
After every meeting last year, Stevens had said that a “period of stability” for rates was best. Indeed that form of words had been adopted at exactly this same meeting at the start of last year.
Those words meant that the rate was unlikely to be cut at future meetings. But it also meant the rate would not be hiked — as some economists had been either predicting or demanding.

ACOSS budget submission calls on Hockey, Abbott to close tax loopholes rather than cut spending

Thu 29 Jan 2015, 10:05am
The peak social welfare group is urging the Federal Government to focus on closing tax loopholes, rather than making spending cuts, to repair the budget.
In its budget submission for 2015-16, the Australian Council of Social Service (ACOSS) said more than $13 billion of savings would be available next financial year, and $18 billion the year after, from reducing tax concessions and tightening middle and upper-class welfare.
Among the tax loopholes, ACOSS said the Federal Government could save $6.6 billion in 2015-16 from axing the private health insurance rebate, $2 billion by curbing the use of trusts and private companies to reduce income tax liabilities, about $800 million through tightening and extending the taxation of superannuation and $2.2 billion from cutting poorly targeted tax rebates and concessions.

Health Budget Issues.

Jan 24, 2015

Medicare reform plans adrift

The AMA’s criticism of proposed changes to Medicare highlights the government’s need to lengthen its own consultation times.
When Brian Owler met Peter Dutton after the budget in May, the president of the Australian Medical Association hoped to change the then health minister’s mind about the government’s plan for a compulsory $7 GP fee and cuts to rebates.
Instead, he got a warning.
“My first meeting with the minister shortly after the budget was essentially an ultimatum: you can either support this proposal or be on the outside,” says the straight-talking Sydney neurosurgeon, who took over at the helm of the AMA in late May.
It was a sign of things to come. The relationship between the influential doctors’ lobby and the government deteriorated rapidly.

Medicare Co-payment Issues.

Government to consult on Medicare reform – statement

By admin Policy & Special Projects Jan 27, 2015
The Government is responding to concerns that have been raised about the new Medicare measure to improve patient care and tackle the problem of ‘six minute medicine’. Changes to Level A and B GP consultation items will be taken off the table and will not commence on Monday 19 January, the Minister for Health, the Hon Sussan Ley MP, has announced.
What follows is here statement in full:
I will be undertaking wide ranging consultation on the ground with doctors and the community across the country in order to come up with sensible options to deliver appropriate Medicare reforms.

Government still in the wilderness

Niki Savva
NORMALLY, opposition parties are forced to cope with life in the wilderness. Not now. Today, and for almost 18 months, we have endured, enjoyed or been bewildered by government in the wilderness.
More disturbingly, the man in charge, so brilliant as opposition leader, so flawed as Prime Minister, shows few signs he is capable of leading his government out of it, and every sign the job is beyond him: that he is not up to it and might never be up to it.
The situation is that dire. Not because of a hostile media, a restless backbench or an effective opposition leader brimming with conviction or ideas, but because of the Prime Minister’s own actions.
Frontbenchers as well as backbenchers are realising it’s time to stop criticising staff and start directing the blame for the government’s predicament where it really belongs. With him. They now accept they have to convince him to change and if they can’t they will be forced to consider changing him. If their survival depends on his elimination, eliminate him they will. Count on it.
That is because ultimately Tony Abbott is responsible for all of it. He decides what is done, as well as who does it, he signs off on it or cedes the authority which ­allows it to happen, or simply turns a blind eye to it.

Tony Abbott is making exactly the same mistakes Campbell Newman did

The PM, like the defeated premier, has squandered the electorate’s trust, with broken promises and harsh policies not mentioned before the election. They thought slogans, rather than explanations, would convince voters
Lenore Taylor, political editor
When Campbell Newman called the Queensland election it was clearly a test run for the federal Coalition’s political strategy. That test run has been a smash-up.
Like Newman, Tony Abbott has been selling voters the message that “tough” decisions – even unpopular ones – are necessary in the national interest. And he’s been banking on those voters ultimately deciding that Labor, who they so recently rejected at the ballot box, is ill prepared and too much of a risk.
He’s also made exactly the same mistakes that meant, for Newman, that strategy didn’t work. He’s squandered the electorate’s trust, with broken promises and harsh policies not mentioned before the election. He’s falsely believed that slogans, rather than painstaking explanations, would convince people to accept his policies.

General patients to pay $6 to see a doctor as Health Minister Sussan Ley backs price signal for Medicare

  • January 30, 2015 12:00AM
  • Sue Dunlevy National Health Reporter
  • News Corp Australia Network

GP rebate change looks 'terminal'

BULK billed doctor’s visits will come to an end for general patients when the next controversial tranche of the government’s Medicare reforms to come into effect.
From July the government will slash the Medicare rebate for general consumers by $5, Medicare payments for pensioners and children won’t be cut and they will still be bulk billed.
At the same time the government will freeze the inflation indexation of the Medicare rebate adding another 75 cents to patient charges.
AMA president Professor Brian Owler has warned doctors will face a substantial cut to their incomes unless they pass these cuts on to their patients and the new charges will deter some patients from seeing a doctor.
30 January 2015, 2.36pm AEDT

Early signs are that the new Health Minister doesn’t get it either…

Michael Vagg
Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist at Barwon Health
I have been waiting for a couple of weeks to see what the evidence was that new Health Minister Sussan Ley was going to be an improvement on her unlamented predecessor. After starting with a flourish, and promising wider consultations, it seems nothing has changed. Although she announced that she would ‘stand ready to engage, to consult, and to talk to the sector’ the Federal Government seem determined to go ahead with a poorly thought-out new tax which nobody wants or had the opportunity to vote against.
Once again, I think it is worth repeating what my practical objections to the GP ‘co-payment’ are. I promise I’ll be brief.

It adds cost where it can be least afforded

The analysis from public health and welfare experts is clear, as it has been for quite some time. Charging a compulsory co-payment means low-income people will be forced to avoid going to see the doctor. We know they will then be sicker when they eventually seek help, most likely at a hospital Emergency Department. That’s way more expensive than a GP visit. We also have abundant evidence that the PBS co-payment leads to irregular filling of scripts (as finances allow) which lowers adherence to medication regimens. If the idea is to target waste in healthcare spending, simply using price to discourage attendance at GPs is the wrong target anyway.

Pharmacy Issues:

5 little-known reasons why pharmacists should not be playing doctor

So there is a budget crisis. There’s also a new federal Health Minister. And, here it comes, community pharmacies are negotiating over a billion-dollar deal with the Government: The Community Pharmacy Agreement sets out the Government funding pharmacists receive for dispensing PBS medicines.
Put these ingredients together and what do you get?
Answer: Community pharmacists who want to be doctors – oh sorry – who want to be paid for what they think are the easy parts of the doctor’s job. Oops wrong again: They want to deliver ‘better and more cost-effective health outcomes’.
If it’s up to the Pharmacist Guild, pharmacists will be:
  • Filling repeat prescriptions to ‘free up doctors time’
  • Treating ‘easy’ minor ailments
  • Giving more vaccinations (e.g. a flu-shot for $25 with no Medicare rebate)
  • Doing ‘easy’ health checks, screening and preventive health services
  • Giving mental health support.
Sounds great doesn’t it? At first glance this improves access to health services and saves tax payers bucket loads of health dollars. This can’t go wrong!

Two-thirds will pay for pharmacy services: Guild

27 January, 2015 Chris Brooker 0 comments
The vast majority of consumers believe they get value for money from pharmacies, and are willing to pay for pharmacy services, the Pharmacy Guild believes.
Findings from Guild-commissioned research showed over 80% of consumers surveyed said they get value for money from their pharmacies, while nearly two-thirds indicated they would be willing to pay a small fee to access services from their pharmacies.
The research showed that 80% of participants have already sought health advice from a pharmacist instead of their GP, said Guild national president George Tambassis.
“When shown a list of services currently accessible from pharmacies, 82% of participants said they would be more inclined to access these services from a pharmacy instead of their GP,” he said.
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 last year 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 and just what impact a change of leader might have?


Terry Hannan said...

All these postings remind me of the plenary session delivered by Dr Mark Smith of the Californian Health Care Foundation- The Hope, the Hype and the Road to Hell.

Trevor3130 said...

These are turbulent times, Health IT could turn in any direction. Turnbull's fate may, or may not, have an influence on that. His Digital Transformation Office may fade away, or be put on the boil. The news about the hacking of Athena in the US is a stern corrective to the "Single Sign On" hypothesis.
Here's a good dose of laxative on the weighty influence of health insurers in the "democratic process". Athena (ex WellPoint) gets a mention. From those multi-million dollar amounts it's obvious that private health will have a big say in the direction of future developments of the woe-begotten NEHR.
I find the MyGov site is getting better all the time, but not so sure about user-friendliness in its broadest terms. They've shifted away from authentication by userID, password and correct answers to 'secret questions' to the standard 2-factor authentication using mobile phone. On the one hand, it's simpler and quicker for the likes of me, but have they tested the procedure on the mass of older citizens?
Anyway, a brighter note is found in Kevin Outterson's blog note on the UK's directions for dealing with antimicrobial resistance.
"Build a modern surveillance system for infectious diseases, with digital capabilities in real time."

Trevor3130 said...

Whoops, Anthem not "Athena". Sorry.

Bernard Robertson-Dunn said...

According to, Mr Paul Madden is now Special Adviser, eHealth Division.

The puzzling thing is that he used to be CIO, but they don't have one now.

So he has either been given a special job (although adviser doesn't sound very special) or shunted sideways and Martin Bowles (the Secretary) will bring his own person over from Immigration as CIO.

Maybe this new person will be given the PCEHR to sort out.

Yes, turmoil rather does describe things. So do uncertainty, directionless and chaos.

Anonymous said...

There once was a CIO who was mad…
For an e-health system that was rad…
But his system went kerplunk!
And his career became defunct…
To ‘special projects’ they sent him, so sad :(