Thursday, November 05, 2015

The Macro View - General And Health News Relevant To E-Health And Health In General.

November 05 Edition
Well this is the week calm returns with the pollies away for another week or so. However we see all sorts of change being mooted with the GST being discussed and Health Insurance being well and truly up for review.
We are going to see a new set of Government accounts next month and it will be this situation that will determine where we go over the next year or so.
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Here is some other of the recent other news and analysis.

The Political Scene.

Five things that matter for Scott Morrison

A few months before the 2013 federal election, economist Stephen Koukoulas issued the incoming Liberal government what he called “a very simple and professional challenge”.
Fed up with all their rhetoric about fixing the budget and turbocharging the economy, Koukoulas challenged the Liberals to improve Australia’s economic performance on five key indicators. The indicators he picked were the ones any good economist looks to when taking the temperature of an economy: gross domestic product growth, unemployment, inflation, wages and interest rates.
As Treasurer 2.0 Scott Morrison starts work on the upcoming mid-year economic and fiscal outlook, he should return to those key indicators. If he does, he’ll find problems on all five fronts. The mid-year budget update is Morrison’s chance to show his government has a plan to get the dials on Australia’s economic dashboard moving the right way again.
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Oct 31, 2015

Turnbull and Morrison: the Coalition’s new power pact

With an alliance redolent of the Hawke–Keating era, the compact between Turnbull and Morrison is key to the government’s fortunes.
When cabinet’s number-crunching committee with responsibility for finalising the budget convened in recent weeks for its first few meetings, it was Malcolm Turnbull rather than treasurer Scott Morrison who chaired the sessions.
As part of his pitch for the leadership, Turnbull made it clear that he felt Tony Abbott and Joe Hockey had failed to sell an economic message and that he was best qualified to rectify this.
“They’re both focused on the mix of politics and the policy. There’s also a big focus on what is actually implementable.”
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General Budget Issues.

Super reform may save budget $6bn

Budget savings of $6 billion a year would be generated by a proposal for taxing superannuation contributions similar to the Henry tax review’s recommendations, with everyone getting the same tax benefit, regardless of income.
The Turnbull government is open to reducing the benefits of superannuation for high-income earners as part of its tax white paper review and an analysis by accounting firm Deloitte shows it could provide funds to be used for broader tax reform objectives.
The Murray financial system inquiry found that half the concessions from superannuation were enjoyed by the highest income-earning 20 per cent of the population, while the lowest earning 20 per cent received just 0.5 per cent of the benefits.
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Superannuation 'circuit breaker' would save budget $6b per year

Date October 26, 2015 - 7:19AM

Peter Martin and Latika Bourke

The Deloitte financial services group has proposed a "circuit breaker" on superannuation it believes will save the budget $6 billion per year while giving every worker in the nation a tax break.
The plan goes further than the one proposed by Labor and rejected by the Coalition under Tony Abbott. It would have raised less than $2 billion per year.
We will consider all good ideas, we will look at them very, very carefully 
It would build on a model developed by the Henry tax review, under which every worker would pay tax on the income they paid into super but then receive a rebate of 15¢ in the dollar.
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An expanding defence budget is a hard sell for new minister Marise Payne

Date October 26, 2015 - 11:45PM

Mark Thomson

Money will need to be found through higher taxes or cuts to services, and the public will rightly demand an explanation.
Defence Review
At the most recent Senate estimates hearing in mid-October, new Defence Minister Marise Payne was asked whether the government remained committed to boosting defence spending to 2 per cent of GDP within a decade. Her response, that "there is no change to that policy", no doubt elicited a collective sigh of relief around the corridors of the Russell Offices.
However, at the same hearing, the minister declined to give a release date for the long-promised defence white paper and its associated capability investment plan. Not unreasonably, she said that time was needed to consider the current draft, adding it would be "irresponsible for the Prime Minister and me to not exercise due diligence in relation to those items".
So we find ourselves in a curious position. The government's policy on defence funding remains unchanged, yet the new Defence Minister and Prime Minister are yet to get across – let alone accept or reject – their predecessors' work on the matter. To do so properly will require at least several meetings of the newly constituted National Security Committee. Consequently, the defence white paper promised for 2015 may well become the 2016 defence white paper.
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Budget’s plunge into the red threatens Australia’s credit rating

David Uren

Scott Morrison faces a battle to preserve Australia’s AAA credit rating with revenue looking as if it will again fail to meet Treasury’s expectations, while little progress is being achieved on budget ­savings.
Ratings agency Standard & Poor’s was crystal clear in its commentary after the budget was handed down in May that Australia’s standing at the pinnacle of global creditworthiness would not survive another blowout in the deficit. “The stable outlook is based on our assumption that Australia’s continued conservative budgetary policies will result in consistently narrowing deficits … We could lower the ratings if Australia’s budgetary performance does not improve broadly as we currently expect,” it warned.
The budget Morrison has inherited from Joe Hockey attempts to hold the line on spending while economic growth generates the revenue to whittle away the budget deficit. The idea is that revenue rises faster than 6 per cent a year across the next four years while spending growth is kept to less than 4 per cent.
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Cormann confident in retaining AAA rating

AAP
October 29, 2015, 5:07 pm
Finance Minister Mathias Cormann is confident Australia will maintain its AAA credit rating.
In July, global credit rating agency Standard & Poor's warned it could cut the country's top-tier rating in the future if Australia's budgetary performance did not improve because of continued parliamentary budget gridlock.
"We do have a plan to get the budget back to balance as soon as possible and also in a way that is economic responsible," Senator Cormann told Sky News on Thursday.
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Global growth won’t do Turnbull’s work for him

In his first six weeks as Prime Minister, Malcolm Turnbull has adhered to that maxim at the heart of the Hippocratic oath: First, do no harm. He has not undone any of the good work of his predecessor and, perhaps more important, he has not fallen for the trap of ruling out any policy options. In fact his single most significant act has been to declare that all fiscal options are on the table. He has left himself a full suite of policy instruments to choose from and — as the opinion polls and tenor of the public debate indicate — voters seem prepared to give him that latitude rather than hold him strictly to the promises of the Abbott cabinet in which he sat. Mr Turnbull confronts a wide range of options and challenges, and has a largely clean slate from the electorate. That is all to the good; but he has done nothing with it yet.
It won’t be long before his critics start to wonder what his plans may be or what agenda he has brought to the job. What is more important, especially between now and the next election, is that the Prime Minister — together with his Treasurer, Scott Morrison — holds firm on his intention to “change the paradigm” and resists the “crazy game” of ruling out various measures. Tony Abbott and Joe Hockey sowed the seeds of fiscal underachievement and political underperformance even before they were elected by ruling out too many of the cost-saving options required for fiscal repair and locking themselves into unfunded expansions of the federal budget.
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Health Budget Issues.

Will six reviews fix or fragment our health ‘system’

Date October 28, 2015 - 11:23AM

Leanne Wells

The scale of the challenges facing the Australian health "system" right now is illustrated by the numerous reviews looking to reform systemic frailties.
There are quote marks around the word "system" because, as has been pointed out before, Australia's national approach to the care of the sick and promotion of health and wellbeing can hardly be called a system.
The worrying gaps and dysfunction in our $140 billion a year health arrangements are graphically highlighted by the fact that there are SIX national reviews proposed or in train examining pivotal aspects of health care and funding in Australia.
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National Press Club Address

Minister for Health Sussan Ley's address to the National Press Club on 28 October 2015.
28 October 2015
Introduction
I believe we need a health system where the patient is centre of everything.
I would like to start today by reading a real-life example about inefficiencies in emergency departments that a GP wrote to me about this week:
“We are becoming rather a “scans on” profession rather than a “hands on” profession. Patients clutter the Emergency Department and they have an excessive amount of investigations because nobody takes the time to take a history or to do a physical examination. Emergency Departments can also have the attitude that they are the front line diagnostic unit of the hospital and they cannot discharge a patient without leaving any stone unturned. This is just one aspect of care and one aspect of ways in which our health dollar could be spent more efficiently.”
In this one example from a GP, I feel that they have managed to encapsulate many of the issues facing our health system right now and why we need an integrated approach to fixing them.
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Lawyers warn on ‘no jab, no pay’ immunisation bill

  • The Australian
  • October 29, 2015 12:00AM

Stefanie Balogh

One of the nation’s peak law groups is cautioning senators against supporting government plans to strip payments from ­parents who fail to vaccinate their children, including conscientious objectors, claiming it is a “punit­ive approach’’ and “not in the best interests of the child’’.
In an unusual foray into public policymaking, the Law Institute of Victoria, while saying it supports efforts to increase childhood vaccination rates, cites the UN Convention on the Rights of the Child to express reservations about the government’s new “no jab, no pay’’ rules.
It fears that “this policy is not in the best interests of the child’’ and “takes a punitive approach to addressing the issue of encouraging childhood vaccinations’’.

Healthcare costs ‘on collision course’: Jennifer Westacott

  • The Australian
  • October 30, 2015 12:00AM

Sid Maher

Low economic growth and its constraint on government revenue will force cuts to Australia’s health system unless it is reformed to tackle unsustainable spending increas­es.
A reform summit organised by the Business Council of Australia and including some of the nation’s leading health experts has been told the fee-for-service culture in the system is driving up costs and that a more consumer-orient­ed approach must be adopted.
BCA chief executive Jennifer Westacott told The Australian the health system must be reformed to allow patients to gain real-time informa­tion on the performance of hospitals or clinicians and the current culture of fee for service must be curtailed to reduce unsustainable spending.
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The squandered health dollars Sussan Ley ignores

Paul Smith | 29 October, 2015 |
Federal Health Minister Sussan Ley offered another slick performance at her Press Club address in Canberra on Wednesday.
People like her, she has good telly presence in a way that happily contrasts with the bad cop menace of her predecessor Peter Dutton.
When she addressed the industry big wigs in the audience – the drug companies, the management consultancies, the medical groups, the private health insurers – you could see them undergo the beautific visions of those who feel goodness had returned to Narnia.
Ms Ley is lucky.
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Angus Taylor: Time to empower patients in healthcare

Date October 30, 2015 - 2:48PM

Angus Taylor

A recipe for health reform

How can the government contain ballooning health spending? Liberal MP Angus Taylor sets out his ideas for reform.
At near double digit rates, health costs are at the heart of government spending rising faster than tax revenues.
While I understand service providers enjoy that growth of spending - I would too if I were a service provider - as a purchaser of services this is simply not sustainable for the federal government.
Health Minister Sussan Ley got it right this week in her address to the National Press Club, reform is certainly needed in funding models.
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Medicare Safety Net.

Why your doctor’s bill could be about to increase

October 29, 20156:14pm
Medicare safety net changes push up medical bills.
Sue Dunlevy News Corp Australia Network
NEARLY 800,000 people with high medical bills will get back less from the Medicare safety net when they visit GPs and specialists under controversial changes.
The changes will hit the chronically ill, pregnant women, cancer patients and anyone who uses the medical system so extensively they rack up out of pocket expenses worth over $600 a year after receiving standard Medicare rebates.
From January the Medicare safety net payout for specialist visits will see out of pocket expenses for those who have qualified increase from $88 to $94.
And the out of pocket cost for non bulk billed GP visits will rise from $7.60 to $19.45 — again, if a patient qualifies for the safety net — the Royal Australian College of General Practitioners has revealed.
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Health Insurance Issues.

Health Minister wants an end to junk policies in private health insurance shake-up

October 29, 2015 1:00am
Renee Viellaris The Courier-Mail
PRIVATE health insurance is facing its biggest shake-up in 15 years as the Turnbull Government questions whether it would be better for Australians to save up for some out-of-pocket costs.
Health Minister Sussan Ley, who in the past few weeks has been ramping up her ­concerns about private health insurance, yesterday revealed that former consumer watchdog head Graeme Samuel had been asked to help find better deals and identify pitfalls for consumers.
Opening the door to dumping another policy of former prime minister Tony Abbott, Ms Ley yesterday would not commit to fully restoring the Private Health Insurance Rebate within a decade.
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Doctors warn against US-style system as changes to health insurance signalled

Health minister Sussan Ley says consumers are concerned with the poor value for money of private health insurance and will seek their views on the industry
Daniel Hurst Political correspondent
@danielhurstbne
Wednesday 28 October 2015 Last modified on Wednesday 28 October 2015
The Turnbull government is paving the way for changes to “inefficient” regulation of health insurance in Australia, prompting doctors to warn against moving towards a US-style system where private funds play a much greater role in primary care services.
The health minister, Sussan Ley, said she would soon seek public feedback on private health insurance so the government could frame policies to “deliver the best value for consumers first and foremost”.
Ley signalled that the health department-led review could have a broad focus, although she sought to avoid buying into specific options, including whether the government was still aiming to eventually wind back Labor’s decision to save the budget billions of dollars by means testing the private health insurance rebate.
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  • Oct 28 2015 at 3:49 PM
  • Updated Oct 29 2015 at 6:14 AM

Health Minister Sussan Ley attacks 'junk' private health insurance

Health insurance policies that exclude certain procedures – often surprising patients who have paid for the increasingly expensive cover – are a waste of money and need to be fixed, Health Minister Sussan Ley said.
Ms Ley, who has launched a review into the $19 billion sector, said consumers and taxpayers were concerned that a $6 billion-a-year rebate that subsidises private cover was not delivering sufficient value for money. 
The government has asked consumers to make suggestions about how to improve health insurance. Ms Ley has also called on former competition regulator Professor Graeme Samuel to assist with meeting consumers and the industry to work out how to remove unnecessary and costly regulation, or add value for the roughly half of the population that has private cover.
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Owler troubled by government stance on health insurance

29 October, 2015 Amanda Davey
The AMA has expressed concern that Australia is moving towards a US-style of health care after the Turnbull government signalled it would remove “inefficient” regulation of health insurance.
Health minister Sussan Ley has announced she will be seeking public feedback on private health insurance as part of a review led by the health department.
While she insists she does not have a predetermined view of what the review should recommend, she wants to explore “opportunities to amend unnecessary and inefficient regulation which adds costs for the consumer”.

Health insurers warn any cut to the ancillary rebate will only hit consumers

Date October 30, 2015 - 4:23PM

Tim Binsted

Health funds have warned their minister Sussan Ley that any cuts to the ancillary rebate will only hit consumers.
On Wednesday Ms Ley launched a nationwide review into private health insurance to run alongside reviews into primary care and the Medicare Benefits Schedule.
She singled out the 30 per cent rebate on ancillaries, which includes things like dental, glasses, and physiotherapy – as a potential savings target. The rebate was part of a package of reforms introduced in 1999 to encourage people to take up private health cover.
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Doctors and hospitals refuse to treat Medibank members

October 31, 20155:27am
Sue Dunlevy and Miles Godfrey News Corp Australia Network
DOCTORS and private hospitals have been refusing to carry out surgery on some Medibank members after hospitals signed up to the fund’s controversial contracts.
The nation’s largest health fund is asking hospitals to sign contracts where it will refuse to pay the hospital if the patient is readmitted within 28 days unless the readmission is related to cancer, palliative care or a chronic illness.
The controversial contract prompted a showdown earlier this year with Catholic Hospital group Calvary which initially refused to sign, it now has.
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Safety net changes to hit pockets of the vulnerable: RACGP

Paul Smith | 30 October, 2015 |
Patients with high medical bills will be left further out of pocket under the Federal Government’s revamp of the Medicare Safety Net.
The original safety net system was created in 2004 and designed to pick up 80% of out-of-pocket costs for out-of-hospital Medicare services once a set threshold had been reached.
But the scheme’s costs have increased, with the government now claiming those living in some of the wealthiest parts Australia are benefiting most from a scheme designed to protect the poor.
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It has been an interesting time with the new Government settling in and all sorts of options now back on the table, including the Harper Competition Review - pharmacy might be worried, as well as a review of Health Insurance. Health is also clearly under review as far as its budget is concerned with six reviews underway. Lots to keep up with here! Enjoy.
David.

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