Thursday, November 12, 2015

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

November 12 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 with even more intensity that last week..
We are also 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.
It does seem that the traditional wind down in political activity and planned change over Christmas might be less noticeable than in other years, with so much up in the air.
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Here is some other of the recent other news and analysis.

The Political Scene.

2:39pm November 2, 2015

Prime Minister Turnbull signals plans for post-Budget election amid rumours of GST increase

9NEWS
November 02, 2015: Prime Minister Malcolm Turnbull has said an election will be held in September or October 2016.
Australia will go to the polls late next year, Prime Minister Malcolm Turnbull has revealed amid speculation changes to the tax system may pressure him into calling an early, pre-Budget election.
“Well, we’ll be going to an election next year… I would say around September, October next year is when you should expect the next election to be,” Mr Turnbull said.
The government had not yet decided on any particular tax reform, such as increasing the GST, he said.
“Any changes to the tax system have to be ones that ensure that there’s no disadvantage to the most vulnerable Australians,” Mr Turnbull told reporters today.
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Tax reform: drive out government waste before raising taxes

Few things excite politicians more than spending money and cutting ribbons. Few things annoy voters more than tax hikes, especially if the extra tax is supporting government spending addictions.
Across the world, governments have resolved this dilemma by accumulating debts, passing the buck to future generations. Australian state governments are on to a better trick — convince the federal government to raise taxes, and then get hold of the money.
As we debate a higher GST, distinguish between two very different motives. The first is pure. Raise GST and give all the money back by reducing other taxes (especially eliminating income tax bracket creep, company tax and stamp duty) and the necessary welfare adjustments. This is good policy which will drive investment, savings, work participation and growth.
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Labor hit-out at potential GST changes

By Matthew Dixon

Nov. 4, 2015, 11:21 a.m.
LABOR have reiterated it will not support any changes to the GST as the issue garners national attention. 
Opposition treasury spokesman Chris Bowen visited Ballarat on Wednesday to talk about the issue. 
Mr Bowen is another in the long list of high profile Labor MPs who have visited Ballarat over the past two months in a sign the party is already putting emphasis on the electorate with an election expected within the next 12 months.  
Changes to the GST are set to become a key election issue with Prime Minister Malcolm Turnbull's plans to reform Australia's tax system already on the agenda.
The most high profile change has been the option of raising the GST to 15 per cent  or the broadening of the tax to cover new items such as fresh food or health services.
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GST hike all pain, no gain

Graham Richardson

Whenever he thought his minister or prime minister was about to do something he did not like, the fabled Sir Humphrey would tell his charge that he was being “courageous”. The mere mention of this word would cause the minister to go weak at the knees and, with Humphrey’s assistance of course, find a way to back down.
In Sir Humphrey-speak, the Prime Minister’s decision to hack off a huge debate on an increase to the rate and/or the base of the GST is indeed courageous. The road ahead for any change to the GST is fraught with perils at every twist and turn — and I say that as a supporter of the idea.
Having gone much further than he should have this week in ruling out a March-April election, the PM faces the prospect of working with Scott Morrison to produce a budget in May just three or four months before a full-term election. That means inflicting some pain on every voter in the land.
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Health minister backs tax reform

AAP
Health Minister Sussan Ley says eliminating waste and not raising taxes is the best way to make savings in the health system.
Ms Ley has endorsed the government's ongoing debate on widespread tax reform, describing it as courageous.
But she says a figure "often reflected back" at her is that waste in the health system runs as high as 30 per cent.
"In health I know there are opportunities to have a far more efficient spend," she told reporters in Adelaide on Friday.
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Tax reform ‘must link to welfare’

  • The Australian
  • November 7, 2015 12:00AM

David Crowe

Welfare payments must be ­overhauled in any reform of the nation’s tax system, according to a senior federal government ­adviser who warns that flaws are being entrenched in a system that costs $150 billion a year.
As Malcolm Turnbull considers expanding the GST, the head of the government’s welfare review is pressing for a radical overhaul to simplify and tighten the delivery of unemployment benefits, the Disability Support Pension and family payments to boost Australians’ incentives to get jobs.
The warning, from former Mission Australia chief Patrick McClure, will widen the debate over tax reform as the Prime Minister prepares the ground for sweeping change, despite grave concerns among Coalition MPs about the political danger of a 15 per cent consumption tax.
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General Budget Issues.

24/7 shopping, alcohol sold in supermarkets among plans to boost economy

November 2, 2015 12:07am
Ellen Whinnett and Tom Minear Herald Sun
SHOPS could open 24/7, and big supermarkets could sell alcohol and open pharmacies under proposals being considered by Treasurer Scott Morrison to boost his Budget bottom line.
Mr Morrison is carefully examining recommendations put to the Government to kickstart productivity by increasing competition across the retail and services sector.
The recommendations were made seven months ago by Professor Ian Harper, but gathered dust until new Prime Minister Malcolm Turnbull and Mr Morrison took a fresh look at them.
The 56 recommendations would, according to Professor Harper, give a 2 per cent boost to Australia’s bottom line.
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3:04pm November 1, 2015

Better tax mix for jobs, growth: Morrison

AAP
Treasurer Scott Morrison has described reports that the government is considering a hike in the GST as "speculative" but economists and tax practitioners say it's an idea worth pursuing.
Mr Morrison says fixing the tax system is not about trying to increase the tax burden on Australians to chase ever higher levels of spending, but about encouraging growth.
"The Commonwealth and states and territories are looking for the best mix of options that are going to encourage jobs growth and economic growth," Mr Morrison told AAP on Sunday.
The treasurer was responding to a News Limited report that said the government was considering raising the GST from 10 per cent to 15 per cent while reducing tax for middle-income earners and keeping fresh food GST-free.
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9:59am November 2, 2015

GST finding not our policy: Morrison

AAP
Scott Morrison insists he doesn't want to slug people with higher taxes, he just wants a better tax system that encourages the nation to grow.
In a round of media appearances on Monday, the federal treasurer flagged "pretty significant" tax changes but wouldn't specifically back a proposal to hike the GST to 15 per cent.
Mr Morrison praised Nationals MP David Gillespie for asking the Parliamentary Budget Office to cost a New Zealand-style model that also broadens the GST to more goods and services than now.
"This is a good contribution," he told ABC radio but stressed it wasn't government or Nationals policy.
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  • Nov 2 2015 at 9:04 AM

Tax system 'retarding growth', Scott Morrison says

Treasurer Scott Morrison says there are still practical hurdles to extending the GST to health and education, but change is needed as the system is 'retarding' growth.
Malcolm Turnbull confirmed a GST increase is on the table last week, before speculation about a 15 per cent increase and broadening of the base arose on the weekend.
Any rise in the GST would have to be in agreement with the states and territories - some of which are hostile to a hike - on getting rid of other taxes, and competition reforms.
Mr Morrison said practical issues had gotten in the way of extending the tax on health and education in the past.
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Scott Morrison's lukewarm reception for wide-ranging New Zealand-style GST

Date November 2, 2015

Latika Bourke

National political reporter

The case for increasing the GST

The GST is back on the political agenda - Nationals MP David has modelled the impact of a 15 per cent rate. Courtesy ABC News24.
Lifting the GST to 15 per cent and applying it to food, health and education would reap $130 billion in revenue in just one year, official costings commissioned by a Turnbull government MP show.
But Treasurer Scott Morrison has stressed the idea is not official policy and sits at the "extreme end" of the options available to the government as it mulls a tax reform package ahead of the next federal election.
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  • Nov 5 2015 at 3:42 PM
  • Updated Nov 5 2015 at 3:42 PM

Use GST hike to spur broader reform push, says Productivity Commission

Any extra goods and services tax revenue may only be paid to states in full if they lift their game on how efficiently they deliver services such as health and education, as well as removing regulatory barriers to investment and hiring.
Treasurer Scott Morrison is understood to be increasingly attracted to the idea – first foreshadowed last month in a report in The Australian Financial Review – and he strongly endorsed a call by the government's independent economic adviser on Wednesday to link tax reform to state innovation and deregulation.
As the national tax debate gathers steam, Productivity Commission chairman Peter Harris suggested it shouldn't always be the commonwealth government facing the microscope on its intentions.
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Reserve cuts forecast growth, raising prospect of multibillion-dollar budget hit

Date November 6, 2015 - 7:37PM

Peter Martin

Economics Editor, The Age

Interest rates on hold

As expected, the Reserve Bank has left interest rates on hold for the sixth consecutive month.
The Reserve Bank says the Australian economy will grow far more slowly than forecast in Tony Abbott's May budget, opening up the possibility of a multibillion-dollar hole in Malcolm Turnbull's first budget, due next May.
The revenue hit is estimated to be somewhere between $3 billion and $11 billion.
The revised Reserve Bank forecast comes on top of news that the Treasury itself plans to downgrade its longer-term projections for growth, potentially slicing billions more from projected revenues.
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Agents of change face resistance in the name of equity

Paul Kelly

This week, Malcolm Turnbull and Scott Morrison advanced the principles that will guide their ambitious yet risky tax reform agenda for the next election, while being warned by the Labor Party of resistance in the name of equity with mounting evidence of changes in the nation’s social contract.
The Prime Minister and the Treasurer are raising expectations they can smash the complacency, drift and negativity in the nation’s political culture. While they have taken no decision about a GST, the logic of their rhetoric points to a substantial tax reform that would involve the GST.
They are still at stage one: explaining the imperative for change. Stage two, the policy design with the necessary electoral viability, lies ahead.
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Health Budget Issues.

8:34am November 2, 2015

Doctors to repay $4m for rorting Medicare

AAP
A number of doctors have been ordered to repay more than $4 million to the federal government for rorting the Medicare Benefits Schedule.
The independent Professional Services Review Agency's annual report shows there was a 40 per cent increase in the number of matters referred for investigation in 2014-15, Health Minister Sussan Ley said in a statement.
Of particular concern was the misuse of chronic disease management benefits, which alone have cost the government $2.7 billion in the nine years since being introduced.
The full report will be tabled in federal parliament on Monday.
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Paracetamol, aspirin and other 'common medicines' will come off PBS

The health minister, Sussan Ley, says 17 over-the-counter medicines will be taken off Pharmaceutical Benefits Scheme from 1 January
Daniel Hurst Political correspondent
The Turnbull government has confirmed it will press ahead with removing common medicines such as paracetamol and aspirin from the list of subsidised drugs.
The health minister, Sussan Ley, said the changes were motivated by concerns that concessional patients “were sometimes paying two to three times the retail price of common medicines when they bought them through a prescription rather than over the counter”.
Ley began laying the ground to make such changes earlier this year, but she confirmed on Tuesday that 17 types of common over-the-counter medicines for conditions such as headaches, heartburn and constipation would be taken off the Pharmaceutical Benefits Scheme (PBS) from 1 January.
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$500m saved as aspirin wiped from script

  • The Australian
  • November 3, 2015 12:00AM

Sean Parnell

Seventeen popular medicines, covering complaints ranging from headaches to constipation, will from next year no longer be available under script.
In a decision published yesterday, and foreshadowed in the government’s recent pharmacy agreement, the Pharmaceutical Benefits Advisory Committee has listed common over-the-counter medicines that from January 1 will not attract the fees and charges associated with other drugs dispensed by pharmacists.
The drugs to be delisted — which last year were on 8.76 million scripts at a cost of $87.3 million to the Pharmaceutical Benefits Scheme — include paracetamol, aspirin, hydrocortisone and glycerol.
While the drugs currently qualify for a co-payment, which is more generous for concessional patients, complex funding rules mean the cost to the patient and government is much higher than if they had been purchased off script or in a supermarket.
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Can Medicare sustain the health of our ageing population?

November 4, 2015 6.05am AEDT

Authors

Helena Britt and 9 Others
With six reviews of the health system currently underway, health minister Sussan Ley is investigating ways to create a “sustainable” Medicare and a stronger health system. One of the main concerns is that our ageing population is putting too much of a strain on the health system.
Like other OECD countries, Australia’s population is ageing due to lower fertility rates and increased life expectancy. The proportion of Australians aged 65 years and over increased from 12.4% in June 2000 to 14.7% in June 2014 (an 18% proportional increase), and the Australian Bureau of Statistics expects it to reach 18.6% by 2030.
We decided to investigate these concerns using data from the Bettering the Evaluation and Care of Health (BEACH) program – Australia’s longest running study of general practice activity. The results are published today in our annual report.
We found that older Australians use far more primary care health resources and the proportion they are using is increasing over time. However, having these patients managed in general practice lowers overall health care costs by reducing expensive specialist and hospital visits.
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Over-65s use twice as many GP resources as average Australian, report finds

Date November 4, 2015 - 12:15AM

Harriet Alexander

Over-65s weigh heaviest on the health system

A new report from the University of Sydney finds that people aged 65 and older are using twice as many GP resources as the population average, as lead investigator Helena Britt explains.
People aged 65 and older are using twice as many GP resources as the population average, according to a report that quantifies the strain on the health system posed by the older generation and the looming challenge for Medicare.
Older Australians are spending more time with their GPs and seeing them more frequently, for more health problems, according to a report by the University of Sydney's BEACH research program.
In turn, they are being prescribed more medication and undergoing more tests.
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Older people requiring more healthcare

  • The Australian
  • November 4, 2015 12:54PM

Sean Parnell

The challenge of providing healthcare for an ageing population is made more complex by older Australians requiring more medical attention than previous generations.
New reports from the University of Sydney’s Family Medicine Research Centre show people aged 65 and older use health resources — including GP visits, prescriptions and tests — at twice the national average.
But a deeper analysis revealed an increase in use of health resources that outstrips their 18 per cent growth as a proportion of the population. Put simply, health providers and funders don’t just have more older patients to care for, but older patients who are using services more.
Comparing this demographic’s market share in 2000-2001 with its share in 2014-2015, the researchers found referrals increased 33 per cent, problems managed in general practice increased 30 per cent, medications increased 27 per cent, imaging and pathology tests increased 24 per cent.
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Crackdown on ‘patient churn’ by GPs saves $50m more than tipped

  • The Australian
  • November 4, 2015 12:00AM

Sean Parnell

A landmark investigation of so-called “patient churn” in corporate medical clinics has resulted in Medicare saving $50 million more than the federal government anticipated.
The Department of Human Services used sophisticated data-matching to identify 60 clinics, mostly in urban areas and offering several specialties, where four or more doctors were servicing a large number of patients.
While doctors normally raise suspicion only if they breach the 80-20 rule, where doctors cannot conduct 80 or more services on 20 or more days over a 12-month ­period, this investi­gation focused on clinics with a number of doctors going close to the threshold.
The Australian has previously revealed more than 200 doctors were interviewed as part of the ­investigation, with at least 16 required to justify their charging to the Professional Services Review.
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6:08pm November 4, 2015

Patients hurt by govt health plan: inquiry

AAP
State governments and health experts have come out swinging against the federal government's plan to slash public hospital funding.
The government's 2014/15 budget included plans to change the way it funds public hospitals from 2017/18, indexing it on population growth and the consumer price index.
Grattan Institute health program director Stephen Duckett told a Senate inquiry in Melbourne on Wednesday the new model is flawed and unsustainable, accusing the government of breaking an election promise.
He says the budget did serious damage to federal-state relations and the confidence of states to plan and manage their health systems.
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Federal health funding cuts equivalent to closing two major Victorian hospitals

Date November 4, 2015 - 6:33PM

Julia Medew

Health Editor

Multibillion-dollar federal funding cuts to Victoria's health system over the next decade equate to closing down two major institutions, like the Royal Melbourne Hospital which employs about 9000 people, state government officials say. 
The Commonwealth's funding cuts would also slash the equivalent of 23,000 elective surgery procedures every two years in Victoria, where patients will likely face longer waits for care in coming years and hospital workers could be sacked, a federal government inquiry into Australia's health system heard on Wednesday. 
As state and federal politicians continue to debate new ways of raising money to fund healthcare, executive director of the Royal Melbourne Hospital, David Alcorn​, told the inquiry that his service was raising millions of dollars through its charity to pay for basic equipment such as hoists to lift patients and bedside chairs because government funding was inadequate. 
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Health overuse hotspots revealed

  • The Australian
  • November 7, 2015 12:00AM

Sean Parnell

Drugs for ADHD are prescribed to children most regularly in the country town of Taree and anti­biotics are dished out like lollies in Sydney’s west, while the residents of Western Australia’s Bunbury have the highest rate of knee arthroscopies in Australia.
A comprehensive report, ­obtained by The Weekend Australian, gives an unprecedented snapshot of the health system, laying bare over-servicing in some regions, while patients struggle to receive adequate medical attention in other areas.
The startling statistics reveal wide variances in medical treatments across the nation: the rate of prescribing drugs for attention deficit and hyperactivity disorder to children varies by 75 times ­between the Taree-Gloucester region and the area of Australia with the least prescriptions.
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Health Insurance Issues.

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Fight for the right insurance

2 November, 2015 Chris Brooker 
A shakeup of the coverage of pharmacy extras should be at the forefront of the federal government’s planned consultation on changes to private health insurance, a pharmacy leader believes.
Federal Health Minister Sussan Ley announced during her recent address to the National Press Club that the government would launch a “public consultation to seek consumer feedback on private health insurance”.
Former Pharmacy Guild of Australia national president Kos Sclavos believes that, for pharmacy, ensuring there are benefits for private prescription purchases should be a centrepiece of any review submission.
Mr Sclavos, now senior health strategist at Sinapse, says a whole-of-industry approach is needed by pharmacy and the pharmaceutical industry to ensure the continuation and viability of the 30% rebate on ancillary cover, such as pharmaceutical services.
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4 Nov 2015 - 5:28pm

Private health incentives needed: nib

The head of nib wants people to receive incentives if the government changes its private health rebate and makes people save to cover their bills.
Source: AAP
4 Nov 2015 - 10:12 AM  UPDATED 46 MINS AGO
Australians should receive tax breaks if they are made to set up savings accounts to help cover some healthcare bills, private health insurer nib says.
Health Minister Sussan Ley announced in October a major review of the private health insurance industry following a rise in complaints about premium rises and policies that were "junk".
She flagged the government's 30 per cent rebate on ancillary cover for services such as optical, dental and physiotherapy could be scrapped, suggesting people could instead set up savings accounts to cover those costs.
The head of nib Mark Fitzgibbon has welcomed the review but says if people are made to set up savings accounts to cover their health costs, incentives are needed.
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Private health funds, doctors and anaesthetists milking the sick

November 6, 20155:14pm

Do I really need health insurance?

Sue Dunlevy News Corp Australia Network
WHEN Donna Smith’s husband developed heart disease and she got cancer they lost their family home and were declared bankrupt because the health insurance they’d paid for all their lives did not cover their medical expenses.
Donna and Larry were the stars of Michael Moore’s movie Sicko, that exposed the punishing inadequacies of the US health system, but many Australian patients are beginning to share their experience.
The Americanisation of Australia’s health system has been happening by stealth.
News Corp Australia has recently exposed how breast cancer patients Tracey Ryan and Leonie Havnen were left with out of pocket medical expenses totalling over $60,000 and $30,000 not covered by either their health fund or Medicare.
A Health Consumers NSW survey uncovered a patient who had to sell their home to cover medical expenses.
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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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