Thursday, November 26, 2015

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

November 26 Edition
The big macro issue at present is a discussion around just how complex, useless and expensive health insurance is and how the tax system is to be reformed in an era of ruling nothing in or out. It also now seems housing is now also being discussed, with older people being offered encouragement to downsize.
Pollies are back this week for a week or so - so we can expect more budget news and more moves on health policy. I wonder will we have some more e-Health thought bubbles
Here is some other of the recent other news and analysis.

The Political Scene.

Tax incentives eyed for home downsizers

  • The Australian
  • November 20, 2015 12:00AM

Gretchen Friemann

David Uren

Scott Morrison is canvassing bold tax reforms designed to persuade retirees to downsize to smaller homes and plough more money into retirement-income products in a move that would boost the housing supply for younger families and create a boom in the use of annuities.
The plan would include a one-off exemption from stamp duty on the purchase of a smaller house.
As an extra incentive, profits from the sale of the family home would be excluded from the Age Pension assets test provided they were channelled into an ­approved retirement product such as life annuities and aged-care bonds.
Since being appointed Social Services Minister late last year, the Treasurer has argued that the burden of the Age Pension could be reduced by allowing retirees to tap the wealth captured in their homes.

General Budget Issues.

  • Nov 17 2015 at 12:55 PM

Treasurer Scott Morrison hints at lower trend economic growth rate

Treasurer Scott Morrison has hinted the economy is unlikely anytime soon to return to the historic pace of growth that would deliver easy budget repair.
Mr Morrison suggested growth needs to rebound to "slightly above" 3 per cent, but effectively conceded it was likely to fall short of that pace.
"We are growing at 2.3 [per cent] and we will look to get ourselves back to about a 3 per cent [rate] which is just under trend.
"Now that's where we need to get to," Mr Morrison said.
Asked whether growth of 3 per cent would generate enough revenue to cover the government's needs, Mr Morrison conceded "you'd need to be slightly above that".

Wage growth hits record low as Scott Morrison tries to lift incomes

Date November 19, 2015

Peter Martin

Economics Editor, The Age

We were preparing for a wages explosion.
Two years ago, in his first major speech as workplace relations minister, Eric Abetz warned of "something akin to the wages explosions of the pre-Accord era" if employers and unions didn't rein in their deals.
Even as he spoke, wage growth was plummeting to new lows, heading down from its long-term average of between 3 and 4 per cent into the twos.
Since the minister spoke wage growth has plunged lower still, hitting 2.1 per cent for private sector wages in the year to September, the lowest result in records spanning back 18 years.

No Morrison mini-budget mid-year

Published: 9:18 am, Friday, 20 November 2015
Don't expect some sort of fiscal extravaganza when Scott Morrison releases his first mid-year budget review.
The treasurer has made it clear that he won't be making the mid-year economic and fiscal outlook some sort of mini-budget for the government's new leadership.
'MYEFO is a budget update ... I have no ambitions for it to be more than that,' Morrison said in a recent interview.
However, he set down some markers in a speech this week, in tune with his predecessor Joe Hockey.
That is, the budget deficit will be reduced by around 0.5 per cent of GDP, expenditure will begin to decline next year from its present peak and net debt will start to decline the year after next.

Health Budget Issues.

Quality of care in Australian hospitals lacks oversight

Date November 16, 2015 - 12:00AM

Jane Lee

Australia needs to collect more information to measure the quality of care that hospitals provide to patients nationally, an OECD report says.
The OECD's review of Australia's health system, to be released on Monday, said that it was performing "remarkably well" despite its "fragmented nature" and "sometimes strained" relationship between federal, state and territory governments over health funding. Australia was the OECD's fifth most obese country, it said, and its health system would in future have to deal with an increasing number of patients with diabetes and other chronic conditions. 
While Australia had improved its national standards for health care, it said: "A surprising lack of data on the quality and outcomes of care marks out Australia from its peers."
"This is particularly the case for primary health care, which has an under-developed pay-for-performance scheme, and for rural and remote health care. There are few indicators promoting quality of clinical care and patient outcomes, and there is little opportunity for GPs to be benchmarked against their peers."

Australia must protect the foundations of its healthcare system

Date November 13, 2015

Brian Owler

What do we want our healthcare system to look in 10 years? The federal government's vision for Australia's healthcare system currently lacks clarity, let alone consensus. 
The Medicare Benefits Schedule (MBS) Review, the Primary Care Review, and now a review of the private health insurance sector are set against the background of reform of the federation and federal-state health-funding arrangements. In the midst of these reviews is a debate about tax reform, including the potential application of a 15 per cent GST on health. 
Is it no wonder that complaints to the health ombudsman are at an all time high, and that the largest source of complaints is patients who do not understand their policies and are unaware of their exclusions? 

Removing natural therapies ‘too costly’, says health review

  • The Australian
  • November 16, 2015 12:00AM

Sean Parnell

Removing unproven natural therapies from the scope of the health insurance rebate is unlikely to deliver sufficient savings to warrant the cost of doing so, Health Minister Sussan Ley says.
The Australian has obtained the final review of natural therapies, commissioned by the former Labor government to ensure taxpayers were not subsidising bogus medicine, confirming there is insufficie­nt evidence to say the treatments benefit patients.
Chief Medical Officer Chris Baggoley chaired a specially convened committee of experts and tasked the Office of the National Health and Medical Research Council with examining the published evidence on 17 natural therapies.
“Overall, there was not reli­able, high-quality evidence available to allow assessment of the clinical effectiveness of any of the natural therapies for any health conditions,” the report concludes.

Natural therapies: no clear evidence of health benefits, government review finds

Date November 16, 2015 - 5:56PM

Jane Lee

There is no clear evidence that natural therapies are effective, a government review says, prompting calls for taxpayers and private health insurers to stop paying for them.
A Department of Health review of 17 therapies covered by private insurance released on Monday stated it could not conclude that any worked.
While there was "low to moderate quality" evidence that some therapies – for example, massage therapy, yoga and tai chi - may have some health benefits, overall "there was not reliable, high-quality evidence available to allow assessment of the clinical effectiveness of any of the natural therapies for any health conditions", the report, by Chief Medical Officer Chris Baggoley, said.

Fears Medicare safety net changes will hit most vulnerable

Date November 16, 2015 - 7:55PM

Jane Lee

A plan to cap rebates for out-of-hospital costs will lead to higher hospital admissions and suicide rates, rather than save the public money, doctors warn.
The Turnbull government had hoped its changes to the Medicare Safety Net would take effect from the start of next year. They are expected to save $266.7 million over five years, which would be put into the Medical Research Future Fund.
The changes will lower the spending thresholds required for patients to access benefits, but cap the benefits payable for individual medical services once this has been reached.
Psychiatrists and oncologists renewed their calls for changes to the legislation, which they say will make life-saving services more expensive for people who need them most.

Medicare: Government 'may face political crisis' over rebate freeze

Date November 17, 2015 - 7:15PM

Gareth Hutchens

The federal government may face a "political crisis" in a few years if it does not reverse the freeze on the indexation of Medicare rebates, the deputy director of the Menzies Centre for Health Policy has warned.
Associate Professor James Gillespie says voters need to realise that Medicare is an industry, GPs are running businesses and that co-payments are here to stay.
But general practitioners may be forced to increase co-payments at some stage, to cover for lost income, if the Medicare rebate freeze continues "for the foreseeable future", he said.
Mr Gillespie told a forum at the Australian National University on Tuesday that Australia's health debate was finally recovering after the damaging row over GP co-payments.

GP-ordered tests and scans a drain on Medicare budget

  • The Australian
  • November 21, 2015 12:00AM

Sean Parnell

GPs putting patients through ­extensive health assessments, or sending them off for sleep studies, iron tests, thyroid examinations or various leg scans, are responsible for some of the biggest increases in Medicare expenditure in recent years.
An expert taskforce reviewing the Medicare Benefits Schedule has been given access to data ­revealing increases by service, specialty­ and demographic, amid a clear trend for Australians to average more medical interventions each year.
The previously unreleased Medicare data gives some insight into the push for patients with chronic illness to be funded outside the traditional MBS system, and the need for clinicians to be compelled to follow evidence-based guidelines to avoid over-servicin­g or poor practice.
But it will only fuel the debate over the reason for the increase in Medicare-funded services per capita and whether doctors are respond­ing to patient concerns or profiteering.

Better protection for consumers of complementary medicines

Date November 20, 2015

Amy Corderoy

Health Editor, Sydney Morning Herald

Australians who use complementary medicines could be protected from dodgy claims and products that don't contain what they say they do under proposals in a landmark review.
The independent review of medicines and medical devices should also please the fast-growing complementary medicines industry, as it also recommends more self-regulation and cutting red tape.
Complementary and alternative medicines are thought to be used by two in every three Australians, generating $3.5 billion in revenue each year in Australia alone, despite a poor evidence-base for many heavily advertised products and federal reviews that have found repeated breaches of advertising regulations. 

Health Insurance Issues.

Let health insurers cover GP visits: Victoria University report

Date November 16, 2015 - 6:11PM

Julia Medew

Health Editor

Health insurers should be allowed to cover more health services, including GP visits, under a more privatised Australian health system, an independent report says.
Victoria University's Australian Health Policy Collaboration is calling for one of the greatest overhauls of Australia's health system since Medicare was introduced to offer universal access to healthcare in 1984.
In a report released on Monday, the group said a national system of mandatory insurance with regulated competition would motivate health services to limit costs.
At the moment, health insurers are not allowed to cover primary care services such as GP visits, radiology and pathology, or outpatient visits to specialist doctors such as endocrinologists or orthopaedic surgeons.
This means healthcare, particularly for people with chronic disease, is fragmented with many different providers and funders, including federal and state governments and health insurers that try to shift costs onto each other. The result is that no one carer or service provider takes responsibility for a patient with incentives to keep them well or to get them better efficiently when they are sick.

Health insurance premiums to rise more slowly in 2016

Date November 17, 2015 - 3:46PM

Jessica Gardner

Companies & Markets Deputy Editor

Next year's health insurance price hike will be slightly lower than previous years, but nib boss Mark Fitzgibbon says customers need to "get used to the idea" of annual premium increases in the region of 5 to 6 per cent.
The push to rein in the rising cost of private health cover is an aim of Health Minister Sussan Ley's review into the $19 billion sector, which heats up this week, but Mr Fitzgibbon played down expectations it would deliver real change.
"I don't think there will be any initial big bang," he said.
Mr Fitzgibbon, speaking at a conference organised by investment bank UBS, said spending on health care across the country had run at about 6 per cent a year for the past 10 years. 

Health insurers slam ‘rampant’ cost variations

Sarah-Jane Tasker

Australia’s top private health insurers are to reveal they are paying $800 million more each year on prosthetic devices compared to what public hospitals pay as they push for change under a federal government review.
NIB Holdings chief executive Mark Fitzgibbon said the insurer and the country’s other top funds had joined forces to engage a consultant to prepare a report on the international benchmarking price for prosthetic devices.
Health funds and hospitals met health department representatives yesterday as part of the government’s consultation on the private health insurance sector and the paper on prosthesis was expected to form part of the industry’s submission.
Mr Fitzgibbon said it was “outrageous” that insurers were forced to spend $800m a year more on prosthetic devices in the private system than they should.

Want real health reform? Integrate public and private health into one mandatory insurance system

20 November 2015, 06:54 CET


  1. Francesco Paolucci
Associate Professor; Head of Health Policy Program, Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University
  1. Manuel García-Goñi
Associate Professor of Applied Economics, Universidad Complutense de Madrid
Health Minister Sussan Ley is considering applications from private health insurers to increase premiums by 6-7% in 2016, four times higher than the rate of inflation. Rising premiums and better value for consumers are on the agenda at Ley’s private health insurance reform consultations this month.
But while health-care costs are growing – due to an ageing population with higher rates of chronic diseases and greater use of health technologies – rising premiums are also the consequence of structural system design flaws.
To make the system sustainable in the long term, our report, released this week by Victoria University’s Australian Health Policy Collaboration, proposes a model that integrates public and private health expenditure into a universal, mandatory health insurance scheme.
Consumers would have the choice between private health insurers and at least one government-run provider (which could be a version of Medicare or an insurer as was Medibank). All insurers would have to provide a comprehensive set of health services to their customers, covering all essential aspects of their health care.
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.

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