Thursday, November 19, 2015

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

November 19 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.
Pollies are away for a while so we can hope for calm for a little while….the come back on the 23rd so calm lasts till then.
Here is some other of the recent other news and analysis.

The Political Scene.

Samantha Maiden: PM Malcolm Turnbull’s high-stakes tax bet

November 8, 2015 12:00am
Samantha Maiden The Sunday Telegraph
MALCOLM Turnbull hates gambling so much that he ­resisted offering a tip on the Melbourne Cup for days.
That’s an interesting quirk from a Prime Minister who shows every sign of betting the Lodge on tax reform.
So why do it? Answering that question is the big issue.
It’s hard to explain to voters right now how all the moving parts of tax reform that the Turnbull government is examining fit together. So here is the cheat’s guide to tax reform.

Federal politics: Treasurer Scott Morrison puts income tax cuts on the table

Date November 8, 2015 - 7:11PM

James Massola

Political correspondent

Scott Morrison signals personal income tax changes

The Treasurer tells Sky News personal incomes tax is a 'silent tax' that penalises working people.
Treasurer Scott Morrison has signalled income tax cuts are squarely in the federal government's sights as part of a sweeping review of the tax system, while warning the states they will not simply be handed a "bucket of money" under an overhaul of the system.
And Victorian Premier Daniel Andrews, one of the most vocal opponents of raising the GST, publicly confirmed on Sunday his government would respect the Turnbull government's plans if it wins a mandate from voters at the next election.

Tax reform may include superannuation tax changes, Treasurer Scott Morrison says

By political reporters Louise Yaxley and Dan Conifer
The Federal Treasurer has signalled changes to superannuation tax might form part of the Government's plans for reform.

Key points:

  • Treasurer indicates interest in proposal to make high income earners pay more on their super contributions
  • Proposal could generate enough Government savings to see 4pc cut to company tax rate
  • Government pushes back release of tax discussion paper to 2016
Scott Morrison has already said changes to superannuation are being considered, and today he took it further, indicating he is interested in a Deloitte Access Economics proposal to make higher income earners pay more on their superannuation contributions.

Policy debate's death by 1000 lobbyists

Date November 14, 2015 - 1:27AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Dr Ken Henry, a former Treasury secretary, says he can't recall a time when the debate about public policies has been poorer. I can't either, and I guess the dreaded MSM - mainstream media - is part of the problem.
But if the challenge of digital disruption has tempted the mainstream to devote more time to political colour and movement and less to debating government policies, there's one respect in which the internet has made things better.
Encouraging unrealistic expectations of tax cuts is only making government more difficult. 
Mike Keating

General Budget Issues.

Headwinds but economy growing: Morrison

By Colin Brinsden, AAP Economics Correspondent
November 8, 2015, 3:41 pm
Treasurer Scott Morrison says the economy is facing a series of headwinds but is still growing.
Treasurer Scott Morrison says the economy is still growing despite facing the strongest possible headwinds.
The economy is facing the impact of reduced commodity prices, a fall in the terms of trade, and the decline in mining investment.
"They were always going to have a very strong impact on our economy, but despite that we are growing," he told Sky News on Sunday.

Budget review just an update: Treasurer

November 8, 20159:15am
TREASURER Scott Morrison has downplayed expectations of his first mid-year budget review.
"MYEFO is a budget update, that's all it is, that's what it has always been, I have no ambitions for it to be more than that," Mr Morrison told Sky News on Sunday.
  • Nov 9 2015 at 9:30 PM
  • Updated Nov 9 2015 at 9:30 PM

OECD cuts Australian growth forecast to 2.6pc from 3pc

Australia's grinding economic performance will continue well into 2017, according to forecasts from the OECD that imply another two years of unemployment above 6 per cent and further delay in the return to budget surplus.
However, in a vote of support for the Coalition government, the Organisation for Economic Co-operation and Development suggested Australia's national tax debate was a potential cause for celebration because it could boost growth.
A shuddering slowdown in global demand for Australia's key resources exports and softer household spending mean the economy's growth rate will remain below average next year, the OECD indicated in its latest economic outlook, released in Paris on Monday.
Only a surprise jump in government spending this year will keep gross domestic product from slowing even more sharply, according to the organisation, which is made up of 30 wealthy countries that discuss and develop economic and social policies including macroeconomics, education and science.

The federal budget is hard to ‘fix’, but here are some solutions

November 11, 2015 6.22am AEDT

Author John Wanna

Sir John Bunting Chair of Public Administration, Australian National University
Why, after decades of relatively good budgetary management in Australia, is the Commonwealth budget so hard to fix? And why don’t many people seem to care?
We have had 24 years of economic growth, yet are now facing our eighth actual deficit in a row, with Budget Papers forecasting another three ahead, and more may come after that.
The combined recent deficits as this budget year rolls out (2015-16) now total a staggering $320 billion (with almost $40 billion still expected in the forward estimates). Moreover, most economic predictions are for much lower economic growth rates well into the future than occurred with the two mining booms of the 2000s to 2012.
  • Nov 10 2015 at 10:30 PM
  • Updated Nov 11 2015 at 8:54 AM

Treasury considers progressive taxation on super contributions

Superannuation contributions would be taxed at 20 percentage points below each individual's marginal income tax rate under a plan being considered by the Coalition government to make the highly paid pay more tax on their retirement savings, and seem fairer to lower and middle-income earners.
Treasury officials have told a range of industry players that the 20 per cent formula would be "revenue neutral", which means it wouldn't raise additional tax to be used to help repair the budget or reduce other taxes.
The change would mean anyone earning above $180,000 would pay super contributions tax of 27 per cent – or 25 per cent once the temporary high income two per cent additional budget levy is removed – rather than the current 15 per cent. Those earning up to $37,000 would pay virtually no super contributions tax.

Health Budget Issues.

4:14pm November 8, 2015

Govt funds 900 medical research projects

New drugs to remove scars and treat ice addiction, depression and pancreatic cancer could become a reality as the federal government pumps hundreds of millions of dollars into medical research.
More than $600 million will be split across almost 900 research projects and 2000 researchers around the country, contributing toward the development of new treatments and cures, Health Minister Sussan Ley announced on Monday.
"Our research workforce is one of the strongest in the world and I have no doubt that through their expertise, talent and creativity, these researchers will make huge advances in improving human health," Ms Ley said.
Cancer research will receive $122 million while $50 million is earmarked for mental health.

Income, literacy emerge as vital to changing health outcomes

  • The Australian
  • November 9, 2015 12:00AM

Sean Parnell

Income and literacy help determine the level of healthcare available to Australians, not just where people live and which doctor they see.
A draft report on variations in healthcare, considered by health ministers on Friday, details for the first time the massive disparities in service delivery across the nation. Some rates reflect the poorer health of a particular community, while others show greater access to doctors and facilities; some suggest a combination of issues that has skewed treatment options.
As revealed by The Weekend Australian , one of the most glaring irregularities was the prescription rate for ADHD drugs in the Taree-Gloucester region of NSW, 75 times higher than for children in the lowest-prescribed area.
The draft was prepared by the Australian Commission on Safety and Quality in Health Care, with help from the National Health Performance Authority and three specially formed advisory groups. It provides the evidence for further investigation and what ministers expect will be a debate over approp­riate levels of servicing.

The case for competition in Australian healthcare

Tax reform is the talk of the town, but when it comes to funding our healthcare system, Health Minister Sussan Ley assures us this week there will be no additional taxes.
Ley says it is a matter of spending our healthcare dollars more efficiently. And no wonder. Expenditure on health care continues to grow and will be over $150 billion this year. Governments will provide around $100bn. We spend around 9.7 per cent of GDP on healthcare, while governments spent around 25 per cent of their tax revenue. Greater efficiency will reduce some of the budget pressure faced by the government.
Therein lies the rub: our healthcare system is less than perfect when it comes to promoting efficiency.
In April this year, the Productivity Commission released a report outlining several areas of inefficiency. The use of health technology assessment, for example, is inconsistent across governments and providers. Our fee for service funding arrangements encourage over-servicing and cost-shifting with no account for quality.

Calculating the codeine cost

12 November, 2015 Meg Pigram 
A new report has revealed proposed codeine rescheduling will cost the federal government $316m annually.
The Pharmacy Guild of Australia-sponsored report, produced by Cadence Economics, analysed the fiscal impacts (and related issues) of moving all codeine-containing medicines to prescription only (S4).
The report reveals that - at a conservative estimate - 53% of patients would visit a GP to obtain codeine-based analgesics. The estimate does not include the MBS cost of any increased GP visits by patients who are no longer able to access codeine containing cough and cold medications without a prescription.
There are 16.4 million purchases of OTC codeine-based analgesics annually and a further 5.2 million purchases of OTC cold and flu medications containing codeine.

Sunday explainer: Does survey signal US-style health system for Australia?

Date November 15, 2015 - 12:15AM

Kate Stanton

The government says it's trying to get better value for money but others fear our healthcare system will become more American.
Health Minister Sussan Ley launched an online survey last Sunday, asking voters what they think about private health cover. She said consumers aren't getting value for their money and called for a review of the private health insurance industry.
But the survey has raised concerns the government is considering US-style insurance reforms that could threaten Australia's universal healthcare system.

Health Insurance Issues.

Federal Government launches public consultation in review of private health insurance

By political reporter Susan McDonald
November 11, 2015
Half a million Australians dropped or downgraded their private health insurance in the last financial year, causing "alarm" for the Federal Health Minister who says consumers are not getting value for money from their policies.
Sussan Ley has launched an online survey that asks voters if premiums should be charged according to a person's smoking status, age, gender or "health risk factors".
"We're not afraid of asking those tough questions," Mr Ley said.
"It's important that we get people's thoughts but I do want to say that I'm really about incentives not exclusions."
However, Labor and the Greens have raised doubts over the Government's plan to potentially take smoking into account, saying it could lead to other risk factors being considered.

Coalition launches private health cover survey, setting sights on 'junk' policies

Health minister Sussan Ley says online survey of expectations will help restore confidence in system as consumers opt out of all-inclusive policies
The federal government has released an online survey on consumers’ expectations of private health insurance. The health minister, Sussan Ley, said expensive “junk” policies had caused half a million Australians to abandon their all-inclusive policies in the last year.
Ley said the survey was aimed at restoring confidence in the private health system, as many policies “let down” patients.
 “In the last 12 months, we have seen 500,000 all-inclusive health insurance policies dumped or downgraded. That is of alarm to me,” she told reporters on Sunday.

Govt To 'Recalibrate' Private Health System, Smokers On Notice

 |  By Sam McKeith
Posted: 08/11/2015 12:21 AEST Updated: 08/11/2015 12:21 AEST
The federal government wants feedback from Australians on the private health industry as it considers a massive overhaul of the ailing sector that could pave the way for smokers to pay more for health cover.
Australian Prudential Regulatory Authority figures released on Sunday show around 500,000 comprehensive health insurance policies were downgraded to policies with hospital cover excluding certain medical services in 2014-15.
The number of consumers with inclusive cover has fallen to 3.5 million, the government claims.
Health Minister Sussan Ley is undertaking a wide-ranging review of the troubled sector, with moves under consideration said to include smokers paying extra for health fund premiums.

Ley defends insurance proposal for smokers

November 8, 2015 5:31pm
HEALTH Minister Sussan Ley has hit back at claims she's "in the pocket" of private health insurers after floating a proposal to charge smokers higher premiums.
THE idea has been put to consumers in an online survey, which will inform the federal government's promised shake-up of the private health insurance system.
It's also asking consumers whether they think different premiums should be charged based on age, gender and lifestyle factors such as obesity.

Private health insurance for GP care will widen the gap between rich and poor

Date November 8, 2015 - 7:12PM

Julia Medew

Health Editor

While asking Australians to share their views on private health insurance on Sunday, Health Minister Sussan Ley said she was committed to preserving universal access to healthcare.
Private health insurance, she said, should be seen as a complement – not a substitute – for services.  
"It's important we're able to ask consumers what they expect from their private health insurance and there's plenty of room to do that without moving towards US or UK models that exclude sick people and make it only available to the rich, which we don't support," Ms Ley said in a press release.

Radical reforms to health insurance flagged by Turnbull Government

Date November 9, 2015 - 9:36AM

Julia Medew

Health Editor

Streamlining private health insurance

The government wants to put 'consumers first' and to cut 'inefficient regulation' says Health Minister Sussan Ley. Courtesy of ABC News.
Private health insurers would be allowed to cover GP visits and common tests such as X-rays under radical reforms being canvassed by the Turnbull government that would shift Australia towards a more US-style health system.   
Health policy experts say the move, flagged in a government survey of Australians about private health insurance, would reduce pressure on GPs to bulk bill their services at the Medicare rate of payment, inflating prices for patients.   

Aged and confused: why the private health insurance industry is ripe for reform

November 10, 2015 6.20am AEDT

Author  Stephen Duckett

Director, Health Program, Grattan Institute
Among a number of reviews announced by Health Minister Sussan Ley is a comprehensive review of private health insurance. This will include consultative round tables for industry, consumer groups and academics, as well as a survey designed to gather consumer opinion about health insurance policy.
The survey, which opened yesterday, has generated extensive commentary over whether private health insurers should be able to vary their premiums to charge more based on member characteristics such as age, gender and smoking status.
But there are other questions that ask about the consumer experience of health insurance, which may be the most productive area for reform.

Cosmetic surgery rules may face federal facelift

  • The Australian
  • November 10, 2015 12:00AM

Sean Parnell

Cosmetic surgery clinics may face further commonwealth scrutiny after three cases in NSW this year in which patients suffered serious adverse events.
The Australian understands federal Health Minister Sussan Ley was expected to ask the Council of Australian Governments Health Council last week to support a review of legislation governing cosmetic surgery to consider whether safety and quality laws could be improved.
However, the formal communique from the meeting did not mention the issue and a spokeswoman yesterday declined to comment.
With the Australian Society of Plastic Surgeons demanding nationally consistent guidelines on cosmetic procedures, the Medical Board of Australia is considering whether patients should have a cooling-off period, more information on the practitioner’s qualifications and experience or, for under-18s, a pre-treatment psychiatric or psychological assessment.

Should health insurers pay for GP visits?

Paul Smith and AAP | 9 November, 2015 | 7 comments Read Later
Private health insurers could be free to cover GP visits, pathology tests and imaging in an attempt to shore up insurance policies described by the Federal Government as “junk”.
Health minister Sussan Ley (pictured) launched a “national public consultation” on Sunday claiming it would help show how private insurers can offer better value for their products.
She said official figures had revealed some half a million ‘all inclusive’ policies were dumped or downgraded last year — despite the government spending $6 billion subsidising the industry.
The survey asks whether premiums should be different for those at high risk of needing healthcare — not just smokers but also the elderly or based on the policy holder’s gender (see box below).

NIB CEO Mark Fitzgibbon says smokers should pay higher health insurance premiums

Date November 10, 2015 - 7:59AM

Julia Medew, Jane Lee and Marc Moncrief

Smokers should be charged higher fees for health insurance under a trial that could pave the way for overweight people to also be charged more, the CEO of one of Australia's largest insurers says.
Just weeks after the Turnbull Government announced that one million Australians would next year take part in an "opt out" e-health trial that would allow their medical records to be shared with third party companies, the head of NIB Mark Fitzgibbon said there was potential for insurers to get involved.
He said while higher premiums for smokers should come first, people could be rewarded for healthy behaviours such as achieving 10,000 steps a day on activity trackers.

Health fund premiums could more than double under reforms

November 10, 20155:17pm
Sue Dunlevy News Corp Australia Network
ELDERLY Australian couples would see their health fund premiums more than double to $6300 a year if Australians opt for a risk-rated system under government reform options.
And women of child bearing age could also pay more because their costs are higher.
The federal government is asking Australians in an online survey to comment on whether health fund premiums should be varied according to age, gender, smoking and health status as it considers reforms to the industry.
The survey says average hospital benefits paid by health funds for the over 70s are $3360 per year compared to just $440 a year for those aged 20-24.

No health fund gouging say doctors

  • AAP
  • November 13, 2015 12:25PM
HEALTH insurance funds can't be allowed to get away with gouging consumers on premiums and prices, Australian Medical Association president Brian Owler says.
DR Owler says the funds need to return to their core business of insuring for in-hospital services, not for ancillary or allied health services or unproven alternative therapies.
He acknowledged there needed to be a strong private health insurance sector.
"But we also need to make sure that they live up to their end of the bargain, that we don't see insurers gouging in terms of premiums and prices," he told ABC radio on Friday.

Families hit with health cover rise as government subsidy cut adds to health insurance woes

November 13, 20158:56pm
Sue Dunlevy News Corp Australia Network
EXCLUSIVE: The government subsidy for health insurance will shrink to just 25 per cent next year, which means premium rises will burn an even bigger hole in your pocket.
Originally worth 30 per cent of health fund premiums, the subsidy fell to 28 per cent this year and is on track to fall to 25 per cent next year in a cut that will cost families with top cover more than $200, and singles $100.
A family on medium cover will pay $159 extra as a result and singles $78.
Health Minister Sussan Ley said the “true pain” of Labor’s cuts to the value of the rebate were only now being felt.
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.
The explainer on the US Health System is especially useful. Well worth a read if you are not across the differences.
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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