Thursday, February 11, 2016

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

February 11 Edition
Here is some other of the recent other news and analysis.
Clearly the big news in the last few weeks has been macroeconomic.
In the last week we seem to be having a significant change for the worse with huge losses now being recorded by the large oil companies for the last quarter of last year (and the oil price has fallen further since) and increasing concern that the effects of the low oil price will impact further.
Out of the blue we now see a continuing bun-fight on health insurance costs. Will be fun to watch.
In breaking news it is now seeming that changes to the GST are increasingly unlikely (Prime Minister on Insiders 7/2/2016)
Here is a summary up until the end of last week:

General Budget Issues.

Dear central bankers, it's time to try something new

Eight years of pumping up markets has failed to deliver, so maybe it's time for central bankers from Beijing to Frankfurt to stop running the same failed experiment ad nauseam, writes Ian Verrender.
Albert Einstein would have made a lousy central banker.
He may have been OK with numbers and pretty nifty when it came to theories relating to matter and energy. But his inability to doggedly persist with proven failed strategies would have raised red flags among the financial elite.
"The definition of stupidity is doing the same thing over and over again and expecting different results," he's reputed to once have said.

Real challenges are ahead for Turnbull and Shorten

  • The Australian
  • February 1, 2016 12:00AM
The scales should fall from the eyes of both Malcolm Turnbull and Bill Shorten as parliament resumes this week and they confront the same realities but face different challenges.
After almost five months as Prime Minister, Mr Turnbull has set a new tone but is yet to deliver the substance required to benefit the nation and ensure his medium-term political success.
Today’s Newspoll results show sustained goodwill from the electorate, with a primary vote that would ensure a resounding Coalition win, but there are warning signs, too, especially on the fiscal reform agenda. The Opposition Leader, on the other hand, can see that while voters are reticent to give Labor a second chance, there is encouragement for his reflexive campaign against a mooted increase in the GST.

Mike Baird's new GST plan cuts company tax to 25% and income taxes by 7%

There’s yet another new GST plan on the table, and this time it answers the concerns of federal Treasurer Scott Morrison.
NSW Premier Mike Baird, who last year proposed increasing the GST to 15% in order to pay for looming health and education cost shortfalls in state budgets, has announced a refreshed plan that includes significant cuts to the company tax rate and personal income taxes.
Morrison has flagged his desire to cut both taxes, especially income tax, in any scenario involving an increase to the GST rate.
Baird’s updated proposal, which would raise $32.5 billion in extra revenue in its first year, would involve giving $8 billion in compensation to lower-income households to make up for increased prices. After that, Baird says Canberra could spend $8 billion cutting the corporate tax rate to 25%, and then $16 billion to reduce all income tax brackets by 7 percentage points.
  • Feb 2 2016 at 11:45 PM
  • Updated Feb 3 2016 at 5:25 AM

Malcolm Turnbull's Swedish solution to lift the GST and balance the budget

Malcolm Turnbull needs to balance both economic and fiscal reform. Following Sweden could help win a mandate for tough changes.

Here's something that just might help the Turnbull government.
As everyone knows, the success of Malcolm Turnbull's prime ministership depends on his being able to persuade voters to accept difficult economic and fiscal reform at a time of elevated unemployment and uncertain economic growth.
The reform can be spread over several years to minimise the adjustment cost – a luxury available to low-debt countries – but the mandate must be won from voters this year.
One survey in which 37 per cent of respondents were open to consider an expanded GST – one component of the required reform – may be an encouraging start, but that's all it is. The cat is still a long way from being in the bag.
  • Feb 3 2016 at 1:11 PM
  • Updated Feb 3 2016 at 6:42 PM

PBO finds Canberra to blame for 80pc of budget slide

About 80 per cent of the collapse in Commonwealth and state government budgets over the second half of last year has been due to the federal government, according to the independent Parliamentary Budget Office.
Warning that the nation's fiscal outlook has "deteriorated significantly" since state, territory and Commonwealth levels of governments handed down their 2015-16 budgets, the PBO said the combined deficit has jumped 28 per cent, or by $34.1 billion, to $122.1 billion over four years.
The independent adviser to political parties and independent MPs also ramped up its alarm about the risks facing the nation, including the recent jitters over global growth as a major concern.

Malcolm Turnbull says states must lift taxes to share rising health costs

The prime minister questions whether increasing the goods and services tax will boost economic growth once compensation and tax cuts are taken in
The prime minister, Malcolm Turnbull, in Canberra yesterday. He says the states must share rising cost of health funding. Photograph: Mick Tsikas/AAP
Lenore Taylor, Political editor
Malcolm Turnbull has demanded state governments increase their own taxes – such as land tax or payroll tax – and run health systems more efficiently to share the cost of the looming hospitals funding crisis.
After a week in which the government has appeared to cool on the idea of increasing the goods and services tax, and backbenchers have openly criticised the idea, Turnbull used an interview with Adelaide radio to talk up the complexities of the move and reinforce the growing perception that he is unenthusiastic about it.

Paul Keating: forget taxing, budget can lose $90bn

  • The Australian
  • February 5, 2016 12:00AM

David Uren

It should be possible to strip $90 billion out of the federal budget — a cut of 20 per cent — Paul Keating claims, based on his achievement as treasurer through the late 1980s.
The former prime minister said yesterday that the burning issue should not be taxes but rather how to adjust the budget to the reality that the income the world was paying us had fallen, and this was cutting both personal and company taxes.
“All these things are pushing down on commonwealth revenue and, when it has been so affected, the penny ought to drop that we ought to be cutting spending,” he said, noting that Scott Morrison was correct to highlight this.

Turnbull says no GST rise unless it can help economy

  • The Australian
  • February 7, 2016 2:02AM

GST increase speculation continues

Malcolm Turnbull has reiterated his doubts the Coalition government should fight this year’s federal election with a GST increase in its platform, adding the government would not seek to raise or widen the 10 per cent consumption tax without putting it to voters.
That could mean any further consideration of a GST increase would have to wait until the election due in 2019. But he left open the possibility of reductions in income tax rates.
He told The Sunday Telegraph the governing MPs would want to be convinced by Treasury before the May budget that a GST increase would foster economic growth before possibly agreeing to adopt it.

Health Budget Issues.

Health in 2016: a cheat sheet on hospitals, Medicare and private health insurance reform

February 1, 2016 6.05am AEDT

Author Stephen Duckett

We start 2016 as we started 2015 – with big challenges for the health system and uncertainty as to how governments will meet them.
The health care headaches in 2016 are, in fact, the same ones we faced a decade ago, albeit different in severity and symptoms. They include population growth, ageing and the rise of chronic disease; inequality in access to care and health outcomes; technological change (the good, the bad and the expensive) and the seemingly inexorable rise in health costs.
Circling for landing are three major reviews on private health insurance, primary care, and low-value care. Their recommendations, and the government’s response to them, are very much up in the air.
Adding to the uncertainty is the broader review of federalism and its consequences for public hospital funding, along with speculation around the 2016 federal election date and what each party’s Santa sack of election promises might contain.

Health expenditure grows year on year to $6248 per person

Date February 2, 2016 - 8:30PM

Jane Lee, Julia Medew, Harriet Alexander

The public cost of Australian health care has grown about four per cent per year over a decade to $6248 per person, a report says.
The Productivity Commission's report on health services on Tuesday showed that the amount that federal, state and territory governments spent on health grew from $4788 per person in 2004/5 to $6248 per person in 2014. This was not due to either inflation or population growth rates, which were both factored in to the results.
Public health experts said the growth was driven by a range of factors, including medical advances, the ageing population and an increase in people suffering chronic illnesses.
It comes as the fight over how health funding should be shared between federal, state and territory governments rages on, with NSW Premier Mike Baird pushing for a rise in GST to cover Abbott-era cuts to hospitals and schools.

Ley to tackle medical device pricing quirk

February 5, 20166:13am
Ley to tackle medical device pricing quirk
The federal government will move to fix up a quirk that makes medical devices more expensive in the private health system compared to the public one.
Health Minister Sussan Ley said there were fixed price benefits that private health insurers are required to pay on behalf of customers for more than 10,000 devices including pacemakers, pins and plates.
Under the public system there is no set price and greater competition around purchasing, so private health insurers are often paying twice as much for medical devices, which is then passed on to patients through higher premiums.

Prostheses list costing patients an arm and a leg

  • The Australian
  • February 5, 2016 12:00AM

Sean Parnell

Excessive prices for replacement hips, pacemakers and other medical devices in the private hospital sector — adding $800 million a year to health spending — have prompted a federal government review expected to reduce pressure on insurance premiums.
The Prostheses List, which the government uses to regulate how much health funds have to pay for prosthetics, human tissues and device implants, will be re­designed and renegotiated by the stakeholders who use it.
Health insurers have long complained that the list has them paying well in excess of what public hospitals pay for comparable items, let alone the cheaper prices available overseas, and believe hundreds of millions of dollars could be saved each year.
The Australian Competition and Consumer Commission has also received allegations of ­private hospitals receiving kickbacks — allegedly sourcing items at a cheaper rate and pocketing the difference — while the Har­per review identified potential for “very substantial efficiencies”.

Public health needs a jab of private productivity

  • Jeremy Sammut
  • The Australian
  • February 5, 2016 12:00AM
Since the 2013 election, the ­national conversation has been dominated by calls to revive the mojo of the 1980s and undertake economic reform to repair government budgets. Yet according to some analysts, South Australian Premier Jay Weatherill’s plan to raise the GST to fund public health and education services is “doable”.
The real question, however, is whether we should do this kind of so-called “tax reform” at all.
Public hospitals and public schools are the two areas of the public sector that have remained largely quarantined from the reform agenda of the past 30 years. Opening other government utilities — such as electricity, ports and transport — to competition and privatisation has improved performance in those crucial areas of the economy. But social services such as hospitals and schools, which consume huge amounts of government expenditure, continue to be sheltered from reform and propped up by taxpayers.

How much is Sussan Ley spending on GP care?

Paul Smith | 3 February, 2016 | 14 comments Read Later
The cash spent by the Federal Government on GP care for each Australian rose by $10 last year — despite ministerial claims future funding is unsustainable.
Figures released on Tuesday by the Productivity Commission showed that the government spent $351.30 on GP care per person in 2014/15.
It was a 2.9% increase on the $341.50 spent per person the year before.
The Report on Government Services said the figures included the money for the Practice Incentives Program and the now-defunct Medicare Locals.

Health Minister Sussan Ley targets $800m medical devices waste

Date February 5, 2016 - 11:29AM

Tim Binsted

Health Minister Sussan Ley has pledged to root out exorbitant pricing of medical devices in private hospitals, which wastes up to $800 million a year, in order to halt surging health insurance premiums.
The Minister said on Friday that reform of prostheses, which includes things like hip and knee replacements, plates and pacemakers, has been made a "priority" to complement the federal review into private health insurance.
"When it comes to medical devices, the first priority always needs to be ensuring they are accessible to patients and safe. But a key part of making sure they are accessible is also making sure they are affordable," she said.

Health Insurance Issues.

Health insurers urge action on costs in return for lower premiums

Date January 31, 2016 - 4:15PM

Tim Binsted


Federal Health Minister Sussan Ley needs to crack down on the surging cost of healthcare if she will not accept requested insurance premium increases, health insurers say. 
Ms Ley wrote to private health insurers on Friday asking them to lower their 2016 premium increases – understood to be about 5 to 6 per cent – or to justify them with further information.
"I request that you rework your application to propose a premium increase lower than was previously submitted," Ms Ley wrote.

Sussan Ley whacking insurers won’t bring premiums down

  • Terry Barnes
  • The Australian
  • February 2, 2016 12:00AM
Everyone knows the joke about why everyone takes an instant dislike to lawyers. Because it saves time.
It’s a joke that equally applies to private health insurance. Half the Australian population has it, and grumble about their PHI coverage and the annual premium rises that are as predictable as the sun rising. The other half doesn’t have PHI, but decry the billions of dollars they see wasted on the private health sector that should be directed to the public system, and especially overstretched public hospitals.
Premiers, as well-off people with their own private health insurance but struggling to contain the cost of their hospitals, straddle both camps.
By a quirk of Howard-era holdover, PHI premiums have to be approved by the federal health minister.
  • Feb 1 2016 at 5:05 PM
  • Updated Feb 1 2016 at 9:05 PM

Sussan Ley's attack on health premiums favours big funds, threatens non-profits

Health Minister Sussan Ley's crackdown on health insurance premium increases threatens the viability of smaller funds and may help big players such as Medibank and Bupa take over their smaller competitors, non-profit funds say.
Ms Ley, who is overseeing a review of the $19 billion private health insurance sector, wrote to health funds on Friday asking them to either lower their requested premium increase or justify their initial request.
"Putting the blame on us might get the minister some good headlines, but it could do long-term damage to the industry and force health funds to the wall," said Matthew Koce, spokesman for the not-for-profit Australian Health Service Alliance and chief executive of non-profit fund lobby group HIRMAA.
"Some funds might decide to fold and leave the marketplace or consolidate with others."

Healthcare insurers queried by Susan Ley over premium increases

  • The Australian
  • February 2, 2016 12:00AM

Sarah-Jane Tasker

Australian health insurers, forced to working on new premium-increase submissions by Health Minister Sussan Ley, expect the federal government to also attack “more obvious” causes of cost escalation.
The minister wrote to health insurers on Friday, more than two months after they had submitted their premium-increase wishlist, telling them to rethink what they were seeking.
In the letter, seen by The Australian, Ms Ley said she was determined to ensure that premium increases were the minimum necessary to maintain insurer solvency requirements, support benefit outlays and meet prudential standards, while also ensuring private health insurance remained affordable and good value for consumers.
She told insurers to propose premium increases lower than what they had previously submitted and asked they take into account their capital adequacy and prudential and solvency requirements.

Mind the gap

Cathy O'Leary
February 4, 2016, 1:10 am
WA’s biggest health fund has warned that moves to block premium rises could lead to bigger gap payments for patients.
HBF managing director Rob Bransby said it was a false economy for the Federal Government to reject applications for increases on the basis it would be better for consumers.
Health Minister Sussan Ley last week ordered health funds to reduce or justify their planned premium increases, arguing consumers were finding it more difficult to shop around for a better deal.
HBF, which has 60 per cent of the private insurance market in WA, confirmed yesterday it would not back down from its original proposal but would not reveal the amount it was seeking.

Health funds demand surgeons swear work’s not purely cosmetic

  • The Australian
  • February 4, 2016 12:00AM

Sean Parnell

Australia’s two largest health funds are demanding doctors sign declarations before performing certain surgery on members to prove it is clinically necessary and deserving of benefits.
Amid debate over rising health costs, Medibank Private and Bupa are requiring signatures for procedures they suspect might be ­merely cosmetic even though the doctor is claiming Medicare rebates on the basis they are needed.
Australian Society of Ophthalmologists president Michael Steiner said yesterday surgeons who operated on eyelids and the tear-duct system were booking in procedures, only for the funds to question their decision-making.
Dr Steiner said Medibank Private and Bupa initially had used pre-approval forms, which the ­society deemed illegal, but last month adopted the same pre-­eligibility forms. He said he knew of several cases where surgery had been cancelled because the surgeon refused to sign, including that of an elderly patient who had travelled three hours to hospital.

AMA accuses private health funds of labelling surgeries as cosmetic to avoid pay-outs

The Australian Medical Association (AMA) has accused private health funds of refusing to pay out some legitimate claims by categorising them as cosmetic procedures, in what they say is a dangerous move in the direction of a US-style health system.

Key points:

  • AMA accuses private health funds of refusing to pay out some legitimate claims
  • Concern it is a dangerous step towards a US-style health system
  • Medibank says certain codes used in hospitals classify procedures as cosmetic and funds must check before paying
Two of Australia's largest funds, Bupa and Medibank, have begun asking surgeons to sign declarations about the nature of their procedures to determine whether they are a cosmetic procedure or not.

Non-smokers worth bonus, say doctors

Kim Macdonald
February 5, 2016, 12:50 am
The Australian Medical Association WA has suggested no-claim bonuses for non-smokers who take private health insurance.
State president Michael Gannon said the move would help address disillusionment with health insurance premiums that are rising about four times faster than Perth’s 1.5 per cent annual inflation rate.
He said “25 years of rolled-gold health warnings” about cigarettes meant anyone born after 1960 should know better than to smoke.
However, he stressed he would not support risk rating on any other grounds because it could discriminate on gender, ethnicity or genetic dispositions to illnesses.
He said premium increases of 6, 7 and 8 per cent year a year were unsustainable, especially when patients questioned the value of their premiums for other reasons.
Health is also clearly still under review as far as its budget is concerned with still a few reviews underway and some changes in key strategic directions. Lots to keep up with here with all the various pre-budget kites being flown! Enjoy.

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