Thursday, March 17, 2016

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

March 17 Edition
The macroeconomic stresses seem to have eased a little more with markets rising around the world.
In Australia, things are also looking up for the present. However we also are now see a set of continuing bun-fights on pathology funding, health insurance costs as well as negative gearing and superannuation. Will be fun to watch. Mr Trunbull and Mr Morrison seem to have disappointed with the lack of a clear plan.
Three weeks ago we heard there would be a before the Budget announcement of  tax proposals so that will happen soon. Now we are hearing the Budget date may move and we might have an early election. Stay tuned!
Here is a summary of interesting things up until the end of last week:
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General Budget Issues.

Time to take a stand against misleading modelling

Date March 7, 2016 - 6:16AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Call to end misuse of economic modelling

The Australia Institute wants a code of conduct introduced for economic modelling following the BIS Shrapnel report into negative gearing.
Many people have been left with red faces following their part in last week's disastrous intervention into the negative-gearing debate by forecasters BIS Shrapnel. Let's hope they all learn their lesson.
This isn't the first time that "independent" modelling purchased from economic consultants has been used by vested interests to try to influence government decisions. Nor the first time the questionable results have been trumpeted uncritically by the media and misrepresented by the side of politics whose case it happens to suit.
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From tax feast to tax famine

Shane Wright, Economics Editor, COMMENT
March 7, 2016, 9:07 am
COMMENT: Five months ago everything was on the tax table. The smorgasbord offered every tax delicacy imaginable. From a gorgeous suckling GST to a wafer of brandy excise, the table was groaning under the weight of scrumptious options.
Malcolm Turnbull and Scott Morrison gazed upon the spread with wide-eyed wonder as they weighed up whether to be careful with their calories or dive straight into heart attack-threatening tax meals.
Five months on and the table offers little nutrition.
The Prime Minister and the Treasurer are looking at a bowl of thin gruel and hoping they might get a second helping.
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  • Mar 7 2016 at 6:12 PM
  • Updated Mar 8 2016 at 5:54 AM

Early budget talk increases as election options narrow

Bringing forward the federal budget by a week remains a live option being considered by the Turnbull government as it narrows the possibilities for a federal election to either a double dissolution on July 2, or a half-Senate election in August.
Either date for an election would still leave the government – if it won – enough time to then organise and hold a plebiscite on same-sex marriage before the end of the year.
Treasurer Scott Morrison said on Monday that the outcome of the plebiscite would be binding on the Parliament and he would be using his status to argue against legalising same-sex marriage.
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  • Mar 8 2016 at 7:20 PM
  • Updated Mar 8 2016 at 7:20 PM

Business Council tax reform fit for purpose

Catherine Livingstone and Jennifer Westacott at the Business Council of Australia have provided a workable framework for tax reform, but their core demand for cutting the corporate tax rate will struggle to gain political traction.
Livingstone and Westacott were smart to abandon the very ambitious tax reform package put forward last year during a summit that pre-dated the demise of the Abbott government.
They released a new strategy on Tuesday, which involves relatively modest changes at first, with the big personal and corporate tax reforms put off for five years and changes to the rate and/or base of the GST for about a decade.
Even though the corporate tax cut target is a modest one the fact is corporate tax cuts are an extremely hard sell.
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Iron ore spike a boost for govt budgets

Shane Wright, Economics Editor
March 8, 2016, 6:12 am
The nation’s miners and the Federal and WA governments may have their bottom lines saved after a surge in key commodity prices overnight led by iron ore.
The spot price of iron ore enjoyed its single largest jump on record, leaping by $US10.20 a tonne or more than 16 per cent to hit $US62.20 a tonne.
It was the fifth consecutive daily lift in the price of Australia’s most important export and followed signs out of China that authorities there are planning a stimulus program to underpin the local economy.
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Risks for Malcolm Turnbull in July 2 double dissolution election

  • The Australian
  • March 9, 2016 12:00AM

Paul Kelly

The idea of a July 2 double dissolution election is generating its own momentum, with the Turnbull government actively preparing this option — yet it is plagued with immense difficulties that would add dangerous unpredictability to this decision.
In recent days the government has been consumed by a tactical uncertainty. This is superimposed on the confusion over taxation policy. Labor takes great heart from two successive Newspolls showing a 50-50 split. Malcolm Turnbull struggles to impose order and discipline on his ranks.
Meanwhile the government is even confused about the list of bills that would provide grounds for the double dissolution election, a somewhat critical point. Some cabinet ministers peddle the nonsense that surrender of the pivotal Australian Building and Construction Commission bill from the list — thereby abandoning any guarantee of its passage post-election — will not be a major campaign embarrassment.
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  • Mar 10 2016 at 9:30 PM
  • Updated Mar 11 2016 at 5:52 AM

Morrison doesn't plan to spend any iron ore windfall

Every dollar from a rebound in the iron ore price will be used to reduce the deficit, not spent on election bribes or boosting what are now looking to be meagre tax cuts.
Amid fears the extra tax revenue could be obliterated by global financial market volatility, senior sources told The Australian Financial Review that ministers should not bother putting their hands out for some of the extra revenue, which could be as much as $15 billion over four years.
The iron ore price, which recorded its biggest increase ever on Monday, remained volatile, could not be relied on over the long term and to do anything with any extra money other than reduce deficit would be "completely stupid",' said a senior Coalition figure.
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Centrepiece of Tony Abbott's last budget fails to deliver promised economic 'turbo-boost'

Date March 12, 2016 - 8:45PM

Gareth Hutchens

The former prime minister tells Sky News he advised Tony Abbott that Peta Credlin should have been removed.
The small business package central to Tony Abbott's final budget does not seem to have delivered the promised turbocharge to Australia's economy.
The so-called "Tony's Tradies'' package, which is set to cost the budget $5.5 billion over four years, was designed to provide a platform for the Abbott government's re-election plans. 
It included a cut in the small business tax rate of 1.5 per cent, and the ability for companies with revenue under $2 million to claim an unlimited number of tax deductions for items that cost less than $20,000 each.
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Health Budget Issues.

All the dumb things: If it doesn't work, don't just try it again

Date March 6, 2016 - 9:23PM

Tim Dick

Columnist

Of all the many dumb things Australians insist on doing which do not work, invasive surgery is the hardest to fathom. Why would you have a surgical intervention to fix tennis elbow if that fix is no better than time?
A new book by orthopaedic surgeon Ian Harris shows how common it is for people to ignore evidence and demand surgery. People prefer to have an expensive operation to inject stem cells into their arthritic knees, even though a placebo makes people feel just as good.
Surgery, the Ultimate Placebo reports that some 6 million unnecessary caesareans are performed each year around the world. It reports that removing the appendix can be worse for the patient than treating appendicitis with drugs, yet few patients opt for the drugs.
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MEDIA RELEASE
Monday, 7 March 2016

A primary solution to Australia’s greatest health problem

The time is ripe for Australia to adopt more effective measures to prevent and treat chronic and complex disease in the community through reforms that would save lives and many millions of dollars, a new report from the Grattan Institute has shown.
“Our greatest health challenge in Australia – reducing chronic disease and treating it more effectively -  is well within our capabilities and what it requires is smarter, better use of existing workforce, financial incentives and infrastructure rather than huge amounts of new spending,” says Consumers Health Forum CEO, Leanne Wells.
“The health debate has to shift away from its preoccupation with hospitals and hospitals financing to fundamental, lasting reforms that are in the long term interests of consumers, taxpayers and a sustainable, responsive, affordable health system – that means investment in a stronger, integrated primary health care system”.
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Avoidable hospital visits cost more than $320 million per year

Date March 7, 2016 - 10:30PM

Anna Patty

Workplace Editor

Failure to prevent illness and better manage chronic heart disease, asthma and diabetes is costing more than $320 million a year in avoidable hospital admissions, a national report has found.   
The Grattan Institute found GPs provide only half the care recommended for patients with chronic conditions.
Of the nearly one million people with type 2 diabetes, only one-quarter are properly monitored and treated.
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Daniel Andrews demands care fund payback

  • The Australian
  • March 8, 2016 12:00AM

Rick Morton

Victoria is owed tens of millions of dollars raised by the increase in the Medicare Levy which it says was promised by Tony Abbott before his government was rolled, adding another layer to a national squabble that threatens the $22 billion disability insurance scheme.
Victorian Premier Daniel ­Andrews has written to Malcolm Turnbull following Friday’s icy disability ministers meeting demanding money from the Disability Care Australia Fund but rejecting an offer to share more of the financial risk of cost overruns.
Victoria was to have received at least $44 million from the DCAF fund in 2016-17, $45.6m the next year and $129.7m in 2018-19.
“The Victorian government’s strong commitment to the scheme is evidenced by our willingness to quickly reach agreement on transition arrangements with the commonwealth to give certainty to clients (and) the sector,” Mr ­Andrews wrote.
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Painful fees at heart of health reform push

  • The Australian
  • March 10, 2016 12:00AM

Sean Parnell

Privately insured patients being lumbered with high out-of-­pocket costs — which in some specialties average $2000 for just one item on a hospital bill — have prompted Health Minister Sussan Ley to focus key reforms on “empowering” consumers.
Ahead of insurance premiums rising by an average of 5.59 per cent next month, and amid concerns over policy coverage and the impact of restrictions and ­exclusions, new data reveals the biggest gap fees after Medicare ­rebates and health fund contributions are taken into account.
Specific Medicare item numbers in plastic and reconstructive surgery — such as eyelid pro­cedures and removal of tissue — carried the highest average gap in the December quarter of $1960.
The Australian last month revealed that Medibank Private and Bupa had sought to contain costs by asking doctors to sign a declaration before surgery that the procedures were clinically necessary and not purely cosmetic.
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AMA calls for urgent health funding as Nepean and Wagga Wagga hospitals reach breaking point

Date March 10, 2016 - 3:15PM

Harriet Alexander

Hospitals are limiting surgery hours and forcing patients to wait longer for elective procedures as an "economic disaster" looms for them, doctors have warned.
The Australian Medical Association is calling for an urgent injection of funds for public hospitals, which will come under increased pressure from next year when annual funding increases that had been promised are severed.
The call comes as hospitals in western Sydney and rural NSW claim they are at breaking point.
Nurses at Wagga Wagga Hospital have said they will have to suspend elective surgery unless the state government closes beds that have not been funded.
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Pathology co-payment ‘to cover bulk billing cuts’

  • The Australian
  • March 11, 2016 12:00AM

Sarah-Jane Tasker

St John of God, a not-for-profit health organisation, will introduce a co-payment of up to $50 for pathology services, warning that bulk billing had become “unsustainable” under the government’s funding model.
Australia’s fourth largest pathology provider this week launched a co-payment pilot in select areas in Western Australia and Victoria before planned government cuts to bulk billing incentives.
Michael Hogan, chief executive of St John of God’s pathology division, said if the proposed bulk billing cuts came into effect in July, it could push small and independent providers to close.
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Human cost of $57 billion in federal government hospital cuts exposed

March 11, 2016 12:00am
Sue Dunlevy National Health Reporter News Corp Australia Network
IF you are waiting for eye surgery, a hip replacement or a colonoscopy get yourself a comfortable chair because the already long queue is about to get longer.
Public hospitals will lose more than a $1 billion in federal funding next year — the equivalent of employing 20,000 fewer nurses or providing tens of thousands fewer hip replacements and heart bypass operations.
And over the next eight years those federal budget cuts will amount to $57 billion.
Already one in 10 patients are waiting over 250 days to get into a hospital for elective surgery.
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$2.7 billion dental program likely to get the chop, say dentists

Date March 12, 2016 - 1:09PM

Julie Power

Reporter

A $2.7 billion dental program that has provided 1 million Australian children with free dental care could face the chop in the next budget, warns Australia's peak dental body. 
As a result of the two-year-old program, many children who have never seen a dentist before are presenting with decayed teeth requiring holes and extractions, say dentists.
More than a million children – far fewer than the anticipated 3 million – have received care under the means-tested scheme since it was introduced in 2014 by the Coalition. Nearly all those children had been bulk-billed, and 80 per cent were treated by private dentists.
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Health Insurance Issues.

Inquiry into why private patients are being charged double the cost for medical devices

March 7, 2016 3:37pm
Brad Crouch Medical reporter The Advertiser
PRIVATELY insured patients are being charged up to double the cost for medical devices compared to public patients, adding to pressure on health premiums according to federal Health Minister Sussan Ley.
Speaking in Adelaide, Ms Ley said she had ordered an inquiry into the cost of prosthetics including knee and hip devices which she hoped would lead to easing pressure on private premiums.
She said the situation was “clunky” as she wanted to ensure the highest standard of medical devices and also not deter entrants to the markets, while at the same time ensuring such devices were affordable and accessible.
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Think you’re safe with insurance? Think again

March 10, 2016 12:01am
Jane Fynes-Clinton News Corp Australia Network
Insurance companies are promoted as white knights, there to help when things go awry.
Buy a policy and you buy compassion and concern because they are there for us in our times of need, the warm and fuzzy TV ads and literature suggests.
What a load of bunkum.
Just ask the poor souls treated abominably by CommInsure as shown on Four Corners this week.
Even those that claim to be all for the members are businesses, pure and simple — slow, indifferent, uncompassionate businesses.
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NSW government pushes for private insurance to cover GP visits

Date March 10, 2016 - 7:32PM

Harriet Alexander

Health Reporter

The NSW government is proposing a greater role for private insurance in primary care.
The NSW government will advocate to allow private health insurers to cover visits to general practitioners, in what would significantly extend the power and reach of the industry.
A submission to the federal government's review of the private insurance industry advocates a greater role for private health insurance in primary care, particularly to manage people with chronic conditions and prevent them from going to hospital.
Critics have warned that allowing private health insurers into GP practices will create a "two-tier system", because those with private cover will get longer consultations and preventative care, while those who cannot afford it will get more superficial treatment.
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The surgeons charging ten times the Medicare fee

March 13, 20167:21am
Sue Dunlevy News Corp Australia Network
EXCLUSIVE
SOME surgeons are charging ten times the Medicare fee leaving patients with gaps of up to $17,000 that makes their health insurance almost worthless.
And News Corp has been told some doctors are rorting heath fund no gap schemes by charging patients secret extra fees in the form of booking fees or second invoices.
Health fund peak body Australian Private Health Care has confirmed its aware of health funds who have taken action against doctors for “inappropriate billing”.
The problem is so bad the Royal Australasian College of Surgeons (RACS) has set up a new fee conduct committee with the power to sanction high charging doctors.
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Pharmacy Issues.

Grattan primary care report is 'right up our alley’: Guild

7 March, 2016 David Rowley 
A report that criticises Australia’s primary healthcare system shows there is much community pharmacies can do to help, says the Pharmacy Guild.
Although the Grattan Institute report doesn’t focus specifically on community pharmacy, “it is certainly a useful source document for those of us who believe community pharmacies could and should do more”, says a Guild spokesperson.
The report titled Chronic Failure In Primary Caresays more than 250,000 hospital admissions a year could be avoided with better primary care for chronic health problems.
It says only 15% of diabetes patients have their blood glucose, weight and blood pressure measured by their doctor each year and just 30% have adequately controlled cholesterol.
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Direct-to-consumer S3 advertising: it’s time

It’s time to get serious about direct-to-consumer advertising of S3 products, says Dr Deon Schoombie

Direct-to-consumer advertising of Schedule 3 or Pharmacist Only medicines has the potential to increase self care options for consumers, raise pharmacists’ profile in the delivery of primary healthcare and drive pharmacy growth of this category.
Current restrictions on the advertising of S3 medicines prohibits consumer awareness of these medicines, which means consumers may continue to consult GPs for conditions which could be safely managed by pharmacists.
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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 still being flown - although narrowing it seems to be largely focussed on Super! Enjoy.
David.

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