Thursday, May 12, 2016

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

May 12  Edition
With the Budget on the Third what we have seen is as follows in the articles below. In broad terms there seem to have been some pretty tough stuff in the sectors such as health and education. Comments welcome on what you thought of the Budget.
Note: A hell of a lot of all this has not been legislated - and now we are in an election mode they may or may not come about depending on the election outcome.
Thus far the polling is not looking good for public reception of the budget.
12:16pm May 7, 2016

Morrison defends budget's poor polling


Treasurer Scott Morrison insists the budget is not about polls after only seven per cent of voters thought they would be better off under it.
A Seven-ReachTel poll - the first survey to ask voters about the budget - found 33 per cent of people believed they would be worse off, while 59 per cent said "about the same".
Speaking after a tour of a western Sydney chocolate and coffee shop to promote the government's tax cuts for businesses that turn over up to $10 million, Mr Morrison said he believed people were with the government on the budget.
"The budget isn't about polls," Mr Morrison told reporters in Sydney on Saturday.
"The budget is about laying out a national economic plan to ensure the economy can transition from the mining investment phase of the mining boom through to a more diversified economy."
Mr Morrison said Labor's attacks over tax cut were disappointing and amounted to locking out small businesses.
Labor and the Coalition are neck and neck in two-party preferred terms as Australia waits for Malcolm Turnbull to visit Governor-General Sir Peter Cosgrove to seek a July 2 election.
The next eight weeks will be very interesting indeed. What is interesting is that someone as well informed as Peta Credlin says the reaction to the super changes may come back to cause a lot of trouble.

General Budget Impacts.

Federal Budget 2016: What not to believe on the night

Date May 1, 2016 - 9:00PM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Like every budget, Tuesday's will be a combination of measures and arguments, each with political and economic dimensions and motivations.  Distinguishing the politics from the economics will be the hard part.
One highly relevant government responsibility is to help limit economic slowdowns by running operating deficits while spending by the private sector is weak. 
It promises to be a budget in which the government does a lot of crying poor. That's partly because Malcolm Turnbull is likely to call an election within a week of the budget, but is prevented mainly for political reasons from making many big spending promises.

Budget 2016: Scott Morrison’s super tax trick

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

David Crowe

A hit on the superannuation savings of high-income earners and wealthy retirees will help pay for $9 billion in tax cuts for average workers and small employers as the Turnbull government post­pones major budget repair to win back voters at the July 2 election.
A surprise $1.6 million cap on tax-free retirement balances is one of the biggest twists in a budget that also scales back the amount that all workers can put into their super every year.
The $2.9bn increase in super taxes combines with a $3.9bn crackdown on corporate tax avoidance to fatten the commonwealth coffers, along with $3.2bn in savings from delaying controversial government policies and a $1.4bn cut to the public service.

Budget 2016: Super shake-up to shift $3bn elsewhere

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

Glenda Korporaal

More than a million Australians who have a combined $600 billion in self-managed super funds are expected to be hardest hit from the budget’s sweeping changes to superannuation.
Self Managed Super Fund ­Association chief executive ­Andrea Slattery warned that the changes would send shock waves through the sector and “severely reduce the ability of people to save for retirement”.
Based on previous research, more than $3bn a year may now be diverted out of super to be ­invested elsewhere or be spent.
The suite of changes to superannuation, including big reductions in the amount people can put into super to $25,000 a year, ­cutting back on transition-to-­retirement benefits and limiting tax-free super balances to $1.6 million, caught the $2 trillion super industry unaware.

Budget 2016: Doubts over safety of retirement super nest eggs

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

David Crowe

There are concerns over superannuation changes regarding retirees’ nest eggs.
Labor has accused Scott Morrison of “lying” about his tax increase on superannuation after the Treasurer insisted yesterday that he was not making retrospective changes to retirement nest eggs.
In an unlikely alliance with Labor, the conservative Institute of Public Affairs also branded one of the changes retrospective ­because it would impose a new tax on people already in retirement after building up their savings under the current rules.
The government is headed for months of consultation and potential division within its own ranks if it wins the election and proceeds with complex legislation to deliver the $2.9 billion in revenue it wants from the super package.

Budget 2016: 10 hidden changes for families

Date May 5, 2016 - 12:15AM

Nicole Pedersen-McKinnon

Money contributor

Where's the love for families in budget 2016? That's the question on everyone's lips since it was finally revealed where the Turnbull-Morrison government would save and spend (well, with the exception of the $1.6 billion they won't yet tell us about). 
Certainly there was not much explicitly for Kevin Rudd's battling "working families". But there were a whole bunch of measures that will directly affect them, for better and worse. 
1. Tax cuts. Wherever you stand on whether $80,000 equals a "middle-income" earner, it's possible your household has one (or two). The government will keep you in the 32.5 per cent tax bracket until your salary hits $87,000, saving an average of $26 a month. It's unspectacular and indeed your family is probably much more excited about the $47 decease in its mortgage repayments the Reserve Bank delivered on budget day (on the average $350,000 mortgage).
  • Updated May 5 2016 at 5:27 PM

Moody's calls Scott Morrison's bluff on the budget

Ratings agency Moody's has challenged Treasurer Scott Morrison's budget, saying the government's inability to curb spending and weak income growth means future deficits will be even larger and last longer than claimed in Tuesday's budget.
In what is an increasingly critical stance by the ratings agency, Moody's highlighted that while debt was low by international standards it was rising faster than lower-rated countries such as Finland and the United States.
Most alarmingly, Australia's debt burden – measured as interest payments as a share of revenue – has increased since 2009 by the most out of all the countries Moody's regards as AAA-rated.

Not all budget plans are equal but they should be consistent

  • The Australian
  • May 7, 2016 12:00AM

Judith Sloan

My three-year-old grandson’s favourite question is: What’s the plan, Granny? What he has in mind is a choice between zoo, playground, ferry trip, babycino at the local cafe or playing dress-ups (doctor, pirate, ­policeman and fireman are his ­favourites).
Last time he posed the question, I told him that having plans is very fashionable. ­Indeed, our federal government has a national economic plan. The Prime Minister and Treasurer are following in the footsteps of other devotees of ­national economic plans, including Vladimir Lenin and Hugo Chavez. Communist dictators have always had a penchant for the national economic plan.
India was very keen on five-year economic plans but the ­leaders ditched this attachment when they realised the plans were running the economy into the ground. Indonesia has always had a national economic plan.

Health Budget Issues.

Budget 2016: health — freeze on Medicare rebates extended

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

Sean Parnell

No major private health insurance reforms were outlined.
Australians face higher out-of-pocket expenses for healthcare after the government last night extended its freeze on Medicare rebates to save another $1 billion.
The Coalition will go to the election with a budgeted plan to extend the controversial freeze on Medicare rebate indexation for another two years from July 2018.
That measure — fiercely opposed by the Australian Medical Association and other lobby groups — is one of a series of “savings” and “efficiencies” outlined in the budget.
While the new cuts announced last night were less dramatic than in the Coalition’s first budget in 2014 — best remembered for the ill-fated GP co-payment and a $50bn reduction in future public hospital funding — they were not offset by any major funding announcements.

Budget 2016: $66m to crack down on ‘dodgy doctors’

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

Sean Parnell

The much-vaunted Medicare review is expected to save only $5.1 million over four years but Scott Morrison has allocated $66m over the same period to crack down on dodgy doctors.
The review was announced after the GP co-payment was ditched, with Health Minister Sussan Ley promising to consider lifting a separate Medicare rebate freeze if sufficient savings were found in the Medicare Benefits Schedule.
However, the ongoing review has so far targeted only obsolete MBS items and the freeze was last night extended for two years to save another $1 billion in another tight health budget.
While the head of the review taskforce, Sydney Medical School dean Bruce Robinson, had foreshadowed an updated MBS being used to guide doctor compliance, as part of a proactive approach favoured by Department of Health secretary Martin Bowles, a tougher approach is already planned.
Health verdict
Sean Parnell
After reshaping Labor’s health architecture, and slashing billions from the sector, it has come down to this: the Coalition will go to the election not responding to its critics but openly defying them.
The Medicare freeze will be extended to save another $1 billion while health practitioners will also lose money in other areas, as will the groups that serve them. This is despite Labor, the Greens and that other political force, the Australian Medical Association, rallying to ‘Save Medicare’ and warning patients of higher costs.
Most reviews launched by the Coalition have so far amounted to little more than trials and interim responses, or privileged discussions, amid a drawn-out frenzy of cuts.
Not a typical budget, let alone an election budget, this is Scott Morrison’s dreaded second opinion of the diagnosis made by Joe Hockey: the Commonwealth spends too much on health and everyone else will feel more pain.

Medical specialists’ fees in need of better diagnosis

  • Mark Metherell
  • The Australian
  • May 4, 2016 12:00AM
The soaring cost of medical specialist services highlighted by The Australian last week provides further weight to the argument that what our health system requires is a searching diagnosis and a good dose of transparency.
A noteworthy aspect of healthcare in Australia is that the anti-competitive shroud that obscures the cost drivers of specialist medical care means, while we may value good medical care, it is difficult to assess whether we are getting best value for money.
A hip replacement may cost the individual, the government and the health insurers in total more than $20,000, and the typical recipient who recovers pain-free mobility will think it a reasonable price to pay. That applies to many of the other routine and expensive procedures, such as a cataract operation that restores vision at a cost of thousands. What price sight, when the actual cost of that procedure is a fraction of the market rate?

Budget 2016: Aged-care cut by $1.2bn to fight blowout

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

Rick Wallace

Payments to aged-care providers will be slashed by $1.2 billion over four years to help curb a predicted blowout of $3.8bn in costs in the residential aged-care system.
The move is designed to curb skyrocketing costs for nursing home residents with complex needs.
Under changes revealed in the budget, the formula for deciding funding levels for patients with complex care needs will be changed, and the rate of index­ation of payments for these ­patients will be halved.
“The government will achieve efficiencies of $1.2bn over four years through changes to the scoring matrix of the Aged Care Funding Instrument that determines the level of funding paid to aged-care providers,’’ the budget papers say.
3 May, 2016

Budget monkey magic: how does cutting another $3 billion improve healthcare exactly?

Posted by Jeremy Knibbs
A short summary of the key healthcare and GP budget measures that were brought down last night by the government with a few responses from around the sector. Warning, it’s not pretty
What Sussan Ley said and what she did:
She said:
“We have a clear focus on integration, innovation and modernisation to deliver the 21st century health services Australians expect. ”.

Federal budget 2016: health experts react

May 3, 2016 8.54pm AEST
What does the budget hold for health care? from


  1. Helen Dickinson
Associate Professor, Public Governance, University of Melbourne
  1. Jim Gillespie
Deputy Director, Menzies Centre for Health Policy & Associate Professor in Health Policy, University of Sydney
  1. Michael Woods
Professor of Health Economics, University of Technology Sydney
  1. Rob Moodie
Professor of Public Health, University of Melbourne
  1. Stephen Duckett
Director, Health Program, Grattan Institute
To help pay for the National Disability Insurance Scheme (NDIS) the government will scrap the carbon tax compensation to new recipients of government welfare benefits. This will save the government A$1.4 billion over five years.
The government is putting $2.1 billion towards the NDIS in this year’s budget. This money will also this come from savings by cutting the NDIS advertising campaign, ceasing to back-date Carer Allowance claims and the reviewing of people’s eligibility for the Disability Support Pension.
There’s $1.7 billion in funding for the Child and Adult Public Dental Scheme leaked before the budget and the agreement made at the Council of Australian Governments for $2.9 billion funding for public hospitals, with reforms to reduce hospital admissions, improve patient safety and boost quality of services.
MEDIA RELEASE Tuesday 3 May 2016

Patients face a battery of higher out of pocket costs face if Senate backs next Government

Consumers face a range of increased out of pocket costs for frontline doctor care and medicines if measures in this and previous budgets pass a future Senate, the Consumers Health Forum says.
Tonight’s Budget will extract another $925 million by freezing Medicare rebates over the next three years, on top of the $1.3 billion already removed in previous years, increasing the pressure on GPs to drop bulk billing and charge gap fees.
The vote of a future Senate could also mean a range of fresh out of pocket costs, including a $5 rise in the co-payment for prescribed medicines and cutting of the $630 million in bulk billing incentives to pathologists and radiologists.

GP co-payment by stealth as prescription medicine costs rise

May 3, 2016 9:22pm
Sue Dunlevy National Health Reporter News Corp Australia Network
THE dreaded GP co-payment has risen from the grave in the Federal Budget with a doctor’s visit likely to cost up to $39 at the same time as prescription medicine prices rise by $5 from January.
Medicare rebates will be frozen at $37 for six years until 2020 to save the Government nearly $1 billion in a move that is likely to force doctors to abandon bulk billing.
The freeze is expected over time to cost a typical GP over $15,000 a year as they face rising wages bills and rents but no increase in Medicare income.

2016 federal budget: Turnbull says no to funding biomedical research centre

Date May 2, 2016

Bridie Smith

Science Editor, The Age

The promise of a new centre for biomedical engineering based in Melbourne hangs in the balance after the federal government refused a request from the Andrews government for $60 million.
Described by Premier Daniel Andrews as "a critically important part" of Victoria's future, the yet-to-be-built Aikenhead Centre for Medical Discovery is a research institute to be located at St Vincent's Hospital in Fitzroy.
The centre is intended to be a research and education hub, concentrating on fields as diverse as organ and tissue regeneration, drug design, next generation biomedical devices and prosthetics.
1:04pm May 4, 2016

GP bulk-billing 'dead, buried, cremated'

Health Minister Sussan Ley is hailing the budget as a way to bridge the divide between city and country but doctors say rural patients are being exiled to healthcare Siberia.
Doctors are warning of a fierce campaign in the lead-up to a July 2 election, bigger than the one that forced the federal government to declare its short-lived GP co-payment proposal "dead, buried and cremated" within months.
Rural Doctors Association president Ewen McPhee says meetings will be planned to co-ordinate a strategy after Tuesday's budget extended a freeze on Medicare rebates, which doctors say amounts to a GP co-payment "by stealth".
Dr McPhee says the freeze is bigger than the GP co-payment.

Our healthcare system under threat

The 2016 Federal Budget has done absolutely nothing to reverse the increasing pressure on Australia’s world-class healthcare system according to The Royal Australian College of General Practitioners (RACGP) President Dr Frank R Jones.
 “This is an illogical Budget which has taken no heed of the sensible advice from the RACGP,” Dr Jones says.
By extending the freeze on the Medicare Benefits Scheme (MBS) for a further two years, the Government is threatening the future and quality of general practice patient services, the frontline of Australia’s healthcare.”
“Extending the freeze until 2019-20 is calamitous and will lead to a loss of more $925 million from MBS funding; it may leave general practices unviable – which is just an extraordinary outcome,” he says.

Government refuses to table $650m cut to diagnostic imaging services

Decision to delay on legislation raises prospect cut will not be made until after Senate rises, preventing opportunity to disallow it before parliament dissolved
On 3 May, the Senate passed a Labor motion ordering the rural health minister to produce the legislative instrument which would give effect to the diagnostic imaging services cut. Photograph: Rui Vieira/PA
The government has refused to table a regulation cutting $650m from diagnostic imaging services such as breast cancer screening, suggesting it will not allow the Senate a chance to disallow the cut before parliament is dissolved.
In December the government announced that it would reduce the bulk billing incentive for diagnostic imaging – and scrap it for pathology services. The changes will net the government $650m over four years and will come into effect on 1 July.

Budget 2016: Ley mans barricades to attack ALP health policy

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

Sean Parnell

Health Minister Sussan Ley has shrugged off criticism of the ­Coalition’s continued budgetary restraint and sought to attack Labor for a lack of health policies and funding commitments.
Tuesday night’s budget extended­ the freeze on Medicare rebates, cut health flexible funds, offered no new money for public hospitals or any significant increase in funding for primary care or specific needs such as mental health.
Cuts from the 2014 budget will have freed up $8.5 billion a year in former health spending once the Medical Research Future Fund is fully established in 2020-21, separate to other savings measures in the more recent budgets.

Budget 2016: More GPs could start charging patients co-payment, warn doctors

Date May 4, 2016 - 5:40PM

Jane Lee

Legal affairs, health and science reporter

Tuesday's federal budget revealed that Medicare rebates would remain static for all GP, medical specialist and allied health services until June 2020. Photo: Andrew Quilty
More GPs could start charging patients a co-payment following the Turnbull government's decision to extend its freeze on Medicare rebates, doctors say.
The federal budget revealed on Tuesday that Medicare rebates, which have not risen with inflation for almost two years, would remain static for all GP, medical specialist and allied health services until June 2020, saving about $925.3 million between 2018 and 2020. 
The Royal Australian College of General Practitioners president, Dr Frank Jones, told Fairfax Media the decision "will make running a quality practice extremely difficult with the probability you will have to charge a small fee which may deter certain patients (who) may present later unwell and require hospital services."

Health Budget 2016 – the reaction

Editor: Jennifer Doggett Author: Jennifer Doggett and health groups on: May 04, 2016In: Federal Budget 2016-17

Budget reactions at a glance

PHAA The Federal Budget was released this evening with the bulk of funding focused on treatment and clinical services instead of prevention initiatives.
AHHA The Government must continue to plan not just for the next electoral cycle, but with a strategic vision for the future of Australian health.
CHF Much more funding is needed to support the substantial changes required to renovate Australia’s health system.
NACCHO The 2016/17 Budget needs to reflect the views of all Indigenous Australians in setting priorities
CHA CHA is concerned that consumers are going to pay more for necessary health care following tonight’s Federal Budget announcements,

AMA: 2016 budget could cost patients almost $1 billion

2016 may be the death nail for bulk billing in Australia, the doctor's association warns.
Amongst the health policies in the 2016 federal budget, the Government announced that it would continue its Medicare rebate freeze until 2020. The move is set to save the Government somewhere in the region of $1 billion, but has been denounced by the Australian Medical Association (AMA).  "The poorest, the sickest and the most vulnerable will be the hardest hit," AMA president Professor Brian Owler said.
Why? The freeze locked in the Medicare rebate for seeing a GP at $37.
In 2013, the AMA warned that this freeze would put an untenable strain on the GPs and threaten the viability of bulk billing. The extension of this freeze to 2020 may become the straw that breaks the camel's back.

Budget 2016: Aged care makes budget cuts an election issue

  • The Australian
  • May 6, 2016 12:00AM

Rick Wallace

Rick Morton

Sections of the aged-care industry are in open revolt over the $1.2 billion in cuts announced in the ­budget.
Victoria’s largest provider is developing a campaign to roll out during the election campaign amid claims of misallocation of beds.
On top of cutting the sector’s funding, the federal government is being accused of shifting 150 beds from the Shepparton region — the centre of a crucial contest between the two conservative parties — and sending the extra places to Melbourne.
Leading Aged Services Australia (LASA), the peak lobby group for aged-care operators, says the federal cuts across Australia in the past year total $3.1bn.

Banks may review pharmacy sector exposure

  • The Australian
  • May 7, 2016 12:00AM

Sarah-Jane Tasker

Small pharmacies could come under pressure
The deregulation of the pharmacy sector that the government is considering could prompt banks to review their $3 billion-plus exposure to the sector, putting the future of small operators in doubt.
Ferrier Hodgson pharmacy sector specialist Luci Palaghia made the warning ahead of the release of a discussion paper by a federal government committee reviewing pharmacy remuneration and regulations.
She said banks had an estimated exposure to the pharmacy sector of more than $3bn and were lending up to 75 per cent of the valuation of a business.
“These lending practices are certain to be revisited by banks if the sector is ultimately deregulated,” she said.

Election 2016: Doctors launch campaign against extended freeze on Medicare rebates

Date May 8, 2016 - 12:49AM

Jane Lee

Legal affairs, health and science reporter

The federal Coalition is facing an early election headache with thousands of GPs set to urge their patients to lobby against the extended freeze on Medicare rebates, arguing the Turnbull government is introducing a "co-payment by stealth".
The Royal Australian College of General Practitioners will launch its campaign against the government's decision to continue to freeze current rebates until 2019/20, which it says will force more doctors to start charging their patients a co-payment. The government expects the move will save it about $925.3 million.
From Monday, the 32,000 members will hang posters in their waiting rooms that warn: "Danger. You and your family's health is being targeted. The extended freeze on Medicare rebates means you will pay more!"
I look forward to comments on all this!

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