Thursday, November 17, 2016

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

November 17  Edition.
Only one real bit of news last week that mattered with the Election of President Trump.
As of Sunday 13 November the markets are elated – but I suspect that might change as people look more closely at just what is on offer.
This blog covered the current plans:
We now have to see how all this gets implemented.
As always time will tell. Right at present (Thursday) it is hard to have any understanding as to how things will play out. Who is appointed to what will decide what the next few years are going to look like! I think by the end of the month will be much clearer.
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Here are a few other things I have noticed.

Trump Election Issues.

COMMENT
  • November 9 2016 - 12:57AM

An economy without growth is far from our biggest worry

Ross Gittins
If you think the possible ascension of Donald Trump is our one big worry you haven't been paying attention. Some climate scientists are worried sick over the possibility that climate change may be passing the point of no return while we procrastinate over controlling it.
Meanwhile, the nation's – nay, the world's – economists worry that the wellsprings of economic growth are drying up in the developed countries. Think of it – an economy without growth!
On Monday the Productivity Commission issued a discussion paper exclaiming that there is "justified global anxiety" that improvements in productivity and the growth in national income they cause have "slowed or stopped".
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COMMENT
  • November 9 2016 - 8:43PM

The consequences of a Donald Trump win are disastrous for the Australian economy

Peter Martin
President Donald Trump will declare economic war on our biggest customer, wipe unprecedented amounts off global stock markets, usher in extraordinary financial instability, and risk turning the world's biggest economy into a basket case by pushing its national debt past 100 per cent of GDP.
And that's just what's known about his economic program. The Economist observed in the leadup to the election that while his policies were unusually short on detail, their direction "could not be clearer".
China takes 1 in every 3 shiploads of Australian exports, more than any nation has since Britain in the 1950s according to consultant Saul Eslake. Even small variations in what it wants sends our budget into conniptions.
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COMMENT
  • November 9 2016 - 8:10PM

US Election: What values do we share with Donald Trump's America?

Peter Hartcher
Australia's alliance with the US has always been based on shared values, as every leader of both nations has affirmed for generations. But what values do we share with Donald Trump's America?
Until now democracy was a shared value. But Trump was not prepared to accept the people's will unless he won. That isn't democracy. It's despotism.
Freedom and equality have always been core shared values. But Trump wants Muslim immigrants banned and has based his political movement on bigotry, disparaging women, Mexicans, Muslims, the disabled and many more.
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ANALYSIS: US election is Brexit on steroids

- on November 10, 2016, 1:21 am
Australia and the rest of the democratic world must hope the biggest lie Donald Trump told during his campaign is that he would keep his promises.
Because if Trump does half of what he said he would, the world will be poorer and less safe.
Global structures decades in the making will be in retreat.
Trade, defence and economic agreements will be torn up. And as America shrinks on the world stage, China will be emboldened. Russia rises again.
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COMMENT
  • November 10 2016 - 10:10AM

President Donald Trump will bring the unexpected, but good things could come out of it

Ross Gittins
Keep your shirt on. The world as we know it may be ending, but if so it won't be for a while. And maybe things won't change as much as feared.
Yesterday the experts were confidently predicting Hillary Clinton would be president. Today they are predicting Donald Trump's presidency will be a disaster with equal confidence. How do they know?
I find it hard to imagine Trump's ascendancy won't end up being bad for our economy, for the rest of the world and the Americans themselves.
But that's a long way down the track and lots of unexpected things could happen between now and then. Maybe even a few good things.
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Is Donald Trump going to burst Australia's housing bubble?

Michael Pascoe
Published: November 12, 2016 - 12:15AM
The caveat has to go up front: given his propensity for lying, exaggerating and generally raving, nobody can know what Donald Trump will actually do as president. He probably doesn't know himself. 
But according to the bond market reaction, he will burst Australia's east coast housing bubble by causing interest rates to rise. 
That would be the relatively nice way to prick the bubble. The more common fear is that he could start a trade war with China that would cause a global recession – one we wouldn't escape. That definitely would not be a nice way to achieve lower housing prices. So let's hope there is enough sanity left in Congress to prevent such madness and just consider the more benign interest rate story.  
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US election: What does a Donald Trump presidency mean for the world?

Paul McGeough
Published: November 12, 2016 - 1:17AM
Washington: A statement, a video and a phone call to congratulate the next US president – never let it be said Israel's Benjamin Netanyahu wasn't paying attention as Russia's Vladimir Putin pressed Donald Trump's ego buttons in the course of the US presidential election campaign.
The world's got it now – Trump has a need to be "liked". This, he believes, is key to doing deals. And given his realtor's view that all deals are transactional, the best we can glean is that guiding America's next president will be the "Emetchizit" doctrine of foreign affairs – as in, the Australian strine pronunciation of "how much is it" going to cost the US?
The art of the deal would be about the bottom line, not the alliances that made it happen.
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Australia must grimace and bear Donald Trump to keep our alliance on track

Michael Fullilove
Published: November 12, 2016 - 12:00AM
Donald Trump's election will ask hard questions of Australia's alliance with the United States.
Since the end of World War II, the US has played the leading role in the maintenance of the international order. In our own region, the United States has been the midwife of modern Asia. For seven decades, the US forward presence in Asia has underpinned regional stability.
But the fact is that the instincts and opinions of presidents shape their foreign policies. George W. Bush's instinctive decision-making and distaste for detail led to the invasion and shambolic occupation of Iraq. Barack Obama's caution about the use of force, informed by his observations of the Iraq War, led to a more reserved global posture.
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Trump’s US election: Don’t appease mad, bad and dangerous views

  • The Australian
  • 12:00AM November 12, 2016

Peter Van Onselen

Any analysis of how Donald Trump got elected president must begin by acknowledging the deep divides in the US that stoked his campaign. Failure to do so ignores the underlying problems in America, indeed failures of the modern state that have left large numbers of voters feeling forgotten.
However, it must be possible to recognise voter dissatisfaction while condemning Trump, what he says and how he acts.
How can anyone who takes governance seriously, or has a shred of decency in their character, choose not to condemn Trump’s sexism, offensive bigotry and policy settings that go well beyond the absurd?
Many of the policy ideas Trump has argued for truly are barking mad, as Bill Shorten described them. Attempts by Malcolm Turnbull and Foreign Minister Julie Bishop to suddenly flip what they have said publicly (and continue to say privately) about Trump just because he tricked a cohort of understandably disaffected voters into supporting him is downright pathetic.
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Kevin Rudd on steroids: Why business is embracing Donald Trump

Peter Martin
Published: November 10, 2016 - 6:58PM
Suddenly, Donald Trump's good for business.
As it became clear that he would win late at night on Tuesday, US time, futures traders pushed down the price of the US Dow Jones industrial index 5 per cent – the maximum allowed.
Then after his gracious victory speech they bid it back up to the point where it closed on Wednesday up 1.4 per cent, a net gain of 6.4 per cent, after one of the most volatile 24 hours in history.
As Jim Cramer, host of CNBC's Mad Money put it, many investors "bid everything up when they saw that Trump wasn't going to threaten to put Hillary Clinton in jail".
Carl Icahn​, the 80-year old billionaire mentioned by Trump as a possible treasury secretary, walked out of the victory party to bet $US1.3 billion ($A1.7 billion) on the market rebounding.
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Budget Issues.

Change to backpacker tax could be left on hold as politicians fight over how much to cut

November 8, 2016 9:04pm
Political Reporter Peter Jean
THE backpacker tax which is driving foreign harvest workers away from Australia could be left on hold at 32.5 per cent because of political bickering over whether to reduce it 19 or 10.5 cents in the dollar.
The tax on working holiday-makers is due to come into force on January 1 but the Government wants to lower the planned rate to 19 cents in the dollar.
A stalemate is looming in the Senate after Labor and Tasmanian independent Senator Jacqui Lambie yesterday made counter-proposals to lower the tax rate to 10.5 cents in the dollar.
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COMMENT
  • November 10 2016 - 5:15PM

If Malcolm Turnbull flicks the switch to renewable energy, a bright future will dawn

John Hewson
The transition from fossil fuel-based power to renewables is inevitable if Australia is to meet its Paris commitments on emissions reductions.
It is irresponsible, it could be said immoral, for government to play short-term politics around this, as the Howard/Abbott/ Turnbull governments have done, attacking the renewables industry and the ALP/Greens for seeking to facilitate and accelerate this transition.
Irresponsible, for example, to blame renewables for the recent blackout in South Australia, where an extreme weather event brought down that state's transmission system, such that it didn't matter how the power was generated, it simply couldn't be transmitted, and to score political points around the recently announced closure of the Hazelwood brown coal-fired power station.
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Boom time for corporate childcare in Australia

Kelsey Munro
Published: November 13, 2016 - 6:47AM
Parents paying up to $190 a day for childcare places are propping up $1 billion in profits for private childcare operators and their landlords, with questions being asked about who is really benefiting from billions in taxpayer subsidies for the sector.
Eight years after the spectacular collapse of Eddy Groves' ABC learning, once the biggest childcare provider in the world, corporate interests have returned to the sector. Research analysts rate childcare "an investment-grade asset".
The childcare services industry made almost $1 billion in profit last year, or more than one-eighth of what the government put into it in fee subsidies, according to IBISWorld's July report on the industry. (That figure does not include the property owners' profits.)
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Health Budget Issues.

  • November 7 2016 - 12:09AM

Radical Medicare revamp will fail patients as Health Care Homes trial funding falls short, say doctors

Kate Aubusson
A Medicare overhaul is set to introduce a tiered system for people with chronic diseases that would see the most unwell patients receive $1795 in GP visits to manage their condition.
But doctors who have championed the revolutionary model say the government appeared to be cost-cutting, and it could fail from a lack of funding, leaving patients worse off.
The first detailed blueprint of the government's cornerstone Health Care Homes trial shows a monthly bundled payment will replace the individual fee-for-service Medicare payments that GPs can claim for each visit to manage patients with chronic and complex health conditions.
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Health Care Home for sale?

The government seems to have lost the goodwill of the profession about their Health Care Homes model. On Friday afternoon the details of implementation stage 1 were published and it was underwhelming – to say the least.
A health reform like this, which should focus on better integration, coordination and team care, must be planned and rolled out in collaboration with the profession and consumers, not quietly published on a Friday afternoon.
Despite initial reassurances from Federal Health Minister Sussan Ley, there has been no consultation with the profession. Many GPs have expressed concerns during the weekend or indicated that they have lost interest in the model.
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  • Updated Nov 6 2016 at 6:30 PM

Health system strong in some areas but lacking policy innovation

by Mark Eggleton
Australia's health system is doing rather well on a global scale when it comes to cost and innovative healthcare but we are lagging in management and policy innovation.
At the recent Innovation in Healthcare roundtable co-hosted by The Australian Financial Review and Philips, participants agreed our health system needs to be re-engineered to better meet the needs of the future and an innovative rethink does not necessarily mean more cutting-edge technology or as Monty Python might have pointed out "machines that go 'bing'."
According to the executive director of The George Institute for Global Health, Vlado Perkovic, there's a real opportunity for us to re-engineer the health system using the tools we have available today that we did not have even a short time ago.
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Government fails to deliver on Health Care Homes

6 November 2016
The Federal Government’s Health Care Homes model is inadequately funded and will not improve health outcomes for millions of Australians living with chronic and complex conditions, according to the Royal Australian College of General Practitioners (RACGP).
The RACGP has declared its’ disappointment following the release of details about practice eligibility, patient eligibility, and payment systems for the Health Care Homes model.
RACGP President Dr Bastian Seidel said the details released on Friday evening confirm that there continues to be a gap between the investment required, and the commitment made by Government.
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  • November 6 2016 - 5:40PM

Complaints about health practitioner board decisions double in the past year

Daniel Burdon
Complaints about decisions by the national health practitioner regulator and the boards that regulate Australia's medical professionals more than doubled in the year to August.
That doubling of complaints triggered the small National Health Practitioner Ombudsman and Privacy Commissioner's office to appoint a new "complaints liaison officer" to help address "the increasing complaint and inquiry workload".
The Ombudsman oversees complaints about decisions made by the Australian Health Practitioner Regulation Agency and the 14 national boards it oversees that regulate medical practitioners from doctors and nurses to psychologists and chiropractors.
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Medical futurology – the changing role of doctors

Authored by Erwin Loh
“The doctor of the future will give no medicine, but will instruct his patient in the care of the human frame, in diet and in the cause and prevention of disease.”
— Thomas Edison, 1903
AS many commentators have observed, our current acute, hospital-based public health system is primarily concerned with managing illness, rather than creating health. Nevertheless, if we scan the horizon for what the future brings in health care, we can see developments in the genetics, technology and artificial intelligence (AI) areas that will revolutionise how health is delivered, and will transform the role of the medical doctor, shifting the paradigm from one of treating sickness to one of health coaching.
A futurist is a person who studies the future and makes predictions about it based on current trends. A medical futurist is one who does exactly the same thing, but with a focus on medicine. So, let us be medical futurists together today, and imagine a tomorrow by examining the recent scientific literature available (all references are less than 1 month old).
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Doctors warn against upcoming Medicare changes

1 Nov 7 2016
Starts at 60 Writers
The government is set to trail a new payment system with Medicare that will cap the number of GP visits you have every year, but a number of doctors are saying it could leave many patients worse off than they are now.
The new tiered system for people with chronic diseases will see patients receive $1795 a year in GP visits to get treatments and checkups, however, doctors say it appears to be just another cost-cutting exercise by the government, reports the SMH.
According to the Department of Health, patients will only be granted access to Medicare funding for up to five GP visits that are not related to their chronic illness. Under the current Medicare system patients have uncapped access to GP care.
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Doctors Call For A Sugar Tax And Subsidies For Health Foods

The AMA wants the Turnbull Government to get serious on fighting obesity.

07/11/2016 11:02 AM AEDT
Australia needs to get tougher on battling obesity, the AMA says.
Australia's doctors want the federal government to step up on fighting obesity by imposing a tax on junk food and providing subsidies for fruit and vegetables.
The call for action from the Australian Medical Association (AMA) is part of a national strategy the organisation wants from the government on the issue under a "whole-of-society approach".
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7 November, 2016

Backflip over Health Care Homes visit limit

Posted by julie lambert
The federal government has dropped its proposal to cap GP visits for chronically ill patients under its Health Care Homes scheme after a blistering reception from doctors.
The RACGP said the Health Care Home trials had been “set up to fail” because of a decision to put a five-visit cap on benefits for HCH-registered patients seeing their GP for reasons not related to their chronic conditions.
Health Minister Sussan Ley blindsided doctors with an announcement late on Friday revealing the first details of the landmark Health Care Homes trials to start in 2017, including a shift from fee-for-service to monthly bundled payments and the surprise five-visit limit on acute care.
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Aust govt must act now on obesity: AMA

  • Australian Associated Press
  • 8:50PM November 7, 2016
Obesity is the biggest public health challenge facing Australia and its prevention must start at the beginning, with pregnant mothers, the Australian Medical Association says.
The AMA has released its revised and updated position statement on obesity, calling on the federal government to show leadership on the serious health threat.
"The AMA recommends that the initial focus of a national obesity strategy should be on children and adolescents, with prevention and early intervention starting with the pregnant mother and the fetus, and continuing through infancy and childhood," the statement says.
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Government backflips on plans to limit visits to the doctor

index&t_product=CourierMail&td_device=desktopSue Dunlevy, National Health Reporter, News Corp Australia Network
November 8, 2016 10:00pm
CANCER patients and those with other chronic illnesses will no longer have a cap placed on the number of times they can visit a doctor each year after a government backflip.
The government has backed down on the controversial element of its Health Care Homes plan just three days after it was announced following fury from both patients and doctors.
The plan, announced late Friday, would have seen chronically patients who signed up to the Health Care Homes plan limited to just five doctors’ visits a year for conditions aside from their chronic illness.
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AMA calls for adequate funding health-care-home

10 Nov 2016
The Federal Government’s landmark Health Care Homes (HCH) reform is at risk of collapse because of a lack of funding, the AMA has warned.
Earlier this year the Government announced the trial of the Health Care Homes initiative, involving 65,000 patients and 200 medical practices in 10 regions across the country. Under the Government’s plans, practices will receive monthly bundled payments to manage patients with chronic and complex health conditions.
Last week the Department of Health released further detail on its website outlining that the bundled payments will vary from $591 for chronically ill patients who can largely self-manage their condition to $1267 for those who need more intensive care and $1795 for those with the most complex health demands.
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No timeframe on pathology collection centres’ rent reforms

  • SEAN PARNELL
  • The Australian
  • 12:00AM November 11, 2016
Health Minister Sussan Ley will not put a timeframe on reforms to rental arrangements for pathology collection centres despite the sector insisting they are needed to reduce costs for ­patients.
Under an election campaign deal between the Coalition and Pathology Australia, the definition of market value for space in GP clinics will be altered to better protect tenants.
Pathology Australia agreed to stop fighting the planned removal of bulk-billing incentives, amid continuing controversy over the government’s Medicare freeze.
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It might be hard to believe but things are getting better

Matt Wade
Published: November 13, 2016 - 12:00AM
What would you say is the average life expectancy for the world's population right now?
Mid-'50s or 60 years maybe? Well, that's far too low – life expectancy at birth reached 71.4 years last year the World Health Organisation says.
My guess is that's higher than you expected.
Polls show that most people in wealthy countries, such as Australia, assume the world is much more poverty-stricken, desperate and sickly than it actually is.
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Health Insurance Issues.

Graeme Samuel urges cuts to price-fixing prostheses list

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

Pamela Williams

A top consultant to the federal government on health reform, former competition boss Graeme Samuel, has strengthened his call for deep cuts to government-­controlled price-fixing for hips, knees and other device implants.
Calling recent recommendations by Health Minister Sussan Ley to cut the prices for private patients by 10 per cent for a range of medical implants “just the tip of the iceberg”, Mr Samuel called for far more substantial cuts.
Mr Samuel took aim at controls by government mandate, which keep prices for implants for private patients up to five times higher than the amount paid by public patients, as well as against international benchmarks. He said that pricing should be left to market forces.
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Medibank’s Drummond: prostheses savings ‘just the start’

  • The Australian
  • 12:00AM November 10, 2016
Sarah-Jane Tasker
Eli Greenblat
Medibank chief Craig Drummond has warned market conditions will continue to be challenged as he flags further government reform is needed to address affordability concerns.
Mr Drummond, speaking yesterday after the private health insurer’s annual meeting in Melbourne, said the market went backwards in the June quarter.
“It is challenging compared to where we were growing at 4, 5, 6 per cent a couple of years ago. Those growth rates have come back substantially,” he said.
“I think affordability is a key issue for our industry and when you have got incomes growing at 1 to 2 per cent per annum and premiums growing at 6 per cent per annum for an extended period that is challenging.
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Health funds profit despite cost complaints

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

Sean Parnell

Health insurers amassed an overall surplus of more than $1 billion last year ­despite slugging members with higher premiums and complaining about the cost of doctors, hospitals and prostheses.
Financial data released yesterday by the Australian Prudential Regulation Authority shows that net margins in the industry in 2015-2016 were a healthy 5.4 per cent, compared with only 4.4 per cent the year before. Industry leader Medibank increased its net margin from 5.4 per cent to 8.1 per cent, while the second largest fund, Bupa, remained steady on about 6.5 per cent.
According to APRA’s data, the after-tax surplus in the industry rose from $1.13bn to $1.25bn, with Medibank ($433 million) and Bupa ($353m) the most profitable.
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BUPA overtakes Medibank as nation’s largest health fund as more premium rises may be on the way

Sue Dunlevy, National Health Reporter, News Corp Australia Network
November 13, 2016 12:00am
HEALTH fund Bupa claims it has stripped Medibank of its mantle as the health fund representing the most Australians.
New data released this week shows Medibank lost 96,661 members in the year to June and now has just 3.6 million members to Bupa’s 3.7 million.
While Medibank still has more policies (1.8 million) to Bupa’s 1.76 million, BUPA covers more Australians, figures released by the Australian Prudential Regulation Authority show.
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Pharmacy Issues.

  • November 7 2016 - 6:55PM

Australia's cheapest chemist? Watchdog probes Chemist Warehouse pay

Royce Millar
Ben Schneiders
Solly Lew is in the fight of his commercial life.
A Fitzroy Street family pharmacist of 35 years standing, "Solly" is a St Kilda institution.
But Chemist Warehouse, the brash upstart of Australian pharmacy, has moved in next door.
Through its no-frills approach the giant discounter has positioned itself as the people's champion - its mission to ensure that all Australians have access to affordable health and beauty care.
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Superannuation Issues.

Super too complex: Costello

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

Damon Kitney

Future Fund chairman and former federal treasurer Peter Costello says Australians are right to baulk at making voluntary contributions to their superannuation because of the extreme complexity that now plagues the nation’s retirement savings system.
Almost two months after the government released its revised super reform package for public consultation, Mr Costello said he was worried about the complexity of the system.
“With growing complexity, extreme complexity, people will shy away from (the super system). And I think they are right to shy away from it because you never know what the rules will be,’’ he said.
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  • November 7 2016 - 10:00PM

Bill Shorten offers alternative super plan for Malcolm Turnbull's budget woes

Mark Kenny
Federal Labor has quibbled with media reports claiming it is poised to support the Turnbull government's modified superannuation package as is, which if passed would save the budget about $3 billion over four years.
Instead, the opposition says it will put forward steeper cuts to generous concessions to help repair the budget.
Sources close to Labor leader Bill Shorten say that on Tuesday the opposition will unveil an alternative set of proposals to make the superannuation system fairer by hitting high-income earners harder, and thereby dramatically increasing the pace of budget repair.
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Morrison slams Labor's 'secret' super plan

Updated: 3:40 pm, Tuesday, 8 November 2016
Treasurer Scott Morrison has accused Labor of lying to Australian voters before the July election by harbouring a secret superannuation agenda.
Mr Morrison will present his superannuation package to parliament on Wednesday.
Labor wants tougher cuts to superannuation tax concessions than the government is proposing, but will likely support Mr Morrison's changes when put to the test in parliament.
The government took a package - first announced in the May 3 budget - to the election, which included a controversial $500,000 lifetime non-concessional cap on fund balances back to 2007.
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  • Updated Nov 8 2016 at 9:49 PM

Industry groans as super fight firms as election issue - again

Labor will take its extra cuts to superannuation tax concessions to the next federal election after Treasurer Scott Morrison flatly rejected demands it adopt them as part of its package of super reforms to be legislated this month.
At the same time, the ALP said it would join others in the Senate to try and further water down the backpackers tax from a proposed rate of 19 per cent to 10.5 per cent. This prompted Mr Morrison to accuse Labor of "forcing Australians to pay more tax so they can give foreign workers a tax cut".
Mr Morrison said a 10.5 per cent backpacker tax would cost the budget $560 million. He said the government would reject the changes if made by the Senate and the rate would default to the current 32.5 per cent to be levied on every dollar earned by a seasonal labourer.
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9 Nov 2016 - 5:24pm

Super changes to give confidence: Morrison

Treasurer Scott Morrison has presented the government's superannuation package to parliament that aims to tighten tax concessions by $3 billion.
Source:
AAP 9 Nov 2016 - 5:24 PM  UPDATED YESTERDAY 5:24 PM
Scott Morrison believes the Turnbull government's suite of superannuation changes will provide greater confidence for Australians to invest for their retirement.
The treasurer introduced his superannuation package to the House of Representatives on Wednesday, having indicated earlier he hopes it will be passed in the final sitting weeks of this year, even if the Senate wants to scrutinise the legislation through an inquiry.
Among the key elements of the package, non-concessional super contributions will be limited to $100,000 per year from July 1, 2017 compared to $180,000 presently, but it allows for catch-up contributions, such as in the case of women returning to work after having a baby.
However, individuals with a super balance of more than $1.6 million will no longer be eligible to make after-tax contributions.
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I look forward to comments on all this!
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David.

1 comment:

Anonymous said...

There is something rotten in our bureaucracy, Just like NEHTA, AHPRA is clueless, arrogant and destructive to people working to improve the health system. AHPRA recently cautioned a doctor for advising patients to eat less sugar, in the same week that the AMA called for a sugar tax??? The ADHA is yet to reveal its true colors but unless it strays from the DOHA leash we are in for more of the same. Come on Tim, show some integrity and break the tradition of clueless government agencies!