Thursday, November 24, 2016

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

November 24  Edition.
Only one real bit of news again this week that continued to rattle around was the Election of President Trump.
As of Sunday 20 November the markets are even more elated – but I still suspect that might change as people look more closely at just what is on offer and how long it will take to happen. As always time will tell.
A side effect of all the excitement regarding Mr Trump has been this outcome:

Rising bond yields threaten sharemarket's safest stocks

Vanessa Desloires
Published: November 19, 2016 - 12:15AM
Simply speaking, rising bond yields are bad news for the Australian sharemarket. The local bourse is laden with bond proxy stocks that in recent years have benefited from yields near record lows.
The seemingly endless prospect of monetary stimulus from central banks sent bond yields in parts of Europe and Japan to negative territory creating a wave of bond refugees into the sharemarket.
It created a boom time for stocks with lower risk profiles. Real estate investment trusts (REITs), infrastructure, utilities, telcos and financials traded at lofty premiums to the market.
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Not many saw that coming so quickly.
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Here are a few other things I have noticed.

Trump Election Issues.

US election: Immigration, healthcare, jobs top of Trump agenda

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

Cameron Stewart

Donald Trump has vowed a “spectacular” start to his presidency, declaring immigration, healthcare reform and job creation will lead his new agenda for the US.
The president-elect has also moved to repair his relationship with key mainstream Republicans whose support he will need to get his ambitious reforms through congress.
In his first visit to Washington since defeating Hillary Clinton in Tuesday’s presidential election, Mr Trump met President Barack Obama at the White House to discuss the transition of power.
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What Trump means for Australia

Nicholas Stuart
Published: November 14, 2016 - 7:30PM
Hillary Clinton blames her loss on the last-minute revelation the FBI was investigating her. But let's not forget that probe only had resonance because of her past history and it was concluded before the election. The reality is Clinton lost because of one reason – herself. She didn't inspire people.
In an election that was decided by fewer than 200,000 votes (out of more than 120 million ballots cast) Clinton won the popular vote. That's irrelevant. The point is in 2012 Barack Obama motivated more than five million extra people to actually turn up at the polling booths. Clinton couldn't. She was a dud candidate selling a bad product: the voters knew it. That's the simple reason she lost.
The complex reason has to do with the crisis of western liberalism. We've entered an age of populist nationalism (think the euro and Brexit, think Schengen open borders) because the political elite (think Clinton, David Cameron) drew too far away from its base and no longer offers an answer to their problems. That's why no recent Australian government has lasted more than two terms and no prime minister more than one. Cut through the voter demographic and the people who turned against Clinton are ordinary and were spread across middle America. The globalised world is working for some but not for them.
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Populism Takes Over the World

America is just the latest country to see a resurgence of this volatile political movement.

November 16, 2016 — 12:13 AM AEDT
When you first encounter the word “populism,” you might think it’s a close cousin of democracy, with all the positive connotations that go along with it. And for some, it may well seem a purer form of a process by which politicians harness the will of the majority.
But that’s only part of the picture. Populism—ostensibly a belief in the rights, wisdom, or virtues of the common people—often requires a bogeyman, be it an existing government, the supposed cultural elite, the media, or a particular ethnic, racial, or religious group.
As a form of horizontal political power, populism has been instrumental to legal, agrarian, and social reforms through the years. But it’s also played a starring role in the rise of demagogues and therefore some of the ugliest episodes in human history.
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Would you trust Donald Trump with $26.6 trillion?

Michael Pascoe
Published: November 17, 2016 - 12:15AM
Would you trust Donald Trump with $US20 trillion ($26.6 trillion) of debt? How about lending him another $US7 trillion or so on top of that? You wouldn't be alone in thinking twice about the prospect. 
Trump was the man who suggested that, as president, he might refinance the American government debt, currently nudging $US20 trillion. Calling himself "the king of debt", he at one stage said he would wipe out the government deficit in eight years – despite announcing several trillion dollars' worth of tax cuts. But in May he also said he could borrow more, "knowing that if the economy crashed, you could make a deal".
Subsequently trying to dig himself out of any suggestion that the US might default, Trump said he really meant he might refinance government debt at a discount should rates rise. 
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Trump's trade policy is dangerous, says Reserve Bank governor Philip Lowe

Peter Martin
Published: November 16, 2016 - 12:23AM
Reserve Bank governor Philip Lowe has labelled US President-elect Donald Trump's trade policy "dangerous" and probably his biggest concern.
Fielding questions at a Committee for the Economic Development of Australia dinner in Melbourne, Dr Lowe said he hoped wiser heads would prevail, but that if Mr Trump made good on his promise to slap tariffs of 45 per cent on imports from China, "there would be some response by China, which would not be good for the US or Chinese economy, and by extension it would not be good for us".
"Australia has for 200 years benefited from openness. We sold the world gold, and then wool and wheat and now minerals, and that's really been the basis of much of what we currently enjoy. Anything that threatens that is a huge threat to our economy," Dr Lowe said.
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Australia has only seen the start of the Trump effect

Peter Hartcher
Published: November 19, 2016 - 12:00AM
When Donald Trump was still campaigning for the White House, the Turnbull government dreaded the thought that he might succeed.
"If Trump wins," said a cabinet minister to his colleagues, "sell everything and put the money under the mattress."
It was the worst-case scenario, yet the government reassured itself that it was surely impossible. The state of denial explained why there was no serious contingency planning  for the possibility of what has now materialised — the greatest external electoral shock Australia has experienced in the postwar era.
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Rise of populism no remedy to political insider cartel

  • The Australian
  • 12:00AM November 19, 2016

Peter Van Onselen

Modern politics the world over is caught between growing populism and a political insider class, neither of which is very palatable.
The shift towards the former often results in poor policies with only superficial appeal. Even Don­ald Trump is backtracking from his campaign musings. The Great Wall with Mexico has become a fence; the proposed 45 per cent tariff on Chinese goods was a misunderstanding; rather than prosecuting Hillary Clinton, Trump now says she is a “good person”; and instead of “draining the swamp” in Washington, DC, all the names being proposed for Trump’s cabinet are insiders.
Many voters are reform-fatigued and cynical about the club that politics has become, so they are drawn to candidates who claim to buck the system; claims that often turn out to be a ­mirage.
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National Budget Issues.

Coin flip: Mysterious surge in demand for cash linked to economic uncertainty

Fergus Hunter
Published: November 15, 2016 - 1:09AM
It will surprise no one that, with the rise of cashless payments and digital transactions, the production of coins has been dwindling for a decade. Until now.
The Royal Australian Mint has recorded a mysterious rise in demand for its cash in the past year, and distrust of modern technology in tighter economic times is a likely cause.
According to new figures, the mint sent more than 247 million coins into circulation in the 2015-16 financial year. The $140 million value of this cash was the largest in six years. In 2014-15, it was down at $106 million from a high of $169 million in 2005-06.
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Spend more on infrastructure to avoid 'new mediocre', IMF tells Coalition

Peter Martin
Published: November 15, 2016 - 7:37PM
The International Monetary Fund has taken aim at the first Turnbull budget for winding back spending too quickly, especially in the coming financial year when, it says, the budget will rip $20 billion out of the economy, about 0.75 per cent of GDP.
In a statement released after a fortnight of consultations in Australia, IMF officials say that unless the government ramps up spending on infrastructure, it will run the risk of creating "a new mediocre" in which underemployment and long-term unemployment climb while wage growth and inflation stay weak.
Reserve Bank governor Philip Lowe backed up the fund's stance on infrastructure in a speech on Tuesday, saying spending on such assets as roads and railways could support the economy and generate productive assets.
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IMF urges gradual approach to budget fix

November 15, 20163:13pm
Colin Brinsden, AAP Economics Correspondent Australian Associated Press
The International Monetary Fund believes the Turnbull government has set an ambitious pace to improve the budget which could prove counterproductive.
In its preliminary findings of its annual official visit to Australia, the IMF says the fiscal consolidation set out in the May budget is front loaded, especially in 2017/18.
"Australia has the fiscal space for undertaking more gradual consolidation to a balanced budget by 2020/21, the target in the budget," it said in a statement released on Tuesday.
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Wage growth plumbs new depths as workers endure record wait for pay rises

Peter Martin
Published: November 17, 2016 - 8:29AM
If you think it has been a long time since you got your last pay rise, you're right. The Bureau of Statistics has found the average wait has nearly doubled over the past four years, from 12 months to 21 months – the longest on record.
And the increases themselves are getting smaller. The bureau says the average wage increase has shrunk from 3.6 per cent to 2.3 per cent.
Combined, the longer wait and the smaller average increase pushed wage growth down to 1.9 per cent in the year to September, the first time annual wage growth has been below 2 per cent since the bureau began compiling the index in the late 1990s.
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Morrison follows Trump up “trickle down” creek

at 8:18 am on November 17, 2016
Treasurer Scott Morrison has used Donald Trump’s Presidential victory and yesterday’s weak wages growth to spruik for cutting Australia’s company tax rate. From The AFR:
The Coalition has seized on weak wage growth to fire up support for company tax cuts amid warnings from business that Australia must match Donald Trump ‘s own tax cut plans or miss out on up to $400 billion in global investment.
Treasurer Scott Morrison warned that failure to keep pace with President-elect Trump’s plan to lower the US company tax rate to 15 per cent from over 35 per cent will erode Australia’s competitiveness because its rate would be double the US, hurting profitability and ultimately workers’ wages…
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Tell us the one about business wanting to pay higher wages – it's hilarious

Michael Pascoe
Published: November 17, 2016 - 10:18PM
Treasurer Scott Morrison and the Business Council of Australia have wasted no time in grabbing Donald Trump's election as a justification for cutting Australian corporate tax rates.
When you're fighting a losing war, you'll grab whatever weapons you can.
ScoMo and the BCA have a fair point about the Australian tax system needing to be competitive. If President Trump wasn't lying when he promised to cut America's corporate tax rate to 15 per cent from 35 with extra concessions for those prepared to repatriate funds from tax havens, Australia's 30 per cent would look expensive.
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Debt party is over: Ultra-cheap credit is coming to an end

Clancy Yeates
Published: November 19, 2016 - 12:15AM
It's over. Governments and big corporations no longer have borrowed money on tap at the lowest interest rates on record.
In a historic shift, one already under way but amplified by the shock election of Donald Trump, investors have dumped the ultimate risk-free asset in finance, an IOU from the US government.
The yield on US Treasury bonds this week surged, with 30-year bond yields hitting a 2016 high above 3 per cent, after bottoming in July. The change means investors are demanding more to lend their money to governments and corporate giants alike.
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How Australia rolls with the economic punches

Ross Gittins
Published: November 19, 2016 - 12:15AM
How has poor little Oz managed to keep our economy growing continuously for 25 years while, in the same period, other economies have suffered a recession or even two? We've had good insurance policies.
That's the answer the new Reserve Bank governor, Dr Philip Lowe, gave in a speech this week. As he explains it, however, it's a detailed story.
Actually, there are two parts to his explanation for our economic success: the first is our good "fundamentals" and the second is our ability to ride out the various "economic shocks" that hit every economy from time to time.
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Samantha Maiden: Breakthrough looms on parental leave pay

index&t_product=DailyTelegraph&td_device=desktopSAMANTHA MAIDEN, Sunday Herald Sun
November 20, 2016 12:00am
Subscriber only
index&t_product=DailyTelegraph&td_device=desktopSNATCHING victory from the jaws of defeat is one way to describe Malcolm Turnbull’s great big new paid parental leave compromise.
After being promised a “Rolls-Royce’’ parental leave scheme by Tony Abbott — twice — when they went to the polls in 2010 and 2013, families got dudded big time.
Regardless of your views on the wisdom of Mr Abbott’s plan to ask taxpayers to ­replace women’s wages for six months after birth, promising it and scrapping it was a broken pledge.
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Health Budget Issues.

Doctors’ home visits under budget scrutiny

  • The Australian
  • 12:00AM November 14, 2016

Sean Parnell

Unprecedented scrutiny will be applied to providers of home-visit doctor services, amid concerns of inappropriate practice with the potential to have a “significant financial impact” on Medicare.
Federal agency the Professional Services Review, which deals with alleged malpractice on referral from Medicare, is concerned some providers are wrongly claiming visits are urgent in an attempt to collect higher rebates.
“Examination of clinical records has shown that some practitioners have billed these items for medical conditions such as an uncomplicated rash, reissuing prescriptions for patients’ regular medication and for routine completion of medication charts in residential aged-care facilities,” the review recently warned in a report to the federal government.
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Health policies increasingly throw Medicare into state of confusion

Terry Sweetman, The Sunday Mail (Qld)
November 13, 2016 1:00am
index&t_product=CourierMail&td_device=desktopACCORDING to Dr Google, confusion can be symptomatic of a lack of oxygen, an infection, a stroke, or low blood-sugar levels.
It can also be caused by trying to keep track of whatever the Federal Government is doing to Medicare and health in general. If the Government has a considered policy, it seems to be keeping it well hidden behind a screen of backflips and inconsistencies.
Any mileage it might have gained by seizing on Labor’s “Mediscare” naughtiness during the last election has been lost as it does its very best to confirm that it does harbour ill-will towards the scheme.
Successive conservative prime ministers have pledged their love for Medicare but then proceeded to creep in like avaricious relatives to place a pillow over its face.
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Future Melbourne: $180 million Victorian biomedical research centre stalled

GRANT McARTHUR, HEALTH EDITOR, Herald Sun
November 14, 2016 6:38pm
A PLAN to reshape Victoria’s economy and create a Silicon Valley-type biomedical hub for 10,000 new workers is being stalled by the Federal Government.
Development of the Aitkenhead Centre for Medical Discovery — where Victoria’s brightest minds believe they can fast track development of projects including the bionic eye, robotic limbs, brain implants to overcome epilepsy and heart muscles grown in a lab — is expected to kickstart dozens of local start-up biotech companies as well as improving the health of people around the world.
But despite being backed by the State Government and private benefactors, the $180 million ACMD cannot proceed because the Federal Government has so far refused to commit a $60 million share.
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Medicare statistics show bulk billing is falling

Sue Dunlevy, News Corp Australia Network
November 15, 2016
index&t_product=AdelaideNow&td_device=desktopBULK billing has begun to decline creating concern the Federal Government’s freeze on Medicare rebates is starting to impact on free visits to the doctor.
The latest quarterly Medicare statistics show the proportion of GP visits bulk billed fell from 85.9 per cent in the three months to July to 85.4 per cent in the three months to September.
News Corp Australia has reported on a number of doctors’ practices around the country who have given their patients notice they will cease bulk billing after the government froze Medicare rebates at the 2014 level of $37 for six years.
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Medicare freeze no check on GP visits

The proportion of patients who put off a GP visit because of cost declined in 2015-16, dropping from 5 per cent to 4 per cent.
  • The Australian
  • 12:00AM November 16, 2016

Sean Parnell

The Medicare freeze has not stopped Australians seeing their GPs, according to the latest official survey that shows fewer ­people putting off their doctor appointments because of cost.
The freeze on rebate index­ation, which doctors warn will force them to charge patients more, was a key factor behind Labor’s so-called Mediscare campaign at the last election.
Yet a regular survey by the Australian Bureau of Statistics, which reported yesterday, has found the proportion of patients who put off a GP visit because of cost declined in 2015-16, dropping from 5 per cent to 4 per cent.
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Medibank may lift premium by lowest level in five years

  • The Australian
  • 1:25PM November 16, 2016

Sarah-Jane Tasker

Health insurance giant Medibank could be set to deliver its lowest premium increase in five years, with analysts forecasting consumers will enjoy a figure below this year’s hike.
Health insurers submitted their 2017 premium proposal to Health Minister Sussan Ley last week and Macquarie’s analysts are tipping that Medibank will increase its average premiums by 4.25 per cent, which is below this year’s increase of 5.64 per cent. Medibank said earlier this year that this year’s increase was its lowest average premium in four years.
Ms Ley had ordered health funds to resubmit their 2016 applications for premium increases with a lower figure, or provide financial statements to show the requested increases were necessary. The Minister will again be expecting a lower premium increase for 2017 given she has announced cuts to the cost of some medical devices used in the private system, which insurers had said fuelled higher costs and led to higher premiums.
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Bigger picture for healthcare

  • The Australian
  • 12:00AM November 16, 2016

Sean Parnell

The $20 billion Medical Research Future Fund will favour efforts to improve systems and structures, rather than pursue any single cure or miracle therapy, in an attempt to maximise the impact of health spending in Australia.
Last week Health Minister Sussan Ley announced six so-called strategic platforms for grants in coming years to “ensure that Australia is research ready to prepare for future challenges”.
“Without health and medical research our health system would be static,” Ms Ley told the Association of Australian Medical Research Institutes. “With it, our health system can be innovative and sustainable.”
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Health Insurance Issues.

NIB health fund under fire for emailing members offers for offshore plastic surgery

Jackie Sinnerton, The Sunday Mail (Qld)
November 13, 2016 1:00am
LEADING health fund NIB is under fire for emailing cut-price Thai boob and nose job offers to its members.
The Australasian College of Cosmetic Surgery is questioning whether NIB Options is in breach of federal legislation that bans ads offering discounted cosmetic surgeries and pressuring consumers to act before a deadline.
The ACCS has referred the matter to the Medical Board of Australia to seek clarification if the emails are illegal.
This is ground-breaking territory in cosmetic surgery advertising regulations.
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Satisfaction with private health insurance providers continues to decline

Lucy Cormack
Published: November 14, 2016 - 1:49PM
Satisfaction with private health insurers has declined to 2013 levels, as survey results show more than 10 per cent of Australians plan to leave their funds in the next 12 months and are shopping around.
The results, from Roy Morgan's Single Source survey of more than 50,000 Australians, found nearly all major health insurance providers had shown declining customer satisfaction in the past year, with overall satisfaction at 74.4 per cent, down from 76.3 per cent at the same time last year.
Over the past three years, HBF has maintained the highest satisfaction level of the five largest funds at 80.2 per cent, followed by HCF (74.3 per cent), Bupa (73.6 per cent), NIB (70.9 per cent) and Medibank Private (70.1 per cent).
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Market failure: private health insurance only worth it for 'the pregnant, the rich and the sick'

Private health insurance system in urgent need of reform as analysts say it is ‘virtually impossible’ for the average person to compare policies’.
If you take out health insurance when you are in your 20s, it may be many years before you start making claims and work out if it’s worth it or not, as Jason and Laura Wolfe found after years of paying for it. Photo by Meredith O’Shea for The Guardian. Photograph: Meredith O'Shea for the Guardian
Laura Rolfe has always had private health insurance, because her mum always had it and she believed that “it’s just what you do”.
The 29-year-old account manager convinced her husband, Jason, that it was something he needed to have as well, fearing he might be left in the lurch if illness or injury struck.
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Experts agree private health insurance is broken. But how can it be fixed?

Reports from government, consumer groups and health bodies depict an unsustainable system. Possible solutions include phasing out private insurance or establishing a single insurer
Experts are calling for Australian policy makers to step back from assumptions about private health insurance and ask if the system is serving the country’s needs. Photograph: Cultura RM/Alamy
Private health insurance is broken and should be scrapped in its current form and replaced by a single health insurer according to health economists and policy experts who have spoken to Guardian Australia.
This drastic assessment has been prompted by numerous reports from government, consumer groups and peak health bodies over the past six months.
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Private health insurance industry says Australian system affordable

Dr Rachel David, chief executive of Private Healthcare Australia, says comments critical of industry are ‘one-sided’
The private health insurance industry has rejected claims that it is unsustainable and offers consumers little value for money, saying the “majority” of Australians value private health insurance and its role in the overall health system.
In a Guardian Australia investigation into the industry this week, health policy analysts and economists called for the private health insurance system to be abolished and replaced by a single insurer.
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Medibank likely to deliver lowest premium rise for five years

Medibank is expected to keep down its annual increase in average premiums to 4.25 per cent. Picture: Annette Dew.
  • The Australian
  • 12:00AM November 17, 2016

Sarah-Jane Tasker

Medibank could be set to deliver its lowest premium increase in five years.
After health insurers submitted their 2017 premium proposals to Health Minister Sussan Ley last week, Macquarie analysts tipped that Medibank would increase its average premiums by 4.25 per cent, down from this year’s rise of 5.64 per cent. Medibank said earlier that this year’s rise was its lowest average premium in four years.
Ms Ley ordered health funds to resubmit their 2016 applications for premium increases with a lower figure, or provide financial statements to show the requested increases were necessary. The minister will also be expecting a lower premium increase for 2017 after she announced cuts to the cost of some medical devices used in the private system, which insurers had said fuelled higher costs and led to higher premiums.
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Families to take $250 health hit

- on November 18, 2016, 12:40 am
Families with health cover could be hit with premium increases of up to $250, as Health Minister Sussan Ley vows to crack down on insurers trying to gouge their members.
Funds have lodged their annual application for increases to the Federal Government but are banned from revealing what they are seeking.
Ms Ley warned she would not hesitate to order them to resubmit their bid to ensure premium rises were kept as low as possible.
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Pharmacy Issues.

Chemist Warehouse is the Bunnings of pharmacy, turning over $4 billion a year for its secretive owners

Dana McCauley, news.com.au
November 19, 2016 1:39pm
WHEN Chemist Warehouse sold $2 million worth of stock in 13 minutes, founder Damien Gance barely batted an eyelid.
In a sign of just how big the chain has become, Mr Gance was pleased but relaxed with his company’s record-breaking sales result — which pales in comparison to the billions of dollars the family-owned business turns over annually.
“It’s another cog and business we’re trying to drive and promote,” Mr Gance told news.com.au.
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Superannuation Issues.

Confusion for many over proposed superannuation changes, survey shows

Paul Gilder, Herald Sun
November 14, 2016 12:00am
index&t_product=HeraldSun&td_device=desktopTHE Federal Government’s latest attempts to tinker with the superannuation system are mystifying fund members, a survey has found, with one in three polled oblivious to proposed taxation changes.
And while respondents deemed the superannuation industry trustworthy, half of those surveyed weren’t sure how much savings they would need in retirement.
The research, commissioned by the Association of Superannuation Funds of Australia, showed that although people were supportive of the system, many still needed to get their heads around it.
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Retirees in aged care should consider options ahead of assets test

  • John Rawling
  • The Australian
  • 12:00AM November 15, 2016
Few people will be more nervous about the government’s planned changes to the age pension, due to come into effect on January 1, than retirees living in residential aged care, many of whom use their pension cheques to pay their accommodation fees.
Before Christmas, Centrelink will send out letters to about 700,000 Australian retirees outlining the new rules. A new assets test will reduce or eliminate pensions for many seniors with substantial investments.
Although it looks like 160,000 of Australia’s four million pensioners will receive a modest increase in their pensions, more than 300,000 face cuts, and nearly 90,000 pensioners will have their pension cancelled completely.
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  • Updated Nov 14 2016 at 12:15 AM

Labor headache for Coalition's super reforms

The Coalition, it seems, is still a long way from getting its flagship superannuation reforms package passed into law. The opposition Labor Party is going to make life as difficult as it can for Treasurer Scott Morrison and his budget changes.
For starters, Labor argues that the government has not gone far enough on its crackdown on tax concessions for the wealthy and is proposing to lower the limit on annual after-tax super contributions to $75,000 from Mr Morrison's planned $100,000. Both caps are considerably lower than the current $180,000 contribution ceiling.
Labor is also calling for the income threshold at which the 30 per cent super contributions tax is applied to be reduced to $200,000 from the government's proposed $250,000 and down from the current level of $300,000.
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I look forward to comments on all this!
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David.

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