Sunday, April 07, 2013

The Next Federal Budget Is Only Six Weeks Away And The Government Is Looking For Money! What Might This Mean For E-Health?

On Friday, after a month or two of intense speculation in the lead up to the Budget, we saw the Government announce a series of changes to Superannuation for Australians - re-introducing a level of tax on superannuants in retirement (aimed at making about $10B in savings over 10 years) as well as a range of other tweaks.
It seems clear that the Government really wanted to extract a whole lot more and to announce these in the Budget in mid-May but having said (Mr Shorten set the hares running) that they were thinking of changes they made so many people anxious and unhappy with uncertainty they were forced  to move and announce a relatively limited package early.
The structural deficit the Australian budget is now in - caused I would argue as excessive unfunded spending by both sides over the last 10-15 years is - is going to need some seriously smart and doubtless painful pruning. (I hear the size of this deficient is the subject of a forthcoming report from the Parliamentary Budget Office which is due soon.)
Indeed yesterday we were told things are so bad that an actual surplus seems to be unlikely in the next 3-4 years at best - and we are meant to be in boom times from mining. See here:

No Labor surplus in foreseeable future

Laura Tingle and Jacob Greber
Federal cabinet’s expenditure review ­committee sees little chance of a forecast surplus in any of the next four years when Treasurer Wayne Swan releases the federal budget on May 14.
The government gave up any hope of being able to forecast a surplus in 2013-14 some time ago, as revenue collections have failed to meet forecasts.
Senior government sources have now confirmed that there appears little prospect of a surplus in the so-called budget “out years” of 2014-15, 2015-16 and 2016-17.
It will argue that a slump in tax ­collections is behind the failure to return the budget to surplus this financial year or to forecast such a return in the next four years.
It will argue that it would be economically irresponsible to impose savage spending cuts to offset low revenue and get back to surplus in a soft, if improving, economy .
At the same time, it will argue that the budget numbers show it ­continues to exercise spending restraint in the short term, and is finding large long-term structural savings like the superannuation changes, to fund major new spending proposals like the National Disability Insurance Scheme and the Gonski education spending increase.
Lots more here
So what we have is a Government framing what, if the pundits are correct, will be its last budget with some very large spending to lock in and dramatically falling revenue. (Note: I believe if the Liberals win they will equally struggle with this - it will need major surgery.)
Against this we have an e-Health Program which looks unlikely to provide any real benefit - economic or health outcome based - for years to come, if ever.
If I were a betting man - which I am not - I would lay long odds on pretty major cuts to the forward funding for the PCEHR and a range of other supporting programs no matter who is in power.

Medicare Locals may also find themselves struggling fundingwise I suspect.
What do you think?


Anonymous said...

"It will argue that a slump in tax ­collections is behind the failure"

If you feed the international consulting locusts with all your money they are going to send as much as they can overseas to their owners! When times get tough they will disappear, just like they did in the UK, where the government has realised the error of its ways and is trying to work with the local SMEs and stakeholders now that they have very little money to spend. When will we learn that lesson and start to get some real value for the taxpayer?

Anonymous said...

There will be chops to eHealth simply because the general public are oblivious to the fact that The Government has spent over 1 billion dollars on its eHealth projects like PCEHR and delivered nothing in return.

Anonymous said...

I agree with Anon 4/08/2013 12:24:00 PM. At first glance I thought you meant to say there will be no chops to eHealth BUT then I released that if the public are oblivious (which they are) it will be fairly painless for the Government to claw back whatever monies they can particularly as the media seem to have lost interest in eHealth since Karen Deane departed the scene. There must be at least $300 mill up for Swannie to pull back into the budget.

Anonymous said...

In the main the general public are oblivious to the PCEHR despite all the trundling trucks, rolling road shows, Wave 1 & 2 sites, and conference presentations to converted advocates.

In the main NEHTA and DOHAs marketing efforts have been self serving and misdirected to create the aura 'it is all happening'.

The most meaningful statistic reflecting use and value is how frequently does an INDIVIDUAL access their PCEHR after they have enrolled for one.

The crude techniques deployed by NEHTA and DOHA will and do not work. Marketing is a refined art and in such a complex field as health with multiple vendors, conflicting cultures and jurisdictions the traditional marketing approaches being deployed simply will not muster the traction required.

Anonymous said...

Anon 4/09/2013 08:49:00 AM understands the problem very clearly but can anything be done about it? The answer is an emphatic NO - because the bureaucrats have hung themselves so far out to dry they have no way of turning back whilst saving face. Also, they have never wanted to engage with anyone who doesn't agree with their way of doing things. Industry needs to find a way around such entrenched shortsightedness else nothing will change.