Monday, May 12, 2014

Pre - Budget Review Of The Health Sector - 12th May 2014.

As we head towards the Budget in Early to Mid-May 2014 I thought It would be useful to keep a closer eye than usual on what was being said regarding what we might see coming out of the Budget.
Budget Night will be on Tuesday 13th May, 2014.
Here are some of the more interesting articles I have spotted this week. This will be the last pre-budget review and later in the week we will review the outcome


Overweight people could pay more for health insurance: NIB chief Mark Fitzgibbon

Date May 5, 2014 - 6:53AM

Dan Harrison

Health and Indigenous Affairs Correspondent

Overweight people could pay more for health insurance if the Abbott government adopts a Commission of Audit proposal to allow health funds to charge some customers higher premiums because of their "lifestyle choices".
Under the current system of "community rating", private health insurers are forbidden from charging older or unhealthier people more for cover.
But in its report, released on Thursday, the Commission of Audit recommended health funds be allowed to vary premiums "for a limited number of lifestyle factors, including smoking, which materially increase a person's health risk".

Commission Report on Delivery of Health Services in Tasmania a Damning Indictment of Labor

A Report by the Commission on Delivery of Health Services in Tasmania has been released by Federal Health Minister Peter Dutton and Tasmanian Health Minister Michael Ferguson.
Page last updated: 05 May 2014

Joint Media Release

Federal Minister for Health
The Hon Peter Dutton MP

Tasmanian Minister for Health
The Hon Michael Ferguson MP

5 May 2014
A Report by the Commission on Delivery of Health Services in Tasmania released today by Federal Health Minister Peter Dutton and Tasmanian Health Minister Michael Ferguson reveals serious concerns about the state’s health system and the mismanagement of the Royal Hobart Hospital re-development.
The report outlines that major changes are needed to ensure the Tasmanian health system meets the needs of patients and highlights inefficient and wasteful practices.
Federal Health Minister Peter Dutton said it was clear the previous Labor and Labor-Green Governments had run the health system into the ground in Tasmania.

Hockey's Commission of Audit anything but responsible

Date May 6, 2014 - 9:15AM

Peter Martin

Economics Editor, The Age

Who in their right mind would hit anyone with an effective marginal tax rate of 94 per cent?
Australia’s top personal income tax rate has never hit 80 per cent. Labor’s resource super profits tax would have been 40 per cent applied to a 28 per cent company tax rate. Labor feared that any more would take away the incentive to mine.
Yet the Commission of Audit wants to hit Australians moving from the dole back into the workforce with an effective marginal tax rate of 94 per cent on wages of $19,0000 to $32,000.
This would stall their reward from work at close to $19,000 even as they took second and third part-time jobs.

Audit commission's rationalist market approach a glimpse into a less caring future

Date May 6, 2014 - 9:40PM

Ross Gittins

The Sydney Morning Herald's Economics Editor

We will hear a few toned-down echoes of the report of the National Commission of Audit in Tuesday’s budget but, apart from that, the memory of its more extraordinary proposals is already fading. And for most Coalition backbenchers, that can’t come soon enough.
But I think the audit commission has done us a great service. It has been hugely instructive. The business people and economists on the commission offered us a vision of a dystopian future.
It’s a view of what lies at the end of the road the more extreme economic rationalists are trying to lead us down. If you’ve ever wondered what life would be like if we accepted all their advice, now you know.

The audit missed healthcare costs

Terry Barnes
There’s a well-worn joke about a lost traveller standing at a crossroads and asking a grizzled old Irishman for directions. “To be sure,” the Irishman replies. “I wouldn’t start from here.”
Prime Minister Tony Abbott, Treasurer Joe Hockey and Finance Minister Mathias Cormann established the National Commission of Audit to give directions on more sensible, structured and sustainable Commonwealth and federal-funded programs and services. But if the commission’s report is the starting point to a better healthcare future, like the Irishman I wouldn’t start from here either.
Overall, an unavoidable impression is that the commission, headed by then-Business Council of Australia chairman Tony Shepherd, didn’t fully grasp Australia’s complex, often economically irrational, and, above all, highly political healthcare infrastructure. Rather than do much original policy thinking, it sought largely to put its own stamp on policy debates already under way, including Medicare co-payments; widening the roles of private health insurance and health professionals other than doctors in primary care; and improving federal-state and public-private co-ordination of effort.

Joe Hockey to swing axe on public sector

MORE than 200 spending programs will be slashed in next week’s federal budget as Joe Hockey vows to shrink the size of government in a “big, structural change” to save billions of dollars.
Agencies will be closed and thousands of staff retrenched over the coming months in a drastic overhaul that will start with the loss of 3000 positions in the Treasurer’s own portfolio.
The axe will fall in major portfolios including environment, transport, industry, agriculture and indigenous affairs.
Mr Hockey told The Australian that spending cuts would do the “heavy lifting” in fixing the deficit, despite growing criticism of looming tax hikes including a lift in fuel excise.

Paul Keating calls for 'longevity levy' to support seniors

Date May 9, 2014 - 8:28AM

Matthew Knott

Communications and education correspondent

Former Prime Minister Paul Keating has called for a new “longevity levy” to support the growing number of Australians who will live between 80 and 100.
Mr Keating, the chief architect of compulsory superannuation, said the superannuation system had not kept pace with increased life expectancy. He said this meant a new national elderly insurance scheme – based on a levy of two to three per cent of wages – is needed to help pay for income support and aged care.
“You can't save under super for 30 years or 35 years and then live another 30 years off from it,” Mr Keating told the ABC’s Lateline program on Thursday night. “In other words, the pool can never be big enough to sustain you till your 90s. 

FactCheck: does the average Australian go to the doctor 11 times a year?

8th May 2014
NO matter how you count it, on investigation Tony Shepherd’s Audit report claim doesn’t add up.
By Richard Norman, University of Technology, Sydney and Philip Haywood, University of Technology, Sydney
All Australians, on average, go to the doctor now 11 times per year. I just don’t think we’re that crook. – Tony Shepherd, Commission of Audit Chairman, press conference on the report’s launch, May 1
The National Commission of Audit’s report, released late last week, recommends a $15 co-payment for all Medicare services. It suggests this cost fall to $7.50 after a “safety net” of 15 visits or services and that concession-card holders pay $5 initially and $2.50 once they exceed the safety net.

Joe Hockey waves goodbye to the Medicare Kingswood

Date May 9, 2014 - 8:36PM

Peter Hartcher

Sydney Morning Herald political and international editor

On Tuesday night, the Abbott government will announce that the free visit to the doctor for most people is to become a historical artefact of Australian life.
It will be one of the most controversial decisions that the government will take.
It will also be one of the hardest-fought as Labor and the Greens try to block it in the Senate. Clive Palmer’s party will get to sit in judgment.
Today, four out of five visits to the doctor are free to the patient because the doctor “bulk bills” the charge to Medicare.

Debt Levy.

Highest earners to wear burden of levy

CABINET ministers will act within days to redraft their $10 billion “deficit tax” in a bid to ensure it would hit only the wealthiest Australians, while reserving the option of scrapping it altogether.
As more Liberals hit out at the proposal, ministers are preparing to limit the tax to those earning well above 100,000, to counter Labor accusations that the “working class” will suffer from a breach of Tony Abbott’s election promises.
One option to be decided by ministers on Wednesday is to apply a 2 per cent surcharge on incomes of more than $180,000, which is more than twice the nation’s average full-time salary.

Former treasurer Peter Costello says 'debt tax' would have 'no economic benefit'

Date May 6, 2014 - 8:30AM

Judith Ireland

Breaking News Reporter

One of the most respected economic figures in the Liberal Party, former treasurer Peter Costello, has hit out against the prospect of a deficit levy, describing it as a political idea that will have no economic benefit.
This comes as Commission of Audit chief Tony Shepherd warned that if the government brings in a deficit levy, it will have to be careful about implementing the commission's report, or risk "shocking the system", and as a new poll shows support for the Coalition has dropped to its lowest level since December 2009.
As the government prepares for its final meetings on the federal budget, which will be handed down next Tuesday, the Coalition continues to face a storm of voter anger, with three polls in the past three days putting Labor clearly in front of the government.

Former Coalition treasurer Peter Costello warns Tony Abbott off deficit levy

  • AAP
  • May 06, 2014 8:18AM
THE Coalition government's proposed deficit levy will have no economic benefit and is purely a political move, former treasurer Peter Costello says.
And the man who headed up a review of government spending, Tony Shepherd, has also cautioned the government against introducing the levy because it could cause a shock to the system.
Mr Costello says the levy - which would begin with a one per cent tax on those earning more than $80,000 - would not benefit the economy nor reduce interest rates.
Rather, it would detract from growth by reducing consumption. The former treasurer says the levy is a political move to gauge public reaction, and there's been enough concern for the government to shelve the idea.

Deficit levy: Tony Abbott's broken promise on tax is in the national interest

Date May 7, 2014 - 9:15AM

Mark Kenny

Tony Abbott has had an epiphany on tax and now accepts he should never have promised not to increase them when in opposition. We know this because he is backing a "temporary" tax rise to accelerate the deficit deletion process.
More importantly, he recognises that not all taxes are bad and that tax policy can be used in a genuinely redistributive way – which is to say, to impose fairness. Who knew?
Bill Shorten could acknowledge this largely positive development and give the Prime Minister the leeway needed to backtrack.
Don't hold your breath on that score though.

GP Co-payments.

$15 co-payment based on ‘dangerous assumption’

5th May 2014
THE National Commission of Audit’s (NCOA) proposed Medicare co-payment is based on a “very dangerous assumption” about over-servicing in the primary care system, RACGP president Dr Liz Marles has said.
The college, Consumers Health Forum and Australian College of Emergency Medicine have joined forces to oppose the plan to implement co-payments for GP visits, saying it would provide a disincentive to seek primary care, which would likely increase the need for hospitalisations and end up costing the health system more. 
A Galaxy poll, commissioned by News Corp and carried out last week, showed only 35% of Australians support a $6 co-payment, while more than half oppose it outright.

GPs warn: Co-payment will be an 'administrative nightmare'

6th May 2014
THE National Commission of Audit's (NCOA) recommendation to introduce a co-payment for doctor visits and Medicare services would be an administrative nightmare for general practice, according to grassroots GPs and practice managers.
Tasmanian solo GP Dr John Wilkins told MO practices would need a sizeable float each day and a cash register; they would need to collect money, give change, write receipts, record transactions, and record bad debts and take money home, among other things.
“How do you know if someone has reached their first cap – as it includes co-payments for radiology, pathology, and other practitioners etc – and calculate the correct payment? 

Abbott hints at budget co-payment

7th May 2014
PRIME Minister Tony Abbott has dropped another hint about the likelihood Australians will have to make a co-payment when visiting the doctor.
"Free services to patients are certainly not free to taxpayers," he said in a pre-budget speech.
That's being taken to mean the much flagged co-payment – possibly as much as $7.50 – is almost a certainty.
The co-payment fits neatly into Treasurer Joe Hockey's pledge to end the age of entitlement and with his "early warning bell" about the sustainability of Medicare.

NCOA’s GP figures a ‘sham’: RACGP

7th May 2014
THE National Commission of Audit's assertion that there are 50,000 general practitioners in Australia has been labelled a "sham" figure by the RACGP.
The first appendix of the NCOA report says there are 50,000 Australian GPs, a number it attributes to the Australian Bureau of Statistics. 
But that number is almost 6500 higher than the most recently available ABS figures, which are from the 2011 census.
The health department's latest general practice workforce statistics, which only count GPs who have provided at least one service and had at least one claim processed in a year, give a far lower workforce headcount – 30,681 GPs for the 2012–13 financial year. 

Is the evidence on GP co-payments as bad as Labor says?

May 5, 2014
Healthcare spending has been named as the nation's single largest long-term fiscal challenge by the National Commission of Audit report.
Earlier this year, Federal Health Minister Peter Dutton said the Government was considering introducing a co-payment for visits to general practitioners in the May 13 budget. This followed a speech in which he said Medicare was on an unsustainable path.
Essentially, a co-payment would mean the 80 per cent of Australians who go to bulk-billing doctors would be required to make a payment of the Government's choosing.

Medicare Locals.

Local service is ‘keeping people out of hospital’

May 6, 2014, 4 a.m.
NEW England Medicare Local is stepping up the services it provides across the region, as community demand continues to increase.
Clinical services network co-ordinator Therese Greenlees told a New England Mutual business breakfast in Guyra last week that in 2012/13, the branch had recorded 10,000 mental health and 10,000 allied health service visits, a considerable increase from previous years.
Services included the likes of podiatry, physiotherapy and preventative health checks in smaller communities across the region, and mental health assessments and education and carer support.
The New England branch is one of 61 Medicare Locals across the nation, established three years ago as part of a $1.8 billion federal government scheme to help co-ordinate and deliver extra health services, including after-hours GP services, immunisation, mental health support and eHealth programs. 

MPs issue health service warning


May 9, 2014, 6 a.m.
SOUTH Coast health-care jobs could be axed if the federal government makes any cuts to Medicare Local in next week’s budget.
Illawarra Shoalhaven Medicare Local chief executive Dianne Kitcher met with MPs last week to discuss fears the service, set up under the Rudd government, would be scrapped.
Cunningham MP Sharon Bird said the region’s diverse population meant a variety of Medicare Local services were crucial to the community.
“The government talks about them as though they’re a bunch of bureaucrats, but they’re not, they’re direct service delivery for really important preventative health initiatives,” she said.


Pharmacies in supermarkets are already here, Guild to blame: union

5 May, 2014 Christie Moffat
Proposed changes to ownership and location rules in the recent National Commission of Audit report will have limited impact, as the rise of discount pharmacy chains have created “supermarkets within pharmacies”, according to the pharmacy union.
Dr Geoff March, president of Professional Pharmacists Australia (PPA), says the “outrage” of the Pharmacy Guild of Australia over the possibility of supermarkets entering pharmacy ignores the fact that the discount approach of pharmacy chains, such as Chemist Warehouse, has already made business difficult for traditional operators to compete.
“This change in community pharmacy has happened under current ownership and location rules. The Guild has done nothing to stop the effective destruction of the community pharmacy model,” Dr March said.

Majority of pharmacists disagree with Audit report: poll

6 May, 2014 Christie Moffat
The majority of pharmacists disagree with the National Commission of Audit recommendations to deregulate pharmacy, according to the results of a poll on the Pharmacy News website.
The poll, launched on the Pharmacy News website last Friday, asked participants ‘Do you agree with the Audit Commission’s proposal to deregulate pharmacy?’
As of today, the majority of respondents (~70%) said they did not agree with the recommendations to deregulate pharmacy. However, 26% said they did agree with the report, and about 4% of the respondents said they were undecided.
Responding to the findings of the poll, the Pharmacy Guild of Australia said that the objective of reform should be to make improvements, not destroy a system that is working.

Pharmacies call for the doctor

Pharmacies are at risk from job losses. Source: The Australian
PHARMACY insolvencies have been tipped to rise to unprecedented levels from next year, as the nation’s largest drugs wholesaler slammed a high-level review into government spending for perpetuating misconceptions about the cost of the Pharmaceutical Benefits Scheme.
With industry conditions set to toughen following the introduction of accelerated price cuts for medicines in October, stockbroker Taylor Collison has estimated that about 300 pharmacies could collapse this year and next — more than 5 per cent of the country’s 5300 community phar­macies.
Last year, about 100 pharmacies were placed into receivership — including the NSW-based Harrisons Pharmacy chain — a tally higher than the previous 10 years combined.

Guild apologises for claims caught in 5CPA 'administration backlog'

8 May, 2014 Chris Brooker
The Pharmacy Guild of Australia is committing extra resources to urgently address the current backlog of claims for payment for 5CPA programs: Home Medicines Reviews, Residential Medication Management Reviews, Quality Use of Medicines, and MedsCheck programs.
The Guild took over administration of the registration and claiming for these programs from 1 March this year.
Under previous claiming arrangements through the Department of Human Services, pharmacists would normally receive payment in the first week of each month for claims submitted within the first 14 days of the previous month.

‘Perfect storm’ predicted to increase rate of pharmacy closures

8 May, 2014 Chris Brooker
The number of pharmacies that could go into receivership over the next two years could dramatically increase, analysts believe.
Analysis prepared by stockbrokers, Taylor Collison, indicates the next two years could see a pharmacy “market rationalisation” with around 300 pharmacies going into receivership, as reported by The Australian.
The Pharmacy Guild of Australia said previously that about 100 pharmacies went into receivership in 2011, while 2013 saw the demise of the Harrisons pharmacy group, among others.

Minster backs community pharmacy model

9 May, 2014 Christie Moffat
Health Minister Peter Dutton (pictured) has reportedly reiterated the Coalition’s support for the community pharmacy model, in private discussions with the Pharmacy Guild of Australia.
The Minister’s support follows the National Commission of Audit report, released last week, which recommended the deregulation of ownership and location rules.
The report also proposed introducing pharmacies in supermarkets, prompting a swift response from the Guild, seeking assurances from the Minister.
Speaking at APP2014, Minister Dutton committed the Government to the current pharmacy model. While no public statement has been made by the Government since the Audit report was released, the Guild said it had received private assurances from the Minister.
The drumbeat suggesting a tough budget continues to build to a frenzy. The final report of the Commission of Audit (COA) has been handed to Government and released with a lot of possible impacts on health. The Budget is now being printed so all we have to do now is wait for Tuesday at 7:30pm.
We already know for certain the pension age will be 70 by 2035.
The new idea to scare the public last week is a so called  ‘debt levy’ - read income tax increase. The political fallout with this idea seems likely to be intense if the News Limited press over last weekend can be believed.
Interesting to see Community Pharmacy is really in the COA gun.
Also, interesting that the politicians of both sides are taking a double hit - salary freeze and debt levy apparently.
To remind people there is also a great deal of useful discussion here from The Conversation.
As usual - no real news on the PCEHR Review. Just a vague comment.
Thank heavens the next report will be the post-budget report.

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