Thursday, July 03, 2014

Review Of The Ongoing Post - Budget Controversy 3rd July 2014. It Is Sure Going On and On!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
Here are some of the more interesting articles I have spotted this sixth week since it happened. Since the budget was handed down all hell has broken out in the Health Sector and has been continuing.
It was interesting to see the AMA President continue come out so strongly against the co-payment. Does not bode well for success in the Senate when it changes on July 1. The level of comment on this issue is also seemingly unending.
Listening to the political conversation last week it seems like very little of the Government’s agenda has an assured passage through the Senate any time soon!
We sure do live in interesting times!


Australia has health success but also challenges

  • AAP
  • News Corp Australia
  • June 25, 2014 2:00PM
AUSTRALIANS are living longer and smoking less but eating themselves to death, new research shows.
The nation ranks in the top 10 in the world for life expectancy, living 25 years longer than they did a century ago.
But while smoking rates continue to fall, and vaccination rates have increased, more than three in five adults are overweight or obese.
The latest health snapshot by the Australian Institute of Health and Welfare says even though there is much to be proud of, lifestyle-related diseases are a growing concern.
The biennial report shows Australian men ranked sixth among Organisation for Economic Cooperation and Development (OECD) countries when it comes to life expectancy, and Australian women seventh.

Canberra chips in for less of health bill, AIHW study finds

Sean Parnell

Health Editor
HEALTH costs are rising but the Commonwealth’s share of the total bill is decreasing, according to a new analysis.
The Australian Institute of Health and Welfare’s 2014 check-up on the population and the system itself has found that while the federal Government continues to provide the majority of health funding, its overall share is declining. The Commonwealth’s contribution dropped from 44 per cent in 2001-02 to 42.4 per cent in 2011-2012, while the States’ contribution grew from 23.2 per cent to 27.3 per cent over the same period.
The report, released today, shows that the proportion of total revenue spent on health is increasing for the States, and decreasing for the Commonwealth, ensuring that, overall, health spending is taking up a greater proportion of government revenue — 26 per cent in 2011-2012, or six percentage points higher than before the Global Financial Crisis. That is likely to feed into the debate between the States and the Commonwealth over the Abbott government’s decision to abandon Labor’s commitment for the Commonwealth to pay a greater share of public hospital costs, and also the other controversial Budget decision to introduce a $7 co-payment for basic Medicare services. Prime Minister Tony Abbott has promised to reform the Federation and negotiations are likely to focus on the perceived imbalance between the States’ obligation to fund service delivery and their limited revenue streams.

Starting on the long task of shrinking government

June 24, 2014
Josh Frydenberg
Among the furious political debates over Medicare co-payments, the indexation of pensions and the deregulation of university fees, one key theme in this year’s budget has been sadly overlooked.
The move to a smaller and more efficient government with the extensive consolidation in the number of government bodies, committees and boards.
Nearly 100 government entities covering areas from agriculture to aid and infrastructure to insurance will be merged or abolished in the most concerted effort undertaken at the federal level to streamline the delivery of services and to reduce cost, complexity and confusion for stakeholders.
The gains are potentially enormous, with net savings of about half a billion dollars expected over the forward estimates.

Crisis in general practice feared with deregulated uni fees

24th Jun 2014
THE federal government's decision to deregulate university fees could spark a crisis in the general practice workforce, stakeholders have warned.
In a letter to Education Minister Christopher Pyne, AMA president Associate Professor Brian Owler said medical students could face debts of more than a quarter of a million dollars each by the time they graduate. 
"With high demand for places, there is no reason to think that competition will keep fees under control," Professor Owler said.
"If [planned] fee structures were to be adopted for domestic students, this would leave a medical student with a debt of over $259,000 plus interest once they have completed both [medical] degrees. On any measure, this is a significant debt, and no matter what upfront loan assistance is provided, it will deter students from low-income backgrounds from entering medicine."

Fact check: Has public hospital funding been cut by $50 billion?

June 23, 2014
Treasurer Joe Hockey says the Federal Government's hospital funding is unaffordable, and his recent budget shows $80 billion of savings from changes to school and hospital funding over the next 10 years.
In response, Labor has accused the Government of breaking promises. Opposition spokeswoman for health, Catherine King, says: "Instead of providing the growth funding that was promised, promised to the Australian public and promised to the states to run the public hospitals, this budget of broken promises in fact cuts a whopping $50 billion from Australia's public hospitals."
But Mr Hockey argues the Government is still growing funding for schools and hospitals, "just not as fast as what Labor suggested they would do".

Health ministers vote to reinstate healthy food star rating website

Date June 27, 2014

Amy Corderoy

Health Editor, Sydney Morning Herald

State and federal ministers will reinstate a healthy food star rating system that was controversially pulled offline by federal Assistant Health Minister Fiona Nash and her junk-food lobbyist chief of staff.
At a meeting in Sydney this morning they voted to reinstate the website, and affirmed support for the scheme that will allow food producers to adopt a voluntary system for comparing the healthiness of different types of foods. 
Similar foods, such as cheeses or drinks, will be given a rating out of five based on their levels of both nutritious and unhealthy ingredients.

Health star rating system on track

Australian and New Zealand Food Ministers agreed further steps for the voluntary healthy star rating front of pack labelling system at the Legislative and Governance Forum on Food Regulation.
Page last updated: 27 June 2014
27 June 2014
Australian and New Zealand Food Ministers agreed further steps for the voluntary healthy star rating front of pack labelling system at the Legislative and Governance Forum on Food Regulation (the Forum) in Sydney today.
Assistant Minister for Health Fiona Nash chaired the Forum, which also considered pregnancy warnings on alcohol products, and food standards.
Minister Nash welcomed New Zealand’s decision to join the Health Star Rating system on a voluntary basis, and acknowledged the work and communication between the Australian and New Zealand Governments regarding the Health Star Rating system.

Medical Research Fund.

Medical research not the only way

THE federal government’s proposed $20 billion medical research fund could be a success, but not at the expense of ripping funding away from other innovation engines, a venture capitalist says.
Australian venture capital firm OneVentures partner and managing director Paul Kelly said the country’s wealth of research and inventiveness was not limited to medical research.
“What the government should be looking to do is to foster innovation across the board and really fuel our transformation into an innovation economy,’’ he said.
“You can’t do that by ripping out or undermining engines of innovation such as NICTA.’’
The Abbott government will direct $20bn from January to ­establish the Medical Research ­Future Fund.

GP Co-payment.

GPs say “no way” to co-payment – Australia’s healthcare quality at serious risk

20 June 2014
The leading representative body for general practice in Australia, the Royal Australian College of General Practitioners (RACGP), will not support the Federal Government’s $7 co-payment scheme as proposed which threatens universal access to healthcare.
The RACGP today released an official position statement on co-payments in general practice in response to wide-spread opposition from the general practice profession and Australian public regarding the Government’s proposal.
RACGP President, Dr Liz Marles said the statement aims to clarify and further reiterate the RACGP’s position on the controversial move and sends a strong message that the RACGP does not support the co-payment proposal.
“The RACGP has been steadfast on its position regarding the introduction of a co-payment model since it was first rumoured at the end of last year,” said Dr Marles.

Rethink rebate and co-payment: AMA

23rd Jun 2014
THE AMA will ask the government to reverse the $5 rebate cut for practitioners and revise its proposed $7 co-payment after talks at the weekend.
A meeting of the AMA’s Council of General Practice reinforced its position of rejecting the planned rebate cut for GP attendances and other items. 
“We don’t accept the rebate cut is fair or viable for practices. The previous rebate has been inadequate and fallen behind over many years from what the proper fee should be,” the council’s chair Dr Brian Morton told MO.
“We call on the government to actually talk to the profession, and specifically the AMA, because it really is a whole-of-profession issue involving diagnostic imaging and pathology, and that goes to other specialists as well.”

Medicare co-payments – Has Tony Abbott closed Australia for (private health insurance) business?

Marie McInerney | Jun 24, 2014 3:50PM |
In this first of a series of posts about Medicare, Margaret Faux notes that the Abbott Federal Government appears to be trying to gain some traction from former Labor Prime Minister Bob Hawke’s introduction of co-payments. But she says, more can be garnered from considering why they were not introduced by John Howard.
Faux is a lawyer, the founder and managing director of one of the largest medical billing companies in Australia and a registered nurse. She has been involved in Medicare claiming for 30 years and is a research scholar at the University of Technology Sydney examining the interface between Medicare and medical practitioners.

Medicare co-payment: AMA rejects Coalition's compromise offer

President of the AMA says doctors will not accept any proposal which reduces the Medicare rebate
The Australian Medical Association (AMA) says the health minister’s willingness to exempt nursing home residents from the proposed $7 co-payment is not enough to win their support for the controversial measure.
Peter Dutton signalled this week that aged care residents would be exempt from the co-payment as part of a compromise in the wake of the May budget.
But Brian Owler, the president of the AMA, which is the peak body representing doctors, says doctors will not accept any proposal which reduces the Medicare rebate.
Under the proposed co-payment the Medicare rebate would be reduced by $5, leaving patients to make up the difference. Doctors fear they would financially penalised for bulk billing.

Tony Abbott to ‘consider alternatives’ to $7 fee for GP visits

Laura Tingle Political editor

Key points

  • PM met the AMA president over doctors’ concerns about Medicare payments.
  • Tony Abbott later reinforced the Coalition’s commitment to a new price model for GP visits.
The first signs have emerged that the Abbott government may make concessions on its controversial $7 Medicare co-payment, with the Australian Medical Association reporting Prime Minister Tony Abbott said he was ­prepared to look at alternative models.
Mr Abbott and Health Minister Peter Dutton met AMA federal ­president Brian Owler in Canberra on Tuesday after the doctors’ body expressed trenchant opposition to the $7 payment on GP visits, as well as ancillary services such as pathology and diagnostic imaging.
The AMA argues the plan, which is forecast to raise just under $3.5 billion over three years, would hit patients on low incomes hard, be bad for ­community health and would have a devastating impact on GP practices across the country.

Coalition says it’s committed to the GP co-payment, after PM told AMA he was willing to revisit model

THE Australian Medical Association says Tony Abbott signalled he’s willing to revisit the $7 GP co-payment, although the Coalition insists it’s committed to the policy.
AMA president Brian Owler, speaking after a “very constructive” meeting with the Prime Minister and Health Minister Peter Dutton in Canberra, said Mr Abbott had told him he was willing to examine alternative models for the co-payment.
He said he would return with alternative co-payment models that would enjoy the public support of his organisation, if adopted.
The currently proposed $7 fee on medical services is designed to discourage unnecessary doctors’ visits and pour $20 billion into a medical research future fund.
Dr Owler said: “The Prime Minister made it fairly clear in the meeting that they were willing to look at alternative models and consider those on their merits.

Tracking GP co-payments could cost 'hundreds of millions'

24 June, 2014 Antonio Bradley
A system that reliably tracks in real time the number of co-payments a patient has made would cost “hundreds of millions” and take years to implement, an IT expert has warned.
Knowing how many co-payments patients have made is a key component of the Federal Government's planned overhaul of general practice funding.
The plan involves cutting all rebates for GP attendance items by $5, along with rebates for pathology and diagnostic imaging.
But to protect children and concession card holders from paying too much, the government said it would return those rebates to current levels once these patients had made a total of 10 $7 co-payments.

Co-pay changes flagged after AMA talks

26 June, 2014 AAP
Prime Minister Tony Abbott says the government will press ahead with the $7 co-payment for GP visits, but is open to discussing changes in its implementation.
AMA representatives held talks with Mr Abbott and Health Minister Peter Dutton in Canberra on Wednesday to discuss the peak body's concerns.
AMA president Brian Owler (pictured) described the talks as "constructive", saying Mr Abbott had indicated a willingness to consider changes.
The AMA does not oppose the principle of a co-payment, but has been critical of the government's design.

Australian Age care residents could be exempt from the $7 GP fee

  •  June 27, 2014 12:00AM
RESIDENTS in aged care homes could be exempted from the $7 GP fee in the first sign the government is prepared to compromise on the controversial Budget measure.
Health Minister Peter Dutton has said he agrees with the Australian Medical Association there are issues with charging the fee in aged care homes where residents have no access to money.
“There are issues that we’ve agreed with the AMA that we can work on, particularly around aged care,” Mr Dutton said yesterday.
“I think there’s more that we can do to try and provide GP and nursing services into aged care, and they’re the discussions we’re having with AMA President, Professor Owler,” Mr Dutton told John Laws on Sydney radio.

Abbott backtracks on co-payment plan

26th Jun 2014
PRIME Minister Tony Abbott has signalled for the first time that he is prepared to soften the impact of proposed $7 co-payments for GP services.
Doctors’ groups have been in intensive talks with senior politicians on both sides of politics, picking over a list of health budget measures that have alarmed many practitioners and face a hostile reception in the Senate.
AMA President Brian Owler emerged from talks with the prime minister and Health Minister Peter Dutton on Wednesday, describing the discussions as “very constructive”. 
The AMA agreed that “a form of co-payment would be an acceptable model”, but it could not accept the proposal for $5 cut in the Medicare rebate to doctors and the impact on most vulnerable patients, he said.

Cost already a barrier for one in eight indigenous seeing a GP, COAG Reform Coucil warns

Date June 26, 2014 - 12:27AM

Michael Gordon

Political editor, The Age

The report finds that three quarters of deaths of indigenous people under 75 were avoidable through early prevention or treatment. Photo: Sasha Woolley
The Abbott government has been warned to think again on its Medicare co-payment, with a major study reporting that cost is already barrier for one in eight indigenous people seeing a GP.
The final report card of the COAG Reform Council also reveals that more than two out of five indigenous people delayed, or did not see, a dental professional due to cost, and one-third delayed, or did not fill, a prescription for the same reason.
In a blunt warning, the council chairman, John Brumby, has observed that much of the good work to close the gap on health outcomes could be undone if barriers are put up to healthcare access for indigenous people.
In a speech launching the report at an indigenous health summit in Melbourne on Thursday, Mr Brumby says when people start to avoid going to their primary or community care provider because of cost they often end up in hospital.

On the risks of private health cover of GP visits & the need for a “real” national conversation on health

Marie McInerney | Jun 23, 2014 11:23AM
In this post below, public policy expert John Menadue agrees with Health Minister Peter Dutton that we need a national conversation about health. He disagrees however that we are having one, saying we are instead seeing an “ill-considered and ideologically driven course” on both co-payments and the prospect of private health insurers being able to cover GP visits.
Quoting US super-investor Warren Buffet who has described the private health industry as “the tapeworm in the US health sector”,  Menadue’s article – cross-posted with permission from his Pearls and Irritations blog – says private health insurance involvement in primary care should be “strenuously resisted”, with international evidence showing it pushes up costs dramatically and does not improve health outcomes.
Primary practice has been until now off limits to insurers, despite their strong advocacy, but all eyes are on the current Medibank Private trial program in southeast Queensland that effectively subsidises GP services.

Co-payment still causing strife

23 June, 2014 Amanda Davey
The RACGP has strengthened its staunch opposition to the Federal Government’s $7 co-payment scheme by releasing an official position statement on Friday to clarify its stance.
Joining the AMA and other doctor’s groups, the RACGP has condemned the Government’s controversial move, arguing the co-payment threatens universal access to healthcare.
The general consensus among doctors groups, including the RACGP, is that the proposed $7 co-payment model will hit vulnerable Australians the hardest.
RACGP President Dr Liz Marles said the position statement sends a strong message.

Health Minister Peter Dutton “100 per cent confident’’ $7 Medicare co-payment would pass the new ­Senate

  • Renee Viellaris
  • The Courier-Mail
  • June 23, 2014 12:00AM

Modelling missing on Medicare co-payment 0:58

CROSSBENCH Senators will be offered sweeteners and the chance to look good in their states by Abbott Government tacticians determined to pass the $7 Medicare co-payment.
Health Minister Peter Dutton, who will next month ­directly lobby independent Senators, has opened the door to horsetrading with the eight powerbrokers, all of whom have different pet causes.
Mr Dutton told The Courier-Mail he was “100 per cent confident’’ the co-payment would pass the new ­Senate, but signalled lowering the $7 fee was not negotiable.
“In NZ the co-payment is $17.50, the Commission of Audit recommended $15. We haven’t gone with an ambit claim and we didn’t strike it at $17.50 hoping that it would give us room for negotiation,’’ he said.
“We’ve struck it at the price we believe is best for the Australian people.’’

Hospital Impacts.

Queensland Health jobs could go under shake-up

Date June 23, 2014 - 9:16AM
Queensland's health minister has conceded jobs could be lost as local health boards gain control of staffing from a centralised bureaucracy.
From July 1, eight of the state's 16 regional Hospital and Health Services (HHS) boards will take control of staffing from Queensland Health.
The other eight HHS boards will gain staffing control in July 2015.
Health Minister Lawrence Springborg said the transfer of staffing power from Queensland Health to local health and hospital boards could lead to job losses in the department.


Guild vows to take compensation fight to Libs

26 June, 2014 Chris Brooker
The fight for community pharmacies to be compensated for the expected financial effects of accelerated price disclosure will continue, the Pharmacy Guild of Australia vows.
Guild leaders are set to take their case to the Liberal Party’s Federal Council meeting this week.
In the Guild’s Forefront newsletter, executive director, David Quilty, says he and Guild national president, George Tambassis are to speak to a range of federal ministers, including Health Minister Peter Dutton, and Treasurer, Joe Hockey.  
Mr Quilty said the reality of accelerated price disclosure has been brought home by the release of the October list of molecules impacted by PBS cuts. These included cuts of 37% to the price of rosuvastatin and 46% to atorvastatin. (To see the full list, click here).

Profession wants price disclosure compensation: poll

24 June, 2014 Chris Brooker 0 comments
A substantial majority of pharmacists believe the profession should be compensated for the financial impacts of price disclosure, a Pharmacy News poll reveals.
In total 138 readers responded to the poll, with 65.2% agreeing that ‘pharmacy should be compensated for the impact of accelerated price disclosure’. Perhaps surprisingly, the remaining one third did not believe the profession was entitled to compensation.
When the acceleration to the PBS price disclosure scheme was announced last year by the then ALP government, there had been hope that there may be some form of compensation for a policy that is estimated to strip up to $90,000 from pharmacy bottom lines in the 2014/15 financial year.

Medicare Local Impacts.

Closure of urgent care service

26 June 2014|0 Comments

EMML has been advised that Ekera Urgent Care at 157 Scoresby Road, Boronia has closed effective as of Thursday 26 June 2014.


After-hours GP Access service at risk: poll


June 27, 2014, 9:30 p.m.
A SERVICE that helps up to 80,000 sick people each year in the Hunter access  after-hours healthcare advice and treatment is at risk.
The GP Access After Hours Service takes pressure off the region’s hospital emergency departments by diverting less urgent patients to its clinics.
But Hunter Medicare Local clinical director Dr Lee Fong said it could be lost after  funding runs out in June next year.
Newcastle GP Dr Annette Carruthers described the service as the ‘‘jewel in the crown’’ of primary healthcare in the Hunter.

Hunter Medicare Local CEO resigns amid concerns over after-hours GP service

April 23, 2014
As concerns are being raised about the future of the Hunter's GP Access After-Hours service, the head of the organisation that administers it has resigned.
Hunter Medicare Local says its CEO Carol Bennett, who only took up the post in February this year, has left the job due to the ill health of a family member.
The organisation's Chair Karen Howard says the Board appreciate Ms Bennett's efforts and wish her well into the future.
Ms Howard says John Baillie, who is a previous CEO with NovaCare, will replace Ms Bennett as head of the organisation, effective immediately.

Carol Bennett third Hunter Medicare Local CEO to quit in 12 months


June 22, 2014, 10:30 p.m.
THE future of Hunter Medicare Local and the services it provides is hanging in the balance with the abrupt departure of its third chief in less than 12 months, key staff say.
Chief executive Carol Bennett has resigned after just five months in the job, at what is a crucial time.
The organisation, which runs the highly acclaimed and popular GP Access After Hours service, will not be funded past June 30, 2015.
It seems the fuss is not yet settled - to say the least. Will be fascinating to see how all this plays out. No Parliament for the next two weeks It is clear the GP co-payment issue is still red-hot and right now it is hard to see how this measure will pass.
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:

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