Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, April 30, 2015

2016 Budget Watch. Parliament Closed Until Budget Day. It’s Coming Very Soon!

Last Budget Night was on Tuesday 13th May, 2014 and it is still not finalised -apparently $27Billion still unresolved!
We now look forward to see what we might see next time. I am sure this will be fun.
It’s now getting down to the wire. Good to see Mr Hockey has called to bottom of the iron ore slump by planning on the price going to $35. Since his call it seems to be going up again!
Budget Night is May 12, 2015.
Articles looking forward and back this week include.

General Budget Issues.

Govt yet to find key budget savings: Deloitte​

The Abbott government has made some important savings but to suggest it has made deep cuts is "completely bogus".
Those are the thoughts of prominent economist Chris Richardson, who says attempted savings have to be viewed against an existing "large bucket" of promises to increase spending in the coming decade.
The economy also keeps wiping out any savings that are being made because of the negative impact on revenue from falling commodity prices and slow wage growth, the Deloitte Access Economics economist says in his latest quarterly business outlook.
The ongoing commitment in Iraq will further challenge the government's attempt to rein in spending growth in addition to negotiating with a hostile Senate on savings proposals.
·  Apr 19 2015 at 5:47 PM

PM and premiers must get serious

by The Australian Financial Review
Friday's meeting of Tony Abbott and the state premiers avoided a dramatic federation dust-up, which is why most of the media downplayed it. So the question is whether the actual outcome is as potentially significant as The Australian Financial Review suggests it could be. As we reported, Friday's Council of Australian Governments resolved that the Prime Minister and premiers would hold a special summit in July to deal with the loss of $80 billion of projected federal health and education grants over 10 years, announced in Joe Hockey's first budget nearly a year ago. As Mr Abbott suggested after the COAG meeting, the absence of scheduled state or federal elections over the next 16 months provided a window of opportunity for "serious structural reform".
The disputed $80 billion crystallises the multiple issues of getting the federal budget back to surplus, reining in spending growth, making the tax system less of a handbrake on economic growth, and reducing overlapping responsibility and blame-shifting between the federal government and the states. To properly deal with all these aspects, by July, however, the Prime Minister and the premiers will likely have to agree on a few threshold issues.

There will be no return to surplus, Mr Hockey

at 8:55 am on April 20, 2015
Treasure Joe Hockey appeared on ABC’s Insiders yesterday and played-down the prospect of the Budget returning to surplus:
JOE HOCKEY: We have consistently said Barrie that we want to have structural reform that helps to deliver a surplus as soon as possible…
BARRIE CASSIDY: But in the budget itself, will you be any more precise than that in terms of talking about a return to surplus, or will that be the language you use – as soon as possible?
JOE HOCKEY: In the budget you’ll see the numbers, you’ll see the numbers…

Labor's $14b superannuation hit to well-off

The well-off would lose $14 billion in superannuation tax concessions over the next decade under a new Labor policy that it says is needed to keep the system sustainable and restore equity.
Firing the opening salvo in the superannuation tax debate, Opposition Leader Bill Shorten will pledge on Wednesday that, if elected, more people will have to pay a higher tax rate on contributions and the tax-free treatment of earnings will end.
From July 1, 2017, once a person is retired and drawing on their super, the first $75,000 in earnings will remain tax free but earnings above that would be taxed at the concessional rate of 15 per cent. 
This change would not affect eligibility for a partial government pension and would affect about 60,000 retirees who have $1.5 million or more in their super accounts. Any capital gains on assets held in funds before the new laws apply would be exempt from the tax. But capital gains realised after July 1, 2017, and which exceed $75,000 would be taxed.

ALP eyes super tax hit for wealthy

Sid Maher

Up to 170,000 Australians face higher superannuation taxes under Labor plans to tackle the budget deficit by raising $14 billion over the next decade from wealthier workers and retirees.
The plan will put further pressure on Joe Hockey over the ­fairness of the looming federal budget by targeting the well-off, while the government flags tightening ­eligibility for pensions to make ­retirement incomes policy sustainable.
  • Apr 22 2015 at 10:24 AM

Labor's super plan 'nothing like enough', says Grattan's John Daley

by Joanna Mather
Labor's plan to reduce tax breaks on retirement savings is a start but does not go nearly far enough, the Grattan Institute says.
"Super has essentially become a large tax avoidance scheme for the well off," Grattan Institute chief executive John Daley said.
"The ALP's proposals are a step in the right direction and a good start, but nothing like enough."
Under the policy to be detailed by Shadow Treasurer Chris Bowen at the National Press Club on Wednesday, super earnings over $75,000 a year would be taxed at 15 per cent.

No party can balance the budget without acting on superannuation

David Crowe

Rethinking the age pension

Labor has made the first move in a long game to undo generous tax breaks on superannuation — and it is only a matter of time before the Coalition moves as well.
Both major parties know the tax concessions are far too generous at a time of deep and lasting budget deficits. Both are weighed down by old election promises that make bold change difficult. Neither can fix the budget without acting.
The politics work to Labor’s advantage. On the day the government announces yet another review of Medicare, Labor announces hard policy on super that could save $14 billion over a decade. It reverses the usual dynamic of an Opposition considering its options while the government acts.
Yet the political win is a momentary gain when both major parties will go to the next election promising changes to retirement incomes. The fact that Labor is already in the field with a tax hit to super makes it easier for the Coalition to do something similar when it is ready.

Budget 2015: $80 billion savings forecasts on health, education still stand, Joe Hockey says

By political reporter Naomi Woodley
Federal Treasurer Joe Hockey says the long-term forecasts on health and education funding in last year's budget will stand, despite Prime Minister Tony Abbott setting up a special retreat with state and territory leaders to discuss the issue.
Mr Hockey's first federal budget predicted $80 billion would be saved over the decade to 2024-25, by reducing the amount promised for health and education by the previous Labor government.
The states have argued that will make their own budgets unsustainable, and the issue will be on the agenda at July's leaders retreat, agreed to at last week's meeting between the Prime Minister and state and territory leaders.

Australians' living standards face the greatest threat in a generation: report

Date April 24, 2015 - 7:55AM

Gareth Hutchens

Australians' living standards face the greatest threat in a generation, with no signs of strong wage growth, longer unpaid commuting times and a rise in workforce casualisation putting more pressure on middle- and lower-income households than they have faced in 20 years.
A new report from Per Capita, an independent think tank, also shows the split of national income between labour and capital is continuing to worsen in Australia, with wages' share of national income dropping from 65.5 per cent at the turn of the century to 59.7 per cent in 2012.
It says this has occurred at the same time as the bulk of productivity improvements have come from labour rather than capital in recent years. 

No reduction in NSW unplanned hospital readmissions

Mark Coultan

Unplanned readmissions to NSW hospitals have not been reduced, despite different attempts to address the problem, according to the state’s Auditor-General.
But they fell in local health districts where funding was tied to this performance indicator. “The linkage of funding to performance appeared to increase organisational focus on the issue,” Auditor-General Grant Hehir found in a report to parliament.
He said NSW hospitals had done a good job at reducing the length of time patients spent in hospital, despite pressures caused by increasing numbers of older and chronically ill patients.
This had been driven by increasing use of same-day care for treatments that previously required patients to stay overnight. As well, there was a notable reduction in the time patients who did require overnight care stayed in hospital.

Apparent Budget Leaks.

I suspect most of the commentary on Pharmacy are actually leaks and negotiation ploys to get leverage against the Pharmacy Guild and drop PBS costs.

Health Budget Issues.

What are the challenges and priorities facing the new Primary Health Networks?

Melissa Sweet | Apr 19, 2015 9:21PM | EMAIL | PRINT
This post compiles some reaction to the Federal Government’s recent announcement of the successful tenders for 28 of the 31 Primary Health Networks (more details here; map of boundaries here - or see the list at the bottom of this post).
The PHNs will have Community Advisory Committees, and their six key priorities for targeted work are mental health (wouldn’t it have been helpful to have seen the Review of Mental Health Programmes and Services before the PHN announcements), Aboriginal and Torres Strait Islander health, population health, health workforce, eHealth and aged care.
Comments below include:
•  What will it take for a system that is truly patient-centred?
By Leanne Wells, CEO of the Consumers Health Forum of Australia.
Raising some questions about PHNs
From The Australian Health Care Reform Alliance
No time to lose
From Rosemary Calder at The Mitchell Institute for Health and Education Policy
PHNs covering rural and remote areas must hit the ground running
From the National Rural Health Alliance

Co-payment ruled out as Sussan Ley announces wide-ranging Medicare review

Date April 22, 2015 - 7:04AM

Dan Harrison

Health and Indigenous Affairs Correspondent

Health Minister Sussan Ley has ruled out a co-payment as she prepares to launch a wide-ranging Medicare review  with no major changes to be introduced until at least 2016.
Ms Ley will on Wednesday use a speech in Sydney to announce an examination of each of the 5500 medical services funded under Medicare, a separate review of care and funding models, and a crackdown on abuse of Medicare by unscrupulous practitioners.
She has asked for advice on priority actions for each of the three areas by late this year. This means there will be no structural reform of Medicare in next month's budget, and raises the possibility that the Coalition could seek a mandate for any significant proposals at the election due in the second half of 2016.
Ms Ley said her decision had been informed by the many conversations she had had with doctors and patients in the weeks since becoming Health Minister in December.

New way of paying the doctor in Abbott Government’s latest GP reforms

  • April 22, 2015 12:01AM
  • Sue Dunlevy
  • News.com.au
PEOPLE with chronic illnesses like diabetes, arthritis and cancer could have fees to see a GP abolished and get an annual treatment budget under health reforms to be announced today.
Three months after dumping its unpopular $5 GP fee, the Abbott Government will announce new reforms to primary care to help Medicare afford the challenge of an ageing population.
Health Minister Sussan Ley will unveil a major review of the Medicare Benefit Schedule that sets the fee Medicare pays doctors for consultations, tests and operations to move outdated items.
The government hopes to save money by cutting fees for medical services that have become cheaper to provide as a result of technological advances.
Low value items such as certain blood tests and knee arthroscopies could have new limits placed on them as a result of the review.

Sussan Ley: Medicare rebates will be reviewed in overhaul of 'bloated' system

The wide-ranging audit could recoup some savings lost when the government was forced to ditch its unpopular co-payment policy
The rebates offered to doctors for medical services will be reviewed in a major overhaul of the Medicare system, health minister Sussan Ley has announced.
The wide-ranging audit of the existing system, which was revealed by Guardian Australia earlier this month, could recoup some of the savings lost when the government ditched its unpopular co-payment policy.
Ley will also review the current pause on indexation for Medicare rebates, which the government had extended until July 2018.
The health minister said she had “overwhelming feedback” that the Medicare rebate system needed an overhaul.

Health system overtreats, wastes billions, report finds

April 22, 2015
The sprawling $147 billion healthcare system wastes billions through excessive testing, diagnosis and treatment of conditions such as cardiovascular imaging of low-risk patients, knee ultrasounds and early ultrasound scans in pregnancy, according to the government's independent think tank.
A Productivity Commission study of one of the government's fastest-growing spending areas recommends creating a high-level taskforce of medical experts to hunt out waste, a suggestion that appears to have been acted on by the government this week.
The report suggestions billions of savings could be banked without smashing the current structure. Examples of waste are expected to be highlighted next week with the launch of the health industry's "choosing wisely" campaign.

Sussan Ley giving up on ‘big-bang Medicare structural reform’

Sean Parnell

Premature X-rays for back pain, unnecessary referrals to allied health professionals and regional spikes in cardiac procedures are areas likely to be reviewed in the Abbott government’s search for Medicare savings.
Yet the former political adviser who claims credit for the ill-fated co-payment policy, Terry Barnes, has accused Health Minister Sussan Ley of giving up on “big-bang Medicare structural reform” and ceding control to the Australian Medical Association.
“After last year’s misadventures over GP co-payments and other mishandled measures, the government clearly has decided to play it safe and not rock medical profession and Senate boats,” he writes in The Australian today.
Ms Ley announced an evidence-based review of Medicare Benefits Schedule items by a new taskforce, tougher compliance measures to ensure clinicians follow best practice, and a primary health advisory group to consult on system and structural reforms.

Pharmacy Issues.

Pharmacy Guild amasses millions for turf war over drugs

The powerful Pharmacy Guild of Australia has amassed a multi-million-dollar war chest in a bid to head off threats to its control over the supply of medicines — a system that has cost taxpayers $15.6 billion over the past five years.
As negotiations into the upcoming sixth Community Pharmacy Agreement overlap with mounting calls to reform the sector, the Pharmacy Guild has ramped up lobbying efforts, including sending delegations of pharmacists to Canberra to promote its case. The push follows a damning audit of the current agreement, which questioned its “value for money”, and comes after two high-level government reviews called for the retail pharmacy sector to be opened up to greater competition.
Health Minister Sussan Ley recently broke with tradition by inviting wider consultation on the agreement, which is a longstanding arrangement between the federal government and the guild whereby its network of more than 5400 pharmacies are paid to run the drug dispensaries that supply drugs listed under the Pharmaceutical Benefits Scheme. A new deal is entered into every five years.
21 April 2015, 7.58pm AEST

Government versus pharmacists in search for big savings

The government is locked in a major battle with pharmacists as it looks for $3 billion in budget savings from the pharmaceutical supply chain.

Author Michelle Grattan

Professorial Fellow at University of Canberra
The government is locked in a major battle with pharmacists as it looks for A$3 billion in budget savings from the pharmaceutical supply chain.
The current five year A$15.4 billion Community Pharmacy Agreement between the government and the Pharmacy Guild runs out at the end of June and a deal must be reached for a new one to start on July 1.
The agreement sets out the government remuneration for pharmacists for dispensing Pharmaceutical Benefits Scheme medicines.
Sources in the sector said the government was playing “hardball” in the talks over the new agreement; the government says the same of the pharmacists. The pharmacists are arguing that they have already contributed substantially to savings over the previous five years and should not be squeezed further.

Chemists put block on cheaper meds

  • April 23, 2015 8:29PM
  • Sue Dunlevy
  • News.com.au
THE Pharmacy Guild of Australia is refusing to sign the agreement that imposes $3 billion in cuts on the medicine supply sector while making medicines $1 a script cheaper to consumers.
News Corp revealed last week the Federal Government is considering introducing a discounted co-payment for generic medicines under the new agreement.
This would cut the price of a generic script by $1, saving some consumers $120 a year.
This week the guild, renowned as the most powerful lobby group you’ve never heard of, announced it had a $54 million fighting fund to campaign against the government cuts.
However the government is preparing to hit back.

Productivity commission calls for supermarket pharmacies

24 April, 2015 Meg Pigram
The productivity commission has called for the lifting of restrictions on ownership and location of community pharmacies.
It has published a report that calls for the federal government to remove location restrictions within a year and for state governments to remove ownership restrictions within the same period. This would effectively allow retail  groups such as supermarket chains to enter the market.
The commission also recommends changes to PBS price-setting mechanisms. These are aimed at eliminating delays in price disclosure processes and applying larger statutory price reductions to PBS items upon the listing of a generic alternative.

Location rules a 6CPA bargaining chip

24 April, 2015 Chris Brooker
The federal government has placed pharmacy location rules under the microscope as a bargaining chip as Sixth Community Pharmacy Agreement negotiations continue, media sources claim.
It has been suggested that the Pharmacy Guild of Australia has been given an ultimatum that includes a threat to remove current location rule regulations. 
According to a News Corp report “senior sources involved in the negotiations have warned the government is prepared to allow location rules that give chemist shops a monopoly to lapse unless the Guild signs the agreement by June 30.”
The Pharmacy Guild of Australia has refused to be drawn into public discussion over the agreement negotiations.

Pharmacy Guild plays dead on the push to scrap over-the-counter drugs

  • Samantha Maiden
  • The Sunday Telegraph
  • April 25, 2015 10:00PM
Taxpayers facing a bill of up to $50 every time a GP prescribes a $2 packet of Panadol to pensioners.
PANADOL, antacids, aspirin and other medicines available cheaper over-the-counter will be kicked off the Pharmaceutical Benefits Scheme in the federal Budget in May.
Saving taxpayers $1 billion, the change will end the practice of taxpayers facing a bill of up to $50 every time a GP prescribes a $2 packet of Panadol to pensioners.
Seniors are likely to oppose the changes, because it will end the practice of aged pensioners obtaining Panadol scripts for free when they hit the annual PBS safety net.
But as a sweetener, Health Minister Sussan Ley will tie the changes to new reforms allowing pharmacists to slash the price of all PBS medicines by up to $1 a script for patients.
The Sunday Times can reveal the optional $1 price cut will apply to all PBS medicines, not just cheaper generic drugs.

Over-the-counter sale of codeine pain killers such as Nurofen Plus and Panadeine may end

Date April 26, 2015 - 12:15AM

Aisha Dow, Julia Medew

Access to Nurofen Plus, Panadeine and other common painkillers sold to millions of Australians each year could soon be curtailed by health authorities amid reports of harmful side effects, addiction and fatal overuse.
Australia's drug regulator is considering a proposal to make about 150 codeine products prescription-only medicines, meaning they could no longer be freely purchased over the counter at pharmacies and would require a visit to a doctor.
Medicines affected by the change could include Codral Original Cold and Flu Tablets, Aspalgin Soluble tablets and Mersyndol Tablets, which are marketed for short-term pain such as headaches, toothaches and period pain.
I also have to say reading all the articles I still have no idea what is actually going to happen with the 2016 Budget but there has been a good deal ruled out (Super changes, dividend imputation changes and a new Medicare Co-payment).
It does seem the Pharmacy Guild are taking a little water however and might be in for a fright!
Nonetheless I am sure there will be lots of fun to observe over the next few weeks.

Wednesday, April 29, 2015

Surely This Is A Problem That Can Easily Solved By Proven E-Health Technology. All It Needs Is Will, Proper Sponsorship and Governance.

This appeared last week.

Doctors say patients are dying because of inadequate IT systems

Date April 22, 2015 - 12:15AM

Julia Medew Health Editor

Victorians are dying because of inadequate IT systems for hospital staff to communicate crucial information about their care to GPs, doctors say – with many still relying on faxes.
Despite more than $1 billion being spent on healthcare technology over the past decade, the Victorian branch of the Australian Medical Association says thousands of patients are being shunted around between doctors every day without a standardised system to efficiently transmit their personal information.
The chairman of AMA Victoria's section of general practice, Dr Michael Levick, said this "ad hoc" approach to communicating patients' diagnoses, test results and treatments was so dangerous, he knew of patients who had died as a result.
In one recent case, he said a patient bled to death after being discharged from hospital because they were on the blood thinning drug warfarin and did not realise they had to get their GP to check their dose in the following days.
"They did turn up to their GP but their GP had no idea they were on warfarin because there was no communication and their blood thinned too much. The patient died," he said. "That can easily happen."
Dr Levick said while most GPs kept safe electronic records of their patients' history and received secure email messages from pathology and diagnostic imaging providers, there was a major breakdown between GP clinics and hospitals.
He said when patients were discharged from hospitals, their GPs could receive anything from a phone call, fax, email or printed letter explaining their diagnoses and treatments, and what needed to happen next. Sometimes, though, they received nothing at all.
"There is no reliable form of communication that everyone uses … so no one can rely on anything that comes out as being the full truth," he said. "In terms of patient safety and inefficiency, it is a huge issue."
More here:
The ABC covered the same topic here:

Poor communication systems between doctors and hospitals put patients at risk, AMA says

April 22, 2015
Doctors in Victoria say patients are dying due to inadequate technology and poor communication between hospitals and local GPs, and have called for $50 million to help fix the problem.
Privacy laws mean emails about patients medical history have to be encrypted, but only a few hospitals have the technology to do that.
The chairman of the Australian Medical Association Victoria's section of general practice, Dr Michael Levick, said vital patient information was instead being passed on via written notes or by fax.
He said that meant updates about major changes to patient treatment while they were in hospital were often delayed or even missed completely.
Dr Levick said communication methods between GPs and hospitals had not changed much in the past two decades.
"It is either a handwritten or typed piece of paper that comes with the patient, sometimes fax, sometimes there's a phone call from the doctor at the hospital to the general practitioner," Dr Levick said.
"Sometimes there's a letter in the mail that comes eventually, or sometimes there's absolutely nothing.
"Some hospitals do have the ability to send secure messages, which is like an email which arrives at the doctor's surgery immediately, but that is few and far between.
"This leads to patients not getting adequately treated or monitored when they come out of hospital."
Dr Levick said in one instance a patient died because their GP was not told about their blood thinning medication, which required daily monitoring.
More here:
What is missing here are the management and governance systems that makes sure the information flows between hospitals and service providers and a little money to get things organised.
Already most GPs can receive secure clinical messages and already most service providers can send secure clinical messages.
It’s the will, governance and management that is missing!
Sadly to get to where we need to be - here and in the rest of the country - we need Government(s) to be acting as enablers and supporters and organisations, like the AMA to push! With that happening this is an easily soluble problem that should have been fixed ages ago!