Thursday, January 21, 2016

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

(Note links are accessed by clicking the actual link above the article title!)

January 21 Edition
Here is some other of the recent other news and analysis.
Clearly the big news in the last few weeks has been macroeconomic with oil slipping to be worth less than $US30 a barrel, sinking global share markets, Chinese manipulation of the yuan, falling bond yields and a gentle uptick in the price of gold.
The key reason seems to be that investors woke up on Jan 1, 2016 and decided there was a world full of overvalued assets and felt they needed to come back a bit now that the US was starting to raise interest rates. Thus far it has not gone all that well!
Interestingly we have had very few comments from the Government. I wonder if they are concerned or not. The falling commodity prices must be putting a huge hole in the Budget!
See here:

Treasurer Scott Morrison goes missing in market storm

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

David Uren

Politicians need a holiday as much as anyone else and issues arising on the national agenda often disappear into the haze over the Christmas and New Year period. Still, the golden silence over the past week and a half of global economic turmoil has been striking. It is already having a measurable impact on consumer confidence. Scott Morrison was on leave until this week and as acting treasurer, Mathias Cormann can be forgiven for not leaping to the microphone.
But Morrison has so far been reluctant to fulfil one of the trad­itional roles of the Treasurer, which is interpreting global economic events for the public, explaining what is happening and what the government can and cannot do about it. He will not comment on sharemarkets. He deflects questions about developments in the Chinese economy, iron ore pricing or Australia’s terms of trade.
“It’s not for me quite genuinely to commentate on these things and that’s not what I’m seeking to do as Treasurer,” he says. “What I’m seeking to do is focus on the policy decisions in response to these ­movements.”

Note: Things seems to have gone from bad to worse since this article and what is worse. As of Thursday afternoon we have had little in the way of a coherent explanation as to why we should not be greatly concerned. The ASX/200 Share index is presently at about 4900 - which means that pretty much every super fund and share portfolio have taken a significant hit this financial year. (down from 5495 or so just a little over six months ago.) While we can all joke about about the various Chinese share markets the synchronised 15%+ drops seen in London, Paris, Frankfurt and Wall St suggest there is something pretty serious wrong.

I don't claim to know what the root cause of all this present turmoil is (other than a needed correction in some excessive Price / Earnings expansion in the US and to a lesser degree elsewhere) but right now it would be a courageous assumption to believe that it will all blow over painlessly - it may very well may not! Time will tell I guess.

General Budget Issues.

'Don't worry' budget plan is built on bracket creep

Date December 21, 2015 - 9:05AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Scott Morrison said the government's budget rules mean any new spending "must be fully offset".
I hope events prove me wrong, but I have a feeling that, whatever its other virtues, the Turnbull government won't be the one to get the budget back to surplus.
And that does matter. One of the reasons we escaped the Great Recession was that, unlike other countries, we went into it with little public debt. This allowed us to stimulate private sector activity and restore confidence with vigour and without hesitation.
It's looking likely we won't be so well placed next time. We used to have exemplary fiscal discipline – an example to the world – but now that distinction is slipping from our grasp.
  • Updated Dec 28 2015 at 5:14 PM

Levers against global volatility

The 2016 budget is going to have to answer questions of whether we can generate real growth without resorting to easy money or more debt, and whether there is sufficient firepower to deal with new threats.

by The Australian Financial Review
Treasurer Scott Morrison will spend the next five months writing the trickiest budget in years. Revenue forecasts routinely crumble these days, while spending is evidently hard to curb. Commodity indices are near their end-2008 lows, our GDP growth is sub-par, and we are only part-way through a transition from mining boom to sustainable non-mining investment.
Mr Morrison, as our chief political correspondent Phillip Coorey reports today, has boldly dumped the fixed timeline to surplus and the political point-scoring that goes with it. But he now has to rely heavily on the markets trusting him to eventually deliver. Budget discipline is not hairshirt economics for the sake of it. The weakness and volatility of the post-GFC world may make it harder to force the pace on budget repair, but it also makes it even more important to protect our fiscal position. Along with monetary policy, fiscal policy is one of the big levers our economic managers can pull when things go wrong.

Tax white paper: Our pension is too mean, our super tax concessions too generous

Date January 13, 2016 - 12:57AM

Miranda Stewart and David Ingles

A more generous pension could be easily offset by reining in super tax concessions and adding the family home to the asset mix.
Why are we so stingy with access to the pension (to the point of discouraging pensioners from working), yet so generous with superannuation tax concessions, even though there is scant evidence they boost savings?
It's one of the biggest questions Treasurer Scott Morrison will have to face as he decides the shape of his tax white paper, expected midyear.
We are proposing a rebalancing of super and pensions that we think would be popular and make Morrison an extra $20 billion  a year, which would come in handy, given the state of his budget.

Two tax options, but only one lifts the GST

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

David Uren

Scott Morrison’s tax white paper taskforce is working on two major options, both including personal income tax cuts, changes to superannuation and limits to negative gearing but only one containing a hike to the GST.
The preference of the Treasurer and Malcolm Turnbull is for the bigger package, with an ­increase in the GST, which could fund a much more comprehensive reform of both federal and state taxes.
But this would need the backing of state governments, several of which have ruled out supporting a change to the GST.
The smaller package, without the GST increase, would enable the Turnbull government to go to this year’s election promising personal income tax cuts to relieve the impact of bracket creep ­together with cuts to superannuation concessions and negative gearing limits that would be presented as enhancing equity in the tax system.

Health Budget Issues.

  • Updated Dec 20 2015 at 8:44 PM

Sussan Ley to fight pathology companies over price rises

Health Minister Sussan Ley has hit back at pathology companies that have threatened to introduce a co-payment in response to federal budget health cuts, slamming price hikes as inappropriate. 
The federal government wants to cut bonus payments it offers for pathology services and reduce incentives for magnetic resonance imaging (MRI) from 15 per cent to 10 per cent of the Medicare benefits schedule fee.
The government hopes the cuts, to apply from July 1, 2016, and laid out in last week's budget update, will save $650.4 million over four years.
One of the largest pathology providers, Sonic Healthcare, came out almost immediately, saying it would make up for the cuts by charging for pathology tests that patients now  get free, while the chief executive of Primary Health Care, Peter Gregg, signalled he would also pass on the funding cuts.

Major pathology business in Health Minister Sussan Ley's electorate to close

Date December 23, 2015 - 11:40AM

Jane Lee

Legal affairs, health and science reporter

A major pathology business in Health Minister Sussan Ley's electorate will close on Christmas Eve, buckling under funding pressures to the sector in recent years.
“It's a bit rich for the sector to now try and portray the aggressive acquisition strategies of big, listed corporations as 'consolidation' in the sector. 
“Health Minister Sussan Ley
Border Pathology, which is based in Albury-Wodonga, in Ms Ley's electorate of Farrer, has been sold to the region's main provider, Dorevitch Pathology, creating a "monopoly" of pathology services in the region, a Border Pathology source familiar with the sale said.

Why we all have a problem with expensive drugs

Date December 23, 2015 - 9:00PM

Adrian Pokorny

Australia has a drug problem. Our health system is addicted to expensive pharmaceuticals.
This in itself is not a bad thing. Medical care has advanced to the point where many previously lethal conditions can be managed as chronic illnesses. We are privileged to live in a time and a place where this is feasible. But is the huge cost of some medications completely justified?
Two recent events have brought this issue to the forefront. The first is the rise and fall of businessman Martin Shkreli. He rose to prominence this year when he bought the manufacturing rights for a drug called Daraprim, a brand of pyrimethamine used to treat both malaria and toxoplasmosis.

Vaccine objector numbers fall to three-year lows as payment cuts loom

Date December 26, 2015 - 11:30PM

Matthew Raggatt

Reporter at The Canberra Times

The federal government's policy where those with a conscientious objection to having their children vaccinated will no longer be eligible for child benefits, has been welcomed by the ACT chief health officer but condemned by some parents.
The rate of recorded conscientious objectors has fallen to three-year lows as vaccine law changes which will strip hundreds of Canberra parents of federal payments worth thousands of dollars take effect from January 1.
The extension to the federal government's "no jab, no play" policy has been welcomed by the ACT chief health officer but condemned as draconian by parents who have reported negative reactions to vaccines.

Medical Benefits Schedule taskforce finds 23 services for chop

  • The Australian
  • December 28, 2015 12:00AM

Sean Parnell

A taskforce reviewing the Medicare Benefits Schedule has identified an initial 23 taxpayer-funded medical services that experts ­believe should no longer be used.
The clinical committees established by the taskforce have for the first time red-flagged MBS items that are either obsolete, wasteful or dangerous, asking the health sector for feedback before the taskforce moves to remove them from the list.
Nine of the MBS items flagged for removal are in ear, nose and throat surgery, seven in diagnostic imaging and five in gastro­enterology, reflecting advances that have occurred in these specialties in recent years. Combined, the 23 items were used 52,500 times in 2014-15, attracting $6.8 million in Medicare benefits that could be saved by the government or redirected elsewhere. In one case, a committee suggested a replacement technology be considered for listing on the MBS.

Nursing home profits soar as patient care declines

Date January 1, 2016 - 11:45PM

Tom Allard

National Affairs Editor

The profits of aged care homes surged 40 per cent in the past year as operators cut hours of nursing care while claiming higher payments from the federal government for servicing more of the most frail patients.
The earnings boom in the sector comes after the government introduced widespread reforms of aged care in 2014, including deregulating fees and lifting restrictions on the accommodation bond that nursing homes can levy on residents.
It also coincides with a spike in false claims by aged care home providers for government subsidies, which rise based on the level of need of the patient.

Major reviews to healthcare system plot more changes in 2016

January 3, 2016 8:50pm
Sue Dunlevy News Corp Australia Network
LAST year was the year we avoided a $7 GP fee and a $5 prescription medicine price hike but six major reviews are plotting other major changes to the health system for 2016.
Primary health care, Medicare rebates, private health insurance, prescription medicine payments, mental health care and electronic health records are all slated for major changes under these reviews.
These and other health reforms, to be rolled out from 2016, will push up the cost of blood tests and scans, change your relationship with your GP, see you dragooned into an e-health record and increase your private health insurance costs — but might save you $1 on your prescriptions.

Pathology Australia To Lobby Government Over Pap Smear Fees, Rallies Scheduled For February

 |  By Sam McKeith
Posted: 10/01/2016 11:16 AEST
The peak body for Australia's pathologists is taking its fight to Canberra over proposed federal government budget cuts that could see pap smears cost up to $30.
Pathologists have warned that women are likely to have to pay upfront costs for the cervical cancer screening test due to the government's removal of bulk-billing incentive payments to pathology services flagged in December.
The proposed scrapping of the payments was outlined in the Government’s Mid Year Economic Fiscal Outlook and relates to pap smears as well as other services like MRIs, blood tests and X rays.

Cuts will force diabetes patients to 'pay hundreds more for blood, urine tests', say pathologists

Date January 13, 2016 - 6:04PM

Jane Lee

Legal affairs, health and science reporter

Diabetics could be out of pocket hundreds of dollars each year for their treatment if cuts to pathology go ahead, raising the risk of complications including kidney disease, doctors warn.
Health Minister Sussan Ley flagged plans to cut and limit bulk billing incentive payments for pathology and diagnostic imaging services last month, saving the government $650 million over four years.
Dr Nick Musgrave, president of Pathology Australia, said that without the payment, most pathology services would no longer be bulk-billed. Major pathology providers have already indicated they will pass losses from the cuts on to patients.
About 1.7 million Australians with diabetes, he said, could have to pay more than $400 upfront for a year of standard blood and urine tests to monitor their kidneys and risk of heart disease. Higher costs could deter some patients from doing the tests "making management of their diabetes more difficult for their doctors, and will result in an increase in complications of diabetes including kidney disease and blindness," Dr Musgrave said.
  • Updated Jan 8 2016 at 4:32 PM

Federal healthcare reform: a major shakeup or a review-fest?

The Department of Health is awash with reviews, any one of which could usher in big changes to the healthcare system. As a group they pose an acid test for health minister Sussan Ley: can she put in place the combined outcomes she has potentially unleashed?
Patient relationships with GPs, private health insurance, care for the mentally ill, the Medicare rebate and the pharmacy sector are all slated for an overhaul.
Meanwhile the Reform of the Federation white paper overshadows the flurry of reviews, with potentially massive shifts in how the Commonwealth and the States fund care.
In total, $154.6 billion was spent on healthcare in 2014, almost 10 per cent of GDP, and the ageing population means that costs will rise.

Health Insurance Issues.

AMA, insurers dig in for private health battle

Date December 21, 2015 - 5:27PM

Tim Binsted


The doctors' lobby has warned the government not to allow health funds to price insurance based on factors such as age and lifestyle, while attacking "junk" policies that don't cover common procedures.
Government budgets are under severe strain and surging healthcare costs have put pressure on public finances and insurance premiums, prompting a federal review into private health insurance, alongside several other reviews into the health system.
In its submission to the review the Australian Medical Association took aim at insurance policies with exclusions, saying patients with such policies are often shocked to discover they are not covered for a common procedure.
"Doctors are seeing this happen on a daily basis," AMA president Brian Owler said.
  • Jan 5 2016 at 6:34 PM
  • Updated Jan 5 2016 at 6:35 PM

Medicare surcharge may have to increase for high earners: health funds

The Medicare levy surcharge may have to be increased to ensure high-income earners continue to opt in to private insurance, the peak body for health funds says.
It is already about $16 cheaper for somebody earning $90,001 to pay the 1 per cent surcharge than to take out a basic level of cover.
The surcharge was introduced to reduce pressure on the public hospital system by encouraging those who could afford it to buy private health insurance.
But with the cost of yearly premiums outstripping wages growth, the surcharge "stick" was becoming less effective, Private Healthcare Australia acting chief executive Steven Fenner said.

Medical errors list pits insurers against hospital operators

  • The Australian
  • January 7, 2016 12:00AM

Sean Parnell

The first official list of avoidable hospital complications is set to reignite the debate between health insurers and operators over who pays when things go wrong.
Medibank Private, the nation’s largest insurer, was last year involved in a protracted dispute with the Calvary hospital group over a list of preventable errors and poor results the health fund argued it should not have to pay for.
At the height of the dispute, Health Minister Sussan Ley asked the Australian Commission on Safety and Quality in Health Care to fast-track an expert list to “help end the current cynical game of thrones where certain private health insurers and hospitals are more focused on painting each other as villains rather than supporting patients”.

Consumers Health Forum urges single insurance standard

  • Rebecca Urban
  • The Australian
  • January 8, 2016 12:00AM
Private hospital insurance would be standardised, providing a minimum level of cover to attract the government rebate, in a proposal being pushed by a leading healthcare advocate.
Weighing in to the federal government’s review of the $19 billion private health insurance industry, the Consumers Health Forum has called for a central database of ­approved policies to be established in a bid to increase transparency across the industry and give customers greater buying power.
It is hoping the plan will weed out so-called “junk policies” that are increasingly being marketed to younger, budget-conscious customers, despite hefty criticism of their highly exclusionary nature.

Pharmacy Issues.

Pharmacy in interesting times: a look back at 2015

AJP takes a look back over the events of 2015, a turbulent year in the history of community pharmacy

“May you live in interesting times,” is purportedly an ancient Chinese saying; regardless of the rather more recent origin of the phrase, it’s meant to be a curse, as interesting times aren’t exactly the most stable to live through.
Australian community pharmacy has had a very interesting year. It’s withstood a barrage of mainstream media attacks on the rules governing it, and recommendations from a variety of quarters that the industry be deregulated.
Even after the Sixth Community Pharmacy Agreement was signed, uncertainty reigns, whether regarding the fate of OTC codeine products, how the Pharmacy Remuneration and Regulation Review will pan out, and what the $1 script copayment discount will mean in practice.

Pharmacists demand Ley fix Osteo 'mistake'

January 11, 2016
Pharmacists demand Ley fix Osteo 'mistake'
Pharmacists are demanding the Turnbull government rectify a "mistake" that could triple medicine costs for pensioners, threatening to campaign against it until it's fixed.
The Pharmacy Guild says the decision to remove Panadol Osteo from the Pharmaceutical Benefits Scheme on January 1 was an "elementary error" that will force almost two million osteoarthritis sufferers to pay significantly more for essential pain medication.
Health Minister Sussan Ley has asked the Australian Competition and Consumer Commission to investigate after the makers of the medicine hiked their prices by 50 per cent.

Panadol Osteo referral: a first for the Minister

It is the first time Health Minister Sussan Ley has referred a company to the ACCC due to the “unique” circumstances surrounding the price rise for Panadol Osteo, a spokesman for the Minister told the AJP.

The spokesperson says the Minister is also concerned about GSK’s market dominance and “misleading claims” and “justification” for the price rise.
GSK said in a letter to wholesalers that in moving to an OTC business model it could no longer sustain its current pricing for Panadol Osteo.
But Minister Ley says there are no additional regulatory or administrative costs associated with this policy change regarding osteo paracetamol products, which was recommended by the PBAC, not government.

Pharmacy guild says changes will only benefit govt

12th Jan 2016 7:30 AM
PENSIONERS collecting their prescriptions at pharmacies can access discounts of up to $1 per script after changes that took effect on January 1.
The reforms mean some pensioners will be able to pay $5.20 instead of the standard $6.20 for their PBS scripts.
However Pharmacy Guild of Australia executive director David Quilty said the measure would have little net benefit for pensioners and mean big savings for the government, which has estimated it will save $373 million over four years.
He said the change would mean concession card holders whose pharmacies offer them the discount will not hit the $372 free medicine threshold until later in the year, effectively leaving pharmacists to absorb the cost.
Health is also clearly still under review as far as its budget is concerned with still a few reviews underway and some changes in key strategic directions. Lots to keep up with here with all the various pre-budget kites being flown! Enjoy.

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