Thursday, July 28, 2016

The Macro View – Post - Election And Health News Relevant To E-Health And Health In General.

July 28  Edition.
“This is being written over the weekend and to date we seem to know that Malcolm Turnbull will remain PM with a level of majority that is yet to be determined.” I wrote this a week ago and it is still true. Maybe next week the result in both the reps and Senate will be clear! – Now 2 weeks and we still have one reps seat being recounted and no clear idea in the Senate just yet!
Since Parliament does not start till August 30 and only sits for 6 weeks  this year change will not be large scale until next year – if ever….
My sense is that the new Government sees itself as having a Mandate to get on with Super and is concerned it needs to re-assure the public re Health. Let’s see how that plays out over the next few months.
The world is not seeming all that happy – as markets keep unaccountably going up!
We have this:

IMF calls for more government spending as rate cuts lose their impact

Global growth remains weak and risks have risen after the Brexit vote, says IMF, as it calls for more infrastructure spending
The International Monetary Fund has called on G20 nations to boost government spending as the impact of ultra-low interest rates begins to reach its limits in developed countries.
Central bank chiefs and finance ministers from the world’s top 20 economies gathered in the south-western Chinese city of Chengdu on Saturday to tackle problems facing the global economy, which have been aggravated by the British vote to leave the European Union.
“Global growth remains weak, and downside risks have become more salient,” the IMF said in a report released ahead of the G20 meeting.
And more worrying for Australia this:

Great fall of China on cards say economists

  • The Australian
  • 12:00AM July 23, 2016

Rowan Callick

The verdict of top China economists is unanimous: there is a debt crisis, there are no signs of policy renewal, and a recession is almost inevitable — either sharp and possibly calamitous, or drawn out like Japan’s.
None is willing to punt on the timescale, but all believe this will happen within the medium term — by 2020 or a little after — though not in the next couple of years. For now, on the streets, life looks the same. But it can’t last.
Debt growth has been outpacing gross domestic product growth for years, with its numbers stepping up a year ago, and that gap will widen as the government has to heap ever more stimulus on the economy in order to hit its 6.5-7 per cent growth target — like throwing more and more kindling on to a fire to keep it alive.
Outstanding loans now stand at a record high of more than 200 per cent of gross domestic product, almost double the figure in 2008.
Total net debt is estimated at about $35 trillion, borrowed both within China and from overseas. China’s debt bubble — the build-up in unproductive loans — has already accelerated past the US 2007 subprime bubble numbers.
Jonathan Anderson, the principal of Emerging Advisors Group, says: “At the current rate of expansion, it is only a matter of time before some banks find themselves unable to fund all their assets safely.


For a list of worries regarding the way Central Banks are causing some risks to us all this table really does it!

All three worth a read or look.
Here are a few other things I have noticed.

General Budget Issues.

Sluggish income growth means Australian households are no better off than in 2009

July 20 2016 - 7:46AM
Peter Martin
If you think you are worse off despite a raft of economic statistics saying things are getting better, you're probably right.
The annual 'Household, Income and Labour Dynamics in Australia (HILDA)' survey has landed.
Australia's longest-running household survey finds home ownership is increasingly out of reach for many of us, one in eight families don't have $500 in savings in case of emergency, and that real household disposable incomes peaked in 2009.
The finding is different from those of other studies that survey different Australians at different times.

Brace for attacks on the middle class and wealthy

  • The Australian
  • 8:51AM July 21, 2016

Robert Gottliebsen

Middle class and wealthy Australians will need to put on their safety helmets as the construction of the 45th Parliament makes them incredibly vulnerable.
And the dangers associated with that vulnerability are underlined by the Melbourne Institute’s revealing survey of the changes in the wealth of Australian households.
Millions of words have been written about the election but what really happened — and therefore what will happen — is simple. The swing to Labor in Victoria was markedly less than in NSW because the forced unionisation of the local volunteer fire fighting body (the CFA) by the Andrews State Government stopped Bill Shorten from campaigning effectively in his home state and also robbed him of the brilliant campaigning skills of the Victorian Premier.
Liberals therefore took a Victorian seat from the ALP rather than the ALP gaining three or four off the back of Shorten’s home-state advantage.

All eyes on inflation next week, but not everything is as it seems...

July 23 2016 - 12:15AM

Jessica Irvine

Something quite odd is happening in the economy.
Economic growth is quite robust and the jobless rate is falling. 

Why does inflation matter?

Inflation has increased slowly over the past decade, but how does that affect you?
But price pressures are abating. How can that be?
Usually, when economies heat up, you expect to see price pressures building. More economic activity drives higher employment, higher wages and higher prices at the store.

Scott Morrison talking tough as Govt attempts to deliver Budget

July 23, 20168:48am

Morrison: Health cannot be a 'money pit'

THE election is over and as far as Scott Morrison is concerned, no more Mr Nice Guy.
Treasurer Morrison is now out of the shadow of the campaign and determined to attack government spending — even in the face of party and electorate protests.
Mr Morrison’s determination should not be underestimated.
It coincides with an informed view that Australians are asking more from government than taxpayers can fund in the long term, and that the swollen deficit is threatening the nation’s public and private finances. And that means the sustainability of programs valued and taken for granted.

Health Budget Issues.

Sussan Ley hangs onto health, sport and aged care in post-election re-shuffle by PM Malcolm Turnbull

18 Jul 2016, 6 p.m.
STAYING PUT: Member for Farrer Sussan Ley has held onto her health, sport and aged care responsibilities in re-elected Coalition government.
SUSSAN Ley has held onto the high profile health minister role in the re-elected Malcolm Turnbull federal government after fears she would be made a scapegoat for Labor’s “Medi-scare” campaign.
The member for Farrer was shielded from much of the heat applied by Labor leader Bill Shortern on the future of Medicare which took his party to the brink of an unlikely election victory on July 2.
Ms Ley was promoted to health minister in late 2014 by former Prime Minister Tony Abbottt and has retained the position in two ministerial re-shuffles following his deposing as PM last year by Mr Turnbull and the election.

Pharmacists’ role is too limited: Duckett

Guild welcomes Grattan Institute leader’s comments in favour of a broader role for pharmacists in Australia

Doctors are seeing patients for conditions that allied health professionals such as pharmacists could manage, says the Grattan Institute’s director of health programs Dr Stephen Duckett.
Health sector roles are “essentially the same as they were 50 years ago” despite improvements in the education of nurses, pharmacists, physiotherapists and occupational therapists, Duckett writes in The Australian.
“Our health professionals now have much greater skills than they used to, but are not always allowed to practise their skills to the fullest,” he says.

Chief calls for more funds into healthcare delivery

  • The Australian
  • 12:00AM July 21, 2016

Sean Parnell

The head of the nation’s peak health funding advisory group has called for more work to be done improving healthcare delivery as key agencies revisit the value-for-money proposition across the sector.
National Health and Medical Research Council chief executive Anne Kelso said that although most research had the potential to improve healthcare delivery, ­focused health-services research could address issues of efficiency and efficacy while ensuring the best results for patients.
“The great majority of our funding is going currently to clinical research and biomedical ­research, a smaller proportion to public-health research and a smaller proportion still to health- services research,” Professor Kelso said.
“There is a need for more funding for health-services research in this country to guide better health-service delivery.”

Sussan Ley back to work after campaign criticism

  • The Australian
  • 11:39AM July 21, 2016

Rosie Lewis

Health Minister Sussan Ley has made a big show of getting back to work after being criticised by some of her colleagues for going missing during the election campaign.
The newly reappointed minister invited cameras into her office ahead of her first official meeting of the term with Australian Medical Association president Michael Gannon, declaring she “couldn’t wait to get started”.
It's #backtowork Thursday for @sussanley who's invited cameras into office to prove it @australian #auspol
— Rosie Lewis (@rosieslewis) July 21, 2016
The awkward photo opportunity follows suggestions Ms Ley didn’t do enough to counter Bill Shorten’s Medicare scare campaign, which claimed the Turnbull government would privatise the nation’s public health system, while others said headquarters had not allowed her to prosecute the case.

AMA would be 'gobsmacked' if Coalition stuck with Medicare rebate freeze, demand phase out

July 21 2016 - 1:47PM
Fergus Hunter
The Australian Medical Association has labelled the Medicare Benefits Schedule freeze the single most damaging policy of the Coalition's election campaign and demanded it be phased out as soon as possible.
Recently elected AMA president Dr Michael Gannon also said that he didn't expect the rebate freeze, originally instituted by Labor and then extended by the Coalition to 2019-20, to be taken to the next election.
"I would be gobsmacked if the government took an ongoing freeze to the next election. They got the scare of their life on health and that was probably the policy which hurt them the most. It makes general practice and a lot of other areas of medical practice potentially unviable," Dr Gannon said, following a meeting with Health Minister Sussan Ley in Canberra.
  • Updated Jul 21 2016 at 6:39 PM

Scott Morrison leaves open lifting Medicare rebate freeze

Treasurer Scott Morrison has left open the option of lifting the freeze on the Medicare rebate paid to doctors but only if the $2.4 billion cost to the budget could be recouped elsewhere.
With his budget already under attack internally from MPs demanding superannuation changes, external pressure was added on Thursday when the Australian Medical Association said the price of peace over Medicare was lifting the rebate freeze.
After admitting health was a critical weak spot for the Coalition during the election campaign, Prime Minister Malcolm Turnbull is trying to make peace with the AMA. Earlier this week, Mr Turnbull rang AMA president Michael Gannon and, on Thursday, Dr Gannon met Health Minister Sussan Ley. He said he wanted the freeze lifted in coming months as a sign of intent.

AMA expects GP freeze to be lifted

Updated: 5:18 pm, Thursday, 21 July 2016
The head of the powerful doctors' lobby insists he would be 'gobsmacked' if the federal government didn't lift its GP rebate freeze before the next election.
Australian Medical Association president Michael Gannon says his first meeting with Health Minister Sussan Ley since she was reappointed to the portfolio this week focused on the fact that health was not the problem with the budget.

Healthcare costs money. Cutting healthcare costs much more

July 21 2016 - 6:53PM
·         Jane Gilmore
If I am dead next week, someone get in touch with Malcolm Turnbull, tell him that Medicare killed me and that I will be coming back to haunt him.
A couple of weeks ago I had a cold, like everyone else in Melbourne. No big deal, hot tea and bed for a few days and I'll be fine. Well, I should have been. But I wasn't. I got a weird rash on my leg and couldn't shake exhaustion, headaches and feeling sick all the time. Over the last two weeks the rash got gross and painful and I felt worse and worse. Immediate and obvious thing to do is go to a doctor, right? But I couldn't. Going to my doctor requires having $80 to pay up front, a day to wait for $30 to come back and another $30 for medication. I didn't have that. So I waited and hoped it would get better.
It didn't.
Turns out staphylococcus infections don't just get better, they get worse. A lot worse. Very quickly.

Govt open to lifting the freeze - with one large caveat

22 July 2016
THE government appears to be leaving the door open to lifting the much-maligned Medicare rebate freeze, but with one very large caveat: the $2.4 billion cost to the budget must be recouped elsewhere.
In recognition of the battering it took on health in the election, the Coalition has been quick to sue for peace with the AMA.
New chief Dr Michael Gannon has already received a phone call from Prime Minister Malcolm Turnbull and met with Health Minister Sussan Ley on Thursday for an exchange of pleasantries.

5 tips to get the government started on real health reform

22 July 2016
Since the election, the Turnbull government has received a great deal of advice on how to counter the pervasive public scepticism about its ongoing commitment to the universality of Medicare.
While the impacts of the so-called Mediscare campaign, the Medicare rebate freeze and the “zombie” policies left over from the 2014-15 budget have driven these calls for Coalition action, the real issue is that the previous Abbott-Turnbull government had no health policy agenda, other than budget cuts and the covert exploration of privatisation and competition in the delivery of health-care services.
In this new term, the government must do more to deliver the health-care system we need for the 21st century – not just to improve its standing with voters, but to meet the health needs of all Australians. Much of this can be achieved through new ways of thinking about policy development and implementation rather than new spending.
22 Jul 2016 - 1:30pm

Ex-health boss rejects co-payment calls

The head of the Australian Medical Association has been criticised for suggesting doctors be given power to decide which patients should pay for GP visits.
Source: AAP 22 Jul 2016 - 1:30 PM  UPDATED 1 HOUR AGO
A former health department boss has rejected calls by the head of the powerful doctors' lobby that GPs be given the power to decide which patients pay for consultations.
Australian Medical Association president Michael Gannon believes patients who can afford to pay for GP visits should, suggesting a rethink of the federal government's deeply unpopular co-payment.
The problem with previous attempts at a co-payment - declared "dead, buried and cremated" by the government last year - was that GPs weren't empowered to decide who could afford to pay.

Will the Government water down changes to super and health?

The government is in a much weakened position after the election, but this week showed much needed signs of strength. On superannuation and health policies, Treasurer Scott Morrison held firm. He refused to throw away budget repair to appease sectional interests, even on the government’s own backbench. It was a laudable show of fiscal responsibility. How long it lasts remains to be seen.
The Prime Minister made it clear as he unveiled his new-look Ministry on Monday that budget repair was his top priority for this term. For his part, Morrison has been pleading for the warnings from ratings agencies to be taken seriously. And yet we’ve seen this week just how tough his job will be and how little some seem to care about the mounting debt problem.
The superannuation policy was announced in the budget and taken to the election. Yet some in the Coalition are still determined to overturn it. Eric Abetz voiced his concerns in the party room meeting on Monday. Two days later, George Christensen posted his complaints on Facebook with a threat to cross the floor. Neither represent particularly high wealth regions of the country that will suffer greatly because of these super changes, but all government MPs are now emboldened with the knowledge that crossing the floor can wreak havoc. The government has the barest of majorities and needs every vote.

How average income earners will be pushed into private health insurance by 2020

July 23 2016 - 10:49PM
Caitlin Fitzsimmons
By 2020 average income earners will be forced to buy private health insurance or pay extra tax after the government quietly extended a freeze in the threshold for the Medicare Levy Surcharge.
The income threshold, where rebates start to phase out and taxpayers without private cover are charged the surcharge, will stay fixed at $90,000 for singles until June 2021.
The Medicare Levy Surcharge originally targeted high-income earners and was indexed to average weekly ordinary-time earnings.
However, the first Abbott-Hockey budget in 2014 paused indexation until June 2018. The 2016 budget extends the freeze for another three years, saving about $370 million on the forward estimates.

Health Insurance Issues.

Medibank customer complaints have sky-rocketed since its privatisation

July 21 2016 - 6:04PM
Esther Han
Medibank customers appear to be the most dissatisfied, with complaints to the Private Health Insurance Ombudsman skyrocketing in the past three years.

Medibank accused of secret policy changes: ACCC

ACCC chairman Rod Sims says Medibank may have affected many customers by allegedly failing to inform them of a 2014 policy change.
Three hundred-and-fifty complaints were made against Medibank between January and March this year, 127 per cent more than in the same quarter in 2014, the ombudsman's latest quarterly bulletin shows.

Superannuation Issues.

Superannuation returns to be lower for longer: JANA’s Jim Lamborn

  • The Australian
  • 12:00AM July 18, 2016

Glenda Korporaal

One of the nation’s most influential investment advisory houses, which oversees the allocation of hundreds of billions of dollars worth of funds, is warning its key superannuation clients to be ­prepared for several years of lower returns and “heightened levels of risk” linked to expensive equities around the world.
JANA Investment, which ­advises asset allocation for some 80 institutional investors, with ­assets of more than $255 billion, is telling clients to take a more ­cautious ­attitude to shares and look to ­defensive investments such as real estate.
The comments by National Australian Bank-owned JANA come even as the Australian sharemarket is enjoying its best run for the year, extending its winning streak to seven sessions on Friday.

Malcolm Turnbull softens defence of superannuation changes as backdown looms

July 17 2016 - 1:21PM
Fergus Hunter
Prime Minister Malcolm Turnbull has softened his rhetoric on the government's proposed superannuation changes, potentially laying the groundwork for a backdown to soothe ongoing anger inside the Liberal Party.
Mr Turnbull has previously pledged no changes to the "ironclad" suite of proposals on high-end superannuation savings, which conservatives inside the party have criticised as retrospective and argued were a weakness during the election campaign.
The Prime Minister has now signalled that he is listening "very keenly" to the concerns inside his party amid reports that Treasurer Scott Morrison is considering various concessions.
"The reforms are important, but in the implementation and transition, there is work to be done. There always is with tax changes. They will go through the normal cabinet and party room process," Mr Turnbull said on Sunday.


Draft super laws to be released before parliament sits

  • The Australian
  • 12:00AM July 22, 2016

David Crowe

The federal government will fast-track its $6 billion superannuation reforms by releasing draft legislation within weeks to clear the way for talks with industry and the wider community over changes that might calm the storm over the controversial tax hikes.
Malcolm Turnbull and his ministers will outline the first draft of the tax proposals well before parliament resumes on August 30 in a bid to ensure weeks of consultation on the detail of the changes before they have to run the gauntlet of the Coalition partyroom.
The draft will stick to the broad plan set out in the federal budget on May 3 but will leave time for critics of the proposals to push for changes, mapping out a strategy to negotiate amendments in the new Senate as soon as possible.

Terry McCrann on Scott Morrison’s superannuation attack ‘shambles’

index&t_product=HeraldSun&td_device=desktopTerry McCrann, Herald Sun
July 18, 2016 9:54pm
TREASURER Scott Morrison’s attempted and ill-thought through — heck, there was no ‘thought’ at all — attack on high-end superannuation has become an even bigger shambles.
It’s bad enough that his proposals combined dumb politics with even dumber policy in a way that worked best — presumably unintentionally — at reminding us of the worst and most chaotic of the Rudd and Gillard days.
Does Morrison really want to steal Wayne Swan’s fiscal dunce’s cap?
But, and you really can’t make this stuff up, Morrison and Prime Minister Malcolm Turnbull seem intent on blundering on even deeper.
  • Updated Jul 20 2016 at 11:45 PM

Super exemption for life events will have to be paid for

The Turnbull government's plans to dilute its most controversial superannuation proposal by allowing exemptions for "life events" could cost the budget between $300 million and $450 million, which would then have to be found elsewhere so as not to threaten the nation's AAA credit rating.
After The Australian Financial Review revealed last week the government was considering exemptions to the $500,000 lifetime cap on non-concessional contributions in order to placate backbench anger, sources have confirmed that when the government releases the draft legislation, there will be exemptions to the cap if there were "life events", classified as one-off windfalls. These would include an inheritance, a divorce settlement, or eligibility for a trust payment. Life events would not include people transferring investments from elsewhere into their super to receive a lower tax rate.
Other exemptions would apply to people with self-managed super funds who, for example, had contractual arrangements made before the May 3 budget, when the change came into effect, to use their fund to buy a property and needed to put extra funds in their account for the purchase.

Scott Morrison digs in against MPs’ dissent on super changes

  • The Australian
  • 12:00AM July 21, 2016

Sarah Martin

Scott Morrison is digging in against backbench MPs threat­ening to cross the floor on superannuation changes, saying that the policy the government took to the election is “essential” for ­budget repair and to make the ­system fairer.
After deferring partyroom ­debate on policy issues until after parliament resumes next month, the government is facing ongoing unrest from within its ranks about the $2.9 billion savings measure, with MPs calling for “drastic” changes to the policy.
Following Malcolm Turnbull’s reshuffle this week, Queensland MP George Christensen has signalled a warning to the Prime Minister that he would be ­prepared to cross the floor unless his concerns were heeded.
Mr Christensen said because of its ­wafer-thin majority, given its 76 seats — which would be 75 MPs on the floor of the house once a Speaker was nominated — the Coalition would have to accept that “every vote counts” if it wanted to pass the budget savings measure. “For me, it is just not possible to vote for the package in the current format,” he told The Australian.

Morrison warns backbench of half-billion-dollar budget hit from super changes

July 20 2016 - 4:25PM
James Massola
Treasurer Scott Morrison has warned that big changes to the federal government's proposed superannuation policies could deliver a half-a-billion-dollar hit to the federal budget.
But he has moved to reassure colleagues there will be further consultation over the $6 billion package of measures, and suggested technical changes to the policies could be made.

Scott Morrison's super warning

It would cost half-a-billion dollars to abandon superannuation changes announced in the budget - and the ratings agencies are unlikely to react well, warns Scott Morrison. Courtesy ABC News 24.

The government's super dilemma

In her first public outing since being reappointed as Financial Services Minister, Kelly O'Dwyer was deliberately spare in her comments about possible changes to the government's planned superannuation reforms.
The cautious wording of her speech to the Financial Services Council on Thursday still left plenty of room for manoeuvre.
"We expect to begin consultation on exposure draft legislation shortly and, consistent with usual practice, will listen carefully to advice on the design of the legislation," she said.
Design can cover a great many things, of course, depending on the extent of the government's desire to provide itself political cover for a shift in approach.

‘Fine tuning’ to superannuation reforms: Turnbull

  • The Australian
  • 10:15AM July 22, 2016

Jared Owens

Malcolm Turnbull has acknowledged “some transitional issues” around the backdated $500,000 lifetime non-concessional cap on superannuation balances, but believes the substance of his government’s announced tax raid on retirement savings is “absolutely right”.
The federal government will fast-track its $6 billion superannuation reforms by releasing draft legislation within weeks to clear the way for talks with industry and the wider community over changes that might calm the storm over the controversial tax hikes.
The draft will stick to the broad plan set out in the federal budget on May 3 but will leave time for critics of the proposals to push for changes, mapping out a strategy to negotiate amendments in the new Senate as soon as possible.

Scott Morrison needs to fix his superannuation mess or go

  • The Australian
  • 12:00AM July 23, 2016

Terry McCrann

Superannuation is now the fundamental defining issue of Scott Morrison’s treasurership. Either he fixes the mess he unveiled on budget night or he announces his total unfitness to be treasurer.
Indeed, his failure to demonstrate even the slightest understanding of how and why he got it wrong — far less, any comprehension of the more substantive and more complex policy issues involved — suggests an incapacity to do the job.
Very simply but very significantly, what is proposed is just very bad policy. It was always going to be the outcome of a process corrupted from gestation, as it aimed solely at generating revenue and devil take any consideration of good policy.
There is not the slightest indication of any substantive analysis of the impact of the proposed changes on the superannuation system in the long term; far less its integration with the old age pension and retirement incomes and social welfare costs overall.
I look forward to comments on all this!

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