Thursday, November 10, 2016

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

November 10  Edition.
Parliament  has come back on the 7th of November. However things are a bit messy with the election of two senators now being reviewed by the High Court.
US election comment and economic fallout.
No need to say much. We all know we have to expect President Trump to be inaugurated on 20 Jan 2017.

Time will tell what it means for all of us. As of Thursday morning markets are all up. I suspect that might not last!
Here are a few other things I have noticed.

Budget Issues.

  • October 31 2016 - 12:15AM

Company directors to face penalties for ignoring climate change

Jessica Irvine
Australia's fall from grace as a global leader in the fight against dangerous climate change was rapid and inglorious.
But any Australian business leaders who think they got away with sticking their heads in the sand should think again.
New legal advice by senior Sydney silk Noel Hutley being released on Monday, suggests it is almost certain that directors of an Australian company will one day face legal action for neglecting to properly account for the potential impact of climate change on their business.

Morrison/Hanson fight wrong battle on welfare reform

at 12:15 am on October 31, 2016
Treasurer Scott Morrison took his war against the unemployed to another level over the weekend, vowing to end the “welfare creep” that encour­ages thousands of Australians to avoid getting a job. From The Australian:
The Australian yesterday revealed that 43,200 welfare recipients were getting more than they could if they worked at the average wage.
The government stood by the analysis that shows at least 43,200 people received at least $45,032 tax-free last financial year from the single-parent payment, childcare rebates and family tax payments.

Lenders at risk if housing prices continue to soar warns S&P

  • The Australian
  • 10:59AM October 31, 2016

Daniel Palmer

Standard & Poor’s has trimmed the outlook on 25 Australian lenders to negative amid developing concerns around swelling house prices and high private sector debt.
In a statement this morning, the ratings agency warned any further build-up in house prices from its base case of moderating growth for the next two years would raise the threat of a “sharp correction”.
“Our base-case scenario remains that the growth in property prices and private sector debt will moderate and remain at relatively low levels in the next two years,” S&P said.
31 Oct 2016 - 4:14pm

Xenophon mocks Roller to clunker PPL

Senator Nick Xenophon will meet with ministers Scott Morrison and Christian Porter this week as the government seeks support for $6 billion of savings.
Source: AAP
31 Oct 2016 - 4:14 PM  UPDATED YESTERDAY 4:14 PM
Senate powerbroker Nick Xenophon will meet with key ministers this week as the Turnbull government attempts to garner support for some $6 billion in welfare budget cuts.
Topping the agenda will be discussions with Social Services Minister Christian Porter over the government's planned changes to paid parental leave provisions to save $1.2 billion.
The government is pursuing an end to what former Liberal treasurer Joe Hockey labelled "double dipping" - a term Mr Porter is now keen to avoid - to stop new mums accessing the taxpayer-funded minimum wage scheme if their employer is running its own leave plan.
  • November 2 2016 - 6:18AM

It is not the budget that's bankrupt, it is the government's penny pinching

Ross Gittins
Did you know our social security system is so open to rorting that it's possible for some people to get more from benefits than they'd earn if they took a job? And we wonder why we have problem with debt and deficit.
This scandalous state of affairs was leaked to an  Australian newspaper by sources close to the minister for Social Services, Christian Porter.

Government to end long term welfare reliance

Young parents, carers and students will be the target of a major shake up of the welfare system.

Governments tax forecasts wilt, peak deficit blows by $30bn

  • The Australian
  • 12:00AM November 3, 2016

David Uren

The failure of tax revenue to meet the excessively optimistic predictions of federal and state Treasury departments has forced the forecast peak in Australia’s public sector debt to be raised by $30 billion since the end of last year.
The Parliamentary Budget Office estimates that the combined federal and state debt will reach a peak of $428.7bn or 20.8 per cent of GDP in 2019-20, based on forecasts contained in their latest budgets.
The federal government is ­responsible for more than 80 per cent of the debt, with its share ­expected to reach $356.4bn. Former treasurer Joe Hockey scrapped a legislated $300bn ceiling on federal debt soon after gaining office in September 2013.

Our Treasurer Must Face Up To Some Urgent Home Truths

Every night in Australia there are enough homeless children to fill Sydney’s Allianz Stadium.

03/11/2016 5:34 AM AEDT |  
"Mr Morrison is wrong to devolve responsibility to the states to fix housing affordability through planning changes alone."
Call me a cynic but I don't think it's a coincidence that Treasurer Scott Morrison made his recent speech on the housing affordability crisis just a week before the Housing Ministers meet in Sydney. Especially when Mr Morrison's key line was to say the housing affordability crisis was a supply and state planning issue. It feels remarkably well timed to pre-empt tomorrow's meeting, where funding, and what the Federal Government will contribute, will be the topic of the day.
As it stands, thousands of people across the country are homeless or living precariously hand to mouth, simply because they can't afford the rent. And hundreds of homelessness services, which help those people find and keep a tenancy, are at risk of having their funding cut.
  • November 3 2016 - 11:45PM

Half the jobs are going, and they're not coming back

·         Gwynne Dyer
"The notion that Uber in London is a mosaic of 30,000 small businesses linked by a common 'platform' is, to our minds, faintly ridiculous," said one of the judges on the employment tribunal. So the tribunal ruled that Uber's 30,000 drivers in London were actually employees, and therefore entitled to be paid the minimum wage, to be given sick pay, even to have paid holidays.
Uber promptly appealed the ruling, because it would wreck its business model in Britain and, if the example spread, worldwide. But it was only a temporary victory for workers' rights, because just as the real jobs have been replaced by fake "freelance" jobs like Uber that strip people of their old legal protections, so the "freelance" driving gigs will soon be replaced by – no jobs at all.
The first self-driving cars are already on the roads. Automation, in the form of artificial intelligence, will probably abolish almost all the driving jobs in the next 20 years. In Britain alone that means 400,000 jobs driving big trucks and almost 300,000 licensed taxi drivers. (The jobs driving delivery vans will last a little longer.) Three-quarters of a million jobs gone, say, and nothing plausible coming down the road to replace them. Scale it up to the size of the United States and that's about 4 million more American jobs gone, not to foreign competition and "outsourcing" but just to technological change. It's harder to replace drivers than bank tellers – "every ATM is the ghost of three bank tellers" – but it just takes a little longer to develop the right software.

Commodity surge hasn't quelled rating row

By AAP | 03.11.2016 01:42 PM
Suddenly the path to budget repair has gotten murkier.
Global ratings agencies like Standard & Poor's raised concerns about the make-up of the Senate following the July 2 federal election and what it would mean for legislation.
Little did they expect the larger crossbench would have started dropping like flies, leaving a big question mark over future government legislation should Labor and the Greens join forces to oppose government bills.

Health Budget Issues.

Rent deal followed Coalition criticism

  • The Australian
  • 12:00AM November 2, 2016

Sean Parnell

The Coalition gave an election commitment to help the pathology sector with rental costs only weeks after stakeholders “dis­agreed vigorously” over the issue, according to minutes of a meeting convened by the ­Department of Health.
During an election debate in May, Malcolm Turnbull ­announced the Coalition had agreed to help pathology companies get cheaper rent for collection centres located in GP clinics. In exchange, Pathology Australia agreed to stop campaigning against the Coalition’s plan to remove bulk-billing ­incentives at a time when Labor was also rallying to save Medicare and was holding events outside pathology clinics.
Pathology Australia is backed by Sonic Health Care, a major pathology provider and former donor to the Coalition. The deal has angered the Royal Australian College of GPs and the Australian Medical Association.

Department of Health warning over market value of space in GP clinics

  • The Australian
  • 11:43AM November 4, 2016

Sean Parnell

Adopting the pathology lobby’s definition of market value for space in GP clinics would render most of the existing leases for 5600 collection centres illegal, the Department of Health was warned.
Under an election campaign deal between the Coalition and Pathology Australia, the definition of market value for space in GP clinics will be altered to better protect leases.
The deal was intended to help offset the impact of the planned removal of pathology bulk-billing incentives and came on the proviso Pathology Australia cease its campaign against the Coalition.
But the Royal Australian College of General Practitioners, the Australian Medical Association and some pathology providers have declared it anti-competitive and likely to push up GP costs.
  • November 4 2016 - 1:39PM

Cartel claims against surgeons to be investigated

Julia Medew
Concerns about potential cartel behaviour among Australian surgeons has been referred to the Australian Health Ministers' Advisory Council for further investigation.
In September, Fairfax Media revealed claims that overseas-trained surgeons were facing anti-competitive behaviour that reached into the Royal Australasian College of Surgeons - a powerful group that largely controls the supply of surgeons in Australia and, allegedly, the level of competition and fees they can charge.
NSW Health Minister Jillian Skinner said after discussing the issue at the Council of Australian Governments' meeting of health ministers last month, concerns about unprofessional behaviour had been referred to the ministers' advisory council.

The nation’s sickest patients could be at risk after a massive Medicare shake-up

November 4, 20167:34pm
Sue Dunlevy News Corp Australia Network
THE nation’s sickest cancer patients and people with diabetes and other chronic illnesses will get a maximum of $1795 worth of GP care a year funded by Medicare under a revolution in the way doctors are paid.
And Medicare will fund just five extra visits to the doctor if these people need medical attention for issues aside from their chronic illness under the Turnbull Government’s Health Care Homes model.
Doctors were expressing deep concern about the adequacy of the payment levels that were released without consultation with medical groups on November 4.
“The modelling is concerning and potentially leaves the whole program at risk of falling over because of being underfunded from the beginning,” AMA vice president Dr Tony Bartone said.
  • November 6 2016 - 12:01AM

New front in Malcolm Turnbull's health war as doctors unite on pathology deal

Adam Gartrell
Prime Minister Malcolm Turnbull's war with doctors is set to intensify as GPs unite to kill off a government deal with pathologists they claim will force bulk-billing practices to start charging or even shut down.
Doctors say patients will be charged an average of $15 to $20 more to visit a GP if the government proceeds with plans to regulate the rents they can charge pathology companies that co-locate in their practices.
But pathologists say they are being charged obscene rents that are jeopardising their ability to keep bulk billing for their services.
The issue is heating up as Health Minister Sussan Ley prepares to unveil her final plans in the coming weeks, with GP practice owners uniting under a new group – the Australian GP Alliance – to force a government rethink.

Extreme Home Makeover — The Role of Intensive Home Health Care

Luis Ticona, M.D., M.P.P., and Kevin A. Schulman, M.D.
N Engl J Med 2016; 375:1707-1709 
November 3, 2016 DOI: 10.1056/NEJMp1608301
Audio Interview
Interview with Dr. Kevin Schulman on intensive home health care as an alternative to hospitalization. (6:11)
·         Listen
In 2010, the department of health in Victoria, Australia, announced the construction of a 500-bed hospital without bricks and mortar. This “virtual hospital” has 33,000 admissions each year, accounting for almost 5% of all acute care bed-days in the state of Victoria and adding much-needed hospital-bed capacity.1 The Australian health system has since expanded this program to reduce the strain on available hospital beds in other regions as well, while avoiding capital expenditures and preserving the quality of care. What incredible technological advance permitted achievement of these impressive results? Home visits.
Intensive home health care services as an alternative to hospitalization are becoming a standard option in many health systems around the world, perhaps most notably the United Kingdom, France, New Zealand, and Australia. These health systems deploy multidisciplinary home health care teams after emergency department evaluation and diagnosis, outpatient evaluation, or an ultra-brief hospital stay to provide acute care services, comparable to hospital-level care, in the patient’s home rather than a hospital. They bundle existing services, including physician oversight and backup, nurse visits for ongoing evaluation and delivery of interventions, home infusion technology and pharmacy resources, telehealth interactions, point-of-care testing, and home health aide services to create comprehensive, customized programs of intensive care at home. Indeed, it’s the existence of these technologies and the growth of the skilled-nursing workforce that enable the creation of such service lines.

Health Insurance Issues.

Health funds’ poor practices show need for reform

“Poor practices” by some health funds are exposing consumers to bill shock and inadequate cover, the Australian Competition and Consumer Commission has found in a new report.
“The ACCC report on health insurance to the Senate indicates that the increasing number of changes health funds are making to their policies are often poorly communicated with unfortunate consequences for their members,” the CEO of the Consumers Health Forum, Leanne Wells, said.
“Not only do we have confused and frustrated consumers, at worst the consequence of bill shock and high-premium low-value cover is reduced access to health care.
  • October 31 2016 - 7:11PM

Health insurance customers left in the dark over policy changes: ACCC

Rania Spooner
Think your health insurance covers that? You might want to check again.
The Australian Competition and Consumer Commission has found insurers are not adequately notifying customers when their coverage or benefits are slashed, and - in some cases - failing to disclose changes entirely.
The more extreme failures identified by the consumer watchdog's annual report on health insurers related to contract changes between insurers and health providers, which would affect benefits payable to customers.  
Confusing and "unhelpful" communication tactics included unclear and misleading language, single notifications without follow up, relying on email, and the blending of benefit change information with marketing information, the ACCC reported.

Health insurer NIB says further price cuts needed for medical devices

  • The Australian
  • 12:16PM November 2, 2016

Sarah-Jane Tasker

NIB chairman Steve Crane has warned the Turnbull Government further cuts to the price of medical devices are needed to address health insurance affordability concerns.
Mr Crane, speaking to shareholders at today’s annual general meeting in Sydney, said the recent announcement by Federal Health Minister Sussan Ley that the price of some medical devices used in the private system would be cut, would help relieve pressure on future insurance premiums.
But he said despite those cuts, there was still more that could be done to lower prices on prosthetic and medical devices.
  • November 2 2016 - 2:38PM

Health insurance premium rises are starting to fade: NIB

Brian Robins
The steam may be finally running out of the fast-paced rise in health insurance premiums of the past decade, with one of the nation's largest insurers seeing the level of 'claims inflation' nearly halve over the past year.
NIB chief executive Mark Fitzgibbon said on Wednesday the slowing trend of cost increases encountered by health insurers that was seen over the past year has continued.
For his company, claims inflation fell to 2.9 per cent in the year to June, well below the expected rate of closer to 5 to 6 per cent. For the year ahead, that is seen moving to between 3 and 5 per cent.

HCF boss Shaun Larkin calls for health insurance reform

  • The Australian
  • 12:00AM November 3, 2016

Sarah-Jane Tasker

HCF managing director Shaun Larkin says change is needed in the health insurance sector to ­address affordability concerns, as he flags the product is evolving, with consumers taking more control of their health needs.
Mr Larkin said the question around the affordability of health insurance was becoming an important one for consumers.
“We need to work out how to solve it,” he said. “The challenge will be that solving it isn’t going to be through some incremental change of what we currently have in place, it will have to be significant change.”
  • Nov 3 2016 at 2:42 PM

Medibank Private attracts double its share of complaints

Medibank Private was the driving force behind a record-breaking number of private health insurance complaints between July and September, the  industry's ombudsman has revealed.
Despite accounting for a 28.6 per cent share of the $20 billion industry, Medibank's customers accounted for 60.7 per cent of complaints and 42.9 per cent of disputes that the Private Health Insurance Ombudsman had to deal with in the three months ended September 30.
Overall claims hit 1683, up 60 per cent on the same time last year and an increase of 23 on the prior quarter, which was a record, PHIO said. "This presented a challenge for the staff of the PHIO and some health insurer complaint handlers."
  • November 6 2016 - 12:45AM

Medibank continues embarrassing streak of record complaints to the Private Health Insurance Ombudsman

Esther Han
Medibank has single-handedly caused the Private Health Insurance Ombudsman to announce a record: the greatest number of complaints in any quarter of its 20-year history.
Despite having less than a third of the market, Medibank's policyholders accounted for 61 per cent of the 1683 complaints made to the ombudsman between July and September, a huge 60 per cent jump in total complaints compared with the same quarter last year.
Medibank is scrambling to save its reputation by promising to offer more value, exceed expectations and invest in customer service, after losing 225,000 customers in the past financial year.
I look forward to comments on all this!

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