Thursday, February 09, 2017

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

February 9  Edition.
Well I think it will be agreed the last week or so with President Trump has been both amazing and deeply worrying!

Thursday Update: The only thing I can usefully add at this point is that things do seem to have calmed down in the last day or so - as more of the Trump Cabinet is confirmed. Maybe there are now a few more adults in the room to stabilise things a bit. We can only hope so!
This says it all.

Donald Trump promised disruption, and that's exactly what he's delivering

Chris Cillizza
Published: January 30, 2017 - 12:09PM
Donald Trump is who we thought he was.
The 45th President campaigned as a radical break from both politics and policy as usual in Washington, promising to restore strength to the White House and the country while ignoring all tradition and political correctness.
He spent the first week of his presidency doing just that - beginning with an executive order triggering the United States' withdrawal from the Trans-Pacific Partnership, continuing through a midweek executive order to begin the process of building a wall along the US' southern border and culminating on Friday with Trump's executive order temporarily halting refugees from entering the country and instituting a full entrance ban on visitors from seven predominantly Muslim countries.
Enough said – this won’t end well I still fear.
On more local news we see it has started again! And it sure has been feisty.
2:19pm February 3, 2017

Parliament returns after summer of scandal

The Turnbull government faces scrutiny over Centrelink, pensions, politicians' expenses, trade and Donald Trump when parliament resumes next week.
There's been little time off from politics over the summer break, with Malcolm Turnbull losing his health minister Sussan Ley to an expenses scandal, Labor querying Centrelink's debt-chasing approach and the Trump election throwing US-Australia relations into chaos.
The Senate has not been without its dramas, with Senate President Stephen Parry to kick off Tuesday's sitting with a statement on Rod Culleton.
Here are a few other things I have noticed.

Trump Material.

Clever or craven: Malcolm Turnbull's soft-shoe shuffle around Donald Trump

Mark Kenny
Published: January 29, 2017 - 4:11PM
Australians are probably wondering what it will take? What breach of national values or irresponsible strategic posturing by Washington will be damaging enough to get a rise out of Canberra?
It's a serious question. Axing a long-held joint commitment to free trade after leading a 12-nation process in good faith? Demanding a Chinese retreat, from territory to which the United States makes no claim, on pain of military action? Abandoning a non-discriminatory immigration policy, and thus being seen to inflame religious tensions with direct implications for Australia and the rights of its citizens? 
As the Turnbull government feels its way forward with the unpredictable, amateurish presidency of Donald Trump, the answer seems to be none of the above.

A Clarifying Moment in American History

There should be nothing surprising about what Donald Trump has done in his first week—but he has underestimated the resilience of Americans and their institutions.
I am not surprised by President Donald Trump’s antics this week. Not by the big splashy pronouncements such as announcing a wall that he would force Mexico to pay for, even as the Mexican foreign minister held talks with American officials in Washington. Not by the quiet, but no less dangerous bureaucratic orders, such as kicking the chairman of the Joint Chiefs of Staff out of meetings of the Principals’ Committee, the senior foreign-policy decision-making group below the president, while inserting his chief ideologist, Steve Bannon, into them. Many conservative foreign-policy and national-security experts saw the dangers last spring and summer, which is why we signed letters denouncing not Trump’s policies but his temperament; not his program but his character.

Trump’s Refugee Bonfire

A blunderbuss order sows confusion and a defeat in court.

Jan. 29, 2017 7:10 p.m. ET
President Trump seems determined to conduct a shock and awe campaign to fulfill his campaign promises as quickly as possible, while dealing with the consequences later. This may work for a pipeline approval, but the bonfire over his executive order on refugees shows that government by deliberate disruption can blow up in damaging ways.
Mr. Trump campaigned on a promise of “extreme vetting” for refugees from countries with a history of terrorism, and his focus on protecting Americans has popular support. But his refugee ban is so blunderbuss and broad, and so poorly explained and prepared for, that it has produced confusion and fear at airports, an immediate legal defeat, and political fury at home and abroad. Governing is more complicated than a campaign rally.

Trump's Travel Ban Is Un-American and Unwise

Jan 29, 2017 3:54 PM EDT
Leave aside the moral, legal, economic, political and practical objections -- and it's quite a list -- and instead consider just the security implications of the executive order President Donald Trump issued late Friday: Will temporarily banning the entry of all refugees and nationals from seven countries make the U.S. safer?
Regrettably and emphatically, the answer is no. First, if the goal is "Protecting the Nation From Foreign Terrorist Entry Into the United States," as the order is titled, then it would make sense to focus on countries from which terrorist attackers have entered. Of the seven countries on the administration’s list (Iraq, Iran, Libya, Somalia, Sudan, Syria and Yemen), only one (Somalia) comes close to fitting that bill. Meanwhile, several countries that do (Egypt, Pakistan, Saudi Arabia) don’t make the list.
Nor does the order convey any acknowledgment that refugees are the most vetted group of travelers to the U.S. That is even more true after they apply for their green cards and undergo another round of biometric screening.

Donald Trump's folly is a once-in-a-century opportunity for Australia

Peter Hartcher
Published: January 31, 2017 - 12:00AM
Donald Trump has created a mess with his  immigration hit list. A great outcry of Australian voices is demanding that Malcolm Turnbull denounce the US President's move.
There is a better response. Expressing vicarious outrage through the medium of the Prime Minister might be emotionally satisfying but it's fated to be futile. 
The leaders of Germany, Britain and France, some of the most powerful Republicans in the US and the greatest US technology corporations have all criticised Trump for the decision. Some countries are considering a retaliatory ban on Americans – foremost among them is Iraq, a key ally in the struggle against Daesh, the so-called Islamic State. What would a Turnbull statement accomplish that all this has not?

The danger of Steve Bannon on the National Security Council

David J. Rothkopf
Published: January 31, 2017 - 1:51AM
While demonstrators poured into airports to protest the Trump administration's draconian immigration policies, another presidential memorandum signed this weekend may have even more lasting, wide-ranging and dangerous consequences. The document sounds like a simple bureaucratic shuffle, outlining the shape the National Security Council will take under President Donald Trump. Instead, it is deeply worrisome.
The idea of the National Security Council (NSC), established in 1947, is to ensure that the president has the best possible advice from his Cabinet, the military and the intelligence community before making consequential decisions, and to ensure that, once those decisions are made, a centralised mechanism exists to guarantee their effective implementation. The NSC is effectively the central nervous system of the US foreign policy and national security apparatus.

The Republicans' deal with the devil

David Brooks
Published: February 1, 2017 - 5:38AM
Many Republican members of Congress have made a Faustian bargain with Donald Trump. They don't particularly admire him as a man, they don't trust him as an administrator, they don't agree with him on major issues, but they respect the grip he has on their voters, they hope he'll sign their legislation and they certainly don't want to be seen siding with the inflamed progressives or the hyperventilating media.
Their position was at least comprehensible: How many times in a lifetime does your party control all levers of power? When that happens you're willing to tolerate a little Trumpian circus behaviour in order to get things done.
But if the last 10 days have made anything clear, it's this: The Republican Fausts are in an untenable position. The deal they've struck with the devil comes at too high a price. It really will cost them their soul.

With Donald Trump in power, Australia urgently needs to re-evaluate its US bases

Margaret Beavis
Published: February 1, 2017 - 12:59PM
Recent changes to the US National Security Council should be ringing loud alarm bells in Canberra.
By demoting the highest-ranking military officer and the highest-ranking intelligence officer, and appointing political adviser Stephen Bannon as a permanent member of the NSC, Donald Trump has seriously escalated the risk of the US launching into ill-advised conflicts. Bannon comes from a role as chairman of the racist, Islamophobic website, and is reported as having been in charge of writing the recent executive order that has banned US entry for refugees and citizens from seven Muslim-majority nations.

Petraeus Warns That Divisive Actions on Muslims Strengthen Extremists

The former general appeared to undercut President Trump's early national security moves.

President Donald Trump has faced criticism from across the political spectrum after signing an executive order last Friday restricting travel from seven majority-Muslim countries. On Wednesday, one of Trump's favorite military minds appeared to add his voice to the public condemnation.
General David Petraeus, a finalist for secretary of state in the Trump administration despite his disgraced exit from the CIA, told the House Armed Services Committee that broad-brush statements from Trump and others in his administration about Islam and Muslims complicate the fight against groups like ISIS.
"We must also remember that Islamic extremists want to portray this fight as a clash of civilizations, with America at war against Islam," Petraeus said at a hearing on national security threats and challenges. "We must not let them do that. Indeed, we must be very sensitive to actions that might give them ammunition in such an effort."

No ‘G’day, mate’: On call with Australian prime minister, Trump badgers and brags

 Greg Miller  Philip Rucker February 1 at 7:13 PM 
It should have been one of the most congenial calls for the new commander in chief — a conversation with the leader of Australia, one of America’s staunchest allies, at the end of a triumphant week.
Instead, President Trump blasted Australian Prime Minister Malcolm Turnbull over a refu­gee agreement and boasted about the magnitude of his electoral college win, according to senior U.S. officials briefed on the Saturday exchange. Then, 25 minutes into what was expected to be an hour-long call, Trump abruptly ended it.
At one point Trump informed Turnbull that he had spoken with four other world leaders that day — including Russian President Vladi­mir Putin — and that, “This was the worst call by far.”

Wake up Australia: the US alliance has never been our security 'guarantee'

Peter Hartcher
Published: February 3, 2017 - 12:15AM
This is a case of alliance shock for Australia. Donald Trump's rough treatment of Malcolm Turnbull is about more than their personalities, more than the refugee deal, and more than relations between two leaders.
It's about the reliability of the US alliance. "It's not unprecedented for the leaders of the US and Australia to have a tough, difficult, robust conversation," says Sydney University's alliance historian, James Curran.
"But it is unprecedented for this sort of private conversation to be leaked." And it was a leak, according to Turnbull, that leaves him feeling "very disappointed".

Trump’s wake-up call to our starry-eyed leaders

  • Bob Carr
  • The Australian
  • 12:00AM February 3, 2017
We know where we stand. Donald Trump’s angry dismissal of Malcolm Turnbull is a damned healthy thing for gallant, gullible little Australia. It clears the air.
So much, for example, for the silly view that the Trump administration is an opportunity for Australia to “get closer” to the US, as if the election of a loudmouth nationalist to the White House was an invitation for us to become an even more rusted-on ally, signing up to send our forces into whatever conflict the new President chooses to dream up.
So much, too, for the romantic view of the ANZUS treaty that has elevated the “alliance” as the only expression of Australia’s international personality.

National Budget Issues.

Scott Morrison to lift credit limit as Australia's debt hurtles towards $500 billion

Adam Gartrell
Published: January 29, 2017 - 12:15AM
The federal government will be forced to lift its own self-imposed credit limit in the coming months as debt hurtles towards half-a-trillion dollars - almost double the number the Coalition inherited from Labor.
Gross commonwealth government debt has reached more than $474 billion after a sharp jump in recent weeks, leaving it just $26b short of the $500b debt ceiling set by former treasurer Joe Hockey three years ago.
Total government debt is now rising by $5.3 million an hour - or $126m a day - according to calculations performed by David Lawson, a commentator who runs the Australian Debt Clock website.

Treasury says tax expenditures cost $150 billion

Peter Martin
Published: January 31, 2017 - 5:38AM
The family home has eclipsed superannuation as Australia's biggest tax break, with new figures showing the capital gains tax exemption on family homes cost the budget a record $61.5 billion in 2016-17, well in excess of the $33 billion lost to superannuation tax concessions.
The $61 billion is made up of $27.5 billion the government believes it would have got if it taxed profits made on the sale of family homes at the present capital gains tax rate, plus an extra $34 billion it would have got if the capital gains tax rate were the same as the marginal tax rate instead of being discounted by 50 per cent.
Treasury's annual Tax Expenditures Statement, required as part of the charter of budget honesty and released quietly on Monday afternoon, identifies 25 tax breaks each costing more than $1 billion, which between them cost close to $150 billion.

Scope 2017 economic survey: Forecasting panel predicts steady rates in a slightly better year ahead

Peter Martin
Published: February 4, 2017 - 8:23AM
The Reserve Bank faces no pressure to adjust interest rates at its first meeting for the year on Tuesday and very little pressure to adjust them at any time during the year as the 2017 BusinessDay Scope forecasting survey predicts a rarity – an entire year of unchanged rates, something that hasn't happened since the survey successfully forecast a year of steady rates in 2014 and before that 2004.
Approaching its 40th year, the exclusive BusinessDay survey is made up of forecasts from 27 leading economists in the diverse fields of financial markets, academia, consultancy and industry. Over time its average predictions have proved to be more accurate than those of any of its individual members.
All of the forecasts are displayed in a table in the print version of BusinessDay and in a click-through interactive graphic on line.

Mining's economic contribution not as big as you might think

Ross Gittins
Published: February 4, 2017 - 12:15AM
With Malcolm Turnbull desperate to keep burning coal for electricity, just how important is the mining industry to our economy? Short answer: not nearly as much as it wants us to believe, and has conned our politicians into believing.
Because people like me have spent so much time over the past decade and more banging on about the resources boom, we've probably left many people with an exaggerated impression of the sector's importance.
It's true that, thanks to a quadrupling in the value of its physical capital, mining now accounts for about 7 per cent of our total production of goods and services (gross domestic product), compared with less than 5 per cent in 2004, at the start of the boom.

Turnbull government looks to trim funding growth for 'over-funded' schools

Matthew Knott
Published: February 5, 2017 - 6:48AM
The Turnbull government is examining how to curtail the funding growth of "over-funded" private schools in a new deal to take effect next year, a move that would free up funds to distribute to needy public and non-goverment schools. 
The move comes as new Education Department data shows the glacial speed at which schools are currently moving towards their appropriate funding level – a process Education Minister Simon Birmingham wants to speed up.  
Fairfax Media understands Senator Birmingham's school funding proposals have been discussed in detail during cabinet meetings over recent months, but a final position to present to state governments and the Parliament has not been approved.

Audit office rips into Tony Abbott’s signature indigenous strategy

  • The Australian
  • 12:00AM February 4, 2017

Stephen Fitzpatrick

The national audit office has found the federal government’s signature $4.8 billion indigenous affairs funding regime, announced in 2014, was poorly planned, badly implemented, lacked adequate performance assessment and had a “below standard” grants administration process.
The scathing review of Tony Abbott’s Indigenous Advancement Strategy follows similarly negative findings last year by a Senate committee and the Prod­uctivity Commission.
A Centre for Independent Studies survey of the strategy found that only 8 per cent of 1082 indigenous programs nationwide, worth $5.9bn annually and funded from all sources, had been properly evaluated.

Health Budget Issues.

Health and healthcare: what Greg Hunt must do

23 January 2017
A strong minister will look beyond doctors and hospitals to improve Australians’ health
Malcolm Turnbull’s appointment of Greg Hunt to the vacancy created by the resignation of Sussan Ley has prompted more than the usual opinions and suggestions about the health minister’s role and priorities. The portfolio is always a key one for voters, but concerns among consumers and health organisations are more potent than usual for several reasons: a growing awareness that significant changes are needed to the delivery, integration and funding of health and healthcare services; frustration at the failure of the Abbott and Turnbull governments to propose and implement coherent policies; and suspicions that the government’s stealth agenda is to undermine the universality of Medicare through further privatisation and higher out-of-pocket costs.
Minister Hunt comes to the task with a mixed record in his previous portfolios and has already sent mixed messages about his new portfolio. He has a substantial task ahead, and little time to get up to speed on the issues. Ley left many issues in the too-hard basket, work on the 2017–18 budget is already under way, decisions must be made about increases in private health insurance premiums for 2017, and public trust in the ability and willingness of the Turnbull government to protect Medicare is eroding.

If GPs pass on cost from rebate freeze, poorer, sicker patients will be hardest hit

January 31, 2017 6.07am AEDT


Rosemary Elkins
Research Assistant - School of Economics, University of Sydney
Stefanie Schurer
Associate Professor, University of Sydney
Not even a fortnight in the job and the newly appointed health minister, Greg Hunt, is already facing pressure from medical organisations to scrap the controversial freeze on Medicare rebate indexation.
Most Australians will remember the series of ill-fated co-payment policies proposed by the Abbott government. The “$7 co-payment” and its short-lived successors were abandoned in the face of sustained public backlash. Though Abbott eventually declared the policy “dead, buried and cremated”, the Medicare rebate freeze has been labelled a GP co-payment “by stealth”.
The freeze, first implemented by Labor and twice extended by the Coalition, means bulk-billing doctors will receive the same reimbursement for a consultation in 2020 as they did in 2014, despite the increasing year-on-year cost of delivering services.

Sick Aussies delaying visits to GP due to cost

index&t_product=NTNews&td_device=desktopLANAI SCARR, Senior writer, News Corp Australia Network
January 31, 2017 10:00pm
AUSTRALIANS are increasingly delaying visits to the doctor and putting off filling prescriptions as out of pocket costs for a trip to the local GP skyrocket.
The cost of visiting a general practitioner is now at its highest ever, increasing 7.1 per cent from 2014-15 to 2015-16.
Sick Australians are paying on average $58.49 in out of pocket expenses to visit the doctor, compared to $54.60 in 2014-15 and $44.98 in 2011-12.

Indigenous health program loses funding

January 31, 20178:03pm
Paul Osborne, AAP Senior Political Writer Australian Associated Press
An indigenous health program which has been running in Queensland for 21 years is set to close this year when federal funding stops.
The federal health department gave the Queensland AIDS Council a 12-month funding extension to keep the 2 Spirits sexual health program operating.
During that time, the department expected the council to "explore more sustainable funding alternatives".

Here is a failsafe proposal to slash health costs: start spending now

  • Tony Cunningham
  • The Australian
  • 12:00AM February 2, 2017
New federal Health Minister Greg Hunt has set an admirable goal for Australia: he wants our ­nation to have the best health system in the world. This is achievable and we should all support it. But with healthcare costs growing year on year, we will need some different thinking if we are to get there.
It may sound counter-intuitive but one way we can reduce the long-term health inflation pressures is to invest more in health and medical research. Deloitte ­Access Economics has calculated that investing in health and medical research delivers at least a $3 return for every dollar invested. This return comes from improved diagnostics, new drugs and other treatments, vaccines and the evidence needed to give effective ­advice on how to prevent medical conditions from occurring in the first place.
Preventive medicine is an area in which Australia has had tremendous success. Skin cancer rates are improving dramatically thanks to people following evidence-based advice, and vaccines developed here — such as Gardasil, which prevents cervical cancer — are saving lives and money.

Health Minister Greg Hunt has unveiled $125 million of funding into medical research projects

LANAI SCARR, EXCLUSIVE, News Corp Australia Network
February 3, 2017 10:00pm
RESEARCH into cancer, dementia and even sports concussions will be the big winners from a $125 million cash splash unveiled by the federal government
News Corp Australia can exclusively reveal Health Minister Greg Hunt will award federal funding to 110 medical research projects as his first act in the new portfolio.
Among the grants include $38.9 million for cancer, $30.5 million for dementia, $12.6 million for indigenous health, $9.7 million for mental health, $3.1 million for cardiovascular diseases, $1.47 million for injury, $958,000 for obesity, $392,000 for diabetes and $177,000 for arthritis-related illnesses.

Greg Hunt’s priority: clear direction to save health

  • The Australian
  • 12:00AM February 4, 2017

Sean Parnell

The Turnbull government will move to reclaim the health policy debate after new minister Greg Hunt identified the need for a long-term strategy to strengthen Medicare, support hospitals, facil­itate world-class medical research and encourage people to take ­better care.
After a first term dominated by budget cuts and reviews, the Coalitio­n was savaged at the polls, not only because of Labor’s contentious “Save Medicare’’ campaign but also a lack of overarching policy direction.
An expenses scandal then prompted the resignation of Sussa­n Ley as health minister and gave Malcolm Turnbull the opportunity to reset relations with the sector under Mr Hunt, the adept former minister for industry, innov­ation and science and, before that, environment.

Drug game-changer for thousands suffering from cystic fibrosis headed for the PBS

LANAI SCARR, News Corp Australia Network
February 4, 2017 10:00pm
AUSTRALIA’S youngest cystic fibrosis sufferers will this week get a massive reprieve when the government lists a life changing medication on the pharmaceutical benefits scheme.
News Corp Australia understands Health Minister Greg Hunt will this week approve the drug Kalydeco on the PBS for 2-5 year-olds.
The medication will be listed from May with the government in negotiations with drug manufacturer Vertex about how to best to ease the burden on families until then.

Health Insurance Issues.

Assistant health minister Dr David Gillespie on easing the concern of health insurance

1 Feb 2017, 10 a.m.
CHANGES are being considered that could save up to $800 million a year on health insurance, according to Assistant Minister for Health and federal Member for Lyne Dr David Gillespie.
Dr Gillespie agreed that the rising costs of health insurance is a source of concern for many Australians. 
He added the federal government was looking at ways to cut health insurance costs with ‘a review into prosthesis’.
He explained a committee was looking into the price of prosthesis, as there appeared to be a ‘arbitrage’ between the market price and the goverment listed price of the artificial body parts.
I look forward to comments on all this!


Bernard Robertson-Dunn said...

Re: Here is a failsafe proposal to slash health costs: start spending now

"It may sound counter-intuitive but one way we can reduce the long-term health inflation pressures is to invest more in health and medical research. Deloitte ­Access Economics has calculated that investing in health and medical research delivers at least a $3 return for every dollar invested."

Whereas, so far every $1 invested in eHealth has returned ....? Will return.....?

Anonymous said...

Very, very, true - but on this forum Bernard, sadly you are preaching to the converted. Do you think anyone anywhere else is listening though?

You could shout it from the top of the Parliament House flagpole and it would still fall on deaf ears.