Quote Of The Year

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


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

Friday, June 30, 2017

The Northern Territory Goes For A Huge Project To Do It All In Health IT.

This appeared a few days ago:

NT prepares for mammoth overhaul of health IT

$259 million to be delivered by InterSystems
Rohan Pearce (Computerworld) 23 June, 2017 14:24
InterSystems Australia has been chosen by the Northern Territory government to replace the NT’s key health IT systems.
The $259 million Core Clinical Systems Renewal Program (CCSRP) involves replacing four separate clinical IT systems used by the NT’s health service.
The program was originally expected to cost $185.9 million, but the territory’s government in this year’s budget upped funding for the CCSRP.
The project involves implementing a single end-to-end system for NT public health services as well as a territory-wide, real-time health electronic record system.
“NT Health has established an advisory group, the Clinical Leadership Team, which will support the CCSRP team for safe implementation of the new integrated ICT solution,” NT health minister Natasha Fyles said.
“This is a major investment delivering a single digital medical record for all territorians. It enables our nurses and doctors to focus on treating patients and delivers the high quality health services that Territorians want and deserve.”
Dialog Information Technology will provide integration services for the project. InterSystems will launch a Darwin office, the NT government said.
“Once implemented, the InterSystems solution will enable territorians to engage with their own healthcare information, clinicians to achieve better connections with patients and one another, and healthcare data to be exchanged among vital institutions through interoperability,” said InterSystems Corporation vice-president, international business, Steve Garrington.
More here:
There is also coverage internationally.

InterSystems lands $259 million healthcare IT project in Australia

Vendor will replace four clinical IT systems in the country’s Northern Territory.
June 23, 2017 02:16 PM

InterSystems Australia will soon begin a clinical systems overhaul of the Northern Territory's core clinical systems under a government program. The goal: to create a single digital medical record. The estimated cost: $259 million.
InterSystems vied for the contract with three other bidders – Telstra Health, Epic Systems and Allscripts.
InterSystems, which has worked in Australia over 25 years, is a known entity in NT Health. In the past, the company has provided NT Health with a pathology system called TrakCare Lab and with its Ensemble integration platform.
InterSystems, headquartered in Cambridge, Massachusetts, is a major global supplier of clinical systems and has operated in Australia for more than 25 years, along with its local integration partner, Dialog Information Technology, which will provide the integration piece of the project.
Once implemented, the InterSystems technology is expected to enable patients and clinicians to better engage with one another and for patients to have better access to their own healthcare information.
Interoperability among health systems and data exchange are also key components of the project.
InterSystems has proven to be a favored global vendor – for both its result and price, according to a May 2017 report from research firm KLAS.
More here:
This is clearly a very big project for the ‘Top End’. It will be fascinating to see how it goes over the next few years.
How the system inter-operates with the myHR will be interesting to see.

Thursday, June 29, 2017

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

June 29, 2017 Edition.
In the USA the big news is the attempt from the Senate Republicans to repeal and replace Obamacare. Amazingly the effect of what they want to do is basically give the poor less health care coverage while giving the rich huge tax cuts. This is apparently what Republicans do. Sadly they have to face elections to it is all getting a bit fraught. Some want a harsher outcome and others are terrified of the electoral backlash. Fun times ahead with all this I suspect.
In Australia we are giving a Gonski while trashing our international economic respectability. A very sad scene on all sorts of levels (Sovereign risk all over with SA bank levies and awful LNG regulations)– and more to play out I fear. I am deeply despondent for Australia’s economic reputation and future I have to say!
There is also another threat looming.

Time to plan for a recession? How to position for it?

Guy Carson TAMIM Asset Management
Back in 2007, a US economist called Edward E. Leemer published a paper entitled “Housing IS the business cycle”. In this paper he studied the causes of every US recession since World War 2, of which there had been 10. What he discovered was that 8 out of the 10 were preceded by substantial problems in housing and consumer durables.” The only two US recessions that are exceptions to the above were the end of the Korean War in 1953, caused by a decline in defense spending, and the 2001 “Tech Wreck”. As the paper was written in 2007, we can now improve the success ratio to 9 out of the last 11 recessions following the 2008 recession, something that Leemer warned about.
When one reads this paper and looks at the current economic environment in Australia, it is hard not to get nervous. Recently, the retail sector has seen a significant selloff and whilst many observers point the finger squarely at Amazon, we believe there might be more at play. As a case in point, the recent downgrades from the two largest car retailers in Australia (AP Eagers and Automotive Holdings Group) tell an interesting story. As far as I’m aware Amazon does not sell cars and yet sales on a national level are falling. What is causing this? Well, Australia has the second most indebted consumer in the world behind only Switzerland with respect to Household debt to GDP (chart below). The rise in household debt in this country has pushed the level above what was seen in places like Ireland and Spain prior to the Global Financial Crisis. Recent out of cycle interest rate hikes from the banks combined with record low wage growth has put significant pressure on this highly leveraged position.
Here are a few other things I have noticed.

National Budget Issues.

Vital Signs: Australia is facing an interest rates dilemma

June 16, 2017 1.59pm AEST
Australia’s central bank has to deal with a Gordian Knot in deciding how to treat interest rates as conditions shift. Image sourced from shutterstock.com

Author Richard Holden

Professor of Economics and PLuS Alliance Fellow, UNSW
Vital Signs is a weekly economic wrap from UNSW economics professor and Harvard PhD Richard Holden (@profholden). Vital Signs aims to contextualise weekly economic events and cut through the noise of the data affecting global economies.
This week: the US Fed makes another interest rate hike, but Australian conditions suggest we may need to cut.
This week the US Federal Reserve, as expected, raised its benchmark interest rate by 25 basis points, to a range of 1-1.25%. This was the third such hike in the last six months.
Fed Chair Janet Yellen said:
Our decision reflects the progress the economy has made and is expected to make.
Yet not everyone was so jazzed about the decision. In a terrific piece former US Treasury Secretary Larry Summers articulated “5 reasons why the Fed may be making a mistake”.

Revealed: How Gonski 2.0 would rip money from Catholic schools to boost public school spending

Matthew Knott
Published: June 17 2017 - 11:45PM
The multi-billion dollar transfer of taxpayer money from Catholic schools to public schools under the government's "Gonski 2.0" funding model has been exposed in secret data given to the Senate crossbench ahead of a crucial vote this week.
The Department of Education data shows the country's public schools would receive a $4 billion windfall over the next decade if the Turnbull government's school funding changes pass while Catholic schools would be $4.6 billion worse off than under the current legislation.
The leaked modelling examines how public, Catholic and private schools around the country would be affected by the Senate's decision to block or support the new funding model.
It shows Catholic schools would lose $705 million over the next four years if the new model is passed while public schools would gain $693 million.

We should demand better of our politicians

Amanda Vanstone
Published: June 18 2017 - 11:45PM
When did you last listen to, read or watch some political coverage that was focused on the substantive issue rather than the toing and froing between various interested parties? The game of politics seems to have become to commentators and news services more important than the substantive issues. 
It's not unimportant. The language used, the style, tone and timing of announcements do have an impact on how we think about them and in the end how we vote. It may also be easier for both journalists and us to participate in and digest.
The current make-up of our Senate and the apparent desire of independents and minors to use it to horse trade makes the day-to-day wheeling and dealing more significant. Equally, personalities and divisions within parties can result in dramatic changes. All of this therefore is worth monitoring and reporting, but so is the substance of the issues.

Desperate switches to populism won’t stop the polling rot

  • The Australian
  • 11:20AM June 19, 2017

Peter Van Onselen

A triumvirate of polling failures has marked the end of the first half of the sitting year for the government.
Three straight Newspolls trailing Labor 47-53 per cent on the two party vote suggests voters sentiments are starting to be baked in.
Since the budget there has been no change to the government’s fortunes. The numbers are worse for the Coalition than the pre-budget Newspoll results were. Meanwhile, Malcolm Turnbull has now racked up 14 straight polls in which the government trails Labor. The PM is almost halfway towards the benchmark he used to oust Tony Abbott in September 2015.
Of course, government strategists will claim Abbott and his supporters (should that really be pluralised readers?) have deliberately undermined the government to damage Turnbull. Even if that’s true, it may simply be a case of what goes around comes around.
  • Jun 19 2017 at 10:58 AM

RBA's Philip Lowe says the next 25 years will be tougher than the last

Reserve Bank of Australia governor Philip Lowe has again delivered an upbeat assessment of the nation's economic outlook but warned the coming quarter century will be tougher than the last 26 years.
Noting that a global upswing would help sustain Australia's expansion, Dr Lowe said there were plenty of reasons for optimism, even if "we are not talking about a boom and there are still plenty of risks out there".
Speaking at the 2017 Crawford Forum, hosted by the Australian National University on Monday, Dr Lowe said longer-term prospects remain positive, but "we need to keep working to keep them that way".
He also downplayed the significance of recent official confirmation of 26 years without a technical recession, saying that period had included periods of rising joblessness and that strong population growth had "flattered" the overall picture.
  • Jun 19 2017 at 1:36 PM

Workers must demand greater share of pie, says RBA governor Philip Lowe

Reserve Bank of Australia governor Philip Lowe has issued an extraordinary challenge to workers that they shouldn't fear "robots or foreigners," or job security, and demand a greater share of the economy's profits through wage gains.
Downplaying angst around the lack of full-time jobs versus part-time work as an "old fashioned" worry that fails to recognise many people don't want to work 100 per cent, Dr Lowe warned too many were still emphasising job security over wage claims.
"When any of us feel like there is more competition out there you're less inclined to put your price up," he told the Crawford Australian Leadership Forum hosted by the Australian National University in Canberra on Monday.
"People value security and one way you can get a bit more security is not to demand a wage rise.

Browned off and switched off: Malcolm Turnbull nears the danger zone

Mark Kenny
Published: June 19 2017 - 10:08PM
For fractious Coalition MPs amassed under Malcolm Turnbull, Monday's depressing 47-53 Newspoll was old news. Fourteen surveys old.
Or, as Turnbull's critics will have it, around halfway to oblivion.
Turnbull famously justified his 2015 move on Tony Abbott on the grounds that the then PM had racked up 30 dud Newspolls. The voters had decided, he fulminated, denial was just that.
Turnbull's promise to fix it was understandably enticing. Yet he now finds himself around halfway to the same benchmark for removal.

Carbon dysfunction drives surging electricity bills

Clancy Yeates
Published: June 20 2017 - 12:50AM
Bill shock is about to return, with a vengeance. From next month, millions of households will start paying up to 19 per cent more for electricity in NSW, just in time for the depths of winter.
Price hikes of 16 per cent to 19 per cent were announced by big retailers AGL, Origin Energy and EnergyAustralia in the past fortnight, and South Australian and Queensland customers will also be affected by varying amounts.
Victorian consumers copped a near 10 per cent increases at the start of the year and, on current form, can probably expect a similar increase in about six months' time when their prices are reset.

Moody's downgrades Australian bank credit ratings

Mathew Dunckley, Clancy Yeates
Published: June 19 2017 - 6:32PM
Credit rating agency Moody's has downgraded a dozen Australian banks, including the big four, citing increased risks in the nation's increasingly indebted households.
Moody's stripped the big four banks - the Australia and New Zealand Banking Group (ANZ), Commonwealth Bank of Australia (CBA), National Australia Bank (NAB), and Westpac Banking Corporation (Westpac) - of their Aa2 long-term rating and placed them on the next level down at Aa3, although it did not alter their short term ratings.
Other smaller banks were also downgraded including Bendigo and Adelaide Bank, Members Equity Bank Limited and Credit Union Australia Limited.

RBA's Philip Lowe says Australians fear foreigners and robots

Eryk Bagshaw
Published: June 19 2017 - 8:51PM
The governor of the Reserve Bank has called on Australians to get over their fear of foreigners and robots and demand wage rises to help put an end to the "real crisis" of record low wage growth.
Speaking at the Crawford Australian Leadership forum in Canberra on Monday, Philip Lowe also took aim at the ongoing gridlock of the Australian political system, blaming it for lost opportunities and stifling economic growth.
"There is a shortage of good ideas that can successfully navigate the political process," Dr Lowe said.
"It is important that we have a sharp focus on the reforms that can make a real difference to our living standards, If we don't do this, we will fall behind."

Finkel numbers don’t add up

  • Paul Kerin
  • The Australian
  • 12:00AM June 19, 2017
We all know damned lies and statistics can be misleading. So too can graphs, modelling assumptions and the omission or glossing over of critically important information. Take the Finkel report.
The report by chief scientist Alan Finkel on the future security of the national electricity market was released on June 9.
In it, Finkel recommended a “clean energy target” for the electricity sector, rather than an emissions intensity scheme. A CET is similar to the existing shockingly dysfunctional renewable energy target, except (in Finkel’s words) “all fuel types, including coal with carbon capture and storage or gas” would be eligible provided they meet an “emissions intensity threshold”.

Moody's move shines light on Australia's home loan risks

Emily Cadman
Published: June 20 2017 - 10:11AM
The decision by Moody's Investors Service to downgrade the ratings of Australia's largest banks has focused attention on the risks lurking in the country's $1.51 trillion of mortgage loans.
"The resilience of household balance sheets and, consequently, bank portfolios to a serious economic downturn has not been tested at these levels of private sector indebtedness," Moody's said in the statement accompanying the downgrade of ANZ Bank, Commonwealth Bank, National Australia Bank and Westpac.
The banks are already bracing themselves for an announcement in coming days from the Australian Prudential Regulatory Authority, which is due to say whether it will require the banks to hold more capital against their mortgage books as part of a wider update on capital requirements. Despite recent steps to rein in their exposure to the riskier areas of mortgage lending, the lenders still sit on by far the largest property lending books of any banks in the world, measured as a proportion of total loans.

Gonski 2.0 victory: Government secures numbers to pass new funding model into law

Matthew Knott
Published: June 21 2017 - 3:12PM
The Turnbull government has locked in the numbers for victory on its Gonski 2.0 school funding package by agreeing to fast-track its spending plan and pump an extra $5 billion into the nation's schools.
The government can pass its changes into law without the support of the Greens after it secured the necessary 10 votes from the Senate crossbench on Tuesday, with independent Jaccqui Lambie the last to add her support at lunchtime.
The victory will be a massive blow to Labor, the Catholic education sector and the Australian Education Union, which all campaigned ferociously against the government's new funding model.
  • Jun 21 2017 at 4:00 PM

The Australian economy is riding on strong tailwinds

by Paul Bloxham
For fans of competitive sailing, it does not get much more exciting than watching the America's Cup finals in Bermuda. The AC50 winged catamarans literally fly across the water on hydrofoils at speeds of over 80 kilometres an hour before turning 90 degrees, seemingly on a dime.
If they nosedive, the two-tonne, 24-metre-tall yachts can upend, or even flip over entirely. For Antipodeans, the excitement is enhanced, as the finals are between the Kiwis and the US and more than half of US Team Oracle, including the skipper, are Australians.
There are also parallels with watching the Australian economy. Much as it would be almost impossible to know who was winning any America's Cup heat, without the aid of the on-screen computer graphics, reading the economy recently has also required an expert eye. This is because many of the indicators we typically look at have been affected by the weather, or measurement issues, or both.

If Finkel review isn't dead it's going to take a miracle to revive it

Peter Hannam
Published: June 21 2017 - 1:13PM
Much like the Pythonesque parrot, Alan Finkel's independent review into the future security of Australia's electricity market is looking very peaky.
Tuesday's Coalition party room meeting decided that all but one of the Chief Scientist's 50-odd recommendations was uncontroversial. 
That almost sounds like our energy crisis might be averted. Consumers and businesses alike are staring at soaring gas and electricity prices, and the prospect of blackouts when summer roars back - if not sooner.

Australia drops five places in 'best places to live' survey

Eryk Bagshaw
Published: June 21 2017 - 8:07PM
Australia has dropped five places in a global survey of the best places to live, but it still remains one of the only countries outside Scandinavia in the top 10.
According to the Social Progress Index, Australia's education, medical care and nutrition levels have helped the country tie with New Zealand to reach ninth overall, but low levels of tolerance and inclusiveness kept Australia's overall ranking below Sweden, Canada and the Netherlands.
The survey, which combines measures of wellbeing, opportunity and basic needs through 16 outcomes researched by Gallup, UNESCO and the Pew Research Centre, found Australia had among the highest standards of living of any country in the world with a diverse population.

Privatisation: has it really been that brilliant? Just look at electricity

Mark Kenny
Published: June 21 2017 - 4:30PM
Privatisation. Back in the day, opposing it was the province of self-interested public sector unions and sentimentalists.
Crucially, Labor governments licensed the process, with the 1980s and 90s still regarded as the golden era of economic reform under Hawke and Keating and state governments of both colours.
An emergent neo-liberal consensus ensured plenty was up for grabs: airlines, telecommunications, banks, public transport, prisons, and energy.

Australia, deep in climate change's 'disaster alley', shirks its moral responsibility

Ian Dunlop
Published: June 22 2017 - 12:15AM
A government's first responsibility is to safeguard the people and their future well-being. The ability to do this is threatened by human-induced climate change, the accelerating effects of which are driving political instability and conflict globally. Climate change poses an existential risk to humanity that, unless addressed as an emergency, will have catastrophic consequences.
In military terms, Australia and the adjacent Asia-Pacific region is considered to be "disaster alley", where the most extreme effects are being experienced. Australia's leaders either misunderstand or wilfully ignore these risks, which is a profound failure of imagination, far worse than that which triggered the global financial crisis in 2008. Existential risk cannot be managed with conventional, reactive, learn-from-failure techniques. We only play this game once, so we must get it right first time.
This should mean an honest, objective look at the real risks to which we are exposed, guarding especially against more extreme possibilities that would have consequences damaging beyond quantification, and which human civilisation as we know it would be lucky to survive.

Scott Morrison: Changes to credit cards are needed to protect vulnerable Australians from predatory behaviour

Scott Morrison, The Advertiser
June 21, 2017 9:30pm
KEEPING a tight rein on your credit card is a routine struggle. Australians currently have around $52 billion worth of debt on their 16.7 million credit cards, with the average balance sitting at $4730.
People can get themselves into a lot of trouble with credit card debt, particularly with rising costs of living and modest growth in wages.
This is particularly the case when households are hit with financial stress or an unexpected setback in life that leaves bills mounting up on the kitchen table.

Scott Morrison: Changes to credit cards are needed to protect vulnerable Australians from predatory behaviour

Scott Morrison, The Advertiser
June 21, 2017 9:30pm
KEEPING a tight rein on your credit card is a routine struggle. Australians currently have around $52 billion worth of debt on their 16.7 million credit cards, with the average balance sitting at $4730.
People can get themselves into a lot of trouble with credit card debt, particularly with rising costs of living and modest growth in wages.
This is particularly the case when households are hit with financial stress or an unexpected setback in life that leaves bills mounting up on the kitchen table.

Rate hikes taking toll on borrowers, says Standard & Poor’s

  • The Australian
  • 12:00AM June 21, 2017

Michael Roddan

Interest rate increases on borrowers are showing signs of stressing the housing market, with global ­ratings agency Standard & Poor’s blaming the household income squeeze on rising loan arrears.
The warning came as ASIC chairman Greg Medcraft said the corporate watchdog had identified lending standards as a “key risk” in the current environment of surging house prices, escalating household debt and stagnant wage growth.
“For a while now we’ve been concerned about low interest rates and property prices, and about people getting in over their heads,” Mr Medcraft told journalists at a Bloomberg forum in Sydney. “That’s why I’ve said, for some people, you’ve got to really think interest rates won’t stay where they are forever and you’ve got to be realistic about your ­income.”
  • Updated Jun 22 2017 at 9:21 PM

South Australia bank tax an act of 'economic vandalism'

The Business Council of Australia has warned that Australia is rapidly becoming a "laughing stock" in global investment circles because of new taxes on banks as erratic decisions by both federal and state governments "carelessly undermine" the rules of doing business.
Australia's big four banks are furious about the move by the South Australian government to impose a new state-based version of the federal government's major bank levy, while the broader business community warned it was partly the fault of the Turnbull government for "letting the genie out of the bottle" in the first place.
The new state-based tax of 0.015 per cent on liabilities is forecast to raise $370 million over the next four years and was one of the revenue raising measures announced in South Australia's budget on Thursday.

South Australia takes on the nation's banks with new tax

Clancy Yeates
Published: June 23 2017 - 1:29AM
The country's five biggest banks are embroiled in a new tax brawl, after South Australia's government infuriated banks by imposing a new levy on the financial giants it said were "significantly undertaxed".
The SA government led by Premier Jay Weatherill, who has long argued for financial services to be subject to GST, on Thursday announced a shock levy that is forecast to raise $370 million over the next four years from Commonwealth Bank, National Australia Bank, Westpac, ANZ Bank and Macquarie.
Banks lashed out at the move, with ANZ chief Shayne Elliott saying it was an "ill-considered cash grab", a NAB spokesman branding the tax "poor policy without logic", and Westpac calling the tax a "disgrace".

Education, not revolution, our best hope to improve workers' share of income

Jessica Irvine
Published: June 24 2017 - 12:15AM
Here's a fact to make every trade union member weep – those few who remain, anyway.
The share of Australia's national income being pocketed by workers has shrunk to its lowest in half a century, mirroring a decline in other countries which has sparked renewed popular interest in pro-union politicians like Bernie Sanders and Jeremy Corbyn.
But before we all take to the streets in protest, there are a few things you should know.

After AI, automation and robots, we can have a working future, says tech guru

Andrew Masterson
Published: June 25 2017 - 12:00AM
Assertions that technological change will create massive unemployment are wrong, says Australia's top tech adviser.
But there is a caveat – Australia must be a leader in the technology charge, and its embrace has to be done with care.
Adrian Turner, head of the CSIRO's technology research division Data61, says  if the country is to prosper from the huge social and economic changes ushered in by artificial intelligence, machine learning and automation, businesses must stop merely modifying overseas models and instead create unique, world-leading innovations.

Health Budget Issues.

Australian-first whole genome sequencing and health testing open to public

Kate Aubusson
Published: June 20 2017 - 5:00AM
An Australia-first service that combines whole genome sequencing and a comprehensive health assessment could offer individuals an unprecedented glimpse into their future health. 
People with a niggling curiosity and $6400 can now find out if their genetics and lifestyle has left them prone to developing a suite of life-threatening conditions including 31 types of cancer and 13 heart conditions across 230 genes.
Launched on Tuesday by Sydney's Garvan Institute's Genome.One lab and corporate clinic Life First, the service also offers individuals the ability to predict how they would likely react to more than 220 medications, allowing clinicians to better tailor treatment to their patients. 

AMA lashes Weatherill record despite pre-poll health spend

  • The Australian
  • 12:00AM June 20, 2017

Michael Owen

As Jay Weatherill continues his pre-election roadshow ahead of Thursday’s state budget to spruik a “rebuild” of South Australia’s public hospitals, the Australian Medical Association has savaged his government’s health record.
AMA state president William Tam said senior clinicians were “taken by complete surprise” by the Premier’s weekend about-face to end two years of controversy by abandoning major reforms in the government’s Transforming Health package.
Welcoming moves to retain cardiac services at the Queen ­Elizabeth Hospital and upgrade its emergency department as “sensible”, the AMA questioned the government’s timing.

More help with medications through community pharmacies

The Australian Government is supporting the expansion of community pharmacy programs to help more patients around Australia better understand and manage their medications and avoid ill-health.
Page last updated: 22 June 2017
22 June 2017
The Turnbull Government is supporting the expansion of community pharmacy programs to help more patients around Australia better understand and manage their medications and avoid ill-health.
Under the Increasing Patient Access to Medication Management Services measure in the Sixth Community Pharmacy Agreement, the Turnbull Government is providing $600 million to continue and expand a number of pharmacy programs.

Pharmacies told to separate medicines

  • The Australian
  • 12:00AM June 23, 2017

Sean Parnell

Complementary medicines would be separated from other drugs in pharmacies to ensure consumers do not mistake their evidence base or efficacy for that of more potent formulas.
Under a reform blueprint ­released yesterday, pharmacies would also be banned from selling useless and possibly dangerous homoeopathic remedies, with tougher enforcement measures to protect consumers.
The Australian last year ­revealed a review of pharmacy regulation, headed by Stephen King from the Productivity ­Commission, identified a potential conflict of interest in pharmacists selling vitamins, for example, that may not have a significant ­evidence base, alongside more stringently regulated and government-subsidised medicines.

Health Insurance Issues.

Why it may not be worth taking out private health insurance

June 23, 20176:12pm
YOUNG people are being pressured into buying private health insurance when they turn 31 years old but new analysis has found it could leave them worse off.
Consumer group Choice has looked at insurance data going back to 2001 to work out what would happen if a typical customer delayed taking out cover until they actually needed the service instead of signing up early to avoid paying the 2 per cent Lifetime Health Cover loading.
“The research shows that in many scenarios you would be better off taking out health cover when you need it rather than just to avoid a costly loading further down the track,” Choice director of campaigns and communications Matt Levey said.

International Issues.

Nine in 10 Australians agree the world has become more dangerous

Matt Wade
Published: June 18 2017 - 11:33PM
The vast majority of Australians say the world is becoming more hazardous and their confidence that America will play a constructive role in global affairs has plummeted since Donald Trump became president.
New polling shows 89 per cent of Australians agree the world has become more dangerous during the past year, 8 per cent more than last year. The survey also revealed just 37 per cent of Australians now believe the United States has an "overall positive" influence on world affairs, a huge 23 percentage points lower than in 2016.
Ipsos Australia research director, Laura Demasi, attributed this slump to the behaviour of Mr Trump since he became the US president in January.
"On a global scale, people are clearly nervous about Trump's unpredictably and are worried about what his 'America first' agenda really means for the rest of the world," she said.

French President Emmanuel Macron set for huge parliamentary majority

Ingrid Melander and Maya Nikolaeva
Published: June 19 2017 - 4:54AM
Paris: Voters turned out in record low numbers on Sunday in the second round of France's parliamentary election, with polls suggesting President Emmanuel Macron had won a landslide majority to help push through far-reaching pro-business reforms.
The vote comes just a month after the 39-year-old former banker became the youngest head of state in modern French history, promising to clean up French politics and revive the euro zone's second-biggest economy.
Mr Macron's centrist La République En Marche (Republic on the Move) party is little more than a year old, yet Mr Macron was on track to win a commanding majority, sweeping aside the mainstream parties and securing a powerful mandate to push through his pro-business reforms.
June 19 2017 - 9:18AM

US warplane shoots down Syrian jet

Thomas Gibbons-Neff and Kareem Fahim

Washington:  A US strike aircraft shot down a Syrian government fighter jet on Sunday shortly after the Syrians bombed US-backed fighters in northern Syria, the Pentagon said in a statement.
The Pentagon said the downing of the aircraft came hours after Syrian loyalist forces attacked US-backed fighters, known as the Syrian Democratic Forces, in the village of Ja Din, south-west of Raqqa. The rare attack was the first time a US jet has shot down a manned hostile aircraft in more than a decade, and signaled the United States' sharply intensifying role in Syria's war.
The incident is the fourth time within a month that the US military has attacked pro-Syrian-government forces.

Donald Trump is just an incompetent oscillator not a fascist

Tom Switzer
Published: June 19 2017 - 12:01AM
During last year's US presidential election campaign, no political label was hurled around more freely at Donald Trump than fascist. Neo-conservative Robert Kagan reflected the prevailing wisdom among intellectuals and journalists when he lamented: "Yes, a Trump presidency would bring fascism to America." 
Such attitudes strengthened in the wake of Trump's shock victory. New Yorker editor David Remnick warned: "This is surely the way fascism can begin." "The neo-liberal era in the United States," warned Cornel West in The Guardian, "ended with a neo-fascist bang."  And on it went.
Yet despite all the scare hoopla, Americans are not yearning for 1930s-style European dictatorship. Many of the white working-class folks who had voted Democrat for a quarter of a century had not suddenly lurched to the authoritarian right. They were simply fed up with an establishment divorced from the thoughts and attitudes of ordinary Americans and happy to find someone finally tapping into their anxieties.

Philippines siege: The terrorist 'caliphate' on Australia's doorstep

Peter Hartcher
Published: June 20 2017 - 1:06AM
What if the butchers of so-called Islamic State set up a branch of their barbarian "caliphate" in South East Asia with the aim of waging their vicious jihad throughout the region?Too late. They already have.
Declaring themselves to be "Islamic State - Eastern Region", they have marked their arrival with trademark violence and bravado. It appeared as a minor news item last month - a gang of armed militants was reported to be attacking a minor city in the Philippines, fighting under the black flag of IS, or Daesh.
The Philippines National Army engaged the thugs. President Rodrigo Duterte promised to wipe them out, and it was widely assumed that this small spot fire would soon be extinguished. But that was fully a month ago now. In spite of heavy fighting, aerial bombardment, tank fire, helicopter gunships and US technical support, the June 12 deadline for victory set by Duterte came and went a week ago.

Russia warns US after downing of Syrian warplane

Ivan Nechepurenko and Michael R. Gordon
Published: June 20 2017 - 4:45AM
Moscow: Russia condemned Monday the US military's downing of a Syrian warplane, suspending the use of a military hotline that Washington and Moscow have used to avoid collisions in Syrian airspace and threatening to target aircraft flown by the United States and its allies over Syria.
The moves were the most recent example of an intensifying clash of words and interests between the two powers, which support different sides in the yearslong civil war in Syria.
The Russian military has threatened to halt its use of the hotline in the past - notably after President Donald Trump ordered the launch of missiles against a Syrian air base in April - only to continue and even expand its contacts with the US military. It was not clear whether the latest suspension would be lasting.

Qatar embargo reveals Donald Trump's diplomatic incompetence

Nicholas Stuart
Published: June 20 2017 - 12:15AM
Those who actually attended Parliament's mid-winter ball last week are well aware that Malcolm Turnbull wasn't creating a diplomatic incident. He was, instead, engaging in some gentle self-mockery, sending up every politician's determination to ignore negative polls.
Unfortunately, half a world away, Donald Trump's chaotic, personalised decision-making and highly impulsive style is provoking an international debacle.
The United States President has made only one international trip since he took office, beginning by touching down in Saudi Arabia. And that's the moment things began to go dramatically wrong.

Facing old foes: Could the fall of IS 'caliphate' be the start of Iran-US war?

Paul McGeough
Published: June 20 2017 - 11:46PM
Washington: Could we be sleepwalking towards another major war in the Middle East?
On Sunday, an American jet downed a regime fighter aircraft, provoking a Russian threat to target the United States and its allies flying over eastern Syria.
Such "incidents" are piling up as world, regional and local powers race for turf and influence ahead of the mooted collapse of Islamic State in Syria.
Washington says its F-18 Super Hornet retaliated after the Syrian Su-22 fighter-bomber dropped its payload near Tabqa, an area close to the Syria-Iraq border occupied by the Syrian Democratic Forces (SDF), a US-backed militia in the fight against IS.

RAAF spy planes to join fight against Islamic State in the Philippines

David Wroe
Published: June 22 2017 - 11:33PM
The RAAF will start flying its advanced intelligence-gathering planes over the southern Philippines to help the country's military beat back an onslaught by Islamic State-affiliated insurgents.
Defence Minister Marise Payne has confirmed to Fairfax Media that Australia will operate two of its P-3 Orion aircraft over the southern region of Mindanao, where the Philippines military is locked in a furious battle with insurgents that has already claimed hundreds of lives and displaced thousands more people.
The decision by the Turnbull government underscores the seriousness with which it views the growing links between Islamists in the Philippines and the so-called Islamic State.

If Abu Bakr al-Baghdadi is dead, who will be the next IS leader?

Maher Chmaytelli
Published: June 24 2017 - 10:56AM
Baghdad: If and when Islamic State leader Abu Bakr al-Baghdadi is confirmed dead - he's been reported killed multiple times -, he is likely to be replaced by one of his top two lieutenants, both of whom were Iraqi army officers under late dictator Saddam Hussein.
Experts on Islamist groups see no clear successor but regard Iyad al-Obaidi and Ayad al-Jumaili as the leading contenders, though neither would be likely to assume Baghdadi's title of "caliph", or overall commander of Muslims.
Russia's defence ministry said last week Baghdadi may have been killed in an air strike in Syria and Interfax news agency quoted a senior Russian parliamentarian on Friday as saying the likelihood that he had been killed was close to 100 per cent.
I look forward to comments on all this!