Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Thursday, November 02, 2017

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

November2, 2017 Edition.
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Internationally Catalonia seems to be going from bad to worse with a risk that the Madrid Government will overreact and make the crisis even worse. It is already looking pretty messy.
In the US Trump has finally realised there is an opioid crisis with 64,000 people dying a year of overdoses and millions more in trouble with addiction. There seems to have been some movement of the Tax Cut front – making Wall St happy – while it seems Janet Yellen (The present Chair of the Federal Reserve) will be replaced by Trump after February.
As for China, now the 19th Plenum is over, we can just watch to see what changes get made. With OZ so dependent on them this really can matter.
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In Australia we have a little political chaos with the High Court having booted five out of Parliament. Barnaby Joyce has a bye-election Dec 2, but he looks pretty certain to get returned. In the mean- time Senator Cash seems to under some pressure after an ill-considered stunt and politicians are all more on the nose than ever. Its good most things seem to work without them.

The NEG seems to have got lost in all the noise and last week’s inflation data means we won’t see any interest rate changes till late 2018 I reckon!

BTW the $A is dropping fast against the US dollar. Have a close look at what is happening if you plan some OS travel in the next few months!
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Here are a few other things I have noticed.
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Major Issues.

Same-sex couples ‘make good parents’: researchers

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

Sean Parnell

Children raised by gay parents do as well as kids raised by straight parents, according to a comprehensive research analysis published in the Medical Journal of Australia today.
The analysis was done by professor Frank Oberklaid and colleagues from Murdoch Children’s Research Institute, the University of Melbourne, the Royal Children’s Hospital, Victorian Clinical Genetics Services, the Children’s Hospital at Westmead, and the Liggins Institute at the University of Auckland.
Correcting what they described as “misinformation” circulating in the same-sex marriage debate, the researchers cited a 2017 review of 79 studies, a 2014 review of more than 40 studies, a 2013 review in Australia and a 2010 meta-analysis of 33 studies in their analysis.
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Clouds are clearing for slow wages growth, says Deloitte

Anna Patty
Published: October 23 2017 - 12:15AM
Clouds over Australia's economy are clearing, according to Deloitte Australia, which predicts a slow start to wages growth.  
The Deloitte Access Economics Business Outlook for the year ahead suggests improvements in business profits and employment levels have primed the economy for some growth in wages which have been stagnating for years.
But any change will be slow. Inflation was so low, that it would be "slow to lift".
"[A]lthough underemployment is falling, it is falling from high levels. Yet the job gains that have already occurred light the path for the turn in wage gains," the report says.
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Productivity Commission blueprint to save billions on living

  • The Australian
  • 12:00AM October 24, 2017

Joe Kelly

Scott Morrison will today unveil a major shift in economic priorities aimed at boosting living standards and driving an ambitious productivity agenda through the delivery of more efficient healthcare, education and cities.
The Treasurer will launch the first of a series of five-year blueprints conducted by the government’s chief economic advisory agency and which flag a series of reforms worth hundreds of ­billions of dollars to the economy over the next two decades.
Mr Morrison argues the 1222-page Productivity Commission report represents the next step in updating the micro and macro-economic reforms of the 1990s, which included trade liberalisation and the sale of government assets, as well as competition and tax shake-ups.
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Shake-up for pharmacies, schools and universities as Productivity Commission unveils multibillion-dollar growth plan

Peter Martin
Published: October 24 2017 - 1:30PM
Automatic dispensaries would replace community pharmacies, low-value health care procedures would be defunded, hospitals would be rated on the basis of outcomes, people with real-world skills would be made teachers, and drivers would be charged for the use of roads under a series of bold proposals the Productivity Commission believes could add hundred of billions of dollars to Australian GDP over the next few decades.
In the first of a series of five-yearly reports commissioned by Treasurer Scott Morrison, Shifting the Dial, the Commission says productivity growth has fallen to a fraction of what it was in the 1990s and that without an improvement, future income growth is likely to be half of historical levels.
It identifies governments as the biggest impediments to lifting productivity, singling out their management of health education and infrastructure as brakes on economic growth.
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This is the difference between Australia's haves and have nots

Conal Hanna and Jamie Brown
Published: October 26 2017 - 11:30AM
Remember the 99 per cent? 
It was one of the Occupy movement's most effective strategies, comparing the ultra-wealthy one per cent to the rest of us.  
Below is an Australian version of sorts.
The Australian Bureau of Statistics calculates the net worth of households, that is the value of everyone in the house's assets (including superannuation), minus their debts. 
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Sydney apartment market has cracked

The repercussions of what has happened in Sydney will quickly spread to the rest of the nation.
  • The Australian
  • 8:21AM October 26, 2017

Robert Gottliebsen

Significant parts of the Sydney apartment market and the associated apartment land markets have cracked and are now suffering serious falls.
The level of decline is much greater than most were predicting three to six months ago. The repercussions of what has happened in Sydney will quickly spread to Melbourne, although the blows may not be as severe in the southern capital because apartments are already much cheaper than Sydney. Brisbane is already in trouble so may be insulated from further big falls.
On an off-the-record basis one of the most influential property analysts in Sydney is forecasting that the building rate of apartments in the city is set to fall by at least 50 per cent which will have a severe downward flow on to economic activity in Australia’s biggest city.
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Wage growth missing in upbeat jobs market

Wage growth remains the missing link in what has become an impressive recovery in the jobs market over the past year.
Source:  AAP 26 October, 2017 
"Jobs and growth is not just a slogan, it's an outcome."
It's Malcolm Turnbull's favourite line each month after what has been an impressive run of employment figures, becoming a slogan in itself.
The latest jobs figures marked a full year of monthly employment gains, the longest uninterrupted run since 1994.
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'Mediocrity beckons': why we should worry about poor productivity

Jessica Irvine
Published: October 28 2017 - 12:15AM
"Mediocrity beckons, if we let it."
So read the dramatic opening statement of briefing notes for the media released this week by the Productivity Commission to accompany its first-ever five-year Productivity Review.
Titled "Shifting the dial", the entire purpose of the 1000-plus-page report is to try to shake Australia firmly out of its current microeconomic policy torpor and kick-start the new era productivity growth that will be needed if Australians are to continue enjoying the increases in living standards we have become accustomed to.
"It's time to take out the microeconomic garbage," the report concludes, in rousing language almost more befitting an Arnold Schwarzenegger action flick than the boffins at the PC.
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No judgement and no answers: chaos engulfs the Turnbull government

Mark Kenny
Published: October 27 2017 - 9:35PM
Dismiss all the desperate spin and sugar-coating. Nothing can obscure the fact that these are dark days for the government and a humiliation for the Prime Minister personally.
While Malcolm Turnbull cannot be blamed for the Nationals' slap-dash vetting procedures going back decades, his ill-judged bullishness in response to the citizenship questions once they arose was all his own work.
"The leader of the National Party, the deputy prime minister is qualified to sit in this house and the High Court will so hold", he decreed during a raucous question time on August 14.
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National Budget Issues.

Clouds clear, but battle scars remain for Australian economy

By Jessica Irvine
22 October 2017 - 11:15pm
The 1987 sharemarket crash. The 1997 Asian Financial Crisis. The 2007 onset of the Global Financial Crisis.
The world has just two months left on the clock to see if it can finally vanquish the decennial curse of the "7".
This year has brought with it no shortage of challenges. The inauguration of Donald Trump and his populist and anti-trade rhetoric. The fallout from the disastrous Brexit vote. China's rapid credit acceleration. North Korea's missile threats.
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Census 2016: Australia's image obsession has triggered a job surge

Eryk Bagshaw, Peter Martin
Published: October 23 2017 - 11:07AM
An image and health-obsessed Australia has provided a jobs boon for fitness instructors and beauty therapists.
That is the verdict from the latest round of census figures, released on Monday four months after the first release in June and focuses on how and where we work, internal migration, education and methods of travel.
It shows the number of people working as beauty therapists and fitness instructors has surged by more than 25 per cent since 2011, despite the country's population climbing by less than 9 per cent.
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Treasurer Scott Morrison says company tax cuts urgent as he prepares to unveil a new wave of reform

Peter Martin, Mark Kenny
Published: October 23 2017 - 11:45PM
Treasurer Scott Morrison has declared business tax cuts are "urgent" as productivity growth dwindles and competitor economies prepare to slash company tax rates in a bid to attract capital and accelerate economic growth. 
In a speech to be delivered Tuesday launching a landmark Productivity Commission report on a new wave of measures to lift Australia's productivity, the Treasurer will say that unless productivity growth lifts and Australia attracts new investment, wage growth will stay low.
The Senate has passed has passed only $24 billion of the government's $50 billion program of company tax cuts, meaning the rate will fall from 30 to 25 per cent for small and medium size businesses but not for big ones.
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Health Budget Issues.

Australians paying too much for inadequate health insurance

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

Adam Creighton

Some readers were shocked to learn last week that they might be paying more in superannuation fees than for electricity. The same is true for private health insurance, where a family of four could easily be paying $400 a month for cover, a sum comfortably ahead of their power bill. At least with electricity you are guaranteed to get something back. About 10,000 Australians a month are now dropping their level of health cover or their ­insurance altogether. For two years the total number of policyholders has been falling.
The government tried to staunch the flow last week, ­announcing a set of changes that should help private health insurers reduce their premiums from February. Premiums have risen by a cumulative 40 percentage points since 2010, while private health insurers’ profit margins have ­barely moved.
A regulatory straitjacket, and the opaque and anticompetitive pricing of medical procedures, has enabled private hospitals and doctors to ratchet up their costs, which get baked into premiums.
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Evidence of mounting pressure on not-for-profit health insurers

Two of Australia's largest not-for-profit private health insurance funds are experiencing mounting pressure on earnings because of policy downgrades and growing concerns about the affordability of health insurance.
The deteriorating financial performance of HBF in Western Australia and HCF in NSW were revealed in annual reports released to ASIC.
Annual reports for the year to June 2017 show HBF recorded a $24.5 million underwriting loss on premium of $1.6 billion, while HCF's underwriting result slumped 32 per cent to $91 million on premium revenue of $2.5 billion.
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Urgent action needed to help GPs prescribe fewer antibiotics: study

Felicity Caldwell
Published: October 23 2017 - 3:06AM
A Queensland academic has called for monitoring of antibiotic resistance rates in the community, new targets and help for GPs to reduce how much of the drug they prescribe.
About 1600 people die directly from antibiotic resistance in Australia every year, according to a piece published in the latest Medical Journal of Australia.
The authors, led by Bond University academic Professor Chris Del Mar, said the situation would get steadily worse until 2050, when deaths from currently treatable infections would overtake total cancer deaths.
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Analysts warns of poor prognosis for health insurance

  • The Australian
  • 12:35PM October 23, 2017

Sarah-Jane Tasker

Australia’s health insurers are less defensive than perceived, analysts warn, with recent reforms unlikely to fix long-term affordability issues or underlying claims inflation.
Morgan Stanley’s Daniel Toohey has also warned that switching and downgrading health insurance policies showed no signs of abating.
Mr Toohey, in a report on a survey on health insurance, highlighted that 56,000 people under the age of 30 year had dropped out of the system in 2017. He said that reversing declining participation likely demanded “value”, not “discounts”.
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  • Updated Oct 23 2017 at 11:00 PM

Morgan Stanley says Medibank Private is ‘worst in class’ for customer satisfaction

Less than 20 per cent of Medibank Private customers would be likely to recommend the health insurer to a friend, the lowest of any insurance company in the country.
That is the one of the key findings in Morgan Stanley's annual AlphaWise survey looking at Australian residents' attitudes to their current health insurance policy.
"Overall customer satisfaction with health insurers is low, reflected by the negative industry net promoter score. The largest for-profit players registered the lowest ratings, with Medibank the worst in class," said Morgan Stanley.
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Mid-life hit to hospital spending

  • The Australian
  • 12:00AM October 24, 2017

Sean Parnell

Traditionally healthy adults aged between 35 and 54 have driven the biggest growth in per-patient hospital expenditure in the past decade, making the demographic an unexpected contributor to rising health budgets.
Although older age groups still cost most overall, the Australian Institute of Health and Welfare has identified an early-middle-age cost spread by looking at the contribution of demographics and disease to hospital expenditure.
Older first-time mothers, better mental health diagnosis and treatment, accidents, and the early onset of chronic illness all appear to be contributing to expenditure growth among those aged in their late 30s to early 50s.
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  • Updated Oct 24 2017 at 9:06 PM

Pharmacists cane vending machine scripts as 'vandalism'

Pharmacists have caned as 'vandalism' a Productivity Commission recommendation for vending machines to dispense medicines with a smaller number of pharmacists to be employed in clinical settings, rather than corner chemist shops.
The powerful Pharmacy Guild, that has successfully fought off attempts to reform its protected retail structure for decades, said the proposal from the Productivity Commission was "ill-informed" and would see the "dumbing down of a revered health profession and inferior care for patients".
The recommendation is one of a raft of reforms the Commission says could boost annual economic activity by $8.5 billion after five years and save $7.9 billion a year in health care expenditure. Gains after 20 years would be $38.5 billion, or $140 billion cumulatively, rising to $200 billion if the health reform Holy Grail of integrated care could be achieved.
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Pharmacists are unfinished business on the productivity agenda

Peter Martin
Published: October 24 2017 - 11:45PM
Why pharmacists? They've got off lightly. Peter Harris, the head of the Productivity Commission, worked for the prime minister's department in the 1990s when the Hilmer competition reforms were ending cozy arrangements for just about everyone, and earlier on prime minister Bob Hawke's personal staff.
Manufacturers lost tariff protection, banks suffered an onslaught of foreign competition and unions were denied industry wide bargaining. Only three industries survived completely unscathed, each due to impressive lobbying.
One was the taxi industry. It has since been buried by the GPS (anyone can find a street) technologically-driven undercutting. Another was newsagents. The cozy rules that prevented one from encroaching on the turf or another and guaranteed they changed hands for high prices have been rendered irrelevant by digital direct delivery.
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Healthcare fault lines ‘risk patients, funds’

  • The Australian
  • 12:00AM October 25, 2017

Sean Parnell

Australian doctors may be less inclined than their overseas counterparts to put patients at the centre of decision-making, and the primary care, public and private hospital sectors do not collaborate enough to improve healthcare, a review has found.
In an inaugural review to be repeated five-yearly, the Produc­tivity Commission has questioned the lack of integration and informed decision-making in health. Not only do these “fault lines” lead to substandard care and inequality, they waste hundreds of millions of dollars each year.
The findings yesterday prompted Treasurer Scott Morrison, who commissioned the review, to link the economic benefits of future health reform to better outcomes for patients.
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Unannounced assessment visits for aged care under new reforms

  • The Australian
  • 12:21PM October 25, 2017

Michael Owen

Nursing homes across the country will be subject to unannounced assessment visits under reforms by the Turnbull government following a national inquiry into federal­ agencies overseeing aged-care centres.
The review, to be released today by federal Aged Care Minister Ken Wyatt, was sparked by an abuse scandal at Adelaide’s state-run Oakden nursing home.
The review, led by former ACT chief minister Kate Carnell, the Australian Small Business and Family Enterprise Ombudsman, was completed earlier this month.
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Increase in health insurance complaints

  • The Australian
  • 12:00AM October 26, 2017

Sean Parnell

Complaints about private health insurance are rising but a regulatory quirk means health funds are contributing less to the cost of the Ombudsman having to deal with their problems.
In an annual report tabled in parliament this week, the Office of the Commonwealth Ombudsman revealed a 30 per cent rise in health insurance complaints last year as the Turnbull government considered major reforms.
“In 2016-17, we received 5750 private health insurance complaints, compared to 4416 in 2015-16,” the Ombudsman said.
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Health Care Homes won't solve chronic disease care

25 October 2017

GUEST EDITORIAL

The establishment of medical homes based on voluntary general practice registration has begun formally, and quietly.  
At the start of this month, the first 22 Health Care Homes pilot sites began registering their patients with chronic illness, with another 180 due to go live in two months’ time.
The Federal Government has agreed to pay practices lump sums of $591 a year for patients with mainly self-managed illness, $1267 for those with moderate illness and $1795 for patients with chronic and complex needs, including palliative care. 
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Natural therapies still ok as 'incentive'

A Senate committee has been told health insurers will still be able to pay for natural therapies but only as a incentive under federal government changes.
Source:  AAP  26 October, 2017 
Health insurers will still be able to offer payments for natural therapies under a federal government shake-up but only as an incentive to sign up.
In his announcement a fortnight ago, Health Minister Greg Hunt said the government had agreed to stop insurers from offering benefits for a range of natural therapies, such as bowen therapy or rolfing.
Australia's chief medical officer Professor Brendan Murphy told a Senate estimates hearing in Canberra that policyholders would not be able to claim for such therapies.
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Pharmacy Guild backs down on codeine changes, Health Minister says

Esther Han
Published: October 27 2017 - 1:36PM
Federal Health Minister Greg Hunt is standing firm on new rules banning over-the-counter codeine products, in defiance of some party room colleagues, state counterparts and the vocal pharmacy lobby.
He revealed the Pharmacy Guild, which has been lobbying heavily for exemptions so that some codeine products can be easily accessible to some patients, had "reversed its position" in its fight to water down the new regulations.
All codeine-based products, including Panadeine and Nurofen Plus, are set to become prescription-only from February next year after the Therapeutic Goods Administration (TGA) found restricting access would reduce addiction and deadly overdoses.

Brain cancer survivor counts her blessings

ANNE MATHER, Sunday Tasmanian
October 29, 2017 12:00am
LAURA Kennedy oozes life, and gratitude.
Having survived brain cancer, which is one of the deadliest cancers, the young Tasmanian artist knows her long-term outlook is still uncertain.
But right now the 34-year-old just feels lucky.
“I feel so grateful,” she said.
“If you look at the brain cancer community, things can be so much worse.”
She is also buoyed by news that a $100 million fighting fundwill fuel an ambitious goal of doubling brain cancer survival rates in the next decade.
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International Issues.

Anti-establishment party led by billionaire wins Czech election

Hana de Goeij and Rick Lyman
Published: October 23 2017 - 6:57AM
Prague: An anti-establishment party founded by a billionaire oligarch overpowered the Czech Republic's long-standing, mainstream parties Saturday, making the blunt-talking, enigmatic tycoon almost certain to become prime minister in a coalition government.
ANO, the party formed by Andrej Babis, 63, had nearly 30 percent of the vote with 99 percent of ballots counted. The Social Democrats, who have been at the centre of Czech politics for a quarter-century and had finished first in the previous election, came in a distant sixth with just 7 percent. The Communists were fifth. And the Christian Democrats, another party that traces its roots to the country's founding, got less than 6 percent, perilously close to the cutoff to qualify for seats in Parliament.
ANO was not the only anti-establishment party to do well. The extreme right-wing Freedom & Direct Democracy, with 10.7 percent, doubled its proportion from the previous election. That was just a fraction of a percentage point behind the youth-oriented Czech Pirate Party, an anti-establishment movement from the opposite end of the political spectrum.
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Japan elections: Shinzo Abe retains supermajority despite distrust

Adam Taylor
Published: October 23 2017 - 6:15AM
Tokyo: Japanese Prime Minister Shinzo Abe has secured a crucial victory in parliamentary elections, with his ruling bloc maintaining a supermajority that could allow it to push for a revision of the nation's pacifist constitution.
With results still trickling in on Sunday night, public broadcaster NHK reported that Abe's Liberal Democratic Party and its smaller coalition partner, Komeito, were set to pass the 310-seat threshold in the 465-seat House of Representatives.
The result further illustrates the political savvy of 63-year-old Abe, who has proved to be an enduring force in Japanese politics despite scandals and fluctuating approval ratings.
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24 Oct 2017

New world order: Xi’s China dream

When the history of post-Deng Xiaoping China is reviewed the keynote address given by party boss Xi Jinping to the 19th Congress of the Chinese Communist Party in October 2017 will likely come to be regarded as a signal moment, even the beginning of a new phase.
" Xi remains a dominant figure the world will have to reckon with a more assertive China."
Whether Xi achieves his 'China Dream’’, as he describes his ambitions for a restoration of China’s greatness, remains to be seen, but what can’t be denied are his ambitions.
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  • Oct 25 2017 at 8:28 AM

Donald Trump's Republicans erupt in civil war

Donald Trump's Republican Party is on the brink of rupturing after two conservative Senators launched scathing attacks on the President's character and one urged more colleagues to end their "complicity" and speak out against his dangerous antics.
In an extraordinary day of internal party brawling in Washington, soon-to-retire Senators Jeff Flake and Bob Corker publicly lashed President Trump for repeatedly telling mistruths, "debasing" the country and putting the world at risk.
The divisions, which erupted as the US stock market hit another record high, threaten to upend President Trump's tax-cut agenda. Republicans control the Senate by a narrow 52-48 majority.
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Why the Trump-Corker feud is a big deal

Jonathan Bernstein
Published: October 25 2017 - 6:25AM
Washington: President Donald Trump's feud with Senate Foreign Relations Chairman Bob Corker intensified Tuesday, with them trading fierce attacks on Twitter and cable news. What are we to make of this? I'll tackle this bullet-point style:
  • A same-party fight at this level is legitimately whopping big news, and should be covered as big news. For a same-party senior, respected senator to go after the president this harshly is shocking. (There's evidence, by the way, that in fact the media normally pays more attention to same-party critics of a president). And this isn't just a same-party senator breaking with a president over a policy point. For criticisms this harsh, we probably have to go back to obscure 19th century precedents. Even Republicans who supported impeaching Richard Nixon weren't quite as severe in their complaints about him.
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  • Oct 26 2017 at 9:23 AM
  • Updated 27 mins ago

Donald Trump’s missed opportunity on tax reform

by Edward Luce
Almost a year ago Donald Trump won the presidency on the promise he would serve the "forgotten American". In the coming weeks Congress is likely to pass the first serious bill of the Trump era: a tax cut. It may be the last, too.
No matter what the question, Mr Trump's Republicans are wedded to the same answer. Tax cuts are always the remedy. The irony is that they will deepen the inequalities that paved the way for Mr Trump's election. But that will be someone else's problem. Before the year is out, the chances are that Mr Trump will finally have the victory he has been craving.
It will have come in spite of Mr Trump. With Congress in Republican hands, he could have engineered a once-in-a-generation tax reform. It would have split the Democratic party and put his name up in lights.
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  • Oct 26 2017 at 8:02 AM
  • Updated Oct 26 2017 at 8:02 AM

What to expect from Xi Jinping's new team

The make-up of Xi Jinping's new leadership team - and it is certainly his team with three close allies giving him a majority among the top decision-makers - provides some indication of China's policy priorities over the next five years.
The expertise and backgrounds of the new leaders suggest the anti-corruption campaign will remain a priority for Xi in his second term, as will managing the relationship with the United States, gradually introducing economic reforms and boosting China's standing and influence in the region. There will also be a strong focus on shoring up Xi's power base, protecting his legacy and further strengthening the role of the Communist Party in government.
Zhao Leji, who will take over from Wang Qishan in overseeing Xi's extensive anti-corruption campaign, will bring special expertise to the job, having managed the party's powerful Organisation Department for the past five years. In that role he oversaw all party appointments and personnel decisions and his department compiled reports on potential leaders. Zhao is in the unique position of knowing where the dirt lies and this will help Xi promote the idea of a party clean-up, while at the same time giving him a powerful hold over colleagues, rivals and enemies.
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Xi Jinping forever? What leader's power play means for China and the world

Kirsty Needham
Published: October 27 2017 - 5:35AM
Beijing: A beaming portrait of Comrade Xi Jinping dominated The People's Daily front page, towering over a smaller image of China's new leadership group of seven men.
The communist party transfers power to a new Politburo Standing Committee twice a decade.
A Chinese president and party general secretary is usually installed just once every ten years.
So five years into the job, this week was the litmus test of Xi's real power.  Entering his second term, it was time to mould an inner circle unfettered by his predecessor, Hu Jintao, and party elder Jiang Zemin.
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The biggest myth about Donald Trump is that he’s a tough guy

IF YOU still believe this myth about Donald Trump, you haven’t been paying attention to the first 10 months of his presidency.
news.com.au October 28, 20177:37pm
WHAT a small, pitiful man Donald Trump is.
The US President thinks he’s a real tough guy, presumably because he spent so many years pretending to fire people on reality TV. But that is, and always has been, a lie. Trump’s supporters mistake his petty, spiteful aggression for strength, when it is in fact the exact opposite.
His endless spats and Twitter tantrums reveal a man who is thin-skinned, self-obsessed and pathetically insecure.
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I look forward to comments on all this!
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David.

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