Thursday, November 16, 2017

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

November 16, 2017 Edition.
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Trump has wandered off to Asia and has visited China and Japan for significant stays. In China the new Chinese Emperor has wowed him and in Japan the Americans have sold a lot of missiles etc. to protect Japan against North Korea. Also big news it the fact we are now starting to see genuine electoral push-back on Trump policies will some actual election wins from election day a week or so ago. A hopeful sign?
Both Brexit and Catalonia are still festering along with no resolution to either! May’s hold on power is looking ever more tenuous by the day!
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Big Mal went off to Vietnam  and now the Member for Bennelong has resigned as well! It is really going very badly for everyone as we all wonder who will be next and when a General Election will be called. It surely can’t be long!
We now officially have a minority Government and you have to be sure there is more to come – on both sides!

And to add to it all we got 61.6% vote yes in the Postal Survey on Wednesday so the Senate is madly debating to make it real!
Elsewhere we have to be grateful most of the State Governments continue to function although Qld is looking a little fragile at present.
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Here are a few other things I have noticed.
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Major Issues.

Few noticed we just saw a radical shift in reform thinking

Ross Gittins
Published: November 5 2017 - 9:00PM
Reading the Productivity Commission's grand plan to "shift the dial" on micro-economic reform gives me a feeling of deja vu all over again.
When I started in this business in the mid-1970s, macro-economics had become a pitched battle between Keynesians and monetarists. It took years for a resolution of that conflict to emerge.
The monetarists didn't win the war, but they did win a lot of battles, and management of the macro economy was changed forever.
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Lovers, prospectors and predators

David Brooks
Published: November 5 2017 - 7:08PM
Harassment is not just sex and it's not just power; it's a wicked mixture of the two.
The world seems full of sexual predators these days. But I don't think good men wake up one morning and suddenly start thrusting their tongue down the throats of people they barely know. You've got to walk through a certain number of doors before you're capable of that kind of behaviour.
Most men are raised with a certain way of thinking about sex. It's the way contained, implicitly, in every children's love story, in most every classic novel and in the lived experience of most married parents. It is: Sex is something you do with the person you love.
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Ignorance is no defence for these idiot dual-citizens

Nicholas Stuart
Published: November 6 2017 - 12:15AM
There is no more crucial requirement for a government than upholding the constitution. This is the basis from which everything else flows. Flawed and in need of amendment though it may be, the constitution is Australia's foundation stone.
Nothing more displays the contempt that Malcolm Turnbull apparently feels for our country's birth document better than his casual dismissal last week of the urgent need for a full audit of parliamentarians' nationality.
The provisions outlined in section 44 may be silly; many laws are. They have, however, always been crystal clear. The simple requirement – that any parliamentarian should be only an Australian citizen – was debated and engraved in that document way back in 1901.
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Why the cost of necessities is forcing Australians to shut the door on shopping

Weak retail figures suggest households are not confident enough to spend any increase in income at the shops
The latest retail trade figures show consumers are shutting their wallets. Retail spending has remained flat for two months in a row – the worst result since 2012. Weak wages growth clearly is having an ongoing effect. But the latest re-weighting of our spending habits by the Bureau of Statistics also shows us moving our spending away from retail towards a mixture of more expensive necessities such as rent, education and utilities, and areas that were cheaper than in the past such as restaurant meals and international holidays.
We used to love to go shopping. From the start of 1990 through to the end of 2007, retail trade spending grew on average by 5.7% each year. The latest figures out last Friday showed that our spending grew by just 2.0% in trend terms in the past 12 months – the lowest ever recorded:
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The fantasy behind America's mass shootings

Michael Pascoe
Published: November 7 2017 - 12:20PM
"I think that mental health is your problem here…this isn't a guns situation," said President Trump of the latest American mass murder. And he is so clearly wrong.
There seems to be something like relief in gun-loving Texas that the Sutherland Springs slaughter was a "domestic situation",  without a racial or sectarian motive. And only in America could the state's attorney general subsequently recommend more people bring guns to church.
There tends to be multiple factors in any disaster, but a key part of the latest American killings big enough to make international headlines is hiding in plain sight: the end result of the fantasy that goes with buying and possessing machines specifically designed for killing people and killing as many people as possible.  Indeed, the gun industry generates around $US13 billion a year ($16.9 billion) in revenue annually in the US.
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ASX at 6000: The long and winding road

Patrick Commins
Published: November 7 2017 - 6:15PM
The ASX 200 sharemarket index achieved a key milestone on Tuesday when it closed above 6000 points for the first time since the global financial crisis.
A powerful rally in resources stocks on Tuesday was the prime mover behind the day's 60-point, or 1 per cent, gain in the ASX 200 index, which ended the session at 6014. The last time it closed above 6000 points was in the teeth of the GFC in January of 2008, towards the beginning of what would ultimately be a 50 per cent sharemarket crash.
The 6000 threshold had become somewhat of a psychological barrier for the Australian stockmarket in recent years after the index came close a number of times only to fall agonisingly short and ultimately drop away. Through March and April of 2015 the ASX 200 moved within three points of crossing 6000 on three separate trading days, and within 15 points on another. The next time it looked close was in April and May of this year, only to fall away again as investors dumped heavyweight bank stocks in response to the government's announcement of a major bank levy.
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Life expectancy. From 45 to 82 years, we've come a long way

Peter Martin
Published: November 6 2017 - 11:45PM
One hundred and fifty years ago on Tuesday  The Sydney Morning Herald broke news that these days would be considered shocking.
The first 'life table' prepared for the British colony put the expected lifespan of a newborn non-Aboriginal Australian at just 45.6 years.
The Bureau of Statistics now gives newborns a lifespan of 82.5 years; 80.4 for boys, and 84.6 for girls.
And that's almost certain to be an underestimate. Improvements in medical technologies throughout 80 years of life are likely to add an extra four years to those totals.
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Better economic days ahead? Sorry, not yet

Peter Martin
Published: November 8 2017 - 11:45PM
Why do people feel so rotten?
It's because they don't believe the federal Treasurer when he says there are "better days ahead".
He's said it 25 times, roughly once a week since April.
If things were really looking up, retailers wouldn't need to cut prices to maintain sales. During the June and September quarters, retail prices fell 0.2 and 0.4 per cent. Fell. It's rare for prices to fall across the entire retail sector for an entire quarter. It's even rarer for them to fall for two consecutive quarters, and rarer still for them to fall that much. It's the biggest wave of discounting this century.
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Hasty interest rate hikes could trigger a property crash, UBS warns

Jessica Sier
Published: November 10 2017 - 1:45PM
A recent correction in Australia's housing market could turn into a full-blown crash if the Reserve Bank hikes rates too soon or too fast, a global investment bank has warned. 
The end of the nation's world record housing boom and the drawing down of household savings has caught the RBA in an interest rate trap, says George Tharenou, chief economist at UBS. 
Dubbing it the "household wealth effect", he has outlined a scenario where rising asset prices, falling savings and the fact that consumption has grown faster than wages leave Australians particularly vulnerable to interest rate hikes.
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Why it has never been more important to tax the rich

Peter Hartcher
Published: November 11 2017 - 12:05AM
Australia's deputy tax commissioner for international affairs, Mark Konza, was looking through an early scan of just a few of the documents from the 13.4 million leaked this week under the name of the Paradise Papers.
One phrase in the papers, all from a single law firm specialising in offshore tax havens, Appleby, happened to catch his eye. One solicitor had emailed another with a striking description of a client. That particular client "stinks", the solicitor remarked.
"We thought, 'that's odd, let's have a look at that'," Konza tells me. "The complaint about the client was 'they've asked us to backdate a document again'." Backdating a document is, of course, fraud.
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Robots coming for our jobs? The data says no to Chicken Little

Simon Cowan
Published: November 11 2017 - 12:15AM
Overnight, on November 10, striking workers broke into a factory and smashed up the machines, reportedly angry that the factory owners were hoarding profits and thinking of cutting jobs.
If you missed this story it's because it happened on November 10, 1811, not 2017. But if it sounds familiar, it's because fears over technology have been around for as long as technology itself. Indeed, the term for someone afraid of technology – Luddite – comes from that 1811 revolt.
Perhaps this is why dire predictions that technology will destroy all our jobs are so persuasive: they tap into long-held fears. And those fears tend to multiply when the predictions extend to the loss of white-collar jobs, as well as typically grim prognoses for blue-collar ones.
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Financially stressed? Please don't blame high prices

Peter Martin
Published: November 11 2017 - 11:45PM
When Tony Abbott first stood for prime minister, he complained about the price of bread.
He told the leaders debate it had shot up 12 per cent. It hadn't. The Bureau of Statistics found it hadn't increased at all – it had been stuck for a year at $3.88.
Head to Woolworths online today and you'll see a variety of prices, for different kinds of loaves. I've averaged them. Today's price is $3.55.
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The neverending story of an election that could take out Malcolm Turnbull

Mark Kenny
Published: November 11 2017 - 5:02PM
Technically, the Korean war is ongoing. Technically, the 2016 Australian election has become similarly open-ended.
Its distended double-dissolution campaign was excruciating at the time, imparting a sense that it would never end. Now we find... it hasn't!
Even the "job lot" evaluation of the "citizenship 7" by the High Court in October, failed to settle things.
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National Budget Issues.

‘Pay your tax’: Morrison issues warning to multinationals

  • The Australian
  • 12:58PM November 6, 2017

Greg Brown

Scott Morrison has warned multinationals to “pay your tax” as he defends moves from his government to crack down on tax minimisation following a leak of tax records out of a law firm in Bermuda.
The Treasurer said this morning the Australian Taxation Office was “on the front foot” in tackling tax avoidance following the data leak from the offshore tax haven, known as the “Paradise Papers”.
“Australia is doing what we must be doing in relation to these latest revelations. We have been leading the charge in relation to international jurisdictions since the last set of papers,” Mr Morrison said this morning.
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Reserve Bank: Interest rates remain on hold as lending restrictions take effect

Eryk Bagshaw
Published: November 7 2017 - 3:08PM
The Reserve Bank has left the cash rate on hold at the record low of 1.5 per cent for the 15th month in a row, as economists warn any lift in interest rates would hit consumers, leading to slower economic growth and fewer new employment opportunities. 
Governor Philip Lowe warned household debt had been outpacing the slow growth in household income for some time and this was "a continuing source of uncertainty".  
Tighter lending practices and housing market slowdowns in Sydney and Melbourne have had the desired effect of a rate rise, without impacting broader spending across the economy, a factor the central bank is keen to avoid in an environment of non-existent wage growth. 
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$30bn boost for Turnbull’s tax reform plan

  • The Australian
  • 12:00AM November 8, 2017

Simon Benson

The full rollout of the Turnbull government’s company tax plan will deliver a $30 billion revenue return to the federal budget, effectively halving the claimed total cost of the policy, according to an official Treasury report to be ­released today.
The report also warns that Australia could suffer a “permanent reduction in the level of GDP and real wages” if it fails to ­respond to the changing global tax environment — fuelled by Donald Trump’s renewed push to cut the US rate to 20 per cent.
The government is likely to seize on the official research ­report to try to shift the focus back to economic management, having seen its agenda derailed by the deepening citizenship scandal, which now threatens its slim parliamentary majority.
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Health Budget Issues.

Australia's health watchdog accused of 'too close' relationship with industry

Joanne McCarthy
Published: November 5 2017 - 3:38PM
Australia's drug and medical device watchdog, the Therapeutic Goods Administration, needs a complete overhaul to distance it from the health industry and allow consumers to sue it for negligence, say academics and consumer advocates after the regulator quietly announced moves to classify all pelvic mesh devices high risk after years of controversy.
"The current regulatory framework is a complete bypass of the interests of consumers. They don't have a stake at the table," said University of Canberra academic Wendy Bonython, after the TGA said the new classification would mean "higher evidentiary requirements" before new devices are approved for use in Australia, and for existing approved devices.
The move comes more than a decade after many pelvic mesh devices were cleared for use by the TGA with little or no independent evidence of safety and efficacy.
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PBS drug price reforms come up $840m short

  • The Australian
  • 12:00AM November 6, 2017

Sean Parnell

A much-lauded savings measure for the Pharmaceutical Benefits Scheme came up $840 million short last year when the returns to government and taxpayers were 26 per cent lower than forecast.
While price disclosure is still delivering savings, the shock ­result is the biggest variation since the measure was introduced a decade ago and raises questions about whether market conditions have changed or the modelling is wrong.
Federal Health Minister Greg Hunt will not update savings forecasts until the next budget in six months and also has other changes to price disclosure before parliament.
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Why cost-shifting, a mammoth-sized rort, is allowed to continue

7 November 2017

COMMENT

Why does everyone ignore the mammoth-sized rort?
The cost-shifting problem has been happening for 15 years. It is done at a localised level. We’re talking about tens of millions of dollars in costs being shifted from state to Federal Government. The feds do care about the issue. They would want to stamp it out — whether it’s a Liberal or Labor government.
But it goes on because state hospital budgets are usually fairly stretched and the hospital managers can get away with it. So yes, it’s a blatant rort: a deliberate breach of the terms of the National Health Reform Agreement.
The problem is that the government is not resourced to investigate every instance when a public hospital doctor is magically transformed into a private bulk-billing doctor who happens to be working in a public hospital.
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Insurers discriminating against people who get genetic test results could hobble research, bioethicists warn

Kate Aubusson
Published: November 8 2017 - 12:15AM
Edwina Sawyer has been denied life insurance by half a dozen policyholders, but she's not sick.
She doesn't smoke or drink excessively, and has taken drastic preventative measures to guard against cancer.
But a genetic test she had a decade ago is barring the mother-of-two and her family access to insurance, she says.
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GPs’ fees up $1 as health funds ask for $200 premium rise

Sue Dunlevy, National Health Reporter, News Corp Australia Network
November 8, 2017 10:00pm
CASH-strapped families are facing soaring medical bills with health funds hiking premiums by $200.
On top of this, doctors fees are set to jump $1 per visit after the Australian Medical Association last week recommended GPs increase their fees by $1 to $79 for a standard consultation.
Health funds are on deadline to present Health Minister Greg Hunt with their applications for their annual April premium rises by November 10.
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APRA tick for government health insurance reforms

  • The Australian
  • 4:02PM November 8, 2017

Sarah-Jane Tasker

New figures showing health ­insurance benefits rising at a ­similar rate to premium increases and hitting a record $19.83 billion highlighted the case for recent ­reforms to the industry, its peak body said.
The 2016-2017 annual report into the private health insurance sector, released yesterday by the Australian Prudential Regulation Authority, comes as the industry finalises requests for the 2018 ­premium increase ahead of tomorrow’s deadline for submissions. This year’s increase was an average of 4.84 per cent and the federal government is expecting next year’s figure to be lower, on the back of the reforms it ­announced last month. Total benefits paid rose 4.5 per cent
Rachel David, chief executive of Private Healthcare Australia, said the annual financial report on the sector highlighted where the Turnbull government was coming from with its health ­insurance reforms.
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  • Updated Nov 10 2017 at 10:00 PM

Private health insurance premium rises likely to slow

Households could get some respite from rising health insurance premiums next year amid signs that insurers' costs are growing at the slowest rate since the global financial crisis.
With the deadline for insurers to lodge their proposals for premium rises with the Health Department expiring Friday, new figures show that the rate of increase in the dollars health insurers paid for benefits for patients in 2016-17 grew by just 4.5 per cent, down from 5.2 per cent previously and the slowest annual rise since at least 2010.
The data from the Australian Prudential Regulation Authority suggests the average increase in health premiums this year could be well below the 4.8 per cent last year, although it will still be far above the rate of general consumer price inflation.
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International Issues.

South Korean adviser warns secret back channels with North Korea have collapsed

Nick O'Malley
Published: November 6 2017 - 12:15AM
Seoul: On the eve of President Donald Trump's first visit to South Korea, tensions remain critical because secret back channels with North Korea have collapsed, says South Korea's First Deputy Chief of National Security Strategies, Sang-chui Lee.
Mr Lee, whose post is similar to that of a deputy minister, said North Korea's nuclear tests had added to the tensions on the Korean peninsula due to the vast conventional forces that have long been posed against one another across the Demilitarised Zone that has marked the border between the two nations since the end of the Korean War.
But he said until recently effective back channels existed between the two armed forces.
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Trump administration is up to its neck in Russians

Jennifer Rubin
Published: November 7 2017 - 5:48AM
The number of Russian connections to President Donald Trump's campaign and to his administration should stun and worry even the most credulous Republicans. We have never seen such a multiplicity of connections to a hostile foreign power and lack of transparency in a presidential campaign or administration - nor have we ever had a campaign in which Russians interfered in such a widespread and deliberate manner.
Newly leaked international documents reveal even more of the Trump team's Russian ties, according to NBC News: "Through offshore investments, [Commerce Secretary Wilbur] Ross held a stake in Navigator Holdings, which had a close relationship with the Russian firm. Ross did not disclose that connection during his confirmation process on Capitol Hill." NBC's report also states:
"Top White House adviser Jared Kushner, Trump's son-in-law, is also implicated. The documents reveal that Kremlin-connected interests invested in social media giants Facebook and Twitter through one of Kushner's business associates. Russian tech leader Yuri Milner, who funnelled the money to Facebook and Twitter, has a stake in a company partly owned by Kushner."
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Donald Trump has done Australia a favour

Peter Hartcher
Published: November 7 2017 - 7:42AM
Could it be that, despite everything, Donald Trump is doing Australia something of a favour? He has jolted the world's confidence in US sanity, shaken the trust of US allies and shattered progress in global market-opening. In other words, he's undercut the fundamental principles and systems that have sustained the America-centric global order since World War II. Yet because of this shock to the system, he is forcing Australia's leadership to think.
Australia's default position for most of the postwar era has been to contract out to Washington most of the thinking on foreign affairs and defence. Australia has automatically relied on the US alliance as the national insurance policy, and sent small contingents to support America's fights in the Middle East as payments to make sure the policy remained current.
It wasn't that Australia lacked independence. It's that we chose dependency. As former diplomat Allan Gyngell​ puts it in an essay in the new journal Australian Foreign Affairs: "No one has forced us to fight particular wars or pursue particular goals. It was all our own doing.
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  • Nov 7 2017 at 10:10 AM

Xi Jinping, Donald Trump and their North Korea problem

by Gideon Rachman
With the threat of another Korean war looming, this week's US-China summit in Beijing could be the most important in decades.
Most western commentary on North Korea has focused on President Donald Trump's warnings of "fire and fury" to combat the regime's nuclear threat. But the Korean crisis also poses a huge risk to China. If a war breaks out, China will literally be on the frontline - potentially exposed to nuclear fallout, refugee flows and dramatic shifts in the regional balance of power.
These acute risks have produced a startling variety of opinions among Chinese experts about the best way forward. There are some who even argue that China and the US should co-operate in joint military operations against North Korea. Others take a completely different line - contending that Washington's policy is leading to disaster, and that it is time for Beijing to break publicly with the US.
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The risk we take when we panic about China's rise

James Laurenceson
Published: November 8 2017 - 12:05AM
 Sometimes Australia can slip into panic mode when confronted by China's rapid rise. Australian universities are now the centre of attention. They increasingly employ Chinese citizens and Chinese-Australians as researchers, and nearly 40 per cent of the fee-paying, international students they host are also from China.
The most recent claim is that Australian universities are collaborating with top military technology universities in China to the benefit of the People's Liberation Army, and to the detriment of our security ally, the United States.
These are serious allegations that deserve an airing and further investigation. At the same time, what is the evidence being offered? A swath of scientific papers co-authored by researchers who had worked or studied at Australian and Chinese institutions, many published in leading peer-reviewed, English-language academic journals.
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Trumpism without Trump: A losing formula in swing-state Virginia

Michael Tackett
Published: November 9 2017 - 2:53AM
For Ed Gillespie, Trumpism was an ill-fitting suit.
His resume was pure Establishment - national Republican Party chairman, counsellor to President George W. Bush, well-connected lobbyist. But the messaging of his campaign for governor of Virginia was that of a cultural flamethrower, emphasising crimes by unauthorised immigrants, monuments to Confederate heroes, even suggesting that his opponent, a pediatric neurologist, supported child pornographers.
As the Republican candidate for governor in Virginia, Gillespie tried to run in a very narrow lane, by embracing some of the most divisive elements of President Donald Trump's agenda while treating him like Voldemort and mostly refusing to utter his name. It was enough to motivate Trump's supporters in rural parts of the state, but fell far short in Northern Virginia on Tuesday, where the wealthy and well-educated voters who were once reliably Republican continued their march toward becoming solidly Democratic. He lost by a margin twice as big as predicted.
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Voters deliver first forceful rebuke to President Donald Trump

Jonathan Martin and Alexander Burns
Published: November 9 2017 - 6:15AM
Voters have delivered their first forceful rebuke of President Donald Trump, with the Demoratic Party capturing governorships in two key states and making significant inroads into suburban communities that once favoured the Republican Party. 
The Democrats crowning success on Tuesday night came in Virginia, where Lieutenant Governor Ralph S. Northam, an understated physician and Army veteran, won a commanding victory for governor, overcoming a racially charged campaign by his Republican opponent and cementing Virginia's transformation into a reliably Democratic state largely immune to Trump-style appeals.
Mr Northam was propelled to victory over Ed Gillespie, the Republican nominee, by liberal and moderate voters who were eager to send a message to Trump in a state that rejected him in 2016. Mr Northam led Mr Gillespie by nearly nine percentage points, the widest victory in decades for a Democratic candidate for governor of Virginia.
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  • Nov 9 2017 at 10:01 AM

Why Donald Trump and the House of Saud are a match made in heaven

by Edward Luce
You might say it is a match made in heaven. With their taste in gold elevators, the Trump family and the House of Saud were destined to alight at the same penthouse.
But the affinity between Donald Trump, US president, and Mohammed bin Salman, Saudi Arabia's de facto monarch, goes beyond a shared aesthetic for "dictator chic". It is chiefly transactional. The US-Saudi relationship is the quintessence of Trumpian diplomacy. Its flowering symbolises the decay in the US-led global order.
Mr Trump's approach to foreign relations is a blend of family and money and a weakness for flattery. Japanese prime minister Shinzo Abe pledged $US50m to the Ivanka Trump-inspired Women Entrepreneurs Finance Initiative — the World Bank's effort to seduce America's first family. Mr Abe, whose first gift to Mr Trump was a gold-plated golf club, hosted Ms Trump in Tokyo shortly before her father turned up.
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'He said he didn't meddle': Trump says Putin denies Russia tampered in US election

Ashley Parker and David Nakamura
Published: November 12 2017 - 2:43AM
Hanoi: US President Donald Trump said on Saturday that Russian President Vladimir Putin has again denied his nation tampered in the US presidential election last year.
Mr Trump told reporters that he and Mr Putin had more than one informal discussion after crossing paths at the Asia-Pacific Economic Cooperation (APEC) forum in Danang, Vietnam, before Mr Trump flew to Hanoi for a bilateral meeting on Sunday with Vietnamese leaders.
The conversations mostly centred on the war in Syria, Mr Trump said, but he added that he pressed Mr Putin on Moscow's role in attempting to tamper in the elections.
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I look forward to comments on all this!
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David.

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