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, December 28, 2017

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

December 28, 2017 Edition.
By the time you read this Christmas will have passed and we will all be waiting for 2018.
Trump has gone to the Whitehouse in the South with his coterie and hopefully will stay out of trouble.
There are some early rumblings of the European Union beginning to splinter in the East as well as Brexit in the West. It feels like it just might go badly and worse still Catalonia has just voted in the pro-independence team again.
In OZ a madman has injured a lot of pedestrians with a SUV and otherwise the Christmas / New Year Snooze is in full swing!
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Here are a few other things I have noticed.
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Major Issues.

A bigger, better public sector will secure our future

Ross Gittins
Published: December 17 2017 - 11:45PM
There are important lessons to be learnt from the latest news about where our strong growth in employment is coming from. But if we listen to the nostrums of the Smaller Government brigade, we'll get them exactly wrong.
The (trend) figures we got from the Australian Bureau of Statistics last week showed employment growth of 370,000 – or 3.1 per cent – over the year to November. More than 80 per cent of the new jobs were full-time.
Great news.
But my esteemed colleague Peter Martin delved deeper came upon a bigger story: the strong growth in employment has not been spread evenly across the economy, but is heavily concentrated in just two industries: "healthcare and social assistance" and construction.
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Revolutionary origins of identity politics explain divisive nature

  • Jason Willick
  • The Wall Street Journal
  • 12:00AM December 18, 2017
In the standard conservative telling, “identity politics” has its roots in postmodernism and the protest culture of the 1960s. But for a broader understanding of the tribalism that today besets both ends of the political spectrum, look back two centuries earlier, to the American Revolution and its aftermath.
That was when Americans grappled most intensely with the idea of “representation” — the question of how a politician could speak on behalf of people who were different from him. The debates took place among wealthy white males, but they nonetheless prefigured the more diverse identity war that dominates discussion today.
What exactly is identity politics? In his recent book The Once and Future Liberal, Mark Lilla offers the following illustration: “Conversations that once might have begun, ‘I think A, and here is my argument’, now take the form, ‘speaking as an X, I am offended that you claim B’.” In this view, “white men have one ‘epistemology,’ black women have another”. The contention is that people with different backgrounds can’t fully understand each other’s experiences.
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A million Australians abuse prescription drugs

Aisha Dow
Published: December 19 2017 - 12:30AM
Almost a million Australians are abusing and misusing pharmaceutical drugs, with legal painkillers posing a growing problem, research has found.
Most people taking opioid medication who do not need it for health reasons are sourcing it legally from pharmacists and doctors.
More than half the people who abuse painkillers buy them at a pharmacy over the counter, while another 18 per cent usually obtain them with a medical prescription.
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Malcolm Turnbull's confidence rolls on, just like the economy

Ross Gittins
Published: December 18 2017 - 4:36PM
It's usually in the interests of us followers to have a leader who is lucky. Malcolm Turnbull has had his share of bad luck but, of late, his fortunes seem to have changed. Latest proof is the mid-year budget update.
According to Scott Morrison and Mathias Cormann, everything is much improved. Although previous mid-year updates have revealed less progress than expected at budget time, this time the budget deficit is expected to be $5.8 billion lower than forecast in May.
The overall budget balance is still expected to be back in (a slightly larger) surplus in 2020-21, and this financial year is expected to be the last one in which the government needs to borrow to cover the day-to-day activities of government (as opposed to its spending on infrastructure), a year earlier than expected.
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Slower debt growth nice but no cigar – or tax cut justification

Michael Pascoe
Published: December 19 2017 - 9:24AM
Nice work by Treasurer Scott Morrison getting in his mid-year budget update spin first over the weekend, picking up headlines suggesting the government will cut $23 billion off the nation’s gross debt by the end of this decade.
First, gross federal government debt failed to become a thing back when Joe Hockey was shadow treasurer – it’s the net debt that counts.
Second, it’s as much the price of iron ore (especially the high-quality Pilbara stuff mined by BHP and Rio) as any government policy that’s improved the budget’s immediate outlook. And it’s arguable that beyond iron ore, it’s been much more a matter of Reserve Bank and key state government policies than what the Feds have been up to.
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‘Overly confident’: 80% of Australians rate themselves as financially savvy

Kate Burketwitter
While the majority of Australians think they’re financially savvy, more than one in three borrowers don’t actually know the interest rate on their own mortgage, a survey has found. 
Almost 80 per cent of people considered themselves to be money smart, according to Mortgage Choice’s inaugural Australian Financial Savviness Whitepaper.
That’s despite more than half of the 1043 people surveyed for the report rating their financial knowledge as either average or poor.
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BHP in split with Minerals Council over climate, coal

  • The Australian
  • 11:29AM December 19, 2017

Matt Chambers

BHP Billiton has threatened to leave the powerful Minerals Council of Australia if the lobby group continues to push for energy policy that prioritises costs and reliability over emissions reduction, and keeps calling for policies that would encourage coal power plant development over other sources.
In a review of its membership of industry groups that hold positions on climate and energy policy, released today, the big miner said it would quit the World Coal Association but for now stay a member of the Minerals Council, for which it is the biggest source of funding.
BHP said it would remain a member of the Minerals Council because it derives a high level of benefit from membership.
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  • Updated Dec 19 2017 at 11:30 PM

More tax on super, but savers are winners anyway

Wages growth is close to non-existent, but workers may find some comfort that strong investment returns are boosting their retirement savings, as well as government coffers.  
Monday's mid-year economic and fiscal update revised company tax receipts upwards by 4.1 per cent or $3.2 billion in 2017-18 to reflect higher corporate profits and compliance activity by the Australian Tax Office
But super tax collections rose by an even stronger 24.3 per cent, or $2 billion, kicked along by larger-than-expected investment earnings and higher capital gains tax revenue.
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Draft strategy proposes radical plan to boost booze prices

ALCOHOL prices could skyrocket under a drastic new strategy to curb Australia’s drinking problem.
Liz Burke and AAP
news.com.au December 20, 20178:09am
WINE lovers and young drinkers would be hardest hit by a government proposal to increase booze prices.
A draft strategy released by federal government ministers, which aims to significantly reduce Australians’ alcohol consumption, has recommended a “minimum floor price” for alcohol.
The pricing plan would prevent the cost of all alcoholic drinks from dropping below set prices, with those in the industry expecting a base price of $1.50 per standard drink, the Herald Sun reports.
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Central bank chief warns over Bitcoin valuations

Ambrose Evans-Pritchard
Published: December 19 2017 - 3:51PM
​Bitcoin has no fundamental value and is likely to end in tears once speculators discover how hard it can be to extricate their cash, Singapore's financial watchdog has warned.
Sopnendu Mohanty, fintech chief for Singapore's monetary authority (MAS), said there was a crucial difference between Bitcoin and rival cryptocurrency Ethereum, but it was far from clear whether either improved day-to-day transactions or had much potential as a tool for central banking.
"Bitcoin has no natural intrinsic value. Can you buy a house with it? Can you use it for daily interactions? It may be valued at $US18,000 ($23,477) right now but what I want to know is how you convert it into fiat currency and realise that value. The risk comes at the moment of conversion," he told London's The Daily Telegraph.
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Climate review: Turnbull government will allow companies to purchase foreign carbon credits

Michael Koziol
Published: December 19 2017 - 4:33PM
The Turnbull government will reverse course and allow businesses to buy overseas carbon credits to meet Australia's emissions reduction targets, a policy long questioned by climate experts and once labelled "dodgy" by Tony Abbott.
Backed by industry and some climate change observers, the move allows big businesses to purchase emissions reductions in other countries - most likely at lower prices - to offset their own carbon production.
Environment and Energy Minister Josh Frydenberg on Tuesday gave "in-principle" support to joining 60 other nations - including Canada, New Zealand, Japan and South Korea - in an international trading market once rules are finalised after 2020.
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At a glance: Australia's climate change policy review

Tara Hayes
Published: December 19 2017 - 5:07PM
The Turnbull government's review of climate change policies has confirmed Australia is on track to reduce emissions by 5 per cent below 2000 levels as part of the Paris agreement, but faces a tough task reaching its goal of a 26-28 per cent reduction by 2030.
The review, released on Tuesday, outlines Australia's international and national efforts to address climate change, including contributions to several major projects and initiatives, research and collaboration with global partners and the integration of climate change action through overseas aid.
But the review also acknowledged policy improvements are needed to keep up with technological changes, and the rest of the world.
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Death rate spikes as legal drug use grows

  • The Australian
  • 12:00AM December 19, 2017

Sarah-Jane Tasker

Australians are increasingly using pharmaceutical drugs such as opioids and sleeping pills for non-medical reasons, with deaths linked to the most common misuse of the medication doubling over the past decade.
A report to be released today by the Australian Institute of Health and Welfare into the non-medical use of pharmaceuticals reveals that in 2016 one million Australians aged 14 years or older reported using a prescribed or over-the-counter drug for non-medical reasons.
The report, which presents trends of the past decade to 2015-16, highlighted that the use of pharmaceuticals for non-­medical reasons in 2016 was higher than all other illicit drugs, except cannabis (10.4 per cent).
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Slash tax rate or lose investors, warns Treasury

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

Simon Benson

Treasury has warned that Australia would suffer a 1 per cent hit to economic growth if it did not ­respond to the US move to dramatically lower corporate tax rates poised to pass congress.
An updated Treasury briefing to the government this week confirmed there would be a significant recessionary impact on the Australian economy and a potential downgrade to revenues that could put at risk the sustainability of Australia’s tax base and the ability to fund the delivery of essential services.
There was a “broken nexus” ­between Australia and other OECD countries, it claimed, that eventually would force a ­revision of tax revenue and the government’s budget position unless the next round of corporate tax cuts was passed by parliament.
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'Snowy 2.0' will go ahead but costs blow out by billions

Bevan Shields
Published: December 21 2017 - 9:35AM
Prime Minister Malcolm Turnbull's much-hyped 'Snowy 2.0' expansion has been given the green light, however the scheme could cost 125 per cent more than first thought and won't be switched on for at least six years.
The government will now officially proceed with the ambitious plan – nine months after the iconic Snowy Mountains scheme emerged as a solution to the country's fragmented and increasingly unreliable energy network.
A $29 million feasibility study to be released on Thursday concludes the project is financially and technologically viable, can stabilise wholesale electricity prices, and reduce Australia's reliance on gas as the main backup for when wind and solar farms are out of action.
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Economic vandalism: We're getting dragged into tax race to the bottom

Michael Pascoe
Published: December 21 2017 - 12:22PM
It is increasingly likely Australia will be dragged into the global corporate tax race to the bottom after the Republican Party’s extraordinary piece of economic vandalism passed US Congress overnight.
The implications are manifold – and none of them beneficial beyond the initial sugar hit stock markets had already priced in.
Among the less obvious, the $US1.5 trillion ($1.96 trillion) Trumpster/Republican tax bill increases the urgency of genuine Australian tax reform – the sort that will have any and all vested interest groups complaining, the sort that requires real leadership, not mere election-focussed income tax trimming and big business pandering.
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Dangers in Scott Morrison's corporate tax argument

Mark Kenny
Published: December 22 2017 - 12:01AM
Scott Morrison's warning that as Australians loaf about on their summer holidays, companies headquartered overseas would be fixing to scarper due to our uncompetitive company taxes, was either political hyperbole or a clear and present danger to prosperity.
Even if it was the former, it was pretty unhelpful – a wallet-closingly grim message from a government supposedly looking to lift confidence.
But if it was the latter, it must surely be justification by itself, for a snap election in the new year to be fought on company tax.
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Trickle-down economics is the only song they know, and we're sick of hearing it

Sally McManus
Published: December 21 2017 - 11:45PM
Scott Morrison and Malcolm Turnbull are like two people performing a duet at a karaoke bar. They sing the same song every Friday night, no matter the circumstance, no matter the mood of the crowd. They sing it well, all the notes are well practiced, but after hearing it over and over you start to wonder, is that all they have got?
Surely they know other songs because I'm getting so sick of hearing this one. This is what it's like listening to them revert to the same tired old trickle-down economics mantra when selling the Government's Mid-Year Economic and Fiscal Outlook (MYEFO).
At a time of record low wage growth, when stressed working families struggle to pay the bills, we hear the same old tune – tax cuts for big business will lead to workers getting pay rises.
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We'd be mugs to panic and cut our company tax rate

Ross Gittins
Published: December 23 2017 - 12:15AM
The Americans' decision to drop their company tax rate to 21 per cent from the start of next year is unlikely to overcome our Senate's resistance to cutting our company tax rate to 25 per cent for big business. Which is no bad thing.
It seems the forces behind the US end of neoliberalism – the distortion of mainstream economics I prefer to call bizonomics (giving big business whatever it wants will be best for all of us) – aren't giving up without a fight.
This US tax bill is a huge win for them, with the company tax rate greatly reduced, plus cuts in personal income tax biased heavily in favour of high-income earners.
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House prices expected to fall in 2018: CoreLogic

Published: December 23 2017 - 10:33AM
Australia's housing market is expected to continue to weaken during 2018 as tighter lending restrictions from banks start to bite.
Property data analytics group CoreLogic expects dwelling price falls across Sydney, and to a lesser extent Melbourne, will lead a national fall in home values next year.
Driving the fall, will be the restrictions on interest-only loans introduced by banking regulator the Australian Prudential Regulation Authority's (APRA) earlier this year, CoreLogic head of research Tim Lawless says.
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Signs encourage more optimism in economy

  • The Australian

Adam Creighton

For the first time since the financial crisis, prospects for the economy are improving. It’s brave to be too confident, but the proverbial green shoots are sprouting all over the place. That annoying refrain of economists, “risks are tilted to the downside”, is being seen less and less.
The unemployment rate, now 5.4 per cent or the lowest level since 2012, is falling faster than predicted on the back of the biggest jobs surge in almost a decade. Total employment grew 3.2 per cent during the year to November, twice as fast as Australia’s population growth, which at 1.6 per cent is among the fastest rates in the OECD. Whatever our gripes, the world continues to vote with its feet for Australia.
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National Budget Issues.

Mid-year budget update: Universities hit with $2.1 billion in cuts and end of demand-driven system

Michael Koziol
Published: December 18 2017 - 1:10PM
The Turnbull government will hit universities with $2.1 billion in cuts as it unwinds the demand-driven system that ushered in a student boom at tertiary institutions, and applies a lifetime cap on student loans.
The government will freeze the amount it pays to universities for two years, before moving to a competitive system in 2020 with funding increases capped at the growth rate of the working age population.
This would effectively remove the incentive for universities to enrol as many students as possible, a legacy of Labor's aim to boost the proportion of young people with a bachelor's degree to 40 per cent.
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Mid-year budget update: Higher tax returns help slash $10b off federal deficits

James Massola, Peter Martin
Published: December 18 2017 - 12:12PM
Fresh government forecasts have slashed $10 billion off federal deficits over the next four years, including $5.8 billion in the current financial year.
Higher company tax returns and better than expected superannuation tax receipts will more than offset a downgrade in expected slower wages growth and lower than previously expected economic growth.
Finance Minister Mathais Cormann said the improvement was so big that after this financial year the government would no longer need to borrow to fund the day-to-day business of government.
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Scott Morrison's budget update to show debt $11.9 billion lower than forecast

James Massola
Published: December 18 2017 - 12:00AM
The Turnbull government will reveal an $11.9 billion projected improvement to the budget bottom line on Monday, confirming Australia is on track to return to surplus by the end of the decade.
The reduction in net debt, the figure most commonly used by economists, means it will now peak at a lower than expected 19.2 per cent of GDP in 2018-19, down from the 19.8 per cent forecast in May.
Gross debt will be $23 billion lower than forecast, a full one per cent lower than the budget predicted but it will still reach a whopping $583 billion by 2020-21.
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Our national Budget numbers are not so beautiful

Shane Wright
Tuesday, 19 December 2017 7:30AM
Too many Budget watchers have succumbed to Stockholm syndrome.
Worn down by years of big deficits, soaring debt and tepid economic growth, people have grabbed on to Treasurer Scott Morrison’s latest mid-year Budget update as if it was the best set of numbers on record.
Let’s put some of this into perspective.
The deficit this year is now expected to be about $24 billion. Next year’s is little better at $20.5 billion.
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MYEFO: Fresh push to ram through company tax cuts as economy lifts budget $10 billion

James Massola, Peter Martin, Eryk Bagshaw
Published: December 18 2017 - 9:07PM
Treasurer Scott Morrison has signalled a fresh push to get the government's $50 billion package of company tax cuts through the Senate, saying that US President Trump is forcing his hand and that the changing composition of the Senate gives him a chance.
Higher than expected company tax receipts helped improve the budget position by $10 billion in the update released on Monday, improving the outlook for 2017-18 by $5.8 billion.
"The Trump tax cuts are coming," Mr Morrison told a Parliament House press conference. Allowing Australian rates to stay high while others fell would kill the goose that laid "the golden egg".
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Mid-year budget update: Housing investment rates to fall, raising prospect of long-term downturn

Eryk Bagshaw
Published: December 18 2017 - 5:13PM
Housing investment will fall further from record levels into negative rates of growth next year, as the Sydney and Melbourne markets prepare for a downturn following the government crackdown on investors.
The sector has driven the economy and fuelled a jobs boom – particularly in NSW and Victoria – but will now come off its peak according to official forecasts revealed in Monday's mid-year budget update.
Treasury has pencilled in a 1.5 per cent drop next year after a similar fall this year in a forecast that leading economists have labelled optimistic.
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MYEFO: More money, but nowhere near enough to fund tax cuts

Peter Martin
Published: December 18 2017 - 6:36PM
Scott Morrison wants you believe the budget's strong enough to fund tax cuts.
It isn't, and the update makes that clear.
As it is required to do, it spells out the stated aim of the budget - what the Coalition has pledged to achieve since its election - on page 31.
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Graph shows the difference between government Budget forecasts, and what really happened

EVERY year, Australia’s politicians make the same promise. This graph shows why you can’t trust a word they tell you.
Charis Chang and AAP
news.com.au December 21, 20179:10am
POLITICIANS have been promising to get the budget into surplus for years but despite their optimistic forecasts, Australia still looks like it’s a long way from being back in the black.
Australia has not had a surplus since 2007-08 when the Rudd Government spent heavily to insulate the country’s economy against the global financial crisis.
Since then, successive governments have released estimates of when the budget would be returned to surplus but each year this date has been pushed further back.
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The federal budget is still in a fragile state and there’s a long way to go before it’s back in good health

Dec 20, 2017, 11:56 AM
A dollop of good fiscal fortune — a scarce commodity in Australia’s recent fiscal history — has enabled Treasurer Scott Morrison to boast of a federal budget deficit revised down by several billions of dollars this year and cruising towards balance in 2020-21.
We should not deny the Treasurer a moment of satisfaction, but on close inspection the mid-year economic and fiscal outlook (MYEFO) reveals nothing much has changed since the May budget.
The revenue gains that take a chunk out of this year’s deficit don’t extend into later years, expenditure remains stuck around 25% of GDP and the deficits and surpluses estimated for 2018-19 to 2020-21 are not much different from those in the budget.
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Health Budget Issues.

Massive overhaul set for after-hours doctor house call industry costing $250m a year

SHARRI MARKSON, The Daily Telegraph
December 18, 2017 12:00am
JUNIOR doctors will be banned from earning the top bulk-billing rate for after-hours home calls, and Medicare will get a funding boost in today’s Budget update.
Health Minister Greg Hunt will announce a massive overhaul of the after-hours doctor house call industry that is costing taxpayers a quarter of a billion dollars each year and lining the pockets of private equity firms.
It comes after an investigation by The Daily Telegraph revealed the system was being exploited by money-hungry companies.
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Blueprint calls for local approach to healthcare

  • The Australian
  • 12:00AM December 18, 2017

Sean Parnell

Australia’s health system would be overhauled to focus on service ­delivery at a more local level, and all government-funded providers forced to report on patient outcomes to enable greater transparency, under a reform blueprint to be released today.
The Australian Healthcare and Hospitals Association has responded to a challenge from federal minister Greg Hunt to come up with ideas to improve the system. In its blueprint, the association highlights the overlaps and gaps in the federation and the risk the system will be unable to ­become more efficient and ­responsive in future years.
“Australia’s public healthcare system is being severely tested by unco-ordinated reforms occurring at both the commonwealth level and within individual jurisdictions, all in the absence of any agreed overarching healthcare strategy, along with mounting ­financial strain and increasing ­demand,” the blueprint warns. As a first step, several agencies should be consolidated into a single independent national health authority, reporting to all governments and parliaments, to drive a regional ­approach to service delivery.
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CHF supports Healthy people, healthy systems

 MEDIA RELEASE MONDAY 18 December 2017
The Consumers Health Forum welcomes the Australian Healthcare and Hospitals Association’s blueprint for a national health agreement as a much-need stimulus for a serious rethink of Australia’s health system.
“We strongly support many of the aims of the report Healthy people, healthy systems,” the CEO of the Consumers Health Forum, Leanne Wells said.
“In too many corners of Australia’s health system, whether it be Medicare, primary care, prevention or health insurance, there is a lack of rigorous evaluation and less than optimal use of available data and knowledge to improve services.
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How to avoid bill shock with out-of-pocket surgery expenses

Starts at 60 Writers December 18, 2017 Money
Hospital visits are stressful at any time, but the lack of transparency around out-of-pocket hospital and medical expenses, what Medicare covers and what your health insurance provider covers, can be an even more painful and expensive maze to navigate.
Choice recently found that having private health insurance can expose you to thousands of dollars of out-of-pocket costs, while public patients enjoy the same treatments for free.
According to Choice, private patients can be slugged with expenses such as consultations with your doctor while you’re in hospital, procedures you are not covered for, pathology costs such as blood tests and prostheses such as an artificial hip. Private patients don’t typically pay for these services.
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Health insurance report provides fresh hope for consumers

MEDIA RELEASE TUESDAY 19 DECEMBER 2017
A Senate committee’s proposals to expose health insurance costs and medical fees to greater scrutiny would represent a great step forward to a more consumer-friendly system, the Consumers Health Forum says.
“We strongly support many of the committee’s 19 recommendations in this ground-breaking report which recognises that the system must meet the needs of the consumer – those who pay for health insurance policies - and not vice versa,” the CEO of the Consumers Health Forum, Leanne Wells, said.
“CHF has argued long and hard for much greater transparency in health insurance and medical fees and this report recommends a battery of changes including a government database of individual medical practitioners’ fees for consumers to consult.
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Improve health insurance transparency: Senate report

  • The Australian
  • 2:36PM December 19, 2017

Sarah-Jane Tasker

Private health insurers should be forced to increase transparency to reduce the complexity of policies, a senate committee has told the Turnbull Government, as it also calls for insurers’ executive pays to be revealed.
The committee tasked with reviewing the value and affordability of private health insurance handed down its report today, which highlighted that premiums had become less affordable at the same time that exclusions and co-payments had increased.
The number of Australians covered by a policy with co-payments or exclusions increased from 7 per cent in June 2007 to 40 per cent in 2017.
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Private health insurance: low-value policies ‘increased dramatically’, report finds

Senate committee inquiry finds exclusions for eye surgery, dental services and maternity care creating unnecessary stress
Australians with private health insurance are increasingly being offered low-value policies, with exclusions for essential services such as eye surgery, dental services and maternity care creating unnecessary stress to patients.
This was one of the findings from a Senate committee inquiry into the affordability and value of private health insurance, which published its final report on Tuesday.
“The number of policies with exclusions or co-payments has increased dramatically in recent years,” the report found. “Hospitals Australia noted that the rise in exclusions can lead to unnecessary stress for policy holders when they require care, particularly if exclusions in a policy are not properly explained.”
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Senators highlight pitfalls of private health insurance

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

Sarah-Jane Tasker

Private health insurers should be forced to increase transparency to reduce the complexity of policies, a Senate committee has said, also calling for insurers’ executive pay to be revealed.
The committee tasked with reviewing the value and affordability of private health insurance handed down its report yesterday, which highlighted that premiums had become less affordable at the same time as ­exclusions and co-payments attached to policies had increased.
“The increases in premiums and in the number of exclusions has eroded the value of private health insurance and led some people to drop or downgrade their cover,” the report said.
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Medicare faces $330m hit for child abuse redress counselling

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

Samantha Hutchinson

The proposed child-sex-abuse ­redress scheme includes uncapped psychological counselling that could cost Medicare about $65 million a year.
The proposed scheme also calls for Medicare to expand the range and scope of psychological treatments available on a subsidised basis to survivors of abuse.
Actuaries consulting to the royal commission have estimated the decision to supply an uncapped number of psychological counselling sessions is likely to cost about $330 million, but they note that there is scope for the cost to go much higher. The subsidies would be made available to victims on a continuing basis, with no fixed end date under the royal commission’s modelling.
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After-hours funding shakeup: How will it actually work?

The government has not accepted all of the MBS Taskforce's recommendations
20th December 2017
Long-anticipated restrictions on who can claim urgent after-hours MBS items will start in March next year, the government has announced.
However, the Department of Health appears to have backed away from some of the recommendations by the MBS Review Taskforce in October.
Minister for Health Greg Hunt announced his reforms on Monday, including that:
  • Only qualified GPs, registrars or those on the fellowship pathway will be allowed to claim item 597 for urgent after-hours attendances, worth $129.80
  • Other doctors will have to claim a new item for urgent after-hours attendances worth $100, dropping to $90 in January 2019
  • However, any doctor in a rural area (Modified Monash Model areas 3-7), even junior doctors, will be able to claim another new item for urgent after-hours attendances that will still be worth $129.80
  • Item 599 for urgent attendances in unsociable hours (between 11pm and 7am) – worth $153 – will still be available to all doctors
  • The sliding scale of rebates for subsequent patients at the same location will be replaced by one item worth $41.95 for every subsequent patient. Currently, the sliding scale for a level B after-hours home visit ranges from $61.95 for the second patient to $51 for the seventh.
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International Issues.

An American pivot out of Asia would force us to play history’s hand

  • Hugh White
  • The Australian
  • 12:00AM December 18, 2017
We are starting at last to have a ­serious debate about the rise of China and its implications for Australia beyond the export bonanza. Even the government’s new foreign policy white paper admits China’s power and ambition have grown in step with its economy, and that it is now overtly challenging the US’s strategic position in East Asia.
Nonetheless, many people — including both the government and the opposition — remain convinced that Australia can still rely on America to resist China’s challenge and shield us from its power. I argue in a new Quarterly Essay that they are being too optimistic. China’s growing economic, military and diplomatic power, and its manifest determination to become East Asia’s leading power, mean the US faces a truly formidable rival, which its seems quite unable to defeat.
My colleague Paul Dibb disagreed on this page last week. He still argues, as he has done for many years, that China’s wealth and power is no match for America’s. He dismisses Treasury predictions in the white paper that on one measure China’s GDP will be almost double America’s in 2030, arguing that other measures of economic weight are more relevant.
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  • Updated Dec 20 2017 at 11:45 PM

Islamic State: what if we won a war and nobody noticed?

by Ross Douthat
There is nothing more characteristic of the Trump era, with its fire hose of misinformation, scandal and hyperbole, than the fact that America and its allies recently managed to win a war that just two years ago consumed headlines and dominated political debate and helped Donald Trump get elected president – and somehow nobody seemed to notice.
I mean the war against the Islamic State, whose expansion was the defining foreign policy calamity of Barack Obama's second term, whose executions of Americans made the US look impotent and whose utopian experiment drew volunteers drunk on world-historical ambitions and metaphysical dreams. Its defeat was begun under Obama, and the hardest fighting has been done by Iraqis – but this was a US war, too, and we succeeded without massive infusions of ground troops, without accidentally getting into a war with Russia and without inspiring a huge wave of terrorism in the West.
Why haven't we noticed this success? One reason is the nature of our victory. As Max Abrahms and John Glaser wrote in the Los Angeles Times, the defeat of the Islamic State didn't happen the way many foreign policy hawks envisioned, because it didn't require also going to war with Bashar Assad or creating a new Syrian opposition army. At the same time, it happened more easily than intervention skeptics feared – so there isn't a pundit chorus, right or left, ready to claim vindication in the victory.
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Donald Trump's US tax cut: What it means for Australia

By business editor Ian Verrender
The pace just picked up, the sense of urgency heightened.
That's the message emanating from Canberra over the need for corporate tax cuts after the US House of Representatives finally pushed through Donald Trump's massive tax bill, his first major legislative victory.
Under the new law, federal corporate taxes in the US will be slashed from 35 per cent to just 21 per cent.
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Poland on collision course with EU after putting courts under political control

Marc Santora and Joanna Berendt
Published: December 21 2017 - 6:32AM
Warsaw, Poland: Poland's president signed sweeping legislation on Wednesday to overhaul the country's judicial system, a move critics say fundamentally undermines the rule of law in a nation that only three decades ago broke free from the yoke of the Soviet Union.
The new laws effectively put the Polish courts under the control of the right-wing governing party, Law and Justice. President Andrzej Duda signed them, defying a formal warning delivered hours earlier by the European Union, which called the legislation a "serious breach" of the core values on which the union was founded.
The warning by the commission, the executive arm of the European Union, invoked Article 7 of bloc's founding treaty. The treaty includes provisions intended to ensure that the 28 member countries maintain "respect for human dignity, freedom, democracy, equality, the rule of law and human rights."
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GOP Tax Bill Fixes Some Problems, But Exacerbates Others

Corporate tax cut and reduction of distortions are high points, but tide of red ink and an array of breaks remain burdensome

By Greg Ip
Dec. 20, 2017 11:27 a.m. ET
For tax reform, it’s the beginning, not the end.
Economists across the political spectrum have long agreed that the U.S. tax system was globally uncompetitive, tilted against investment, riddled with distortionary tax breaks, and incapable of financing the country’s fiscal promises.
The package that Congress has passed and President Donald Trump will soon sign bears only limited resemblance to the reform most economists envisioned. It fixes some of these problems but makes others worse, which will force legislators to return to the table in coming years.
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Catalan separatists get majority in regional election

Aritz Parra and Ciaran Giles
Published: December 22 2017 - 9:54AM
Barcelona: Catalonia's secessionist parties have won enough votes to regain a slim majority in the regional parliament and give new momentum to their political struggle for independence from Spain.
It was hardly an emphatic victory, however, as the separatists lost support compared to the previous vote in 2015, and a pro-unity party for the first time became Catalonia's biggest single force in parliament.
The anti-independence, pro-business Ciutadans (Citizens) party garnered 37 seats in the 135-seat regional assembly with nearly 99 per cent of the votes counted on Thursday.
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Pope Francis denounces 'traitors' in Vatican during Christmas message

Published: December 22 2017 - 1:47AM
Vatican City: Pope Francis issued a stinging new critique of the Vatican's top administration on Thursday, saying "traitors" stood in the way of his reforms and made any change as hard as cleaning Egypt's Sphinx "with a toothbrush".
For the fourth year running, Francis used his annual Christmas greetings to the Roman Catholic Church's central bureaucracy, or Curia, to lecture the assembled cardinals, bishops and other department heads on the need for change.
"Reforming Rome is like cleaning the Sphinx of Egypt with a toothbrush," he said, quoting a 19th-century Belgian churchman. The phrase did not evoke much laughter when the pope read it in the frescoed Clementina Hall of the Vatican's Apostolic Palace.
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Australia to end air strikes in Iraq and Syria following victory over Islamic State

Fergus Hunter
Published: December 22 2017 - 12:53PM
Australia will wind back its military operations against Islamic State after the Iraqi Prime Minister declared victory over the extremist group, which three years ago seized control of large swathes of the region.
Defence Minister Marise Payne announced on Friday that Australia's contribution to US-led coalition air strikes will end, while emphasising that other operations – including the training, advising and assisting of local forces – would continue.
"After more than three years of air operations, the number of coalition air strike commissions has steadily dropped since the last major population centre, Hawija, was captured in October," Senator Payne said on Friday.
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Billion-dollar writedowns pile up as companies analyse US tax bill

Natasha Rausch, Brandon Kochkodin
Published: December 23 2017 - 11:41AM
US President Donald Trump has signed a tax overhaul and companies are rejoicing. But the most immediate effect of the new law could be a one-time accounting headache.
Hours after the bill signing, announcements started to roll in from some of the world's biggest companies - with some spectacular numbers. While the bill benefits most companies through a lower rate, it also requires them to recalculate some of the tax positions they may have been holding on their books for years.
Biotechnology company Amgen said it would take a $US6 billion ($7.77 billion) to $US6.5 billion charge. Bank of America plans to take a $US3 billion hit, and Credit Suisse will take a writedown of 2.3 billion Swiss francs ($3 billion).
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I look forward to comments on all this!
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David.

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