Quote Of The Year

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


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

Saturday, March 31, 2018

Weekly Overseas Health IT Links – 31st March, 2018

Here are a few I came across last week.
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

Special Report: Remote monitoring and self-care

The use of technology to support self-care is considered to be a holy grail of any sustainable health service. So how can the NHS utilise and share such information to improve patient experience and empower them to manage their health better? Jennifer Trueland reports.
In the relatively short time since Mona Johnson started working as a GP she has noticed a significant shift in the way that patients and clinicians interact.
Rather than almost every contact being face-to-face and in person, there’s an ever-increasing menu of options including video appointments, text messaging, sending information via remote monitoring devices, and even the distinctly old-tech telephone.

e-Observations system improves patient safety at East Sussex

DHI Admin
19 March 2018
Since introducing System C’s CareFlow Vitals electronic observations software across the Trust’s two acute hospitals, East Sussex Healthcare Trust (ESHT) has seen marked improvements in patient safety – notably with reduced cardiac arrest rates and improving outcomes for patients. Other benefits include smarter, more pro-active working and earlier interventions. The software has also helped the Trust develop a culture of improvement, using real-time data to drive change.
The Trust’s implementation and use of CareFlow Vitals (formerly Vitalpac) by its Outreach Team is praised by the CQC as an area of excellence.

Google launches Cloud Healthcare API to address interoperability conundrum

Owen Hughes
20 March 2018
Google has launched a new cloud application programming interface (API) that aims to address interoperability challenges in the healthcare industry.
Cloud Healthcare API is an open-source tool designed to enable healthcare providers to collect and manage various types of medical data via the cloud, including DICOM, HL7 and Fast Healthcare Interoperability Resources (FHIR) standards.
Google hopes the API will provide a jumping-off point for healthcare organisations to launch analytics and machine-learning projects in the cloud, using data aggregated from multiple clinical systems.
Healthcare providers will be able to run analytics on this data to identify patterns that could help improve patient outcomes.

Early uses of AI begins to pay dividends in healthcare

Published March 23 2018, 2:43pm EDT
Artificial intelligence is beginning to provide an early down payment on benefits to healthcare providers, but the industry is still early in understanding how to use advanced computing to improve care.
Still, the potential is great, because providers are accumulating significant patient data that can be used to deliver precise and effective care, said presenters this week at Solve: Healthcare, an event sponsored by Intel to discuss the role of AI in healthcare and medicine.
“We’re using less than 5 percent of (patient) data” as clinicians make decisions on providing care, says Rachel Callcut, MD, a trauma surgeon and director of data science and advanced analytics for UCSF Medical Center.

HIT Think Why providers’ biggest cybersecurity risk could be their vendors

Published March 23 2018, 5:09pm EDT
When Hancock Health was hobbled by ransomware, it wasn’t for the usual reasons. No one had clicked a suspicious link in a phishing email. It had its system fully backed up and recoverable.
The attack came from an outside vendor. Hackers stole credentials from one of Hancock Health’s hardware providers, then targeted the hospital’s backup site.
They delivered the ransomware via the connection between the backup site and the hospital’s main site server farm, compromising the backups, the connection and the hospital’s records.

CMS launches Blue Button 2.0 to free up claims data

Published March 22 2018, 7:26am EDT
The Centers for Medicare and Medicaid Services is leveraging HL7’s Fast Healthcare Interoperability Resources standard and OAuth 2.0 security profiles so that Medicare beneficiaries will be able to access and share their claims data in a universal digital format.
“CMS is going to be releasing Medicare claims data, and what’s different about Blue Button 2.0 is its going to be using the open API FHIR protocol as well as OAuth 2.0,” said National Coordinator for Health IT Don Rucker, MD, at Wednesday’s HIT Advisory Committee meeting. “It will be the first of a number of efforts there with the ultimate goal of getting everything on people’s smartphones.”

VA Cerner Implementation Contract Balloons to $16 Billion

The VA Cerner implementation contract jumped from $10 billion to $16 billion, according to a recent House Appropriations hearing.

March 21, 2018 - The price tag for the VA Cerner implementation contract has spiked by 60 percent, judging by testimony given at a recent House Appropriations subcommittee hearing.
In her opening statement, House Military Construction and VA Appropriations Subcommittee Ranking Member and Representative Debbie Wasserman Schultz (D-FL) revealed the cost of VA’s EHR modernization project had increased $6 billion above what was initially expected to be a $10 billion contract.
“The FY 2019 budget requests $1.2 billion to continue the massive implementation, preparation, development, interface, management, rollout, and maintenance of a veteran’s electronic healthcare record system which is excruciatingly long overdue,” said Wasserman Schultz.

HIT Think Why patient confidence hinges on medical device security

Published March 22 2018, 5:53pm EDT
Over the past year, healthcare-related hacks like WannaCry have made for some significant headlines. Yet, this recent surge of cybercrime—and its effects on consumer confidence—is unsurprising.
The Unisys Security Index™, which gauges the attitudes of consumers on a wide range of security-related issues, found that security concerns regarding viruses/malware and hacking rose dramatically.
Given that an electronic medical health record (EHR) can be worth hundreds or even thousands of dollars on the black market, compared with just 25 cents for a typical credit card number, it is no surprise that healthcare has been increasingly targeted by hackers. From a member and patient perspective, robust security is not an option; it is an absolute necessity.

What happens when an algorithm cuts your health care

Illustrations by William Joel; Photography by Amelia Holowaty Krales
For most of her life, Tammy Dobbs, who has cerebral palsy, relied on her family in Missouri for care. But in 2008, she moved to Arkansas, where she signed up for a state program that provided for a caretaker to give her the help she needed.
There, under a Medicaid waiver program, assessors interviewed beneficiaries and decided how frequently the caretaker should visit. Dobbs’ needs were extensive. Her illness left her in a wheelchair and her hands stiffened. The most basic tasks of life — getting out of bed, going to the bathroom, bathing — required assistance, not to mention the trips to yard sales she treasured. The nurse assessing her situation allotted Dobbs 56 hours of home care visits per week, the maximum allowed under the program.
For years, she managed well. An aide arrived daily at 8AM, helped Dobbs out of bed, into the bathroom, and then made breakfast. She would return at lunch, then again in the evening for dinner and any household tasks that needed to be done, before helping Dobbs into bed. The final moments were especially important: wherever Dobbs was placed to sleep, she’d stay until the aide returned 11 hours later.

Researchers say EHRs must be refocused on patient life, health goals

Published March 21 2018, 7:22am EDT
Electronic health records are poorly designed to support longitudinal, personalized healthcare and must be reconfigured around patients’ life and health goals, providing clinicians with relevant and actionable information that is responsive to patient needs.
So argues Zsolt Nagykaldi, associate professor and director of research in the Department of Family and Preventive Medicine at the University of Oklahoma Health Sciences Center, and an international team of primary care researchers.
Writing in the latest issue of the Annals of Family Medicine, Nagykaldi and his colleagues contend that most existing EHR systems were “designed in the prevailing disease- and payment-focused care paradigm that often loses sight of the goals, needs and values of patients and clinicians.”

Could Goal-Directed EHR Functionality Optimize Health Outcomes?

Pivoting from problem-oriented EHR functionality to a goal-oriented EHR design may improve patient health outcomes.

March 21, 2018 - Health IT developers should consider creating new EHR functionality that supports goal-directed healthcare rather than problem-oriented healthcare, according to a new report by researchers at the University of Oklahoma Health Sciences Center Department of Family and Preventative Medicine.
In the study published in the Annals of Family Medicine, researchers made a case for innovating a new EHR design that highlights life and health goals as top priorities to help healthcare providers deliver truly comprehensive patient care that focuses on the full scope of health and wellness.
Current EHR functionality primarily supports a problem-oriented, fee-for-documentation-based health system. This EHR design is not conducive to supporting the goals, needs, and values of patients and clinicians, researchers argued.

Europe's GDPR privacy law is coming: Here's what US health orgs need to know

By May 25, U.S. providers caring for EU patients will need to brush up on consent forms, data sharing and privacy monitoring because the General Data Protection Regulation is tougher than HIPAA.
March 21, 2018 09:31 AM
The European Union General Data Protection Regulation will go into effect on May 25, and healthcare organizations who treat patients from any of the 28 EU nations will need to familiarize themselves with the law to ensure compliance.
GDPR requires companies to gain affirmative consent for any data collected from people who reside in the EU. And organizations that violate the law could face fines up to four percent of their global annual revenue or 20 million euros -- whichever fine is higher.
While U.S. organizations must remain HIPAA-compliant, GDPR rules could be a game-changer for those who care for EU patients. Providers will need to consider data flows, cross-border data transfer, privacy and security monitoring, to ensure their policies are compliant with the law.

Mass General, Brigham and Women’s launch digital pathology project with Royal Philips

The organizations said they intend to establish digital pathology centers and to create best practices and protocols for the digital transformation of the field.
March 20, 2018 11:58 AM
Massachusetts General and Brigham and Women’s announced on Tuesday that they will roll out Philips IntelliSite digital pathology tools to both enable research and support clinical diagnosis and collaboration.
Mass General and Brigham and Women’s, both part of Partners HealthCare in Boston, expect the work will help inform the use of digital pathology across the country using best practices and protocols.
Pathology is a branch of medicine that deals with the laboratory examination of samples of body tissue for diagnostic or forensic purposes.

Drug safety experts react to Trump’s plan to build a 'nationally interoperable' PDMP

Mar 21, 2018 8:54am
Part of a plan unveiled by President Donald Trump on Monday to address opioid abuse includes transitioning states to a nationally interoperable Prescription Drug Monitoring Program (PDMP) designed to reduce the number of opioid prescriptions across the country.
Trump’s plan, which aims to reduce the number of opioid prescriptions by one-third over the next three years, is part of a three-pronged effort to stem the opioid epidemic through increased awareness, tighter prescribing practices and a push to prosecute drug dealers with the death penalty.
A nationally interoperable PDMP network that shares prescribing data across state lines is popular among health IT and drug abuse experts that see it as one of several tools to improve data collection and integrate clinical decision support tools.

Dr. Rasu Shrestha, UPMC chief innovation officer, to lead VA's open API pledge

Written by Jessica Kim Cohen | March 20, 2018 | Print  |
Rasu Shrestha, MD, chief innovation officer for Pittsburgh-based UPMC, will helm the U.S. Department of Veterans Affairs' open application programming interface pledge, the agency announced March 19.
VA Secretary David Shulkin, MD, unveiled the API pledge March 9 at the HIMSS Annual Conference & Exhibition in Las Vegas. An initial 11 providers signed on to the initiative during the conference.
Under the pledge, providers commit to collaborating with the VA to advance EHR interoperability through the Fast Healthcare Interoperability Resources standards framework.

6 EHR pitfalls physicians should watch out for to avoid 'legal misadventures'

Written by Brian Zimmerman | March 19, 2018 | Print  |
While the integration of EHRs into America's health system aimed to advance the practice of good medicine and improve patient safety, the technology's rapid adoption occurred with little insight from providers, causing unforeseen shortcomings that have compromised productivity and the patient-physician relationship, according to a commentary article published March 7 in Anesthesiology News.
In the commentary, Peter Papadakos, MD, a professor in the department of anesthesiology at the University of Rochester (N.Y.) Medical Center, argued the implementation of EHRs was mainly carried out to aid in the transition from the fee-for-service model to value-based care, rather than to optimize productivity. Dr. Papadakos believes the key to resolving these issues is provider education.
"Medical providers at all levels need to gain exposure to digital training along with their traditional education in pharmacology, physiology and physical diagnosis," Dr. Papadakos wrote. "Human-to-technology interfacing should have a major role in training providers to recognize, evaluate and correct faults in computer records, guarding against errors and increasing patient safety, which could prevent legal misadventures."

ECRI Institute, Pew, 2 others to launch National Health IT Safety Collaborative

Written by Jessica Kim Cohen | March 20, 2018 
Four advocacy organizations penned a letter March 14 to the ONC and HHS' Agency for Healthcare Research and Quality to request support for their joint National Health IT Safety Collaborative.
In their letter, the ECRI Institute, the Alliance for Quality Improvement and Patient Safety, the Bipartisan Policy Center, and The Pew Charitable Trusts highlighted their decision to establish a national health IT organization, the National Health IT Safety Collaborative, to improve the use and safety of health IT.
The four organizations requested in the letter ONC and AHRQ send agency representatives to participate in the collaborative.

HIT Think How finding a champion is key to a successful implementation

Published March 21 2018, 5:20pm EDT
Hospital staff and executives often sit through meetings where important tasks are discussed, but when it comes time to delegate the work or follow-up afterward, things get lost in the shuffle, particularly in an emergency department.
However, during an EHR implementation, those leading the implementation cannot afford to get lost. They need to be focused, stay driven and keep up with the timeline for the go-live date.
But how do leaders keep a department full of busy clinicians on schedule and on task? By doing two things—finding champions, and facilitating clear, constant communication.

Virtual reality enables 3D view of anatomy before surgery

Published March 20 2018, 7:22am EDT
Interventional radiologists at Stanford University Medical Center are using visualization software from EchoPixel that turns 2D CT scans into 3D images so they can virtually view patents’ unique arterial anatomy to help them prepare for endovascular repair of splenic artery aneurysms.
According to Zlatko Devcic, MD, a fellow of interventional radiology at Stanford University School of Medicine, splenic artery aneurysms—a rare and life-threatening clinical disorder—have complex anatomy that require meticulous pre-procedure planning.
“Treating splenic artery aneurysms can be very difficult because of their intricate nature and anatomic variations from patient to patient,” says Devcic. “This new platform allows you to view a patient’s arterial anatomy in a three-dimensional image, as if it is right in front of you, which may help interventional radiologists more quickly and thoroughly plan for the equipment and tools they’ll need for a successful outcome.”

Trump opioid plan calls for interoperable exchange of prescription data

Published March 20 2018, 7:16am EDT
President Trump on Monday announced a wide-ranging policy initiative aimed at confronting the forces of supply and demand that are fueling the country’s opioid epidemic, including cutting nationwide opioid prescription fills by one-third within three years.
In an effort to reduce demand and over-prescription, the Stop Opioids Abuse and Reduce Drug Supply and Demand initiative calls for leveraging federal funding opportunities related to opioids to “ensure that states transition to a nationally interoperable Prescription Drug Monitoring Program (PDMP) network.”
PDMPs are electronic databases that help states track controlled substance prescriptions by flagging suspicious patient prescribing activities. Last year, the President’s Commission on Combating Drug Addiction and the Opioid Crisis called for more data sharing among state-run PDMPs, charging that these databases are being significantly underutilized in the vast majority of states.

Opioid plan offers hope that docs may get real-time prescription info

Published March 21 2018, 7:29am EDT
The new Trump administration program to fight the opioid crisis is suggesting a constructive data-based approach to monitoring problematic prescriptions through its proposal for a national prescription drug monitoring network, says the head of Health IT Now, an industry coalition.
“Instead of tinkering around the edges with tweaks to our existing Prescription Drug Monitoring Program, the White House’s opioid plan looks to be taking a bolder stance: embracing our proposal for a new nationwide interoperable prescription safety alert system,” says Joel White, executive director at Health IT Now, representing patient, provider, employer and insurance organizations seeking incentives to use health information technologies to improve care and outcomes.
The nationwide initiative complements the role of PDMPs “while addressing troubling blind spots in the current system to deliver real-time information to clinicians at the point of care,” White says.

Biden takes issue with Trump administration's interoperability plans

The MyHealthEData Initiative, announced by CMS' Seema Verma at HIMSS18, is too light on detail to make much of a difference, said the former VP – who offered his own way forward.
March 19, 2018 04:44 PM
A new commentary from former Vice President Joe Biden says interoperability roadblocks have been standing for far too long – and that the Trump administration's current plans to fix the problem are insufficient.
Writing for Fortune, Biden alluded to HIMSS18, where Centers for Medicare and Medicaid Services Administrator Seema Verma unveiled the MyHealthEData Initiative, which aims to make patients a lynchpin of data exchange improvements, and where White House Advisor Jared Kushner said President Donald Trump is "is determined to make interoperability a reality for all Americans."

The biggest security challenges in working with third-party vendors, and how to avoid them

Cybersecurity experts offer valuable advice on dealing with third parties because while a third party may be responsible for a breach, it's the healthcare organization that is accountable.
March 19, 2018 02:23 PM
Healthcare continues to come under attack from cybercriminals looking for easy pickings. And one of the weak links in the healthcare chain is connections to third-party vendors that hackers can exploit to break into hospital networks.
So what can healthcare information security teams do to protect against penetration through third parties? Cybersecurity experts point out the specific vulnerabilities and offer a variety of suggestions for actions to be taken.
Although the third-party challenges to a healthcare provider around cybersecurity tend to be vast, there are several prevalent, top-of-mind and significant challenges currently within the industry, said David Stanton, a managing director and a cybersecurity expert at Protiviti, a global consulting firm.

HIT Think How healthcare security efforts can incorporate sophisticated tech tools

Published March 20 2018, 5:48pm EDT
Information technology staff for hospitals and other healthcare providers must regularly give their cybersecurity practices thorough reviews to keep them abreast of the latest security challenges.
In its annual study on privacy and security of healthcare data, Ponemon Institute reported that almost 90 percent of healthcare organizations have been breached. Potentially more alarming is that the average cost of each data breach for a healthcare provider is $2.2 million.
In 2018, most industry observers predict that cyberattacks will become increasingly sophisticated, more pervasive and costlier. Underscoring this point is a recent Deloitte survey of 370 medical device professionals, which found that more than a third had experienced a cybersecurity incident in the last 12 months, and that the regularity of such incidents is expected to increase.

EHR data helps predict opioid use

Published March 19 2018, 7:31am EDT
A prediction model leveraging electronic health record data could be used to help providers identify hospitalized patients who are at highest risk of progressing to chronic opioid use after they’re discharged from the hospital.
Researchers at the University of Colorado Anschutz Medical Campus, who developed the model using patient data from the Denver Health Medical Center, say the model could be integrated into the EHR and activated in the form of an alert when a physician orders opioid medication, informing the doctor of their patient’s risk for developing chronic opioid use.
“The goal was to identify who these patients were to let providers know at the time of care that these patients are at higher risk, so they think twice before they prescribe an opioid or think about other ways to manage their pain in the hospital setting,” says Susan Calcaterra, MD, a fellow in addiction medicine at the CU School of Medicine and lead author of a study published last month in the Journal of General Internal Medicine.

Thinking of trying a blockchain project? Here are some must-do first steps

As healthcare organizations start to dip their toes in the waters of distributed ledger technology, the COO of Hashed Health offers advice about doing it right.
March 19, 2018 10:12 AM
Blockchain is no longer the far-out and inscrutable mystery it once was. More and more healthcare professionals are starting to understand how it works – and how it can work for them.
"They're beginning to understand the technical questions around it, which is fundamentally about shared infrastructure," said Corey Todaro, chief operating officer at Nashville, Tennessee-based blockchain company Hashed Health.
At its core, blockchain is about networks: "Enterprises jointly share and operate transactional infrastructure, and they do so for a value proposition," Todaro explained at HIMSS18.

Hospital leans on machine learning to reduce sepsis-related mortality rate

Cabell Huntington Hospital also diminished the average sepsis-related hospital length of stay with machine learning-generated clinician alerts.
March 16, 2018 03:57 PM
Last year, Cabell Huntington Hospital faced sepsis head-on and came out on top. Implementing machine learning technology specifically designed to fight sepsis in part through clinician alerts, the organization saw the sepsis-related in-hospital mortality rate was 33.5 percent lower during the post-implementation period and the average sepsis-related hospital length of stay was 17.1 percent lower during the same period. Analyses included 2,298 adult patients in the emergency department and intensive care unit.
Through an ongoing review of internal data, it appears that InSight clinical alerts, from machine learning vendor Dascena, and clinical documentation/coding of sepsis are showing an increased correlation, said Hoyt J. Burdick, MD, chief medical officer at Cabell Huntington Hospital.
“Of course, this phenomenon is not just dependent on the machine logic alerting, but is also subject to clinician education, documentation, coding and billing variables,” he explained. “But since we only recently began to adjust some of the machine logic parameters, it seems more likely that the clinicians are more confident in making diagnoses and decisions based upon the improved alerts.”

Federal prosecutors warn of fraud risks for health IT

Mar 16, 2018 8:30am
As more startups enter the healthcare space, health IT companies that aren't aware of the industry's unique fraud and abuse laws could draw the ire of investigators and face steep penalties, according to two federal prosecutors.
With an influx of new companies testing the waters of healthcare, navigating fraud regulations can mean the difference between a successful business model and a prison sentence, the officials with the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) told audience members during a session at the HIMSS annual conference in Las Vegas.
What passes for an innocuous gimmick in one industry—a gym that offers a $25 credit for members who refer a friend, for instance—could lead to civil or criminal charges for companies and executives that work with providers. 

Mortality risk model combines EHR data, language processing to account for frailty

March 16, 2018 | Anicka Slachta
Applying natural language learning and deep neural networks to mortality risk models could help predict cardiovascular outcomes with more accuracy than modern support vector machines, researchers said at the 67th annual American College of Cardiology conference in Orlando.
In an effort to represent heart patients more wholly and predict postoperative outcomes after major cardiovascular procedures, Yijan Shao, PhD, and colleagues designed a risk model that used electronic health record (EHR) data to estimate frailty—a factor crucial to the care of elderly patients but one that’s frequently unaccounted for.
Death after major cardiovascular procedures is common among older patients, Shao said, but frailty isn’t taken into consideration in clinical prediction models.

Washington waking up to threats of AI with new task force

Elon Musk has been one of the few Silicon Valley luminaries to place intense attention on the potential dangers of AI, raising a billion dollars with Y Combinator’s Sam Altman to found OpenAI . Musk has continued the drumbeat on AI’s dangers, telling a crowd at SXSW this week that “A.I. is far more dangerous than nukes” and asking “So why do we have no regulatory oversight? This is insane.”
Well, the wheels of Washington are turning, and DCers are starting to investigate the opportunities and challenges that AI poses to the nation. Today, the Center for a New American Security (CNAS), one of America’s top defense and foreign policy think tanks, announced the creation of a Task Force on Artificial Intelligence and National Security, as part of the organization’s Artificial Intelligence and Global Security Initiative.
The task force will be co-led by Andrew Moore, the current dean of Carnegie Mellon University’s School of Computer Science, and Robert O. Work, who was deputy defense secretary from 2014-2017 and formerly CEO of CNAS.

HIT Think Why AI is securing a stronger foothold in radiology

Published March 19 2018, 4:57pm EDT
It’s clear that artificial intelligence is continuing to stake territory in radiology, and professionals are looking to incorporate the technology in helping them deliver care.
For the first time at this month’s European Congress of Radiology, there was a dedicated section of the Expo for AI—the Artificial Intelligence Future Lab. There were also a handful of medical imaging AI companies dotted around the main exhibition halls, and most of the major vendors found an angle to add AI to their booths.
From walking the exhibition floor, it’s clear that AI continues to make inroads into medical imaging and the pace of technology commercialization is accelerating.

Friday, March 30, 2018

A Few Tips On Escaping The Facebook Ecosystem And Keeping Some Personal Privacy.

This appeared a few days ago:

How to protect your privacy

Social media users are rushing to lock down their privacy settings.
  • The Australian
  • 12:00AM March 22, 2018
Chris Griffith

It’s time to thoroughly check the data you entrust to Facebook and, through it, to connected apps. Whenever we open an app using our Facebook credentials, there is the likelihood we have shared our Facebook personal information with the app’s developer.

Personal data can flow the other way too, from apps we have interacted with into Facebook.

The scariest part is when you have nothing to do with the data flow — when you are the friend of someone who on Facebook loves quizzes, or those mad graphics apps that construct a photo of you at 90, or nine months old.

That app may glean your personal information simply because your friend has authorised the app to access their friends’ data. Now let’s address this state of ­affairs.

In the Facebook smartphone app, press the three parallel lines icon, select Settings (iOS) or Settings Privacy (Android), Account Settings;Apps. You’ll see 4 headings under “Apps and Websites”.

Logged in with Facebook lists apps you access using your Facebook credentials. Press the icon at the right, and you’ll see a list of them. When you tap on each one, you’ll see the information you have inadvertently shared with these apps, such as your public profile, friend list, relationship status, work, education history and the rest. Just scroll to the bottom, and remove the app. Do that in each case.

Now choose the second heading Platform. These are apps that, somehow, you authorised to interact with your Facebook account – and its data. Under Apps and Websites select “Turn off Platform”. When activated, Facebook can receive information about your use of third-party apps and websites.

The third heading, Apps Others Use, lists personal information belonging to you that is available to applications, games and websites used by your friends. Uncheck all the categories, unless you want your friends to share your personal data with strangers.

You can also access the settings on a computer from your browser. On your Facebook website, go to app settings and select apps in the left-hand column.

This is just the start. You should revisit permissions that you give apps on your smartphone too. That includes who has access to your location, and the history of where you’ve been.
More tips here on handling the smartphone apps here:
I hope these tips are useful to help some to escape this pernicious privacy invasive social utility.
Baring amazing news this will be the last post until after Easter - except, of course, the overseas links. Enjoy the break and observe the season as you see fit with family and friends! I sure will.

Thursday, March 29, 2018

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

March 29, 2018 Edition.
I really can’t keep up. The Donald is becoming progressively more feral with firings, trade tariffs and appointment of very dangerous people to his inner circle. (John Bolton – the new National Security Adviser - was the neo-con who was one of those responsible for the erroneous WMD scare that led to the Iraq War and all that followed – ISIS etc.)
The effect of this man on Global Trade, China and ultimately Australia is just unknowable but reckon there is a real risk we could be badly hurt economically. Frankly the man is a global menace! I wonder how long for the US politicians notice and act to get rid of him?
Elsewhere both major parties in Australia are just crazy with rancid identity and class politics and are only outdone by the extremists and populists. Give me Hawke, Keating, Howard again please – or someone else with the leadership skills and political nous of those…we need stability and sanity to cope with what is coming I fear.
And today (as I type) the leadership group of the Australian Men’s Cricket Team have deliberately conspired to cheat in a Test Match in South Africa. The world has turned upside down!
Here are a few other things I have noticed.

Major Issues.

  • Mar 18 2018 at 4:44 PM

Sydney, Melbourne housing boom is over auction clearance rates show

The Sydney and Melbourne housing boom is over as investors retreat further and sellers' price expectations continue to wind down.
Preliminary auction clearance rates, a proxy for how the housing markets fare week on week, were in the 60 per cent range for the two biggest housing markets last week, Corelogic data shows.
For the full week, Sydney's auctions cleared at a preliminary 67.8 per cent while Melbourne's clearance rate was 68.9 per cent.
  • Updated Mar 18 2018 at 11:00 PM

Labor's dividend imputation policy unfairly targets self-managed superfunds

by John Maroney
Labor's proposal to cancel cash refunds for excess dividend imputation credits is bad policy, unfairly targeting the self-managed superannuation fund sector on the false premise that it's only taxing the wealthy. The reality is Labor's proposal will hurt many SMSF retirees who have prudently saved for retirement, forcing them back to the drawing board to rethink – yet again – their investment strategies.
On our calculations, the median SMSF retiree earning about $50,000 a year in pension income will be out of pocket by about $5000. It's just semantics to tell these people, and we believe the number far exceeds Labor's estimate of one in three SMSFs, they won't be paying any more tax.
It's not just an issue of retirees losing income, important as that is. Once again politicians have decided to rewrite the super rule book; a system that requires stability is being turned on its head. Again. What is being neglected in this debate is the fact refundable franking credits have been a well-established bipartisan principle for nearly two decades, having been introduced on July 1, 2000 with Labor's support, and, accordingly, SMSFs in retirement phase have structured their investment and income strategies around this policy.
  • Mar 19 2018 at 10:31 AM

ASIC chairman James Shipton says finance needs to lift standards

Corporate regulator James Shipton has called on the financial industry to lift its standards of professionalism as the trust gap between the public and brokers, advisors, bankers has grown wider.
In his first speech since taking over at the corporate watchdog, the former Hong Kong regulator, Goldman Sachs banker and Harvard University academic said he would make it his mission to lift the standards of the industry, and his own organisation if necessary.
The Australian Securities and Investments Commission chairman pointed toward the creation of the Financial Advisers Standards and Ethics Authority as "a policy tool" to lift standards and said he was prepared to "pursue this approach again".

Why it’s finally time to ban mortgage broker commissions

By Jessica Irvine
18 March 2018 — 10:35pm
Something is rotten in Australia’s $1.6 trillion mortgage market. That is the inescapable conclusion of the explosive first week of hearings of the Turnbull government’s bank royal commission, which continue today.
In painstaking and meticulous detail, the commission’s Senior Counsel Assisting, Rowena Orr, continues to lay out case study after case study of proven misconduct, including bribery, forgery, fraud, fudging of figures, unacceptable delays and other assorted misdemeanours visited upon consumers of bank products.
The evidence is well and truly in that Australia’s once stately banking industry has been invaded by a toxic sales culture which has contributed to Australian households racking up some of the biggest debts in the developed world, and fuelling, in turn, higher house prices.

Crunching the numbers on global peace

By Matt Wade
18 March 2018 — 12:00am
What are the world’s most peaceful nations?
That's a question Steve Killelea - one of Australia’s biggest individual overseas aid donors – asked himself while visiting a war-torn region in the Democratic Republic of the Congo a bit over a decade ago.
He figured there must be things to learn from peaceful places that could help with the development projects he was supporting among conflict-ravaged communities.
“It’s a pretty simple question,” said the IT entrepreneur from Sydney.
“But I searched the internet and couldn’t find a thing.”

Stephen Hawking had pinned his hopes on 'M-theory' to fully explain the universe – here's what it is

By Lorenzeo Bianchi
16 March 2018 — 9:06am
Rumour has it that Albert Einstein spent his last few hours on Earth scribbling something on a piece of paper in a last attempt to formulate a theory of everything. Some 60 years later, another legendary figure in theoretical physics, Stephen Hawking, may have passed away with similar thoughts. We know Hawking thought something called "M-theory" is our best bet for a complete theory of the universe. But what is it?
Since the formulation of Einstein’s theory of general relativity in 1915, every theoretical physicist has been dreaming of reconciling our understanding of the infinitely small world of atoms and particles with that of the infinitely large scale of the cosmos. While the latter is effectively described by Einstein’s equations, the former is predicted with extraordinary accuracy by the so-called Standard Model of fundamental interactions.
After his degenerative muscle disorder was diagnosed, the British theoretical physicist defied medical opinion by living five decades longer than expected.

Memorable quotes from Stephen Hawking

14 March 2018 — 3:55pm
London: Eminent professor and author Stephen Hawking, who has died aged 76, captured the public's imagination as a trapped mind exploring the boundaries of scientific knowledge.
Here are some memorable pearls of wisdom from one of the world's most famous scientists:
- On the reason why the universe exists: "If we find the answer to that, it would be the ultimate triumph of human reason - for then we would know the mind of God." - A Brief History Of Time, published 1988.
- On being diagnosed with motor neuron disease: "My expectations were reduced to zero when I was 21. Everything since then has been a bonus." - Interview in The New York Times, December 2004.

Immigration the cheap and nasty way to grow the economy

By Ross Gittins
18 March 2018 — 12:04pm
The ABC's temerity in hosting a debate about the merits of high population growth has drawn predictable ripostes from the economic establishment. Shades of the legendary note in the margin of a politician's speech: "shout here - argument weak".
There are at least four counts against the advocates of high immigration. First, their refusal to engage with the academic environmentalists arguing that we've exceeded the "carrying capacity" of our old and fragile land. Scientists? What would they know?
A bigger population requires a bigger government, with more debt.

Banks are digging themselves a deeper hole on trust

By Elizabeth Knight
20 March 2018 — 12:05am
At the same time as Australian Securities and Investments Commission’s new chair James Shipton delivered an address in Sydney on the need for the community to trust in the financial services sector, the royal commission in Melbourne was hearing from bank executives and customers about how this trust has been abused.
It was was weird disconnect.
No doubt Shipton was seizing the opportunity of the publicity and interest surrounding the banking royal commission into industry misconduct to increase the traction surrounding his first major address in the role.

Sydney house prices set to fall: Moody’s Analytics

  • The Australian
  • 12:41PM March 19, 2018

Elizabeth Redman

Sydney house prices are likely to fall 4.2 per cent this year and are overvalued after a period of constrained supply and population growth that sent prices soaring, Moody’s Analytics said.
But the correction is tipped to be short-lived, with prices set to recover a modest 0.9 per cent next year, the CoreLogic-Moody’s Analytics Australia Home Value Index Forecast found.
The prediction comes after some months of price falls in the heated Sydney market and a slowdown in most capital cities — with the notable exception of the more affordable Hobart — amid regulatory clamps on lending and buyer exhaustion.
  • Mar 20 2018 at 12:01 PM

High debt, weak wages leave RBA on 'different track' to US Fed

High household debt and the lack of a "definitive pick-up" in wages growth were key reasons the Reserve Bank of Australia left the official cash rate steady this month, putting it on a "different" trajectory to the US Federal Reserve, according to Treasurer Scott Morrison.
In another sign monetary policy is to remain stalled in 2018, minutes of the Reserve Bank board meeting two weeks ago said there would need to be faster wage growth before inflation gathers strength.
The official cash rate has been stuck at a record-low 1.5 per cent since August 2016, a record run of policy stability in the inflation-targeting era that began in the early 1990s.

Government winds back marine protections to support fishing industry

By Nicole Hasham
20 March 2018 — 7:13pm

Talking points

  • Former prime minister Tony Abbott began the marine mark overhaul, reportedly saying he did not want to “lock up our oceans”.
  • Labor says a sustainable future for commercial fishing was entrenched in the original plan.
  • Opponents of the changes say the government is pandering to recreational fishers, of which there are more than 3.5 million in Australia.
The Turnbull government will strip back highest-level protections in a host of sensitive marine areas, including critical waters near the Great Barrier Reef, saying it is protecting the environment while supporting fishing and tourism.

Are banks irresponsible about responsible lending?

By Elizabeth Knight
21 March 2018 — 12:05am
How many times do banks have to inadvertently breach the laws governing responsible lending before they can be reasonably accused of having a culture of carelessness about their customers?
We are only in week two of the royal commission but a clear pattern is emerging from banks that their focus on responsible lending is coming up short.
On Tuesday, the commission heard that for four years the Commonwealth Bank failed to detect a computer programming error that wrongly assessed the ability for customers to afford overdrafts.
  • Mar 21 2018 at 11:10 AM

Ten things to know about markets in volatile times

by Mohamed El-Erian
As the Nasdaq endures its longest string of daily losses since November 2016, and with other stock indexes also under pressure, there is a notable sense of unease among investors who believed until recently that sell-offs were very limited in duration, of small magnitude, and quickly reversible.
Now, markets suddenly seem less confident about their ability to shrug off political factors.
They also appear more vulnerable to contagion from company-specific news such as Facebook's apparent entanglement in questionable political-messaging practices.
There are also significant realignments that result in these 10 issues:
  • Updated Mar 21 2018 at 5:29 PM

Little evidence to support ACTU wage claims: economists

The casual war
Claims by ACTU secretary Sally McManus businesses are denying workers their "fair share" of company profits aren't supported by official data, say economists who warn against a slide back to combative 1970s style analysis of the labour market.
"This old attitude is that if business is winning, then it's at the expense of employees," says Stephen Walters, chief economist at the Australian Institute of Company Directors.
"It's a good battle cry but it's not the reality of the modern workplace."

Who's telling the truth about casual workers in Australia

By Jessica Irvine
21 March 2018 — 5:02pm
Amid record low wages growth, industrial relations has emerged as a key battleground for the next federal election.
The first skirmish has erupted this week with a debate over the degree of casualisation in the Australian workforce.
Launching the union movement’s “change the rules” campaign on Wednesday, union boss Sally McManus made the claim that: “Casual work has increased”.

Employment grows as jobless rate rises to 5.6pc in February

  • James Glynn
  • Dow Jones
  • 11:31AM March 22, 2018
Australia’s economy remained a steady engine for job creation in February, with a further 17,500 jobs added during the month.
The country’s unemployment rate rose to a higher-than-expected 5.6 per cent during the month from 5.5 per cent in January, according to government data.
Economists had expected an unemployment rate of 5.5 per cent in February.
  • Updated Mar 23 2018 at 8:08 AM

Lot of bad policy and bad politics in the past 15 years

Down at the Parliament House coffee shop, Aussies, on Wednesday, the day-to-day humdrum of politics was playing out amid the ruckus of passing schoolchildren, who seemed blissfully oblivious to the machinations over company tax cuts unfolding before their eyes.
At one table, the ACTU were deep in discussion with Glenn Druery, the man known as "the preference whisperer" who is now advising Senator Derryn Hinch.
At another table, Council of Small Business chief executive, Peter Strong was checking his phone between talking to passing senators.

Expensive money: Why the RBA may not raise rates any time soon

By Andreea Papuc and Stephen Spratt
Updated23 March 2018 — 9:38amfirst published at 9:15am
There's fresh reason to think that the Reserve Bank of Australia, as Treasurer Scott Morrison anticipates, may not be raising interest rates anytime soon.
Short-term borrowing costs in Australia's financial system have been surging, and will tighten financial conditions if it lasts, even without action by the central bank's policy makers.
The jump in a key benchmark, the three-month bank-bill swap rate, has been something of a head scratcher, though most explanations centre around the impact of overseas dynamics:

Revealed: the powerful Facebook data matching tool the Liberal Party rejected over legal fears

By John McDuling & Fergus Hunter
23 March 2018 — 7:37pm
Facebook approached Australia's major political parties during the 2016 election with a new and powerful data matching tool, but Liberal strategists rejected the offer out of fear it could breach the law by sending voters' personal details to the social media giant's offshore servers.
The opportunity for "advanced matching" in Facebook's so-called Custom Audience feature could be used by campaigns as a way to target specific people - including undecided voters in marginal seats - with highly targeted online advertising.

Australia's worst nightmare: to be caught in cross fire of trade war

By Kirsty Needham & Darren Gray
23 March 2018 — 5:59pm
Beijing: Australia's great fear of a trade war breaking out between its largest trading partner and closest security ally is unfolding, as China and the United State exchange threats and release multi-billion dollar punitive tariff plans targeting each other.
After US President Donald Trump signed a document to trigger $US60 billion ($A78 billion) in tariffs on Chinese technology products, China responded within hours with a $US3 billion plan to hit 128 US products including pork, fruit, nuts, wine and steel.
Wine importer Treasury Wine Estates, which brings Californian wine into China, is among the Australian companies likely to be caught in the immediate crossfire of a US and China trade battle. But experts say the bigger risk to the Australian economy is a breakdown of global trading rules.

Labor, unions risk awakening a political beast

  • The Australian
  • 12:00AM March 24, 2018

Paul Kelly

Australia’s progressive alliance — Labor and the trade unions — keeps getting more radical and making more risky bets that the Australian public will follow it.
ACTU chief Sally McManus issued an extreme and naive agenda for workplace transformation this week. The ACTU activist “change the rules” campaign threatens to miss the mark entirely and overreach in a threat to jobs, investment and growth.
This follows Labor’s imputation credits policy the previous week that creates a large number of losers and many problems arising from intended and unintended consequences.

What if we have got it wrong on Alzheimer's?

By Liam Mannix
23 March 2018 — 11:29am
Science is about getting it wrong, until you get it right. What if we're refusing to admit we're wrong about a horrifying disease?
"The hard but just rule is that if the ideas don't work, you must throw them away," wrote astronomer Carl Sagan.
But when your career and everything you’ve ever worked for is on the line, admitting you might be wrong is very hard to do.

Former privacy chief lambasts 'incredibly secretive' political parties

By Nicole Hasham
Updated 24 March 2018 — 5:27pm first published at 4:58pm
Former federal Privacy Commissioner Malcolm Crompton has blasted Australia’s major political parties as “incredibly secretive” about the information they gather on voters and suggested their exemption from privacy laws is indefensible.
His comments come after Fairfax Media revelations that Facebook approached the major parties before the 2016 election, offering a new and powerful data-matching tool, and that Labor used the technology.
Scrutiny of the use of personal information by data analytics has intensified following claims Cambridge Analytica improperly harvested Facebook data to target American voters.

National Budget Issues.

A free kick for Libs: battlers the losers in Labor’s franking debacle

  • The Australian
  • 12:00AM March 17, 2018

Alan Kohler

Frankly, this is Labor’s Work­Choices.
Why bother to save for my own retirement? It’s just a piggy bank for politicians to raid.
— Talkback radio caller this week.
The franking credits cash refund crackdown may be Bill Shorten’s and Chris Bowen’s first big mistake.
For months, they’ve just had to sit back and watch the show on the other side. The banking royal commission has got off to a cracking start — and a humiliating one for the banks and for the Coalition that opposed the ALP’s push for it for so long and then grudgingly agreed.

Crackdown on black economy could yield $6bn: KPMG

  • The Australian
  • 12:00AM March 20, 2018

Adam Creighton

Cracking down on the black economy could save almost as much as Labor’s plan to wallop self-funded retirees by removing full cash refunds for franking credits, based on new research published by KPMG today.
The report says the federal government could “conservatively” raise an extra $5.8 billion from the black economy — which includes legal and illegal activity — estimated at $32bn a year. Labor expects to raise about $5.9bn from its policy to increase tax on shareholders, announced last week.
“At a time when other revenue measures are struggling for bipartisan support, the proposed crackdown on the black economy is more likely to gain passage through the Senate, generating much-needed additional revenue for budget repair,” said Grant Wardell-Johnson, a KPMG partner at the Economics and Tax Centre.

How your age affects your tax bill

By Ross Gittins
21 March 2018 — 12:05am
Talk about missing the point. The media spent all last week working themselves into a lather over Labor's newly announced policy to abolish cash refunds for unused dividend imputation credits. (If you have no idea what that means, it probably wouldn't affect you.)
This promise would be terribly unfair to dirt-poor self-funded retirees, we were told. And it was utter stupidity for Bill Shorten to drop such a monumentally unpopular proposal in the last week of the Batman byelection, which he was now safe to lose.
Except, of course, that Labor won comfortably, with little sign the policy had much effect.
March 22 2018 - 8:00AM

Department of Home Affairs plans new tax on parcels being posted to Australia

·         Eryk Bagshaw
Australian shoppers would have to pay a $5 tax on every parcel posted from overseas under a federal government plan to cover skyrocketing security screening costs. 
Parcels containing purchases like clothing, makeup and books worth less than $1000 - which now represent 90 per cent of deliveries entering Australia - would attract the new tax.
The Department of Home Affairs proposal will provoke opposition from online retailers like eBay and Amazon, as well as delivery providers who have warned the full cost would passed on to consumers already preparing to pay GST on small online purchases from July 1.

The best case for the company tax cut just isn't that good

By Peter Martin
21 March 2018 — 7:23pm
What’s the best case for a cut in the company tax rate? It’s that we’ll be better off and earn higher wages, eventually.
The modelling published by the Treasury looks at what will happen in the long term, after the company tax rate has inched down from 30 to 25 per cent and everything has settled. That could be in 10 years' time, or it could be in 20.
It produces a one-off change, rather than an annual change. So, in the modelling first published by the Treasury after-tax wages would eventually be 0.43 per cent higher than they would have been. With wage rates at present growing by 2 per cent a year, it’s four months' worth of wage increases, delivered well into the future.
  • Updated Mar 23 2018 at 6:32 PM

Budget deficit almost halved in just two months as tax revenue surges

The Federal budget has improved by almost $10 billion in just two months, creating a war chest for the Turnbull government's pre-election income tax cuts, affectively halving this year's deficit, and potentially allowing it to announce an early return to surplus.
However, it is understood the government is very unlikely to bring forward its first surplus from 2020-21 to avoid repeating the dashed promises of both the former Labor government and the early years of the Coalition's time in office.
Finance Department figures released on Friday suggest the trend towards narrower-than-expected deficits that started 18 months ago has not only become entrenched, but is now accelerating.

UK-style bank tax possible as economy funds extra income tax cuts

By Peter Martin
23 March 2018 — 6:36pm
A UK-style bank tax is emerging as a compromise that might get the Turnbull government’s proposed company tax cuts through the Senate.
The tax, announced by the Britain’s Conservative government in 2015 along with a program of cuts in the broader company tax rate, added 8 percentage points to the rate for banks, meaning that when the company tax rate was 20 per cent, banks were taxed at 28 per cent, and that when the company tax rate is cut to 17 per cent in 2020 banks will pay 25 per cent.
It replaced a lower and differently calculated levy on bank balance sheets along the lines of the one introduced by the Turnbull government in the 2017 budget.

How yesterday's spending could ruin tomorrow's budget

By Mark Kenny
24 March 2018 — 2:05pm
As the Senate crossbench wrestles with the fiscal implications of slashing company tax, a separate argument rages over whether to reverse a piece of past generosity of similar scale – giving tax “refunds” to individuals for tax they didn't pay.
The juxtaposition of the two fights - company tax and dividend imputation reform - gives us a glimpse of the budgetary future if we see how today’s shortfall arose from past decisions.
Labor’s proposed cancellation of dividend imputation, or franking, credits has its roots in events more than a decade ago.

Health Budget Issues.

UV confusion: Most Australians don't know when they need sun protection

By Esther Han
18 March 2018 — 7:29pm

In numbers

·         Australians who know they need sun protection when UV levels are 3 or above 8%
·         Australians who mistakenly thought temperature was a useful way to tell their risk of sunburn for the day 24%
·         Number of Australians projected to die from melanoma this year 1905
It's the sunburnt country, but an astonishing 92 per cent of Australians do not know they need to start protecting themselves from the sun's harsh rays when the UV level reaches three or above, new Cancer Council research shows.

$1m Medicare bonus but health group still in the red

  • The Australian
  • 12:00AM March 20, 2018

Sean Parnell

A prominent Queensland health group under investigation for fraud changed its name after ­experiencing financial problems and was banking on a $1 million Medicare bonus to clear tax and superannuation debts.
But, according to documents filed in the Supreme Court, debts remained even after Caboolture Community Medical received the $1,059,775 Practice Incentive Payment in February last year, leading one of the directors to ­allege company money was being diverted for private use.
Caboolture Community Medical was formerly known as the Murri Health Group and has been under investigation for ­alleged Medicare fraud since at least 2014. It services Aboriginal communities and has medical and dental clinics using Medicare funding, government grants and charity.

HIV drug PrEP price slashed by subsidy

9:13am Mar 21, 2018
People at risk of HIV will save hundreds of dollars from next month with the price of a preventative drug slashed.
Pre-Exposure Prophylaxis (PrEP) is a daily drug recently recommended for listing on the Pharmaceutical Benefits Scheme.
It is 99 per cent effective in preventing the transmission of HIV among gay and bisexual men, and from April will be available to high-risk general patients for $39.50 a monthly script, with concessional patients to pay $6.40.
Without the $180 million government subsidy patients would have paid nearly $2500 a year.

Federal Labor launches campaign for hospital funding agreement that will hand WA $14 billion

EXCLUSIVE, Sarah Martin, Federal Political Editor | The West Australian
Wednesday, 21 March 2018 11:38AM
Federal Labor will today launch a campaign promising to fix the country’s hospitals, taking aim at a national hospital funding deal that has been accepted by WA Premier Mark McGowan.
Opposition Leader Bill Shorten said the funding agreement, which will give WA $14 billion for public hospitals from 2020 to 2025, will short-change the State by $77 million — equal to 115,000 emergency department visits.
Nationally, Labor says its commitment to fund 50 per cent of hospital spending is $715 million more over five years, compared with the Fed-eral Government’s pledge to fund 45 per cent of the budget.

Thousands of back pain sufferers given 'harmful' treatments

By Liam Mannix
21 March 2018 — 7:29pm
Hundreds of thousands of Australian back pain sufferers are being given harmful or useless treatments, leading researchers say, prompting them to make an extraordinary plea to protect the public.
Thirty-one of the world’s leading back pain researchers have published a call to action in medical journal The Lancet saying lower back pain is being mistreated on an enormous scale.
Doctors regularly prescribe addictive opioids and potentially harmful treatments including spinal fusion surgery, despite there being little evidence these treatments work, they say.

Health fund group slams Victorian Royal Women’s Hospital for private patient charges

  • The Australian
  • 12:00AM March 21, 2018

Sarah-Jane Tasker

The peak body for not-for-profit health funds has hit out at the Victorian Royal Women’s Hospital for raising accommodation charges for private patients by up to 18 per cent this year.
Matthew Koce, chief executive of Members Health, said prices had been rising over the past five years, lifting the cost for room categories by up to 211 per cent.
Data collated by Members Health — the peak body for 24 not-for-profit health funds — showed that over the past five years, prices for stays of up to 14 days in advanced surgical, surgical, obstetric and medical room categories had increased by ­between 132 per cent and 165 per cent. Stays of more than 14 days had increased by as much as 211 per cent for ­advanced surgical.

Private health insurance needs reform to survive

  • Gerard Fogarty
  • The Australian
  • 12:00AM March 22, 2018
It’s an awful thought: is there a point where Australia’s private health system collapses because not enough people are insured?
About 12 million Australians have some form of private health insurance, but the industry is under duress as seldom before despite the government’s recent attempt at reform.
The nub of the problem is simple: affordability.

Medical college limits on training places hit patients

  • The Australian
  • 12:00AM March 24, 2018

Sean Parnell

Thousands of medical graduates are at risk of being locked out of specialist medical colleges, ­despite a critical need to address nationwide shortages in the disciplines with some of the longest waiting times and highest out-of-pocket expenses.
An increasing number of ­graduates are caught in bottlenecks caused by a lack of specialist training positions, and the problem appears worse in the professions where the ramifications of supply constraints are well known.
An analysis by The Weekend Australian has highlighted three specialties — ophthalmology, ­orthopaedics and otolaryngology (ear, nose and throat) — that have excessive wait times for elective surgery and high gap fees. They have also drawn recent scrutiny as to whether certain services, including cataract surgery and knee procedures, are being performed too often in some areas and not enough in others.

Dentists seek political support in resisting intrusion by insurers

  • The Australian
  • 1:00AM March 24, 2018

Sean Parnell

Dentists are lobbying the major political parties to support patient savings accounts in an effort to limit the influence of health insurers on the industry.
Behind the controversy over continuing changes to hospital cover, some insurers have been taking a tighter rein over the benefits they pay dentists under general treatment or “extras” cover.
Australia’s largest insurer, Bupa, has taken the lead in this area, not only contracting dentists but buying dental networks in an effort to provide certainty of costs and treatment to members.

International Issues.

  • Updated Mar 18 2018 at 12:10 PM

Donald Trump attacks FBI and his lawyer says Russia probe must end

President Donald Trump escalated his assault on federal law enforcement agencies over the weekend while one of his attorneys argued that the controversial firing of a top FBI official was reason to end the Justice Department special counsel's expansive Russia investigation.
After Attorney General Jeff Sessions acted late Friday night on Trump's publicly-stated wishes to terminate former deputy FBI director Andrew McCabe - just hours before he was set to retire with full benefits - the president celebrated the ouster as a triumph that exposed "tremendous leaking, lying and corruption" throughout law enforcement.
The move emboldened McCabe, who said in a public statement that his dismissal was a deliberate effort to slander him and part of an "ongoing war" against the FBI and the Russia probe being led by special counsel Robert Mueller III.

Republicans defend Russia probe as Trump openly attacks Mueller

19 March 2018 — 3:16am
Washington: Republican senators warned US President Donald Trump on Sunday against firing Special Counsel Robert Mueller and said he must let federal investigators looking into Russian meddling in the US election do their jobs.
The Republican President renewed his Twitter attacks on both the Federal Bureau of Investigation (FBI) and Mueller's probe since the firing on Friday of the bureau's deputy director, Andrew McCabe, days before he was eligible to retire with a full pension.
Republican Senator Jeff Flake said it appeared the President's latest comments were aimed at the firing of Mueller.

Putin easily wins another six-year term, firms grip on Russia

By Vladimir Soldatkin
Updated 19 March 2018 — 7:22am  First published at 5:47am
Moscow: Vladimir Putin has claimed victory after cruising to re-election, with authorities reporting high voter turnout in balloting that was widely expected to bring the Russian president a fourth term.
Putin thanked voters for their support at a victory rally in Moscow and said Russia had a great future ahead of it provided its people stayed united.
Russian President Vladimir Putin won re-election on Sunday, extending his rule for another six years at a time when his ties with the West are on a hostile trajectory.

Trump shakes off the shackles and says what he really thinks

By Maggie Haberman
19 March 2018 — 1:28pm
Washington: For months, US President Donald Trump's legal advisers implored him to avoid so much as mentioning the name of Robert Mueller, the special counsel, in his tweets, and to do nothing to provoke him or suggest his investigation is not proper.
Ignoring that advice over the weekend was the decision of a President who ultimately trusts only his own instincts, and now believes he has settled into the job enough to rely on them rather than the people who advise him.
A dozen people close to Trump or the White House, including current and former aides and longtime friends, described him as newly emboldened to say what he really feels and to ignore the cautions of those around him.

Aung San Suu Kyi: fallen lady has no good answers

By Peter Hartcher
20 March 2018 — 12:05am
It's the quiet genocide. That's partly because the government of Aung San Suu Kyi bans the media and the UN from any access to the area of Myanmar where the army has been killing and purging the Rohingya minority.
It's partly because in the West the political right doesn't want to make too much fuss about a pogrom against Muslims. It's partly because the political left in the West is still in lovelorn bewilderment at the shocking transformation of their fallen angel.
The woman who won the Nobel Peace Prize when she was the victim of the Myanmar army's repression has become its chief apologist.

No retreat for Vlad the prevailer

By Henry Meyer
19 March 2018 — 3:23pm
Moscow: Vladimir Putin has cruised to a landslide victory in Russia's presidential vote, extending his 18-year rule amid escalating confrontation with the West.
The Kremlin's longest-serving leader since Soviet dictator Joseph Stalin had almost 77 percent of the vote with about 99 percent of the ballots counted, putting him on track for a new six-year term. If he lasts his full term, he will have ruled Russia for 24 years, compared to Stalin's 30 years.
The results represented record support for Putin, who barely campaigned before Sunday's vote and faced no real competition in an election that even some of his seven rival candidates described as a farce.

How Cambridge Analytica harvested Facebook data, triggering new outcry

20 March 2018 — 7:33am
The New York Times report that a political firm hired by the Trump campaign acquired access to private data on millions of Facebook users has sparked new questions about how the social media giant protects user information.
Who collected all that data?
Cambridge Analytica, a political data firm hired by President Donald Trump's 2016 election campaign, gained access to private information on more than 50 million Facebook users. The firm offered tools that could identify the personalities of American voters and influence their behaviour.
Cambridge has been largely funded by Robert Mercer, the wealthy Republican donor, and Stephen K. Bannon, a former adviser to the president who became an early board member and gave the firm its name. It has pitched its services to potential clients ranging from Mastercard and the New York Yankees to the Joint Chiefs of Staff.

'It almost feels like espionage': what Facebook did to democracy

By Nick Miller
21 March 2018 — 8:19am
Has Cambridge Analytica intentionally broken democracy? Or is it just a good direct marketer which worked on a few elections?
Is all this fuss about CA the start of a backlash against the subversion of our political system by malevolent technological elites and oblivious social media behemoths, or is it just prim disgust with the political sausage machine from lifelong sausage eaters?
This is, as one political observer said to me, the “million-dollar question”. Which puts quite a cheap price tag on the integrity of Western politics.

'We made mistakes': Zuckerberg breaks silence

22 March 2018 — 7:00am
Breaking more than four days of silence, Facebook CEO Mark Zuckerberg has admitted mistakes and outlined steps to protect user data in light of a privacy scandal involving a Donald Trump-connected data-mining firm.
Mr Zuckerberg said Facebook had a "responsibility" to protect its users' data and if it failed, "we don't deserve to serve you".
Mr Zuckerberg and Facebook's No. 2 executive, Sheryl Sandberg, have been quiet since news broke Friday that Cambridge Analytica may have used data improperly obtained from roughly 50 million Facebook users to try to sway elections.
  • Updated Mar 20 2018 at 11:49 AM

Donald Trump seeks allies' support in trade campaign against China

The US will press foreign allies - including, possibly, Australia - to lean on China to cut steel overproduction and end pilfering of intellectual property, as the Trump administration seeks to counteract criticism that its protectionism risks igniting a global trade war.
Senior Trump administration officials, including Treasury Secretary Steven Mnuchin, are seeking to shift the blame to China for international trade tensions. Mr Mnuchin will meet with Australian Treasurer Scott Morrison at the Group of 20 meeting in Argentina this week.
The emerging US strategy seeks to build a global push back against China and was evident in remarks last week by President Donald Trump's new chief economic adviser, Larry Kudlow, a free trader who dislikes tariffs but wants to get tougher against Beijing.

China influence debate needs to calm down amid stigma

By Kirsty Needham
21 March 2018 — 11:06pm
Beijing: More than 30 China scholars in Australia, including world-renowned sinologist Geremie Barme, have urged the Turnbull government to delay its foreign influence legislation amid warnings that Chinese Australians are being stigmatised.
The Foreign Influence Transparency Scheme is a threat to intellectual freedom, the scholars say in an open letter, and wider public consultation is needed. But the tone of the debate on the issue also needed to be calmer, they wrote.
University of Sydney senior lecturer David Brophy said: “The idea that Australia’s sovereignty is threatened by a vast Chinese conspiracy has been a popular talking point in the debate around these new laws. We didn’t want parliament to debate the laws without knowing that many of Australia’s China experts reject this narrative. More than that, they see it as divisive and dangerous."

Global technology giants facing $8b tax on revenues from EU

By Tim Wallace
Updated 22 March 2018 — 11:03amfirst published at 11:00am
The world's biggest technology firms face an extra €5 billion ($7.95 billion) tax bill each year to operate in the EU as governments face "an ever-bigger black hole" in their finances.
Technology companies with global revenues of more than €750 million and EU revenues above €50 million face a charge of 3 per cent of those revenues.
It will target companies that make money from digital marketplaces, apps to share goods and services, and online adverts - which include social networks, search engines and retail sites such as Amazon.
  • Mar 22 2018 at 1:26 PM

Zuckerberg's latest hollow message shows it is time to forget Facebook

Zuckerberg promises changes after data scandal
It took a while, but Facebook founder and chief executive Mark Zuckerberg has finally peeped out at the world from behind his digital blinds and acknowledged the unholy mess his platform has enabled ... yet again.
In a rambling post, four days after Facebook tried to pretend it was on the front foot in the privacy battle by suspending shady British mood manipulators Cambridge Analytica (it was forced into action by pending news stories), Zuckerberg laid out some new rules for app developers and tried to suggest it had already fixed most of the problems that led to the scandal.
Like a serial abuser, his explanations were tinged with thinly veiled attempts to garner sympathy and position Facebook as the victim, by suggesting its innocent trust was betrayed by the quiz app developer Aleksandr Kogan and Cambridge Analytica. 

Trump’s $60b trade threat puts China’s 'helmsman' on the spot

By Steven Lee Myers
23 March 2018 — 8:53am
Beijing: For the better part of two decades, China's leaders have made the most of the global trade rules set by the United States and others, seizing on opportunities to bolster their nation's economic rise while finessing American complaints that they were not always playing fair.
Now, for the first time, China faces an American president who is embracing protectionist measures, and that has presented its leader, Xi Jinping, with an extraordinary challenge: Even as he has elevated his status as the country's "helmsman," with a new mandate to rule indefinitely, the US is moving to treat China more seriously as a strategic rival and to recast an economic relationship that has long bound the two countries.
The punitive actions unveiled by President Donald Trump on Thursday – about $US60 ($A77 billion) billion in tariffs a year and other penalties targeting Chinese goods, as well as new restrictions on Chinese investment in the United States – will put Xi on the spot, forcing him to consider retaliatory action that could send a shudder through the global economy and complicate his efforts to sustain China's rapid growth in the face of rising debt and an aging population.

'We'll fight to the end': China fumes as Trump slaps $60b-worth of tariffs on hi-tech imports

By Kirsty Needham
23 March 2018 — 7:37am
Beijing: China warned it would take action to defend its interests and was considering a World Trade Organisation complaint in response to punitive tariffs set to be imposed by the United States.
The Trump Administration will impose tariffs worth $US60 billion ($A78 billion) on Chinese goods – targeting technology products – restrict Chinese investments, and would file a WTO case.
A strongly worded statement from the Chinese embassy in Washington late on Thursday said Beijing does not want a trade war but will not recoil from one and "would fight to the end ... with all necessary measures".

Trump dumps McMaster, picks super-hawk Bolton as security advisor

By Mark Landler, Julie Hirschfeld Davis & Peter Baker
23 March 2018 — 9:41am
Washington: Lieutenant General H.R. McMaster, the battle-tested Army officer tapped as President Donald Trump's national security adviser last year to stabilise a turbulent foreign policy operation, will resign and be replaced by John Bolton, a hard-line former US ambassador to the United Nations, White House officials said Thursday.
McMaster will retire from the military, the officials said. He has been discussing his departure with Trump for several weeks, they said, but decided to speed up his departure, in part because questions about his status were casting a shadow over his conversations with foreign officials.
The US officials also said that Trump wanted to fill out his national security team before his meeting with North Korea's leader, Kim Jong Un. He replaced Secretary of State Rex Tillerson with CIA director Mike Pompeo last week.

Tariff exemption only temporary for Australia, new quotas introduced

By Peter Mitchell
23 March 2018 — 12:08pm
Los Angeles: President Donald Trump will slap import quotas on Australian steel and aluminium and the tariff exemption he granted Prime Minister Malcolm Turnbull may only be temporary.
US Trade Representative Robert Lighthizer and Mr Trump's policy adviser Peter Navarro offered new details on the tariffs on Thursday, US time.
Australia, Europe, South Korea, Canada, Mexico, Argentina and Brazil were named by Mr Lighthizer as the nations that will initially escape America's 25 per cent steel and 10 per cent aluminium tariffs, which come into force on Friday.
  • Updated Mar 24 2018 at 5:44 AM

President Donald Trump reluctantly signs federal government spending bill

by Julie Hirschfeld Davis and Michael D Shear
President Donald Trump signed a $US1.3 trillion spending bill into law on Friday (Saturday AEDT), avoiding a government shutdown that had suddenly become a possibility when the president vented on Twitter about his frustration with the bipartisan legislation.
The president backed down from his threat to veto the spending bill in a head-spinning four hours at the White House that left both political parties in Washington reeling and his own aides bewildered about Trump's contradictory actions.
Speaking at the White House, Trump placed his hand on a stack of budget documents and criticised what he called "this ridiculous situation" but he said the spending plan was important because it increases money for the military.

Big tech's bad week has made the world wake up

By Peter Hartcher
23 March 2018 — 8:50pm
America's Big Tech firms have had a free run for a long time now. The normal standards were suspended for them. The soft power of their image gave them worldwide licence to evade tax, break laws, abuse customers' trust and exploit workers.
Less likeable firms like Monsanto or Exxon Mobil could never get away with flaunting such systematic, anti-social lawlessness year in and year out. But Big Tech merely rebranded it as "disruption" and it was suddenly cool, fun, and freewheeling.
This week has been a signal moment for the sector. It's a moment where American politics and officialdom are rethinking their hypertolerant approach, and governments everywhere need to do the same.
  • Updated Mar 24 2018 at 11:22 AM

Donald Trump advised to expel Russian diplomats over UK poison attack

by Jennifer Jacobs and Nick Wadhams
US President Donald Trump's advisers are poised to recommend he expel a number of Russian diplomats from the US in response to the nerve-agent poisoning of a former Russian spy living in the UK, a person familiar with the matter said.
The advisers reached the preliminary recommendations at a National Security Council meeting on Wednesday and honed them on Friday in a gathering that included Deputy Secretary of State John Sullivan, according to two people familiar with the meeting.
Trump has not made a decision and is unlikely to do so before next week.
I look forward to comments on all this!