Quote Of The Year

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

Friday, August 31, 2018

I Wonder What The ACT Health Department Has In Mind With This?

These appeared last week:

Government to act on all recommendations from health data review

By Daniella White
22 August 2018 — 12:00am

Talking points

  • The review came after ACT failed to give key data to the productivity commission in 2017
  • The report made nine core recommendations 
  • There have previously been 175 recommendations from data reviews since 2012
A review of ACT Health's data failures has found staff were not fully aware of the impacts of poor data or told about the benefits of quality data.
The system-wide data review was ordered by Health Minister Meegan Fitzharris in February 2017 after the department failed to provide figures on its emergency department to the Productivity Commission due to concerns over accuracy.
It came after six previous external reviews and two auditor general reports on ACT health's data since 2012, culminating in 175 recommendations.
The current review showed only 69 of those recommendations have been completed.
The report was tabled in the Legislative Assembly on Tuesday - about five months late - and made nine core recommendations.
Ms Fitzharris said the government was committed to implementing all recommendations of the current report - including to build a new data repository - with the rollout to begin this year, but the full cost not yet known.
Among the other key recommendations was to routinely review data quality, create user friendly documents, maintain security and privacy through staff training and deliver timely information.
The review painted a picture of a chaotic data system with 250 different systems in place that hold patient information across ACT Health.
It found governance of data was confused, with no single area responsible for the 1200 requests for data each year.
Data definitions were found to not be consistent or aligned with national standards.
It found some staff were not aware of the impact of poor or inaccurate data entry. They were also not fully aware of the benefits of having high quality data and staff were not supported to meet their data training responsibilities.
The report noted the public did not have access to timely data and there were gaps around privacy of data.
Ms Fitzharris said previous reviews' recommendations had become confused over time.
She said she was committed to making the data useful and meaningful for consumers in real time, such as by having current emergency department wait times online.
“As Minister for Health and Wellbeing I called this review because data reporting and management is integral to running an informed hospital and health care system that is accountable, transparent and responsive," Ms Fitzharris said.
More here:
And here:

ACT Health to build 'single source of truth' data repository

By Justin Hendry on Aug 24, 2018 11:30AM

Will consolidate 250 different systems.

ACT Health has started building a single repository to unify its data holdings following a system-wide review of the territory’s health data management processes.
The “single source of truth for all data requirements” is one of nine key recommendations from the review [pdf] accepted by the government earlier this week to improve data governance, collection and management.
The review had been order by Health Minister Meegan Fitzharris last year after ACT Health was unable to provide the Productivity Commission with figures on emergency department performance because of concerns with the accuracy of its data.
The new data repository and reporting capability will “collect, store, extract and transform quality data to deliver better insights to the community”.
It will see the more than 250 different system – a number of which are outdated in part due to budgetary constraints – in place across the agency that hold patient data reformed.
“This is a complex environment to collect, store, transform and report consistent information on the 1.5 million episodes of care that ACT Health provides each year,” the review states.
More here:
Things are made clearer reading this very recent Implementation Plan report from ACT Health.
Reading this makes it pretty clear that information and data management in the ACT needs a genuine ‘reboot’ with adoption of best practice and use of a lot of learnings from entities like the Aust. Institute of Health and Welfare and their data-dictionary and their information governance expertise. It is also clear that, from what has gone on in the past, major change is needed.
This is a big job in even the smallest of our health systems!
David.

Thursday, August 30, 2018

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

August  30, 2018 Edition.
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Well what a week last week. Trump in all sorts of trouble with pleas of guilty and convictions of close aides. There is excited talk of impeachment but that won’t happen, if it does, till after the mid-term elections in Nov. Oh and it seems progress with North Korea has stopped – Trump has been played I reckon…
What can you say about Australia other than it is a political fiasco. We will have a Labor Government sooner rather than later I reckon. I hope they can hold it together in some form to give us some sort of decent opposition.
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Here are a few other things I have noticed.
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Major Issues.

As The Turnbull Govt Implodes, It’s Still Making Policy. It’s Just Really, Really Bad Policy

By Ben Eltham on August 20, 2018 Australian Politics
With talk this morning of a possible leadership challenge to the Prime Minister by Home Affairs minister Peter Dutton, Ben Eltham reviews what landed the coalition in trouble in the first place.  
Covering federal politics is never the most uplifting of tasks, but the past month has been something else again. 
The dog days of winter have revealed a splintering Australian polity and an alarming resurgence of overt racism, a Liberal government that has all but exhausted any claim to the moniker of ‘liberal’, policy stasis bordering on dereliction of national duty, and a rightwards drift of conservative thought that should concern all thinking Australians, especially those who identify as conservatives.
I could talk about the racism – about the neo-Nazi on national television, or the Senator flourishing a reference to the ‘Final Solution’ in a maiden speech – and in an accompanying article, I will.
- Note discussion on myHR! (Good summary)
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  • Updated Aug 19 2018 at 11:59 PM

Fairfax-Ipsos poll should be a wake-up call. But it won't

Today's poll should provide a wake-up call to those hell-bent on tearing down the Coalition. But it won't.
It is no surprise that the Coalition has gone backwards at a fast rate of knots on the back of more than a week of vicious infighting over energy policy which, in turn, unearthed a heap of other anxieties which have been building since Longman.
People are grizzling about all sorts of things. Malcolm Turnbull hasn't visited my seat or he didn't speak out over this or that.
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Malcolm Turnbull removes all climate change targets from energy policy in fresh bid to save leadership

By David Crowe
20 August 2018 — 10:07am
Prime Minister Malcolm Turnbull has staged another dramatic retreat on energy policy in the face of a dire threat to his leadership, removing climate change targets from the National Energy Guarantee in his second policy reset in four days.
The revised scheme will go ahead without federal legislation to stipulate a 26 per cent cut to greenhouse gas emissions under changes aimed at averting a challenge from Home Affairs Minister Peter Dutton.
Asked on Monday morning whether his leadership was under threat, the Prime Minister declared: "I enjoy the confidence of the cabinet and my party room."
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We all know how this ends and Australians are failing to see the joke

By Tony Wright
20 August 2018 — 11:15am
More than 100,000 Australians are homeless. Drought is wringing the life out of the land and those trying to survive on it. Fires burn up and down the NSW coast. Housing and financial stress is at record levels across the land.
And what are the nation’s leaders and would-be leaders focussing their energies upon?
We have seen this play before. It is getting so old.
Malcolm Turnbull and his travails are not so much the exception as the norm now.
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Hidden revolution: changing the rules is changing Australia

  • August 21, 2018
While the whole of Australia is mesmerized by the incredible leadership ructions in Canberra, we are oblivious to what, longer-term, will be a more important nation changing event: the transformation of our capital system.
Popular politics, political correctness and, importantly, bad management are in the process of causing governments and regulators to both restrict and change large sections of Australia’s private enterprise structure. In some cases it will create paralysis.
It’s only when you step back and look at the totality of what is happening in Australia and link it to the US events that an incredibly dangerous situation emerges. It looks like we will need to suffer the consequences before reversing some of measures that are now being put in place.
The industries that are in the front line of attack/change are among our biggest non-government employers, including banks, gas, electricity, hospitality, (including hotels and restaurants) telecommunications and retailers. And that’s just what is happening on the federal Coalition’s watch. If the ALP wins power in Canberra, which now looks certain, the attacks will extend to those who have saved modest amounts for retirement (the rich escape) and sections of the health and medical industry. At the same time, a totally different set of strategies have sparked a boom in the US but have also created trade wars.
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Fixed income fails investors

  • By Will Hamilton
  • 12:00AM August 21, 2018
One of the biggest dilemmas for investors in recent years has been how to reconcile the poor returns from fixed-interest allocation with the need for a balanced investment portfolio.
Some investors have asked me what proportion of assets should be in fixed income.
But fixed income has me worried. Simply put, it has failed to deliver returns. You don’t want to be fixed (duration) and it doesn’t produce much income. Also, the flattening of the yield curve reflects a tightening in monetary policy.
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  • Updated Aug 21 2018 at 11:00 PM

Peter Dutton will not solve the existential crisis of the Liberal party

Tuesday's Liberal leadership ballot settles nothing. Malcolm Turnbull's victory margin of 48 votes to 35 practically guarantees another challenge to the Prime Minister, if not from Peter Dutton than from any number of contenders.
Neither does yesterday's vote settle the fundamental question the Liberal Party has been been grappling with since the retirement of John Howard and Peter Costello. For a decade the Liberal Party has struggled with the question of what should be its philosophy and its principles.
It is undeniable that over the last 10 years, the Liberal Party and its policies have drifted from the free market and centre-right towards the centre. When a political party of the centre-right moves towards the centre, by definition it is moving towards the left.
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What’s so momentous that the country must discard its prime minister?

By Peter Hartcher
22 August 2018 — 12:01am
The dismal cycle of government leadership challenges has resumed.
Once 40 per cent of a political party’s parliamentarians have voted to remove a prime minister, the Australian people are grimly familiar with the inevitable outcome.
But the overarching question is why? What’s so momentous that the country must discard its prime minister, disrupt its parliament, confound its people and unsettle its business community partway through a term?
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How to fix the flaw at the heart of Australian politics

By Dave Sharma
22 August 2018 — 10:45am
I recently returned from four years serving as Australia’s ambassador to Israel, a country known for its fractious politics and unstable, coalition governments. During my term, I dealt with only one Israeli prime minister, Benjamin Netanyahu. But I served four different Australian prime ministers - Julia Gillard, Kevin Rudd, Tony Abbott and Malcolm Turnbull.
To lose one prime minister may be misfortune. To lose two may indicate carelessness. But to cycle through four prime ministers in four years, and be on the brink of yet another defenestration of a sitting prime minister, suggests something more profound - a structural flaw at the heart of Australian politics.
There are several easy targets to blame for Australia’s new-found fondness for political instability.
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Centre-Right implosion has Australia turning left

  • 12:00AM August 22, 2018
The Turnbull government is being destroyed from within but the real damage is far greater — the ­centre-Right of Australian politics is locked into a spiral of self-­destruction likely to endure for many years, with the Shorten Labor Party positioned to win the election and shift our national life to the Left.
What was the scorecard last evening? The Turnbull government is being torn apart. Turnbull is a crippled leader heading a divided party with the certainty of more bad polls.
Peter Dutton from a standing start got 35 votes and has gone to the backbench, ready to strike again and terminate Turnbull. Yet Dutton, an effective minister, would be an experimental gamble as PM with no certainty he would poll better than ­Turnbull.
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'He's just not one of us': Conservatives explain Turnbull's turmoil

By Mark Kenny
23 August 2018 — 12:01am
When Malcolm Turnbull laid siege to the sitting Liberal MP Peter King in a bruising pre-selection battle for Wentworth in 2004, the republican frontman received votes from an unlikely group: pro-monarchy women.
Conservative Liberal preselectors concluded that, despite his obvious progressive leanings, Mr Turnbull was better than the incumbent.
Key to that early victory was Concetta Fierravanti-Wells, an avowed monarchist, leading figure in the NSW Liberal Party' right faction, and until 24 hours ago, a member of the Prime Minister's executive.
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Take a sophisticated view to sidestep the three big international risks

  • By Reshma Kapadia
  • 12:00AM August 21, 2018
Navigating the three biggest global risks for investors right now requires a more nuanced view of international investing. Barron’s canvassed managers and strategists to assess the big picture in some countries, and to find companies that are more insulated from the changing world order than the market thinks. The three big risks are populism, trade wars and currency. Here’s why.
Populism
Populism is a vague term used to describe movements led by both US President Trump and French President Emmanuel Macron, whose world views couldn’t be more different. For investors, populism is shorthand for the anti-­establishmentarianism, fuelled by growing income inequality, that is partially behind Britain’s decision to leave the European Union, Trump’s victory, and, more recently, the elections of Andres Manuel Lopez Obrador in Mexico and the creation of western Europe’s largest anti-establishment government in Italy.
These movements are disruptive — and investors must pay attention to them.
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Turnbull government collapses, gaggle of ministers resign

By Tom Burton • 23/08/2018
Cabinet and party room support for the Turnbull government is collapsing after key senior ministers this morning turned their support against the prime minister, in favour of challenger Peter Dutton.
After a morning of tumult, Turnbull scheduled a press conference, saying he was prepared to call a party room meeting for midday tomorrow, but this would be conditional on seeing there was majority support for a party meeting. Dutton’s supporters have been circulating a petition which needs 43 MPs to sign if the party room meeting is to go ahead
The prime minister said he wanted to also check the eligibility of Dutton to be an MP. Dutton may be in breach of the Constitution because of his family’s interests in two child care centres.
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  • Updated Aug 24 2018 at 8:42 AM

The media 'bullies' destroying Malcolm Turnbull's government

'War' being waged against Turnbull
Don't give in to the bullies, was Malcolm Turnbull's last-gasp tactic to hold on to power.
He wasn't referring to Tony Abbott, who has spent years undermining his successor's authority. Or Peter Dutton, the former home affairs minister trying to take his job.
Turnbull was speaking of enemies outside Parliament, Ray Hadley and Alan Jones from 2GB and News Corp's and Sky News' Peta Credlin, according to sources familiar with his thinking.
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Action urged as Victoria faces summer blackouts

By Cole Latimer
24 August 2018 — 12:02am
The electricity grid operator says there is a one in three chance of power failure in Victoria this summer unless immediate action is taken.
Its latest Electricity Statement of Opportunities forecast report painted a tough picture for Victoria as the energy network ages and Australia faces another record hot summer.
 “There remains a relatively high forecast likelihood – a one in three chance – of some unserved energy (load shedding or blackouts) this summer without further action,” the Australian Energy Market Operator said.
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  • Updated Aug 24 2018 at 11:00 PM

Leadership spill: Scott Morrison must unite this rabble

Malcolm Turnbull has been twice been dumped as leader – by a combined total of four votes.
He lost to Tony Abbott in 2009 by one vote and on Friday, despite all the carpet bombing and hysteria about how his support had collapsed, he fell short by three votes.
This, combined with the subsequent victory of Scott Morrison, who is just as loathed by the Coalition conservatives and their media acolytes as Turnbull, may just start to convince people that as important as hard-line conservatives are, they are not all that matters to the Liberal Party.
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Why you should take the alt-right seriously

By Matthew Knott
25 August 2018 — 12:00am
New York: From his earliest days, David Neiwert knew first-hand about the extensive reach of the American far right. "This is the water I was swimming in," the journalist and author says of his childhood in a rural, predominantly Mormon, town in southern Idaho.
Some members of his family were members of the John Birch Society, an ultra-conservative anti-communist group that believed socialists were infiltrating the US federal government.
Alt-right leader Richard Spencer has used Nazi propaganda and described white people as "children of the sun" at the National Policy Institute conference on November 19 in Washington, D.C.
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Capital’s victory comes at a cost for conservatives

  • 12:00AM August 25, 2018
On full display now is the complete breakdown in the relationship between business and conservative politicians.
Business people are frustrated and angry that the Coalition has failed not just to get any pro-business reforms through, such as the company tax cut and any kind of energy policy, but even to keep themselves nice and stay in power.
For their part Coalition politicians are frustrated and angry about what’s coming out of the royal commission and things like AGL’s refusal to play ball on the Liddell Power Station.
In the light of yesterday’s events, the rift between the big end of town and the political conservatives might seem like a side issue but I believe it is at heart of the Coalition split and this week’s chaos.
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  • Updated Aug 24 2018 at 11:00 PM

How coup capital status is hurting Australia

by Nick Bryant
Long before the US comedian John Oliver realised there was gold to be mined from Capital Hill in Canberra, the cultural cringe had been displaced in the minds of many Australians by a sense of political inferiority.
Tony Abbott's penchant for raw onions, Barnaby Joyce's response to Johnny Depp's Yorkshire terriers, and a conga line of here-today-gone-tomorrow prime ministers have made Australian public life an international laughing stock.
Those looking for antipodean political star power and stability have increasingly found it over the Tasman Sea, from Jacinda Ardern, the new mum PM who has almost achieved cult status, and John Key, who won three back-to-back elections.
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The battle for the soul of the Liberal Party

By Matthew Knott
25 August 2018 — 11:45pm
Speaking just before Friday's Liberal party room meeting, Terry Barnes had little hope that whoever triumphed in the leadership contest - Malcolm Turnbull, Peter Dutton, Scott Morrison or Julie Bishop - could rescue the party.
"Today is not going to fix anything," the former senior advisor to Liberal health ministers Tony Abbott and Michael Wooldridge told Fairfax Media.
"We are going to lose the next election. In opposition we are going to have a cataclysmic and existential fight and I'm not sure the Liberal Party as we know it will survive.
"We are at risk of becoming irrelevant."
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Time to pop the vox popped back in their box

By Ian Warden
26 August 2018 — 12:00am
Glued to ABC radio news and current affairs in recent days during the Liberal Party shenanigans the people who have given me the worst horrors have not been the men and women of our parliament.
No, twice as horrifying and irritating have been the men and women in the street.
They have been endlessly consulted in so many of those "vox pop" interviews that look to capture the (imaginary) innate wisdom of the lumpenproletariat. Alas, in recent days, almost everyone I've heard vox popped has emerged as a muddle-headed ignoramus.
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Lags should hog the attention of economists

By Ross Gittins
25 August 2018 — 12:00am
I’m compiling a short-list of the main things economics teaches us. One is: economic developments take longer to affect the economy than you’d expect. Economists call these delays “lags”. That there are so many of them – and their lengths keep changing – does a lot to explain why economists’ forecasts are so often wrong.
Last week Dr Luci Ellis, an assistant governor of the Reserve Bank, gave a prestigious lecture at the Australian National University devoted solely to the problem of lags.
The royal commission's work showed the "benefit of sunlight" by exposing banks' attitude of sales before customer service says Reserve Bank of Australia Governor Philip Lowe.
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Dutton camp, reactionary Right flank fumbled their coup

  • 12:00AM August 25, 2018
The decision to blow up the Liberal Party and the government has done irreparable damage to the Coalition’s chances of re-election. A poor result at the looming federal election can be blamed on the Dutton camp and the reactionary Right flank of the party. They created this mess, even if their incompetence meant they couldn’t even get their man up ahead of Scott Morrison.
The Dutton push was all about a small band of hard-Right members pitching their policy ideas at a similarly small number of lay party members — the so-called “base”, which is an ever shrinking cohort of Australians who choose to join a major political party.
The days of the mass party model are long over. The base is unrepresentative of mainstream Australia, and designing policies to appeal to it (or appease it) is a sure way to lose the political centre. Commentators who talk only to micro audiences in their tiny echo chambers like budgies talking to a mirror seem not to comprehend this. More surprisingly, so many politicians also mis­understand the breadth of the electorate.
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Tony Abbott ‘part of the blame’ for Liberal Party leadership fight

  • August 26, 2018
Liberal Party federal president Nick Greiner says Tony Abbott is “part of the blame” for the government’s instability, warning Labor will win the next election if the party does not unite.
Mr Greiner said Mr Abbott should use his abilities to fight Labor rather than engage in internal wars.
“He has part of the blame, his behaviour has been, as I have often said, more focused internally than where his skills are best used,” Mr Greiner told Sky News.
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Financial Royal Commission Issues.

  • Updated Aug 19 2018 at 11:00 PM

Turnbull under pressure to extend Hayne royal commission

Prime Minister Malcolm Turnbull is facing growing pressure to extend the banking royal commission, as Commissioner Kenneth Hayne considers whether more time is needed.
Pressure has been mounting to extend the hearings over the past week after NSW Liberal Julian Leeser called for the commission to hold more public hearings to scrutinise Commonwealth Bank's takeover of Bankwest.
That followed Queensland cross-bencher Senator Fraser Anning moving a motion last week to extend the commission by 12 months and broaden its investigation to include the insolvency sector's treatment of farmers.
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Where to now for superannuation?

By John Collett
21 August 2018 — 4:30pm
Commissioner Kenneth Hayne presiding over the royal commission into banking and financial services.
Photo: Fairfax Media
Superannuation fund members are vulnerable, disengaged and disadvantaged by a lack of financial literacy, leaving them "readily able to be taken advantage of".
That's how counsel assisting the banking royal commission, Michael Hodge, QC, summed up the situation in his concluding remarks on Friday following the commission's two-week deep-dive into the superannuation industry.
The royal commission heard evidence of how the big banks and AMP, as well as IOOF, sought every-which-way to keep the fees flowing into their coffers.
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Pressure mounts on banks over $300m in kickbacks

By Clancy Yeates
24 August 2018 — 12:15am
Banks and wealth managers face mounting pressure to scrap an estimated $300 million a year in kickbacks paid to financial advisers, after the royal commission highlighted the persistence of such conflicted payments.
With the Hayne royal commission's lawyers set to hand down "open findings" on superannuation misconduct on Friday, banks are busily reviewing their position on a recurring problem underlined in the latest round of hearings: the payment of "grandfathered" commissions.
Documents handed over by banks show National Australia Bank, Commonwealth Bank and ANZ Bank continue to pay tens of millions of dollars each in commissions to advisers, sparking debate about how these payments can be in members' interests.
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'Don't trust them': Internal AMP report reveals new CEO's big task

By Emily Cadman
23 August 2018 — 5:12pm
The size of the challenge facing AMP's new Chief Executive Officer Francesco De Ferrari in repairing the wealth manager's battered reputation has been laid bare in an internal research report detailing the "grim" impact of months of turmoil.
The 169-year-old company has been the biggest casualty of the royal banking commission into misconduct in the financial system. The firm has admitted to misleading regulators over charging customers fees for services they didn't receive, which may lead to criminal charges. The revelations led to the ouster of the previous CEO and chairman, customers have pulled hundreds of millions of dollars from its funds and the shares have tumbled to a record low.
"AMP's fall from grace has been greater than the banks," said the report, which was obtained by Bloomberg News. "AMP's highly visible management turmoil made its wrongdoings feel more systemic, serious and intentional than others involved" in the royal commission, says the 51-page presentation, dated August 2018 and titled 'Rebuilding Trust.'
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NAB, CBA recommended for criminal charges in commission findings

By Sarah Danckert, Clancy Yeates ; Ruth Williams
24 August 2018 — 8:08pm
National Australia Bank and the Commonwealth Bank could face possible criminal charges over legal breaches in their superannuation arms following recommendations by the royal commission.
Preliminary findings from the royal commission released on Friday night also made strong criticisms of market heavyweights IOOF and AMP while there were few adverse findings made against the industry funds examined during the hearings earlier this month.
NAB's Andrew Hagger is pressed by Commissioner Kenneth Hayne QC on whether NAB was open and transparent about telling ASIC the full extent of likely compensation.
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Super traps for the unwray

By Daryl Dixon
26 August 2018 — 12:00am
The stream of misconduct revelations emanating from the Banking Royal Commission shows how little successive governments and regulators have done over the years to protect superannuation investors. It has brought the benefits of compulsory super under scrutiny because of fund rip-offs, unwanted insurance coverage and inadequate controls to ensure employers make their mandatory contributions.
It’s easy to understand why many, particularly younger people, take little interest in their super fund and end up with multiple funds. Long gone are the days when super balances could be cashed out at low tax rates on changing jobs.
The cost of compulsory super also affects the ability of employees to boost take home pay and increases the attractions of cash economy transactions. Compared with the tangible benefits of paying off a house mortgage, building up the balance in a super fund untouchable till at least age 60 has little immediate appeal.
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National Budget Issues.

  • Updated Aug 21 2018 at 5:18 PM

Big energy breakup power a 'catastrophe', says Danny Price

Giving the Australian Competition and Consumer Commission the power to break up powerful energy companies would be a catastrophe for the electricity market.
Energy expert Danny Price said it would freeze fragile investor confidence and make things much worse for consumers.
Mr Price, the architect of the carbon emissions intensity scheme once championed by Prime Minister Malcolm Turnbull, said a breakup power aimed at energy companies would also freeze investment in other sectors facing scrutiny, such as banking and supermarkets.
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Our concern about the drought isn't fair dinkum

By Ross Gittins
22 August 2018 — 12:05am
It’s taken him too long, but public concern and the looming election has finally obliged Malcolm Turnbull to do the right thing by our farmers struggling with severe drought.
In Forbes on Sunday, Turnbull announced a further $250 million in assistance to farmers and communities, including initial grants of $1 million each to 60 drought-affected councils in NSW, Queensland and Victoria, bringing Canberra’s direct handouts to $826 million.
Add a further $1 billion in concessional loans and the total outlay comes to $1.8 billion.
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Turnbull government's company tax cuts defeated in the Senate

By Eryk Bagshaw
22 August 2018 — 11:14am
The $35.6 billion remaining of Prime Minister Malcolm Turnbull's flagship company tax cuts have been defeated in the Senate, putting an end to legislation that has fuelled unrest in the Coalition and culminated in a challenge to Mr Turnbull's leadership on Tuesday.
Mr Turnbull put the company tax cut package at the front and centre of his "jobs and growth" mantra when he was elected in 2016, warning a failure to cut the company tax rate from 30 to 25 per cent for companies earning over $50 million would end in investment fleeing Australia.
The political wisdom of that philosophy - argued forcefully by his lieutenants Finance Minister Mathias Cormann and Treasurer Scott Morrison for two years - took its final hammer blow before lunch on Wednesday when the Senate voted down the $35.6 billion remaining of the package 36 votes to 30.
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Health Budget Issues.

  • Aug 20 2018 at 9:43 AM

'Edit your DNA': Nib Holdings eyes consolidation after bumper profit

Health insurer Nib Holdings outlined a future in which DNA editing "to wipe put a potential disease" and other preventative measures are as important as controlling costs and premiums as it unveiled a solid profit and dividend bump and flat guidance for the coming year. 
The company said it would use big data and other technology to help patients better manage their health and wellbeing after reporting a 20 per cent higher underlying net profit of $185 million and a 12 per cent increase in statutory operating profit to $169 million.
Nib "has an appetite for industry rationalisation within each market sector it operates...and is actively assessing opportunities," chief executive Mark Fitzgibbon said.
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More people are dying from overdosing on prescription opioids

By Kate Aubusson
20 August 2018 — 12:00am

Talking points

  • 1,045 Australians died from opioid overdoses in 2016
  • The rate of opioid induced deaths almost doubled in ten years 
  • Pharmaceutical opioids were involved in three quarters of all drug deaths.
  • Almost 500 people died from overdosing on natural and semi-synthetic opioids such as morphine, oxycodone and codeine (3.1 deaths per 100,000 people).
  • 214 deaths were caused by synthetic opioids such as fentanyl, tramadol and pethidine.
Rising numbers of Australians are dying from accidentally overdosing on prescription drugs morphine, codeine, oxycodone and fentanyl, the latest drug deaths data shows.
Australia has so far been spared the magnitude of the opioid "epidemic" in the US and its emerging fentanyl crisis, but drug experts were closely monitoring the creeping death rates linked to the synthetic drug.
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20 August 2018

Urgent call to overhaul hospital accreditation system

Accreditation Government Hospitals
Posted by Julie Lambert
Medical colleges would refuse to place trainees in clinical units with poor patient-safety records in a proposed overhaul of Australia’s hospital accreditation.
A new Grattan Institute report says the hospital accreditation system, adopted in 1974 on a voluntary basis, is not supported by clinicians and does not encourage better safety.
“It does not improve patient outcomes; doctors dismiss it as irrelevant, or worse, a waste of their time; it provides no incentives for excellent safety performance; and accreditation reports are kept secret,” the report says.
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Hospitals looking at ‘$1.5bn bonus from better safety’

  • 12:00AM August 20, 2018
More rigorous safety programs in hospitals could reduce harm to patients and save the system at least $1.5 billion a year.
In a report released last night, the Grattan Institute put the cost of hospital complications at $4bn in public hospitals and $1bn in private hospitals. It estimated that if all hospitals lifted their performance to match the best 10 per cent of hospitals, an extra 250,000 patients would have clinical benefits and $1.5bn could be used elsewhere in the system.
The institute’s health program director, former bureaucrat Stephen Duckett, also took aim at accreditation arrangements and called for an overhaul to ensure they were capable of raising the alarm and preventing problems.
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Hospital complications 'cost $5 billion a year'

By Dana McCauley
19 August 2018 — 9:00pm
Pressure is mounting on state governments to pull back the curtain on hospitals' individual performances, with patient complications costing Australia's health system at least $5 billion a year.
A new analysis by the Grattan Institute has found taxpayers could save $1.5 billion nationally if all hospitals lifted their safety performance to match the best 10 per cent of facilities, allowing an extra 250,000 patients to go home complication-free each year.
And the key to raising performance lies not in financial incentives or penalties, but in making secretive hospital incident data public, according to the report's co-author, Stephen Duckett.
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Patients jabbed in the wrong places: botched, painful catheters rife

By Kate Aubusson
21 August 2018 — 12:00am
It’s one of the most common medical procedures in hospitals around the world.
So why are millions of patients every year getting needled with catheters in places that aren't recommended, and left unused and unmonitored, risking painful malfunctions and infection?
Two in three peripheral intravenous catheters (PIVCs) are inserted into areas not recommended by international guidelines or risk failing before patients get the treatment they need, a major international study shows.
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NIB cuts costs as Shorten government looms

  • 12:00AM August 21, 2018
Health insurer NIB is preparing for a Bill Shorten-led government by cutting costs, in light of Labor’s plan to cap annual premium rises.
NIB managing director Mark Fitzgibbon said yesterday that bookmakers were predicting a change of government, with an election likely next year.
“I am certain if we do see a change in government Bill Shorten will make good his policy commitment,” he said.
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Australian under-prepared for outbreak of infectious disease

  • 12:00AM August 22, 2018
The boom in pathology tests is fuelling concerns Australia may not be fully prepared for a major infectious disease outbreak, with the federal government looking at contingency plans to avoid a zika or tuberculosis disaster.
Five years after a parliamentary committee warned Australia’s communicable disease systems were too fragmented, the Department of Health is asking the private sector to help develop a “national public-health laboratory strategy” to bolster the testing and reporting infrastructure.
The department has acknowledged public-health laboratory testing is often being done with little or no additional funding, while, in contrast, the private sector benefits from rising patient demand and Medicare ­rebates.
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Another health minister bites the dust: Greg Hunt quits

MP tenders his resignation after just 18 months in the portfolio
23rd August 2018
Australia will soon have its fifth Minister for Health in as many years, following the resignation of Greg Hunt.
On Thursday morning, Mr Hunt announced that he had resigned from the ministry after 576 days in the health portfolio. 
He is reportedly running as deputy to Queensland MP Peter Dutton, himself a former health minister, who is hoping to take over the leadership of the Liberal Party and the Prime Ministership from Malcolm Turnbull.
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International Issues.

  • Updated Aug 20 2018 at 6:31 AM

Turkey set for rate rise of 3 percentage points under furtive policy

by Justin Carrigan
London | Turkey may be on the path toward a 300 basis-point interest rate increase with barely a whisper from the central bank as the country struggles to contain a currency crisis that's reverberating around the world.
By shutting banks off from borrowing at the benchmark 17.75 per cent repo rate and forcing them to turn to the overnight lending rate - now at 19.25 per cent -- policy makers have effectively enacted a 150 basis-point hike within a week. Should they close down the overnight market too, it would compel borrowers to turn to the emergency late liquidity window, where rates currently stand at 20.75 per cent.
"The repo rate is no longer relevant because all the funding is done at the overnight lending rate," said Ziad Daoud, the chief economist for the Middle East at Bloomberg Economics in Dubai. "It'll be interesting to see whether the central bank will stop here or or whether it'll use the late liquidity window to lift rates further."
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  • Updated Aug 19 2018 at 5:22 PM

European banks' double jeopardy: Turkey trouble, Russia rout

by Geoffrey Smith
Emerging markets have long been rich sources of growth for European banks. But the higher interest rates and fat margins on offer in places like Turkey and Russia come at a price, as the last 48 hours have shown.
The latest round of US sanctions against those nations reverberated through European banks, whose shares tumbled Friday. Potential defaults and weakening currencies hammered lenders including Spain's Banco Bilbao Vizcaya Argentaria, Italy's UniCredit and Dutch-based ING Groep.
The sell-off spilled over into other emerging markets and embroiled banks, such as Deutsche Bank, with relatively low exposure to them. The moves reflect how sensitive investors remain to risks in a sector which lost billions in Greece and has yet to restore profitability, 10 years after the financial crisis.
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Trump increasingly takes aim at a new foe - China

By David Nakamura
19 August 2018 — 11:08am
Bridgewater, New Jersey: After 18 months of treating North Korea as the top national security threat, US President Donald Trump has increasingly turned his attention to China, taking a more confrontational approach that experts said shows a risky shift in US policy.
From an escalating trade war to a new defence budget that counters Chinese maritime expansion, the Trump administration has taken aim at the East Asian power in a contest of wills that has led to a growing consensus in Beijing that the United States is seeking to contain China's rise.
Trump's rhetoric has grown sharper since last year, when he attempted to strike a rapport with his "good friend" President Xi Jinping. Last week, Trump cited the Chinese military as the rationale for creating a new "Space Force" at the Pentagon, and in a tweet on Saturday he injected China into the spectre of foreign influence of US elections.
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Trump: 'Dangerous' when companies like Twitter regulate own content

By Steve Holland and Jeff Mason
21 August 2018 — 10:10am
Washington: US President Donald Trump said on Monday that it is "very dangerous" for social media companies like Twitter and Facebook to regulate the content on their own platforms.
Trump's comments in an interview with Reuters come as the social media industry faces mounting scrutiny from Congress to police foreign propaganda.
Trump has made his Twitter account - with more than 53 million followers - an integral and controversial part of his presidency, using it to promote his agenda, announce policy and attack critics.
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With Nord Steam 2 pipeline, Putin waltzes into the heart of Europe

By Nick Miller
21 August 2018 — 5:50am
London: Vladimir Putin came to Europe on the weekend for a wedding in Austria – and on the wedding night he worked to consummate a new tie to Germany.
Though the Russian President had a great time in Austria, he will probably count his meeting with Merkel the bigger success, in an apparent blow to US interests.
Putin enjoyed Saturday’s wedding – which he called a “private” visit. He danced with the bride, Karin Kneissl, who has been Austria’s minister for foreign affairs since December, and in a speech made a well-received joke about her boxer dogs, before proposing a toast.
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Facebook removes, 652 disinformation pages created by Russia, Iran

By Craig Timberg
22 August 2018 — 10:06am
Washington: Facebook has taken down more than 600 phony pages, groups and accounts that were part of two separate disinformation campaigns - organised by Russia and Iran - targeting people worldwide, the company announced on Tuesday night, local time.
The revelation is unusual for targeting people in many countries and for involving a nation-state actor other than Russia, which has been the main focus of reporting on disinformation operations targeting the United States. The discovery was made by cyber security firm FireEye, Facebook said.
"We've removed 652 Pages, groups and accounts for coordinated inauthentic behaviour that originated in Iran and targeted people across multiple internet services in the Middle East, Latin America, UK and US," said Nathaniel Gleicher, the company's head of cyber security policy, in a blog post.
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Train wreck is coming: why markets look like an accident waiting to happen

By Jeremy Warner
22 August 2018 — 11:07am
There was a pleasant surprise for me in the post the other day. The bi-annual statement detailing how my pension investments are doing showed another hefty gain, as it has done pretty consistently for some years now and as would be the case for more or less everyone who has their pension pot invested substantially in equities. Stock markets have on the whole been doing well for nearly 10 years now, remarkably so when it comes to the US, which is about to enter the record books with the longest bull run in history.
As ever, the question is for how much longer can it last?
I don't want to dwell unduly on the extended duration of the current economic expansion, suffice it to say that it is already exceptional by historic standards. The law of averages alone suggests that it must soon draw to a close, as likely as not ended by Federal Reserve tightening, to the growing frustration of Donald Trump, who told a Republican fundraiser in the Hamptons at the weekend that he thought he had appointed an advocate of cheap money when he made Jay Powell the Fed chairman, but instead finds an independently minded policymaker of apparently hawkish tendency. Like president Recep Erdogan in Turkey, Trump expects a compliant central bank. As it is, it seems ever more probable that Fed tightening is going to shift the global economy into an at best still growing, but fast slowing, disposition.
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Russia shows off new weapons ahead of massive war games event

RUSSIA is preparing for its “biggest war games in 40 years” in a show of force that will involve China and Mongolia — but that’s not all the Kremlin is up to.
news.com.au August 22, 20189:00am
AS RUSSIA gears up for its biggest war games event in 40 years, the country is keen to show off its new toys.
The country kicked off its Army 2018 military expo this week just weeks before it’s scheduled to conduct the Vostok-2018 war games in a show of force which will include China and Mongolia.
The expo, held at a shooting range just outside of Moscow, featured Russia’s latest fighter jet, the Su-57, the Kinzhal hypersonic weapon and the Armata battle tank among other new weapons. It also featured robotic systems.
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  • Updated Aug 22 2018 at 10:43 AM

Donald Trump’s day of living dangerously

by Edward Luce
It was Robert Mueller's best day so far, which meant it was Donald Trump's worst. Minutes before Mr Trump's former campaign manager was convicted on multiple counts of fraud, the president's former personal lawyer said he had been directed by Mr Trump to break federal law to cover up affairs with a former porn star and a model. Both men were convicted on eight counts. It provided the clearest signal yet that Mr Mueller's investigation is closing in on Mr Trump.
Next month, Paul Manafort, who was Mr Trump's campaign chairman, and who personifies the Washington swamp his former boss vowed to drain, faces a separate criminal trial for conspiracy against the US. He already faces a lengthy sentence. The prosecution has recommended a sentence of up to 63 months for Michael Cohen, Mr Trump's long-time fixer. Yet Mr Mueller has barely scratched the surface. The drama will now intensify. There are three immediate risks to Mr Mueller.
The first is that Mr Trump could sack him. He has already twice tried to do so before. This time, aides may find it impossible to restrain the president. Before the latest verdicts, Mr Trump had already taken to calling Mr Mueller a "disgraced and discredited" man and alleging that the former FBI chief — and registered Republican — is in cahoots with Hillary Clinton's people.
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For Teflon Trump, the scandals just don't stick

By Gavin Hewitt
23 August 2018 — 8:00am
London: President Trump's opponents are in full cry. He is facing serious allegations that cannot be brushed aside as fake news. Some senior Democrats are declaring that "we're in a Watergate moment".
This latest crisis was prompted by two courtroom dramas. In one, Trump's former campaign chairman was found guilty of tax crimes and bank fraud. It is, however, a second case that carries the most risk for the President. Michael Cohen, Trump's former personal lawyer, who once said he would take a bullet for him, has pleaded guilty to paying hush money to two women just before the 2016 election. One of the women was a former Playboy model and the other an adult-film star.
Cohen said that he made the payments at the "direction" of a candidate for federal office. He did not name Donald Trump, but his lawyer did, accusing the President of directing Cohen to commit the crime of influencing the outcome of an election. Trump had said previously he knew nothing about the payments.
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America's illegitimate president

By Max Boot
23 August 2018 — 6:56am
Washington: Donald Trump probably would not have become president without his victory in seven of the 11 primaries held on Super Tuesday, March 1, 2016. Now his presidency is in danger of being undone by Terrible Tuesday - August 21, 2018.
This was the day when his campaign manager, Paul Manafort, was convicted of eight felony counts in a Virginia courtroom and his personal lawyer, Michael Cohen, pleaded guilty to eight felony counts in a New York courtroom.
The Manafort charges of tax and bank fraud do not directly implicate the president, but they do vindicate the special counsel, Robert Mueller, showing that his inquiry is no "Rigged Witch Hunt" but a serious investigation that has produced 35 indictments, six guilty pleas and one conviction. No special counsel has done more, faster. If Manafort had been found not guilty, it would have been a massive blow to Mueller. Because he was found guilty, it is a blow to Trump.
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The 'most hated bull market ever' rolls on - but trouble is ahead

23 August 2018 — 10:50am
The US stockmarket is on its longest bull run in history after a record nine-year charge that began amid the ruin of the financial crisis.
A surge underpinned by ultra-loose monetary policy at central banks and later accelerated by the global economic recovery hitting top gear has now stretched over a record 3,453 days uninterrupted.
The S&P 500's bull market turned 3,453 days old on Wednesday, making it arguably the longest such streak in history, according to some investors' definition.
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A changing story, but with one constant: It wasn't true.

By Glenn Kessler
23 August 2018 — 2:45pm
Washington: The first denial that Donald Trump knew about hush-money payments to silence women came four days before he was elected president, when his spokeswoman Hope Hicks said, without hedging, "we have no knowledge of any of this".
The second came in January of this year, when his attorney, Michael Cohen, said the allegations were "outlandish". By March, two of the president's spokesmen, Raj Shah and Sarah Huckabee Sanders, said publicly that Trump denied all the allegations and any payments. Even Cohen's attorney, David Schwartz, got in on the action, saying the president "was not aware of any of it".
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  • Updated Aug 24 2018 at 11:00 PM

Don't write him off yet: Trump regroups after Mueller setbacks

For a brief moment Donald Trump appeared to lose his swagger this week, which is a scary thing for a man who has built his presidency on selling a reality-TV image of strength – of winning so much it hurts.
Smashed by the twin revelations that two of his close former allies had fallen into America's judicial maw, the tweeter-in-chief went silent.
Into the vacuum, as a clearly stunned White House drew breath, surged an avalanche of media and expert speculation that this was the moment – the killer blow that pushes the ooze of corruption directly to the doors of the White House, consumes the administration, the Republican Party, and leads to the impeachment of the president.
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The three illegal acts that may have helped Trump win the presidency

By Philip Bump
25 August 2018 — 8:40am
Washington: The nation heard this week accusations that President Donald Trump was personally involved in the decision to offer two women money shortly before the 2016 election to keep them from sharing stories of alleged affairs. Trump's longtime personal lawyer, Michael Cohen, admitted under oath to having been instructed by Trump to work with David Pecker, chairman and chief executive of American Media Inc., to arrange a payment to former Playboy model Karen McDougal. He also admitted to having been instructed by Trump to pay off adult film actress Stormy Daniels. Both payments involved felony violations of campaign finance law.
That revelation is remarkable in its own right. But it's also worth remembering that it becomes the third allegation of an effort to surreptitiously aid Trump's 2016 campaign that violated the law.
The hush money
According to the government's delineation of how the campaign finance violations occurred (an account which Cohen attested was accurate and which has been bolstered by reports that Pecker is cooperating with authorities), AMI and Pecker's commitment to aid Trump in burying unfavourable stories began in August 2015. The first occasion on which that effort was realised (that is publicly known) was the payment to McDougal, which was made in early August 2016. The payment was made with a commitment by Cohen to repay the money, the subject of the recorded conversation between Trump and Cohen that was released last month. In early October, Pecker called that deal off.
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Pope Francis to find Ireland transformed, troubled by Catholic Church

By Nick Miller
25 August 2018 — 9:15am
London:  “I have never seen so many nuns, lanyards, or nuns wearing lanyards,” said the BBC’s religious correspondent on arrival in Dublin for this weeks’ World Meeting of Families.
But appearances can be deceiving. Behind the ample wimples, Irish Catholicism is in crisis.
The meeting is a big triennial Catholic festival, expected to attract hundreds of thousands of the faithful from Ireland and around the world, culminating in an open-air mass in a Dublin park by Pope Francis on the first papal visit to Ireland since John Paul II’s in 1979.
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In Ireland, pope says he shared 'pain and shame' of sexual abuse

Updated 26 August 2018 — 2:40am first published 25 August 2018 — 11:30pm
Pope Francis said on Saturday that he shared the "pain and shame" of the Catholic Church over its failure to adequately address the sexual abuse of young people by clerics.
Pope Francis vowed on Saturday to end the sexual exploitation of children by clergy during a highly-charged visit to once deeply Catholic Ireland and, according to victims, said the corruption and cover-up of abuse amounted to human excrement.
The pope said in a speech at Dublin Castle that "bishops, religious superiors, priests and others to adequately address these repellent crimes has rightly given rise to outrage and remains a source of pain and shame for the Catholic community."
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  • Updated Aug 24 2018 at 11:00 PM

Propaganda and politics figure in Xi's trade battle with Trump

The hottest thing on television in China at the moment is a soap opera centred on a group of imperial Qing Dynasty concubines vying for their emperor's favour.
The Story of Yanxi Palace, set in Beijing's Forbidden City 300 years ago, has smashed viewing records on iQiyi, China's version of Netflix – attracting 500 million views on a single night – and dominated social media.
The 70-episode drama is also a timely reminder of China's long history of autocracies in which people have gone to great lengths to appease all-powerful leaders.
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I look forward to comments on all this!
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David.