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"

or

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

Thursday, January 25, 2018

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

January 25, 2018 Edition.
Trump continues to astound with this week the US Government defunding itself and he is zooming off to hob-nob with the super-rich in Davos. I am sure his favourite coal miners will be impressed.
We are now just ¼ of the way through this nightmare and I have to say I am sick of it already!
Europe is slowly getting back to business and in the UK the NHS is under severe stress due to ‘Aussie Flu’. Germany slowly seems to be closer to getting a Government and Australia is all still at the beach believing life is good and trying to figure out what to do with the date of Australia Day!
My take is that the noise will not ever subside on the issue so we has better just get on and fix it somehow. Open to any sensible suggestions!
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Here are a few other things I have noticed.
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Major Issues.

Rising cost of essential services putting the squeeze on homes

  • The Australian
  • 12:00AM January 15, 2018

David Uren

Government-led costs are squeezing household budgets much more than the private sector, with prices of essential ser­vices such as health and education far outstripping near-­record low inflation.
Outlays on childcare have doubled in the past six years, while primary and secondary education costs for the typical household are up 50 per cent, detailed household budget figures from the Australian Bureau of Statistics show.
Overall, households are spending 23 per cent more on ­essential services, with prices ­influenced by government, than they were five years ago, while spending on goods and services with prices set by the market is up by 15 per cent.
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'Much slower transition': New graduates struggling to find full-time work despite economic recovery

Michael Koziol
Published: January 12 2018 - 12:00AM
Recent university graduates are struggling to find full-time work despite the growth in overall employment, with one in five employed university leavers unhappily working part-time in 2017.
Although there have been small improvements since 2014, employment outcomes for new graduates are still significantly worse than before the global financial crisis – despite a general employment boom.
But in the medium-term – three years after leaving university – almost 90 per cent of graduates were in full-time work, with two-thirds saying their degree was important or very important to their current job.
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Fifty years on, is life better for everyone?

Jessica Irvine
Published: January 15 2018 - 12:00AM
About this time every year, Australians are struck by an uncharacteristic bout of self-reflection.
As we swan around on beaches, we pause to ask ourselves the big questions.
Questions like: why do I always forget to put sunscreen on the tops of my feet?
Is John Farnham's That's Freedom or AC/DC's Thunderstruck the most Australian anthem of all time?
And, is it really ok to hold a national day of celebration to commemorate the day our forebears invaded a landmass and began treating its inhabitants quite dreadfully indeed?
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The false economy of sacking public servants in favour of consultants

Andrew Leigh
Published: January 14 2018 - 12:15AM
Would you burn $1 of petrol driving to the other side of the city so you could save 50 cents filling up? Would you recommend to a friend that they buy the cheapest printer, knowing it has the most expensive ink cartridges? Do you advise family to save money by not getting the flu vaccine?
Of course not. Fortunately, we're familiar with the idea of a false economy: a saving that turns out to be illusory because it eventually costs you more.
Unfortunately, not everyone seems to have cottoned on to what this means for the Australian Public Service. While public service jobs have been decimated, spending on consultants has ballooned. Work that used to be at the core of the public service, like policy development and stakeholder engagement, is increasingly outsourced.
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The National Road toll: what can be done?

Tony Joseph
Published: January 15 2018 - 12:00AM
The Christmas and New Year holiday period arrived yet again with stories of family tragedy and loved ones killed and injured on the nation's roads. Apart from the deep personal loss to the families and the community, another tragedy is that most of these deaths and serious injuries are preventable.
In 2011, Australian governments signed up to the National Road Safety Strategy (NRSS) to commit to an agreed set of national road safety goals and actions. The strategy target is to reduce Australia's annual number of road deaths and serious injuries by at least 30 per cent by 2020.  Unfortunately, the target will not be met as only a 13 per cent reduction has been achieved since 2011. December 2017 was particularly bad with 127 deaths on the roads, a 25 per cent increase in the December average for the last 5 years. There were 1225 road fatalities for the 12 months ending December 2017, which is a 5.3 per cent decrease from 1293 deaths in 2016, and a very modest improvement.
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Why we shouldn't be too scared of dramatic house price drop predictions

Michael Pascoe
Published: January 15 2018 - 5:23PM
Multibillionaire Meriton tsar Harry Triguboff has picked up this year where he left off last year, and the year before – decrying any and all moves to tighten up on foreign investors buying the apartments he churns out.
Harry talking his own book, who'd have thought it?
The interesting thing about Triguboff's recent warnings in The Australian Financial Review is that the story contains good reasons to think the much-headlined cooling of the housing price boom will be mild.
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Where will the global political hotspots be in 2018? (Spoiler alert: it’s not all about Donald Trump)

January 16, 2018 6.10am AEDT
With so many global flashpoints, and so little diplomacy, 2018 could be a turbulent year. AAP/The Conversation

Author Tony Walker

Adjunct Professor, School of Communications, La Trobe University
Writing for Foreign Policy, Robert Malley, the newly appointed head of the International Crisis Group, makes a good point when discussing global challenges in 2018:
It is not all about Donald Trump.
To be sure, an erratic American presidency contributes to unsteadiness around the globe. American global leadership is now contested as never before since the Allies triumphed in the second world war.
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  • Updated Jan 15 2018 at 11:00 PM

If political liberalism is dead – then what comes after it?

by Ross Douthat
Fourteen months ago, in the first flush of power, Steve Bannon gave an interview to Michael Wolff – beginning a relationship that would prove his undoing – in which he boasted about his plan to realign our politics. His nationalist-populist movement, he argued, would transform the GOP into something truly new: a right-wing worker's party that spent freely, "jacked up" infrastructure all over the country, and won "60 per cent of the white vote" and "40 per cent of the black and Hispanic vote" on its way to a 50-year majority.
"We're just going to throw it up against the wall and see if it sticks," Bannon said. "It will be as exciting as the 1930s."
As exciting as the 1930s is not a line you hear every day, but rather than an "alt-right" dog whistle, what I heard in Bannon's formulation was the idea that in the Trump era, as in the crisis years that gave us both FDR and Hitler, everything might be up for grabs: not just electoral coalitions, but the nature and destiny of the liberal order. Which would be a terrifying prospect but also an exciting one, since it would mean that the long "end of history" that followed the Cold War had irrevocably ended, and that it was time to imagine radical revisions to a stagnant-seeming liberal West.
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  • Updated Jan 4 2018 at 11:00 PM

America's retreat into tribalism

by David Brooks
Imagine three children running around a maypole, forming a chain with their arms. The innermost child is holding the pole with one hand. The faster they run, the more centrifugal force there is tearing the chain apart. The tighter they grip, the more centripetal force there is holding the chain together. Eventually centrifugal force exceeds centripetal force and the chain breaks.
That's essentially what is happening in this country, New York University's Jonathan Haidt argued in a lecture delivered to the Manhattan Institute in November. He listed some of the reasons centrifugal forces may now exceed centripetal: the loss of the common enemies we had in World War II and the Cold War, an increasingly fragmented media, the radicalisation of the Republican Party, and a new form of identity politics, especially on campus.
Haidt made the interesting point that identity politics per se is not the problem. Identity politics is just political mobilisation around group characteristics. The problem is that identity politics has dropped its centripetal elements and become entirely centrifugal.
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The jobs that will (or won't) be getting a pay rise this year

Eryk Bagshaw
Published: January 15 2018 - 6:17PM
Thousands of employees in the retail, media, mining, transport and rental industries will struggle to keep up with the cost of living after signing wage rise agreements that are set to fall below inflation in the next two years. 
New figures from the Department of Jobs and Small Business show that employers are signing half as many agreements with employees as three years ago, while those that are being negotiated are netting an average wage increase of just 2.2 per cent, barely above the rising cost of a bag of groceries. 
According to figures from the Australian Bureau of Statistics, wage growth has been stuck at historically depressed levels, but the latest figures from the department show the pinch is set to continue, particularly in the private sector, where newly approved agreements hit a 25 year low of 2.4 per cent. 
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Banks' bad debt charges to rise in 2018: Fitch

Clancy Yeates
Published: January 16 2018 - 12:15AM
Australia's major banks face a tougher grind in the year ahead, as charges for bad loans creep up from record lows and the lenders are put under the microscope of a royal commission, Fitch Ratings warns.
After the big four chalked up more than $30 billion in combined earnings last year, the credit ratings agency on Monday maintained a "negative" outlook on the sector and said there would be greater "pressure" on profit growth, due mainly to various economic trends buffeting the industry.
"Profitability is likely to slow in 2018, reflecting low interest rates, slow asset growth, competition for assets and deposits, higher funding costs, and a rise in loan-impairment charges," it said in an outlook report.
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Flat wages to worsen intergenerational inequality: thinktank

Mark Kenny
Published: January 15 2018 - 10:30PM
Australia has avoided recession but new research by a progressive thinktank suggests low wage growth and unequal spending on the "infrastructure of opportunity" threaten to entrench wealth inequality.
The Labor-aligned McKell Institute's report, Mapping Opportunity: a national index on wages and income, found the income gap is widening and that the opportunity to earn differs markedly across the country's 150 federal electorates.
And it found that along with the traditional drivers of social mobility, such as education and training, and locality, access to the internet has emerged as a "key determinant" of socio-economic opportunity.
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Apartment glut risks blowout amid policy missteps

  • The Australian
  • 9:19AM January 16, 2018

Robert Gottliebsen

When property prices are falling and there are significant amounts of unsold stock, like what’s happening in the inner city apartment markets of Sydney Melbourne and Brisbane, truth often falls by the wayside.
But if we don’t start facing the truth we will have a major collapse that could cause banks to lose large sums on their developer loans. However, even if we avoid a collapse, we are on the brink of fundamental changes in the apartment industry.
We opened the year with a debate about negative gearing but avoided the inconvenient truth that Scott Morrison in the last budget introduced his own version of the ALP’s negative gearing proposal and it slashed the price of inner city apartments by about 7 per cent, bringing the total price fall in Sydney used apartments to around 20 per cent, with greater falls in Melbourne and Brisbane.
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ASX starts 2018 where it ended 2017: at the bottom

Patrick Commins
Published: January 16 2018 - 11:46PM
Here we go again. Early days, I know, but already in 2018 we are witnessing an extension of a last year's clear trend: the relatively poor performance of Aussie equities against their overseas counterparts.
Since the turn of the year the global equity rally has rolled on as investors grow increasingly confident that the synchronised global economic growth which emerged in 2017 has become more entrenched. Shrugging off the recent jump in bond yields, US stocks are up over 4 per cent year-to-date, as are Chinese and Japanese shares, while European equities have added more than 3 per cent. The ASX? Down 0.4 per cent.
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How technology is keeping a lid on inflation

Clancy Yeates
Published: January 17 2018 - 12:05AM
Digital gadgets such as the iPhone have well and truly transformed how many of us go shopping, entertain ourselves and stay in touch with friends.
But here's another result of the online revolution you may not know about: it's keeping inflation lower for longer, and dampening growth in pay packets, too.
One of the biggest questions hanging over the economy in 2018 is whether inflation and wage growth can finally recover from historic lows. The extent to which this happens will be crucial for official interest rates, which are used to manage inflation, and are at record lows.
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'We pay for access': Minerals Council's admission on political donations

Fergus Hunter
Published: January 17 2018 - 10:55AM
The Minerals Council of Australia has admitted it makes donations to political parties to gain access to politicians, an unusually candid statement from a donor about the influence of money in politics.
The mining lobby group's submission to a Senate committee examining the role of donations in Australia's political system contrasts with the explanations given by other lobby groups and businesses, which said their donations were intended to support democratic processes.
"The MCA makes the political contributions detailed above because they provide additional opportunities for the MCA to meet with members of parliament," the Minerals Council said.
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What kind of company sells a dud like this to its customers?

Peter Kell
Published: January 18 2018 - 7:44AM
It is tempting to wonder why a person might pay more than $6000 for insurance cover that was capped at a maximum payout of $6000 – or why someone would buy an insurance policy under which they were never eligible to make a claim.
But the real question should be why a company would treat its own customers that way by selling them such a policy?
There can be no justification for such behaviour. Unfortunately, ASIC has found these practices are all too common in the add-on insurance sector – and we are determined to see them disappear. Too many consumers have simply not understood what they were being sold.
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Australian household debt-to-income ratio taps 200pc

  • The Australian
  • 11:01AM January 18, 2018

Michael Roddan

Australia’s household debt-to-income has exploded to the 200 per cent level for the first time after rules requiring the accurate measurement of property investment by self-managed superannuation funds were included in official statistics.
The Australian Bureau of Statistics upwardly revised its debt levels to account for the prudential rules, which take into account leveraged self-managed super funds, taking Australia’s household debt levels to 200 per cent, from 194 per cent — making it one of the highest in the world.
“Household debt in Australia is extremely elevated,” UBS analyst Jonathan Mott said. He said it was “concerning” to see official debt statistics upwardly revised, which now leave households in almost $2.5 trillion of debt.
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There's good and bad in comprehensive credit reporting

John Collett
Published: January 19 2018 - 8:00AM
Those with a chequered credit history could find it more difficult to obtain credit this year, or pay a higher rate of interest, with the Turnbull government forcing the big banks to join the comprehensive reporting regime.
Credit agencies have been collecting more information since the new credit reporting regime started in March 2014.
Before the change, credit reports, which credit agencies provide to lenders when they check on applicants, only held negative information such as missed payments of more than 60 days, and bankruptcies.
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Stand back – working women coming through

Michael Pascoe
Published: January 18 2018 - 4:37PM
Mark 2017 down as the year of the working women's surge: Females accounted for the majority of the sharp 403,000 rise in employment, entering more full-time jobs than males.
And that was only one of the mileposts passed in the latest labour force statistics.
For the first time, the gap between the male and female employment-to-population ratios fell below 10 per cent – 67 per cent for men, 57.3 per cent for women, which is the highest such figure for women ever.
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We should focus on helping individuals rather than 'improving' income inequality

Daniel Wild, Andrew Bushnell
Published: January 19 2018 - 12:05AM
The most important task of public policy is to ensure the next generation of Australians have more opportunities to flourish than the last. But declining business investment, worsening school results, family breakdown, and youth joblessness suggest we are failing in this task.
This week, the left-leaning McKell Institute contributed to this important debate with the release of their report Mapping Opportunity: A National Index on Wages and Income.
Unfortunately, the report misses the mark.
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End of bond boom spells danger for Australia

  • The Australian
  • 10:28AM January 19, 2018

Robert Gottliebsen

Despite a few interruptions, US bond interest rates have been falling since the early 1980s as US bond prices rose, forcing yields lower.
That bond boom is over.
American interest rates in 2018 are now set to rise sending shockwaves around the world. Here in Australia the US directional change will edge our interest rates higher. As I will explain below, we have our own set of forces pushing rates higher, although our interest rate fate is not as clear as the US because of the dangers of the apartment glut and our high leverage.
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Zombies, bubbles and the hidden risks of record low interest rates

Jessica Irvine
Published: January 20 2018 - 12:41AM
It's the gold standard of financial advice that if something appears too good to be true, it probably is.
And so too should mortgage holders view this current period of record low interest rates.
Last week, I wrote about the likelihood that interest rates will rise in 2018. Jobs figures released this week only underscore the strength evident in Australia's labour market in the second half of last year.
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January 19 2018 - 9:47PM

Confidence returns for Australian coal miners

Cole Latimer
Did the doubters declare the death of thermal coal too soon?
Certainly the major listed Australian thermal coal miners have all seen positive movement in their share price from late 2017 through into 2018, bucking the wider perception of a market in decline.
That was in turn driven by a resurgent thermal coal price after its massive bust three years ago.
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Australia's ongoing governance failures, and how to fix them

Crispin Hull
Published: January 20 2018 - 12:15AM
What's the difference between "governance" and "government"? Some say nothing and that "governance" is just affectation, but political scientists usually make the distinction.
Governance, they say, is the overarching architecture of government: the constitution, broad electoral rules, rules on disclosure, and the institutional set-up. Government, on the other hand is the nitty-gritty of everyday revenue-raising and spending, and the myriad pieces of legislation and regulation dealing with everyday matters.
To continue the architecture analogy, with a house, governance deals with things like whether you: build an extension; revamp your kitchen with a new fridge or revamp your bathrooms; or install solar power or a swimming pool. Government is: what do you put into the fridge; what should come out of it when; or when you should run air-conditioners (as distinct from whether they should be installed in the first place).
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Murray warns against SMSF property borrowing

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

Michael Roddan

The surge in self-managed super funds borrowing large sums of cash to plough into investment properties is threatening to hit the retirement savings of tens of thousands of Australians, as falling house prices and stalling rents ­reduce earnings.
The fast rate of growth in borrowings has prompted renewed warnings by financial system inquiry head David Murray that market risk in self-managed retirement savings funds is “higher than it has been before”.
The latest figures from the Australian Taxation Office reveal the number of DIY super funds that have borrowed from the bank to invest in property has doubled over the past five years to more than 50,000 accounts.
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Now everyone admits it: political donations buy access and influence

Adam Gartrell
Published: January 21 2018 - 12:00AM
The major political parties and their wealthy benefactors have long sought to perpetuate the mutually beneficial myth that political donations are somehow a good thing for the Australian people.
The donors and their lobbyists claim their contributions are some form of civic philanthropy: they're just helping finance election campaigns to ensure a vigorous contest of ideas and a healthy democracy.
And the politicians insist the money comes with no strings attached: it does not buy access or influence or favours or votes. But it does save taxpayers the cost of financing those election campaigns themselves.
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National Budget Issues.

Cabinet ministers fearing electoral defeat consider sweeteners for pensioners

Renee Viellaris, Federal Political Editor, The Courier-Mail
January 17, 2018 1:00am
CABINET ministers fearing the defeat of the Turnbull Government have discussed giving more generous concessions to aged pensioners, signalling a looming showdown with Malcolm Turnbull and Scott Morrison.
Ministers in several states have held one-on-one conversations about the need to win back the Howard battlers, whose votes have been lost to One Nation and Labor, especially in Queensland.
Former Howard and Turnbull government minister-turned Queensland Resources Council chief executive Ian Macfarlane said yesterday that if the Galilee Basin was fully opened, billions of dollars would flow to the Commonwealth, which could pay for pension increases.
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There are jobs galore, but Turnbull still challenged

  • The Australian
  • 12:00AM January 18, 2018

David Uren

The economy delivered a near ­record 380,000 jobs last year — most of them full-time — and yet the Turnbull government has gained no political dividend, languishing 5 to 10 percentage points behind Labor in Newspoll ever since September 2016. Scott Morrison is hoping that a lift in the consumer mood will deliver better results this year.
The Treasurer has said his “summer homework” is fashioning a personal tax relief package for middle and low-income workers who have been squeezed by low income growth and rising living costs, particularly for essential services. He was frank about the challenge last month when presenting the September quarter’s national accounts, which showed household spending had risen just 0.1 per cent. He produced Treasury analysis showing spending on discretionary items was falling to make way for the rising costs of rent, childcare and electricity. “Many Australians were concerned about the cost of living and the pressures on their household budget,” he said.
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Sugar has its tobacco moment as voters call for new tax

Peter Martin
Published: January 17 2018 - 6:39PM
Imagine a tax that Coalition voters actually wanted. They certainly don't want more income tax (only 12 per cent do, according to an Essential poll), they certainly don't want more company tax (they want less) and they will cop an increase in GST only if it brings down other taxes.
But then there is sugar. This week's Essential poll reveals the sort of disdain for sugar there is for tobacco.
An extraordinary 57 per cent of Liberal and National Party supporters say they want a special tax on sugar-sweetened drinks. That's more than the 54 per cent of Labor voters that want it.
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The fiscal nuclear option: pass unfunded tax cuts and leave the mess for Labor

Simon Cowan
Published: January 20 2018 - 12:15AM
The Turnbull government is reportedly considering tax cuts in the next budget. Given the deficit, they are expected to be modest. While this would be prudent fiscal management, there is an argument for the government to take a much bolder, more controversial, approach.
One option is to leverage the populists' disregard for budget discipline to lock in big cuts to personal income tax and company tax each year for the next five years. Don't combine this with unpopular spending cuts upfront; instead, promise to deal with the Senate on cuts/closing loopholes after the tax changes are in place. If the Senate won't compromise on budget repair before the next election, and it's the next government's problem, so be it.
One relatively common complaint in conservative circles is that centre-right governments are typically elected to rectify the fiscal messes of a previous government. And having shelved their own platform to do the hard work of paying for someone else's big-spending progressive agenda, they get turfed out – and the spending ratchet begins again.
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Health Budget Issues.

Alarm over drug companies' extravagant spending and influence on doctors

Esther Han
Published: January 14 2018 - 9:13PM
Sponsoring "educational activities" for doctors is so financially lucrative that pharmaceutical companies are spending upwards of $200,000 on a single event, sparking fresh calls for a ban on industry funding.
The latest sponsorship disclosures from industry body Medicines Australia show drug company AstraZeneca spent the biggest amount on a single event – $241,000 – followed by Celgene and Novartis, between November 2016 and April 2017.
In terms of total spend on all events in the half-year period, AstraZeneca came second to Roche, which saw fit to splash $877,000 on 64 meetings, from breakfast symposiums to journal club meetings.
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  • Updated Jan 15 2018 at 11:00 PM

Insurers want Medicare Levy surcharge hike

Private health funds want wealthy Australians who refuse to take out basic hospital cover to be hit with a surcharge of up to 2 per cent.
The call comes despite the fact the number of individuals paying the surcharge hit a record low of 164,535 in 2014-15, the latest figures available.
Singles earning more than $90,000 a year who do not have private health insurance pay the Medicare levy plus a surcharge of up to 1.5 per cent. The threshold for families is $180,000. The surcharge is meant to encourage people into the private system and therefore ease public costs.
Private Healthcare Australia wants the surcharge increased by 50 basis points, which would lift the top rate from 1.5 per cent to 2 per cent.
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Private health insurers should improve 'useless' products, not punish people who avoid them: AMA

Fergus Hunter
Published: January 16 2018 - 5:11PM
The Australian Medical Association says private health insurers should address low quality and sometimes "useless" products instead of attempting to use punitive tax hikes to push people into taking up their policies.
In a submission to the Turnbull government's budget process, Private Healthcare Australia, the sector's peak body, has said the Medicare levy surcharge should be raised for high-income earners who do not have private health insurance.
The representative body said the surcharge should be "recalculated" to boost the incentive for the wealthy, recommending a change that would see the top rate lifted from 1.5 per cent to 2 per cent.
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Health premiums to rise, but at 15-yr low

Health Minister Greg Hunt wants health insurers to deliver the lowest premium rise in over 15 years, but families could still have to pay $200 a year more.
Updated 17 Jan 2018
Australians will have to pay yet more for their private health cover from April, but Health Minister Greg Hunt insists he's pursuing the lowest rise in health insurance premiums in more than 15 years.
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Medibank premium increase to dip below 4pc in 2018: Macquarie

  • The Australian
  • 12:21PM January 17, 2018
Health insurance giant Medibank is tipped to announce an average premium increase of around 3.85 per cent this year, coming in below the rumoured industry average of around 4 per cent.
Investment bank Macquarie’s analysts have run the numbers on the annual health insurance premium and also expect Nib’s average increase to be around 3.8 per cent. That figure would also come in below Macquarie’s tip for the sector weighted average premium increase of 3.9 per cent to 4.1 per cent.
Medibank’s (MPL) average rate increase in 2017 was 4.6 per cent, its lowest in 15 years. It was also below the industry average of 4.84 per cent, which was a decade low.
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Greg Hunt: ‘We love private health insurance’

  • The Australian
  • 3:44PM January 17, 2018

Rachel Baxendale

Health Minister Greg Hunt has insisted a predicted health insurance premium hike which is double the rate of inflation is good news, because it will likely be the lowest increase in 17 years.
The predicted 3.9 per cent hike is likely to cost the average family an extra $200 a year, at a time when wage growth is stagnant.
Mr Hunt is due to release details of the April 1 increase shortly.
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NSW ranked worst for healthcare costs and access, international comparison shows

Kate Aubusson
Published: January 18 2018 - 6:31AM
NSW has been ranked the worst for healthcare affordability among older patients in the latest survey that pits Australia's most populous state against international health systems.
The results released on Thursday showed a larger proportion of NSW patients 65 and older struggled with their medical costs than their counterparts in Australia overall and 10 other OECD countries.
NSW fared worst when it came to the percentage of respondent who said they had problems paying their medical bills (15 per cent), compared to just 1 per cent in Sweden and 10 per cent in the US, found the survey of 24,000 people including 1175 in NSW.
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Consumers to be slugged with $200 private health insurance price rises

Adam Gartrell
Published: January 17 2018 - 3:51PM
Consumers will be slugged with an average 4 per cent rise in private health insurance premiums this year despite major Turnbull government reforms designed to rein in costs.
While the numbers are yet to be finalised, Health Minister Greg Hunt has revealed there is likely to be an average 3.9 per cent rise for policyholders on April 1 this year.
A 3.9 per cent increase would represent the lowest premium increase since 2001 – but would still be nearly twice the rate of general inflation. It would add close to $200 dollars to the average policy a year, and is likely to force more families to drop their cover.
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Non-clinical therapies excluded from private health cover

Saturday, 20 January 2018 7:30AM
Cathy O'Leary
A hit list of natural therapies including naturopathy, yoga and Pilates will be excluded from private health cover next year unless they are offered only as incentives.
Despite petitions from the natural therapy industry, which argues many Australians use the treatments to stay well, the Federal Health Department confirmed this week that 16 items would not be funded under health insurance policies that were government-subsidised.
From April next year, Alexander Technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, homeopathy, iridology, kinesiology, naturopathy, reflexology, Rolfing and shiatsu will not be covered.
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International Issues.

Iranian oil tanker sinks off China: report

Published: January 14 2018 - 10:30PM
BEIJING: A burning Iranian oil tanker that had drifted into Japan's exclusive economic zone has sunk after a collision on January 6, Chinese state television reports.
The stricken tanker, called the Sanchi, which had been adrift and on fire for more than a week following the accident with another vessel in the East China Sea, had "suddenly ignited" around noon local time on Sunday, China Central Television said.
"Currently it has already sunk," CCTV said, citing the Shanghai maritime search and rescue centre. It showed video of a tower of billowing black smoke and flames on the surface of the water.
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America Last? EU says US is losing on trade under Trump

Philip Blenkinsop and Noah Barkin
Published: January 16 2018 - 7:00AM
Brussels: The European Union's trade tsar has no idea what Donald Trump will tell his audience at the World Economic Forum in Davos next week, but she is clear what the EU's message to the US President will be.
America is shooting itself in the foot by withdrawing from global leadership on trade, Cecilia Malmstrom, the 49-year-old Swede who has served as Europe's trade commissioner for the past three years, said.
Under Malmstrom's direction, the EU has juggled a dizzying array of trade talks over the past year. In July it clinched a preliminary deal with Japan. And early this year it hopes to seal agreements with Mexico and the Latin American Mercosur bloc.
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Twin suicide blasts leave dozens dead, injured in Baghdad

Published: January 16 2018 - 4:00AM
Baghdad: A pair of suicide bombers blew themselves up in central Baghdad on Monday, killing 27 people and injuring scores more in the first major attack in the capital since Iraq declared victory over Islamic State (IS) in December.
The attack also breached one of Baghdad's most secure areas, underscoring the urgency of what Iraqi and American officials have said is a crucial transition from combat to traditional counterterrorism.
There was no immediate claim of responsibility for the attack, which came just as electoral coalitions began taking shape this week ahead of expected national elections in May. Previous elections have been marred by terrorism and Monday's violence raised concerns that despite the military victory over IS, this campaign season would be no different.
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While Donald Trump's words are divisive and dangerous, his actions are far less reckless

Tom Switzer
Published: January 16 2018 - 12:00AM
One of the few consolations about the past year is that the actions of the Trump administration have been more conventional than its words. It reminds one of the public-service adage: pay attention to what governments do rather than what they say.
Donald Trump demonstrates the point. Notwithstanding his divisive and dangerous rhetoric, Trump's presidency has been marked by more orthodox policies than his opponents feared and his supporters expected.
That is how his unedifying remarks about Haiti, El Salvador and Africa last week should be seen: the utterly unacceptable comments drew global condemnation, but will they really scuttle bipartisan reform on young undocumented immigrants? The record shows that the US is not quite a prisoner of its President's rhetoric.
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Pentagon confirms existence of Russian ‘doomsday’ weapon

A NEW weapon of immense destructive power is now in Russia’s hands — and the rest of the world should be worried.

Russia opposes U.S. bid to change Iran nuclear deal

THE Pentagon has confirmed that Russia has developed an unmanned underwater nuclear drone that has the potential to devastate US ports and harbours, according to a leaked government report.
The revelation is one of many alarming findings in a draft version of the US’s Nuclear Posture Review due for release next month.
The paper, published by the Huffington Post, argues that America has been left exposed because Russia has continued to develop nukes since the end of the Cold War, while the US has reduced their role in its security strategy.
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  • Updated Jan 16 2018 at 11:00 PM

Donald Trump: the 'genius' President

Trump defends his mental fitness
by Marc Fisher
The genius in the White House has always believed that what makes him special is his ability to get things done without going through the steps others must take.
In school, he bragged that he'd do well without cracking a book. As a young real estate developer, his junior executives recalled, he skipped the studying and winged his way through meetings with politicians, bankers and union bosses. And as a novice politician, he scoffed at the notion that he might suffer from any lack of experience or knowledge.
So when Donald Trump tweeted last weekend that he "would qualify as not smart, but genius ... and a very stable genius at that!" it was consistent with a pattern of asserting that he will do this his way, without bending to expectations about what constitutes proper presidential behaviour.
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Russia probe: Robert Mueller subpoenas former Trump aide Steve Bannon

Sarah Lynch and Patricia Zengerle
Published: January 17 2018 - 5:49AM
Washington: US President Donald Trump's former chief strategist Steve Bannon has arrived at Capitol Hill to be interviewed for the House Intelligence Committee's Russia probe.
As he made his way into the panel investigating Russia's meddling in the 2016 election and the possible links between Trump's associates and Russia, The New York Times revealed he was subpoenaed last week by special counsel Robert Mueller to testify before a grand jury, according to a person with direct knowledge of the matter.
The move marked the first time Mueller is known to have used a grand jury subpoena to seek information from a member of Trump's inner circle. The special counsel's office has used subpoenas before to seek information on Trump's associates and their possible ties to Russia or other foreign governments.
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Donald Trump did 'exceedingly well' on cognitive test in presidential medical exam

Jenna Johnson and Lenny Bernstein
Published: January 17 2018 - 9:44AM
Washington: President Donald Trump requested that his first formal medical exam include a cognitive test and "did exceedingly well," receiving a score of 30 out of 30, the top White House doctor announced on Tuesday afternoon.
Navy Rear Admiral. Ronny L. Jackson, who has been the lead White House doctor since 2013, said that he has interacted with the president several times a day for the past year and saw no need for a cognitive test. Jackson said that the president is "very sharp" in their conversations and does not repeat himself. He added that he has seen no evidence of any cognitive problems.
At the president's request, Jackson said that he reviewed a number of cognitive tests and then administered the Montreal Cognitive Assessment during Trump's first presidential physical exam on Friday afternoon at Walter Reed National Military Medical Center. The 10-minute exam is designed to detect mild cognitive impairment, generally in older patients. Trump answered all 30 questions correctly, Jackson said.
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Steve Bannon's mysterious - and potentially pivotal - grand jury subpoena

Aaron Blake
Published: January 18 2018 - 3:14AM
Washington: There have been a few moments in the Russia investigation that, in retrospect, seemed to indicate a notable shift or an expansion. The day President Donald Trump fired FBI Director James B. Comey. The Lester Holt interview. When we first found out about Donald Trump jnr's meeting with the Russian lawyer. The early-morning raid of Paul Manafort's Virginia residence. Michael Flynn's guilty plea.
Wednesday may have provided a smaller but significant one.
We just found out that special counsel Robert Mueller's investigation last week issued its first known grand jury subpoena to a member of Trump's inner circle. The recipient: Steve Bannon. The story broke the same day that Bannon was testifying behind closed doors in a marathon 10-hour interview with Congress' own Russia probe, and it suggests that Mueller is switching up tactics - or at least starting to employ new ones. The big, unanswered question is why.
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Russia probe: Bannon avoids grand jury after deal with Mueller

Karen Freifeld
Published: January 18 2018 - 9:05AM
Washington: Former White House strategist Steve Bannon has done a deal with US Special Counsel Robert Mueller that will see him avoid appearing before a grand jury, a source familiar with the matter said on Wednesday.
Bannon, who was a close adviser during President Donald Trump's 2016 election campaign and in his first months in office, had been subpoenaed to testify before a grand jury in Mueller's probe of links between Russia and Trump's campaign. The subpoena could prove pivotal. 
But the source, who spoke on condition of anonymity, said Mueller offered Bannon the option of being interviewed by his investigators instead, and that Bannon accepted. It was unclear when the interview would take place. 
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Former nuclear launch officer shares fears about Trump administration’s Nuclear Review Posture Review

A SHOCKING new plan for America’s arsenal of weapons has alarmed former nuclear officers, who are speaking out in fear.
news.com.au January 18, 201811:29am
EVERY day for two years, Peter Hefley would drive through Wyoming farmland to work, hoping he wouldn’t be called upon to act.
The nuclear launch officer, then 25, was one of two people who worked in an Air Force command and control centre deep underground from 2005 to 2007, maintaining a squadron of 50 of the world’s most devastating missiles and waiting for instructions to launch.
“If you imagine a hardened bunker 60 feet below the ground, that’s what we were doing,” he told news.com.au.
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No place for the race card in the political pack, but Trump plays it anyway

John Hewson
Published: January 19 2018 - 12:05AM
One of my greatest concerns with the recent, global movements against traditional politicians, major parties and political processes has been the direct or implicit reliance on racism and prejudice as a basis for the arguments advanced in support of the quest for a "political messiah", an "outsider", and for a "disruption" of the traditional.
Of course, there is a huge academic literature on the appropriate definitions to be used in discussing the issues of race and ethnicity, but most of this is irrelevant to the point in the sense that most people know and can recognise racism when they experience it, hear it, or read about it. Sometimes its quite overt, sometimes a mere "nod and wink", but few miss the racist-based message.
There should be little doubt about US President Donald Trump's views on race, despite his occasional "denials", assertions of "fake news", and/or his semantic distinctions. His election campaign theme was effectively a promise to "Make America Great Again; America First and Only" and – nod, nod, wink, wink – to Make America White Again.
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The Olympics will only make the Korea crisis worse

David Clay Large
Published: January 18 2018 - 11:40PM
Washington: In the lead-up to the 2018 Winter Olympics, scheduled for Feb. 9 to 25 in Pyeongchang, South Korea, representatives of the two Koreas have suddenly resumed direct talks, suspended two years ago, and Kim Jong-un's reclusive regime and South Korea have agreed to field a combined women's ice hockey team and march together under one flag. Kim is also sending a 130-member orchestra to the event.
Such comity is fully in accord with the modern Olympic ideal as fashioned by the movement's founder, Frenchman Pierre de Coubertin. He envisaged his project as a wonderful vehicle for international peace, global understanding, and goodwill.
But if we go by actual Olympic history, rather than the lofty claims set forth by Coubertin and his successors, the current promises of improved international relations and durable inter-Korean reconciliation could well turn out to be hollow. Participating nations have always seen the Olympiads as perfect opportunities to strut their sovereignty on a grand global stage.
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January 18 2018 - 11:00AM

Sweden prepares public for war amid unease about Russia

·         Ben Farmer
London: Sweden is preparing to issue a public information manual on what to do in the event of war, as debate in the country grows over how to deal with the threat from Russia.
The brochure due to be sent to 4.7 million households will inform the public how they can take part in "total defence" during a war and secure water, food and heating.
The booklet, with the working title If Crisis or War Comes, will also give guidance on dealing with threats from cyber attacks, terrorism and climate change.
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Loss of US soft power the hard reality of Trump's first year

Hal Brands
Published: January 20 2018 - 12:00AM
The downsides of President Donald Trump's first year in office are legion, but among the most serious has undoubtedly been his effect on American soft power. Case in point is the global response to the President's alleged remarks that the US should no longer accept immigrants from "shithole countries" such as Haiti and various African nations.
 The President's entire first year has represented a veritable assault on American soft power – one that is likely to cause damage outlasting Trump's time in office.
When we talk about America's soft power, we are talking about several related things: the global perception that America is a flawed but basically admirable society; the sense that US foreign policy serves not just its self-interest but also the broader common wellbeing; the use of non-coercive tools to achieve diplomatic goals. Over the decades, the US has benefited enormously from all these forms of soft power.
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  • Updated Jan 20 2018 at 11:16 AM

Japanese Prime Minister Shinzo Abe's soft sell to Australia

Shinzo Abe offers a half smile and the briefest of handshakes before settling himself into a green armchair at his official residence in Tokyo.
The Japanese Prime Minister has just returned from a six-nation swing through Eastern Europe and acknowledges his testing schedule with a weary laugh.
"Yes, just yesterday," he says of his return to the capital.
From that most ephemeral of opening exchanges, Abe is business-like without being unfriendly as he sits down with The Australian Financial Review, while hosting Thursday's official visit from Prime Minister Malcolm Turnbull.
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Senate Democrats block funding bill, US government shuts down

Mike DeBonis
Published: January 21 2018 - 7:32AM
Washington: Senate Democrats blocked passage of a stopgap spending bill to keep the US government open past midnight on Friday, local time (4pm ADST).
A vote to end debate on a short-term spending bill started at 10pm in a last-ditch move to avert the freeze on government spending. At 00:02 the New York Times reported the government was now officially shutdown and lawmakers would try for a bill to reopen it temporarily until a more permanent agreement could be reached.  
Democrats were demanding that a stopgap include a provision permanently shielding some undocumented immigrants from deportation, while Republicans wanted to keep that issue separate from funding and budget negotiations.
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Trump blames Democrats for government shutdown

Published: January 21 2018 - 7:42AM
Washington: For President Donald Trump, this weekend was supposed to be a celebration.
On the first anniversary of his presidency on Saturday, with the stock market roaring and his poll ratings finally rising, he had planned to rest at his Mar-a-Lago estate in Florida, feted by friends and admirers.
Instead, Trump stayed in Washington after he was unable to avert a government shutdown.
His failure to win passage by the US Congress of a stop gap bill to maintain funding for the federal government further damaged his self-crafted image as a dealmaker who would repair the broken culture in Washington.
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I look forward to comments on all this!
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David.

This Looks Like A Pretty Useful Package Of Innovations For Dermatology In The Bush.

This appeared last week.

Groundbreaking telehealth platform brings dermatology to far-flung Australia

Thea Cowie | 17 Jan 2018
An Australian telehealth dermatology service has been described as “five years in front of” anything else in its field at a recent global conference.
The Teledermatologist smartphone platform, developed by the team behind Newcastle Dermatology, offers same-day consultations for patients in rural and regional areas.
“At the World Congress of Teledermatology last year, the feedback from committee members was that our service is five years in front of anyone else in terms of the way we've done it and the platform we've used,” said Murray Corbett, who is CEO at Newcastle Dermatology and has dedicated much of the last two and a half years to developing Teledermatologist. 
The platform, which has been in operation since July, involves two apps built around FileMaker Pro 16 and incorporating a custom video conferencing system and SSL/TLS 256-bit encryption.
The first app – the client-facing app – uses the phone's built-in camera to take high-definition photos of the area to be treated and collects basic patient information. 
It can be used by patients, GPs and nurses to request a new case.
“The photos are all kept within our app – they're not stored on the doctor's or the patient's phone – and we're alerted to the fact that someone wants a consultation. Our coordinator then collects a referral and appoints one of our rostered dermatologists to the case, ” Corbett said. 
“Generally speaking, we can hook someone up to a dermatology conference within a few hours, as opposed to them waiting six months and travelling hundreds or thousands of kilometres.”
Meanwhile, the dermatologist-facing app allows the specialist to easily navigate between the secure video conference, referral letter, patient details, photographs and notes section. 
It allows dermatologists to not only diagnose, said Corbett, but also treat patients with the help of local healthcare professionals.
More here:
This seems like a carefully thought out system to provide improved skin care to the bush.
David.

Wednesday, January 24, 2018

More Confirmation It Would Seem That The Federal Government Is Not Very Realistic And Not Very Good At Big IT

This was released a few days ago:

Administration of Medicare electronic claiming arrangements

19 Dec 2017
Description
Electronic claiming for Medicare benefits was first introduced in 1992. Channels to facilitate electronic claiming were progressively introduced for use by medical practitioners, members of the public and private health insurers over the intervening decades. In 2016–17, claims for just over 97 per cent of the approximately $22 billion of Medicare benefits paid were lodged electronically.
The Department of Human Services (Human Services or the department) currently administers eight electronic claiming channels: six provider channels for point of service claiming1 and two channels for claiming by patients at their convenience. In addition Human Services provides a number of manual claiming options (in-person, dropbox, post and phone). Most of the electronic claiming channels were introduced ten or more years ago—prior to Medicare’s integration into the Department of Human Services in July 2011.2 The provider channels are:
·         Simple Mail Transfer Protocol (1999);
·         Medicare Online (2002);
·         Electronic Claim Lodgement and Information Processing Service Environment (2004);
·         Easyclaim (2007);
·         Bulk Bill Webclaim (2015); and
·         Patient Claim Webclaim (2016);
The additional channels for use by patients are Claiming Medicare Benefits Online (2011) and Express Plus Medicare Mobile App (2013).
The department’s administration of claiming channels is focussed on its overarching strategy of achieving as close as possible to 100 per cent electronic claiming.
On 19 October 2016, the Government announced it will replace the current systems used by Human Services to deliver health, aged care and related veterans’ payments as they are ‘old, complex and at risk of failure and therefore need to be upgraded’.3 The program of work is being led by the Department of Health and supported by the Departments of Human Services and Veterans’ Affairs, and the Digital Transformation Agency. This decision provides Human Services a further opportunity to consider what if any changes could be made to the current channel service offer.
Audit objective and criteria
The objective of this audit was to assess the effectiveness of Medicare electronic claiming arrangements, including an assessment of the extent to which claiming and processing efficiencies for the Government, health professionals and Medicare customers have been achieved.
To form a conclusion against the audit objective, the ANAO adopted the following high level criteria:
·         Was effective planning undertaken for the implementation and ongoing delivery of Medicare electronic claiming channels?
·         Has the implementation and ongoing delivery of Medicare electronic claiming channels been effective?
·         Does Human Services monitor and evaluate the efficiency and effectiveness with which it delivers Medicare electronic claiming?
Audit methodology
The audit’s methodology included:
·         examination of documentation relating to the administration of Medicare electronic claiming channels, including program documentation and performance reports;
·         review and analysis of departmental data related to the performance (take-up, costs/savings and timeliness) of the range of electronic channels currently available;
·         ANAO analysis of quantitative data from Human Services ICT systems; and
·         interviews with relevant departmental staff.
Conclusion
The Department of Human Services has been effective in driving the take-up of Medicare electronic claiming, with more than 97 per cent of all claims for Medicare services being lodged electronically. The department’s approach to implementing future Medicare electronic claiming could be improved by clear analysis of the costs of developing and maintaining individual claiming channels and the extent to which planned efficiencies have been realised.
The objectives of introducing electronic claiming (to improve convenience and timeliness and reduce costs to Government and the health care sector) have been met through the introduction of a range of individual channels over time to allow claiming by different users. Human Services has mechanisms in place to identify issues and consider whether channels can be improved to meet user needs.
The introduction of electronic claiming channels has led to improved access to payments for the community and providers. More than 97 per cent of claims for Medicare services are lodged electronically and a majority of these are paid within one day of lodgement.
The ANAO reviewed the available data related to expected savings and costs from implementing electronic claiming channels. These expected savings were only estimated by Human Services in some cases. Where estimates were made either take-up rates or dollar savings have not been achieved.
Although the department monitors rates of electronic lodgement and tracks movements between channels by claim type and reductions in manual services, the long term benefits and relative efficiencies from introducing individual channels are largely unknown.
Human Services’ monitoring and reporting includes business analytics used to inform channel delivery, and departmental management of risks and issues are supported by a range of plans. The department’s delivery of claiming channels is not supported by either: benchmarking of expected achievements; or a full understanding of the costs and benefits of individual claiming channels. There is a lack of information on whether the development of individual channels has delivered the intended administrative savings; and whether the savings achieved have outweighed the costs of introducing new channels. As such the department has not established a sufficiently strong information base to inform its business decisions.
Publication Details
Identifiers:  ISSN:  2203–0352 (online)
ISBN:  978-1-76033-319-5 (online)
Copyright:  Commonwealth of Australia 2017
Language: English
License Type: CC BY-NC-ND
There is a link to the full Audit here:
This paragraph summarises the problem:
“The ANAO reviewed the available data related to expected savings and costs from implementing electronic claiming channels. These expected savings were only estimated by Human Services in some cases. Where estimates were made either take-up rates or dollar savings have not been achieved.”
So they are really over optimistic on what can and will be achieved.
It would be really useful to get an audit of the myHR to assess what has been claimed for the myHR and what has actually been achieved. I can the ADHA fighting like hell to prevent that happening!
David.

This Looks Like Really Good News To Me. Nobel Prize Winning Stuff If Proven Up I Reckon.

This appeared duding last week:

Blood tests deliver cancer breakthrough

  • The Australian
  • 6:00AM January 19, 2018

John Ross

Scientists have created a blood test that can detect eight of the most common cancers long before they turn lethal, in a breakthrough that could save millions of people from premature death.
The “liquid biopsy” identifies early-stage tumours from proteins and genetic mutations circulating in the blood.
Trials have found that it can uncover fledgling cancers in about 70 per cent of cases, and up to 98 per cent for some types, long before they become detectable by other means. They include deadly conditions such as pancreatic cancer, which usually goes unnoticed until it has spread. The goal is to spot tumours before that happens, when survival rates are still high.
Dubbed CancerSEEK, the test delivers almost no false positives, sparing patients needless heartache and unnecessary medical procedures for non-existent diseases. It can also pinpoint ­tumours’ locations in about five cases out of six, paving the way for rapid treatment.
Outlined this morning in the journal Science, CancerSEEK was developed by an international team led by Johns Hopkins University in Baltimore. Three researchers from Melbourne’s Walter and Eliza Hall Institute contributed to the work.
Much more detail here:
There is also coverage here:

Major breakthrough as researchers develop blood test for eight common cancers

Aisha Dow, Gene Efron
Published: January 20 2018 - 2:20AM
An annual blood test for eight common cancers could soon become part of Australians' regular health check-up, revolutionising early detection for the deadly disease and potentially saving thousands of lives.
In a major breakthrough, researchers say they have developed a test that can identify eight types of early cancer in the period before they spread to the rest of the body.
The test screens for ovarian, liver, stomach, pancreatic, oesophagus, colorectal, lung and breast cancers - diseases collectively responsible for more than half the cancer deaths in Australia each year.
Last year they killed an estimated 25,000 people.
The test, dubbed CancerSEEK, offers particular hope for pancreatic cancer, because it is notoriously difficult to diagnose in its earlier stages. As a result, more than nine out of 10 people with the disease die within 5 years of being diagnosed.
But the researchers said there was a "wide window of opportunity to detect cancers prior to the onset of metastasis."
"For many adult cancers, it takes 20 to 30 years for incipient neoplastic lesions to progress to late-stage disease."
Although the test was not able to pick up all early stage cancers, identifying 70 per cent, it had a very low false positive rate of less than 1 per cent.
The study was led by a team of US researchers from Johns Hopkins University.
It also involved more than 400 patients from Melbourne's Footscray Hospital and two Australian scientists from the Walter and Eliza Hall Institute, Associate Professor Jeanne Tie and Professor Peter Gibbs.
Professor Gibbs said he envisaged that the test would be widely used for annual screening of older Australians more susceptible to cancer, aged about 50 to 75.
"It's also a test you would do in young people if they had a strong family history, or any other risk factor for cancer," he said.
"Because it's a blood test, it's fairly simple, we could do it quite frequently … likely once every 12 months."
Professor Gibbs said a new larger study involving 10,000 people in the United States was now underway to confirm CancerSEEK could save lives, although the consumer demand would probably be so great that it would become commercially available before that work was complete.
"It is probably about $1000 to do it at the moment," he said.
"It's likely over the coming years it will drop down to a few hundred dollars."
The closest similar test presently available is the PSA test, said Professor Gibbs. But it only tests for prostate cancer, and has been controversial because of its high rate of false positives (around 9 per cent).
The new tests screens for key proteins and gene mutations that indicate the presence of cancer, and is also able to identify the location of the cancer in many cases.
More here:
We really do live in wondrous times.
David.