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."

Saturday, January 23, 2016

Weekly Overseas Health IT Links - 23rd January, 2016.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Patients struggle with sharing health information online, cite privacy concerns, breaches, Pew report says

Fear of hacking and context of data sharing are of top concern among consumers.
January 15, 2016 04:24 PM
Just over half of Americans feel it would be acceptable for doctors to use health information websites to manage patient records, according to a new Pew Research Center survey.
Another 20 percent of respondents said it would depend on the scenario. Just 26 percent said this type of data sharing was unacceptable.
"It depends on exactly what records are shared,” one respondent said. "It would have to be a very secure site for me to trust it. Scheduling appointments online wouldn’t bother me though."
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Teledermatology helps improve access to face-to-face care

January 15, 2016 | By Susan D. Hall
A teledermatology program helped improve patient access to face-to-face care in a study at the Mann-Grandstaff Spokane Veterans Administration (VA) Medical Center in Spokane, Washington.
Most teledermatology research focuses on specialist visits avoided, notes the report, published in Telemedicine and e-Health. In light of the VA wait-time scandal, these researchers wanted to examine the effect of teledermatology on wait times for specialist appointments.
As a means of dealing with the burgeoning demand for dermatology services, the VA center trained two primary care physicians to perform basic dermatology procedures at its rural clinics. It also implemented a store-and-forward teledermatology program at the rural clinics. Later, it expanded teledermatology at its main Spokane location.
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Why Big Data still isn't putting a dent in Medicare fraud

January 12, 2016 | By Evan Sweeney
Big data and predictive analytics were supposed help Medicare prevent fraudulent payments the same way credit card companies deny suspicious charges. Fraud schemes still plague Medicare because the Centers for Medicare & Medicaid Services (CMS) is too concerned about provider backlash to use the full force of claims data, according to an article published in Pacific Standard.
The article dives into the history of Medicare fraud and the way organized crime entities have infiltrated the system by setting up sham clinics, stealing physician and patient information and billing Medicare indiscriminately. CMS pays the claims until it recognizes an anomaly, but by then, the scammers have moved on. Some investigators have referred to this "pay-and-chase" model as an endless game of Whac-a-Mole.
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Mercom: Healthcare IT funding reached $4.6B in 2015

January 14, 2016
Healthcare IT funding, spread across 574 deals, reached $4.6 billion in 2015, according to Mercom Capital Group. This was a drop from the 2014 total, when Mercom recorded $4.7 billion in 670 deals.
The market intelligence firm said that between 2010 and 2015, healthcare IT funding reached $13.4 billion in 2,050 deals.
Some of the larger rounds that Mercom tracked include China-based Guahao’s $394 million, NantHealth’s $200 million, ZocDoc’s $130 million, and Virgin Pulse’s $92 million.
“After an incredible run from 2010-2014, VC funding into health IT companies leveled off last year,” Mercom Capital Group CEO and Cofounder Raj Prabhu said in a statement. “We are beginning to see a slowdown in early stage deals, a sign the sector is beginning to mature. We are also seeing funding trends shift from practice-focused to consumer-focused technologies and products. Apart from innovative technologies and solutions, business and revenue models are becoming more important.”
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Stakeholders Question Efficacy of New Cybersecurity Law, HHS Task Force

by Joe Infantino, iHealthBeat Senior Staff Writer Thursday, January 14, 2016
A soon-to-be-convened HHS task force and its forthcoming report on cybersecurity mark a step toward strengthening privacy and security in health care, but it might have been the wrong one to take, some experts say.
"The industry already knows what needs to be done," said David Harlow, a health care attorney, consultant and author of HealthBlawg, citing data encryption and training to avoid human-error breaches as a few best practices. "We don't have to wait for a report in order for those things to happen."
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ONC task force solicits information on creating EHR comparison tool

January 13, 2016 | By Marla Durben Hirsch
The Office of the National Coordinator for Health IT's new certified technology comparison task force held both a virtual hearing and a meeting last week, in its goal to create draft recommendations on a tool that can compare electronic health record systems.
According to the task force, the tool could be useful for providers making their first EHR purchase, considering a modular component purchase to meet new health IT needs, and determining what products are in the market to assess further purchases. The task force acknowledged that purchase needs vary by practice size, location, specialty and provider type, and that the tool should be searchable by multiple categories at a time. Existing tools do not include comparisons on cost, interoperability or usability (workflow and safety); the tools also need to provide information beyond what is captured through ONC's certification program.
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HL7 and ONC launch challenge seeking C-CDA rendering tools for clinicians

The new contest offers $15,000 in hopes of better managing an viewing an 'overabundance of data' rendered by electronic health records.
January 14, 2016 04:23 PM
Health Level 7 and the Office of the National Coordinator for Health IT kicked off a new challenge that aims to alleviate provider frustrations with the usability of HL7's consolidated clinical document architecture standard. 
The C-CDA is s an XML-based document markup standard specifying the structure and semantics of documents – imaging reports, discharge summaries – exchanged among providers and patients.
The process by which C-CDAs are made human readable is called rendering: a chief requirement of the documents is that all relevant clinical content be present – and renderable – in human readable form.
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Report: Majority of mHealth Apps Contain Critical Security Vulnerabilities

January 13, 2016
by Rajiv Leventhal
While most mobile health (mHealth) app users and executives believe that their apps are at least adequately secure, many of the health apps tested that were approved by FDA or the UK National Health Service (NHS) were actually found to be vulnerable, according to a report from Bethesda, Md.-based IT security vendor Arxan Technologies.
 A combined 84 percent of mobile app users and mobile app executives believe that their mobile health and finance apps are "adequately secure," and 63 percent believe that app providers are doing "everything they can" to protect their mobile health and finance apps. However, according to the report, the 5thAnnual State of Application Security Report, the majority of mobile health and finance apps contain critical security vulnerabilities.
The new research is based on the analysis of 126 popular mobile health and finance apps from the U.S., UK, Germany, and Japan, as well as a study examining security perspectives of consumers and app security professionals.
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Theresa May refuses to say whether UK spies access medical data

  • 13 January 2016
Theresa May has refused to say whether Britain's security services are accessing medical records and other potentially sensitive information.
The home secretary said she did not want to "go down the route of giving information about the sort of data sets that are being acquired".
She was speaking to the draft Investigatory Powers Bill committee.
It was revealed last year that GCHQ is downloading large amounts of personal data to aid its investigations.
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Feds change HIPAA rule to facilitate gun background checks

Jeff Rowe
Jan 13, 2016
The Office of Civil Rights (OCR) has taken a number of steps recently designed to provide greater protections to both patients and the public under the HIPAA Privacy Rule.
First, last week, in response to President Obama’s executive actions on gun control, OCR said it will change the rules so that mental health providers can share data with the National Instant Criminal Background Check System.  This will allow mental health providers to show the identities of patients subject to a federal mental health prohibitor that prevents them from shipping, transporting or possessing a firearm.
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Why the Feds Want Better Patient Records Access

JAN 11, 2016 9:58pm ET
The HHS Office for Civil Rights recently issued extensive guidance for providers, insurers and patients on rules under the HIPAA law to enable patients to get paper or electronic copies of their medical records.
The guidance is long overdue; patients have had this right for a decade or longer, and many still face obstacles in getting their records. But how useful will the guidance actually be? And with little federal enforcement over the years, will compliance improve?
OCR has paid attention to the right of patient access, responding to patient complaints by working with providers and helping them understand their compliance obligations, says Jodi Daniel, formerly director of policy in the Office of the National Coordinator for Health Information Technology and now a partner in the law firm of Crowell & Moring.
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Precision medicine plus electronic health record data can boost outcome predictions

Battelle research leader Nancy McMillan will delve into the use of big data in healthcare at HIMSS16 in Las Vegas.
January 12, 2016 08:10 PM
Electronic health records are making data more readily accessible to physicians and laying a foundation for the next big step: translating EHR data into actionable information for precision medicine.  
"Precision medicine is a great opportunity to start using behavioral health data, like activities and eating patterns," said Nancy McMillan, research leader of advanced analytics at Battelle.
McMillan will delve into the use of big data in healthcare at HIMSS16 in Las Vegas, beginning in late February.
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Meaningful use will likely end in 2016, CMS chief Andy Slavitt says

New regulations aimed at value-based payment models demand a more streamlined regulatory approach, acting administrator tells audience at J.P. Morgan Healthcare Conference.
January 12, 2016
04:32 PM 
The meaningful use program is on the cusp of major changes, the Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt said late Monday, adding that 2016 would likely see the end of the program altogether.
The Medicare Access & CHIP Reauthorization Act of 2015, with its emphasis on a new Merit-Based Incentive Payment System and alternative payment models, demands a new streamlined regulatory approach, he said, speaking at the J.P. Morgan Healthcare Conference in San Francisco.
Slavitt also posted the news on Twitter on Monday.
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Meaningful Use Program 'Effectively Over,' Says CMS Head

Scott Mace, for HealthLeaders Media , January 13, 2016

MU will be "replaced with something better," says Andy Slavitt. Reaction from healthcare CIOs is largely one of relief.

For the first time, the leader of the Centers for Medicare & Medicaid Services has said publicly that the agency "has the opportunity" to sunset the meaningful use program in 2016.
Andy Slavitt, acting administrator of CMS, made his remarks Tuesday at the J.P. Morgan Healthcare Conference in San Francisco. Slavitt's full remarks were then posted on the CMS blog, and summarized in a series of tweets.
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Why CIOs must start building wearables infrastructure

January 11, 2016 | By Judy Mottl
Ensuring user privacy and keeping customer data safe must become non-issues before the healthcare industry will fully embrace mHealth wearables, according to new industry research.
The Forrester report reveals 21 percent of consumers are now using a wearable to track health and wellness activity, and the data is providing a much more accurate depiction of a user's healthcare status. But challenges such as meeting HIPAA mandates and regulatory compliance on data storage must be solved before the data gathered via Internet of Things (IoT) technologies, such as wearables, can be leveraged for full benefit.
"While, in theory, clinicians should be rushing to promote these devices and incorporate the data from them into care methods, the reality is that there are significant impediments before they can use it," Kate McCarthy, a Forrester senior analyst serving chief information officers, writes in the report.
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HIMSS: 5 key points on the value health IT

Written by Carrie Pallardy | January 11, 2016
Health IT, particularly EHRs, is often criticized as cumbersome and expensive, but this technology can produce value. 
The 2016 HIMSS Value of Health IT Survey examines the various ways in which EHRs can prove valuable to healthcare stakeholders. Here are five key areas of value.
1. Clinical value. Eighty-three percent of survey respondents indicated their organization's EHR implementation resulted in improved clinical staff quality performance efficiencies. Additionally, 52 percent of respondents reported increased staff productivity.
2. Savings value. Most organizations (90 percent) have a formal measurement in place with at least one financial metric, according to survey respondents. Of these respondents, 81 percent indicated their organizations documented a positive impact in savings. The three most common areas for savings were coding accuracy, days in accounts receivable and transcription costs.
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Supercomputer helps Minneapolis doctors with cardiac decisions

Doctors at Allina Health hope to reduce invasive procedures using new technology. 
By Jeremy Olson Star Tribune
January 11, 2016 — 11:28pm
Jerry Holt • jerry.holt@startribune.com Colleen Loye, 77, was able to avoid an invasive cardiac test thanks to a new supercomputer. She has suffered two heart attacks and also has breathing problems from a lifetime of smoking and working amid chemicals as she restored old cars.
A California supercomputer is advising heart specialists in Minneapolis on when they should — and more importantly when they shouldn’t — thread instruments inside patients’ blood vessels to examine blockages.
The so-called HeartFlow system uses images from a patient’s CT scan and analyzes them against volumes of data on the human vascular system and the science of fluid dynamics. As a result, it can diagnose patients’ needs — and help doctors avert heart attacks and stroke — without the costly and invasive procedure of inserting a catheter.
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HHS unveils new tools to help patients understand privacy rules under HIPAA

Federal agency says people too often face obstacles to accessing their health information.
January 11, 2016
04:17 PM
To make it easier for people to gain access to their personal health information, the U.S. Department Health and Human Services had posted some clarifications about individuals' right under HIPAA privacy rules.
“Unfortunately, based on recent studies and our own enforcement experience, far too often individuals face obstacles to accessing their health information, even from entities required to comply with the HIPAA Privacy Rule,” Jocelyn Samuels, HHS director of the Office for Civil Rights wrote. “This must change.” 
HHS explained that the “Privacy Rule requires HIPAA covered entities (health plans and most health care providers) to provide individuals, upon request, with access to the protected health information about them in one or more ‘designated record sets’ maintained by or for the covered entity,” HHS said. ”This includes the right to inspect or obtain a copy, or both, of the PHI, as well as to direct the covered entity to transmit a copy to a designated person or entity of the individual’s choice.” 
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Telemedicine use at senior living communities reduces ED visits

January 11, 2016 | By Katie Dvorak
Providers, payers and other organizations should consider teaming up with senior living communities (SLC) on telemedicine to reduce visits to the emergency department.
Patients living at communities that are more engaged with technology and telemedicine see a decrease in ED use, according to a study published in Telemedicine and e-Health.
The researchers, from the University of Rochester School of Medicine and Dentistry and the University of Wisconsin School of Medicine and Public Health, examined a total of 1,219 seniors. Of those, 479 received telemedicine care, while 740 did not.
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HIT startups may see more scrutiny following Theranos scandal

January 11, 2016 | By Katie Dvorak
Startups may find the healthcare market harder to break into and the scrutiny of what they offer more severe after recent reports about the veracity of lab testing company Theranos' technology.
New health IT entrepreneurs will have to be careful of overhyping their products, Justin Smith, a pediatrician and medical advisor for digital health at Cook Children's in North Texas, tells Fast Company.
"If we overhype things that aren't real--and I'm not saying it [Theranos's technology] is not--that we'll have a harder time getting buy-in for things that are real," he says.
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AMA Lists Health Data Security, Telemedicine Among Top Issues Facing Physicians in 2016

January 8, 2016
by Heather Landi
This week, the American Medical Association (AMA) released a list of the top nine issues physicians should follow closely in 2016 and a number of health IT issues, namely data security and telemedicine, made the list.
Medicare reform and the electronic health record (EHR) Meaningful Use program topped the list.  “The Merit-Based Incentive Payment System (MIPS) under development is intended to streamline the various reporting programs for physicians, and alternative payment models (APM) will support physicians in adopting new models of care. Shaping the MIPS so that it fixes the problems of the current system and is beneficial for both physicians and patients will be at the heart of Medicare reform efforts in the coming year,” the AMA wrote in a release.
The AMA said it would continue its work on this front, including a task force of physicians who already drafted and delivered to the Centers for Medicare & Medicaid Services (CMS) 10 principles to guide the foundation of the MIPS.
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2016 Will Be the Year Person-Centered Care Comes to the Forefront

by Carla Smith Monday, January 11, 2016
2015 set significant foundations for change. From the 8.4 million Americans obtaining insurance through Obamacare to the rise in digital health investments, reaching more than $4.3 billion in funding and 180 merger and acquisition deals, value-based and person-centered care were increasingly discussed in 2015. In 2016, we'll experience more change as value-based care continues to expand in health facilities across the nation. The future looks bright as we strive to ensure the right care is provided to the right person at the right time in a cost-effective manner. Here are a few predictions for health care in the New Year:

Prediction One: Changing payment models will increasingly require value for the patient, and we'll see a corresponding reduction in payments for volume-based care.

A year ago -- in January 2015 -- HHS set a goal that fundamentally changes the way Medicare pays for care. Across the nation, providers and beneficiaries are adjusting their relationships in anticipation of this pivotal change in payments becoming increasingly tied to care quality and care value. Thanks to its influence over the speed with which other payers transition to value-based care payment models, HHS' goal represents a game-changer.
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The Federal Vision For Healthcare IT: A Dystopian Paradise

Posted Dec 31, 2015 by Roy Wyman
Roy Wyman Crunch Network Contributor
Roy Wyman is a partner at Nelson Mullins Riley & Scarborough LLP and is a member of its Healthcare Regulatory and Transactional Team.
In a year not too distant, Loretta, a woman in her late 20s, hears a pleasant tone from her watch and checks to see a text. The message isn’t from a friend or work, it’s from the watch itself: “You’re pregnant.” Loretta is surprised; conception was merely days before. But pregnancy is one of the many tests constantly checked by her wearable and household technology.
A minute later, a second text comes through — this time automatically generated by her doctor’s office — conveying a list of dates and times that her calendar and her physician’s are both open for a video conference. Based on that meeting, a plan of care will be agreed upon, with any necessary medications automatically delivered to Loretta’s home, dispensed through a small, web-connected device in her kitchen, paid for by her insurance company automatically and seamlessly.
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Enjoy!
David.

Friday, January 22, 2016

How To Prove You Are A Really Tin-pot Institution Not Worthy Of Being Called A University. - Updated

This was reported last week. Approving a thesis of this sort is all the proof you need!

Anti-vaccination activists spruik PhD thesis as proof of conspiracy

  • The Australian
  • January 16, 2016 12:00AM
Anti-vaccination activists have seized on a PhD thesis accepted by the University of Wollongong, claiming a vast conspiracy between global health agencies to push immunisations, to argue that the thesis is proof vaccines are ineffective and unsafe.
Judy Wilyman’s thesis, awarded through the university’s social sciences faculty, included unreferenced claims that the World Health Organisation was “perceived to be out of touch with global communities and … controlled by the interests of corporations and the World Bank”.
Social media accounts aligned with the Australian Vaccination-sceptics Network urged followers to “download, read, share” the thesis, while a Gard­asil (HPV vaccine) awareness group posted “This study shows that not all vaccines are safe and effective, or indeed necessary”.
The PhD awarded to Dr Wily­man — who has previously falsely linked vaccination with autism — has dragged the university into a debate about immunisa­tion and academic rigour. Dr Wilyman is not the first academic at the university to make similar links.
More here:
If ever there was some branch of science where the science is settled vaccination is it!
That the world is free of smallpox, almost free of polio and that in developed countries vaccine preventable deaths have all but disappeared is demonstrable and obvious.
The UoW has no mature medical school to balance this nonsense and it is clearly a place where pseudo-science has much too much influence. That the university's internal systems did not prevent this nonsense reflects a rather sad lack of scientific pursuit of truth and objectivity.
The place should simply be defunded.
David.

Update Jan 27, 2016.

This article has appeared in the Australian.

Wollongong should never have accepted Judy Wilyman’s thesis

  • The Australian
The awarding of a PhD to Judy Wilyman has been slammed by critics from many corners. The thesis, purportedly a critical analysis of the Australian government’s rationale for its vaccination policy, was conducted under the supervision of Brian Martin, professor of social sciences at the University of Wollongong.
Wilyman appears to demonstrate such a profound lack of understanding of vaccination and immunology that the thesis is simply not fit for purpose. Making errors that would surely be unacceptable in an undergraduate course, Wilyman also appears to demonstrate a lack of understanding of the principles of vaccination, distort and misrepresent references, and present bizarre conspiracy theories to explain vaccination policy.
Martin has lately written an article in Wilyman’s defence, claiming that the criticism is a “clear and direct attack on academic freedom”. Rather, Martin and Wilyman need to accept that freedom runs two ways — while they are free to write a thesis, I and others are free to express our opinion and criticise it. Martin, it seems, makes a habit of supervising controversial students and then publishing articles about how poorly their work is received.
As a medical practitioner, I am compelled to exercise my freedom of speech when confronted by dangerous public health misinformation. No one has earned the right not to be criticised when their misguided opinion may endanger the lives of those around us. And with academic freedom comes responsibility.
Wilyman has been exercising her freedom of speech for some years, sometimes in a cruel and inhumane fashion. In 2012, she wrote that she suspected the parents of a child who died of whooping cough were receiving money from a lobby group to promote vaccination. She requested that her inquiry be passed on to those parents. Read that again, and consider how callous it is.
As you might expect, Wilyman and her “research” have been the subject of some scrutiny for several years. She published much of it in newsletters and on her website prior to submission, and her seemingly flawed understandings were repeatedly pointed out to her. Time and again, she refused to correct these glaring errors.

.....

The University of Wollongong has failed several times over. In my view Wilyman did not have adequate supervision from a person qualified to consider and remedy her lack of scientific appreciation of vaccination. Her supervisor admits to taking a passive role in her study and seems to have neglected to prevent her committing fundamental errors. He should not be permitted to use students as a means to push his own erroneous “whistleblower” wagon.
The University of Wollongong has failed its current and past PhD graduates. By demonstrating how low its standards are in accepting a thesis, it has increased the likelihood of other PhDs being tarred with the same brush. It has attempted to spin criticism of Wilyman’s thesis as an attack on academic freedom, but has failed dramatically. The release of this thesis demonstrates the failings of the university on multiple levels.
The university has failed its students and staff, and has potentially been complicit in one of the worst miscarriages of academic endorsement this country has ever seen.
John Cunningham is an orthopedic surgeon and spokesman for Stop the AVN.


Here is the link:

http://www.theaustralian.com.au/higher-education/opinion/wollongong-should-never-have-accepted-judy-wilymans-thesis/news-story/304956bbe891402206dbbbccfa02e340

 All I can say is keep up the good work John!

David.

Thursday, January 21, 2016

The Macro, Macro View - General And Health News Relevant To E-Health And Health In General.

(Note links are accessed by clicking the actual link above the article title!)

January 21 Edition
Here is some other of the recent other news and analysis.
Clearly the big news in the last few weeks has been macroeconomic with oil slipping to be worth less than $US30 a barrel, sinking global share markets, Chinese manipulation of the yuan, falling bond yields and a gentle uptick in the price of gold.
The key reason seems to be that investors woke up on Jan 1, 2016 and decided there was a world full of overvalued assets and felt they needed to come back a bit now that the US was starting to raise interest rates. Thus far it has not gone all that well!
Interestingly we have had very few comments from the Government. I wonder if they are concerned or not. The falling commodity prices must be putting a huge hole in the Budget!
See here:

Treasurer Scott Morrison goes missing in market storm

  • The Australian
  • January 14, 2016 12:00AM

David Uren

Politicians need a holiday as much as anyone else and issues arising on the national agenda often disappear into the haze over the Christmas and New Year period. Still, the golden silence over the past week and a half of global economic turmoil has been striking. It is already having a measurable impact on consumer confidence. Scott Morrison was on leave until this week and as acting treasurer, Mathias Cormann can be forgiven for not leaping to the microphone.
But Morrison has so far been reluctant to fulfil one of the trad­itional roles of the Treasurer, which is interpreting global economic events for the public, explaining what is happening and what the government can and cannot do about it. He will not comment on sharemarkets. He deflects questions about developments in the Chinese economy, iron ore pricing or Australia’s terms of trade.
“It’s not for me quite genuinely to commentate on these things and that’s not what I’m seeking to do as Treasurer,” he says. “What I’m seeking to do is focus on the policy decisions in response to these ­movements.”

Note: Things seems to have gone from bad to worse since this article and what is worse. As of Thursday afternoon we have had little in the way of a coherent explanation as to why we should not be greatly concerned. The ASX/200 Share index is presently at about 4900 - which means that pretty much every super fund and share portfolio have taken a significant hit this financial year. (down from 5495 or so just a little over six months ago.) While we can all joke about about the various Chinese share markets the synchronised 15%+ drops seen in London, Paris, Frankfurt and Wall St suggest there is something pretty serious wrong.

I don't claim to know what the root cause of all this present turmoil is (other than a needed correction in some excessive Price / Earnings expansion in the US and to a lesser degree elsewhere) but right now it would be a courageous assumption to believe that it will all blow over painlessly - it may very well may not! Time will tell I guess.
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General Budget Issues.

'Don't worry' budget plan is built on bracket creep

Date December 21, 2015 - 9:05AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Scott Morrison said the government's budget rules mean any new spending "must be fully offset".
I hope events prove me wrong, but I have a feeling that, whatever its other virtues, the Turnbull government won't be the one to get the budget back to surplus.
And that does matter. One of the reasons we escaped the Great Recession was that, unlike other countries, we went into it with little public debt. This allowed us to stimulate private sector activity and restore confidence with vigour and without hesitation.
It's looking likely we won't be so well placed next time. We used to have exemplary fiscal discipline – an example to the world – but now that distinction is slipping from our grasp.
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  • Updated Dec 28 2015 at 5:14 PM

Levers against global volatility

The 2016 budget is going to have to answer questions of whether we can generate real growth without resorting to easy money or more debt, and whether there is sufficient firepower to deal with new threats.

by The Australian Financial Review
Treasurer Scott Morrison will spend the next five months writing the trickiest budget in years. Revenue forecasts routinely crumble these days, while spending is evidently hard to curb. Commodity indices are near their end-2008 lows, our GDP growth is sub-par, and we are only part-way through a transition from mining boom to sustainable non-mining investment.
Mr Morrison, as our chief political correspondent Phillip Coorey reports today, has boldly dumped the fixed timeline to surplus and the political point-scoring that goes with it. But he now has to rely heavily on the markets trusting him to eventually deliver. Budget discipline is not hairshirt economics for the sake of it. The weakness and volatility of the post-GFC world may make it harder to force the pace on budget repair, but it also makes it even more important to protect our fiscal position. Along with monetary policy, fiscal policy is one of the big levers our economic managers can pull when things go wrong.
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Tax white paper: Our pension is too mean, our super tax concessions too generous

Date January 13, 2016 - 12:57AM

Miranda Stewart and David Ingles

A more generous pension could be easily offset by reining in super tax concessions and adding the family home to the asset mix.
Why are we so stingy with access to the pension (to the point of discouraging pensioners from working), yet so generous with superannuation tax concessions, even though there is scant evidence they boost savings?
It's one of the biggest questions Treasurer Scott Morrison will have to face as he decides the shape of his tax white paper, expected midyear.
We are proposing a rebalancing of super and pensions that we think would be popular and make Morrison an extra $20 billion  a year, which would come in handy, given the state of his budget.
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Two tax options, but only one lifts the GST

  • The Australian
  • January 16, 2016 12:00AM

David Uren

Scott Morrison’s tax white paper taskforce is working on two major options, both including personal income tax cuts, changes to superannuation and limits to negative gearing but only one containing a hike to the GST.
The preference of the Treasurer and Malcolm Turnbull is for the bigger package, with an ­increase in the GST, which could fund a much more comprehensive reform of both federal and state taxes.
But this would need the backing of state governments, several of which have ruled out supporting a change to the GST.
The smaller package, without the GST increase, would enable the Turnbull government to go to this year’s election promising personal income tax cuts to relieve the impact of bracket creep ­together with cuts to superannuation concessions and negative gearing limits that would be presented as enhancing equity in the tax system.
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Health Budget Issues.

  • Updated Dec 20 2015 at 8:44 PM

Sussan Ley to fight pathology companies over price rises

Health Minister Sussan Ley has hit back at pathology companies that have threatened to introduce a co-payment in response to federal budget health cuts, slamming price hikes as inappropriate. 
The federal government wants to cut bonus payments it offers for pathology services and reduce incentives for magnetic resonance imaging (MRI) from 15 per cent to 10 per cent of the Medicare benefits schedule fee.
The government hopes the cuts, to apply from July 1, 2016, and laid out in last week's budget update, will save $650.4 million over four years.
One of the largest pathology providers, Sonic Healthcare, came out almost immediately, saying it would make up for the cuts by charging for pathology tests that patients now  get free, while the chief executive of Primary Health Care, Peter Gregg, signalled he would also pass on the funding cuts.
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Major pathology business in Health Minister Sussan Ley's electorate to close

Date December 23, 2015 - 11:40AM

Jane Lee

Legal affairs, health and science reporter

A major pathology business in Health Minister Sussan Ley's electorate will close on Christmas Eve, buckling under funding pressures to the sector in recent years.
“It's a bit rich for the sector to now try and portray the aggressive acquisition strategies of big, listed corporations as 'consolidation' in the sector. 
“Health Minister Sussan Ley
Border Pathology, which is based in Albury-Wodonga, in Ms Ley's electorate of Farrer, has been sold to the region's main provider, Dorevitch Pathology, creating a "monopoly" of pathology services in the region, a Border Pathology source familiar with the sale said.
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Why we all have a problem with expensive drugs

Date December 23, 2015 - 9:00PM

Adrian Pokorny

Australia has a drug problem. Our health system is addicted to expensive pharmaceuticals.
This in itself is not a bad thing. Medical care has advanced to the point where many previously lethal conditions can be managed as chronic illnesses. We are privileged to live in a time and a place where this is feasible. But is the huge cost of some medications completely justified?
Two recent events have brought this issue to the forefront. The first is the rise and fall of businessman Martin Shkreli. He rose to prominence this year when he bought the manufacturing rights for a drug called Daraprim, a brand of pyrimethamine used to treat both malaria and toxoplasmosis.
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Vaccine objector numbers fall to three-year lows as payment cuts loom

Date December 26, 2015 - 11:30PM

Matthew Raggatt

Reporter at The Canberra Times

The federal government's policy where those with a conscientious objection to having their children vaccinated will no longer be eligible for child benefits, has been welcomed by the ACT chief health officer but condemned by some parents.
The rate of recorded conscientious objectors has fallen to three-year lows as vaccine law changes which will strip hundreds of Canberra parents of federal payments worth thousands of dollars take effect from January 1.
The extension to the federal government's "no jab, no play" policy has been welcomed by the ACT chief health officer but condemned as draconian by parents who have reported negative reactions to vaccines.
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Medical Benefits Schedule taskforce finds 23 services for chop

  • The Australian
  • December 28, 2015 12:00AM

Sean Parnell

A taskforce reviewing the Medicare Benefits Schedule has identified an initial 23 taxpayer-funded medical services that experts ­believe should no longer be used.
The clinical committees established by the taskforce have for the first time red-flagged MBS items that are either obsolete, wasteful or dangerous, asking the health sector for feedback before the taskforce moves to remove them from the list.
Nine of the MBS items flagged for removal are in ear, nose and throat surgery, seven in diagnostic imaging and five in gastro­enterology, reflecting advances that have occurred in these specialties in recent years. Combined, the 23 items were used 52,500 times in 2014-15, attracting $6.8 million in Medicare benefits that could be saved by the government or redirected elsewhere. In one case, a committee suggested a replacement technology be considered for listing on the MBS.
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Nursing home profits soar as patient care declines

Date January 1, 2016 - 11:45PM

Tom Allard

National Affairs Editor

EXCLUSIVE
The profits of aged care homes surged 40 per cent in the past year as operators cut hours of nursing care while claiming higher payments from the federal government for servicing more of the most frail patients.
The earnings boom in the sector comes after the government introduced widespread reforms of aged care in 2014, including deregulating fees and lifting restrictions on the accommodation bond that nursing homes can levy on residents.
It also coincides with a spike in false claims by aged care home providers for government subsidies, which rise based on the level of need of the patient.
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Major reviews to healthcare system plot more changes in 2016

January 3, 2016 8:50pm
Sue Dunlevy News Corp Australia Network
LAST year was the year we avoided a $7 GP fee and a $5 prescription medicine price hike but six major reviews are plotting other major changes to the health system for 2016.
Primary health care, Medicare rebates, private health insurance, prescription medicine payments, mental health care and electronic health records are all slated for major changes under these reviews.
These and other health reforms, to be rolled out from 2016, will push up the cost of blood tests and scans, change your relationship with your GP, see you dragooned into an e-health record and increase your private health insurance costs — but might save you $1 on your prescriptions.
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Pathology Australia To Lobby Government Over Pap Smear Fees, Rallies Scheduled For February

 |  By Sam McKeith
Posted: 10/01/2016 11:16 AEST
The peak body for Australia's pathologists is taking its fight to Canberra over proposed federal government budget cuts that could see pap smears cost up to $30.
Pathologists have warned that women are likely to have to pay upfront costs for the cervical cancer screening test due to the government's removal of bulk-billing incentive payments to pathology services flagged in December.
The proposed scrapping of the payments was outlined in the Government’s Mid Year Economic Fiscal Outlook and relates to pap smears as well as other services like MRIs, blood tests and X rays.
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Cuts will force diabetes patients to 'pay hundreds more for blood, urine tests', say pathologists

Date January 13, 2016 - 6:04PM

Jane Lee

Legal affairs, health and science reporter

Diabetics could be out of pocket hundreds of dollars each year for their treatment if cuts to pathology go ahead, raising the risk of complications including kidney disease, doctors warn.
Health Minister Sussan Ley flagged plans to cut and limit bulk billing incentive payments for pathology and diagnostic imaging services last month, saving the government $650 million over four years.
Dr Nick Musgrave, president of Pathology Australia, said that without the payment, most pathology services would no longer be bulk-billed. Major pathology providers have already indicated they will pass losses from the cuts on to patients.
About 1.7 million Australians with diabetes, he said, could have to pay more than $400 upfront for a year of standard blood and urine tests to monitor their kidneys and risk of heart disease. Higher costs could deter some patients from doing the tests "making management of their diabetes more difficult for their doctors, and will result in an increase in complications of diabetes including kidney disease and blindness," Dr Musgrave said.
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  • Updated Jan 8 2016 at 4:32 PM

Federal healthcare reform: a major shakeup or a review-fest?

The Department of Health is awash with reviews, any one of which could usher in big changes to the healthcare system. As a group they pose an acid test for health minister Sussan Ley: can she put in place the combined outcomes she has potentially unleashed?
Patient relationships with GPs, private health insurance, care for the mentally ill, the Medicare rebate and the pharmacy sector are all slated for an overhaul.
Meanwhile the Reform of the Federation white paper overshadows the flurry of reviews, with potentially massive shifts in how the Commonwealth and the States fund care.
In total, $154.6 billion was spent on healthcare in 2014, almost 10 per cent of GDP, and the ageing population means that costs will rise.
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Health Insurance Issues.

AMA, insurers dig in for private health battle

Date December 21, 2015 - 5:27PM

Tim Binsted

Reporter

The doctors' lobby has warned the government not to allow health funds to price insurance based on factors such as age and lifestyle, while attacking "junk" policies that don't cover common procedures.
Government budgets are under severe strain and surging healthcare costs have put pressure on public finances and insurance premiums, prompting a federal review into private health insurance, alongside several other reviews into the health system.
In its submission to the review the Australian Medical Association took aim at insurance policies with exclusions, saying patients with such policies are often shocked to discover they are not covered for a common procedure.
"Doctors are seeing this happen on a daily basis," AMA president Brian Owler said.
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  • Jan 5 2016 at 6:34 PM
  • Updated Jan 5 2016 at 6:35 PM

Medicare surcharge may have to increase for high earners: health funds

The Medicare levy surcharge may have to be increased to ensure high-income earners continue to opt in to private insurance, the peak body for health funds says.
It is already about $16 cheaper for somebody earning $90,001 to pay the 1 per cent surcharge than to take out a basic level of cover.
The surcharge was introduced to reduce pressure on the public hospital system by encouraging those who could afford it to buy private health insurance.
But with the cost of yearly premiums outstripping wages growth, the surcharge "stick" was becoming less effective, Private Healthcare Australia acting chief executive Steven Fenner said.
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Medical errors list pits insurers against hospital operators

  • The Australian
  • January 7, 2016 12:00AM

Sean Parnell

The first official list of avoidable hospital complications is set to reignite the debate between health insurers and operators over who pays when things go wrong.
Medibank Private, the nation’s largest insurer, was last year involved in a protracted dispute with the Calvary hospital group over a list of preventable errors and poor results the health fund argued it should not have to pay for.
At the height of the dispute, Health Minister Sussan Ley asked the Australian Commission on Safety and Quality in Health Care to fast-track an expert list to “help end the current cynical game of thrones where certain private health insurers and hospitals are more focused on painting each other as villains rather than supporting patients”.
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Consumers Health Forum urges single insurance standard

  • Rebecca Urban
  • The Australian
  • January 8, 2016 12:00AM
Private hospital insurance would be standardised, providing a minimum level of cover to attract the government rebate, in a proposal being pushed by a leading healthcare advocate.
Weighing in to the federal government’s review of the $19 billion private health insurance industry, the Consumers Health Forum has called for a central database of ­approved policies to be established in a bid to increase transparency across the industry and give customers greater buying power.
It is hoping the plan will weed out so-called “junk policies” that are increasingly being marketed to younger, budget-conscious customers, despite hefty criticism of their highly exclusionary nature.
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Pharmacy Issues.

Pharmacy in interesting times: a look back at 2015

AJP takes a look back over the events of 2015, a turbulent year in the history of community pharmacy

“May you live in interesting times,” is purportedly an ancient Chinese saying; regardless of the rather more recent origin of the phrase, it’s meant to be a curse, as interesting times aren’t exactly the most stable to live through.
Australian community pharmacy has had a very interesting year. It’s withstood a barrage of mainstream media attacks on the rules governing it, and recommendations from a variety of quarters that the industry be deregulated.
Even after the Sixth Community Pharmacy Agreement was signed, uncertainty reigns, whether regarding the fate of OTC codeine products, how the Pharmacy Remuneration and Regulation Review will pan out, and what the $1 script copayment discount will mean in practice.
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Pharmacists demand Ley fix Osteo 'mistake'

January 11, 2016
AAP
Pharmacists demand Ley fix Osteo 'mistake'
Pharmacists are demanding the Turnbull government rectify a "mistake" that could triple medicine costs for pensioners, threatening to campaign against it until it's fixed.
The Pharmacy Guild says the decision to remove Panadol Osteo from the Pharmaceutical Benefits Scheme on January 1 was an "elementary error" that will force almost two million osteoarthritis sufferers to pay significantly more for essential pain medication.
Health Minister Sussan Ley has asked the Australian Competition and Consumer Commission to investigate after the makers of the medicine hiked their prices by 50 per cent.
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Panadol Osteo referral: a first for the Minister

It is the first time Health Minister Sussan Ley has referred a company to the ACCC due to the “unique” circumstances surrounding the price rise for Panadol Osteo, a spokesman for the Minister told the AJP.

The spokesperson says the Minister is also concerned about GSK’s market dominance and “misleading claims” and “justification” for the price rise.
GSK said in a letter to wholesalers that in moving to an OTC business model it could no longer sustain its current pricing for Panadol Osteo.
But Minister Ley says there are no additional regulatory or administrative costs associated with this policy change regarding osteo paracetamol products, which was recommended by the PBAC, not government.
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Pharmacy guild says changes will only benefit govt

12th Jan 2016 7:30 AM
PENSIONERS collecting their prescriptions at pharmacies can access discounts of up to $1 per script after changes that took effect on January 1.
The reforms mean some pensioners will be able to pay $5.20 instead of the standard $6.20 for their PBS scripts.
However Pharmacy Guild of Australia executive director David Quilty said the measure would have little net benefit for pensioners and mean big savings for the government, which has estimated it will save $373 million over four years.
He said the change would mean concession card holders whose pharmacies offer them the discount will not hit the $372 free medicine threshold until later in the year, effectively leaving pharmacists to absorb the cost.
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Health is also clearly still under review as far as its budget is concerned with still a few reviews underway and some changes in key strategic directions. Lots to keep up with here with all the various pre-budget kites being flown! Enjoy.
David.