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, February 16, 2017

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

February 16  Edition.
I have this funny feeling people are starting to rather get used to ‘The Donald’ and are starting to sit back and reflect just what all this might mean.
For Goldman Sachs it seems they are becoming rather concerned:

Goldman Sachs Economists Are Starting to Worry About President Trump

Get ready for a wild ride.
by Julie Verhage
6 February,2017, 7:03 pm AEDT
A rethink, if not an outright reversal?
Just a few weeks ago, Wall Street analysts were busy boosting their economic forecasts on the expectation that President Trump would implement sweeping corporate-tax reform, a rollback of regulations, and new fiscal stimulus. Two weeks into his term and the president has been focused primarily on immigration and trade, causing a reevaluation among analysts at some banks that harks back to pre-election concerns about Trump's uncertain effect on markets and U.S. economic growth.
"Following the election, the positive shift in sentiment among investors, business, and consumers suggested that the probability of tax cuts and easier regulation was seen to be higher than the probability of meaningful restrictions to trade and immigration," Goldman Sachs Group Inc. economists led by Alec Phillips wrote in note published late last week. "One month into the year, the balance of risks is somewhat less positive in our view."
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Our Reserve Bank stills seem to be drinking the Kool aide!
  • Feb 10 2017 at 9:00 PM

Reserve Bank of Australia's new mantra 'Don't worry, be happy'

Reserve Bank of Australia boss Philip Lowe is well-known for his optimistic outlook on life, a personality trait that has long distinguished him from his more dour central banking peers.
So traders should not have been so stunned this week when Lowe adopted a more upbeat tone in the statement released after the RBA's first board meeting for the year, noting that the improved outlook for the global economy had buoyed commodity prices and boosted Australia's national income.
Nor should they have been taken aback by Lowe's address this week to the A50 Australian Economic Forum – attended by more than 50 of the world's wealthiest investors in which he noted that "the improvement in the global economy since late last year should also help us".
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Only one will be right!
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Here are a few other things I have noticed.
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Trump Material.

Warning of bump for Donald Trump next year with slide into recession

Tim Wallace
Published: February 7, 2017 - 12:27AM
US President Donald Trump's economic honeymoon could come to an end as soon as next year, senior London fund managers have forecast, with the US at risk of plunging into recession.
Nine years on from the start of the financial crisis, the US recovery may be overheating, Legal & General Investment Management economist James Carrick has warned.
He has predicted a series of interest rate hikes will tip the US into a 2018 recession.
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What if Trump is a vehicle for Bannon’s ideological project?

  • Jacek Rostowski
  • The Australian
  • 12:00AM February 8, 2017
In the weeks since Donald Trump’s inauguration as US President, it has become clear that he intends to roll back to the starting block the progressive egalitarian agenda that is commonly associated with political correctness — not just in the US, but globally.
Stephen Bannon, Trump’s White House Svengali and former CEO of the extreme-right Breitbart News, has long pursued this ideological project, and we now know that what he or Trump says must be taken both seriously and literally.
Trump’s transition was initially reassuring, because he nominated many undeniably serious (if also seriously well-heeled) people to his cabinet. But after the inauguration all hell broke loose as Trump and Bannon began to implement their project in earnest.
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President Trump could be good for the economy, says Reserve Bank governor Philip Lowe

Peter Martin, Eryk Bagshaw
Published: February 10, 2017 - 6:50AM
Reserve Bank governor Philip Lowe has predicted some of the Trump administration's economic policies could be good for Australia and the global economy, while warning it could also turn out "very badly" if America retreats from the international order of the world.
In answers to questions following his first public address of the year, opening the A50 forum of leading international fund managers in Sydney, Dr Lowe said the RBA "was in watch and wait mode like everyone else" with the US administration.
"It's very difficult to predict how the new US administration is going to effect economic policies," he said.
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National Budget Issues.

What type of Aussie are you? Meet the 7 new political tribes

Conal Hanna, Inga Ting, Matt Wade
Published: February 6, 2017 - 11:29AM
Progressive Cosmopolitans are city dwellers. Lavish Mod-cons like to splash the cash. And Anti-Establishment Firebrands? Well they're definitely the most likely to vote for Donald Trump if they had the chance.
Welcome to the Political Persona Project, a comprehensive attempt to examine Australian political attitudes, lifestyles and social values.
It's a joint project between Fairfax Media, the ANU's Social Research Centre and digital information analysts Kieskompas.
Why did we do it? Because the political world has seemingly turned upside down.
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Australians almost united in their desire to manufacture more at home

Matt Wade, Inga Ting
Published: February 6, 2017 - 7:21AM
What do Donald Trump, Nick Xenophon, Pauline Hanson and 83 per cent of Australians have in common?
In a survey covering dozens of hot-button issues put to a representative sample of Australian voters, a desire to rely less on imports and to manufacture more at home stood out as the number one thing most people agreed on.
In the aftermath of Mr Trump's US election victory, where he strongly advocated reviving that nation's manufacturing industry, nearly 83 per cent of surveyed Australian said they strongly agreed (42 per cent) or agreed (40.5 per cent) with the notion we are too reliant on foreign imports. Only 6 per cent disagreed.
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$8b Zombie measures prove headache for Turnbull

Shane Wright, Economics Editor
Tuesday, February 07, 2017 10:34AM
The Turnbull Government has more than $8 billion worth of zombie Budget measures – many from the controversial 2014 Budget – that are still to be made law.
A report from the independent Parliamentary Budget Office, released this morning, shows the fiscal mountain facing Treasurer Scott Morrison in trying to reduce the Budget deficit and cut Government debt.
Of the 24 measures identified by the PBO 13 are from the 2014 Budget while there is just one from last year’s Budget.
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  • Updated Feb 7 2017 at 8:35 AM

Government considers welfare deal to secure childcare package

by Phillip Coorey
Recipients of family welfare payments may get to keep their full benefits under a compromise being considered by the government in order to secure the passage of its childcare reforms.
With Parliament to resume on Tuesday, one of the government's priority pieces of legislation will be to usher in the childcare reforms that were designed several years ago when Treasurer Scott Morrison was social services minister.
The government has never implemented them because they were to be funded by about $3 billion in welfare cuts, through the abolition of end-of-year supplements for Family Tax Benefits part A and B.
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Cracks Are Appearing in Australia’s Trillion-Dollar Debt Pile

by Emily Cadman and Chris Bourke
8 February,2017, 5:00 am AEDT
  • Caution sounded as borrowers’ metrics show some deterioration
  • Rate hikes would ‘knock the wind’ out of housing market: CBA
The Reserve Bank of Australia frequently seeks feedback on the health of the economy. It might want to call the debt counselors soon.
Homeowners, consumers and property investors around Australia are making more calls to financial helplines as three warning signs back up the spike in demand: mortgage arrears are creeping up, lenders’ bad debt provisions have increased and personal insolvencies are near an all-time high.
“Its steadily out of control -- I don’t know of too many financial counseling services where demand doesn’t exceed supply,” said Fiona Guthrie, chief executive officer of Financial Counselling Australia, who says the biggest increase in calls is from people suffering mortgage stress. “There are more people who have got mortgages that they can’t afford to pay.”
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Child care, paid parental leave, family tax benefit changes to be introduced in omnibus budget savings bill

By political reporters Jane Norman and Julie Doyle
February 8, 2017
The Federal Government is combining a range of stalled and revised welfare measures into a single bill to try to force billions of dollars' worth of savings through the Parliament.
After months of negotiations with the Senate crossbench, the Government will also announce it has made concessions to its proposed cuts to family tax benefits in a bid to secure the passage of its child care reforms.
The Government had planned to abolish the end-of-year supplements for Family Tax Benefits (FTB) Part A and B — and use the savings to pay for its child care package — but the move was blocked by the Senate.
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Government announces major compromises to secure Senate support for childcare package

Matthew Knott
Published: February 8, 2017 - 10:24AM
The Turnbull government has moved closer to victory on its signature $3.5 billion child care package by watering down proposed cuts to family payments and extending the taxpayer-funded paid parental leave scheme.
The government will on Wednesday introduce a bill into Parliament containing both its childcare and family tax benefit changes.
Key crossbencher Nick Xenophon said the government was moving in the "right direction" and One Nation leader Pauline Hanson indicated her support.
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With $1 trillion of Australian mortgages, the RBA might be getting worried

Emily Cadman and Chris Bourke
Published: February 8, 2017 - 8:39AM
The Reserve Bank of Australia frequently seeks feedback on the health of the economy. It might want to call the debt counsellors soon.
Homeowners, consumers and property investors around Australia are making more calls to financial helplines as three warning signs back up the spike in demand: mortgage arrears are creeping up, lenders' bad debt provisions have increased and personal insolvencies are near an all-time high.
"It's steadily out of control -- I don't know of too many financial counselling services where demand doesn't exceed supply," said Fiona Guthrie, chief executive officer of Financial Counselling Australia, who says the biggest increase in calls is from people suffering mortgage stress. "There are more people who have got mortgages that they can't afford to pay."
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Home truths about how we actually measure home prices

Jessica Irvine
Published: February 7, 2017 - 9:22AM
How much are homes worth in Australia?
It's not difficult to understand the frenzied interest in the answer to this question.
For most home owners, their pile of bricks is the most expensive asset they'll ever own. For investors, they want to know how their investment is performing.
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  • Updated Feb 8 2017 at 7:56 PM

Raid Future Fund and it will run out, says PBO

The Coalition government is being challenged to justify any likely decision to raid the Future Fund and help deliver wafer-thin surpluses next decade, with the Parliamentary Budget Office warning the fund could be wiped out by mid-century.
In one of the most potentially politically sensitive reports released by the independent body in its 4 1/2 years of operation, the budget office in effect suggests the government would be better off keeping its hands out of the $127 billion fund for longer.
Treasury currently assumes the government will begin taking money after June 2020 from the fund – which was established in 2006 to cover the Commonwealth's gargantuan future unfunded public service pension bill, expected peak at $284 billion in 2040-41.
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It’s time Turnbull showed courage and swung the abbott-era axe

  • The Australian
  • 12:00AM February 9, 2017

David Uren

Treasurer Scott Morrison and Joe Hockey before him have been lugging ­savings measures from one year’s budget to the next as the Senate refuses to approve measures that adversely affect people on lower incomes. Increasing co-payments for pharmaceutical benefits, cuts to higher education and tighter eligibility for family tax benefits are derided by Labor as “zombie” measures that were never going to see the light of day.
In government, Labor had itself clung to a key savings measure — means-testing the private health insurance rebate — for successive budgets before finally getting it through the Senate, so the Coalition is following Labor’s precedent.
But the unlegislated measures, which the Parliamentary Budget Office assesses total $8.7 billion over the next four years, leave budget projections looking unrealistic. They contribute to a perception, which has been damaging among the credit rating agencies, that the government is not capable of implementing its policy.
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There is no real prospect that Malcolm Turnbull or Bill Shorten can create jobs

John Hewson
Published: February 9, 2017 - 1:09PM
Both sides of our politics have declared jobs as their primary focus, as conveyed by the government's slogan "Jobs and Growth", and the Opposition's "Jobs, Jobs, Jobs".
Both prattle on wanting to create the impression that they are better than the other at "creating" jobs, and ensuring job security, but neither provides much detail as to just "how": which policies, which industries, at what pace, and over what time period. The government focuses on its "massive" corporate tax cuts, to stimulate investment, that in turn is claimed will create jobs and improve wages, while the Opposition emphasises education and training as fundamentally important. But, that's about all we are told.
What if it is unlikely that either will ever succeed? What if there are structural shifts in our economy and society such that there won't ever be enough jobs to meet the desires of those who wish to work?
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RBA’s Lowe rejects Labor line on company tax cuts

  • The Australian
  • 8:00PM February 9, 2017

Adam Creighton

Andrew White

Reserve Bank Governor Philip Lowe has rejected Labor’s argument that cuts in the company tax rate aren’t affordable, stressing the need to keep Australia’s tax system internationally competitive at the same time as the budget is brought back to surplus.
In his first speech of the year Dr Lowe said Australia risked losing the valuable insurance it enjoyed before the financial crisis unless it rebuilt its “fiscal buffers”.
“Looking forward we need to make sure that we continue to have this insurance,” he said, noting that the government’s net debt “was still low” but had increased dramatically.
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Dinner Remarks to A50 Australian Economic Forum

Philip Lowe
Governor
A50 Australian Economic Forum Dinner
Sydney9 February 2017
I would like to offer you all a very warm welcome to Sydney for the A50 Forum. To those of you who have travelled to our shores from afar, thank you for visiting. I am confident that you will find your investment in time a worthwhile one. In just a short period, you will hear from the leaders in the worlds of politics, business, the policy institutions and the investment community. You will find an openness and transparency that is not always seen elsewhere around the world and you will experience a genuine desire to share perspectives.
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Govt to introduce new multinational tax

Updated: 12:57 pm, Thursday, 9 February 2017
The Turnbull government says it will no longer let major multinational companies deliberately thwart Australia's tax laws.
Treasurer Scott Morrison today introduced a new bill that will impose a 40 per cent tax on diverted profits from July 1 - as proposed in the last budget.
Mr Morrison has told parliament the government is determined to have the strongest rules against tax avoidance and level the playing field to deliver a fairer tax system for all.
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Funding crash as foreign investors retreat

  • Simon Benson
  • The Australian
  • 12:00AM February 11, 2017
Australia faces a potential investment crunch with Treasury analysis revealing that foreign ­direct investment has already crashed almost 50 per cent on 2015 levels.
The downward trend is more concerning because it runs against growing global flows; Australia’s share of the $US1.8 trillion ($2.36 trillion) global foreign direct investment pool tumbled from 3.2 per cent in 2011 to 1.3 per cent last year as other countries became relatively more attractive.
Seeking to intensify the ­urgency of the debate over the government’s corporate tax plan to cut rates to 25 per cent, Scott Morrison told The Weekend Australian the analysis showed that Australia was already on a worrying slide down the world investment rankings, partly because of its high company tax.
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Now the economy's transition phase is ending, wages can start rising

Ross Gittins
Published: February 11, 2017 - 12:15AM
This year should see the end of the economy's protracted "transition" back to business as usual. You beaut.
Resources booms - or any other booms - are nice, but the subsequent busts are always hard. We'll know the bust is over when the fall in investment in mining construction - which began in late-2012 - tails off at the end of this year.
According to Reserve Bank governor Philip Lowe, we've already come 90 per cent of the way.
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Health Budget Issues.

Families fed up with delays in receiving rebates from Medicare

Life & Style  Lisa Allan 5 Feb 2017, 11:00 a.m.
WHEN Elise Krupka lodged her claim with Medicare after paying a $1400 doctor’s fee for her daughter’s surgery, she thought she would wait for a refund before she paid the anaesthetist’s bill.
That was at the start of December. Nine weeks later, she is still waiting.
The mother-of-three from NSW eventually had to take the money off her mortgage to pay for the anaesthetist, and says she is now owed more than $1400 by Medicare.
In the past two months she has lodged the forms in three different ways, sent several emails and made more than 30 phone calls, but she is yet to receive a response from Medicare, or speak to a human.
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Divide between rich and poor in Australia is growing

Anna Patty
Published: February 6, 2017 - 10:30AM
The divide between rich and poor is growing in Australia, according to a new national survey which found more than a quarter of households have experienced a drop in income.
But wealthier Australians were most likely to be getting richer.
The latest Household Financial Comfort Report of 1500 Australians to be released on Monday found almost one in two (or 46 per cent)  households with incomes of more than $100,000 reported income gains, compared with 17 per cent of households earning under $40,000.
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Miners urge Canberra to push for reforms, defy protectionism

  • The Australian
  • 12:00AM February 6, 2017

Annabel Hepworth

Mining giants have urged Treasurer Scott Morrison to use the May budget to outline reforms to spur growth and say that defying the global trend towards protectionism is crucial if the government is to show a credible path back to surplus.
In a pre-budget submission ­obtained by The Australian, the Minerals Council of Australia — whose members include BHP Billiton, Rio Tinto and Glencore — implore the government to set out a reform agenda that would include tax cuts, a crackdown on vexatious legal challenges by anti-development activists, an overhaul of the GST carve-up and industrial relations reforms.
“The resurgence of protectionist sentiment means that the ­national benefits of low taxation, fiscal rectitude and competitive markets are more contested than in previous decades,” the submission says.
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Funding cuts threat for radiation patients

  • The Australian
  • 12:00AM February 6, 2017

Sean Parnell

Radiologists have warned that a $23.7 million cut to federal support for cancer-fighting equipment will undermine services and threaten patient access to the latest interventions.
In the mid-year economic and fiscal outlook, the Turnbull government made a brief reference to “net efficiencies” of $18.7 million over four years through changes the radiation oncology health program grants (ROHPG) scheme.
The savings, offset by a $5 million capital injection for the Australian Radiation Protection and Nuclear Safety Authority in 2017-18, follow an independent ­review of the scheme and attention from the Australian National Audit Office.
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A taxing stand-off

Tax data set to be the new battleground between the Pharmacy Guild and the Review of Pharmacy Remuneration and Regulation

The simmering disagreement between the Pharmacy Guild of Australia and the panel reviewing pharmacy remuneration and regulation continues, with a new battleground over tax information set to ignite.
A number of Guild members have expressed concern that the review panel was seeking information from the Australian Tax Office, raising privacy and business confidentiality concerns, AJP believes.  
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Price of prescription medicines likely to rise by $5

index&t_product=HeraldSun&td_device=desktopRob Harris, Herald Sun
February 7, 2017 10:30pm
A $5 price hike to the cost of prescription medicines remains alive after the Federal Government last night refused to rule out revising the contentious measure.
The Pharmaceutical Benefits Scheme co-payment — previously rejected by the Senate — would save the Budget about $700 million over four years and $3.2 billion over a decade.
Despite previously ruling out the prescription hike, the Turnbull Government continues to count the savings to reduce its Budget deficit.
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Homeopathy sells dangerous lies to patients

Vyom Sharma
Published: February 7, 2017 - 11:45PM
As a doctor, I lie to my patients every day. I'll say "this won't hurt a bit" before giving injections when, in fact, it does hurt (a bit). I'll promise kids that if they stop crying and let me examine their ears, their mother will buy them a pony. These small lies are well intentioned, sometimes comical and instantly forgiven.
But there are some lies I won't tell. I won't, for instance, substitute the vaccine in a syringe with water, and tell parents their baby will now be protected against measles. That would be a vile and unconscionable betrayal of the truth. Can we at least agree on that? Apparently not.
There is an epidemic of false cures being sold to sick Australians. But it's not an underground black-market trade. It's a certified, rubber-stamped official practice. It is enshrined in government policies, codified in professional code of conducts, funded with our taxes and sold by pharmacists. An intricate web of lies protects the pernicious practice of homeopathy in Australia.
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ABC’s Four Corners takes aim at pharmacists

10 February, 2017 Heather Saxena 
ABC’s Four Corners is taking aim at pharmacists who sell vitamins, supplement and complementary medicines.
In episode titled Swallowing It to be broadcast on Monday, the program takes a swipe at pharmacists who sell “unproven” products.
The program explores the regulation and marketing of complementary medicines, and questions “whether the credibility of chemists is threatened by selling them”.
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4:34pm February 8, 2017

Govt backflips on kids' dental cuts

By AAP
The federal health minister has backflipped on cuts to kids' dental - hours before the Senate was expected to overturn them anyway.
Greg Hunt said the government would reinstate the $1000 cap three million Australian children are eligible to access every two years under the child dental benefits schedule - just one month after the cap was slashed to $700.
It came just hours before Labor and the Greens were set to disallow the cuts in the upper house on Wednesday afternoon.
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No time for the meek as health budgets blow out

  • Rohan Mead
  • The Australian
  • 12:00AM February 9, 2017
Just days into their new roles, it may already be dawning on new federal Health Minister Greg Hunt and even newer NSW Health Minister Brad Hazzard that they (together with other state health ministers) carry much of the responsibility for ­sec­uring Australia’s broader econ­omic future.
The health sector costs about $160 billion a year, about 10 per cent of GDP. That proportion continues to rise as the population ages, lives with more chronic disease and invests more of its money in health.
With this in mind, Hunt and Hazzard have a critical job to do in formulating a long-term prescription for effectively reshaping health expenditures while ensuring strong health outcomes for the community. They have no time to be daunted by the dimensions of the challenge.
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Health costs are on track to swallow the budget

  • The Australian
  • 1:06PM February 10, 2017

John Durie

Medibank’s Craig Drummond is 100 per cent correct in his call for fundamental reform in the health services sector after he pocketed the 4.6 per cent premium increase the Government has given him.
On average health insurance will cost an extra 4.5 per cent, which is about the increase the health sector is grabbing from Government taxes at both the federal and state levels.
The bottom line is health costs are on track to swallow the budget and something must be done to reform the system.
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Health Insurance Issues.

Australian families reconsider having health insurance with premiums tipped to rise

February 6, 20179:49am

Do I really need health insurance?

MANY health insurance customers will reconsider whether it’s worthwhile having cover if prices continue to climb significantly come April 1.
It’s expected the Federal Government will allow premiums to rise for the 16th year in a row again, hitting households hard as the increases are typically well above inflation.
In 2016 the average premium rose by 5.59 per cent but rises vary depending on the fund and product.
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Economists say health insurance premium hikes well above CPI are unwarranted

Esther Han
Published: February 7, 2017 - 2:13PM
Most economists believe that health insurance premium hikes that are well over the inflation rate can't be justified, a survey shows.
In the lead-up to the federal government's decision on what sort of premium increase it should allow, a survey has found 12 out of 18 economists and economic experts believe hikes well in excess of the Consumer Price Index (CPI) of 1.4 per cent are "unwarranted".
The 18 respondents, including economists Saul Eslake and Shane Oliver, were part of a broader, monthly survey involving 32 economists and economic experts by comparison website Finder.
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Health insurers seek a halt to ‘$800m prosthetics wastage’

  • The Australian
  • 12:00AM February 8, 2017

Sean Parnell

Health insurers have renewed calls for the federal government to address the high cost of prostheses, with Medibank data showing some devices used in the private sector cost 700 per cent more than they do in the public sector.
After persistent complaints about the Prostheses List used in the private sector, the government last year agreed to legislate to cut the price of cardiac devices and intra-ocular lenses by 10 per cent, and hip and knee prostheses by 7.5 per cent. The move was expected to save insurers $86 million in the first year, putting downward pressure on insurance premiums, and saving $394m over five years.
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Bupa head tackles government for further reductions on costly prostheses

  • The Australian
  • 12:00AM February 9, 2017

Sarah-Jane Tasker

Bupa is calling on the Turnbull government to further reform medical device prices as the health insurance giant pushes for greater transparency to force ­prices lower.
Private health insurers have long called for cuts to prices on the Prostheses List, which sets how much funds pay for devices, but were disappointed last year when the government announced $86 million worth of cuts: they were targeting $800m.
Richard Bowden, Bupa’s Aust­ralia/New Zealand managing direc­tor, who recently took the top job after a stint at its British arm, said the price difference between Britain and Australia for some devices­ was “indefensible”.
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Health fund premiums rise $200 a year — how state governments are to blame

index&t_product=DailyTelegraph&td_device=desktopSue Dunlevy, National Health Reporter, News Corp Australia Network
February 9, 2017 10:00pm
HEALTH Minister Greg Hunt has approved an average health fund premium rise three times the inflation rate that will add up to $200 a year to the cost of family cover.
But the hike could have been more if not for reforms to cut the price health funds pay for hip and knee replacements and other prostheses.
Mr Hunt will on Friday announce an average 4.8 per cent premium rise, the lowest in 10 years.
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PM wants Australians to keep health insurance

Updated: 1:04 pm, Friday, 10 February 2017
Malcolm Turnbull wants Australians to stick with private health cover despite his government approving a hike that will cost families up to $200 extra a year.
While the average 4.84 per cent increase is the lowest in 10 years, the cumulative impact over that time is about 50 per cent - three times the rate of inflation.
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Prostheses list: Insurers and healthcare majors square off

  • The Australian
  • 12:00AM February 11, 2017

Sarah-Jane Tasker

The fiery battle between private health insurers and medical device companies has kicked up a gear as the Turnbull government considers reforms that could have a significant impact on both sectors.
A Senate inquiry into the pricing system for the Prostheses List, which dictates what funds must pay for medical devices, has forced both sides of the debate to defend their position, with insurers arguing the list has been on “set and forget” for a long period of time and was being gamed by medical device providers.
The prostheses issue was highlighted by insurers yesterday when federal Health Minister Greg Hunt announced premiums would rise this year by an average 4.84 per cent. The top insurers used their annual increase announcements to defend the rise and highlight how rising health costs and prostheses pricing affected policy prices.
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Superannuation Issues.

Fight over super's objective heats up

Clancy Yeates
Published: February 6, 2017 - 8:10AM
Should compulsory superannuation aim to give Australians a retirement that is "comfortable," "adequate" or "dignified"? Or should it have the more modest goal of providing retirement income to substitute or top up the age pension?
The $2.1 trillion super sector is making a last-ditch plea for some version of the former, as the government looks to enshrine the objective of superannuation in law.
Following a recommendation from the financial system inquiry, the government last year introduced legislation describing super's purpose as "to provide income in retirement to substitute or supplement the age pension," and this is being reviewed by a Senate inquiry.
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Clarity on the new super rules, wealth management’s hot topic

Scott Morrison’s controversial super changes come into effect in just four months.
  • Monica Rule
  • The Australian
  • 12:00AM February 7, 2017
Perhaps the outstanding issue for wealth management in recent times has been the major changes announced for superannuation.
For many people, there is a sense that the changes have only become clear very recently as the final legislation did not get passed until the end of 2016. Worse still, many people were misled by earlier reports which attempted to capture the changes before they were finalised by the government.
Either way, we suddenly find ourselves in February 2016 with only four full calendar months before Scott Morrison kicks off the new regime on July 1. Self-Managed Super Fund members need to understand the basics: Today I want to spell out the key changes and importantly identify some variations that have become clear this year.
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I look forward to comments on all this!
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David.

Its Rather A Pity That What Should Be Routine Provisioning For Clinical Systems Gets Into The News. It Had To Be ePAS Again!

This appeared last week.

SA Health hopes new hardware will fix sluggish EPAS

By Paris Cowan on Feb 8, 2017 12:08PM

Publishes data centre shopping list to cure doctors' frustration.

South Australia’s health department hopes replacing the hardware underpinning its notorious patient administration system will end bedside frustration felt by the state’s doctors and specialists over the sluggish platform.
The $422 million electronic patient administration system (EPAS) is currently used by about 8000 SA health workers in the seven health regions that have been part of the rollout to date.
But in many cases it hasn’t been the blessing doctors were promised, as they struggle with workstations that have a tendency to crash if users switch between EPAS screens too quickly, long waits to change between EPAS modules, and up to two outages a day.
In November last year, the system suffered a nine-hour outage that health officials blamed on a piece of rogue software eating up all its compute resources.
The department is now kicking off the replacement and decommissioning of two end-of-life IBM XIV SANs that currently host EPAS data within one of its three Adelaide data centres.
All the details are here:
From the problems described one would have to conclude this is long overdue!
David.

Wednesday, February 15, 2017

With All The Excitement Around Digital Health It Is Important To Preserve The Evidentiary Perspective!

These two articles appeared close together and serve to ram home the point that we must all resist the hype.
First:

Why the pressure’s rising for EMRs to make an impact

Published February 06 2017, 2:44pm EST
As the country wonders about the next iteration or obliteration of the Affordable Care Act, the 1996 movie Jerry Maguire starring Tom Cruise and Cuba Gooding, Jr., provides all the information needed to prepare for changes in the healthcare marketplace in 2017. Cruise plays sports agent Jerry Maguire who represents Rod Tidwell, a fictional Arizona Cardinals wide receiver played by Gooding.
In one poignant scene, Rod chastises Jerry in an effort to motivate him to work harder to secure a more valuable contract for Rod’s services to the Cardinals. Through the repetitive mantra “Show me the money, Jerry,” Rod makes it clear to his agent that only the monetary value of the contract matters.
After spending more than $30 billion on incentive payments, many in and outside government wonder what value that investment in electronic medical records (EMR) delivers to patients. Similarly, many hospital boards of directors, provider organization leadership groups and physicians in private practice wonder what type of return on investment they are receiving from implementing these healthcare information technology (HIT) systems.
EMRs are expensive to implement and maintain. In addition, there exists no clear evidence that they increase productivity, enhance quality or reduce medical errors. Although studies do show some benefits obtained from the use of EMRs, this evidence is not definitive, and any benefits are not widely reported across the industry.
To understand our struggle to obtain value from EMRs, it is important to “show you the money.” The HITECH act motivated organizations to purchase EMRs to obtain incentive payments from the Federal government through the Meaningful Use program.
As deploying an EMR is both an expensive and risky task, provider organizations focused on implementing the EMR in its most basic format, forgoing the process and clinical workflow redesign necessary to effectively leverage the power of EMRs to positively impact patient care. Organizations most feared loss of revenue because of suboptimal coding, so they therefore focused on proper documentation by clinicians to preserve current revenue streams.
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The fourth paragraph really says it all.
Second we have:

Claims that mHealth can save costs may miss the mark

Feb 6, 2017 11:22am
mHealth research doesn't always offer a comprehensive account of the economic impact.
Proponents of mHealth apps often say the tools can help hospitals cut patient treatment costs by streamlining care. But a more detailed look shows there's often inadequate evidence to support those assertions.
Although almost all studies address the economic factors of an mHealth intervention, including cost savings tied to improved outcomes, many of those studies fail to consider a range of factors that could influence the economic impact, according to a study published in PLOS One.
Researchers with the University of Washington and Columbia University reviewed 39 studies spanning several mHealth interventions—including behavioral health and text messaging—and found that most do not account for all of the Consolidated Health Economic Evaluations Reporting Standards (CHEERS) developed by the International Society for Pharmacoeconomics and Outcomes Researcher (ISPOR), which include a broad spectrum of economic factors.
On average, the studies evaluated included less than 80% of the CHEERS guidelines. Meanwhile, less than one-third of the studies were considered “high quality” based on adherence to CHEERS.
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So, in summary, the evidence for much of what is being done on the conviction that ‘it obviously works and is useful’ is rather less than rock solid. As various other sceptics are prone to say ‘just saying!’
David.