Review Of The Ongoing Post - Budget Controversy 3 June 2014. It Is Sure Going On!
Budget Night was on Tuesday 13th May, 2014 and the fuss has not settled.
Here are some of the more interesting articles I have spotted this third week since it happened. Since the budget was handed down all hell has broken out in the Health Sector and has been continuing.
Senate Estimates on E-Health on 2nd June - Late in day
We sure do live in interesting times!
-----
General.
Our science suffers from a national delusion
Date May 31, 2014
Nicky Phillips
Science Editor
The country's chief scientist rolled out a sports analogy to make his point recently.
If Australian science was a cricket team we would have a few great players, but a pretty average team, Professor Ian Chubb said in Adelaide.
This may come as a surprise to many. Australians are used to being told we're the best. We produce "world-class research" and continually "punch above our weight", or so we say. But we are better than the top 11 European Union nations and the United States in only 16 out of 91 science fields.
-----
Budget hole opens up
Date May 26, 2014
Mark Kenny, Anne Davies
EXCLUSIVE
The Abbott government is facing an early budget shortfall because it has no hope of passing many of its key measures through the existing Senate and members of the new Senate, starting on July 1, have said they will not support retrospective or backdated legislation.
As expected, on Sunday Labor finance spokeswoman Penny Wong confirmed Labor will wave through the Senate one of the most contentious "broken promises" of the budget, the 2 per cent temporary deficit levy on high income earners, which will rake in $600 million in 2014-15.
But other measures, many of them due to take effect on July 1, could be held up. This means savings will be lower than stated or changes will have to be legislated retrospectively to claw money back.
-----
Budget estimates: Tony Abbott faces pressure to explain contradictory budget cuts
Date May 26, 2014 - 8:21AM
Fergus Hunter, Jonathan Swan
The Abbott government is under pressure to explain contradictory budget cuts in the same portfolios in which it announced eye-catching new policies.
Several contradictions ''hidden'' in the fine print of the budget papers will be raised in Senate estimates hearings and other forums this week.
Universities Australia chief executive Belinda Robinson says the government's much lauded $20 billion medical research fund is a fine idea, but says it is undermined by cuts in other areas of research.
Ms Robinson said some of these other cuts are likely to deter Australians from training as researchers and pursuing PhD and masters level research.
-----
Specialist bulk-billing and safety nets need overhaul: study
27th May 2014
THE government should consider creating an incentive for specialists to bulk-bill pensioners and children together with an overhaul of healthcare safety nets, a Senate inquiry has been told.
A paper by researchers from the George Institute, the Menzies Centre and Sydney University’s Discipline of General Practice said poor Australians and those with chronic illness faced unfairly high healthcare cost burdens.
Any claims to equity and fairness in Australia’s health system were undermined by the large number of people who face hardship and reduced access to treatment because of out-of-pocket healthcare costs, the submission to the Senate Standing Committee on Community Affairs said.
-----
Health Minister stirs states on hospital procedure figures
Date May 29, 2014
Dan Harrison
Health and Indigenous Affairs Correspondent
Health Minister Peter Dutton has accused the states of overstating the number of procedures they perform in public hospitals to get more federal funding.
Addressing the National Press Club in Canberra on Wednesday, Mr Dutton made the comments when asked to reconcile cuts to public hospital funding in the federal budget with his pre-election pledge that the Coalition would match the level of hospital funding promised by Labor over the next three years.
The budget shows federal funding for public hospitals will be reduced by more than $800 million over the next three years. Deeper cuts totalling more than $1 billion will occur in 2017-18.
-----
Health professionals warn fewer doctors, fewer visits and fewer medicines as a result of the Budget
- May 30, 2014
- SUE DUNLEVY NATIONAL HEALTH REPORTER
- News Corp Australia Network
DOCTOR shortages will get worse, more than two million patients will avoid medical care and more than one in ten will not get their scripts filled as a result of the Budget.
The shortage of general practitioners in poorer areas will be made worse by the $7 GP fee because doctors won’t work where patients can’t afford to pay, a GP group says, and nursing home visits may become economically unviable.
Medical statistics reveal there are already 40 per cent fewer GPs per 100,000 population in Sydney’s West than in the inner city or eastern and lower north shore suburbs.
Bulk billing rates in the region are up to 99 per cent and there is growing concern doctors in the area won’t be able to charge the $7 fee without suffering a loss of business.
-----
University fees to be regulated under Pyne's reforms
Date May 31, 2014
Ross Gittins
The Sydney Morning Herald's Economics Editor
The greatest economic puzzle in the budget is Tony Abbott's intention to ''deregulate'' university fees in 2016. There's a lot more to it than many people imagine.
Punters who make no profession of understanding economics think fees will skyrocket. Advocates of the change, who think they know more than the punters, say increases will be constrained by competitive pressure.
The more economics you know, the less certain you can be about how things will turn out. But you can make a pretty persuasive case that, for once, the punters may be closer to the truth than the advocates.
Abbott and his education minister, Christopher Pyne, plan two main changes: the deregulation of fees and changes to the HECS loan scheme. I'll leave the loan changes for another day and focus on the fee changes.
-----
Joe Hockey's budget beyond the Australian concept of fair
Date May 30, 2014 - 10:27PM
Peter Hartcher
Sydney Morning Herald political and international editor
The Abbott government’s first budget inevitably will increase inequality in Australia. This has been at the centre of its hostile reception.
But isn’t it normal to have rising inequality? Isn’t it simply a natural condition of human society from time immemorial?
It’s certainly true that inequality has been a feature of human societies for at least the past 5000 years. But, intriguingly, for most of the existence of humans on planet earth, it was not.
According to a study by a pair of distinguished US archaeologists, economic inequality is a relatively recent invention.
“Anatomically and intellectually, modern humans were already present during the Ice Age” around 15,000 BC, write Kent Flannery and Joyce Marcus in their 2012 book The Creation of Inequality.
-----
Tony Abbott, Joe Hockey face new Senate road bloc
Date June 1, 2014
Heath Aston
Political reporter
The federal government faces a new hurdle in the Senate, with Family First and the Liberal Democratic Party forming a new voting bloc.
David Leyonhjelm, the NSW senator-elect representing the Liberal Democrats, has revealed he would vote in alliance with South Australia's Bob Day of Family First when the new Senate sits from July 1.
They have agreed to vote together on all economic issues, but will decide their own positions on social issues. As a self-described libertarian, Mr Leyonhjelm supports same-sex marriage, for example, whereas Family First is opposed to it.
-----
Medical Research Fund.
Liberal MP Dennis Jensen fires broadside at his government's medical research fund
Date May 28, 2014 - 7:33AM
Matthew Knott, James Massola
A Liberal MP has blasted the Abbott government's defence and science policies – including the budget centrepiece of a $20 billion medical research fund.
In a speech delivered in Parliament on Tuesday night, West Australian MP Dennis Jensen described the government's science policies as "foolish" and incoherent.
Dr Jensen, a former research scientist and defence analyst, criticised the government for cutting funding to the CSIRO and Australian Research Council while creating a medical research fund.
-----
Peter Dutton defends budget’s $20b medical fund
Joanna Heath and Michael Bleby
A $20 billion medical research fund will result in budget savings in the long-term, the government says, after the policy came under attack from within its own ranks.
West Australian MP Dennis Jensen, a former scientist, criticised his colleagues for cutting funding for scientific research in other areas and favouring the new fund.
“I just think quite frankly it’s incoherent, for one side to have an increase in funding and on the other side to have cuts,” Dr Jensen told journalists on Wednesday morning.
Minister for Health Peter Dutton said Dr Jensen was entitled to his views on the fund.
-----
Govt waxes lyrical about medical research
12:30pm May 31, 2014
Prime Minister Tony Abbott has been waxing lyrical about the benefits of the medical research fund that will be partially funded by the unpopular $7 co-payment.
The prime minister was joined by Health Minister Peter Dutton and Communications Minister Malcolm Turnbull at the round-table discussions at the Victor Chang Cardiac Research Institute on Saturday, as the coalition struggles to get voter support for the co-payment which will go some way towards paying for the medical research fund.
The visit also came the same week Mr Abbott came under fire from members of his own party for cutting scientific research funds in the budget.
Mr Abbott said the one of the institute's cardiac specialists Professor Robert Graham had called the government's policy "visionary and innovative".
-----
GP Co-payment.
Diverted hospital patients face $7 fee: doctors
Date May 26, 2014
Henrietta Cook
State Political Reporter at The Age
Patients seeking treatment in emergency departments will be hit with the Abbott government's proposed $7 co-payment if referred to a hospital's GP clinic, doctors say.
The Napthine government has ruled out new charges, including an emergency department co-payment, for Victorians who present at emergency departments.
But Australian Medical Association Victorian branch president Tony Bartone said the proposed GP fee would slug Victorians who went to emergency departments, were deemed less critical and referred to the hospital's after-hours GP clinic.
-----
New AMA president Brian Owler vows to pressure government on $7 co-payment
Date May 25, 2014
Kirsten Lawson
Chief Assembly reporter for The Canberra Times.
The new president of the Australian Medical Association, Brian Owler, has indicated no let-up in the fight against the $7 budget co-payment for GP visits and medical tests.
The peak doctors' group looks set to fight the payment by highlighting the people it will hurt - such as the "young woman with a breast lump”, who the AMA suggests could be an extra $63 out of pocket in co-payments alone by the time she had a mammogram, ultrasound, biopsies, pathology and follow-up GP visits.
Dr Owler is possibly most widely known as the face of the “Don’t Rush” road-safety advertising campaign, in which he stares close down the camera and delivers sharp multiple-choice questions such as these: “Would you rather (a) be a few minutes late for the family lunch, or (b) speed, hit a pole, make your wife a paraplegic.”
-----
New AMA boss will fight co-payments
26th May 2014
THE AMA’s new president Associate Professor Brian Owler has made it clear he will fight for a fairer alternative to planned co-payments for medical services, signalling room for compromise where the government says there can be none.
With parliamentarians returning to Canberra today, Labor, the Greens and key crossbenchers lined up to oppose the contentious $7 Medicare co-payment, while Treasurer Joe Hockey said the fee had to stay to fund the proposed medical research future fund.
After being elected to the AMA presidency at the weekend, Professor Owler told the media the peak doctors’ group did not oppose the co-payment in principle but it saw a lot wrong with the impact on the poor, the vulnerable and the chronically ill.
-----
Inevitable co-burden of public anger
Dr Robert Wells
Deputy CEO,
The Sax Institute, Sydney
20th May 2014
THE headline implication for the primary care sector in the 2014 budget is the introduction of a co-payment per service for GP services and out-of-hospital pathology and diagnostic imaging.
Safety nets will apply for cardholders and children.
As well, the PBS co-payment per script will increase by $5 for other than concession cardholders (there with a lesser increase in co-payments for cardholders).
The mechanism for applying the GP co-payment is to reduce the rebate by $5, with doctors having the discretion to have the patient make up the difference or to accept the reduced rebate as payment.
-----
Peter Dutton rules out watering down GP co-payment
- Daniel Burdon
- 26th May 2014 2:14 PM
FEDERAL Health Minister Peter Dutton seems to have ruled out any talks on watering down the Abbott government's $7 GP co-payment.
Mr Dutton told reporters in Canberra on Monday that the government believed strongly in the controversial co-payment, which will be charged on the first 10 GP visits for most Australians from July.
He said the government's Medicare package was "worth supporting and on that basis we are not for negotiating".
Rather, Mr Dutton said if opponents of the GP co-payment were considering negotiating, if they wanted to continue the Medicare model then "you need to support this package".
-----
Interview on ABC News Breakfast with Michael Rowland
Minister for Health Peter Dutton was interviewed on ABC News Breakfast with Michael Rowland.
Page last updated: 26 May 2014
26 May 2014
SUBJECT: Co-payments
MICHAEL ROWLAND: The Health Minister Peter Dutton is reportedly considering a compromise option in order to get that measure through the Senate and Peter Dutton joins us now from Parliament House. Minister, good morning to you.
PETER DUTTON: Good morning Michael.
MICHAEL ROWLAND: How far are you willing to compromise on this co-payment?
PETER DUTTON: We had put to us the co-payment should have been $15. We had a look at the New Zealand model where it's $17.50 and we believe we've struck the right balance at $7; $5 of which goes into the Medical Research Future Fund and $2 goes to the GP to supplement the money that comes from Medicare now. We believe we've got a good model to go forward and importantly we retain bulk billing to provide services ongoing for those who can't afford the $7 out-of-pocket fee and I think we’ve got a great basis for strengthening Medicare as you go forward.
-----
-----
$7 co-payment won’t curb costs: experts
27th May 2014
EXPERTS have challenged government claims that the $7 co-payment will curb health expenditure growth, telling AMA conference delegates the move will create a number of hidden costs.
"Take the patient on warfarin, who... is now only coming every second or third month. Will you need to consider changing them to a 10-fold more expensive medication to maintain appropriate anticoagulation?” AMA Council of General Practice chair Dr Brian Morton asked of the assembled delegates at the weekend.
“How will you manage [patients] clinically if they decide to ration their healthcare services?”
-----
GPs to charge residents under co-payment
General practitioners will be forced to charge aged care residents under the Federal Government’s proposed co-payment model, the Royal Australian College of General Practitioners (RACGP) has said.
Under the co-payment model, all Medicare Benefit Schedule (MBS) rebates for GP consultations – including for surgery consultations, after-hours consultations, home visits and visits to aged-care homes – will be reduced by $5 and GPs will have the choice to absorb this reduced rebate themselves or ask patients to pay the $7 co-payment.
RACGP president, Dr Liz Marles said it was not feasible for GPs to collect money from patients in aged care facilities or when they do a home visit.
-----
Welcome to Health Minister Dutton’s alternative universe – where “strengthening Medicare” means reducing access
Melissa Sweet May 28, 2014 8:07PM
Health Minister Peter Dutton’s expression appeared most sincere today at the National Press Club when he spoke about strengthening Medicare, which he described as “much-loved” by the public and the Government.
No matter that the Budget reveals a clear lack of commitment to enhancing universal health care, as well as a distinct lack of interest, whether you look in the health portfolio or elsewhere, in improving or even maintaining the community’s health.
Given the level of concern in the community and the health sector about the Budget’s impacts – particularly for Aboriginal and Torres Strait Islander peoples, and for the poor, sick and vulnerable (like unemployed youth) – I was expecting Dutton might face some tough questioning from the floor.
-----
Opposition to new GP co-payment continues
Doctors continue to express concern over the federal budget announcement that the Liberal government will introduce a $7 co-payment for GP visits.
At the AMA National Conference in Canberra over the weekend, delegates passed a resolution calling for urgent talks with the federal government to overhaul the GP co-payments plan.
The AMA says it is not opposed to co-payments in principle, arguing that it is reasonable for people with appropriate means to make a contribution towards the costs of seeing a doctor. However, outgoing AMA president, Dr Steve Hambleton, said the co-payments announced in the budget could hurt the most needy and vulnerable.
-----
Don’t can co-payment: Dutton appeals to Senate
29th May 2014
HEALTH Minister Peter Dutton has urged crossbenchers not to take the obstructionist path over the proposed $7 GP co-payment that's central to the government's Medicare overhaul.
Labor, the Australian Greens and Palmer United Party will oppose the payment to visit the doctor, making its passage through the Senate all but impossible.
Speaking at the National Press Club on Wednesday, Mr Dutton again said the $7 co-payment was non-negotiable, stating it was central to making Medicare sustainable.
Mr Palmer has two options when the PUP becomes a key player in the Senate from 1 July, he said.
"The first option is the Greens option, which is to block everything and negotiate on nothing, essentially to be an obstructionist," he said.
-----
Five ways the government could make the GP fee work
Terry Barnes
With the ugly parliamentary brawling over the Abbott government’s first budget, it’s clear the proposed introduction of a $7 co-payment on bulk-billed general practitioner, pathology and radiology services will not pass the Senate.
What was announced was designed more for huge savings to the health budget – which were then, to everyone’s surprise, channelled into a new perpetual Medical Research Future Fund (MRFF) – than to effect structural reform ensuring Medicare’s long-term financial stability. Health Minister Peter Dutton has argued cogently in the plan’s defence, but has been undercut by the government’s poor sales job and knee-jerk reactions from political and medical profession opponents.
If the government believes the bulk bill co-payment is needed to change the way Australians view and use “free” medical services, it must strip back its over-engineered plan to make it palatable to the public, crossbench senators and self-appointed (and self-interested) guardians of Medicare such as the Australian Medical Association.
-----
A timely study reinforces value of access to primary care
Melissa Sweet May 29, 2014 7:23PM
At the National Press Club yesterday, Health Minister Peter Dutton spoke of the importance of evidence in formulating health policy.
I wonder if his advisors are reading The Medical Journal of Australia, which this week has published a study from the NT concluding that:
“Improving access to primary care in remote communities for the management of diabetes results in net health benefits to patients and cost savings to government.”
The authors report below that creating barriers to access to primary care through a co-payment will have adverse consequences for the health of Indigenous Australians in remote NT communities. (And, as we’ve already heard at Croakey, these concerns are not limited to the NT).
-----
Call to abandon key budget measures
- 29th May 2014 4:17 PM
THE "unfair impact" of the Abbott government's first budget on rural health was on the agenda in Canberra on Thursday, during the second meeting of a "parliamentary friends of allied health" group.
While the new group has members across the political spectrum, chairman and Independent MP Andrew Wilkie confirmed neither Health Minister Peter Dutton nor Assistant Minister Fiona Nash had been invited.
-----
Labor championed doctor co-payment fees
- Michael McKenna and Stefanie Balogh
- The Australian
- May 30, 2014
SENIOR Labor leaders have championed for years the introduction of the user-pays system for medical services now vehemently opposed by the party, with the former Beattie government in Queensland going as far as proposing an $800 fee for overnight hospital admissions.
As Tony Abbott accused federal Labor frontbencher Jenny Macklin yesterday of being the “mother of the co-payment’’ — after advising the Hawke government on its plans for a $3.50 Medicare charge in 1991 — documents show that in 2005 the Queensland government considered billing patients $50 for same-day admissions and more for overnight hospital visits. The documents have emerged as the Abbott government struggles to win parliamentary backing to introduce a $7 co-payment on GP services.
Then premier Peter Beattie commissioned modelling “to increase cost recovery from patients’’ after a 2005 review of the state hospital system warned the system was financially unsustainable without new funding.
-----
Co-pay will spark fall in vaccination rates: expert
Vaccination rates across the country will fall if the Federal Government successfully brings in its controversial co-payment plans, a leading immunisation expert warns.
Federal Health Minister Peter Dutton has continually brushed off concerns that the $7 co-payment will put parents off from vaccinating their children, but fears of a public health risk are growing.
The Queensland Government is considering funding free vaccination clinics to keep vaccination rates up if the co-payment goes ahead and, on Wednesday, prominent immunisation expert Professor Robert Booy spoke out against the plans.
-----
Medicare ads spruik $7 GP fee even though law hasn't passed Parliament
Date May 29, 2014
Lisa Cox
National political reporter
The federal government has come under fire for a message on its Medicare hotline informing patients of the introduction of the $7 GP fee before the legislation has passed the Parliament.
Labor MP Richard Marles complained the government was using "an answering machine to do their dirty work" and without a guarantee its measures would find support.
The automated message tells callers a "patient contribution of $7 will be introduced" from July 1 next year, despite the fee facing significant hurdles as it does not currently have the support of opposition or crossbench senators.
-----
Abbott confident co-payment will pass
Updated: 10:09 pm, Saturday, 31 May 2014
Prime minister Tony Abbott says he's confident the budget measure to impose a 7 dollar co-payment to visit the doctor will get through the senate.
He's promising more talks with key cross-benchers to ensure the passage of the controversial measure, saying it's vital to create a world class medical research fund.
The prime minister was joined by Health Minister Peter Dutton and Communications Minister Malcolm Turnbull at the round-table discussions at the Victor Change Cardiac Research Institute on Saturday, as the coalition struggles to get voter support for the co-payment which will go some way towards paying for the medical research fund.
-----
GP numbers won’t slide
- 30th May 2014 10:02 AM
FEDERAL Health Minister Peter Dutton's office yesterday rejected fears Gympie's GP shortage could worsen under changes to a young doctor program that entices medicos to the bush.
A spokesman for the Health Minister said, in fact, the changes to the Prevocational General Practice Placements Program would "markedly improve standards of care in regional and remote Australia".
The PGPPP encourages junior doctors to consider a career in general practice by funding a number of short-term training placements, he said. But a "bottleneck of junior doctors unable to secure vocational training places" means it is no longer necessary to encourage people into the profession.
-----
Hospital Impacts.
SA to close hospital beds in budget casualty
Phillip Coorey and Laura Tingle
The South Australian government plans to close hundreds of hospital beds when it releases its budget next month, a move that will escalate the budget war between Canberra and the states.
A South Australian government source said the bed closure would be “pretty dramatic’’. It will follow Victoria and be blamed directly on the federal budget decision to reduce state hospital and school funding by $80 billion over the next 10 years.
“It is inevitable unless there is a change in direction,’’ a source said. “Unless there ‘s a reversal, the steps will commence immediately.’’
The June 19 state budget will include bed closures that will be effective immediately.
-----
Pharmacy.
Flexible hours and rent help needed to avoid jobs, service cuts
More flexible working hours for pharmacists and staff, and measures to help pharmacies deal with increasing rental costs are essential to avoiding expected staff and service cuts, the Pharmacy Guild of Australia says.
In a detailed submission to a Productivity Commission review of ‘The Relative Costs of Doing Business in Australia: Retail Trade Industry’, the Guild pulled together its previous warnings that pharmacies had, or would be, forced to shed around 10,000 jobs, and that one in 10 pharmacies would be forced to reduce their opening hours, while many cut professional services.
It was estimated that 2229 pharmacists and 4400 pharmacy assistants could lose their jobs in the next 12 months, in addition to some 3200 pharmacy jobs having already been lost in the previous 12 months.
-----
Minister rejects call for price disclosure help
Health Minister Peter Dutton has ignored calls to protect pharmacy from the impact of simplified price disclosure, questioning Guild data on its financial effects.
The Minister told Parliament yesterday, when responding to last year’s Pharmacy Guild of Australia petition, that “the Government understands pharmacists are concerned about the effect of Simplified Price Disclosure on their incomes…. but due to the current fiscal environment, the Government needs to proceed with the changes”.
The Guild presented the petition, signed by 1.2 million Australians, to Parliament in February. it called for action to ensure that community pharmacies receive the support they need to stay in business.
-----
Pharmacy divided over discount threat
Current penalty rates provisions are harming traditional community pharmacies in their battle with discounters, the Pharmacy Guild of Australia believes, while employee pharmacists say lifting pay rates would best combat the discount threat.
Writing in the latest edition of Guild newsletter, Forefront, David Quilty, Guild executive director, says penalty rates are the industrial relation issue “most commonly raised by Guild members”
He says the majority of Guild members “pay their staff well above” the Pharmacy Industry Award (PIA), putting themselves “at a cost disadvantage to a discount chain whose pharmacist wages are considerably lower”.
The Guild’s recent submission to a Productivity Commission review advocated more flexible working hours, and now Mr Quilty says they will commission research “into the impacts of the PIA on community pharmacy, both from the perspective of proprietors as well as its effectiveness in ensuring a strong safety net for employees”.
-----
Comment:
It seems the fuss is not yet settled - to say the least. Will be fascinating to see how all this plays out. Parliament this week will be very interesting indeed! It is clear the GP co-payment issue is red-hot and right now it is hard to see how this measure will pass.
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:
Enjoy.
David.
