Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
It is amazing how the discussion on the GP Co-Payment just runs and runs. Lots more this week.
Here are some of the more interesting articles I have spotted this twelfth week since it was released.
Parliament has now got up for the Winter Recess we can take a breath and see where we are. This will end on August 26 when parliament returns
The main fun this week has been to watch Mr Hockey make such a huge mess of consultation and selling the now rather apparently dead Budget.
General.
New budget would be a second chance for the PM
Date August 11, 2014 - 12:15AM
Paul Sheehan
We may be about to see history made by the federal government, a change of direction forced on Prime Minister Tony Abbott by a hostile Senate and a hostile public. We may see a do-over budget.
The first Abbott budget has proved to be a debacle. The opinion polls provide the proof. The content, the fairness and the selling of the budget have seen a spectacular adverse turn in the fortunes of Treasurer Joe Hockey. He’s gone from being the best performer in Parliament to the best target in Canberra. His key policy of introducing a $7 service fee for visits to the doctor and putting the bulk of the proceeds into a giant fund for medical research (rather than into reducing the budget deficit, something people could understand) is one of the most maladroit policies I have ever seen.
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Tony Abbott acknowledges disappointment of voters and starts to tighten up government management
- August 11, 2014
- MALCOLM FARR, National Political Editornews.com.au
Tony Abbott in Holland. Source: TheAustralian
THE groaning burden of buyer’s remorse has been acknowledged by the Abbott government, and the Prime Minister last week began steps to placate his political customers.
Opinion polls and stark anecdotal evidence has made clear that while voters are not ready to switch to Labor, they are not happy with the Coalition product they bought at the last election. The Tony Abbott era has not been the clean, efficient transition they hoped.
It hasn’t been simply a matter of switching off the turmoil of six years of Labor, and the absence of an untroubled changeover has troubled many voters.
Here are seven issues contributing to that buyer remorse.
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Joe Hockey's budget overtures may be too little, too late
Date August 12, 2014
James Massola
Joe Hockey is right to argue the budget needs to be placed on a more sustainable footing over the long term. It is also correct that most of the budget has already passed through the Parliament.
But that's not the point. About $40 billion in structural savings including the $7 GP co-payment, changes to welfare, higher education, other social security measures and the restarting of fuel excise indexation (to say nothing of the mining tax and its associated spending measures) are outstanding.
But even as Hockey engages in belated cross-bench diplomacy, criss-crossing the country for the last fortnight, it's hard to escape the feeling that it may be too little, too late. Public debate on measures that carry the imprimatur of the Treasurer may be lost. If anything, the fallout from the budget has worsened as the weeks have passed.
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Budget deadlock: Former RBA official says fresh polls could be the answer
Date August 12, 2014
James Massola
Former Reserve Bank board member Warwick McKibbin has suggested a new election may be needed to resolve the Senate impasse holding up vital budget savings, and has hit out at the political populism of the Greens and Palmer United Party.
And Bank of America Merrill Lynch economist Saul Eslake has suggested a mini-budget is ''one of the options the government needs to think about'' as consumer confidence falls, unemployment rises to 6.4 per cent and if the political uncertainty continues, which could potentially hit business confidence.
Treasurer Joe Hockey is scheduled to meet PUP leader Clive Palmer on Tuesday. Mr Hockey has rejected former Treasurer Peter Costello's call to drop the proposed $7 GP co-payment, declaring that budget critics should not write off important measures.
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Tone-deaf Treasurer: Joe Hockey the budget's worst enemy
Date August 14, 2014 - 6:08PM
John Hewson
Treasurer Joe Hockey made a meal of his first budget and is making an even bigger meal of settling and selling it.
He was clearly "best on field" in the run up to the budget but has been near to the worst since, with some now wanting his contract reviewed. They certainly don't see him as "foreman material".
Hockey (and Prime Minister Tony Abbott) seemed genuinely surprised that the budget was criticised and rejected so widely. Yet Hockey waited some 10 weeks before attempting to woo the essential crossbench senators and was AWOL in the media much of that time, except for the serious distraction created by the release of his ill-conceived biography, Hockey: Not Your Average Joe. This only served to further undermine the budget's integrity and to raise questions about his judgment.
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Uni deregulation? It’s the budget bottom line, stupid
- The Australian
- August 16, 2014
Peter van Onselen
THE government is putting health and education policy reforms front and centre between now and the next election. Notwithstanding the rise and rise of national security as an issue set to dominate political discourse, the policy debates surrounding higher education reforms and reining in Medicare costs are central to budget discussions. They are what you may describe as core elements of the economic debate.
This creates an interesting dichotomy. In the minds of voters, Labor tends to register as the preferred party to manage health and education policy, but according to Newspoll the Coalition has long dominated as the best party to manage the economy. Which is why a Galaxy poll two weeks ago showing more voters, since the budget, trust Labor to manage the finances must have been chilling for government MPs. Arguably, managing the economics of health and education into the future is becoming more central to fiscal sustainability, given the financial constraints on government and the ageing of the population.
Last Saturday this column praised the job being done by Education Minister Christopher Pyne when it comes to setting out his agenda and negotiating reforms through the Senate. He indicated his respect for the bicameral process, and he is tackling higher education reforms previously thrown into the too-hard basket, including by the Howard government.
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‘Fix budget, quit the argy-bargy’: Tony Shepherd warns of loss of confidence
- The Australian
- August 16, 2014
Annabel Hepworth
NATIONAL Commission of Audit chairman Tony Shepherd has urged the Coalition and crossbench senators to reach a compromise on the budget, warning uncertainty will drain business confidence and distract the government from other important reforms.
Amid escalating frustration in the business community about the Senate derailing the Coalition’s agenda, the former Business Council of Australia president and respected company director has likened maintaining current government spending levels to a “short-term sugar hit”.
Writing in The Weekend Australian today, Mr Shepherd says that in the “toing and froing” on the budget, people have lost sight of why government spending needs to be cut.
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Tony Abbott to step up budget sales job
- The Australian
- August 16, 2014
David Crowe
CABINET ministers will move within days to reboot the government’s budget strategy after Joe Hockey sought to end a damaging row over fuel excise by apologising for the hurt caused by his remarks about the poor.
Tony Abbott will redouble the government’s effort to win the economic debate in a political offensive across cities, including a cabinet meeting in Melbourne to assess the harm to the government’s economic message.
Labor dismissed the Treasurer’s apology as coming too late and used it to heighten pressure on the government to abandon unpopular budget changes such as the $7 fee on bulk-billed visits to GPs.
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Joe Hockey makes things worse, say political advisers
Date August 17, 2014
Matthew Knott
Communications and education correspondent
Veteran Liberal Party campaign strategist Toby Ralph says the Germans have a perfect word for Joe Hockey's car crash of a week: schlimmbesserung.
It means an attempt to make things better that ends up making them a lot worse.
Mr Ralph, who worked on all of John Howard's election campaigns, says the Treasurer's biggest mistake was not the original defence of a rise in fuel excise by saying the ''poorest people either don't have cars or actually don't drive very far in many cases'' in a radio interview.
It was the fact Mr Hockey then attempted to defend his comments as statistically accurate - citing the total amount wealthy households spend on petrol. It was only after two full days, and a slap down from Tony Abbott, that Mr Hockey finally gave a full apology.
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Federal Budget to get family-friendly reboot with with mining tax concessions, university reforms, $7 GP fee and revamped $810 school kids bonus
- Samantha Maiden
- The Sunday Telegraph
- August 17, 2014
THE Budget will get a family-friendly reboot, with concessions on the mining tax, university reforms, the $7 GP fee and a revamped $810 school kids bonus.
Determined to ensure key budget measures pass the Senate, Treasurer Joe Hockey is under intense pressure to split the mining tax legislation, which would allow the government to secure support for dumping Labor’s failed tax.
By splitting the bills, the government could axe the tax while accepting Clive Palmer’s demands to retain some of the $10 billion in popular spending linked to it.
These include the school kids bonus, the low income superannuation contribution scheme and the low income support bonus.
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Specialist Fees.
Doctors have a fat co-payment scheme of their own
Terry Barnes
While relentlessly attacking the federal budget’s $7 co-payment on bulk-billed GP services measure as unfair, neurosurgeon and Australian Medical Association president Brian Owler asserts doctors’ rights to charge co-payments generally. His specialist members certainly do with gusto, and presumably he does too.
If he but realises it, Health Minister Peter Dutton is ideally placed to drive a hard bargain with the AMA on containing excessive out-of-pockets, especially given the doctors’ trade union is pressuring the government to dump the $5 cut to Medicare rebates intended to drive GPs to charge the co-payment.
The ace up Dutton’s sleeve is that doctors, particularly surgeons and specialists, depend on Medicare income like a smoker depends on his nicotine fix. Even if Medicare rebates don’t cover the full cost of medical services plus a reasonable margin, their subsidies make costly specialist services accessible and affordable to most Australians on low to middle incomes, especially the pensioners and fixed-income retirees who dominate the demand for medical services.
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GP Co-Payment.
Government considers $7 GP fee compromise to exempt pensioners, disadvantaged
Date August 12, 2014 - 1:37PM
Latika Bourke
The government says it is looking “seriously” at a plan that would exempt pensioners and other disadvantaged Australians from paying the proposed $7 GP fee.
Health Minister Minister Peter Dutton says he has sought costs for an alternative plan being put forward by the doctors' union, the Australian Medical Association.
The AMA's counter policy would void the fee for the elderly and disadvantaged as well as indigenous Australians who visit their doctor through Aboriginal Medical Services.
Mr Dutton says he has asked his department to cost the policy.
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Govt costing AMA co-payment plan
- AAP
- August 12, 2014
Peter Dutton says GP co-payment models suggested by AMA and crossbenchers are being taken seriously. Source: AAP
THE Abbott government is crunching the numbers on potential changes to its unpopular GP co-payment that would exempt pensioners and other vulnerable patients.
HEALTH Minister Peter Dutton says the coalition is "seriously" considering the proposal from the Australian Medical Association as it attempts to get the $7 co-payment through the Senate.
The doctors group opposes the original model for the impost, which charges all patients $7 to visit the GP.
Key Senate crossbenchers David Leyonhjelm and Bob Day have also called for a rethink on the co-payment, while it has been rejected outright by the Palmer United Party.
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Clive Palmer goes quiet as Coalition seeks deals on health and education
Health minister confirms he is ‘seriously considering’ medical association’s compromise proposal on GP co-payment
Daniel Hurst, political correspondent
Tuesday 12 August 2014 17.42 EST
Clive Palmer has declined to comment on possible compromises on health and education policy, despite previously insisting his three senators would oppose any Medicare co-payment or deregulation of university fees.
The Palmer United party (PUP) leader was reluctant to express a firm position on such options before a meeting with the treasurer, Joe Hockey, on Tuesday night, which was part of the government’s attempts to avoid defeat on contentious budget measures.
Ministers signalled last week they were open to the need to negotiate changes to the health and education proposals in order to secure Senate approval, and Hockey has been using the winter parliamentary recess to travel around the nation talking to crossbench senators.
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Doctors chief sounds alarm on $7 co-payment
Date August 13, 2014
Dan Harrison
Health and Indigenous Affairs Correspondent
Australian Medical Association president Brian Owler has warned the Coalition's proposed $7 Medicare co-payment could destroy recent gains made in indigenous health by deterring people from seeking care.
The annual closing the gap report delivered by Prime Minister Tony Abbott in February showed the nation was on track to halve the gap between indigenous and non-indigenous infant mortality within the decade.
It also showed some improvement in indigenous life expectancy, but warned progress would need to accelerate considerably in order to meet the target of closing the life expectancy gap between indigenous and non-indigenous Australians by 2031.
Speaking to Fairfax Media in Alice Springs where he was touring health facilities, Associate Professor Owler said there was a risk that the proposed $7 fee and $160 million in other cuts to indigenous health programs would cause progress ''not only to stall but go backwards''.
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Co-payment faces battle in Senate
Phillip Coorey Chief political correspondent
The government is likely to increase exemptions from its proposed Medicare co-payment rather than reduce the $7 charge, Health Minister Peter Dutton has indicated.
Regardless of changes made,Mr Dutton’s task of securing its passage through the Senate remains tough.
Clive Palmer reiterated that his three senators, who have a balance of power role in the Senate, will not approve any form of co-payment, which is designed to discourage people going to the doctor a lot.
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AMA’s co-payment model in the spotlight
The Abbott government is crunching the numbers on proposed changes to its GP co-payment that would exempt pensioners and other vulnerable patients.
Health Minister Peter Dutton says the coalition is seriously considering the proposal from the AMA as it attempts to get the $7 co-payment through the Senate.
The AMA opposes the original model for the impost, which charges all patients $7 to visit the GP.
Key Senate crossbenchers David Leyonhjelm and Bob Day have also called for a rethink on the co-payment, while it has been rejected outright by the Palmer United Party.
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Clive Palmer signals he’s willing to compromise on GP co-payment
- The Australian
- August 13, 2014
Jared Owens
PALMER United Party senators would consider supporting the government’s controversial Medicare co-payment if pensioners and low-income Australians were exempt, Clive Palmer says.
The PUP leader, following budget talks with Joe Hockey in Brisbane last night, said the pair agreed the government should “get revenue aligned with expenditure”.
Mr Palmer, who claimed in May that the purported debt crisis was “just more bullshit being fed to the Australian public”, also admitted that Australia faced a “critical economic crisis”.
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August 13, 2014, 12:23 am
Federal Health Minister Peter Dutton has revealed the Government is considering exempting the elderly from the Medicare co-payment proposal.
The Government does not have enough support to get its proposed $7 GP fee through the Senate.
The Australian Medical Association (AMA) has given the Government an alternative co-payment model, which the ABC understands would exempt some groups, including pensioners.
AMA president Brian Owler says the alternative model would support vulnerable people and meet the Government's need to send a price signal.
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Dutton hopeful on GP co-payment
- August 14, 2014
- AAP
HEALTH Minister Peter Dutton says he's still hopeful of persuading Senate crossbenchers to back his contentious GP co-payment, ahead of a dinner with Clive Palmer.
MR Dutton will meet the billionaire MP on Thursday night to discuss the Palmer United Party's concerns about the $7 charge to visit the doctor.
The government has so far struggled to sell the co-payment to the crossbenchers, but the health minister on Wednesday described negotiations as "fruitful".
"I think we can be hopeful but there is a lot of work to do and these are long-running negotiations," he told ABC radio.
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Pensioners miss GP safety net
- The Australian
- August 14, 2014
Sean Parnell
Jared Owens
A MAJORITY of pensioners and other concession card holders would not benefit from the safety net built into the $7 medical co-payment.
As the federal government negotiates with Senate crossbenchers and stakeholders to push through key budget measures, new figures from the Department of Health cast doubts over the protections built into a co-payment.
Health Minister Peter Dutton, who has agreed to consider alternatives from the Australian Medical Association, has long argued that the budget proposal includes an “appropriate safety net” for concession card holders and children, capping the number of annual co-payments to 10.
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Palmer and Dutton talk co-payment
Pensioners and other concession card holders may not benefit from a capped number of GP co-payments spruiked by the federal government on its proposed budget measure.
The government has argued it would cap the number of $7 co-payments for concession card holders and children to 10.
But figures from The Department of Health reveal the average number of visits for GP, imaging and pathology services by concession card holders was eight, falling short of the safety net, The Australian reports.
Few will pay the $7 GP fee under AMA plan
- Sue Dunlevy National Health Reporter
- News Corp Australia Network
- August 15, 2014
Dutton, Palmer talk GP payment
VERY few patients will pay the $7 GP fee and the government will make almost no savings under the Australian Medical Association proposal being considered “seriously” by the government.
The AMA wants Federal Government to exempt large groups of people including pensioners, nursing home patients, indigenous Australians and the chronically ill.
The government would also have to back track on plans to cut the Medicare rebate by $5 under the plan, wiping out most of the $3.5 billion in savings.
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Medicare fee jeopardises Aborigines
Date August 15, 2014
Dan Harrison
Health and Indigenous Affairs Correspondent
Health leaders have warned the Abbott government's proposed $7 Medicare fee could widen the gap in life expectancy between indigenous and non-indigenous Australians.
John Paterson, the chief executive of the Aboriginal Medical Services Alliance Northern Territory, said its 26 member health services would waive the fee, incurring an annual reduction in their income of between $250,000 and $750,000 for each service.
"It's going to obviously widen the life expectancy gap. If there are any cuts, it will delay closing the gap by another 10 or 20 years," he said.
Olga Havnen, the chief executive of Danila Dilba health service, which serves about half of the indigenous population of the Darwin region, said there was "no way" it could charge the proposed $7 fee to its patients.
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GP co-payment and a healthier economy are polar opposites
Date August 15, 2014 - 12:15AM
Toby Hall
"While a $7 fee sounds easy, the policy flies in the face of good evidence that encourages a different approach."
Occasionally during a particularly divisive and protracted debate, someone just hits the nail on the head, an enabler who helps us to see the woods for the trees in what previously seemed intractable foggy territory. In relation to the shortfalls of the government’s proposed GP co-payment, this enabler has come in the form of AMA President Brian Owler.
At the National Press Club last month Professor Owler outlined the AMA’s concerns about the co-payment, saying it threatens “the universality and affordability for healthcare for the neediest and sickest in the community”. While touring indigenous health clinics in Alice Springs this week he foretold of the “devastating effect on people attending the clinics” the co-payment would have.
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GP co-pay: Palmer takes on Dutton with Oz Doc stats
Health Minister Peter Dutton will be attempting to save his $7 GP co-payment plan on Thursday night in a one-on-one meeting with mining mogul billionaire Clive Palmer.
Mr Dutton has already declared he is considering 'exemptions' for pensioners and the vulnerable.
"I'm going to break bread with Mr Palmer tonight and I think like all of us Mr Palmer wants to see a Medicare system which is sustainable," Mr Dutton said.
But it is likely he will get short shrift from Mr Palmer whose opposition is apparently rooted in Australian Doctor's Stop the Co-Pay Cuts: GPs make the difference campaign.
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http://www.australiandoctor.com.au/news/latest-news/exemptions-could-kill-off-$7-co-pay-policy-for-g
'Exemptions' could kill off $7 co-pay for good
Health Minister Peter Dutton seems to have put the tank in reverse gear over the GP co-payment even if he's not quite hit the accelerator.
On Tuesday, he was on the radio saying that he wants to crunch the numbers on providing 'exemptions' to his $7 co-pay for pensioners and the vulnerable.
The "exemptions" have apparently been pitched by the AMA during recent meetings and it would be good to provide the general practice community with the specifics.
But the AMA says it's all secret — so no one outside the chosen few have any idea what it's been whispering in the minister's ear.
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FOI reveals GP co-pay modelling
12th Aug 2014
INTERNAL emails released this week as part of a Freedom of Information request complicate an embarrassing error about general practice made in the aftermath of the May budget.
An email exchange between two bureaucrats suggests Treasurer Joe Hockey was briefed on the average number of times Australians visit the doctor, despite going on to incorrectly claim they visit their doctor 11 times a year while justifying the $7 co-payment.
A treasury official emailed a health department bureaucrat on 9 May — four days before the budget was handed down — asking for numbers on access to pathology and diagnostic imaging for concessional and non-concessional patients. The email quoted statistics on the average GP visits, which showed concession card holders accessing services at a far greater rate than their non-concessional counterparts.
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'Disastrous' GP co-payment under fire
Implementing the federal government's $7 GP co-payment proposal would be disastrous for indigenous healthcare, the AMA president says.
Associate Professor Brian Owler has been touring the Northern Territory since Monday, including visits to Alice Springs, the Tiwi Islands and Darwin, and says the GP co-payments have been the key issue raised with him.
"Everyone who knows anything about indigenous healthcare and anyone who's been to the NT will realise it's just impractical to suggest you're going to be charging $7 for each GP and clinic visit and each pathology or X-ray test you order," he told AAP on Thursday.
In its current form, the co-payment would cost remote healthcare providers up to $14 per patient, or about one-third of the cost of the consultation.
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Modernising Medicare: Don’t reinvent the wheel, just use the co-payments we already have.
Margaret Faux writes:
It seems that despite overwhelming opposition to the co-payment plan, the Abbott government is determined to press ahead, though success in the Senate may be challenging.
Most Australians by now would agree that a considered and coordinated multipronged reform approach is more likely to produce sustainable outcomes and ensure the long term viability of Medicare than blunt quick fixes such as GP co-payments. But if we must make a sudden cut to costs, a much better place to start than primary care might be our current aftercare arrangements. It’s an outdated concept where savings in the vicinity of $400 million per annum could be achieved without too much fuss and with no loss of income for doctors, pensioners or the poor.
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Medicare Locals.
Hunter Medicare Local's finances to be examined
By GABRIEL WINGATE-PEARSE
Aug. 15, 2014, 9:30 p.m.
THE embattled Hunter Medicare Local has come to the notice of the Federal Department of Health which will be putting the $35 million company’s finances under the microscope.
The department issued a statement on Friday saying it is undertaking a performance audit of the organisation, which runs the ‘‘jewel in the crown’’ of the Hunter primary health system, the highly acclaimed GP Access After-Hours Service.
The future of Hunter Medicare Local is hanging in the balance with no funding guaranteed past June when the 61 Medicare Locals around Australia will be replaced with a smaller number of Primary Health Networks.
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Model GP clinic raided by Medicare
- The Australian
- August 16, 2014
Sean Parnell
AN indigenous health service promoted by the Abbott government as a model for the primary care sector is under investigation for alleged misuse of Medicare funds.
The Weekend Australian has learned the Murri Health Group, which runs GP and dental clinics and an outreach service north of Brisbane, has been raided by Medicare investigators after allegations were raised about its operations.
Prime Minister Tony Abbott’s parliamentary secretary for indigenous affairs, Alan Tudge, earlier had visited the service and declared its “model of success” could be replicated across Australia.
“They haven’t had government funding and are delivering terrific results,’’ Mr Tudge said after a tour of the Murri Medical clinic at Caboolture with local Liberal Party colleague Wyatt Roy in January.
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Pharmacy, PBS and Medicine Issues.
News Review: Which aisle has the blood tests?
The threat posed by retailers to community pharmacist ownership of pharmacies is a recurring theme in Australian pharmacy history.
It is also once again topical, after what seems to be an abortive attempt, since denied, by supermarket giant Woolworths to have young pharmacists running in-store 'health checks'.
The situation first came to light when advertisements recently appeared on employment website Seek.com, placed by consumer engagement company, XPO Brands, looking for health professionals.
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Services and technology keys to the future: Tambassis
Pharmacy must overcome resistance to increasing its service offering if it is to survive, a senior Pharmacy Guild figure believes.
Speaking at an event in Melbourne today, Guild national president George Tambassis emphasised the importance of incorporating technology and adopting better services into community pharmacy.
Mr Tambassis spoke at the ‘Pharmacy Freedom’ event this morning, which featured the launch of Transpharmation, a multimedia pharmacy business guide by pharmacist Robert Sztar.
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Remuneration for services a 6CPA necessity: Sinclair
Remuneration for services must be at the centre of the next Community Pharmacy Agreement, one of its key negotiators believes.
Paul Sinclair, president of the NSW branch of the Pharmacy Guild of Australia, says services such as Webster packaging, free home deliveries and providing after-hours and weekend access “must now be remunerated if they are to be maintained”.
Mr Sinclair, who will head the Guild’s negotiating team for the Sixth CPA negotiations, due to commence this year, said in the NSW Guild Bulletin said “much of what we have done for so long has gone unacknowledged, because it has been effectively cross-subsidised by generic trading terms.”
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Comment:
It seems the fuss is not yet settled - to say the least.
Lots to browse with all sorts of initiatives going rather pear shape - think security, sanctions and so on! I also have to say reading all the articles I have no idea what is actually going to happen with the Budget at the end of the day!
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.
