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, April 13, 2017

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

April 13, 2017 Edition.
A complicated week with Mr Trump pulling a big surprise with an attack on a Syrian airbase after a chemical attack by Mr Assad. From non-interventionist to interventionist while President Xi was even in to room – Amazing stuff!
Here at home it is all about house prices and if/when greed and fear of missing out result in economic chaos and pain for all of us. There is risk and the regulators need to get their arms around the issue and stabilise things quickly. To not do so could mean things do not go well and is just possible things have already gone too far. Time will tell! Clearly to ignore the issue and hope it goes away is folly.
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Here are a few other things I have noticed.
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National Budget Issues.

Scott Morrison’s May Budget challenge and his business tax plan

April 2, 201711:54am
Staff writers, wiresNews Corp Australia Network
TREASURER Scott Morrison has not given up pursuing the remainder of the government’s 10-year business tax plan and will present the next phase to the Senate when the government believes it will pass.
The parliament on Friday agreed to a tax rate of 27.5 per cent for businesses with a turnover of up to $50 million, to be phased in over the next three years, or “stage one of the plan”, as Mr Morrison describes it.
“We haven’t moved away from this at all,” he told ABC television’s Insiders. “We remain absolutely committed to this plan because this plan is what is going to attract investment.” He does not necessarily believe in waiting until after the next election, given the Senate crossbench has already shifted from supporting a rate reduction for businesses with a turnover of up to only $10 million.
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Sorry folks, this ain't no property bubble

Jessica Irvine
Published: April 4, 2017 - 2:53PM
Believe me, no one is keener than me to see a property bubble burst.
But sadly – for would-be buyers, at least – I just don't see it happening.
Sure, there are risks.
If it turns out that banks have been lending to people who really can't afford it, then we have a problem when interest rates start to rise.
But banks insist they stress test customers for a 2-percentage-point rise in interest rates and require "interest-only" borrowers to prove they could afford to repay principal too, if required.
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RBA keeps rates on hold amid increasing concern about house prices

Peter Martin
Published: April 4, 2017 - 4:04PM
The Reserve Bank of Australia has held the cash rate steady at 1.5 per cent for the 12th consecutive month amid growing pressure for it to increase rates to contain soaring house prices.
The futures market is pricing in no change in rates until late 2018, when there will be an increase.
In the year to March 31, Sydney home prices climbed 18.9 per cent, Melbourne prices 15.9 per cent and the average of capital city prices 12.9 per cent.
In the past week, both the Australian Prudential Regulation Authority and the Australian Securities and Investments Commission have announced tighter rules and increased supervision of banks' lending to investors in an effort to contain the growth in lending to investors to 10 per cent.
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  • Updated Apr 3 2017 at 9:47 PM

Budget could contain tax increases, says Mathias Cormann

Finance Minister Mathias Cormann has hinted there could be tax increases in the May budget but says the government will adhere to its medium-term target of the overall tax take not exceeding 23.9 per cent of the economy.
While the budget is expected to include changes to the Petroleum Resources Rent Tax designed to deliver billions more in revenue, Senator Cormann is fighting to protect the tax-to-GDP ratio from blowing out. He, along with others, is adamant that the deficit levy be abolished on July 1, as promised, and he is fighting internally against proposals to curb the capital gains tax deduction for investors to try and cool the housing market.
The Australian Financial Review has previously reported the government has been considering its own changes to CGT as part of its housing affordability policy and a recent freedom of information request lodged by Labor revealed extensive work had been done by Treasury.
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Beware of politicians selling empty promises of jobs and growth

Ross Gittins
Published: April 4, 2017 - 11:58AM
What's the four-letter word politicians of both stripes most use to bamboozle voters? Jobs. Or, as Neville Wran, former NSW premier and never given to understatement, used to say Jobs, Jobs, Jobs.
Economists and business people worship at the shrine of Growth because it raises their material standard living. Materialism is the god of our age.
But growth is rarely what the pollies try to sell the public on. No, what presses the right button with ordinary folk is jobs.
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Federal budget to tackle illegal cash economy costing up to $15b in lost revenue

Nassim Khadem
Published: April 5, 2017 - 8:12AM
The Turnbull government is expected to announce some interim measures in the May federal budget aimed at beginning a long journey to claw back up to an estimated $15 billion in lost federal tax revenue and illegitimate welfare payments due to widespread cash economy activity.
The man heading the federal government's "Black Economy Taskforce", Board of Tax chairman Michael Andrew, told Fairfax Media he was shocked by the scale of the problem, with exploitation of vulnerable workers such as students and temporary visa holders rife.
The black economy was hard to tackle because Australians viewed taking cash-only payments and not declaring it as "almost a national sport", Mr Andrew said.
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'Jobs and growth': $24 billion company tax cut could be worth just 0.2 per cent to economy

James Massola, Eryk Bagshaw
Published: April 5, 2017 - 7:04AM
The Turnbull government's $24 billion company tax cut will boost the economy by less than 0.2 per cent when fully implemented, according to a preliminary analysis by the Grattan Institute.
The federal government has been resisting pressure from Labor to outline the growth dividend from the cuts, which will see company tax fall to 25 per cent over a decade for companies with a turnover of up to $50 million, after they passed the Senate last week. 
Prime Minister Malcolm Turnbull and Treasurer Scott Morrison said on Tuesday the company tax cut would deliver "substantial economic growth", but would not quantify the contribution to GDP.
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Growing inequality is a 'ticking time-bomb', Nobel prize-winner Muhammad Yunus warns Australia

Latika Bourke
Published: April 4, 2017 - 9:22AM
A renowned Nobel Peace Prize-winning economist and entrepreneur, who is considered the father of microfinance, has warned that growing inequality is a "ticking time-bomb" that will "explode" the political system if it is not addressed, arguing the amount of wealth locked up with the wealthiest in society is not tenable.
Professor Muhammad Yunus, who spoke to Fairfax Media ahead of an Australian visit this week, has also called on the Australian corporate sector to radically transform the way they think and to create "selfless " or "social businesses" that solve societal issues with market-based solutions.
Professor Yunus said business needed to remember that humans were not just "money-making robots and that capitalism could and should be humane."
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APRA plays Santa Claus for bank CEOs

Michael Pascoe
Published: April 6, 2017 - 12:25AM
Hats off to Westpac CEO Brian Hartzer for the use of understatement by declaring Australian Prudential Regulation Authority's (APRA) alleged crackdown on real estate investors wouldn't have "any particular profitability impact".
Boosting profits by a few billion tends not to hurt. And higher profits tend to lead to higher bonuses. APRA is playing Santa Claus for bank CEOs.
No toasting of any gullible media though, who swallowed the line that investor fervour would be noticeably cooled by reducing the proportion of new interest-only loans from 40 per cent to 30 per cent. Good for banks that will charge higher rates to encourage a proportion of investor customers to switch to principal-and-interest loans, negligible impact on the size of the investor book that can continue to grow by up to 10 per cent a year.
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Australian Bankers Association head Anna Bligh concedes banks face 'implosion' of public trust

Heath Aston, political correspondent
Published: April 5, 2017 - 2:31PM
Banks are dealing with an "implosion of trust and an explosion of scrutiny", former Queensland premier Anna Bligh has warned.
In her first speech since her controversial appointment as head of the Australian Bankers Association lobby group, Ms Bligh said it was her mission to reverse a "profound and fundamental shift in trust" against institutions like banks that is happening all over the world.
"Banks here in Australia are under an unprecedented level of pressure and scrutiny. I think there is a direct correlation between the implosion of trust and explosion of scrutiny," she told the Australian Financial Review's wealth and banking summit in Sydney on Wednesday. 
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RBA governor Philip Lowe blames lax lending, tax concessions for house prices

Peter Martin
Published: April 5, 2017 - 7:44AM
Reserve Bank governor Philip Lowe has intervened in the debate over tax ahead of the May budget, blaming the tax arrangements for property investors as well as lax bank lending standards for the explosion in Sydney and Melbourne home prices.
In remarks addressed to a private dinner between Reserve Bank board members and the Melbourne business community to which television cameras had been invited, Governor Lowe said too many loans were being made "where the borrower has the skinniest of income buffers".
In some cases banks were "assuming that people can live more frugally than in practice they can", leaving little for them to live on if things went wrong.
Close to 40 per cent of housing loans (and 60 per cent of investment loans) were interest-only, not requiring the scheduled repayment "of even one dollar of principal at least in the first years of the life of the loan; only interest".
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  • Updated Apr 6 2017 at 2:58 PM

Malcolm Turnbull backs RBA warning as household debt hits new record

Household debt is rocketing towards 190 per cent of disposable incomes, ramping up pressure on the Reserve Bank of Australia and regulators to take action that avoids a US-style debt crisis.
Prime Minister Malcolm Turnbull endorsed Reserve Bank governor Philip Lowe's warning that household debt is rising too fast and linked the high burden of servicing loans to the need for the Commonwealth to manage its debt.
A key reason for maintaining the government's AAA credit rating is that credit agencies assume Canberra will bail out any banks that are blind-sided by a housing crisis.
"All of the warnings that the Reserve Bank and APRA have made about rising levels of debt are well made," Mr Turnbull said in Sydney on Wednesday. "That's their job, the system is working.
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  • Updated Apr 6 2017 at 11:00 PM

Housing set for 'orderly' correction

The world's biggest ratings agencies have warned of an unwinding of Australia's overheated house prices, but say the strength of the banking system and its regulators would ensure any falls are "orderly".
The brutally frank assessment emerged on an explosive second day of The Australian Financial Review Banking and Wealth Summit, where Treasurer Scott Morrison backed the regulators' attempts to quell demand for home loans and improve the stability of the banking system.
Representatives from Fitch Ratings, Moody's and S&P Global Ratings agreed that although the Australian banking system was among the best-regulated in the world, risks were rising in line with growing levels of household debt and property prices.
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  • Updated Apr 7 2017 at 8:30 AM

Major banks short at least $20 billion of equity

One of this column's firmest convictions has been that the major banks must continue deleveraging their balance sheets, which in respect of their biggest asset exposure (home loans) remain more than 40 times their equity capital base. This did not jive with the prevailing zeitgeist, with many bank investors, analysts and executives crowing that the capital raising debate was "over".
Yet arguably Australia's finest regulator, Wayne Byres, once again "shocked" complacent stakeholders during the week with a hard-hitting message that materially more equity capital was coming.
This will likely result in the majors targeting core risk-weighted common equity tier one (CET1) capital ratios above 10 per cent, which CLSA's Brian Johnson estimates leaves them pro-forma short about $20 billion assuming no further rises in the risk weights applied to investment property loans, which account for 35 per cent of their housing books. If they do climb, which is probable, then the shortfall expands by $10 billion for every 10 percentage point increase in risk weights.
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Banks are still lending too much to property buyers

Noel Whittaker
Published: April 7, 2017 - 7:00AM
Real estate continues to dominate the headlines in tandem with speculation on the future of the housing market as the banking regulator's crack down on interest-only loans begins to bite.
Bank of Queensland chief executive John Sutton was front-page news last week when he revealed that some of his competitors were offering maximum loans of up to 30 per cent more than his bank was prepared to write. He finished with a timely warning: "This will end in tears."
To test the veracity of that statement I spoke to a friend who works for one of the major banks. I asked him to run the numbers to let me know how much his bank would lend to a couple earning $85,000 a year each, with an adequate deposit and no debts. I was astounded to learn they could qualify for a loan of $1 million.
Let's do the calculations with the figures rounded for ease of reading. Income tax including Medicare Levy on an $85,000 a year salary would be $21,000. Therefore, our hypothetical couple should be receiving combined take-home pay of $128,000 a year.
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Scott Morrison and Liberals seek scapegoat for tax fumbles

  • The Australian
  • 12:00AM April 7, 2017

John Durie

When your leadership fails you, cast around for someone to blame — and that’s what Scott Morrison is doing right now.
That’s the reaction of one senior businessperson to the Treasurer’s pitch that big business has failed to come to the party supporting a tax cut for the big end of town.
Morrison blamed a lack of business support and business’s own lack of credibility for the failure to get a cut in big company taxes.
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Scott Morrison eyes $4 billion budget bonus from resources price boom

James Massola, Eryk Bagshaw
Published: April 5, 2017 - 8:00PM
Treasurer Scott Morrison is eyeing a $4 billion bonus from booming iron ore and coal prices, a month out from the May 9 budget, and is likely to plough it back into reducing the federal deficit.
Government MPs familiar with budget deliberations confirmed to Fairfax Media that forecast deficits of $36.5 billion in 2016-17 and $28.7 billion in 2017-18 could come in lower than expected.
Mr Morrison last month told Parliament the government's "fiscal strategy is to reduce the deficit and to reduce debt on every opportunity, if there is any improvement in commodity prices or improvement in the parameters that would lead to that result".
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5 Apr 2017 - 2:58pm

Business frustration with Canberra grows

Business groups are becoming increasingly frustrated by the slow pace of reform and the political bickering that goes with it.
Source:
AAP 5 Apr 2017 - 2:58 PM  UPDATED 5 Apr 2017 - 2:58 PM
A business leader has vented his frustration at the state of modern day politics where even the simplest of measures strikes disagreement and risks Australia falling behind the rest of the world.
Australia Industry Group chief executive Innes Willox says the lack of agreement at both the federal and state levels is damaging confidence and more importantly business investment.
"There is deep and endemic frustration about not just the pace of reform, but the nature of the debate in Australia, the inability to agree on even quite simple measures," Mr Willox told the National Press Club on Wednesday.
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Our complacent reliance on foreigners’ savings

  • The Australian
  • 12:00AM April 7, 2017
Savvy consumers are careful with debt, just as citizens ought to be troubled when government relies heavily on foreign savings. Commonwealth net debt is heading for $317 billion by June but many Australians are complacent about it. Truth is, they are relieved when the spurious “fairness” argument trumps yet another reform of middle-class welfare. They feel less pressure to be self-reliant and to pay their own way, thanks to populist politics. The result is massive borrowing — not for growth-spurring infrastructure but to cover recurrent spending in big-ticket areas such as health, welfare and social security. And this demand on funds will only increase as our population ages, leaving the tax and transfer system reliant on ever fewer workers. In 2015, there were 4.5 working age people to support one person aged 65 or over. By 2045, that ratio will fall to three.
As economics editor David Uren reported yesterday, the government will have to borrow­ more than $60bn a year over the next four years to finance­ continuing budget defic­its and roll over existing debts. Treasurer Scott Morrison’s coming budget will be the 10th in a row with a big deficit. We are spending more than $1bn a month on interest. And commonwealth debt is unlikely to be paid off until 2047 at the earliest. The Howard-Costello budget surpluses are a distant memory. Debt has risen at an average rate of $50bn a year since the 2008-09 financial crisis, when Labor’s temporary stimulus became a permanent bloat of recurrent spending. The 2014 Abbott-Hockey budget represented a serious attempt to rein in unsustainable spending but the politics were mishandled. Ever since, obstructionist Labor and a populist Senate have blocked fiscal repair. Morrison has managed only modest savings measures. As Uren wrote, the Turnbull government’s strategy is failing. “At best, the savings measures to date have stopped the deficits growing but have made no meaningful impact on narrowing them.” The government is left with the fragile hope that the economy will speed up enough for revenue to rebound. It protests that bringing a sense of urgency to budget repair might only undermine confidence. Maybe so, but putting off tough talk means a more painful adjustment to fiscal reality when it does come.
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Morrison budget vow to ease household costs

  • The Australian
  • 12:00AM April 7, 2017

Sarah Martin

Michael Roddan

Scott Morrison has pledged next month’s budget will put downward pressure on housing and energy costs, as he seeks to play down broader concerns about Australia’s rising household debt levels.
The Treasurer has flagged a housing affordability package will be a keystone of the May 9 budget, and told industry and business leaders yesterday that the government would continue its “unapologetic focus” on jobs and growth “because lifting the living standards of hardworking Australians and their families depends on jobs and growth.
“Jobs and growth are significant contributors to wealth,” Mr Morrison said. “We will ensure the budget works to place downward pressure on the cost of living, especially on energy and housing.”

Australia has $1 trillion foreign debt. Should we be worried?

Ross Gittins
Published: April 8, 2017 - 12:15AM
When you consider how many people worry about the federal government's debt, it's surprising how rarely we hear about the nation's much bigger foreign debt. When it reached $1 trillion more than a year ago, no one noticed.
That's equivalent to 60 per cent of the nation's annual income (gross domestic product), whereas the federal net public debt is headed for less than a third of that – about $320 billion – by June.
Similarly, when you consider how much people worry about the future of the Chinese economy, American interest rates and all the rest, it's surprising how little interest we take in our "balance of payments" – a quarterly summary of all our economic transactions with the rest of the world.
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Why we need to worry about the level of Australian household debt

Elizabeth Knight
Published: April 8, 2017 - 12:15AM
The balance sheets of Australian households with a mortgage are dangerously exposed to any fall in house prices. It isn't just that household debt relative to disposable income has reached the record high of 189 cent, it's that households' ability to service that debt is potentially a ticking time bomb.
If you look at the health of a household balance sheet in the same way as a company's balance sheet there are two things that come into the picture, the first is the size of the debt against the assets and the second is the ability to pay interest based on the income.
The main reason the average Australian household balance sheet doesn't look like a crisis in the making is that the asset side of the ledger is healthy because house prices have appreciated enormously.
  • Updated Apr 7 2017 at 9:00 PM

Housing correction 'won't be orderly'

Ask respected property analyst Martin North what form the coming downturn in the housing market might take and "orderly" is not the description he uses.
Instead North anticipates a much more significant downturn in the investor-driven, debt-laden markets like Sydney and Melbourne.
"Orderly" is how S&P Global Ratings director Sharad Jain described the likely unwinding of the overheated housing market, where annualised house price growth is running close to 20 per cent in Sydney and Melbourne.
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The $22 billion cost of work-related tax deductions to be tackled in federal budget

Nassim Khadem
Published: April 8, 2017 - 12:15AM
The Turnbull government wants to take a stab at reducing an estimated $22 billion in tax deductions for work-related expenses each year, and may consider introducing a standard deduction for all taxpayers or doing away with certain deductions in favour of lower tax rates.
A government inquiry pushed by Treasurer Scott Morrison has been examining whether a host of work-related tax deductions claimed by individuals every year could be scrapped or reduced, and instead replaced with low personal tax rates.
Mr Morrison last year asked his department to look into a universal cap on income tax deductions that would apply to work-related expenses, as well as housing tax breaks including negative gearing and the capital gains tax concession, which he later ruled out any changes to.
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Health Budget Issues.

Why aren't GPs more concerned about Health Care Homes?

3 April 2017
Money is important: it’s what the Medicare rebate freeze anger is all about; it’s why the GP co-payment plan obliterated Abbott’s premiership; it’s why the debate about bulk-billing rates and their effect on clinical practice won’t die any time soon.
This is stating the obvious so far. But there’s another very obvious issue missing from this GP grievance list.
Why is there no noise, no public debate, no discussion from grassroots GPs about the looming Health Care Homes reforms?
Yes, the phrase ‘Health Care Homes’ hits you with the same dynamism as news of a summer sale at Bunnings Warehouse.
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Health Insurance Issues.

Australian Medical Association reveal best and worst health funds as premiums rise on April 1

Sue Dunlevy, National Health Correspondent, News Corp Australia Network
March 31, 2017 10:00pm
EXCLUSIVE
DOCTORS have revealed the best and the worst health funds in a new report card that shows some policies will leave their members with gap fees on half of all medical services.
The Australian Medical Association has warned people to avoid “junk” policies as they look to switch funds in the wake of the $200 premium hike that takes effect today (Saturday).
The AMA has released its annual Private Health Insurance Report card which says the amount health funds pay in benefits can vary widely between states with some health funds providing benefits for cataract surgery that are 20 per cent lower in one state than another.
Payouts for knee replacements are 18 per cent higher in some states than others.
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Insurers again blame Prostheses List for high premium costs

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

Sarah-Jane Tasker

Australia’s top health insurers have continued to call for regulatory reform and sector collaboration to stop consumers cancel­ling policies because of afford­­ability concerns.
Nib’s group executive of Australian residents health insurance, Rhod McKensey, said conditions remained soft as consumers listed affordability as a key concern.
“Rising healthcare spending and an increasing ratio of tax­payers to retired, often high-cost, Australians means on balance any policy or regulatory change needs to encourage private health insurance participation,” he said.
“Some real prospects to improve system efficiency include further prosthetic pricing, risk equalisation and community rating ­reforms. New Health Minister Greg Hunt seems very determined to improve system ­efficiency and we will continue to prosecute for change.”
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Industry specific health funds find favour

  • The Australian
  • 12:10AM April 8, 2017

Verity Edwards

In the past 30 years the health insurance industry has seen massive changes as premiums rise, needs differ and the number of people taking out cover drops per capita.
Debate is raging over premium rises and over the demands public hospitals place on private patients to use their own insurance to help cover funding shortfalls.
As people contemplate cutting their level of cover or withdrawing entirely to save money, Michael Oertel has watched the not-for-profits he has headed for the past 22 years, Police Health and Emergency Services Health, increase membership. His staff has grown from two to 50.
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Concern as health funds limit mental health cover

April 8, 20176:18pm
Sue Dunlevy News Corp Australia Network
EXCLUSIVE
Health fund members are facing huge out of pocket costs for mental illness treatment as funds move to restrict cover for mental health to drive down premiums.
The move is alarming mental health advocates who claim it is happening by stealth and catching patients unaware.
Many funds are now only providing cover for mental health treatment in a private hospital in top cover policies.
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Superannuation Issues.

Understanding ‘total superannuation balance’ crucial for SMSFs

  • Monica Rule
  • The Australian
  • 12:00AM April 8, 2017
As we move towards July 1 and the biggest suite of changes to superannuation rules that most advisers have ever seen, the term “total superannuation balance” is something that all superannuation fund members must come to understand.
Up until now, many articles have been written on the $1.6 million transfer balance cap. This is the total amount an SMSF member can have on the day they start their retirement pension account (from July 1).
Separately, a member’s total superannuation balance is also struck at a figure of $1.6m but is a rolling limit — it is to be assessed every year.
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I look forward to comments on all this!
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David.

This Is A Really Useful Set Of Basic Resources On Health IT And Safety.

This appeared  a few days ago.

ONC updates health IT safety guides for providers

Published March 29 2017, 7:25am EDT
The Office of the National Coordinator for Health Information Technology has released updated guides to help providers assess the safety and usability of their respective electronic health record systems.
First published in January 2014, the ONC Safety Assurance Factors for EHR Resilience (SAFER) guides are voluntary provider self-assessments that take the form of vulnerability checklists as well as evidence-based recommendations and best practices for how to safely use health IT.
Recommended best practices in the SAFER guides help organizations know what to do to optimize the safety and safe use of their EHRs. Specifically, the guides address nine areas—high-priority practices; organizational responsibilities; contingency planning; system configuration; system interfaces; patient identification; computerized provider order entry with decision support; test results reporting and follow-up; and clinician communication.
Each guide contains 10 to 25 recommended practices that can be assessed as fully implemented, partially implemented or not implemented.
“These checklists allow you to work through a really simple format for asking yourself questions about your system as it exists right now,” says Rebecca Freeman, ONC’s chief nursing officer. “It gives you the chance to systematically identify gaps or hotspots that may need a little attention.”
Key updates to the SAFER guides include:
  • The Test Results and Follow-up Reporting Guide, which recommends practices to optimize the safety and safe use of the EHR with respect to diagnostic testing, calls for improving communication of abnormal results to patients. It’s based on recommendations from a 2015 National Academy of Medicine report.
  • The Contingency Planning Guide, which identifies recommended safety practices associated with planned or unplanned EHR unavailability, addresses best practices for prevention and mitigation of ransomware attacks as well as new recommendations about “downtimes”—those times when systems are completely unavailable or partially unavailable, when response times are unacceptably slow.
Freeman notes that she came to ONC “out of the implementation space” where she has “implemented—from start to finish—these health records” in ambulatory and community hospital settings. At the same time, she contends that, despite widespread adoption of EHRs by provider organizations “they’re not super user-friendly for many of our clinicians,” regardless of the healthcare environment in which the systems operate.
“Many of the reasons for usability and user experience issues have to do with the decisions that were made when the system was being put in place,” says Freeman. “What we need to focus on now is how to make the systems more usable and really keep an eye towards safety.”
More here:
Here is the link to the information and resources:
There is a great deal of useful material here to be downloaded and learnt from.
David.

Wednesday, April 12, 2017

I Wonder Why The myHR Is Not Mentioned When Talking About Government IT And Its Problems?

This appeared last week:

Is government IT getting worse?

By Paris Cowan on Apr 6, 2017 2:00PM

Opposition says the public isn’t happy.

Labor’s digital transformation spokesman Ed Husic says public confidence in the government’s ability to deliver modern digital services has gone down the gurgler, hit by high-profile tech prangs like with the Census, ATO and Centrelink.
He told the AIIA's digital government summit yesterday that these sagas weren’t just teething pains.
“A whole row of front teeth have been knocked out after the government stumbled and tripped over its botched digital transformation efforts," Husic claimed.
“And the response to this has been some cosmetic surgery."
Husic’s office has dug through the AGIMO archives to unearth a 2011 government-run survey of user satisfaction with the Commonwealth’s digital efforts.
It found users rated their satisfaction high as 86 percent. The AIIA ran a similar survey with Galaxy this year which found only 19 percent considered digital services to be meeting their expectations.
Husic welcomed Coalition policies like the establishment of the Digital Transformation Agency, and insisted Labor would be bipartisan "where we can - certainly when it helps to create certainty for industry”.
But he also warned the opposition that the party “won’t be dragooned as cheerleaders when we see things going off the rails”.
IT mud-slinging is a tricky game in Australian politics, with unblemished records rare. Husic acknowledged that Labor had experienced “its fair share of IT problems in office too”.
Assistant Minister for Digital Transformation Angus Taylor told the same event that much of Canberra’s burden comes from years of IT underinvestment during the Labor years, which he said the Coalition plans to address by boosting the Commonwealth’s annual IT expenditure to $9.5 million a year.
Taylor insisted that “despite some real challenges" - like the Census bungle, ATO outages and Centrelink robo-debt controversy - "we are starting to see some projects really deliver”.
He pointed to airport Smartgates, Medicare’s work automating registration for newborns, and the DTA’s GovPass digital identity program as examples of successful IT initiatives.
More here:
This really is a simple question. It is really clear that the PCEHR was a failure and right now, without compulsion, so is the myHR.
That being the case, why are we not reviewing the myHR for value and effectiveness and for meeting its objectives.
Mr Husic, it is time to start asking!!
David.

Tuesday, April 11, 2017

Another Uninformed Commentary Regarding The myHR Appears In The Mainstream Press.

This appeared during last week:

We can gain a lot by sharing our sensitive health data

Sam Crosby
Published: March 29, 2017 - 12:00AM
Years back, I worked with a group of people who had contracted Hepatitis C. The experience of one woman stayed with me. 
Julie looked every inch your average working mum. Hep C was a hangover of a past life she was desperate to escape. 
But when she confided her positive status to a co-worker, word spread throughout her office. 
She found herself shunned by one group of fearful colleagues, and pitied by another.
Julie's story stuck with me, because it was such a striking example of how sensitive medical data is. Its unauthorised release wrecked her work life.
It's this sensitivity that has meant the benefits of e-health have eluded our nation for a decade.
We know that fully digitising and unifying our personal medical data would dramatically improve our health and save billions each year. Yet our decision makers are jumpy about the potential consequences. 
This reluctance contrasts sharply with the way in which we have bounded toward exposing our other private information.
Instead of the anonymity of cash we use electronic transfers that track our activity. Instead of relatively untraceable mail and phone calls, we allow servers in foreign countries to house our personal correspondence. Instead of keeping our thoughts to ourselves we publish them on Facebook, which quietly catalogues a complete history of our photos, our networks, our lives. 
We could quite easily stop doing all of these things, because whenever you start collating data in the one place there is always at least some risk of a hack or theft. But we don't, because it would be a hassle.  We trade off the security of our privacy for convenience. 
But our health records feel different – they are the most sensitive, private information we have. Then again, the benefits on offer are so much greater than a mere convenience.
"Personalised medicine" would allow doctors and nurses to use a combination of patient history, behaviours, and genetic data to identify individualised treatments and drugs.
Our lives – and the lives of our children – could conceivably be saved through the swift transfer of pertinent information. 
Better, freer data would also enable those who run the health system, including hospitals and the PBS, to better identify areas of low-quality care.
It is now 10 years, however, since the Rudd government launched its e-health initiative. It failed due to poor pick up and low stakeholder support. 
The current government has looked to reboot efforts through its My Health Record program, but take-up is still poor and, like its predecessor, it faces a critical issue: doctors don't endorse it. 
The Australian Medical Association's key objection is that under existing regulations patients can remove anything from their own records without even leaving a note about the omission. This renders any record dangerously unreliable.
Yet government has allowed this loophole, because it is so keen to ensure every potential privacy concern is catered to.
That's a shame. Because there is a lot of evidence that indicates if government moved more decisively, we might well be receptive. 
…..
Sam Crosby is executive director of The McKell Institute.
The full article is found here:
This is really a pretty sad article.
First – on Julie’s story – it is outcomes and experiences  like this that should and indeed do make people share health information very carefully. Once material like this is out it is very hard to get back!
Second I know of no evidence that overriding people’s privacy is likely to make them happier to have their privacy violated!
Third, where is the evidence that the government will be careful and secure with information, given what they did recently in leaking personal information for their own political purposes.
Fourth what is the evidence the information in the myHR is actually useful for the purposes Sam proposes.
All this enthusiasm comes from the analysis reported in this report:
The much more measured approach to the use of Data in a careful and transparent way almost certainly has merit but going at it like a ‘bull at a gate’ is not the way forward. Let’s build trust, public awareness and confidence first before proceeding!
Anyone who knows anything would not use the myHR as a base for the sort of datamining discussed other than in desperation!
See the most recent poll of the view of readers.
Please download the report and then comment if you have a moment! With the revelations from earlier on the way the myHR can leak private information, use of this information needs very careful thought - to say the least.

David.

Dr Mukesh Haikerwal And Paul Madden Speak On The myHR And Privacy.

This appeared earlier today.

My Health Record: Is your private information protected?

The My Health Record is a computer based system designed to collate all of your desired health records into one place, with the aim of making it easier to share this information with your various healthcare providers.
However, concerns have been raised about the security of the system, with some arguing that 650,000 healthcare professionals now have unlimited access to people’s health records.
Wendy Harmer speaks to Dr Mukesh Haikerwal, Former AMA President about the potential pitfalls of the system.
And Paul Madden, Deputy Secretary in the Federal Department of Health, who is responsible for Digital Health issues including the My Health Record.
Duration: 23min 20sec
Broadcast: Tue 11 Apr 2017, 8:30am
Published: Tue 11 Apr 2017, 11:47am
Here is the link:
Enjoy. 

I do wonder why we have Paul Madden and not Tim Kelsey talking about the Department's view?
David.

The MyHR Seems To Be Way Less Protected And Secure Than Anyone Knew – What A Mess.

This appeared this morning.

Optometrists and dentists will know if you’ve had an abortion or mental illness in health record bungle

Sue Dunlevy, National Health Reporter, News Corp Australia Network
April 10, 2017 10:00pm
THE private health records of Australians can be accessed by more than half a million people under the latest bungle with the $2.2 billion electronic My Health Record.
News Corp Australia has learned that the privacy settings on the government’s computerised My Health Record, which lists every medicine a patient takes and records every medical visit and procedure, are automatically set on “universal access”.
This means every registered health practitioner in the nation — 650,000 people — can view them, not just the family GP, unless the patient specifically requested to opt out.
Occupational therapists working for an employer, doctors working for insurance companies, a dietitian, an optometrist or a dentist or their staff can view the record and see if individuals have a sexually transmitted disease, a mental illness, have had an abortion or is using Viagra.
“Potentially your employer’s occupational therapist can look at your record and get information they really shouldn’t be getting access to, its confidential data,” says former AMA president Dr Mukesh Haikerwal who was a government consultant on the My Health Record.
The bungle came about because the record was originally set up as an opt in system and when people set up their record they were given the option to set a PIN number to protect the information and determine who got to see it.
Nearly four million people set up a My Health Record under the opt in system but doctors weren’t using it because four years after it was established 83 per cent of Australians still did not have one.
Last year the Turnbull Government trialled turning the failed record into an opt out system.
One million people in the Nepean Blue Mountains area of NSW and Northern Queensland were given a record unless they opted out.
News Corp has now learned only 147 of these one million Australians automatically given a record under the trial set up a PIN number to protect their health information.
“147 My Health Records created in the trials have access controls set to restrict which healthcare providers can see the record, or have controls restricting access to certain documents in the record,” the Department said.
“This equates to 0.0151 per cent of My Health Records automatically created in the trials. This is consistent with the rates of access controls set by those who have opted to register for a My Health Record,” a spokeswoman for the department said.
Vastly more here:
There is an editorial here:

Editorial: Prognosis bad in medical record bungle

April 11, 2017 12:30am
Editorial
THE privacy scandal unfolding in the troubled My Health Record electronic medical records system is ample proof why citizens should be vigilant and maintain a healthy scepticism about governments and Big Brother bureaucracies.
As revealed in today’s The Advertiser, your medical records may be an open book to 650,000 registered medical practitioners.
Had a mental illness? Your dentist can view details. A sexually transmitted disease? A bored pharmacist interstate might be curious. At risk of a hereditary disease? Your potential employer or insurance company might be very keen to know, via their in-house medical staff.
Workers in large corporations may never look at their in-house nurse in quite the same way again, knowing he/she may have checked on a medical history which has nothing to do with work performance.
This cavalier approach to sensitive and intensely private information, where people have to “opt out” to safeguard their privacy, is a disgrace. Here in South Australia we have been through the aftermath of the shocking death of then-Crows coach Phil Walsh, when sticky beak clinicians pried into the medical records of his mentally-troubled son, Cy.
The result of that snooping was a stern warning that any SA Health staff making deliberate, unauthorised access of medical records would be sacked – seven have been terminated in the past year as some continued to pry.
Yet we have a national system where any registered medical practitioner can browse records on the My Health Record database.
We live in an era of mega metadata, where everyone from social media giants to intelligence services want all your information, for sales and surveillance.
Medical information must not be part of this exponential invasion of privacy.
The Federal Government must act to ensure a patient’s medical information can only be accessed by clinicians who need specific information for their patient’s treatment.
Here is the link:
My take is that this reveals the myHR to be an utterly insecure unused failure.
What to others think?
David.