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, June 08, 2017

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

June 8, 2017 Edition.
It is all back on again now on the Trump front as he has finished  wandering around the world causing trouble with climate change control, defence policy and a range of other issues. Of course he also came out of the Paris Agreement last week to everyone seemingly saying he was wrong.
The current week will be fascinating with more leaks happening and the Comey testimony due on June 8.
On the Australian front we seem to have increasing talk of an economic slowdown. Time will tell just where we land up.
The most interesting bit of news this week was this:
  • Updated May 29 2017 at 11:00 PM

Altair Asset Management hands back cash to clients citing looming correction

Australian asset manager Altair Asset Management has made the extraordinary decision to liquidate its Australian shares funds and return "hundreds of millions" of dollars back to its clients, citing an impending property market "calamity" and the "overvalued and dangerous time in this cycle".
"Giving up management and performance fees and handing back cash from investments managed by us is a seminal decision, however preserving client's assets is what all fund managers should put before their own interests," Philip Parker, who serves as Altair's chairman and chief investment officer, said in a statement on Monday.
The 30-year veteran of funds management said that he had on May 15 advised all Altair clients that he planned to "sell all the underlying shares in the Altair unit trusts and to then hand back the cash to those same managed fund investors".
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Here are a few other things I have noticed.
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National Budget Issues.

Borrowers warned to brace for across-the-board mortgage rate increases

John Collett
Published: May 28 2017 - 12:15AM
Despite official interest rates being on hold at an historic low of 1.5 per cent since August 2016, mortgage rates have been rising over that time.
Experts say mortgage rates will be hiked even further as a result of the government's proposed levy on the big four banks and Macquarie Bank, to start from July 1.
They are likely to recoup much of the $6 billion the government estimates it will reap over four years, by increasing interest rates on their mortgages and, perhaps, lowering dividends to shareholders.
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We should be thankful for Tony Abbott. No, really

Jessica Irvine
Published: May 28 2017 - 11:45PM
The 2014 budget was so unfair that it reset the national conversation.
It is said we can learn as much – if not more – from our mistakes as our successes.
After a particularly challenging event recently, I tried to take on board this advice, comforting myself with the thought "what a wonderful opportunity for personal growth this presents".
So, too, should we view the leadership of former prime minister Tony Abbott.
Abbott's now infamous 2014 budget horror show was so manifestly unfair in the way it targeted different groups of Australians in the quest to restore the budget to balance that it has, for the moment at least, fundamentally altered the national conversation about the role of government in society and how governments should best go about collecting taxes and spending them to improve the wellbeing of the nation.
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Our universities aren't earning the money we give them

Ross Gittins
Published: May 29 2017 - 6:35AM
Sorry, but the small funding cuts imposed on the universities in the budget don't rouse any sympathy from me.
In an ideal world we'd be investing more in our universities, but our world is far from ideal. And so are our unis. They're inefficient bureaucracies, with bloated administrations and over-paid vice chancellors.
To hear them talk, you'd think unis were the fount of all economic virtue. According to Sydney University's Michael Spence, the budget was "an opportunity missed, because the government's done nothing about the significant cost of research and, of course, university research is fundamental to the innovation economy about which the government is so enthusiastic".
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No rose-coloured glasses: Treasury secretary John Fraser says this time things really are picking up

Peter Martin
Published: May 29 2017 - 10:47AM
Treasury secretary John Fraser has defended his budget forecast for economic growth, saying there are indications "the long period of growth undershooting forecasts is beginning to come to an end".
In the past three budgets the Treasury has forecast a lift in economic growth of 3 per cent and has been disappointed. 
But Mr Fraser told a Senate estimates hearing on Monday there were indications that this time economic growth would climb to 3 per cent by 2018-19 after climbing to 2.75 per cent in 2017-18.
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Bank levy amounts to 'quasi nationalisation' of the major banks: think tank

Stephanie Peatling
Published: May 28 2017 - 11:58PM
A Liberal-leaning think tank has written to all MPs urging them to oppose the Turnbull government's bank levy, saying it amounts to "quasi nationalisation" of the major banks and will impede economic growth.
The Institute of Public Affairs, often considered a breeding ground for conservative MPs, says the levy will discourage investment in Australia and its costs will inevitably be borne by investors and customers of the big banks.
"The government's proposed changes will undermine the free enterprise system by effectively turning banks into an arm of the bureaucracy," a briefing note on the levy says.
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Treasury expects economic growth rebound

  • Colin Brinsden
  • The Australian
  • 9:40AM May 29, 2017
Treasury head John Fraser expects economic growth to rebound over the next couple of years after a year dogged by weather-related events. The economy suffered a contraction during the September 2016 quarter due to bad weather while the more recent tropical Cyclone Debbie is expected to reduce growth by 0.25 percentage point during the June quarter, dragging the annual rate down to 1.75 per cent in the 2016/17 financial year.
However, growth is expected to rebound to 2.75 per cent in 2017/18 and three per cent in 2018/19.
“The lift in economic growth is expected to occur as the drag from mining investment diminishes, growth in household consumption improves and exports continue to grow strongly,” Mr Fraser told a Senate committee in Canberra on Monday.
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Impact of bank levy 'trivial', Treasury secretary John Fraser says

Peter Martin
Published: May 29 2017 - 12:49PM
The head of the Treasury has dismissed the impact of the $6.2 billion budget levy on banks as "trivial", saying he expects it to have next to no impact on interest rates.
Asked at a Senate hearing whether he stood by the budget forecast that the levy on the liabilities of the big five banks would raise $6.2 billion over four years, Treasury secretary John Fraser said he did.
"We are in the process of confidential discussions with the banks and we see no reason to change our forecasts," he said.
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Impending property 'calamity' an 'over-reaction'

Simon Johanson
Published: May 31 2017 - 12:15AM
Senior property industry executives have dismissed fund manager Altair Asset Management's surprise liquidation of its entire Australian share funds because of an impending property market "calamity" as an "over-reaction."
Altair Asset Management caught the market's attention on Monday when its chairman and investment officer Philip Parker said the fund had advised clients it would sell "hundreds of millions" of dollars of "underlying shares in the Altair unit trusts and then hand back the cash to those same investors".
Mr Parker cited a roll call of reasons to exit riskier shares and property markets including Australia's east coast housing "bubble" and its "impending correction", China's hot property sector and rising debt levels, geopolitical risks and unpredictability in the US and Australia's "overvalued" equities market.
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Sydney and Melbourne property prices slip in May

Patrick Hatch, Clancy Yeates
Published: May 30 2017 - 2:54PM
There are further signs of heat coming out of the east coast housing market, with Sydney and Melbourne leading a 1.1 per cent fall in property prices across Australia's five largest cities this month.
In a preview of its monthly home value index, CoreLogic said the 1.1 per cent fall indicated a negative month-on-month result for May.
"The weak preliminary result is largely influenced by a month-on-month fall in Sydney and Melbourne dwelling values," CoreLogic's head of research Tim Lawless said.
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Turnbull government to allow green bank to fund 'clean coal'

Adam Morton, Peter Hannam
Published: May 30 2017 - 9:13PM
Coalition wants CEFC to be able to back 'clean coal' technology.
The Turnbull government will test support for coal in Parliament by introducing changes that would allow the green bank to invest in carbon capture and storage technology if it cuts pollution by at least half.
Environment and Energy Minister Josh Frydenberg said the Clean Energy Finance Corporation [CEFC] would have its mandate expanded so it could back fossil fuel power plants that include the technology, sometimes described as "clean coal".
The technology, which involves capturing the emissions at the source and burying them underground, was explicitly banned when the CEFC was set up under a Labor-Greens agreement in 2011.
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When will you get a pay rise? Back story to Australia's low wage growth conundrum

Jessica Irvine
Published: May 30 2017 - 5:23PM
Something quite odd is happening to the pay-packets of Australian workers.
Wages, not including bonuses, rose just 1.9 per cent over the year ended the March quarter.
Over the same period, the cost of purchasing the typical basket of consumer goods and services went up 2.1 per cent, in part due to a surge in petrol prices.
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Pimco says it's time to accumulate cash to offset rising risks

John Gittelsohn
Published: June 1 2017 - 8:58AM
Pacific Investment Management Co has a message for investors: It's time to stop taking the markets for granted.
Investors have become too complacent and monetary, fiscal, trade and geopolitical risks abound, Pimco's Richard Clarida, Andrew Balls and Dan Ivascyn said in a report issued overnight. There's a 70 per cent chance of a recession in the next five years, they said.
"We believe that many market participants today are too relaxed, that medium-term risks are building and that investors should consider using cyclical rallies to build cash to deploy when markets eventually correct - and possibly overshoot - as risks are repriced," the executives said in Pimco's annual "Secular Outlook" for the next three to five years.
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Australia must fix its 'spectacular housing bubble', Citi warns

James Thornhill
Published: June 1 2017 - 9:01AM
Australia is experiencing a "spectacular housing bubble", which needs to be addressed with tougher regulatory measures, said Willem Buiter, Citigroup's chief economist.
A shortage of housing, coupled with record-low interest rates, has made Sydney the world's second-most expensive property market. The city's home prices jumped 16 per cent in the 12 months through April, helping stoke record household debt and putting ownership increasingly beyond the reach of many.
"It had better be focused on immediately, to try and tether a soft housing landing," Buiter told reporters in Sydney on Wednesday. "Clearly if these things are not managed well they can be a trigger for a cyclical downturn."
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Mine games. Why Adani is banking on the unbankable

Peter Martin
Published: June 1 2017 - 12:00AM
You would think Adani would have gone away by now.
The giant Indian conglomerate can't get a loan for its proposed $22 billion Queensland coal mine from an Australian bank, it can't seem to get one from an Indian bank, the mine would be so big it would depress the world coal price, and the Indian government plans to phase out coal imports altogether.
In documents released to Fairfax Media under freedom of information laws, the Queensland Treasury as good as described the project as "unbankable''.
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  • Updated Jun 1 2017 at 6:15 PM

Scott Morrison hints at temporary growth slowdown next week

Treasurer Scott Morrison has warned of a second quarterly slump in economic growth in just nine months, with at least one major bank predicting a contraction.
Speaking less than a month after he told the nation that "better days" lie ahead, Mr Morrison cautioned that there were questions around the strength of household consumption, as well as uncertainty around dwelling investment and non-mining business investment.
Following on from "lumpiness" in the second half of 2016, recent months have been dominated by more troubling signs, he suggested.
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The (Really) Lucky Country: Talk of recession as Australia takes world record

Peter Martin, Mark Kenny
Published: June 3 2017 - 4:59AM
Past federal treasurers from both sides of politics have praised the economic growth miracle that will see Australia move to the top of the league table next week, cementing its reputation as the world's most blessed economy.
And the achievement has even prompted a degree of political bipartisanship, with the former foes acknowledging each other's economic policy contributions.
Official figures to be released on Wednesday are expected to show Australia has clocked up 103 consecutive quarters without a recession – an improvement on the record set by the Netherlands in the 26 years leading up to the global financial crisis. Continued growth over the following days will allow Australia to claim the mantle of the world's most resilient economy.
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Health Budget Issues.

Leaked documents reveal secret plan for radical hospital overhaul

Adam Gartrell
Published: May 29 2017 - 2:21AM
The private health insurance rebate would be abolished, consumers would be charged more for extras cover and the states would be forced to find more money for public hospitals under radical funding changes being considered by top government officials.
Documents obtained by Fairfax Media reveal the nation's most senior health bureaucrats are part of a secret taskforce developing a proposal for a 'Commonwealth Hospital Benefit' – a new funding formula for public and private hospitals that would have widespread ramifications for patients and the medical industry.
Under the plan, the Commonwealth would "pool" the approximately $20 billion it currently gives to public hospitals each year with the $3 billion it pays to private sector doctors and the $6 billion it spends on the rebate to help people pay their private health insurance premiums. 
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Health chiefs consider hospital funding shake-up abolishing private health insurance rebate

May 29, 20177:43am

Hospital funding overhaul examined

FEDERAL bureaucrats are considering a radical overhaul of hospital funding that could leave the states and patients scrambling to find more money for care.
The “Commonwealth Hospital Benefit” plan would pool all funds the federal government now provides for public hospitals, private sector doctors and health insurance rebates and use it to pay a standard amount for services regardless of whether patients were in public or private hospitals, Fairfax Media reported on Monday.
The plan has been discussed by a taskforce on hospital funding that includes top bureaucrats and Fairfax says it does not suggest Health Minister Greg Hunt knows about or is pushing it.
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Health chiefs consider hospital funding shake-up abolishing private health insurance rebate

May 29, 2017
Sue Dunleavy News Corp Australia Network
A radical hospital funding model that would have seen the subsidy for private health insurance scrapped and the government pay 40 per cent of the cost of all hospital treatment has been ruled out by Health Minister Greg Hunt.
News Corp reported last November on the plan that was being considered by the government as part of its private health insurance reforms.
However Health Minister Greg Hunt said this morning he would not proceed with the plan instigated by former health minister.
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Health Minister Greg Hunt shoots down department's secret hospital plan

Adam Gartrell
Published: May 29 2017 - 2:57PM
Health department bosses have described their radical proposal to remake hospital funding as "future gazing" after the Turnbull government declared it would never adopt the controversial policy.
The private health insurance rebate would be abolished, consumers would be charged more for extras cover and the states would be forced to find more money for public hospitals under the plan.
As revealed by Fairfax Media on Monday, the nation's most senior health bureaucrats – Department of Health Secretary Martin Bowles and his deputy Mark Cormack – are members of a secretive taskforce formed to develop the policy around a "Commonwealth Hospital Benefit" (CHB).
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SA Health faces claims hospital waiting times were ‘sanitised’

  • The Australian
  • 12:00AM May 30, 2017

Meredith Booth

Scores of patients waiting for emergency treatment at a public hospital north of Adelaide were given sham admissions to “sanitise” waiting times, says a former SA Health specialist.
Flinders University emeritus professor Warren Jones said the “dishonest and unethical” practice, involving Modbury Hospital patients being admitted to a ­virtual ward or under the care of a doctor who had since left the hospital, was adopted to take them off the emergency waiting list before a critical four-hour limit was reached.
The Liberal opposition has called for an independent audit on what it claims is a “scandalous threat to patient safety”.
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https://www.spectator.com.au/2017/05/the-health-department-boss-should-pack-his-bags/

The Health Department boss should pack his bags

30 May 2017 4:25 PM
If I was Health Department secretary, Martin Bowles, I’d be checking my superannuation paperwork is in order.
Over three hours on Monday morning, in a Senate estimates committee room, Bowles’s public service career blew up.
That morning, Fairfax papers ran a front-page splash on the work of a ‘secret’ policy task force, funded by federal government money, to develop an alternative hospital funding mechanism.  This mechanism, a Commonwealth Hospital Benefit, would pay for all public and private episodes from a funding pool containing what the Commonwealth pays the states for public hospital services, the private health insurance rebate, and Medicare payments for hospital-related services.
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Twice as many households worse off under Coalition's Medicare levy rise plan

James Massola
Published: June 1 2017 - 12:00AM
Twice as many households will be worse off under the federal government's plan to raise the Medicare levy by half a percentage point than under Labor's alternative, according to new modelling by the ANU's Centre for Social Research and Methods
And middle-income earners will do much more of the heavy lifting under the Coalition than under Labor, the research by Associate Professor Ben Phillips finds.
The Turnbull government announced an across-the-board 0.5 per cent hike in the Medicare levy to 2.5 per cent from July 1, 2019, in the federal budget. The increase aims to raise $8.2 billion over two years, with the money to help fund the National Disability Insurance Scheme.
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South Australia slashes pathology, medical science jobs

  • The Australian
  • 5:03PM May 31, 2017

Verity Edwards

Medical unions say timely patient treatments and diagnoses could be at risk after the South Australian government yesterday cut 25 per cent of its pathology workforce, equivalent to 196.6 full time equivalent jobs.
Professionals Australia director Sarah Andrews said the roles to go included medical scientists and technical officers, who pathologists relied on to interpret test results.
Staff will begin industrial action in bureaucratic and training areas from tomorrow, but Ms Andrews said it would not affect patient care or test results.
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Laws introduced to 'guarantee' Medicare

June 1, 201711:12am
Australian Associated Press
The Turnbull government insists a new multi-billion dollar fund will guarantee the future of Medicare, amid claims it's merely an accounting trick.
Treasurer Scott Morrison on Thursday introduced legislation to parliament that will ensure proceeds from the Medicare levy - minus the portion set aside for the national disability insurance scheme - is paid into the fund annually.
It will be topped up with money collected via personal income tax to cover the cost of the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme.
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Health Insurance Issues.

ACCC takes health fund NIB to court over concealing changes to its MediGap Scheme

Esther Han
Published: May 30 2017 - 10:51AM
The consumer watchdog has taken health fund NIB to court, accusing it of concealing changes to some of its policies that left members with surprise out-of-pocket costs.
The Australian Competition and Consumer Commission, in its announcement on Tuesday, said NIB had breached consumer law by engaging in "misleading or deceptive conduct, unconscionable conduct and making false or misleading representations".
The action relates to NIB's MediGap Scheme, in which members who went to participating doctors didn't incur any out-of-pocket costs for certain services.
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Health fund nib faces fine for allegedly failing to tell members it removed procedures from Medigap scheme

May 30, 2017  Sue Dunlevy News Corp Australia Network
HEALTH fund nib faces a $1.1 million penalty for failing to notify its members it removed some eye procedures from its Medigap scheme in 2015.
The consumer watchdog announced this morning it would be taking the health fund to court claiming it had “contravened the Australian Consumer Law by engaging in misleading or deceptive conduct, unconscionable conduct and making false or misleading representations”.
NIB members had been able to receive eye procedures with no out of pocket expense when they saw a participating doctor under the Medigap scheme.
However, the ACCC alleges that in November 2015 NIB removed the eye procedures from the scheme without notifying its members in advance.
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Health insurers in the frame for misleading customers

Elizabeth Knight
Published: May 31 2017 - 12:15AM
Health insurers are in the sights of the regulator and investors are watching.
Large health insurance companies are on notice. The Australian Competition and Consumer Commission has them in its sights for the widespread and long-standing practice of hiding negative changes to customer's medical benefits.
For the second time in less than a year, a major health insurer, has been pinged by the competition watchdog for allegedly misleading customers who, as a result, have been hit with thousands of dollars in out-of-pocket expenses they were not expecting.
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Medibank: chronic pain costs economy $22bn a year

  • The Australian
  • 12:00AM May 31, 2017

Sarah-Jane Tasker

Health insurance giant Medibank is pushing for a greater focus on primary care, instead of ­surgery intervention, for a leading cause of chronic pain that is costing the economy $22 billion annually.
Andrew Wilson, Medibank’s group executive of healthcare and strategy, used an industry event yesterday to highlight that osteoarthritis was one of Medibank’s leading areas of expenditure. “Often that is expenditure at the tail end of the person’s disease progression, so we are funding care that is very expensive,” he said.
Osteoarthritis, the most common chronic condition of the joints, affects 2.2 million Australians, and a leading cause of chronic pain, disability and lost productivity in Australia, costing the health system $3.75bn last year and the economy about $22bn a year in lost productivity.
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International Issues.

Angela Merkel says Europe can no longer rely on Donald Trump's America

Michael Birnbaum and Rick Noack
Published: May 29 2017 - 4:26AM
London: German Chancellor Angela Merkel on Sunday declared a new chapter in US-European relations after contentious meetings with President Donald Trump last week, saying that Europe "really must take our fate into our own hands."
Offering a tough review in the wake of Mr Trump's trip to visit EU, NATO and Group of Seven leaders last week, Ms Merkel told a packed Bavarian beer hall rally that the days when Europe could rely on others was "over to a certain extent".
"This is what I have experienced in the last few days," she said.
It was a stark declaration from the leader of Europe's most powerful economy, and a grim take on the trans-Atlantic ties that have underpinned Western security in the generations since World War II.
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Donald Trump blasts Germany again as Angela Merkel talks up relations with India

Patrick Donahue and Arne Delfs
Published: May 31 2017 - 5:28AM
US President Donald Trump blasted Germany anew over trade and defense, ratcheting up a dispute with Chancellor Angela Merkel that risks getting personal and undermining a trans-Atlantic bond that is the bedrock of US-European relations.
Mr Trump's comments came in an early-morning tweet on Tuesday issued just as Mrs Merkel hosted Indian Prime Minister Narendra Modi in Berlin, where they held a joint cabinet meeting and signed cooperation agreements.
"We have a MASSIVE trade deficit with Germany, plus they pay FAR LESS than they should on NATO & military," the US president posted on Twitter. "This will change."
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John McCain calls on Australia to sustain alliance with United States during Donald Trump presidency

Nick O'Malley
Published: May 30 2017 - 8:26PM
In an extraordinary address in Sydney on Tuesday evening, Republican giant John McCain begged an Australian audience that included two former prime ministers, diplomats and business leaders for patience and even leadership to sustain the alliance between the US and Australia during the Trump presidency.
Speaking as a guest of the United States Studies Centre in the State Library's grand reading room, McCain began his speech with a reverent reflection upon the shared sacrifices of Australian and American soldiers over a century, before acknowledging the uncertainty the new administration had caused around the world.
"I realise that I come to Australia at a time when many are questioning whether America is still committed to these values," the US senator said early in his 30-minute address. "And you are not alone. Other American allies have similar doubts these days. And this is understandable.
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If America were a movie, it would be a 'tragic dumb-ass comedy': Robert De Niro

Sam Blewett
Published: May 31 2017 - 7:41AM
London: Robert De Niro has said that if the US was a movie it would now be a "tragic, dumb-ass comedy".
The two-time Oscar-winning actor and vocal Donald Trump critic said his nation had descended to this point having been an "inspiring, uplifting drama" just four years ago.
De Niro, 73, was welcomed with applause and laughter as he made the remarks in a speech to graduating students at Brown University in the New England state of Rhode Island.
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Larry Summers: What history tells us about Trump’s budget fantasy

May 30 at 8:48 AM
At the risk of beating a dead horse, here are some thoughts on the Trump administration’s 3 percent growth forecast. Zero interest rates seemed inconceivable 15 years ago, and yet they happened. Almost no one forecast the productivity boom that took place in the United States between 1995 and 2005 or the magnitude of the 2008 financial crisis. So any statement that a given forecast is inconceivable is unwarranted.
It is, though, reasonable to use history to try to gauge the likelihood of possible outcomes. I do not see how any examination of U.S. history could possibly support the Trump forecast as a reasonable expectation.
In thinking about growth, it is only logical to focus on the record of growth domestic product per adult, since if the adult population of a country rises more rapidly one should expect its GDP to rise more rapidly without any improvement in productivity. Here is a chart showing the evolution of GDP per adult for the United States and its seven-year moving average along with the Trump administration forecast.
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  • Updated May 31 2017 at 9:52 AM

The rise and fall of American leadership

by Martin Wolf
Donald Trump has been the American president for just over four months. It is still impossible to predict what his presidency will mean. But it is already a transformative event: Mr Trump has revolutionised our ideas of what the US stands for. We live in the world the US made. Now it is unmaking it. We cannot ignore that grim reality.
Mr Trump's domestic programme is in accord with the agenda of the Republican party. Its aim is to cut taxes on the rich by lowering spending on the poor.
The Congressional Budget Office's analysis of the American Health Care Act, recently passed by the House of Representatives and the replacement of Barack Obama's Affordable Care Act, is startling. Over the 2017-26 period, the act would reduce tax revenues by $US992bn, paid for by a $1.1tn reduction in expenditures on Medicaid and other subsidies. According to the CBO, the number of uninsured might have increased by 23m by 2026.
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Donald Trump's call to 'put America first' by exiting Paris climate accord to backfire

Peter Hannam
Published: June 2 2017 - 7:09AM
That Donald Trump's decision to withdraw the US from the Paris climate agreement was widely anticipated does little to moderate its impact on efforts to avoid dangerous global warming and America's standing in the world.
The US will exit from its voluntary obligations - now set at a reduction of 26-28 per cent of 2005 emission levels - but begin negotiations to re-enter but at terms that are "fair" for America, Trump said.
The Paris accord was "less about climate and more about other countries getting a financial advantage over the US", he said, amounting to "a massive redistribution of United States' wealth to other nations".
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World leaders react as Donald Trump withdraws US from Paris climate deal

Published: June 2 2017 - 7:40AM
World leaders have pledged to keep up the fight against global warming as US President Donald Trump announced he was pulling out of the Paris climate accord.
The US exit from the climate pact could raise doubts about the commitment of the world's largest economy to curbing global warming and make it more difficult to hold other nations to their environmental commitments.
All but two countries — Nicaragua and Syria — signed onto the 2015 accord, which was a signature diplomatic achievement for President Obama.
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I look forward to comments on all this!
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David.

The Internet And Digital Health As You Do Not Know Them. Amazing Stuff.

This appeared a day or so ago.

Mary Meeker’s amazing Internet Trends 2017

By Graham Hand on June 8, 2017

Each year, Mary Meeker of venture capital firm Kleiner Perkins Caulfield Byers produces a report on global internet trends and technology. It has become the ‘must-read’ for technology and business, and the 2017 Report fills 355 slides (up from 213 last year).
There is so much in it, including global macro trends, it’s almost impossible to summarise unless a single topic is chosen. It was delivered by Meeker at the Code Conference in a rapid-fire 33 minute presentation but she says the material is meant to be read, not presented.
It’s worth flicking through the 2017 Internet Trends Report in full, but here are the ‘focus topics’:
  • Online Ads and Commerce: A review of current advertising trends shows an increased focus on the measurability of online ads and the interconnectedness of ads and commerce (slides 10-79).
  • Interactive Games: Evolving and driving innovation, becoming leading spectator sports with growing use of games for education, learning and driving the consumer and tech landscape (slides 80-150).
  • Media Distribution Disruption: Digital streaming businesses have changed the media game through scale and personalisation. Consumers want choice but are concerned about privacy (slides 151-177).
  • Healthcare: Digitisation of patient data, pharmaceutical testing and medical records lead to more accurate diagnosis (slides 288-319).
  • China: Mobile user engagement is creating an evolution in mobile-centric entertainment and financial technology, plus leading on-demand transportation (slides 193-231).
  • India: Behind China, but leapfrogging to new technologies and 1.2 billion people with digital identity profiles (slides 232-287).
Almost every business is affected in some way by the changes Meeker describes. There are now 3.4 billion internet users worldwide, growing at 10% a year. Online advertising is rapidly increasingly, with mobile gaining share over desktops. Internet advertising exceeded television advertising for the first time in 2017, with an incredible 85% of ad growth going to Facebook or Google. Meeker describes the type of ads that work on different platforms.

There is more here:
The general Internet material is amazing and the Digital Health material is must not miss in my view.
Enjoy
David.

This Seems Like An Unambiguously Good Idea For Those Involved In There Care Modalities.

This came out last week:

Online resource for end-of-life care

The Federal Minister for Aged Care, Ken Wyatt, has launched a new website containing important evidence-based medical and practical information to support the provision of palliative care to older people at the end of life.
Page last updated: 25 May 2017
25 May 2017
The Federal Minister for Aged Care, Ken Wyatt, today launched a new website containing important evidence-based medical and practical information to support the provision of palliative care to older people at the end of life.
Speaking at a function at Parliament House to mark Palliative Care Week, Minister Wyatt said civilisation can be measured by how it treats its older people.
“This is even more meaningful when it comes to caring for the aged and vulnerable at the concluding stages of their lives,” he said.
“This new online resource, www.palliAGED.com.au, collects under one umbrella a wide range of valuable research data and information.
“palliAGED is funded by the Australian government and managed by Flinders University through the CareSearch website.
“It features new medications, medical practise, models of care, advice on cultural and other considerations, symptoms and treatment decisions, risk analysis, ways to support people and their families and public and consumer experience.
 “All of this will help health professionals, aged care staff, family and friends, to provide the best possible care for older people at the end stage of their life.”
 Minister Wyatt said the new resource is both timely and hugely beneficial, because care for older people is becoming ever more important as the number of older Australians grows.
“Last year, 15 per cent of the Australian population, or 3.7 million people were aged 65 and over,” he said.
“By 2026, it is estimated that 18 per cent of the population will be aged 65 years and over (5.0 million people) and 2.3 per cent (644,000 people) will be 85 years and over.
“Today, thanks to advances in medical science and care, Australians are living longer and healthier lives. We look forward to longevity.
“When we require palliative care this should become the centre of comfort and compassion towards people, their families and the wider community.
“I congratulate Flinders University and the CareSearch team on this outstanding community initiative,” Minister Wyatt said.
Media contact: Kay McNiece, 0412 132 585
Here is the link:
A nice cleanly designed site with a wide range of useful content. Pleasing to see.
David.

Wednesday, June 07, 2017

There Is A Lesson Here For The System Operators Of The myHR.

This appeared last week:

No system is infallible: ATO boss on tax fraud

  • The Australian
  • 11:53AM May 30, 2017

Ben Butler

A dozen ATO employees have been sacked for accessing the private information of friends, celebrities or other taxpayers so far this financial year.
The ATO’s internal compliance teams have investigated 30 staff members for privacy breaches, compared to 23 in the previous financial year, a senate committee heard this morning.
Taxation Commissioner Chris Jordan told the Estimates Committee that “stupid people try to look at their friends”.
“To lose your job for having a look at someone’s records that you weren’t supposed to is pretty severe,” he said.
“They know they shouldn’t do it, they get picked up, our fraud and detection people are good.”
There are more than 20,500 ATO employees, according to the organisation’s most recent annual report.
The committee was told about the investigations against the backdrop of an alleged $165 million payroll tax fraud case that has snared the children of ATO deputy commissioner Michael Cranston.
In earlier evidence Mr Jordan says his deputy committed “a huge error of judgment” by trying to find out information for his son, the alleged head of the $165 million Plutus Payroll scam Adam Cranston.
Mr Cranston has been suspended from the ATO and is expected to be charged with misusing his office over his role in the Plutus affair.
Appearing before the Senate Estimates committee this morning, Mr Jordan said AFP Commissioner Andrew Colvin told him about the relationship between Operation Elbrus target Adam Cranston and Michael Cranston on January 11.
Lots more here:
This report really puts a lie to any belief that you can trust people not to go poking around where they should not.
The saving grace with the myHR – as opposed to the tax office – is that the information is much harder to search and look around in, due to the pile of .pdfs approach to information storage.
That said people will be people as health systems all over the world have observed.
David.

Tuesday, June 06, 2017

Somehow Jeremy Knibbs Seems To Think He Has A Plan To Fix The myHR. My View, He’s Dreamin’

This appeared late last week:
2 June 2017

That’s not a compact: THIS is a compact

The Hill
Posted byJeremy Knibbs
The RACGP and AMA compacts with the federal government aren’t seen by most GPs as meaningful, which isn’t surprising. At just 55c extra per consult this coming year, a drawn-out path to a full lift of the freeze over the following two years, and not much else, these contracts were always at risk of being seen as limp. The agreements might in fact be locking in a position of no progress, or worse,  ongoing regression.  After all, we’ve now firmly agreed to snail’s pace changes to MBS rebates, which essentially keep GPs well under any sort of indexed pay rise for the next few years. And that’s the tangible part of this compact.
As much as the RACGP has led with its chin by making such a compact, blaming the College is probably a little simplistic. They are, after all, mainly a training organisation. Plus, they’ve grown into an organisation that is large and struggling to undersand what it is. As  such it is a little unwieldy in terms of governance and leadership in matters like these. Which is a long way of saying, the College at this point really isn’t set up for this sort of stuff.
The AMA is largely an employment and lobbying organisation, so perhaps we could blame them a little more, but as with the RACGP, navigating the politics of such big organisations tends to dilute the ability to lead change.
So is there any hope of transformative change for general practice in the near future?
There might be. But from the most unlikely of places. Perhaps from a place that has been moribund for so long it has entered mythology as one of greatest government screw-ups of all time. From the agency that brings us – I’m almost reluctant to mention the name here lest you stop reading or fall asleep in your chair – the My Health Record. Yes, the Australian Digital Health Agency, previously NEHTA.
Before you click away, or flip the page, bear with me for just a second. The federal government didn’t get into the game of digital transformation just to make us all laugh, or cry, at how much they could screw things up so thoroughly. They had good intent. They just didn’t have a clue after that. Which doesn’t exactly excuse spending nearly $1.5 billion on trying to establish a nationwide digital health record for all Australians and four years on, having very little to show for it.
But just say you could make some form of the My Health Record meet some of its intended specifications sooner rather than later. Say you could make substantial progress towards this goal within the next nine months. What might that look for GPs and their patients?
Do not click away chuckling.
I’m suggesting it because the Australian Digital Health Agency (ADHA), the organisation now responsible for the MyHR, could, more or less, enter into a compact with the GP profession and the public right now – a compact that could deliver tangible and substantive progress within nine months. That’s not that long to wait, given what we’ve gone through so far.
Under this plan, if the ADHA didn’t deliver within the timeframe, they would have broken the compact, and we could all return to our exhausted and cynical corners, having wasted at least another $200m or so. And presumably, those in charge would fall on their respective swords.
Currently, I don’t agree with how much the ADHA and thus, the MyHR, is spending, and on what. But if the basics of this compact were realised, we would all see tangible progress towards potentially transformative change. Change that would effectively benefit patients and doctors, and even lead to increased GP incomes, well above what would be delivered under the RACGP and AMA compacts.
So here it is. The MyHR ADHA 10-point compact between the Australian healthcare sector and the Australian people, authored by me but with input from various sources, whether they know it or not.
Read the 10 point compact here:
Right at the end of the article we read the following:
“These are exciting times. I hope everyone sees this compact for what it is and gives it all their support and constructive criticism. And we should all endeavour to keep the players honest to their compact initiatives as specified.
If we give it our all, and we don’t play politics, commercial tic tac toe, or my brilliant career games, and it still doesn’t work? We will have at least put this thing properly to bed. So we can move on.”
I am happy to wait but sadly I believe the outcome will be as I have consistently predicted – a useless and wasteful system. All the ideas are wonderful, as far as they go but sadly they really are just the proverbial lipstick on a horrible looking pig.
Until the myHR is fundamentally re-organised to ensure there is only one copy of the patient record, that this is held by the patient’s GP, and is made accessible to others who need it with the patient’s consent and agreement the whole thing is junk. A large database off asynchronous inaccessible .pdfs held by the Government is no-one’s idea of useful clinical system.
Please remember we are talking about a national health records system that is neither fish nor fowl or even koala since it does not properly meet the needs of the patient, the doctor or the Government. A triple fail!
We need to start again with a much better base architecture and concept. It really is as simple as that.
David.