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, September 07, 2017

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

September 7th , 2017 Edition.
On the overseas front we now see President Trump sulking in the White House frustrated with North Korea and the ongoing fiasco internally. It is interesting that the Secretaries of State and Defence are really seeming to operate independent of Trump.
Hurricane Harvey has turned out to be a calamity of quite epic proportions and it will be literally years before things are put right. The cost is estimated to be greater the $130 Billion to say nothing of the awful cost in lives and suffering.
I wonder will the scale and frequency of these hurricanes recently cause a change of mind about the reality of climate change – it should!
As late breaking news we have:

North Korea claims to have advanced hydrogen bomb

Published: September 3 2017 - 9:32AM
Seoul: North Korean scientists have built an advanced hydrogen bomb that can be mounted onto an inter-continental ballistic missile, state media says.
Pyongyang's official mouthpiece, the Korean Central News Agency (KCNA), said on Sunday leader Kim Jong Un was present at a factory as the nuclear weapon was loaded onto a missile.
The bomb has an explosive power that is adjustable up to "hundreds" of kilotons and can be detonated at high altitudes with its indigenously produced components allowing the country to build as many nuclear weapons as it wants, KCNA reported.
In January 2016, North Korea claimed it had successfully tested a hydrogen bomb, its fourth test of an atomic device, but Western experts doubted it had the power of a hydrogen nuclear explosion.
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In Australia we are seeing even more extreme solutions being argued on virtually every front and the dysfunction rolls on. The LNP is accusing Labor of being socialist when they are the most interventionist Government ever seen in the operation of out increasingly non-market economy (think banks, electricity, gas etc.) Pots and kettles spring to mind!

Thursday Update:

Internationally the big news is that the situation in the DPRK seems to have eased a little and the is a monster hurricane (Irma) flattening all it passes over and heading for Florida. If is does a presently predicted it will be truly awful. In the Caribbean whole islands have essentially been flattened

In OZ the High Court has agreed to the Postal Survey and the Energy Mess rolls on. 
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Here are a few other things I have noticed.
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National Budget Issues.

Malcolm Turnbull to announce millions in funding for Snowy Hydro 2.0 pet project

James Massola
Published: August 27 2017 - 6:07PM
Prime Minister Malcolm Turnbull is set to announce millions in extra funding for his pet project, Snowy Hydro 2.0, after visiting the power station on Monday morning.
The money will be spent on meeting some of the cost of the $29 million feasibility study and will come from the Australian Renewable Energy Agency. 
It represents a major new investment from the federal government, which has only committed $500,000 so far to the project, despite Mr Turnbull frequently championing Snowy Hydro 2.0 as a game-changer for the east coast electricity market.
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Renewable energy booming but could soon turn to bust, analysts warn

Nicole Hasham
Published: August 27 2017 - 11:29PM
Australia produced enough renewable energy to power 70 per cent of households last financial year, new data shows, but advocates warn the booming industry will flounder unless the Turnbull government commits to a clean energy target.
The government is sharply divided over whether to adopt the target, the central recommendation of Chief Scientist Alan Finkel's review of the national electricity market.
New data to be released on Monday shows Australia produced enough renewable energy to power 7.1 million homes, or 70 per cent of households, in the year to June.
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Housing affordability set to be a problem for at least 40 years

Published: August 29 2017 - 7:26AM
Housing affordability is likely to be an issue for at least 40 years, with the demand for new homes needing bold policy, a major new report says.
The report by the Committee for Economic Development of Australia, to be released on Tuesday, says policy needs to reflect the great Australian dream of owning a home is over for many people.
"What the CEDA report highlights is that ... the issue is far more complex and without changes now, could have longer-run consequences," CEDA chairman Rodney Maddock says in the report.
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Elder abuse on the rise in step with galloping property prices

Graham Hill
Published: August 29 2017 - 9:30AM
Spiralling house prices are fuelling rising levels of elder abuse in Australia.  This wickedness can, however, be addressed if there is the political and public will to put a stronger legal safety net under vulnerable elderly people.
Growing numbers of older people are being pressured by adult children to guarantee enormous loans. Legal aid commissions regularly deal with elderly parents who have gone guarantor without understanding they will be legally liable for the debt if the borrower defaults. This problem will only worsen unless we require lenders to ensure older Australians have independent legal and financial advice before these individuals offer their home to secure a loan or agree to be guarantor. As well, there should be a "cooling off" period within which guarantors can withdraw from the arrangement.
The pressure on older people can be immense. Adult children sometimes deny access to grandchildren if an elderly parent does not agree to be a guarantor or provide funds for a home deposit. Legal Aid family law divisions regularly provide advice to grandparents about gaining access to grandchildren. All too often, we hear of conversations that go like this: "Mum, if we can't get funds to complete our deposit, and get a guarantor for our loan, we'll have to move interstate. The other option is that we move in with you at your place. It's too big for you since Dad died." 
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It's time to get banks back to nation-building basics

Stephen Anthony
Published: August 30 2017 - 12:15AM
Public confidence in Australia's banks has been steadily eroding since financial deregulation in 1983 to the point where now the brand of the Big Four banks, and especially the Commonwealth Bank, is at its nadir.
It appears Australia's banks are more satisfied with earning a fast buck than supporting real investment in projects and jobs for the betterment of all Australians.
Consider the loan book of major deposit-taking institutions: Around 60 per cent of new lending is for housing; around 80 per cent of all housing loans are for the purchase of existing property; around 60 per cent of all new loans are made to investors for negatively geared investments; and around 40 per cent of housing loans are interest only.
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A craven nation that prefers statues to agility

Mark Kenny
Published: August 29 2017 - 2:42PM
Australia is a nation scared. Scared to fully stake out its own flag. Scared to install an Australian as head of state. Nervous even about bringing into the daylight a more complete account of its own creation.
This is at odds with our strongly internalised ruggedness myth. And it is even more inconsistent with the legendary "fair go".
The selfless courage made sacred on the Western Front, Gallipoli, Changi and Long Tan, is strangely absent at the official level. And the giant-slaying competitiveness that has seen Australians punching above their weight in global sports – literally, in the cases of Lionel Rose and Anthony Mundine – went missing on the offer of republican sovereignty.
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Defeated by high legal costs: the terrible injustice most of us could face

Ross Gittins
Published: August 30 2017 - 2:24AM
It's one of the most glaring gaps between theory and practice in our community, a huge disconnect between our democracy and our economy. A terrible injustice most of us could face. Everyone knows about it, but it's rarely discussed. What is it?
The prohibitively high cost of justice. We're all supposed to be equal before the law, but you ain't anything like equal if they can afford a lawyer and you can't.
The president of the Law Council of Australia, Fiona McLeod, is running a campaign to highlight the plight of people who, in theory, should be receiving aid to help them with their legal problems but, in practice, often aren't.
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Turnbull government ignoring 'easiest way' to cut power prices, say electricity companies

James Massola
Published: August 28 2017 - 5:17PM
Electricity generators have rebuked the Turnbull government for delaying the introduction of a clean energy target, arguing a target will trigger new investment and bring down power bills. 
Mr Turnbull will meet the bosses of some of Australia's biggest power companies in Sydney on Wednesday for a second round of discussions about skyrocketing rising power prices.
At an earlier meeting in August, a deal was struck for millions of Australians to be notified when their discount electricity plans expire, which could save households more than $1000 a year, as well as some other consumer protection measures. 
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Give employees a say in our company boardrooms

Nick Dyrenfurth
Published: August 29 2017 - 11:45PM
In 2017, the Australian way of life – a fair day's pay for a fair day's work, equal opportunity for all and preventing excessive inequalities of wealth, status and power – is fraying. While we avoided the GFC's worst effects, inequality has risen to heights not seen since the early 1940s. Good, secure, well-paying jobs are being replaced by low-skill, low-wage insecure work. Less than half of Australian workers hold down full-time jobs; 23 per cent are employed casually. Underemployment has hit a record high of 8.6 per cent. Wage theft is rife. Company profits remain healthy – rising by 40 per cent in 2017 – yet wages growth is sluggish. The fruits of 26 years of continuous, record economic growth have not been shared equally, which is bad for working people, bad for the economy, and bad for democracy, encouraging extremist politics. In any case, our world-beating growth numbers belie a more fragile outlook. Productive investment is poor. Exports are less diversified than any time since the 1950s. Our economic institutions are not working in the interests of the majority.
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Labor’s $1.6b fund will overcome WA’s rotten GST deal

Bill Shorten
Wednesday, 30 August 2017 12:05PM
I was in Perth at the weekend. It was my eighth trip to Western Australia since the election (not counting the outstanding holiday Chloe and I had in Broome). It doesn’t matter where I am when I visit — Mt Lawley or Rivervale, Freo or Carlisle — the number one issue people raise with me is the unfair deal WA is currently getting from GST payments.
You know what 34¢ in the dollar means in the real world.
It’s the train line that isn’t being extended, the road that isn’t being upgraded or the hospital beds that aren’t being added.
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  • Updated Aug 29 2017 at 11:00 PM

Regulation is eroding 23pc of returns, banks say

The weight of regulation and taxes imposed on banks over the past 18 months is costing shareholders of the big four almost one quarter of their returns, according to the industry.
Banking insiders have calculated that the combination of the $6 billion bank tax, capital adequacy requirements, loan restrictions for investors and a raft of regulation imposed to stave off calls for a royal commission are the equivalent of a 3 percentage point decline in return on equity.
That fall from about 13 per cent to 10 per cent represents a 23 per cent drop on the amount of net income returned as a percentage of shareholders' equity.
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  • Aug 31 2017 at 9:35 AM

Dispute over Noble Group credit default swaps raises questions about new rules

Janet Yellen, the head of the US Federal Reserve, may already be ruing her stout defence of tougher post-crisis financial regulations.
At the US central bank's annual Jackson Hole retreat on the weekend, Yellen avoided any discussion of interest rates, and instead devoted her entire speech to chronicling the disastrous events of financial crisis, and to defending the range of regulatory responses – such as tougher capital rules for banks and requiring big US banks to undergo annual stress-tests – that have been introduced to make the financial system safer.
But her words have proved highly controversial. An editorial in the Wall Street Journal thundered that Yellen's speech "shows how political the world's central bankers have become".
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Trust in institutions eroded: Ken Henry

Clancy Yeates
Published: August 31 2017 - 12:15AM
The erosion of public trust in banks reflects a wider decline in sentiment towards large institutions, which will take a long time to rectify, National Australia Bank chairman Ken Henry says. 
After the banking regulator this week acknowledged the community's trust in banks had suffered after a series of scandals, Dr Henry said he understood why people felt this way about banks, but argued the issue went beyond the financial sector.
"You know it's not just banks. Actually on comparisons across industries, banks are relatively well trusted, believe it or not, compared with entities operating in other sectors," Dr Henry said at a Trans-Tasman Business Circle lunch in Melbourne.
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Earnings season: more profit than loss for 'mum and dad' shareholders

John Collett
Published: August 29 2017 - 4:31PM
Qantas is the star performer of the "mum and dad" stocks this profit reporting season with its declaration of its second-highest ever profit.
Its share price had soared to about $5.30 at the end of July from about $3.20 a year earlier. After its profit result of last week, the flying kangaroo's share price jumped to more than $5.60.
Add the dividends and that's a total return for Qantas shareholders of more than 73 per cent – far and away the best performing of the widely held stocks.
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Scott Morrison puts $31bn price on Labor tax plans

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

Simon Benson

Scott Morrison has ­accused Labor of exploiting ­worries about low wage growth to justify its “socialist agenda” that he claimed would amount to a $31 billion extra annual tax burden on the economy and threaten Australia’s standard of living.
Delivering his annual Bloomberg address today in Sydney, the Treasurer will also flag a new policy direction to lift Australia’s national productivity by targeting the health and education of people as the new drivers of ­efficiency and growth.
Ahead of the release of the first of a five-yearly Productivity Commission report, Mr Morrison revealed the report had ­signalled that Australia needed to “shift the dial on our productivity agenda”.
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Scott Morrison puts big business on notice

  • The Australian
  • 5:01PM August 31, 2017

Michael Roddan

Treasurer Scott Morrison has warned big business the government will keep targeting highly regulated sectors that are taking advantage of consumers, telling the banking, financial and energy industries they are not operating in a “free market nirvana”.
“Complexity and inertia in highly regulated markets is big business profit’s best friend and often the consumer’s worst nightmare,” he said.
The Turnbull Government this week ordered energy retailers to explain to customers how to save on their bills, where around 30 per cent of the cost is captured by retailers. That followed a surprise announcement by the banking regulator, APRA, that it would be launching an extensive six-month investigation into the nation’s largest lender, Commonwealth Bank, following allegations it flouted anti-money laundering laws and a string of other high-profile scandals.
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Government claims cashless welfare card a success, third trial site to be named

Amy Remeikis
Published: September 1 2017 - 10:38AM
The government will push ahead with a third trial site for its cashless welfare card, despite opposition, after a final evaluation of the policy found it had "considerable positive impact" in its original trials.
The trials, which quarantine 80 per cent of welfare payments for essential services, has received a mixed response, with critics arguing it is dehumanising and forces problems underground.
But in releasing the final evaluation of the first two trials, held in Ceduna in South Australia and East Kimberly in Western Australia, Human Resources Minister Alan Tudge said the research showed a reduction in drinking and gambling among those involved in the trial, with "some evidence that there has been a consequential reduction in violence and harm".
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Three charts that show why world's economic optimism hasn't spread to Australia

Garfield Clinton Reynolds
Published: September 1 2017 - 12:28PM
The global optimism about economic growth - spurred by improved momentum in the US, Europe and China - is struggling to be felt in Australia.
The only thing rising in August across local assets has been government bond yields -- whose advance slowed -- as economic data reinforced the divide between ebullient businesses and downbeat consumers.
Construction and capital expenditure jumped, but home prices, mortgages and retail sales sagged and wages stagnated.
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Protect yourself in a frenzied property market

Mark Bouris
Published: August 31 2017 - 4:54PM
When a market is in trouble, people get scared and sell their shares or make a run on the bank. And when a market is hot, everyone wants to own the asset.
But when things get really hot, you have fear and greed together – the desire for the asset and the fear of being the one who doesn't own the asset.
It's a frenzy and it's happening right now in some parts of the real estate market.
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Why our leaders lie, and we don't care

Scott Phillips
Published: September 3 2017 - 1:29AM
Times have been good recently for Canberra's cabbies. And the airport cafes have done a roaring trade. The cause? A seemingly endless line of CEOs and their aides being summoned to the nation's capital.
The Prime Minister and Treasurer have taken a lead from the past RBA governor, Glenn Stevens -- the man widely assumed to have the best jawbone muscles in the country. Stevens made an artform out of 'jawboning': trying to preempt moves in the Aussie dollar by threatening to move interest rates.
It was the Clayton's interest rate move: Stevens hoped that by floating the possibility of a rate reduction, he could avoid having to do it. In other words, the rate cut you have when you don't have a rate cut. The jawbone probably wasn't as effective as Stevens hoped, but it likely had some effect.
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Australia and East Timor strike 'landmark' deal to end Greater Sunrise dispute

Lindsay Murdoch
Published: September 2 2017 - 4:50PM
Bangkok: Australia and East Timor have reached agreement on developing billions of dollars of oil and gas reserves in the Timor Sea, ending years of bitter disagreement.
A deal has been reached on a maritime boundary as well as sharing arrangements for the $US50 billion Greater Sunrise oil and gas field.  
Foreign Minister Julie Bishop hailed the agreement struck in confidential talks at The Hague as a "landmark day" in relations between the two countries.
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Health Budget Issues.

'Do I really need that diagnosis?'

Ray Moynihan
Published: August 27 2017 - 8:00AM
Receiving a diagnosis of a dreaded disease is surely one of the saddest things that can ever happen to us. But what if some of those diagnoses were unnecessary?
Growing evidence suggests doctors are diagnosing many diseases far too frequently, and this problem of "over-diagnosis" is leading to much overtreatment – even threatening the sustainability of our health system.
Don't take my word for it. This month a group of extremely influential Australian healthcare organisations – including health professionals, consumers and policy-makers – endorsed a call to action to address the problem.
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Bupa’s Crombie says AMA has head in sand over fees, feedback

  • The Australian
  • 12:00AM August 28, 2017

Sarah-Jane Tasker

Bupa’s Australian health insurance boss, Dwayne Crombie, has dismissed concerns about increased transparency around doctors’ fees and performance, arguing it was patients driving the push, not insurers.
Dr Crombie, who is Bupa’s managing director of its Australian private health insurance arm, told The Australian that Michael Gannon, the head of the Australian Medical Association, was putting his “head in the sand” around the issue of transparency.
“I think Michael Gannon and the AMA need to get real. Consumers will give feedback — they’re giving feedback now in a completely unmoderated fashion. It’s time to listen to the feedback, not try and pretend that you’re immune from it,” he said.
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Health funds must pass on reform savings

  • The Australian
  • 12:00AM August 29, 2017

Sean Parnell

Health funds will be made more accountable for any efficiencies arising from federal government reforms to ensure the savings are passed on to members already struggling with high premiums.
The Department of Health last week advised health funds that the process and paperwork for their annual applications to increase premiums had changed.
Insurers have until November 10 to make applications for ­increases to take effect on April 1 next year. The department, in consultation with the Australian Prudential Regulation Authority, will make recommendations to Health Minister Greg Hunt.
Amid ongoing discussion of possible reforms to bring down costs in the private health sector, the department provided health funds with application forms it noted had undergone “significant changes” since the last round.
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ACCC’s Medibank case thrown out of court

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

Sean Parnell

The consumer watchdog has suffered a major blow in its efforts to defend the rights of private health insurance members with a Federal Court judge yesterday dismissing its high-profile case against Medibank.
The Australian Competition & Consumer Commission had ­accused Medibank, the formerly government-owned fund and market leader with 3.9 million members, of making false, misleading or deceptive representations and engaging in unconscionable conduct.
It was somewhat of a test case centred on Medibank’s decision to limit benefits payable for in-hospital pathology and radiology services, and came amid federal government efforts to make the industry more transparent and easier for consumers to navigate.
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Health Department forced to adjudicate on skin surgery dispute

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

Sean Parnell

The health department has been forced to intervene in a dispute between health funds, doctors and private hospitals over skin proced­ures that left some members with unexpected bills.
The Department of Health, in consultation with the Australian Society of Plastic Surgeons, last year altered the item numbers relatin­g to skin lesion procedures listed on the Medicare Benefits Schedule and for which insurance funding also applies.
But three of the items were subsequently listed as having to be done in a doctor’s rooms unless there was a clinical need for a hospital visit. This exacerbated long-running tensions between doctors and insurers, amid allegations of health funds inappropriately rejectin­g certificates given as evidence of clinical need, and doctors rebranding their rooms as day surgeries to attract more funding.
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Ramsey chief Craig McNally warns of ‘two-tiered Medicare’

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

Sarah-Jane Tasker

Ramsay Health Care managing director Craig McNally has warned it is a “political imperative” that both the Liberal and Labor parties put the brakes on public hospitals targeting private paying patients.
He has argued that neither side of politics would want a run-up to the next election with a perception that there was a two-tiered Medicare system, with private patients getting quicker access in public hospitals — a fact he says is backed by data.
“We have seen Health Minister Greg Hunt’s position on what elements he could tweak and he has that negotiation to have with states to resolve that,” Mr McNally said.
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Pressure on Hunt after Federal Court’s health fund ruling

  • The Australian
  • 12:00AM September 1, 2017

Sean Parnell

Health Minister Greg Hunt is under pressure to deliver on long-promised reforms to the complex and confusing private health insuranc­e market after a Federal Court judge found Medibank members were not entitled to better­ information about policy inclusions.
The Australian Competition & Consumer Commission had accuse­d Medibank of making false, misleading or deceptive representations and engaging in unconscionable conduct. The case centred on the information given — or not given — to members after the fund decided to limit bene­fits payable for in-hospital pathology and radiology services.
But judge David O’Callaghan dismissed the case on Wednesday, giving a legal inter­pretation of com­mon insur­ance terms, including that “the word ‘cover’ cannot be read to mean ‘entirely cover’ ”.
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Is private health insurance worth it?

Georgina Dent
Published: September 3 2017 - 12:15AM
At the beginning of last year, my husband needed to have his wisdom teeth taken out. He had the rumblings of an infection and having the offending teeth removed – along with a course of antibiotics – was deemed the necessary course of action, so we booked it in.
As lifetime holders of private health insurance, we didn't give any thought to the medical bills that would be associated with the procedure. We have top hospital cover so assumed we would be covered. We weren't.
When the doctor's rooms rang a few days after the procedure to inform my husband our health fund had declined to pay the bill, we both thought there had been an error. There hadn't.
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International Issues.

  • Aug 29 2017 at 10:30 AM

Kim Jong Un's theory of nuclear victory

by Thomas Wright
Why is Kim Jong Un pursuing intercontinental ballistic missiles that would give him the capability of hitting the mainland United States with nuclear weapons?
Part of the answer is survival—the United States will not launch a preventive war against North Korea if Pyongyang could retaliate with nuclear weapons. But if that were the only reason, the situation would not be so dire.
After all, deterrence worked in the Cold War. Once Kim gets his ICBMs, both sides would be cautious, or so the argument goes.
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Australia ready to support Japan following North Korean missile launch: Julie Bishop

Amy Remeikis, Stephanie Peatling
Published: August 29 2017 - 10:57AM
Australia stands ready to support Japan "at any time", as leaders from across the political spectrum condemned the "illegal, provocative and threatening" behaviour of North Korea after it fired a missile over Japan.
Foreign Minister Julie Bishop said Australia was focussed on de-escalating tensions, which had increased following the succession of Kim Jong-un to North Korea's leadership.
Ms Bishop said China was playing " a significant role" in persuading Pyongyang to halt its nuclear weapons program by participating in the toughest sanctions ever placed on the regime.
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Once again, Donald Trump demonstrates his taste for racist brutality

Nicole Hemmer
Published: August 28 2017 - 11:45PM
There are clarifying moments in every presidency, choices that define the administration's values and goals in ways mere rhetoric never can. For Donald Trump, one such moment occurred on Friday, when he issued a pardon to Joe Arpaio, the notorious Arizona sheriff convicted of contempt after refusing to follow a court order to stop racial profiling.
The Arpaio pardon is clarifying not because it will change the course of Trump's presidency, but because it succinctly sums up the Trump doctrine for domestic and international policy: not more effective, just more cruel.
Cruelty is the defining feature of the two law enforcement officers Trump holds up as heroes, Joe Arpaio and David Clarke. Both men came to national fame as regulars on Fox News, and both appeared at the Republican National Convention in support of Trump. Conservative media mainstays and Trump loyalists, Arpaio and Clarke have the perfect resumes to win plaudits from the President.
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South Korea’s show of force over missile

UPDATED: South Korea has responded to the North’s missile launch with an aggressive show of force, conducting a live-fire drill on its eastern coast.
Seoul’s presidential spokesman Park Su-hyun said four F-15 fighters dropped eight MK-84 bombs that accurately hit targets at a military field near the eastern coast.
The South Korean Air Force said a MK-84 bomb has an explosive yield of a ton. The exercise was aimed at sharpening the military’s ability to completely destroy “the enemy’s leadership”, the Air Force told news agency Yonhap.
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Kim Jong-un: missile test a `prelude' to containing Guam

Shinhye Kang
Published: August 30 2017 - 9:58AM
Seoul: North Korean leader Kim Jong-un said the test-firing of a missile over Japan on Tuesday was a "meaningful prelude" to containing the American territory of Guam, adding he will continue to watch the response of the US before deciding on further action.
Kim guided the firing of the intermediate-range strategic ballistic rocket and urged his military to conduct more such launches into the Pacific Ocean in the future, according to a statement from the official Korean Central News Agency.
The missile firing was part of "muscle-flexing" to protest annual military exercises being held between the US and South Korea, KCNA said. North Korea had threatened earlier this month to launch missiles over Japan toward Guam, which prompted threats of retaliation from American military officials.
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  • Aug 31 2017 at 9:33 AM

Winter is coming in Donald Trump's Washington

by Edward Luce
It is often tempting to think Donald Trump can do no worse. Yet he keeps finding that extra mile.
America's president began the holiday season with a threat of nuclear strikes on North Korea. This week Pyongyang launched its most ominous missile test in years. In between, Mr Trump gave a rocket boost to the Ku Klux Klan and pardoned America's most racist sheriff in memory.
Thankfully August is ending. Alas, September is likely to be worse. Then comes October. Nobody - least of all Mr Trump - can halt the disintegration of what we still politely call his administration.
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How the pardon power could end Donald Trump's presidency

Philip Allen Lacovara
Published: August 31 2017 - 11:14AM
Washington: US President Donald Trump's pardon of former Arizona sheriff and civil rights abuser Joe Arpaio raises the question of whether the President may act with impunity to pardon individuals caught up in special counsel Robert Mueller's investigation of the Trump campaign's dealings with Russia.
Based on my experience studying the pardon power during the Watergate investigation, I believe the answer is no.
Almost certainly, a presidential decision to preemptively pardon any of those caught up in Mueller's investigation, whether former campaign chairman Paul Manafort, former national security adviser Michael Flynn or Donald Trump jnr, would be effective and would spare those pardoned from prosecution, at least on the federal level.
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Signs of maturity as India and China diffuse border tensions

Mihir Sharma
Published: August 30 2017 - 4:25PM
Delhi: As summer reached the high Himalayas in June, one corner of the mountains turned hotter than expected.
On a small plateau called Doklam, close to where the India-China border meets the tiny kingdom of Bhutan, two of the largest armies in the world faced off against each other. Chinese soldiers, convinced they were on Chinese territory, had brought equipment to extend a road; Indian soldiers, who viewed the land as disputed, blocked the earth-movers.
For three months, the armies camped just metres away from each other, the Indians on the higher ground and the Chinese in a little valley. Neither government seemed to know how to back down.
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France unveils contentious labour overhaul in big test for Emmanuel Macron

Aurelien Breeden
Published: September 1 2017 - 1:22AM
Paris: The French government announced on Thursday a plan to overhaul the labour code, a highly awaited and contentious effort to loosen regulations and stimulate the economy that has been met with opposition from unions and left-wing parties who say the changes go too far in repealing workers' rights.
The labour overhaul was one of Emmanuel Macron's major promises during his campaign, and it represents one of the first big tests of his pledge as president to reshape France's social and economic landscape, a move that was being closely watched by the country's European partners and by investors abroad.
Mr Macron, who has slipped significantly in the polls the summer, is trying to avoid the intense backlash that led to street protests when his predecessor,  François Hollande, introduced changes.
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US bombers drill over Korean peninsula

Jack Kim and Kaori Kaneko
Published: September 1 2017 - 10:05AM
Seoul: South Korean and Japanese jets have joined exercises with two US B-1B bombers above and near the Korean peninsula on Thursday, two days after North Korea sharply raised tension by firing a missile over Japan.
The drills, involving four US stealth F-35B jets as well as South Korean and Japanese fighter jets, came at the end of annual US-South Korea military exercises focused mainly on computer simulations.
"North Korea's actions are a threat to our allies, partners and homeland, and their destabilising actions will be met accordingly," said General Terrence O'Shaughnessy, Pacific Air Forces Commander, who made an unscheduled visit to Japan.
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Turnbull comments show Australia a 'second class citizen' says Chinese newspaper

Kirsty Needham
Published: September 1 2017 - 2:08PM
Beijing: Prime Minister Malcolm Turnbull's call for China to cut off its oil pipeline to North Korea has prompted a fierce rebuke from a high-circulating Chinese newspaper, which accused him of going beyond even Donald Trump.
The Global Times, which sells more than one million copies, devoted an editorial to Mr Turnbull's "indiscreet" and "absurd" comments, and saying Australia was a "second class citizen of the West".
"Although President Trump has complained about China in contradictory statements, he has so far never publicly asked China to cut North Korea's oil supply," the Global Times wrote.
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North Korea and United States on brink of war, warns Vladimir Putin

Andrew Osborn and Dmitry Solovyov
Published: September 2 2017 - 12:04PM
Moscow: Russian President Vladimir Putin has warned that the standoff between North Korea and the United States is close to spilling into a large-scale conflict, and said it was a mistake to try to pressure Pyongyang into halting its nuclear missile programme.
Mr Putin, due to attend a summit of the BRICS nations (Brazil, Russia, India, China and South Africa) in China next week, said the only way to de-escalate tensions was via talks, and Sergei Lavrov, his foreign minister, said Washington – not Pyongyang – should take the initiative.
"It is essential to resolve the region's problems through direct dialogue involving all sides without advancing any preconditions (for such talks)," Mr Putin, whose country shares a border with North Korea, wrote on the Kremlin's website.
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Trump says he will not talk to North Korea. Experts fear he will

Mark Landler
Published: September 2 2017 - 12:30AM
Washington: US President Donald Trump this week vowed that he would not talk to Kim Jong-un, cooling off what has become his on-again, off-again cultivation of North Korea's rogue dictator.
The U.S. has been talking to North Korea, and paying them extortion money, for 25 years. Talking is not the answer!
— Donald J. Trump (@realDonaldTrump) August 30, 2017
But if Trump's tweet, in which he said, "talking is not the answer!" seemed to reignite tensions with North Korea, it also revealed a paradox in how Asia experts view the crisis. Some fear less that Trump is going to start a war with Kim than that he is going to stumble into a risky, unpredictable dialogue with him.
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North Korea crisis: Malcolm Turnbull treads a careful path through US confusion

Mark Kenny
Published: September 1 2017 - 4:08PM
It is tempting to explain America's mixed messaging towards North Korea as the old "good cop, bad cop" routine. If only it were that simple. Or rather, that complicated.
Instead, the world awaits the reactions of two men in Donald Trump and Kim Jong-un, whose hair styles are way-too-interesting, and their behaviour no less adventurous.
Modest pelts such as Defence Secretary Jim Mattis and Secretary of State Rex Tillerson, provide some comfort to a nervous world as they act to curb Donald Trump's freewheeling bravado.
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I look forward to comments on all this!
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David.

It Seems We Are Rather A Long Way Behind With Digital Health – Do You Believe The Report?

This appeared a while ago but I have only just spotted it?

Australia ranked last for connected technologies uptake but Australians think the system is better than it is

Lynne Minion | 16 Jun 2017
Australia has ranked last in its adoption of connected care technologies in the healthcare sector, according to research into the future-readiness of the healthcare systems of 19 nations, but Australians believe their system is far more digitally interconnected than it is.
With a “reality” score of 9.1 out of 100, Australia’s bottom ranking places it a stunning 31.9 points below the next lowest ranked healthcare sector of Saudi Arabia, which scored 41.
Despite the reality, many Australians perceive their healthcare system to have already implemented connected care devices and policies, earning a “perception” score of 50.5.
The last place slot in the connected care technologies category was a reflection of Australia’s low levels of spending on IoT hardware as a percentage of GDP and the lack of a cohesive health technology policy, according to the report commissioned by Royal Philips.
Yet the vast majority of healthcare professionals in Australia view connected care technology as important in improving the treatment (84 per cent) and diagnosis (82 per cent) of medical conditions.
“Australia is now falling behind globally,” Managing Director of Philips Australia and New Zealand, Kevin Barrow, said.
Industry initiatives such as the My Health Record are strong stepping stones in seeing patients take more ownership of their own health, Barrow said, but policy makers and private companies need to support industry in recognising the potential of technologies in healthcare.
“We need to move away from the current episodic diagnosis and treatment model. The adoption of connected care will greatly facilitate this, but getting it right requires input across both the public and private sectors, and policy-makers. Australia currently lacks industry-wide policy around integration and connected care technologies, and while discussions are happening, we are yet to see effective action.”
The problem is cost, with the Future Health Index finding 53 per cent of the population is concerned that the technologies will increase the price of healthcare, while 69 per cent of healthcare professionals believe that current funding mechanisms will prevent Australia from moving to a patient centric healthcare system.
But Barrow said connected care brings with it cost benefits.
Lots more here:
There is also some press coverage:

Australia’s healthcare fails global efficiency test

Sarah-Jane Tasker

Australia’s high cost of healthcare is not matched by efficiency, ­according to a new study, which says government policy must ­encourage integration and the use of connected-care technology across the sector.
The Future Health Index, which surveyed more than 33,000 individuals across 19 countries, shows that Australia’s healthcare outlay of 9.4 per cent of GDP was above the global average but that relative to the expenditure, ­Australia’s health outcomes could be improved.
The global study, commissioned by Royal Philips, shows that Australia’s efficiency ratio at 9.5 falls below the 19-country ­average of 10.5, indicating the ­outcomes achieved by the healthcare outlay were not optimal.
Kevin Barrow, managing director of Philips Australia and New Zealand, said Australia’s ­current approach to healthcare had afforded the population great access and results but it had come at a high cost.
“The reality is that we still need better integration and the adoption of healthcare technologies to facilitate a more efficient value-based model of care,” he said.
The results of the survey also revealed that Australia was behind when it came to integration across the healthcare system and adoption of connected care technologies, compared to the 19-country average.
“It was surprising that when you look at integration of care and connected care, roughly half of the healthcare professionals and public surveyed in Australia said we were performing quite well, but in reality those scores were quite low,” Mr Barrow said.
“Sometimes the general public, because they have a fitbit, think technology is very pervasive, but the reality is it’s often not connected to useful information to manage their illness or general well being.”
Mr Barrow said there was an appetite in the industry to do something “different” in the healthcare system, but he was not confident the policy shift needed by government would be tackled in the short term.
“The sort of structural reform that is required can only be taken with a long-term view and we know that our nation’s leaders are constrained on occasion for shorter time frames,” he said.
“But when you talk to the people that operate in the system, there is a tremendous appetite for them to want to do things differently. Eventually, the population knows we cannot keep going on at this rate in terms of expenditure.”
Here is the link:
To me this seems a bit too harsh. We are not perfect but I am not sure we are quite as far down the ranking as that.
Interested to hear from others as to how credible this seems to be.
You can download and read the report from this link:
This is the direct link to the report:
Worth a browse to see how we compare globally in connecting our health information.
David.

Wednesday, September 06, 2017

And You Think You Can Trust The Government With Your Private Health Data?

This appeared last week.

Alan Tudge urged to act following Department of Human Services fraud allegations

Steven Trask
Published: August 31 2017 - 2:45PM
The need for a Senate inquiry into bungled government IT projects has been vindicated following allegations of fraud at the Department of Human Services, the Labor party says.
On Thursday Fairfax Media revealed that as many as 50 IT subcontractors were under investigation in a fraud probe at the government's largest department.
The allegations related to fake invoicing practices and the use of false CVs and qualification records to secure government contracts.
Linda Burney, Labor's human services spokeswoman, and Ed Husic, their digital economy spokesman, said Human Services Minister Alan Tudge must front up.
"The minister that brought us the robo-debt debacle has questions to answer about reports of massive tech contractor fraud that occurred right under his watch," they said in a joint statement.
"It also highlights that Labor was right to push for a Senate inquiry into the management of digital transformation projects under the Turnbull government's watch."
The fraud allegations were proof the government had "lost a grip on managing its ICT projects," they said.
At least one DHS employee is also under suspicion and the department has called in the Australian Federal Police to help with the investigation.
More here:
Related we have this:

My Health patient data will be safe despite Medicare breach, GPs say

RACGP has told a Senate inquiry layers of security will help prevent breaches such as the theft of Medicare numbers that were sold on the darknet. 

Melissa Davey 

Sunday 3 September 2017

The breach of Medicare data that resulted in patient card numbers being sold on the darknet should not have any significant implications for the government rollout of My Health Record, says the peak body for general practitioners.

My Health Record will involve patient’s health information being uploaded to an online database.

In its submission to the Senate inquiry into the Medicare data breach, the Royal Australian College of General Practitioners (RACGP) said a Medicare card number alone would not allow access to a patient’s My Health Record.

“The authentication process for both the consumer and provider portals of the My Health Record are complex and have many layers of security,” the college said. “Individuals can elect to opt out or can set strict privacy controls, enabling full control over third-party access to personal information. A clear and targeted consumer communication strategy will be important during the implementation of the opt-out My Health Record System to allay any fears of identity theft and connection with this recent data breach.”

My Health Record will be in place for every Australian by 2018, and people will have to opt out if they don’t want their information uploaded and shared between doctors, hospitals and other health practitioners.

Lots more here:

https://www.theguardian.com/australia-news/2017/sep/03/my-health-patient-data-will-be-safe-despite-medicare-breach-gps-say

So the Department of Human Services has 50+ contractors under investigation and the RACGP are suddenly experts on IT security of large systems.

Believe that if you will. For me I would keep well away of the myHR.

Your call.

David.

I Wonder What This Might Mean For Digital Health In Australia If It Is Sold?

This appeared last week.

Telstra could sell health unit

  • The Australian
  • 12:00AM September 1, 2017

Bridget Carter

Scott Murdoch

Telstra is expected to start considering the future of its struggling health business as it looks to cover its $3 billion revenue black hole and the forgone benefits of its NBN earnings securitisation plan.
NBN Co’s decision to stop Telstra fast-forwarding the delivery on its NBN payments means the telco will forgo about $5.5bn.
The revenue was not officially accounted but was a major part of its future plans and the telco was keen to lock in the payments. Under the existing plan, Telstra will still receive the annual payments of $1bn for the next 30 years.
The move by NBN to say no means that Telstra’s future buyback programs will be put on hold, along with debt-reduction plans, in yet another decision that is likely to displease Telstra’s already weary investors.
The dividend payout ratio was reduced this year to preserve capital and naturally investors are now starting to wonder where the next leg of growth will come from.
Telstra chief executive Andy Penn last year warned that the company was facing a $3bn capital black hole after 2021 as the NBN rollout progressed.
The company has flagged $2bn in cost cuts but the plan won’t cover the entire revenue loss, prompting speculation as to Telstra’s next step.
There is a growing chance that Telstra Health could be put on the chopping block, despite investing in the business over the past 2.5 years.
More here:
I guess there will be a few nervous people at the Telstra e-Health Group but I wonder, having put this together, might it not be good to have a separate entity of reasonable scale with the skills and experience they have built up.
I guess it will all depend on just how profitable it can be stand-alone.
As always time will tell and comments welcome.
David.

Tuesday, September 05, 2017

A Valuable Review Of The Potentialities Of The Use Of Health Data For System And Clinical improvement Purposes.

This useful review appeared last week:
30 August 2017

Uncovering Scandinavia’s health-data secrets

Posted by Felicity Nelson
I’d just crumpled onto the couch at home when an unknown number flashed up on my mobile. “It’s Christian Nøhr calling from Denmark,” said a warm voice down the line. I did the awkward phone-to-shoulder contortion as I scrambled for a pen, notepad and dictaphone.
I wasn’t expecting this call.
My half-hour chat with Professor Nøhr, a health informatics expert from Denmark’s Aalborg University, opened a small window into what I’ve decided to call “data heaven”.
Until very recently, Australian researchers have had to beg federal, state and territory governments for linked health data and could wait years to gain access.
In one instance, cited by the Productivity Commission in its March 2017 report, there was a five-year delay in the supply of vital data that went on to show an increased cancer risk for young people undergoing CT scans.
“Had [the] study been approved sooner, and been able to proceed at an earlier date… we would have had results sooner, with potential benefits in terms of improved guidelines for CT usage, lesser exposures and fewer cancers,” one researcher said.
Contrast this to the Danish system, where GPs, specialists, pharmacists and hospitals all interact using a central database, which has been in place since 2010. Each patient’s journey through the system can be tracked in detail using a unique ID number, and there is a clearly defined process through which researchers can seek ethics approval and access de-identified data.
Denmark’s primary care portal, Sundhed.dk, allows 98% of GPs to communicate directly with other healthcare professionals. Patients cannot receive treatment outside the system and are unable to edit their medical information. But they do have the ability to tag specific medicines as “private”, which means doctors can be fined for not seeking consent prior to accessing the information (unless it’s an emergency situation).
The most remarkable aspect of the Danish system – and the most alien from an Australian perspective – is the broadbased acceptance of data collection and monitoring by government. “We expect the public system to take good care of our data”, said Professor Nøhr. By comparison, lack of trust in data sharing arrangements is “choking” the use of health data in Australia, according to the Productivity Commission.
This is unfortunate because linked, de-identified medical records are the Holy Grail for health researchers. Retrospective analysis of millions of anonymised data points can reveal a whole galaxy of patterns, without the expense and hassle of a clinical trial.
Once granted access to government-held medical data, researchers can view real-life information about the long-term outcomes of patients taking particular medications. And linking that information to social variables can yield an even richer understanding about how the health of individuals is affected by education, employment, housing, or income. The health system can be made vastly more efficient using the insights from data analytics.
But while other countries are increasingly using health data in clever ways, Australia is being left behind. “This is a global phenomenon and Australia, to its detriment, is not yet participating,” the commission’s report said.
So what are Scandinavia’s secrets to safely unleashing the power of health data, and what’s stopping Australia from doing the same?

ID numbers 

To find out, I emailed peak bodies for health research in Norway and Sweden and asked them to spill the beans. Both of these countries were listed as top nations for health data sharing and linkage by the OECD’s 2015 report, along with Denmark, Finland, Canada, Czech Republic, Israel, Korea, New Zealand, Singapore, and the UK.
Birgitta Lindelius, a spokesperson for the National Board of Health and Welfare in Stockholm, Sweden, said: “One reason is probably our long tradition when it comes to registers and the personal identity number (PIN) that is an important part of the registers. The PIN gives us the possibility to link data.”
Statistics of diseases and surgical treatment of patients have been published for more than 100 years in Sweden, regulated by the Act for Health Data Registers. County councils are, by law, obliged to send information on the care given to the National Board of Health and Welfare.
Data are disclosed for research purposes up to 400 times every year by means of an exception in the Public Access to Information and Secrecy Act. “We believe there is a big trust among both researchers and citizens in general in this system,” said Ms Lindelius.
Norway has a similar tale. Using the 11-digit ID number given to all citizens, data from different registries can be linked together. “This provides valuable knowledge about the occurrence of disease, the use of healthcare services and results from public health measures,” Marta Ebbing, the director of Health Registries at the Norwegian Institute of Public Health, said.
Denmark introduced its central person register number in 1968. This ID is used for everything in relation to national and local government, including healthcare, drivers’ licences, bank accounts, public education and employment. “It gives a unique opportunity to do research, especially within epidemiology where you can actually trace many, many different bits of information about the individual from birth to death,” said Professor Nøhr.
In fact, all OECD countries with a strong health data linkage use a single number to identify individuals and link data sets together. New Zealand has a national health index number, South Korea has a resident registration number, Israel has an ID number and the UK has an NHS number.
By comparison, there was a furore over the Hawke government’s proposed Australia card in the 1980s. Even today, Australian health data can’t be linked using the Medicare number because people can have multiple cards (or multiple people can have the same Medicare number). Instead, researchers use statistical techniques to piece together health data sets in Australia as best they can.
“Researchers might take the first three letters of your first name and surname, your date of birth and something else and then creating a hash key out of it and that then becomes unique to you,” Dr Christopher Pearce, the vice-president of the Australasian College of Health Informatics, said.
There is vastly more here:
The bottom line, to me, in all this is that we need to do a much better job of communicating the benefits of data linkage and use and establish a trusted framework for this to happen.
As I put it to a correspondent the issue is this:
"To point out the obvious they (the countries cited) are all small homogeneous countries with high levels of trust in Government.
We (Australia) are much bigger, more diverse and less trusting!"
To me it is these issues that need to be addressed first. It will also need dramatic improvement in the levels of trust in Government and the ADHA specifically!
David.