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, November 09, 2017

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

November 9, 2017 Edition.
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Trump has headed off to Asia for a round of meetings and so on after having managed to have a ‘tax cut’ bill introduced to Congress and appointing Jerome Powell to replace Janet Yellen as boss of the US Federal Reserve. The first has been met with scepticism and the second is seen a pretty much to most sensible thing he has done so far – rather than the better alternative of leaving Ms Yellen in place.
Both Brexit and Catalonia are still festering along with no resolution to either!
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Big Mal went off to Israel and while he was gone the dopey President of the Senate decided he was a dual citizen and so had to resign! Really the Australia political class are a collection of self-obsessed nit-wits. I have no idea what is going to break the cycle of ever worsening detachment from reality and good policy?
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Here are a few other things I have noticed.
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Major Issues.

More than 100 Joyce and Nash decisions at risk from legal challenge: QCs

Adam Gartrell, Stephanie Peatling
Published: October 30 2017 - 8:11AM
More than 100 Turnbull government decisions are vulnerable to legal challenge as a result of Barnaby Joyce and Fiona Nash's dual citizenship status, with lawyers concluding there is a high likelihood the work the pair has done over the last year will end up before the courts.
The federal opposition sought urgent legal advice at the weekend after the High Court disqualified Mr Joyce and Ms Nash from Parliament - plunging the government into crisis, threatening its majority and forcing a byelection in the NSW seat of New England.
The advice from two senior silks - Matt Albert QC and Matt Collins QC - says Mr Joyce's and Ms Nash's ministerial decisions are now at risk under section 64 of the constitution, which requires ministers to be members of Parliament. While there is some leeway in terms of timing, Mr Joyce and Ms Nash effectively ceased to be ministers on October 20 last year - three months after they were sworn in.
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The biggest stock collapse in world history is set to get worse

Kana Nishizawa and Aibing Guo
Published: October 30 2017 - 8:20AM
It's going to take more than the biggest stock slump in world history to convince analysts that PetroChina has finally hit bottom.
Ten years after PetroChina peaked on its first day of trading in Shanghai, the state-owned energy producer has lost about $US800 billion ($1.04 trillion) of market value -- a sum large enough to buy every listed company in Italy, or circle the Earth 31 times with $US100 bills.
In current dollar terms, it's the world's biggest-ever wipeout of shareholder wealth. And it may only get worse. If the average analyst estimate compiled by Bloomberg proves right, PetroChina's Shanghai shares will sink 16 per cent to an all-time low in the next 12 months.
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Facebook dismay over 'outrageous' scale of Russia-backed ads

Sarah Frier
Published: October 31 2017 - 9:27AM
Washington: Facebook is planning to tell a Congressional panel in more detail just how deeply Russian ads and posts infiltrated the news feeds of US voters on its social network, according to prepared testimony obtained by Bloomberg.
At a Senate Judiciary subcommittee hearing Tuesday, General Counsel Colin Stretch will say that 29 million people were directly served content from accounts backed by the Internet Research Agency, a pro-Kremlin Russian group. Those posts, after they were liked, shared and commented on, travelled to the news feeds of approximately 126 million people at some point over a two-year period, his testimony states. That's equivalent to about 40 per cent of the US population.
Facebook's testimony portrays the company as shocked about Russian use of its platform for political means -- and eager to come up with solutions so it doesn't happen in the future. The planned remarks underscore that the social network is doing its part to coordinate with Congress so investigators can understand the problem. The hearing on Tuesday and two more planned for Wednesday mark the culmination of a weeks-long communication offensive with legislators, including blog posts, executive outreach and the hiring of crisis public relations firms. Facebook may be betting that being helpful and conciliatory now makes it less likely to face cumbersome regulation -- though the company says it is open to some legislation on advertising.
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  • Oct 31 2017 at 12:37 PM

IMF warns that volatility bets loom as next big financial shock

by Miles Johnson
The International Monetary Fund has warned the increasing use of exotic financial products tied to equity volatility by investors such as pension funds is creating unknown risks that could result in a severe shock to financial markets.
In an interview with the Financial Times Tobias Adrian, director of the Monetary and Capital Markets Department of the IMF, said an increasing appetite for yield was driving investors to look for ways to boost income through complex instruments.
"The combination of low yields and low volatility facilitates the use of leverage by investors to increase returns, and we have seen rapid growth in some types of products that do this," he said.
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'Never say never': another GFC possible, says former US Federal Reserve board member Randall Kroszner

Nassim Khadem
Published: November 2 2017 - 8:10AM
The world isn't in the "all clear" when it comes to the possibility of another financial crisis, says former United States Federal Reserve board member Randall Kroszner.
He admits he's now at greater liberty to be frank with his opinions on monetary policy and financial markets.
It's not a privilege he feels he had in his previous gig since there's a market obsession with "every single word, every single syllable that comes out from the Fed".
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Wednesday, November 1, 2017

Report heralds big change in economic reform priorities

Government reports come and go with great rapidity. Some are acted on, most are quickly pigeonholed. Last week Scott Morrison tabled a report from the Productivity Commission called Shifting the Dial, but it was soon lost amid all the excitement about raids on a union and politicians being thrown out of their jobs.
Despite this inauspicious beginning, let me make a fearless prediction: when the history of the economy in the early decades of the 21st century is written, this report will get prominence.
Why? Not because this government or the next will rush out to implement its recommendations, but because it will be seen as a turning point in the thinking of the nation's economic advisers.
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Citizenship crisis threatens legitimacy of the Australian political system

Mark Kenny
Published: November 2 2017 - 12:26AM
The dual citizenship question burning like a subterranean coal fire beneath capital hill, is threatening collapse. A full blown "legitimation crisis" looms.
Confidence between the represented and the representative, is threadbare.
It is far from clear that more dual-allegiance MPs will not come forward, or be named in politically calamitous circumstances.
Governments are usually blamed for chaos in parliament, as Tony Abbott showed in Julia Gillard's day.
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  • Updated Nov 2 2017 at 12:42 PM

Mortgage stress soars to record highs as borrowers struggle with jumbo loans

by Duncan Hughes
The number of Australian families facing mortgage distress has soared by nearly 20 per cent in the past six months to more than 900,000 and is on track to top 1 million by next year, according to new analysis of lending repayments and household incomes.
That means net incomes are not covering ongoing costs in nearly 30 per cent of the nation's households, up from about 25 per cent in May, the analysis by Digital Finance Analytics, an independent commentator, shows.
Stagnant incomes, rising costs, unemployment, the likelihood that rates are more likely to rise than fall mean the number of families struggling to make ends meet is expected to continue increasing, the analysis shows.
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US government reports humans cause climate change, contradicting Trump officials

Lisa Friedman
Published: November 4 2017 - 11:01AM
Washington: Directly contradicting much of the Trump administration's position on climate change, 13 federal agencies have unveiled an exhaustive scientific report that says humans are the dominant cause of the global temperature rise that has occurred since the start of the 20th century, creating the warmest period in the history of civilisation.
Over the past 115 years, global average temperatures have increased 1.8 degrees Fahrenheit, leading to record-breaking weather events and temperature extremes, the report says.
The global, long-term warming trend is "unambiguous," it says, and there is "no convincing alternative explanation" that anything other than humans - the cars we drive, the power plants we operate, the forests we destroy - are to blame.
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'It will hurt': The age of easy money is nearly over, in test for global markets

Christopher Anstey
Published: November 4 2017 - 1:46AM
After a decade of flooding economies with money, key central banks around the globe will finally start turning off the tap next year.
Since the GFC, they've kept interest rates near zero and some have bought trillions of dollars in government and corporate bonds. The idea was that low rates would encourage spending by businesses and consumers.
Although experts disagree about how effective the stimulus was in stoking broad-based economic growth, two conclusions are in little dispute: The deluge of cash staved off a global financial collapse, and it helped propel stocks and bonds to record levels. Now policy makers believe their economies are strong enough to thrive with less stimulus.
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Judge the Australian economy by its shape, not its size

Richard Denniss
Published: November 4 2017 - 12:15AM
The decades-long debate about the preferred size of the Australian economy has stifled a more important debate about the preferred shape of the economy. The fight over energy policy, for example, is not really a fight over the size of our energy sector, or the size of the economy; it is a fight about the kind of energy supply we want more of and the kind of energy supply we want less of. It's not complicated.
Most people want more investment in renewables and some people want more investment in coal-fired power stations. Given that we don't need both, the political fight about which technology to invest in will have a lasting effect on the shape of our economy. It's no different from the debate about removing trams from Sydney back in the 1960s and the debate about building light rail in Canberra in 2015. All investment decisions "create jobs", but only some investment decisions build the society most of us want to live in.
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Jerome Powell, like Janet Yellen, a steady hand on US Fed’s levers

  • Greg Ip
  • The Wall Street Journal
  • 12:00AM November 4, 2017
President Donald Trump’s selection of Federal Reserve governor Jerome Powell to succeed Janet Yellen as chairman of the central bank is something of a gamble. Unemployment is at a 16-year low, economic growth is picking up, the stockmarket is setting records, and yet Mr Trump is changing leaders at the institution most responsible for all of that.
As gambles go, it looks like a safe one. Of all the candidates Mr Trump considered after deciding not to keep on Ms Yellen, Mr Powell’s temperament and views come closest to hers. He believes the Fed should use all available tools — bond buying, interest rates and verbal guidance — to get unemployment down and keep inflation at its target of 2 per cent. He backs the regulatory framework put in place under president Barack Obama, albeit with less strict implementation.
Mr Powell’s job will be turning those beliefs into effective policy. Heading the Fed’s policy committee is harder than being a member: it means not just voting but deciding what will be voted on, gathering support for it, then explaining it to the markets and the public.
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From boom to gloom: how rising house prices have become a worry

Matt Wade
Published: November 5 2017 - 12:05AM
When Australians are asked what worries them most, things such as healthcare, the cost of living, unemployment and crime are always near the top of the list.
But during the past two years a new source of anxiety has registered in the polls: housing.
The trend has been most obvious in our biggest cities. Anxiety about the cost of housing has reached all-time highs in Melbourne and Sydney following a five-year property boom.
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National Budget Issues.

Why the time is right to abolish stamp duty

Jessica Irvine
Published: October 30 2017 - 12:00AM
Scarcity. It's been called the "central economic problem".
Economists consider it a great cruelty that the supply of resources in an economy – including time and money – will never be enough to satisfy the infinite wants and needs of the human heart.
And yet, scarcity is also the force which ultimately gives value to our lives.
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Fixing productivity is about government — we’re doomed

  • The Australian
  • 6:42AM October 30, 2017

Alan Kohler

It’s pretty interesting that the Productivity Commission’s first big five-yearly review of what’s wrong with the Australian economy zeros in on government, what it calls the “non-market economy”.
“…something is awry in our economic fundamentals,” it says.
And shouting from between the many lines of this report, called “Shifting the Dial” and some 1,200-pages long, is that what is awry is the way various levels of government operate, or don’t. Even the chapter on improving the efficiency of markets is all about fixing regulatory and governance cock-ups.
In which case, we’re doomed.
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Data revolution to transform four pillars model

Clancy Yeates
Published: October 28 2017 - 12:15AM
You're browsing through Facebook when a message pops up, asking if you'd like to check whether you're getting a decent interest rate on your savings.
Curious, you tap the screen to find out more.
It asks you to provide a bit more information about your financial goals – you're saving for a deposit on a house and hope to buy in about two years.
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Could land tax 'Bowie bonds' be a nifty fix for stamp duty?

Peter Martin
Published: November 1 2017 - 12:01AM
An economist from Melbourne University believes he just might have found a way around the roadblock that's been stopping NSW and Victoria replacing stamp duty with land tax.
The swap has been commended by the Rudd government's Henry tax review, the Abbott government's tax discussion paper, and by last month's Productivity Commission review for the Turnbull government.
The Treasury believes stamp duty is one of the most distorting taxes and land tax one of the best, meaning that a swap would benefit the economy by as much as 72¢ in every dollar raised.
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Australian military's age-old habit of buying duds

Nicholas Stuart
Published: November 1 2017 - 12:15AM
The political class has failed us. A glance around the current dysfunction masquerading as a parliament proves it. So why should we be surprised when the deformity spreads, like a tumour, through the corridors of Russell Hill.
A couple of weeks ago, I wrote a column detailing some of the flaws of Rheinmetall's Boxer. A recommendation to buy these as our army's new combat reconnaissance vehicles is already speeding its way across Lake Burley Griffin to cabinet's national security committee. Now that I've sat, again, in the vehicle, I can understand exactly why.
It's perfect for its specs. If I needed to go into combat, there's nothing I'd rather be transported in. Unfortunately, it has problems reaching the battlefield.
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Borrowers to get 'better deal' as Scott Morrison mandates credit data sharing

Clancy Yeates
Published: November 2 2017 - 12:15AM
Australia's major banks will be forced to share more detailed credit data about millions of customers, a move the government says will result in better deals on loans and greater competition in banking.
Treasurer Scott Morrison will on Thursday announce plans to mandate a system known as "comprehensive credit reporting" from the middle of next year, and the new requirements will apply to the Commonwealth Bank, ANZ Bank, Westpac and National Australia Bank.
The credit reporting regime, which has been voluntary for the past few years, will mean the major banks must give credit bureaux more detailed data about their customers' financial behaviour.
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Jury out on merits of cutting company tax rate for big end of town

By business reporter Andrew Robertson
Posted yesterday at 10:24am
Last year the Government cut the tax rate for businesses with a turnover of less than $10 million a year to 27.5 per cent.
It was the first stage of a plan to reduce the company tax rate for all businesses, big and small, to 25 per cent.
"$5 million would add directly to about 50 more team members in terms of the people who have the skills to develop software, to spend time with our customers, engaging in the sorts of problems we would be able to solve for them, and of course then there is a multiplier effect of that," explained Tim Reed, the boss of accounting software company MYOB.
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It's time (to take Labor seriously)

Peter Martin
Published: November 1 2017 - 11:45PM
The shape of the next Labor government is becoming clearer.
This week we learnt that it will end the practice of signing Australia up to trade agreements that haven't survived a benefit-cost analysis.
Seriously. Korea, Japan, China. None of the three big agreements boasted about by Tony Abbott and Malcolm Turnbull has been subjected to an independent assessment of its benefits and costs. And nor has the far bigger, 5600-page, Trans-Pacific Partnership agreement signed by trade minister Andrew Robb shortly before he resigned and took up a position with the Chinese investor that runs the Port of Darwin.
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SA govt's bank tax rejected by upper house

South Australia's bank tax has been rejected by state's upper house, and the opposition and business groups say the proposal should now be abandoned.
Benjamin Weir
Australian Associated Press November 2, 20178:35am
The South Australian government's controversial proposal for a bank tax has been rejected by a single vote in the upper house of parliament.
The Liberal opposition, independent John Darley and Australian Conservatives all voted on Wednesday night to remove the proposed levy from Labor's budget measure bill.
Premier Jay Weatherill tweeted his disappointment with the opposition.
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Health Budget Issues.

Doctors blame our discount flu vaccine for record flu season

Sue Dunlevy, National Health Reporter, News Corp Australia Network
October 29, 2017 10:00pm
AUSTRALIA suffered the worst flu season on record because we used a cheap vaccine that did not protect the elderly, doctors have warned.
As the virus finally recedes it can be revealed more than 217,000 Australians had laboratory confirmed cases of the flu this year — more than twice the previous record of just over 100,000 in 2015.
Doctors are blaming the $6 budget version of the flu vaccine used in the national vaccination program for the problem.
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Codeine crackdown will do nothing but increase pain for all

  • Jessica Borbasi
  • The Australian
  • 12:00AM October 30, 2017
Health Minister Greg Hunt’s proposed codeine crackdown is yet another lurch away from patient-centred care towards a health system that benefits the providers and profits the producers.
Under the guise of possibly protecting the few from addiction, the rest of the country — while being told elsewhere to become more health literate and self-manage their chronic conditions — will be subsequently forced to make (and pay for) a 15-minute appointment with their already too-busy GP for a codeine script.
Understandably, this has raised the hackles of not just consumers and state health ministers.
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De-doctoring medicine via another layer of bureaucracy

Authored by  Aniello Iannuzzi
THE draft report of the Independent Review of Accreditation Systems within the National Registration and Accreditation Scheme (NRAS) for health professions has been released and it proposes massive changes, and is not to be glossed over.
To remind those who may have forgotten:
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30 October 2017

Another way to provide patient-centred care

Posted by Julie Lambert
Dr George Somers is sitting out the government’s Health Care Home trials for now.
Instead, the Melbourne GP has invested $1.5 million to bring in a clutch of allied-health providers, recruited a business manager and a clinical-care coordinator, and adopted a team-based model including shared consultations.
It’s part of the “patient-centred medical home” Dr Somers is creating to provide what he calls “wraparound” care.
“We put our hand up for Health Care Homes, but we have chosen not to join at this stage,” Dr Somers said.
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Report: Practitioners, patients and insurers are all at fault

"Reform to our health system could save $140 billion over 20 years."

The Productivity Commission has completed a comprehensive five year review of Australia's health care system and found that while Australia's health is generally tracking well, there's clear room for improvement in almost all areas, with doctors, patients, hospitals, insurers and legislators all needing to make a change.
"Reform to our health system could save $140 billion over 20 years" concludes the report.
Key challenges highlighted by the commission include:
  • Many doctors and practitioners are set in their ways at the expense of patient health.
  • Patients are poorly educated about their own healthcare and could be doing a lot more.
  • Funding systems are counter-intuitive and do little to incentivise effective preventative healthcare.
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Health funds poised to cheat members of $1.5 billion in savings says device manufacturers

HEALTH insurance customers could miss out on promised cuts to hefty fund premiums unless the nation’s chief financial watchdog takes a stand.
Sue Dunlevy
News Corp Australia Network October 31, 201710:00pm
HEALTH fund members could be cheated out of promised cuts to health fund premiums unless the nation’s chief financial watchdog audits their books, the Senate has been told.
To drive down premiums, Health Minister Greg Hunt has slashed by $1.5 billion the amount health funds have to pay manufacturers of hip and knee replacements and other medical devices.
The companies that make the devices have told a Senate inquiry there are already signs the savings health funds make won’t be passed on in full to their members as lower premiums.
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3D printing and precision medicine to get $5m in government funding

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

Sarah-Jane Tasker

Australian innovators in 3D printing and precision medicine can now apply for finance after a call was put out for ­expressions of ­interest for a slice of $35 million in government funding.
Those specific sectors have been identified by Health Minister Greg Hunt for the first $5m in government ­investment. Australian companies and entrepreneurs in the two sectors will be told today to finetune their business cases to attract a grant from the first funds available under that wider investment.
The first $5m will consist of $3m for ideas in precision medicine, a new approach for disease treatment and prevention, and $2m for ways to ­develop 3D anatomical printing for everyday medical use.
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Australians buying 'useless' health insurance, AMA head says

Dr Michael Gannon says people should not need medical training to understand what insurance products cover
Australian Associated Press
Australians are buying “useless” health insurance and should not have to be an actuary or doctor to understand what those products cover, the president of the Australian Medical Association, Dr Michael Gannon, has said.
Gannon also blamed the health insurance industry for increased premiums in order to pay shareholders, while reducing choice for patients by “controlling what services are provided”.
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New subsidies for Aust health treatments

More than 30 treatments for patients with heart disease, breast cancer, lymphoma and other life-threatening conditions are being subsidised by Medicare.
Source:  AAP
The cost of some treatments for heart disease, epilepsy, stroke, breast cancer, lymphoma and liver tumours are set to become much cheaper for thousands of Australians.
Health Minister Greg Hunt has announced 33 treatments will be subsidised by Medicare from today, helping thousands of Australians reduce their medical bills.
The move by the government is based on recommendations from the independent Medical Services Advisory Committee (MSAC).
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Private health insurers under pressure to limit premium rises and be more transparent

Esther Han
Published: October 31 2017 - 9:17PM
Private health insurers are under pressure to limit their annual fee increases to the Consumer Price Index following government-led reforms that saw the industry win $1.5 billion in savings on the cost of medical devices.
At a Senate inquiry into health insurance on Tuesday, the Medical Technology Association of Australia (MTAA) said given the "significant" cuts to the cost of devices on the prostheses list, it would be "reasonable" to expect premium increases of 2 per cent, rather than the 5 per cent or so seen each year.
It also said that with $6.4 billion in taxpayer subsidies funnelled to health funds each year, the Australian National Audit Office should scrutinise the insurers' books to ensure the savings are passed on to customers.
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Morale crisis at WA hospitals: survey

A survey of doctors in Western Australia has found morale at public hospitals has plummeted while relationships with management have crumbled.
Sophie Moore
Australian Associated Press October 31, 20177:34pm
Morale at Western Australia's public hospitals has plummeted and almost half of all doctors have considered resigning in the past year, a survey shows.
More than 860 senior doctors responded to the Australian Medical Association WA survey, revealing a fractured relationship with management and a health system under pressure.
AMA WA president Omar Khorshid said the survey reflected angst and anger from senior doctors, with many labelling the system broken and in crisis.
"Trust has been lost between medical staff and management," he said on Tuesday.
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Bioethicists raise alarm about conflicts of interest in Australia's IVF industry

Esther Han
Published: November 2 2017 - 12:15AM
The IVF industry has been accused of increasingly placing profits over patients, with a new study suggesting that some doctors are offering women more treatment cycles than appropriate or necessary.
A team of Australian bioethicists has found that conflicts of interest are leading to fertility doctors making decisions that financially benefit them and their employer, at the expense of their patients.
The first IVF cycle costs about $9000.
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Gap fees are the real problem with private health insurance, not the premiums

Crispin Hull
Published: November 4 2017 - 12:15AM
The Howard-Abbott-Turnbull attempts to bury Medicare while publicly praising it and its attempt to boost the bottom line of the private-health providers are now proving to be corrosive not only of the public health system, but of the private system as well.
A couple of weeks ago I wrote that the government's bribing and blackmailing people (especially young people) to take out and keep private-health insurance by reducing premiums by a trivial amount missed the point. The main gripe is not so much high premiums but the shocking out-of-pocket and gap expenses that privately insured people face when they come to call upon that insurance.
Since then several readers have told of their experiences. There has also been evidence to the parliamentary committee on private insurance.
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Medical training reforms and getting doctors in the regions

  • The Australian
  • 1:00AM November 4, 2017
The federal government has taken further steps towards reforming medical workforce training and distribution in the hope Australia will become less reliant on foreign doctors. Some of the changes, however, already have caused controversy, and other issues now on the political agenda are likely to be even more contentious.
Honouring a Coalition election promise, the government has appointed Australia’s first national rural health commissioner, with the former dean of medicine at Flinders University, emeritus professor Paul Worley, taking on the role.
Assistant Health Minister David Gillespie says Worley has a deep understanding of the work of rural doctors and will be charged with developing national rural generalist pathways to recognise the broad nature of such work.
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International Issues.

Are we in an era of unprecedented instability or just ignorant of history

Tom Switzer
Published: October 30 2017 - 12:00AM
Is today's emerging regional terrain more volatile than the late 1940s and 1950s when our leaders faced the challenges of decolonisation, communism and Asian nationalism?
How often do you hear pundits and politicians insist that what is happening now, and to us, is of unprecedented significance? That the world is the most uncertain and unpredictable in living memory, or that our politics has never been more polarising and partisan?
When people place too much emphasis on what seems to be relevant to the here and now, and fail to put contemporary events in a broader historical context, they are giving in to what the influential University of Sydney philosopher John Anderson called "the parochialism of the present".
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Robert Mueller's moves send message to other potential targets: Beware, I'm coming

Devlin Barrett, Sari Horwitz and Ellen Nakashima
Published: October 31 2017 - 6:56AM
Washington: The one-two punch delivered on Monday by special prosecutor Robert Mueller - an indictment of President Donald Trump's former campaign chairman and a guilty plea from a former campaign adviser - is designed to send a powerful message to everyone else caught up in the probe: the prosecutors aren't bluffing.
"This is the way you kick off a big case," said Patrick Cotter, a white-collar defence lawyer in Chicago who once worked as a federal prosecutor in New York alongside Andrew Weissmann, who is spearheading the prosecution of former Trump campaign chairman Paul Manafort and his deputy, Rick Gates.
On the same day the indictment was unsealed, prosecutors also announced a guilty plea and cooperation from former campaign adviser George Papadopoulos about his interactions with people linked to the Russian government. Papadopoulos has admitted to lying to FBI agents who questioned him about those contacts, according to court records.
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Deposed Catalan president surfaces in Belgium

Raphael Minder
Published: October 31 2017 - 10:57AM
Barcelona: Hours after the Spanish authorities announced that they would seek to prosecute Catalonia's separatists for rebellion, Carles Puigdemont, the region's dismissed leader, turned up Monday in Belgium, where he may seek asylum.
Puigdemont's reputation for unpredictability has grown with every turn of Catalonia's secessionist drama. On Monday, he all but disappeared as the Madrid central government began using emergency laws to take over direct administration of Catalonia after its declaration of independence last week.
Speculation had mounted as to what he was up to over the course of the day, until a lawyer in Belgium finally ended the mystery surrounding Puigdemont's whereabouts.
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The man who rained on Xi's parade

Peter Hartcher
Published: October 31 2017 - 12:58AM
 The Chinese know how to do pageantry. This was on full display last week in Beijing where the world's most durable one-party state showcased the enthronement of its leader, Xi Jinping.
Many observers, including supposedly hard-headed foreign analysts, duly genuflected at the sight of Xi with the backdrop of the huge, golden hammer and sickle emblem framed by 10 enormous red flags in the Great Hall of the People.
Some 2,200 delegates sat in serried ranks, voting unanimously and applauding rapturously in a spontaneous display of democracy with Chinese Communist Party characteristics.
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  • Updated 1 hr ago

The west must face the challenge of Xi Jinping's Leninist autocracy

by Martin Wolf
"Whether you like it or not, history is on our side. We will bury you!" Thus in 1956 did Nikita Khrushchev, then first secretary of the Communist party of the Soviet Union, predict the future.
Xi Jinping is far more cautious. But his claims, too, are bold. "Socialism with Chinese characteristics has crossed the threshold into a new era," the general secretary of the Communist party of China told its 19th National Congress last week. "It offers a new option for other countries and nations who want to speed up their development while preserving their independence." The Leninist political system is not on the ash heap of history. It is, yet again, a model.
Kruschev's claim seems ridiculous now. It did not seem so then. The industrialisation of the Soviet Union had helped it defeat the Nazi armies. The launch of Sputnik in 1957 indicated it had become a technological rival for the US. Yet 35 years after Kruschev's boast, the USSR, the Soviet Communist party and its economy had collapsed. This remains the most extraordinary political event since the second world war. Meanwhile, the most remarkable economic event is the rise of China from impoverishment to middle-income status. That is why Mr Xi is able to talk of China's a model.
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Xi Jinping vows to end poverty in China by 2020

Javier Hernandez
Published: November 1 2017 - 12:01PM
Chashan, China: From his home in the mountains of northeast China, Li Zhi has watched from a distance as prosperity has transformed China into a land of high-speed trains, billionaires and skyscrapers.
But the economic boom that made China rich never came to Chashan, a desolate village of 40 people about a six-hour drive from Beijing. Li, 72, spends his days limping along dusty roads to collect rubbish in exchange for tips. Stiff and gaunt, he subsists on a diet of rice, steamed bread and hard liquor.
"The country doesn't care for me," Li said as he rolled a cigarette in his home. "Nobody cares for me."
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Republicans unveil plan for big US corporate tax cuts

  • Richard Rubin
  • Dow Jones
  • 7:03AM November 3, 2017
House Republicans in the US, seeking the biggest transformation of the US tax code in more than 30 years, aim to permanently chop the corporate tax rate from 35 per cent to 20 per cent, compress the number of individual income tax brackets, and repeal the taxes paid by large estates starting in 2024, according to a detailed summary of the plan reviewed by The Wall Street Journal.
The GOP plan repeals the deduction for state and local income and sales taxes. It allows a deduction for property taxes, but caps it at $US10,000. That limit applies to married filers and individuals.
To partly offset that lost revenue, Republicans plan to curtail the deductions individuals take for state and local tax payments and the ones businesses get for the interest they pay on debt. But the plan released Thursday morning stops short of touching other popular tax breaks that were being considered for change, such as the ability of individuals to park up to $US18,000 a year in pretax funds into 401(k) savings accounts.
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Trump’s year of defying all effort to predict his actions

  • The Australian
  • 12:00AM November 4, 2017

Paul Kelly

One year since his shock election, Donald Trump has failed to ­deliver for his faithful backers, ­offered no convincing agenda “to make America great again”, ­accentuated the cultural and partisan malaise tormenting his coun­try — but can point to a booming sharemarket and the prospect of passing a sweeping tax reform in coming weeks.
Trump is yet to be tested in a genuine crisis — economic or military — when presidential judgment faces its supreme test. There is profound apprehension within the US system about how he would handle an existential moment. On the balance of probability it will eventuate.
This is a presidency like no other since World War II. Trump projects as temperamentally ­unstable, politically inept and an executive decision-making incompetent. His actual achievements along with tangible damage so far are meagre, mainly because of these limitations. But there is one certainty: if Trump succeeds and wins a second term it will be a very different America.
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George H.W. Bush, George W. Bush blast Donald Trump in new book, The Last Republicans

THE White House has hit back at both Bush presidents after they delivered a scathing assessment of Donald Trump’s leadership in a new book.
Staff writers
News Corp Australia Network November 5, 20176:27am
THE White House has hit back at both Bush presidents after delivered a scathing assessment of Donald Trump’s leadership in a new book about the father and son.
Former president George H.W. Bush publicly rebuked Trump, describing him as a “blowhard” in historian Mark Updegrove’s new book, The Last Republicans. His son, George W. Bush, also had some harsh words for his Republican successor: “This guy doesn’t know what it means to be president.”
A White House official reportedly told CNN that “if one presidential candidate can disassemble a political party, it speaks volumes about how strong a legacy its past two presidents really had”.
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China’s economic success challenges Western democratic dominance

  • The Australian
  • 12:00AM November 4, 2017

Alan Kohler

The 19th Chinese Communist Party Congress last month would have been a troubling event for the world’s capitalists, if they weren’t too busy salivating over the billion or so potential middle class consumers there, shopping online and booking airline tickets.
At least the Soviet Union had the decency to collapse in 1991, so that the proposition that democracy and economic success always go together could be elevated to the status of truism, along with the reverse — that communism and autocracy were synonyms for failure.
It seemed undeniable then, but back in 1956 when Nikita Khrushchev declared “We will bury you”, nobody laughed. (Nobody’s laughing now, either, as Vladimir Putin’s Russia “buries” the US political system, but undermining an election with Facebook ads and colluding with one side’s campaign staff was not quite what Khrushchev had in mind.)
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I look forward to comments on all this!
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David.

Wednesday, November 08, 2017

The Voice Of The ADHA CEO From India Reveals An Switch In Emphasis Or Does It?

This appeared last week.

Better use of technology should be the first priority for any healthcare service provider: Tim Kelsey

The cost on society of a paper based health service is enormous, the inefficiencies are tremendous, clinicians find their administrative burden takes them away from those crucial moments in which they can counsel their patients.
October 31, 2017, 08:13 IST
interview with ETHealthworld, Tim Kelsey, Chief Executive of the Australian Digital Health Agency, talks about the role of technology in expanding healthcare services. Edited excerpts:
About Australian Digital Health Agency
The Australian Digital Health Agency was setup in July last year and the intention by all the governments of Australia was to harness the power of modern information revolution to empower and enable clinicians to offer the industry, entrepreneurs and innovators a new platform for delivery of new services for patients and citizens and to provide citizens with new ways in which they can engage with the health and wellbeing. The agency has recently had the new national digital health strategy approved by the governments of Australia and that calls out seven key priorities for Australia.
Programme priorities
The first of these is a programme to give every Australian citizen a personal mobile health record which they can access through the mobile telephone. They can access online, which they can share with their clinicians if they choose to. The programme will have given all Australians access to by the end of 2018 unless they choose not to have one. So, that’s the priority and new strategy.
The second priority is around providing clinicians, doctors, nurses and allied health professionals with tools that enable them to communicate securely with each other without the fax machine, to avoid paper based healthcare. India & Australia have in common the challenge of ending the age of paper based healthcare and delivering digital services that’ll enable to secure real time communication between clinicians at the frontline of delivery.
‘My Health Record’ is a summary of a person’s health information; it includes the medication history, pathology reports, radiology reports and many other items of information. It’s not a comprehensive EMR type presentation of information instead it has the summary of a person’s health information accessible online through their mobile telephone, something that is shared with their clinicians. It’s quite different to the concept of an electronic medical record, say in a hospital or in general practice where you have fully comprehensive records of a person’s medical history. ‘My Health Record’ helps the clinician treat the patient to identify key history that’ll help them to prevent an error and improve the outcome for that patient.
Lots more here:
Assuming the reported heard Mr Kelsey correctly I find it interesting that a mobile personal health record is the ADHA’s highest priority.
One can only assume that what this is as an access mechanism to the myHR which will mean all the content, currency  and data integrity issues remain.
In the National Digital Health Strategy (as the first point) the following is found:
1. Health information that is available whenever and wherever it is needed.
By the end of 2018, every Australian will have a My Health Record, unless they choose not to. By 2022 all healthcare providers will be able to contribute to and use health information in My Health Record on behalf of their patients, providing potentially lifesaving access to reports of their medications, allergies, laboratory tests and chronic conditions, and supporting significant improvements in the safety, quality and efficiency of healthcare for the benefit of individuals, the healthcare system and the economy. Patients and consumers will be able to access their health information at any time online and through mobile apps.
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So it seems this is due for 2022 and is what is being discussed is in the last sentence. I rather think most GPs will be offering mobile direct access to their live credible EMR records long before this occurs.
I certainly know what I would prefer to access!
David.