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 30, 2017

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

November 30, 2017 Edition.
Overseas, in the week this is published we will get a good idea if Trump is going to get the Tax Legislation he wants through. There are many differences between the House and Senate versions and it will be interesting to see if they can be reconciled. Current betting is that something will get through but won’t look much like what the President was hoping for!
In Europe the Irish Government has almost collapsed so that is going to complexify Brexit negotiations! Germany is also still without a Government!
In Asia the problems in Myanmar continue and elsewhere the Argentinians seems to have lost a Submarine with 44 lives (pretty sad).
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The main thing this week in OZ has been the apparent instability of the Turnbull Government and Parliament delayed etc. It may get worse as the week after next is the time when foreign citizens have to confess and apparently there are 1 or 2 who are in trouble!
Also last week we had a defence White Paper released which basically seems to suggest we are going to hope the US will help us balance the rise of China. With Trump in the Whitehouse I am not sure we don’t need a Plan B!
We can be assured of a pretty wild December I suspect.
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Here are a few other things I have noticed.
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Major Issues.

Message from a techno-optimist: the kids will be OK

Jessica Irvine
Published: November 20 2017 - 12:05AM
In an increasingly rare occurrence, I found myself propping up the bar at a fancy hotel past 1am. All the bright young things of journalism were there. And me, about to unwittingly invite ridicule for my increasing techno-inadequacies. The catalyst for my humiliation? The simple act of pulling out my wallet.
There is no surer way to read a persons age these days than the simple act of paying for something. To watch our grey-haired elders make a purchase is to see pockets or purses stuffed with cash, cough drops and handkerchief or two. Me, I consider myself a modern woman. My wallet is stuffed with credit cards. I know how to Bpay.
But my wallet also contains a - potentially dangerous – secret. A little piece of moleskin notepad with a list of all my passwords written on it. Rest assured, the information stored within is written in a code only the gals at Bletchley Park could hope to break. But still. As a member of the Xennial generation – too old to be a true Millennial, too old to be a Gen X – I still struggle to keep up. Born analogue, living in a digital world.
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Labor plans further blow to Treasury power

Ross Gittins
Published: November 19 2017 - 9:47PM
It's a process that's gone on for so long few people have noticed it: the waning influence of the once-mighty federal Treasury.
There was a time, 40 years ago, when Treasury sought to monopolise the economic advice going to the federal government. But those days are long gone.
The peak of Treasury's influence came with the sweeping micro-economic reforms and opening up of the economy in the 1980s and 1990s. It first convinced its minister, John Howard, of the need for widespread reform, but he made little progress under Malcolm Fraser.
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Australia could be 'world leader' in energy storage despite public skepticism

Nicole Hasham
Published: November 20 2017 - 12:15AM
About 1.8 million Australians with rooftop solar could lower their bills and take control of their electricity supply by storing their own energy, but many fear a repeat of the failed home insulation scheme, a report has found.
The research, co-funded by the office of Chief Scientist Alan Finkel, found Australia could be a world leader in developing and exporting energy storage. However, this was being held back by a lack of effective planning, investment and incentives – partly driven by poor public knowledge of the technologies.
The report, produced by the Australian Council of Learned Academics, warned that unless storage played a greater role in the energy system, electricity costs would continue to rise and supply would become less reliable, which could severely hurt the Australian economy.
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Scott Morrison seeks hand after bank levy punch

  • The Australian
  • 12:13PM November 20, 2017

John Durie

It’s a bit rich for Scott “cry me a river” Morrison to be urging business support for tax cuts when he was instrumental in inflicting one of the more heinous big business taxes in recent memory with his bank tax.
When told about the bank reaction he replied “cry me a river for the big banks”.
Now he wants those same bank bosses out on the street handing out leaflets in support of big business tax cuts.
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Reserve Bank frets over low wage growth

  • James Glynn
  • The Australian
  • 11:35AM November 21, 2017
The Reserve Bank of Australia is nervously watching labour markets in other major economies, noting scant wage pressures even as full employment has been reached.
The global labour market trends could signal a problem for the RBA, which expects inflation to rise back to within its 2-3 per cent inflation target over time, as excess job market capacity is slowly eroded.
Wages growth has been at record lows for a number of years in Australia, helping to contain inflation.
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Housing loans still too large: APRA

  • Stuart Condie
  • The Australian
  • 9:31AM November 21, 2017
APRA remains concerned about the size of the mortgages consumers are taking on despite intervention by the banking regulator having curtailed housing market risks.
Australian Prudential Regulatory Authority chairman Wayne Byres today said limits on investor and interest-only mortgages had brought growth in investor mortgage lending back into line with owner-occupied loans.
But, he said, the size of loans being issued by the big banks remained an issue, with consumers vulnerable if historically low interest rates move upwards.
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  • Updated Nov 21 2017 at 9:36 AM

APRA targets living expenses, total debts in home lending crackdown

The prudential regulator is worried that mortgage lenders are underestimating borrowers' living expenses and total indebtedness leaving them highly vulnerable to unexpected shocks.
In stern comments made after a year of intense action of scrutiny of home lending standards Wayne Byres, the chairman of the Australian Prudential Regulation Authority said the regulator was now focusing on how lenders assessed living expenses and total indebtedness. 
He told the banks to "devote more effort to the collection of realistic living expense estimates from borrowers," as their research showed the majority of loans appeared to be assessed based on living expense benchmarks rather than borrowers' stated expenses.
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RBA flags end of certainty with automation and competition to hit workers

  • The Australian
  • 12:00AM November 22, 2017

Adam Creighton

Australia has entered an uncertain chapter of its economic ­history, marked by meagre wage growth, intense global competition among retailers, high household debt and elevated house prices, the Reserve Bank governor has declared.
In a speech in Sydney last night, Philip Lowe said automation and growing competition from foreign workers were sapping workers’ wages — now growing at their slowest pace in 50 years — and dragging down prices in ways that had confounded the Reserve Bank’s economists.
“We are still trying to understand this,” Dr Lowe conceded, ­revealing confusion at the top of the nation’s peak economic establishment that has already enveloped its counterparts in ­Europe and the US.
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Quasi-nationalisation of banks is too dangerous

  • The Australian
  • 7:07AM November 22, 2017

Robert Gottliebsen

If former Prime Minister Ben Chifley were alive today his heroes would be Treasurer Scott Morrison and APRA Chairman Wayne Byres.
I was a young boy when “pig iron Bob” (Robert Menzies) defeated the ALP hero Ben Chifley on the issue of bank nationalisation in the 1949 election. I suspect Menzies’ promise to end food rationing attracted more votes but at least for the record books the government changing issue was bank nationalisation. Neither Morrison nor Byres have any intention of nationalising the Australian banks but instead have embarked on a program of quasi-nationalisation. Under quasi-nationalisation the government or government organisations take away or modify the key decision making and key appointment powers, normally the province of boards and top management. And the 2017 attack on bank management is made all the more potent by the ASIC writs on the banks over market manipulation and the AUSTRAC action against the CBA bank over money laundering, plus the ALP push for a Royal Commission into banking. This is an unprecedented attack on an Australian industry - let alone the industry that hosts the bulk of our savings, both equity and loan.
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RBA Governor rules out rate rises as he blames employers for low wage growth

Peter Martin, Eryk Bagshaw
Published: November 22 2017 - 2:14AM
Reserve Bank governor Philip Lowe has pointed the finger at employers for Australia's extraordinarily low growth in wages, saying they are not paying more despite the tightening jobs market.
Partly as a result, he said, the bank was unlikely to increase interest rates in the "near term".
Addressing business economists in Sydney Tuesday night, Dr Lowe said that as long as Australia remained short of full employment and wage growth and inflation remained low, the Reserve Bank's cash rate would remain "accommodative".
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Here's how much your bank is stiffing you for being loyal

Michael Pascoe
Published: November 21 2017 - 7:31PM
What's your bank loyalty worth? The better part of $5 billion a year. Well that, of course, is what it's worth to the banks – what it's theoretically costing existing customers who don't shop around.
The story is told in the accompanying graph from the Reserve Bank's head of domestic markets, Marion Kohler.
What it quantifies for the first time is how much more banks are prepared to discount interest rates for new customers, compared with what they charge their existing, loyal customers. And the discount has increased over the past couple of years.
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Malcolm Turnbull's tax cut news scant on detail – but it will have an effect

Ross Gittins
Published: November 21 2017 - 6:38PM
Yippee! It's almost Christmas and Malcolm Turnbull has dropped a big hint that tax cuts are coming. Good old rich Uncle Mal has been to see his bank manager, got the overdraft extended, and is determined we'll all have a great Chrissie, no matter what.
Actually, it's all a bit vague at this stage. We don't yet know whether the cuts will even be announced before Christmas, let alone when they'll be delivered. Nor do we have any idea whether they'll be large, small or indifferent.
Wouldn't surprise me if they were on the small side, nor if we got them only as a reward for voting Turnbull back into office at the next election, to be held late next year or in the middle of 2019.
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  • Updated Nov 22 2017 at 5:45 PM

Chris Richardson: Hello personal income tax cuts, goodbye budget surplus

Turnbull's tax cut
by Chris Richardson
Tax cuts got flagged by the Prime Minister on Monday night, but I'm not cheering.
After all, the Australian economy doesn't need any support from tax cuts. Job growth is a thing of beauty, unemployment is relatively low, and the world economy is in the best shape it's been for years.
And the task of budget repair certainly doesn't need them – by definition, tax cuts hurt budget repair.
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Personal income tax cuts a question of mathematics for Canberra

Shane Wright, Economics Editor, Analysis
Wednesday, 22 November 2017 10:26AM
Tax cuts are governed by mathematics.
In the case of the Federal Budget, the Government is banking on a surge in personal income tax receipts to bring the nation back into the black.
Over the next four years, tax siphoned from the wages of ordinary Australians is set to climb to a record $259 billion.
It’s driven by a huge step-up in wages growth and the Government’s increase in the Medicare levy to help cover the cost of the National Disability Insurance Scheme. The extra $50 billion in tax is the reason Treasurer Scott Morrison and Prime Minister Malcolm Turnbull believe the Budget will show a surplus in 2020-21.
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Wages-unemployment model 'close to broken': UBS

Liam Cormican
Published: November 22 2017 - 1:08PM
It is a mystery that is confounding economists - why is wage growth at record lows when the economy is not all that far off full employment?
UBS chief economist George Tharenou has said the Phillips curve - an economic model that describes the inverse relationship between unemployment and wage inflation - is "close to broken".
Mr Tharenou said Australia had the necessary conditions to push wages higher, if the Phillips curve was anything to go by.
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Reserve Bank reveals 'considerable uncertainty' over wages

Eryk Bagshaw
Published: November 21 2017 - 2:15PM
The Reserve Bank has played down expectations of wage rises for Australian workers and offered little hope to struggling retailers in an economic assessment that has pushed forecasts for the next interest rate rise until the end of next year. 
In the minutes of its November meeting, released on Tuesday, the central bank appeared to concede that the experience of other advanced economies - where growth in wages had been low despite ongoing reductions in unemployment - might be unavoidable in Australia. 
Globalisation and technology were likely to blame, the board found, which had led "wage growth to be less responsive to changes in the demand for labour, which could continue for a while". 
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  • Nov 23 2017 at 2:48 PM

A decade of bad government since the Rudd government was elected

Friday marks 10 years since the Rudd government was elected. It's 10 years to the day since Australia last had good government.
On 24 November 2007, after portraying himself as "John Howard-lite", Kevin Rudd became prime minister. Some might argue it's been downhill for the country ever since. It's also a measure of how much the country has changed that in 2017 the Coalition now sees its path to popularity as being "Labor-lite".
Saying we haven't had good government for decade is not to say there haven't been some good things governments have done. Julia Gillard made some worthwhile efforts in school education, while Tony Abbott restored a measure of integrity to the country's immigration policies.
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  • Updated Nov 23 2017 at 7:19 PM

Canberra's endemic short-termism should terrify the RBA, and the rest of us

For much of the past decade – and Friday marks exactly 10 years since the election of Kevin Rudd – economic leadership has been heavily underwritten by the Reserve Bank of Australia.
The big bank not only had the ammunition to act whenever the big house in Canberra descended into one of its regular spasms of farce and dysfunction. It showed a willingness to deploy its interest-rate cutting tool when the adults went AWOL. That can't go on forever.
Government after government has flailed and flopped. We've had five prime ministers over that time and some of the more wild-eyed dupes out there are knuckle pounding the ground for a third Coalition PM, as if that will work.
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The billionaires have started something. Now to make it work

Peter Martin
Published: November 24 2017 - 6:43AM
On the face of it, $2 trillion in super funds needing a home and tens of thousands of Australian businesses needing long-funding is a match worthy of The Bachelor, or The Bachelorette.
Even more so, when you consider how poorly matched things are at the moment. Australian super funds have an outsized half of their funds invested in share markets. Overseas it's more like 10 per cent. Beyond share markets, commercial properties and government bonds, they are poorly diversified.
At the same time Australia's biggest corporations, giants such as BHP, have to head overseas when they are looking for finance, even though a few blocks away in Melbourne there are hundred of billions of our dollars looking for a home.
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Trust deficit: Cabinet leaks and poor polls see risks multiply

Mark Kenny
Published: November 23 2017 - 3:44PM
Among the overreactions a weakened Prime Minister can commit is to order a leak inquiry into his own cabinet.
Leaks are a serious thing but nothing screams dwindling authority and dysfunction like a probe into the integrity of the most trusted council of the executive. 
Quite apart from the fact that such forays are usually inconclusive, there's the obverse danger of it turning up a villain. Man overboard, no question. From inconvenience to full-blown crisis.
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  • Nov 24 2017 at 10:09 AM

Australia faces housing hangover twice size of US subprime era

by Chris Bourke
The party is finally winding down for Australia's housing market. How severe the hangover is will determine the economy's fate for years to come.
After five years of surging prices, the market value of the nation's homes has ballooned to $7.3 trillion - or more than four times gross domestic product. Not even the US and UK markets achieved such heights at their peaks a decade ago before prices spiralled lower and dragged their economies with them.
Australia's obsession with property is firmly entrenched in the nation's economy and psyche, fuelled by record-low interest rates, generous tax breaks, banks hooked on mortgage lending, and prime-time TV shows where home renovators are lauded like sporting heroes. For many, homes morphed into cash machines to finance loans for boats, cars and investment properties. The upshot: households are now twice as indebted as China's.
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Has spring sprung in the economic garden?

Ross Gittins
Published: November 25 2017 - 12:15AM
With the year rapidly drawing to a close, the chief manager of the economy has given us a good summary of where it looks like going next year. The word is: we're getting back to normal, but it's taking a lot longer than expected.
The chief manager of the economy is, of course, Reserve Bank governor Dr Philip Lowe, and he gave a speech this week.
For years Lowe and others have been tell us the economy is making a difficult "transition" from the resources boom to growth driven by all the other industries. But now, he says, it's time to move to a new narrative.
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'It would have been devastating': Kevin Rudd reveals emergency call to George W Bush to avert GFC disaster

Peter Hartcher
Published: November 25 2017 - 6:30AM
 As a contrast in prime ministerial retrospectives, it's a cracker.
This week, on the 10th anniversary of John Howard losing power to Kevin Rudd, the two former prime ministers were asked to look back on their terms in office.
In hindsight, Sky's David Speers asked Howard, is there anything you would do differently? "Probably not," he replied.
Which is pretty remarkable for a man who as prime minister served four terms, waged five campaigns and made decisions daily for nearly 12 years. Especially when his term included such utter disasters as the Iraq war.
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Thanks to Canberra for Australia’s lost decade

  • The Australian
  • 12:00AM November 25, 2017

Alan Kohler

As well as being full of buzz around Amazon’s entry into this country as a full-scale online retailer, yesterday was also the 10th birthday of a decade of bad government in Australia (the election of Kevin Rudd as prime minister).
Arguably bad government actually started in 2006 with two successive budgets that rained $58.4 billion in permanent tax cuts on an ultimately ungrateful citizenry, based on a temporary mining boom, but let’s go with November 24 for the sake of symmetry.
What’s the connection with Amazon? Well, November 2007 is roughly when Australia’s political agenda started to be ruled by climate change to the exclusion of most other things, and also when the world started to change. Amazon in Australia is one of the culminations of that. The online bookseller launched the Kindle e-book reader in November 2007, and Google and a group of partners launched the Android operating system in the same month.
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National Budget Issues.

Scott Morrison urges company CEOs to support government's tax cuts

Matt Coughlan
Published: November 20 2017 - 10:04AM
Federal Labor is maintaining its opposition to the government's plan for further cuts to company tax after the treasurer called on CEOs to take up the fight for tax cuts on its behalf.
Treasurer Scott Morrison has written to hundreds of corporate leaders asking for their support.
But Opposition Leader Bill Shorten says his party won't budge on the government's proposal to reduce the corporate tax rate to 25 per cent over the next decade.
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Malcolm Turnbull flags tax cuts as IMF talks of a year of steady interest rates

Peter Martin, James Massola
Published: November 20 2017 - 8:00PM
Prime Minister Malcolm Turnbull has flagged tax cuts for millions of Australians in the lead-up to the next federal budget, or sooner if an election is called early next year.
In a move that will draw clear battlelines between the Coalition and Labor ahead of the election, Mr Turnbull told a Business Council of Australia dinner in Sydney that work on the tax cut was already under way.
"You know our plans on corporate tax. In the personal income tax space, I am actively working with the Treasurer and my cabinet colleagues to ease the burden on middle-income Australians, while also meeting our commitment to return the budget to surplus," he said.
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Health Budget Issues.

  • Nov 19 2017 at 11:00 PM

Health insurance pressure can only crimp margins

by Sean Fenton
The ageing population in Australia has been a strong structural factor driving demand for hospital services. To help pay for this the government has promoted private health insurance with a carrot and a stick.
The carrot of private health insurance rebates has been augmented by the stick of Medicare levy surcharges and lifetime healthcare loading for non-participants. These policies have helped drive private health insurance participation higher and has been a boon for private hospital operators and the private health insurers alike.
However, this dynamic is under threat as affordability issues have seen people start to downgrade their policy cover or drop out altogether.
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Canberra Centre for Personalised Immunology has proved life-changing

Daniella White
Published: November 19 2017 - 11:45PM
Seemingly out of nowhere, Emily Stokes woke up one day unable to move.
She had come down with a mysterious rash the day before, but there were no other warning signs of her debilitating condition.
"Some mornings I can't talk, I can't eat," she said.
"I couldn't do anything for myself, you don't realise how much you need your hands until you can't use them."
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Health system ‘fails the dying’: myths ‘shroud’ end of life care

  • The Australian
  • 12:00AM November 20, 2017

Olivia Caisley

It is a “myth” that more Australians would prefer to die at home and what they really want and need is access to better and more comprehensive palliative care in hospitals, a report says.
The Centre for Independent Studies report, Life Before Death: Improving Palliative Care for Older Australians, says that of the 130,000 Australians who should have received palliative care last year, only 14,300 did, raising questions about how hospitals will accommodate the needs of an ageing population.
It says Australia’s health system has failed to evolve in line with increasing life spans and patient needs where the majority of elderly Australians now die from chronic disease.
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$600m hospital bill blowout for commonwealth

  • The Australian
  • 12:00AM November 21, 2017

Sean Parnell

The federal government paid out $600 million more than anticipated for public hospital services in 2015-16 — an unforeseen increase of more than 4000 per cent in some locations — and is withholding a similar amount from the states after a highly contentious review.
The Australian revealed in ­August that the commonwealth had ordered a review of hospital activity and funding after discovering unusual growth in non-­admitted services in 2015-16. It has since emerged the review was ­secretly initiated by Treasurer Scott Morrison.
While some states expressed concern the review was an attempt to strip them of hundreds of millions of dollars, Health Minister Greg Hunt said it was important to understand why there had been unexpected growth of more than 4000 per cent in some areas.
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Government’s one-stop healthcare shop on life support

  • The Australian
  • 12:00AM November 22, 2017

Sean Parnell

The Turnbull government’s flagship primary care initiative, a $111 million, two-year trial of Health Care Homes, has suffered from a lack of awareness and support among consumers, according to internal research.
If the research commissioned by the Department of Health is an accurate indicator of public sentiment, the 200 sites selected for the trial may struggle to recruit 65,000 participants. This is despite the initiative being in the works for well over a year.
The ORC International research, completed in July and obtained by The Australian under Freedom of Information laws, found “not one person offered an accurate definition” of Health Care Homes and many had questions even after it was explained to them. “The name ‘Health Care Home’ does not work,” the research concluded.
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No 'free kicks' from government for healthcare industry, says Primary Health boss

Nassim Khadem
Published: November 23 2017 - 2:58PM
 The pathology industry has "reached the limit" when it comes to consolidation and after years of being squeezed on fees, says the boss of one of Australia's leading healthcare companies, Primary Health Care.
Malcolm Parmenter took over as the company's managing director in September, after former CEO Peter Gregg's decision to step down in May to fight charges of falsifying company records when he was at Leighton Holdings.
After a long fight with the healthcare industry for most of last year, the Turnbull government was forced to scrap plans to dump incentive payments for pathology and diagnostic imaging.
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St Vincent's Hospital calls in external consultants to staunch $18 million blowout after touting on budget performance

Kate Aubusson
Published: November 25 2017 - 12:15AM
A budget-blowout at St Vincent's Hospital Sydney will force staff to find $18 million worth of cuts as external consultants are called in to audit the hospital's services. 
The hospital's financial woes blindsided doctors who spoke to Fairfax Media, after a memo from the executive in September celebrated St Vincent's on budget performance in 2016-17 "in the face of extraordinary activity levels". 
But in an email to staff earlier this week, chief executive Anthony Schembri said "over the past months our financial position throughout St Vincent's Health Network has been challenged". 
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http://www.abc.net.au/news/2017-11-24/deaths-from-prescription-drug-fentanyl-up-by-1800pc/9184396

Fentanyl crisis: Figures show 1,800pc rise in overdose deaths from potent painkiller

RN
By Hagar Cohen and Tiger Webb for Background Briefing
Deaths from the potent prescription drug fentanyl have rapidly increased in Australia, with a senior doctor calling the trend a "national emergency".
A report from the National Coronial Information Service (NCIS), commissioned by Background Briefing, shows 498 fentanyl-related deaths occurred between January 2010 and December 2015.
This figure marks an 1,800 per cent increase on the previous decade, where NCIS data records 27 fentanyl-related deaths.
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International Issues.

Angela Merkel's 'Jamaica coalition' in jeopardy as deadline passes

Abby Young-Powell
Published: November 20 2017 - 9:39AM
Berlin: Angela Merkel's political future is hanging in the balance after political parties last night failed to meet a self-imposed deadline to form a new government.
Talks were due to end on Sunday at 6pm, but no agreement was in sight at the appointed hour, and negotiators signalled that talks could once again run into the night.
Disagreements around immigration have been a major part of the discussions after Germany's open-door policy to refugees in 2015 and the differences could prove irreconcilable.
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Robert Mugabe resigns as Zimbabwe president

Norimitsu Onishi and Jeffrey Moyo
Published: November 22 2017 - 11:05AM
Harare: Robert Mugabe, who has ruled Zimbabwe since independence in 1980, resigned as president on Tuesday shortly after lawmakers began impeachment proceedings against him, according to the Speaker of Parliament.
The Speaker read out a letter in which Mugabe said he was stepping down "with immediate effect" for "the welfare of the people of Zimbabwe and the need for a peaceful transfer of power".
Lawmakers erupted into cheers, and jubilant residents poured into the streets of Harare, the capital. It seemed to be an abrupt capitulation for Mugabe, 93, the world's oldest head of state and one of Africa's longest-serving leaders.
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  • Updated Nov 23 2017 at 12:00 AM

Alarm bells ring on China's rise in foreign policy white paper

The Turnbull government is warning that China's increasing belligerence over territorial disputes and potential clash over democratic values calls for stronger efforts to maintain American presence in Asia and to bolster ties with neighbouring democracies as a check against Beijing's rise.
Without US political, economic and security engagement in the region, power would shift too rapidly to Beijing to Australia's detriment, the government's Foreign Policy White Paper says as it strikes a hawkish tone about Beijing's behaviour. 
The white paper, to be released on Thursday by Prime Minister Malcolm Turnbull, Foreign Minister Julie Bishop and Trade Minister Steven Ciobo, redefines Australia's most important strategic focus to the Indo-Pacific region and expands it from south-east and north-east Asia to include India and the Indian Ocean.
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How a worried Australia should deal with a mighty and demanding China

Peter Hartcher
Published: November 23 2017 - 12:15AM
Australia is a country worried about a future under a mighty and demanding China, and afraid that American leadership has already checked out.
Those concerns have been the motive behind the Turnbull government's white paper on foreign policy. And the white paper itself is the government's plan for what to do about it.
A breakthrough concept in the paper is that Australia should start something it has never done before. Balancing.
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Australia needs to engage China and hedge the risks of this relationship

  • The Australian
  • 12:00AM November 25, 2017
Independence is a powerful, unifying idea that has coursed through Western history from Thermopylae to Catalonia, inspiring nations to greatness and sometimes war. But Australia’s march to independence was relatively uneventful and prosaic. Statues of iconic liberators are notably absent in our cities and towns because there was no war of independence or bloody struggle to throw off the colonial yoke.
Whether through the absence of heroic sacrifice or our sometimes obsessive need for great and powerful friends, it is remarkable how perceptions that Australia lacks foreign policy independence persist more than a century after our formal separation from England.
Russian Foreign Minister Sergei Lavrov is reported to have dismissed Australia “as not a real country”. Many of our Asian neighbours still regard Australian foreign policy as subservient to Washington’s, a position echoed by domestic critics such as Paul Keating, who castigates the government for ceding foreign policy to the US.
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Egypt launches air strikes after deadly mosque attack

Farid Farid
Published: November 26 2017 - 2:07AM
Cairo: Egypt raised its security alert to the highest level on Saturday as it emerged that the Islamic State may have been behind a mosque attack in the restive north Sinai in which more than 300 people died, the most lethal single assault in the country's recent history.
Hours after the midday attack on Friday, the military said it launched overnight airstrikes that destroyed vehicles believed to have been used in the gun and bomb attack on the mosque west of the city of Al-Arish.
There has been no claim of responsibility, but analysts said it bore the hallmark of an Islamic State affiliate that operates in the area and highlighted the challenges President Abdel-Fattah El-Sisi faces restoring security and reviving economic growth after years of upheaval since the 2011 Arab uprisings.
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I look forward to comments on all this!
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David.

It Looks Like The Opioid Epidemic Is Staring To Really Hit Here In Australia.

This week Radio National has run two programs on our increasing problem with opioid over and mis-use.
First we have this:

Are doctor-shoppers really at the heart of our opioid crisis?

Tuesday 21 November 2017 5:30PM
Around 600 Australians die each year from prescription drug overdoses, and the figure rises each year.
When it comes to prescription opioid overdoses, they involve members of the community we might never normally associate with addiction.
To tackle the epidemic, Australia is to introduce Real Time Prescription Monitoring next year, but is it enough?
If this program raises any issues for you or anyone close to you please contact Lifeline, 13 11 14, which has a special addictions support service.
Here is the link:
and second we have this:

Prescription killer: Australia's imminent fentanyl epidemic

Sunday 26 November 2017 8:05AM
Fentanyl is the prescription opioid so deadly a dose the size of ten grains of sand can kill you.
In the US it's fuelling a national emergency, making up a third of all drug overdoses there.
New exclusive figures show alarming numbers of Australians are dying from fentanyl overdoses at increasing rate.
Undercover recordings show just how easy it is to get. Hagar Cohen investigates.
Here is the link:
Both shows have transcripts or you can download the audio and listen.
Overall one gets the sense that this is a complex problem, will need carefully thought out solutions and that real time prescription monitoring will help but needs to be part of a wider program.
Hardly a surprise given the complicated causes that have got us to where we are with so many addicted and sadly dying.
David.

Wednesday, November 29, 2017

I Think I Have Been Making This Point For Years - The myHR Does Not Know What It Wants To Be!

This appeared a few days ago.

A GP diagnoses My Health Record's ills

21 November 2017

COMMENT

The main problem is that it's a bureaucrat's solution which tries to be all things to all people, an anonymous GP writes.
The MyHealth Record is like my garden. You can stick fancy plants in, ask people the flower they want to see blossom and plant those too. It needs money, too, but then it will look very pretty. Then, no matter what you do, the plants suddenly wilt and die and the garden is left barren.
There is an alternative to health IT horticulture: you spend your time fertilizing the soil, digging it, nurturing the local ecosystem, and then sow tiny inexpensive seeds. Some germinate, grow and flower, some fail. But you learn what works.
Last year we were nearly self-sufficient in vegetables and herbs all year. And that only took two years.
How long has the My Health Record been going for now?
The trouble is this: it's not a clinical record, nor is it a true patient record. It’s something that is trying to be all things to all people – to patients, to politicians, to health department officials, to emergency doctors, hospital doctors, nurses, to private specialists, after-hours doctors, allied health workers and the neighbour’s dog.
But it’s a bureaucrat’s solution to a bureaucrat’s notion of the communications issues plaguing the health system. These solutions need to be clinically lead and clinically implemented — properly — not just token consultations so that someone in a suit can tick a box and say they’ve listened.
The My Health Record is built on a variety of assumptions: that more documents are better; that patients want and need access to everything; that patients have the necessary health literacy to use it in a way that will inform their health choices.
And it is built on the assumption that just accessing this information treasure trove without context or discussion is useful.
More here:
I would have to say this really gets it! As I have said often enough you cannot make an EMR that is ideal for clinician use while at the same time expecting the same record to provide a compelling consumer experience – forgetting all the other actors who want to have their problem solved!
The sooner we stop this madness the better in my view!
David.