Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, June 21, 2018

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

June 21, 2018 Edition.
After last week it is hard to be sure just what comes next other than there seems to be more and more sabre rattling on trade with China, Canada and the EU. It is more than possible this ends badly.
In OZ we have a fevered 2 weeks of parliament and the Royal Commission starts up next week in Brisbane – so lots of headlines to cope with there!
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Here are a few other things I have noticed.
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Major Issues.

Economists: male, upper class, out of touch

By ROSS GITTINS
10 June 2018 — 6:27pm
Could there ever be a shortage of economists? And if there were, would that be a bad thing?
At the risk of being drummed out of the economists’ union, it wouldn’t be a big worry of mine.
What I do find of concern is the decline in the number of students studying economics at school and university, as outlined by the Reserve Bank’s Dr  Jacqui Dwyer in a recent speech.
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Odds shorten on a Turnbull backflip to a spring poll

By Mark Kenny National affairs editor
9 June 2018 — 4:43pm
Labor is quietly preparing for a spring election, despite Malcolm Turnbull's continued assurances of a 2019 poll.
Sources confirm the Opposition has recently stepped up its internal processes for completing policy documents, finalising candidates, and mapping out its media buys.
The flurry of activity reflects Labor's hard-headed assessment of the electoral landscape spearheaded by a particular wariness about the super-Saturday byelections on July 28.
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Security bill will muzzle human rights activists

By Claire O’Rourke
11 June 2018 — 12:05am
In this era of so-called “fake news”, civil society plays a critical role in holding governments to account.
And yet, with Labor capitulating to the government on the proposed National Security Legislation Amendment (Espionage and Foreign Interference) Bill, it may soon become a crime to hold the Australian government to account on its human rights record. The truth itself would not be a defence.
By joining regimes around the world in passing new, restrictive laws attempting to suffocate civil society under pretexts of "treason" and "security", the opposition and government are lurching towards authoritarianism.
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In Australia's relentless culture wars, Tony Abbott strikes again

By Tony Walker
10 June 2018 — 11:52pm
Nothing, it seems, stirs the blood of the country’s cultural warriors more than an argument about academic license or press freedom if it’s not favourably disposed to their side.
One is tempted to ask what would these mavens of "political incorrectness" do without academia and the ABC to rail against; although it might be observed that one person’s political correctness is another person’s political incorrectness.
Take the question of whether the Australian National University should have accepted money from a private body to establish a course in Western civilisation, aimed at educating a new generation in the foundations of our own society in the broader sense.
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Special forces case could forge new legal territory, experts say

By David Wroe
11 June 2018 — 7:30pm
Military legal experts say any prosecutions following the inquiry into some special forces soldiers’ conduct in Afghanistan would enter new legal territory for Australia and would face challenges establishing sufficient evidence.
David Letts, a former naval officer who now heads the Australian National University’s military law program, said the closest previous comparison in Australia was the charging of two Australian commandos after the death of five children in Afghanistan.
Those charges were dropped by the Director of Military Prosecutions before it went to a court-martial.
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The dark side of personal data and why it pays to care about it

By Nigel Gladstone
11 June 2018 — 11:53pm
A ''renaissance man'' who started a billion-dollar technology company is aiming to enlighten the "dark side" of data and change how the internet pays for the stuff we put in our brains.
Jim McKelvey is an engineer, author and the co-founder of Square, a company worth more than $20 billion that allows credit cards to be accepted as payment on a smartphone. He is also a master glass artist, works for the Federal Reserve as an independent director in St Louis, founded a non-profit organisation called LaunchCode, and is building a new "business-model stack” for the media industry.
In Sydney last month to talk about the "dark side of data", Mr McKelvey spoke to the Herald about why personal data matters - "it can be ransomed for bitcoin" - and the risk from people "drowning in data", and losing control of their information.
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Time to judge our wars in Iraq and Afghanistan

By Travers McLeod
11 June 2018 — 11:12pm
 “We will never forget that 100 years ago a young and brave nation on the other side of the world made history by writing our history. Lest we forget.”
So ended French Prime Minister Edouard Philippe’s tribute to the Anzacs in April this year at the opening of the Sir John Monash Centre at Villers-Bretonneux.
Compare this to what a former Afghan refugee who calls Australia home wrote after Fairfax Media reported our special forces may have committed war crimes in Afghanistan.
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Clouds over world economy 'getting darker by the day'

12 June 2018 — 1:01pm
IMF managing director Christine Lagarde says the risks to the global economy are rising as major industrial nations sharpen threats of a trade war.
"The clouds on the horizon that we have signalled about six months ago are getting darker by the day - and, I was going to say, by the weekend," Ms Lagarde said at a news conference in Berlin on Monday.
Her remarks follow a chaotic two-day meeting of the Group of Seven in which US President Donald Trump shocked fellow leaders with his disregard for US allies. After leaving the summit early, Mr Trump tweeted he was pulling US support from a joint statement and he accused the host, Canadian Prime Minister Justin Trudeau, of being weak and dishonest.
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  • Updated Jun 12 2018 at 11:00 PM

Retirement incomes: how does Australia stack up?

by David Knox
How does Australia fare globally when it comes to retirement incomes?
Our superannuation savings framework is often highlighted as a long-term success of the decisions made in the 1980s and 1990s. Yet the latest OECD numbers show that the system is not delivering an acceptable level of retirement income across all wage earners.
When compared with 10 other countries with similar economies, Australia's results are skewed.
Odd as it may seem, Australia's wealthiest and the very poorest are doing well from our compulsory superannuation system. But average wage earners are not. This incongruity means that the system is far from perfect.
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The small improvements that could deliver a big boost to our wellbeing

By Matt Wade
12 June 2018 — 7:13pm
Australia is back at the “top of the global leader board”. That’s how Treasurer Scott Morrison framed things when official economic growth figures last week showed gross domestic product expanded by 1 per cent in the first three months of the year, the best quarterly result in six years.
But a few days earlier another gauge of national performance, for exactly the same period, told a very different story.
NAB’s Australian Wellbeing Index dropped for the third successive quarter to the lowest mark since it began five years ago.
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Blocking foreign meddling in our affairs

13 June 2018 — 12:05am
The resignation of former Senator Sam Dastyari late last year got Labor out of a tight political spot but solved none of the underlying problems that had led Mr Dastyari into strife in the first place. They are problems that go to the heart of the way countries seek to influence each other's internal affairs in the digital age.
Mr Dastyari's undoing came after a joint Fairfax Media-ABC investigation revealed startling new details of the "soft power" exerted over our political system by China's Communist Party. That reporting showed how vulnerable our system is to the distortions of lobbying, often accompanied by political donations, by agents of foreign governments – without the usual diplomatic formalities and all done far away from the glare of media or public scrutiny.
And the challenges do not end there. In the digital age, as the 2016 US election showed, foreign powers can cause havoc during election campaigns by exploiting the anonymity of the internet to seed division, misunderstanding and "fake news".
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  • Jun 13 2018 at 11:12 AM

Sydney's housing bubble deflates as loans revisit GFC declines

by Michael Heath and Garfield Reynolds
Australia's east-coast property bubble is showing signs of deflating at a faster clip as home-lending data recorded the longest losing streak in almost a decade.
Housing finance fell 1.4 per cent in April, the fifth straight monthly drop and the longest stretch of declines since September 2008, when Lehman Brothers collapsed and a month before the Reserve Bank of Australia slashed its key interest rate by a per centage point.
The downturn is most prominent in Sydney where prices slid 4.2 per cent in May from a year earlier, when they were rising at an annual pace of 17 per cent. Sales at auctions have slumped to the lowest since early 2016 in Australia's biggest city, with only around half of properties successfully selling.
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  • Jun 13 2018 at 1:20 PM

RBA governor Philip Lowe warns weak wages may see inflation fall short of target

Reserve Bank of Australia governor Philip Lowe has warned the current pace of wages growth is not compatible with his goal of keeping inflation at 2.5 per cent, is eroding the nation's "sense of shared prosperity," and makes much-needed productivity enhancing economic reforms more difficult to achieve.
Reiterating that the Reserve Bank expects wages growth will gather pace as unemployment falls, Dr Lowe said a return to a world where wage increases start "with a 3 rather than a 2 is both possible and desirable".
"This is not a call for a sudden jump in wages growth from current rates to 3-point-something. Rather, we will be better off if this increase takes place steadily over time as the economy improves."
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  • Jun 13 2018 at 4:30 PM

Is an Australian financial crisis on the cards?

Household leverage may have peaked, house prices are falling, and credit conditions are tightening. The combination of the three should have all of us asking: what next?
The question is crucial because Australia is one of the few economies to have increased its debt burden since the global financial crisis. Household debt to GDP has tailed off a touch of late, but sits at record highs of around 120 per cent. The next nearest is Canada, at 100 per cent. We also have one of the highest household debt-to-income ratios in the world: 190 per cent. Five years ago it was 160 per cent.
"Economic history shows that there is usually a consequence of a prolonged period of rapidly rising debt, the only question is: how bad will the consequence be", Capital Economics chief Australia economist Paul Dales writes in a provocatively titled new report "Is a financial crisis looming?".
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Pink tax versus blue tax: the case for taxing women lightly

By Peter Martin
13 June 2018 — 7:41pm
If women were to be taxed differently to men, it wouldn’t be the first time.
Treasurer Scott Morrison says the idea is absurd.
“You don’t fill out pink forms and blue forms on your tax return. It doesn’t look at what your gender is any more than it looks at whether you are left-handed or right-handed,” he said last week.
He even said, wrongly, that Labor has been suggesting it.
But such a move has happened before.
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Ramsay Centre controversy a high-stakes affair

By John Warhurst
13 June 2018 — 10:00pm
The controversy surrounding the rejection by the Australian National University of the proposal by the Ramsay Centre for a large private donation to support a new area of study in Western Civilizations has become the subject of hostile newspaper editorials and assertive current affairs interviews of the ANU Vice-Chancellor, Brian Schmidt. Even the Prime Minister has got into the act.
Another ANU entity, the Centre for Arab and Islamic Studies, has been dragged into the furore, as have other institutes and donors elsewhere in the Australian university system, such as China’s Confucius Institutes. The ANU, not for the first time, has felt compelled to defend the Centre for Arab and Islamic Studies and indirectly its director, Professor Amin Saikal.
This is a high-stakes affair. The players could hardly be more prominent. On one side the Ramsay Centre’s funds come from a bequest by the late health care industry billionaire Paul Ramsay. Its public spokesman is Australia’s second-longest serving prime minister, John Howard. Behind Howard, tossing political hand-grenades, is another former prime minister, Tony Abbott.
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Brian Schmidt: At the end of the day, it's a matter of principle

By Brian Schmidt
7 June 2018 — 5:56pm
The news came yesterday that Australian National University remains ranked by QS as No. 1 in Australia and in the top 25 universities in the world. We take this global reputation seriously – one that is built on the basis of academic autonomy and free academic inquiry.
The ANU has declined donations in the past and will again where we are unable to meet the donor's wishes within our normal practices. It is right that we explore opportunities openly and in good faith, but it is also right that we let prospective donors know when we cannot provide them with what they want.
Our decision to end negotiations with the Ramsay Centre for Western Civilization has attracted a great deal of interest. In this case, the prospective donor sought a level of influence over our curriculum and staffing that went beyond what any other donor has been granted, and was inconsistent with academic autonomy.
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  • Updated Jun 14 2018 at 11:23 AM

This is why productivity growth has slowed so much

We live in an age judged to be one of exciting technological change, but our national accounts tell us that productivity is almost stagnant. Is the slowdown or the innovation an illusion? If not, what might explain the puzzle?
The slowdown, if true, matters. As Paul Krugman, also a Nobel laureate, argued, "Productivity isn't everything, but in the long run it is almost everything." Improvements in standards of living depend almost entirely on rising output per worker.
The productivity slowdown is a major explanation for the stagnation in real incomes and the pressure for fiscal austerity in high-income countries. Gene Grossman of Princeton and three co-authors even argue that the marked slowdown in the growth of incomes per head also explains the decline in labour's share of national income in wealthy countries.
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Zombie alert! Fed and ECB's next moves could expose the living dead

By Stephen Bartholomeusz
Updated14 June 2018 — 1:04
When the history of the global economy post-crisis is written, this week might be seen to have provided a significant moment - and one not necessarily universally positive.
At face value, the US Federal Reserve board's decision to raise the federal funds rate by 25 basis points -- the second increase this year and the sixth since late 2015 – is an endorsement of the strength of the US economy and the progress in normalising US monetary policy.
The Fed flagged another rate rise later this year and, by a slender majority, indicated there might even be a fourth. With US GDP growth pushing towards 3 per cent, the unemployment rate falling below 4 per cent and inflation around 2 per cent it signalled the trajectory of rates is steepening.
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Brace yourself: Why the fallout from the next GFC will be much worse

By Satyajit Das
13 June 2018 — 10:18am
No one can predict how bad the next financial crisis will be. What's certain, though, is that a lack of liquidity will make the fallout much worse.
Holders of shares, currencies and commodities need trading liquidity so they can adjust positions, raise cash to meet redemptions, reduce their risk, or limit losses. Yet they seem to anticipate more liquidity than there actually is.
Outside of a few stocks, major currencies and some government securities that trade consistently in large volumes, few instruments are truly liquid. High trading volumes and low bid-offer spreads [low differences between the highest price a buyer is ready to pay and the lowest price a seller is willing to accept] are misleading. Earlier this month, as political chaos gripped Italy, volumes shrank and the bid-offer spread tripled with alarming speed.
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On the down Lowe: it's workers who will experience the real penalties

By Jenna Price
Updated15 June 2018 — 7:32amfirst published 14 June 2018 — 10:00pm
Here are two oppositional forces at work: the governor of the Reserve Bank Philip Lowe with a reprise of the song he has been singing since last year; and the latest round of cut to penalty rates which begins on July 1.
What's he singing?
He's singing Pink Floyd's Another Brick in the Wall, an anthem about alienation. Not exactly. He is a bit too reserved (ahem) for that. But the themes are more or less the same. We need higher wage growth for a happier Australia (yeah, I'm paraphrasing but only a little).
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Employment comes off the boil — now for the NDIS factor

  • The Australian
  • 12:00AM June 15, 2018

Judith Sloan

Yesterday’s labour force figures were really not much to crow about, even though the Prime Minister gave it his best shot. The rate of employment growth is clearly slowing after the bumper year that was 2017.
The number of employed people increased by only 12,000 in May and the fall in the rate of unemployment — from 5.6 per cent to 5.4 per cent — reflected a drop in the participation rate. For the year to May, overall employment grew 2.6 per cent, but note that the population is growing at the rate of 1.6 per cent.
Full-time employment actually fell almost 21,000 (in seasonally adjusted terms) last month whereas part-time employment rose nearly 33,000. In 2017, three-quarters of new jobs over the calendar year were full-time.
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Evolutions in Growth, Trade and Geopolitics

PIMCO’s Global Advisory Board discusses the outlook for major economies and geopolitical developments.
By Global Advisory Board June 2018
The six members of PIMCO’s Global Advisory Board, a team of world-renowned macroeconomic thinkers and former policymakers, recently joined the discussion at PIMCO’s annual Secular Forum, where they addressed critical factors likely to shape the global economy over the three- to five-year horizon. The board’s insights constitute a valuable input into PIMCO’s investment process. The discussion below is distilled from their far-ranging conversation.

Q: What is the outlook for U.S. growth, business sentiment and monetary policy over the secular horizon?

A: Tailwinds supporting continued U.S. growth, at least over the early part of the secular timeframe, include the synchronized global recovery, accommodative financial conditions, tax reform, the regulatory environment and the fiscal policy impulse. Demographics are a drag on growth, but over time we could see productivity begin to improve.
“If tightening financial conditions do some of the Fed’s work for it, then it doesn’t have to be quite as aggressive on short rates.”
- Ben Bernanke
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Trump triggers talk of Australia going nuclear

By Peter Hartcher
16 June 2018 — 12:16am
Should Australia develop its own nuclear weapons? It seems an outlandishly radical thought for such a safe country to consider. But a former adviser to Malcolm Turnbull and Julie Bishop thinks it's an idea whose time is fast approaching.
In his book Why Australia Slept, launched this week, Peter Hendy says that Australia needs to consider nuclear weapons because "if we could financially afford them, [they] would secure an even more independent foreign policy" for the country.
Hendy, a former Liberal federal MP, former head of the Australian Chamber of Commerce and Industry and now a consultant, is not the first to raise this delicate subject. The way things are going he won't be the last.
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Australian dollar could slump to 'mid-60s', says Vimal Gor

By Matthew Burgess & Ruth Carson
16 June 2018 — 7:11am
A Sydney-based fund manager that profited from the selloff in Turkey's bonds and currency last month now expects a slump closer to home, as a stronger greenback weighs on the Australian dollar.
The Aussie may fall more than 10 per cent to the "mid-60s" US cents in 12 months, said Vimal Gor, head of income and fixed interest at Pendal Group, at a conference. A hawkish Federal Reserve will continue raising rates "until something breaks," while its Australian counterpart stands pat, he said.
"The US is the only country that's genuinely hiking rates, so the interest-rate differential story is giving a huge tailwind to the dollar," Tim Hext, a portfolio manager in Gor's team, said separately.
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The $2.7 trillion question: why trade wars do matter

By Mark Gongloff
16 June 2018 — 10:22am
An old Wall Street saw says "Buy on the sound of cannons, sell on the sound of trumpets," meaning stock traders see wars as buying opportunities. The story may be different if those cannons are aimed at their wallets, however.
Until recently, President Donald Trump's waving of the trade-war stick at China and various allies has generally elicited stock-market yawns. But Trump's new tariffs on Chinese goods today may have been a hot pot of coffee. China fired back with massive tariffs of its own, and Trump has threatened to retaliate for China's retaliation.
Suddenly the trade wars seem to matter a bit more to stocks; the S&P 500 fell about one per cent before recovering at the end of the day. And trade wars matter in some quarters more than others.
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What doors would a 'Western Civilisation' degree open?

By Richard Denniss
16 June 2018 — 8:54am
It’s not that long ago that right wing politicians saw arts degrees as an expensive indulgence that distracted universities from the real task of training the next generation of accountants and marketing executives. But these days John Howard, Tony Abbott and Malcolm Turnbull all think that an education in ‘Western Civilisation’, albeit a privately funded one, is the most important thing a university can provide.
Amongst all of the fire and fury about the Australian National University’s decision to decline an offer of private funding for a course in Western Civilisation, a couple of key questions are yet to be asked. The first is simply, what job would a student of Western Civilisation be qualified to do?
After 20 years of neoliberalism, most universities now define themselves by their ability to design undergraduate courses that the employees of tomorrow will need. Course titles, curriculum content and even assessment tasks are all designed to signal to students and employers that graduates are ‘job ready’. But has anyone ever heard of a skills shortage for those well versed in Greek literature?
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Elderly Australians pressed by adult children to sell, move out

  • The Australian
  • 12:00AM June 16, 2018

Luke Griffiths

As the dream of home ownership becomes less achievable for the young, older Australians are increasingly under pressure from their children to hand over their wealth, Age Discrimination Commissioner Kay Patterson says.
Dr Patterson, a Howard government health minister, said this form of “elder abuse” was ­expected to escalate as the population aged and house prices rose.
“People are living much longer, so those who might have expected an inheritance aren’t getting it when they think they deserve it … leading to so-called ‘inheritance impatience’,” she said.
  • Updated Jun 15 2018 at 11:00 PM

A five-point plan to right Australian foreign policy

"We should be smart" may not sound like a sophisticated strategy for Australia in a world where international relations are taking on hallucinatory colours, but it's the way to go.
The sight of a US President condemning the leader of Canada, America's closest ally, as "weak" and "dishonest" and a couple of days later embracing a brutal, murderous dictator who was threatening to attack American cities with nuclear missiles is, let's face it, surreal.
It forms the backdrop to advice from Australian foreign policy veterans that Australia must be "positively alert" and "agile and imaginative". This doesn't sound like what jargon-meisters call "an integrated policy" but, hey, these aren't the sort of times where the old rules apply.
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Liberal Party members call to sell ABC nothing but 'pure self-indulgence'

By David Crowe
16 June 2018 — 8:14pm
Liberal Party federal president Nick Greiner had some good advice for his colleagues on Friday night but they struggled to remember it on Saturday morning.
“I think in some ways, across the party, we’ve occasionally been lazy and self-indulgent when we put our own internal tiffs, our internal arguments, over the wellbeing of the party overall,” he said.
The Liberal Party’s peak council has voted almost 2:1 to privatise the ABC, but the treasurer says there are 'no plans'.
Greiner urged party members to put aside divisions in order to focus on what really matters – the big ideas needed to win the election and govern the country.
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Australia vulnerable to 'full-blown trade war' as US-China tension deepens

By Eryk Bagshaw
16 June 2018 — 4:57pm
Australia is overexposed to a full-blown trade war between the US and China, business leaders have warned, as the Trump administration increases sanctions on Chinese products.
The Turnbull government moved quickly to put itself at the front of negotiations on Saturday after it was revealed a 25 per cent tariff on $US50 billion ($67 billion) worth of 1102 Chinese imports would take effect from July 6.
Foreign Minster Julie Bishop urged the world's two largest economies to take their dispute to the World Trade Organisation before it hit global standards of living and economic growth.
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ABC won't be sold despite Liberal vote

Treasurer Scott Morrison says there are no plans to privatise the ABC despite calls from Liberal rank-and-file members to sell it off.
Australian Associated Press June 16, 20182:31pm
The ABC will not be privatised despite rank-and-file Liberal members calling on the government to sell off the national broadcaster's city operations.
The Liberal federal council passed a motion with a two-to-one majority calling on the coalition to sell off the ABC, except for in regional areas.
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Real conservatives do not wear rose-coloured glasses

  • The Australian
  • 12:00AM June 16, 2018

Peter Van Onselen

The term conservative has been hijacked by right-of-centre activists who, frankly, do not qualify for its ideological camp. The worst part about this is the profoundly adverse effect it is having on the broader right’s ­capacity to win political arguments and convince mainstream voters of the merits of their ideological positioning.
“Liberals” aren’t much better, but their failure is generally a lack of policy courage rather than ideological understanding. Liberalism also needs to decouple itself from neo-liberalism, but that’s a complicated topic for another day.
Conservatism is a worthy world view. The concept of defending institutions and pressure-testing ideas before change is adopted can be prudent. Equally, liberalism is a valuable ideo­logical construct. Embracing the importance and the value of the market, alongside the usefulness of protecting liberties and personal freedoms, is something Australia needs.
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Financial Royal Commission Issues.

Dover Financial shuts up shop

By Mathew Dunckley & Sarah Danckert
10 June 2018 — 2:05pm
Financial planning group Dover Financial Advisers has abruptly pulled the pin on its advice services just weeks after its founder collapsed on the stand at the Hayne royal commission.
Dover Financial, based in the Melbourne suburb of Cheltenham, is one of the 10 biggest financial planning outfits in Australia and has more than 400 planners operating under its licence around the country.
Industry sources have confirmed that Dover wrote to its planner network on Friday telling them to cease offering new advice immediately, putting an estimated 50,000 clients in limbo.
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'Read email thoroughly, it contains unhappy news': Dover shuts down

By Mathew Dunckley & Sarah Danckert
10 June 2018 — 2:05pm
Financial planning group Dover Financial Advisers has abruptly pulled the pin on its advice services just weeks after its founder collapsed on the stand at the Hayne royal commission.
Dover Financial, based in the Melbourne suburb of Cheltenham, is one of the 10 biggest financial planning outfits in Australia and has more than 400 planners operating under its licence around the country.
Fairfax Media has obtained an email Dover's owner Terry McMaster wrote to the company's network of planners on Friday telling them to cease offering new advice immediately as the corporate watchdog was going to remove its licence, putting an estimated 50,000 clients in limbo.
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'If you can't trust your kids' - bank chief warns on small biz loans

By Clancy Yeates
11 June 2018 — 12:00am
Raising banks' threshold for small business lending from $3 million to $5 million would risk forcing up interest rates and restricting the supply of credit, Bendigo and Adelaide Bank chief executive Mike Hirst warns.
With business banking practices under the microscope, Mr Hirst said that if banks classify loans worth up to $5 million as small business lending - as the corporate regulator has backed - it could exacerbate the long-held complaint of small businesses: that it is too hard to get credit.
 “I’d be concerned for funding availability to small business. Without knowing how it will all play out, I’m wondering whether or not it means more expensive lending for small business and less of it,” he said in an interview with Fairfax Media.
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  • Jun 11 2018 at 9:33 AM

Dover Financial Planning shutdown puts $4 billion of client's money in limbo

An estimated $4 billion of clients' funds and 10,000 customers could now be in limbo after financial planning group Dover Financial Advisers abruptly closed down just weeks after its owner collapsed while testifying at the banking royal commission.
The Melbourne-based company is one of the country's 10 largest largest financial planning businesses with more than 400 advisers and about 260 practices across the country.
On Friday, owner Terry McMaster wrote to Dover advisers telling them they were no longer able to provide new financial advice under the company's Australian Financial Services Licence (AFSL).
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  • Jun 11 2018 at 11:11 AM

Sean Fenton: Beware the Royal Commission effect

by Sean Fenton
Revelations at the Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry have impacted many stocks, but the focus on responsible lending across the banking sector has the potential to drive wider ranging economic impacts.
The Australian housing market has already been softening following moves by APRA to limit interest–only lending in an effort to contain runaway house prices.
The tightening in credit availability and repricing of mortgages by the banks has seen a decline in auction clearance rates and house prices in nearly all capital cities.
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What I learned … James Kirby, Alan Kohler and Richard Gluyas on the banking royal commission

  • The Deal
  • 10:00AM June 12, 2018
Don’t miss a special edition of The Deal magazine in The Australian this Friday, in which we’ll reveal Australia’s Top 50 Financial Advisers. And in a special sneak peek from this week’s magazine, The Australian’s Alan Kohler, Richard Gluyas and James Kirby comment on the fallout from the royal commission into banking and financial services and reveal what they’ve learned.
Alan Kohler
What I’ve learnt from the royal commission is that things are worse than I thought in the financial services industry. I’ve known for years that the use of financial advisers as sales people — that it’s the distribution arm of the wealth management industry — was continuing despite the efforts of the ALP through the Future of Financial Advice legislation, in which commissions were banned and advisers were required to act in the best interests of clients, and which remains despite the efforts of the Coalition to gut it. I thought at the time that more would be needed than FoFA, and that the switch to “fee for service” instead of sales commissions was a fig leaf.
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Call to warn parents over guaranteeing kids' loans

By Clancy Yeates
14 June 2018 — 9:41pm
Banks would have to bluntly warn parents planning to guarantee their children's business debts that they risk losing their home, and that many small businesses end up failing, under proposals to the royal commission.
After the commission last month delved into parental guarantees of business loans, Bank of Queensland (BoQ),  Legal Aid NSW and the Finance Sector Union (FSU) backed changes to ensure guarantors were making informed decisions when putting their home on the line.
However, the major banks are resisting further change, arguing current laws and the industry's revamped code of conduct give guarantors enough protection, with one suggesting further change could make it harder to get a loan.
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National Budget Issues.

$500,000 wind farm experts provided no advice in two years

By Nicole Hasham
11 June 2018 — 4:35pm
A $500,000 scientific committee created by the Coalition government to monitor the health effects of wind turbines held one face-to-face meeting in two years, failed to provide any official advice and had its work repeatedly rejected by research journals.
Documents also show that while the federal environment department’s budget has declined steadily under the Coalition, bureaucrats have splashed out on travel, treadmills and office refurbishments.
The Independent Scientific Committee on Wind Turbines was established in October 2015, fulfilling a commitment by the previous Abbott administration.
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Flat income tax rate will limit people 'gaming the system': research finds

By Eryk Bagshaw
12 June 2018 — 6:13pm
Eliminating the second highest tax bracket would help "wipe out bunching" and reduce endemic levels of legal tax avoidance, one of Australia's leading tax experts says, in comments that are likely to be seized on by the Turnbull government to help push their $144 billion income tax package through a resistant Parliament.
An analysis of 160 million Australian tax records between 1999 and 2014 has found six times the expected number of taxpayers hovering just below the 37 per cent tax bracket.
The phenomenon -  known as "bunching" - suggests taxpayers or their agents are deliberately structuring their affairs to avoid falling into a higher tax rate.
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Weaker jobs growth puts wage boost in doubt

By Peter Martin
14 June 2018 — 5:02pm
Jobs growth has slid dramatically, with new employment figures showing only 95,900 extra workers employed during the past six months, down from 208,000 employed in the previous six months.
It came as the Westpac Melbourne Institute index of unemployment expectations ticked up in May, undoing the improvement since December.
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Everyone pays the energy price

By David Crowe
15 June 2018 — 12:15am
Australians are learning daily of the full venality of a banking industry that has cheated customers, flouted regulators and created a market where nobody can be sure who is pocketing a hidden fee from their savings.
The testimony at the banking royal commission has shamed an entire industry and jolted politicians into planning tougher measures, with a natural focus on one sector alone.
But are financial advisers the only ones who take a cut as they pass consumers through a byzantine industry? The energy business is making all the same mistakes – and building a political timebomb for whoever takes power in Canberra at the next election.
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Josh Frydenberg issues blunt warning to energy retailers

  • The Australian
  • 9:24AM June 15, 2018

Rick Morton

Energy retailers will see “more intervention” from the federal government if they don’t sort out major issues with the market such as prices and reliability, Josh Frydenberg says.
The Energy Minister issued a blunt warning to the sector this morning after the release of a new report from the Australian Energy Market Commission which shows public trust in retailers has hit record lows.
“My message to the retailers is unless they get prices down and they pick up their act, you will see more intervention because that is what the public will demand of their political leaders,” Mr Frydenberg told ABC Radio National.
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Health Budget Issues.

Are out-of-pocket medical costs out of control?

Authored by Hugo Wilcken
DOCTORS’ fees have once again been in the news, following a recent Four Corners report that put a brutal spotlight on the huge out-of-pocket medical expenses some patients pay.
Take, for example, the case of John Dunn, a privately insured patient in need of surgery after a diagnosis of aggressive prostate cancer. John wound up with a bill of $25 000, an eye-watering $18 000 of which was out-of-pocket expenses, after Medicare and private health fund rebates. Most of this went to his GP-referred surgeon, who charged $16 000. But there were also fees for the anaesthetist (over $3000), the biopsy ($1600), the magnetic resonance imaging ($450) and sundry other expenses.
“It shocks you,” Mr Dunn told Four Corners. “You live in this world where you have Medicare, a universal health fund, and you’ve got a private health fund, you’re paying in substantial fees, and lo and behold, you’re 18 grand out of pocket when you have one operation.”
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Breast cancer the most expensive for patients, say researchers

  • The Australian
  • 12:00AM June 11, 2018

Sean Parnell

People diagnosed with breast cancer are left with the highest out-of-pocket costs of any cancers treated in Australia, according to a study highlighting the inconsistency and lack of transparency in healthcare bills.
In the latest Medical Journal of Australia, associate professor Louisa Gordon and colleagues from QIMR Berghofer Medical Research Institute in Brisbane detail out-of-pocket cancer treatment costs.
The researchers kept records on 452 patients who were diagnosed with one of five major cancers between November 2010 and November 2011. Analysing all consultations, tests, imaging, procedures and pharmaceuticals billed through Medicare, they discovered the highest median out-of-pocket costs over a two-year period was for breast cancer ($4192) followed by prostate cancer ($3175). Both have higher surgical fees, including the controversial use of robotics in prostate cancer cases. The lowest median out-of-pocket cost was for lung cancer ($1078), which also has a lower survival rate. Yet lung cancer had the highest median provider fees — $22,011, just above breast cancer with $21,581. The median proportion of fees covered by Medicare was 63 per cent — ranging from 51 per cent for prostate cancer to 89 per cent for lung cancer — however, the results may be skewed by the fact more patients were covered by insurance than the national average.
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Hospitals cover excess to tempt sick to go private

  • The Australian
  • 12:00AM June 13, 2018

Sean Parnell

State-run public hospitals are spending tens of millions of dollars a year on insurance excess payments for patients to bill the much larger cost of treatment to their health fund.
The likely scale of the excess payments, revealed only after a Right to Information search in Queensland, emerges amid a ­debate over private patients in public hospitals and the challenge of rising health costs.
In recent years, public hospitals have ramped up their private billing, which insurers complain is a $1.1 billion cost-shift that pushes up insurance premiums and threatens the balance in the health system. While public hospitals are obliged to provide treatment to Australian citizens without charge, and cannot compel health fund members to use their insurance, they make private billing more attractive by paying the excess so there are no out-of-pocket costs for the patient.
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Push to get health services out of hospitals, into the home

  • The Australian
  • 12:00AM June 14, 2018

Sean Parnell

A quiet revolution is under way in the health system, with government and insurance funders looking to shift more services — such as chemotherapy, dialysis, rehabilitation, mental health and palliative care — out of high-cost hospitals and into the community or home.
The debate over rising health costs, especially in the private sector, has brought a renewed emphasis on new models of service delivery and major reforms are now likely. This may prove controversial, however, with some providers financially dependent on maintaining the status quo, and concerns that cost-cutting may compromise the quality of care.
In the public-hospital sector, the Independent Hospital Pricing Authority on Tuesday flagged more work on funding different models, following the success of a Victorian chronic disease program aimed at reducing avoidable hospital visits.
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‘Stuffed mental health set-up needs review’

  • The Australian
  • 12:00AM June 14, 2018

Rick Morton

The country’s “mental health archi­tecture is stuffed” and should be reviewed by the Productivity Commission after years of ­rewarding activity instead of outcomes, a mental health commissioner says.
Ian Hickie, a member of the federal government’s National Mental Health Commission, told a conference in Canberra yesterday that successive governments had “increased access of care ­rather than quality of care”, which had ultimately led to ­poorer outcomes.
“I’m one of these people that says the Uberisation of mental health is going to happen because I actually don’t think we can fix the system we have,” Professor Hickie said.
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Rising prices for medical specialists

  • The Australian
  • 12:00AM June 15, 2018

Sean Parnell

Out-of-pocket costs for specialist services are growing at a rate of 5.5 per cent each year, according to analysts who are unable to predict whether the surge in medical graduates, or proposed transparency measures, will provide patients with any relief.
An ANZ Melbourne Institute report found significant variation in bulk-billing rates and out-of-pocket expenses by, and within, specialties.
Similar ­variation was evident in specialist earnings, with ortho­pedic surgery the highest and 2.4 times that of the lowest, endocrinology.
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Push on for supplies of local plasma to supplement imports

  • The Australian
  • 1:00AM June 16, 2018

Sean Parnell

Blood plasma from US and European donors — many of whom are paid for their contributions — has become increasingly vital to the health system, despite Australia’s long-held policy of self-sufficiency through voluntary donations.
National Blood Authority figures suggest more than half of Australia’s immunoglobulin stocks soon will come from overseas, with clinical ­demand constantly exceeding local donor supply. In 2016-17, 44 per cent of immunoglobulin was purchased from overseas companies, with that expected to become a maj­ority this year.
Immunoglobulin is used in different forms to treat conditions where immune replacement or immune modulation therapy is required, and also in cases of severe blood loss. Sourcing and supplying such plasma products takes up half of the NBA’s $1 billion-plus government-funded budget, with costs rising from $205.2 million to $504.6m across the past 14 years.
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International Issues.

  • Jun 10 2018 at 11:30 AM

Donald Trump throws G7 into disarray with tweets attacking Justin Trudeau

Lashing out at the longtime US ally and northern neighbour, President Donald Trump tweeted that Canadian Prime Minister Justin Trudeau is "dishonest & weak" and that the US was pulling back its endorsement of the G7 summit's communique in part because of what he called Trudeau's "false statements" at a news conference.
In an extraordinary set of tweets aboard Air Force One, on its way to Singapore for Tuesday's summit with North Korea's Kim Jong Un, Trump threw the G7 summit into disarray Saturday and threatened to escalate his trade war just as Canada released the G7's official communique.
Its statement took a generally positive view of the leaders' positions on trade matters while acknowledging tensions with the US.
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  • Jun 11 2018 at 8:35 AM

Donald Trump scolds US friends, embraces foes in show of strength to Kim Jong-un

For friends and foes of the United States, Donald Trump is rewriting history before our eyes.
Astonishingly, the disruptive US president on the weekend condemned Canada's Prime Minister Justin Trudeau as "very dishonest and weak", en route to a historic summit with North Korea's tyrannical leader.
After pouring scorn on America's democratic neighbour and defying other Western allies, Trump will try to make nice with oppressive dictator Kim Jong-un to try to convince North Korea to forfeit its nuclear weapons.
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  • Jun 11 2018 at 7:02 AM

Germany's Angela Merkel says Donald Trump's G7 tweets were 'depressing'

by Michael Nienaber
​Europe will implement countermeasures against US tariffs on steel and aluminium just like Canada, German Chancellor Angela Merkel said on Sunday, voicing regret about President Donald Trump's abrupt decision to withdraw support for a G7 communique.
Trump's announcement on Twitter, after leaving the Group of Seven summit in Canada early, that he was backing out of the joint communiqué torpedoed what appeared to be a fragile consensus on a trade dispute between Washington and its top allies.
"The withdrawal, so to speak, via tweet is of course ... sobering and a bit depressing," Merkel said in an ARD television interview following the G7 summit.
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Trump baffles as he divides - but Russia inclination offers a clue

By Nick O’Malley
10 June 2018 — 3:53pm
Donald Trump went into the G7 meeting in Canada declaring that Russia should be readmitted to the group despite its annexation of the Crimean Peninsula and left it tweeting insults at his host, Canadian Prime Minister Justin Trudeau.
Sometime between taking off from Canada and landing in Crete to refuel, Trump made the decision not to sign the G7’s joint communique.
The US President threw the G7’s efforts to show a united front into disarray after he became angry with Canadian Prime Minister Justin Trudeau.
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  • Updated Jun 11 2018 at 8:03 AM

How Donald Trump plays loose with the truth on trade - putting him in the wrong

by Hope Yen and Josh Boak
He is using some goosey numbers to rationalise his aggressive rhetoric on trade, disregarding strong points in US competitiveness to paint a dark portrait of a world taking advantage of his country.
Conversely, he's glossing over aspects of the economy that don't support his faulty contention that it's the best it's ever been. The complexities of health care for veterans are also set aside as he hails a new era in the Department of Veterans Affairs' system.
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China’s Master Plan: A Global Military Threat

From the East China Sea to Africa, Beijing is flexing its muscles. 
by Hal Brands
June 11, 2018, 12:00 AM GMT+10
 (This is the first in a series of columns on China's effort to supplant the U.S. as the world's pre-eminent geopolitical power.)

I wrote a
column recently about how a longstanding assumption of America’s China policy -- that economic integration between the two countries is an unalloyed good -- has now been overtaken by events. But this isn’t the only area in which China’s rise is forcing a re-evaluation of old beliefs.
Now, as the first in a series of columns on this phenomenon that Bloomberg Opinion will publish in the coming days, I'll delve into another issue with enormous implications for U.S.-China relations and American interests: the rise of China as a more globally oriented military power.
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  • Updated Jun 11 2018 at 11:00 PM

A special place in hell for those who start trade wars

The world is now seeing the full extent of Donald Trump's crazy brave foreign policy: first he abuses his allies at a G7 meeting in Quebec, preposterously suggesting that Russia be readmitted into a forum designed for economic superpowers, before welching on a deal he had agreed to sign. Then he jets off to Singapore for a landmark summit with North Korean dictator Kim Jong-un, where he claims that he will know "within the first minute" if Mr Kim is serious about denuclearising the hermit kingdom.
In Quebec, the Americans had reluctantly agreed to sign a joint statement including the words that "we strive to reduce tariff barriers, non-tariff barriers and subsidies". That agreement came even after Mr Trump slammed minor tariffs on US good as "ridiculous and unacceptable" and promised to end a situation where the US is "like a piggy bank that everybody is robbing" while defending aluminium and steel tariffs he himself has imposed. As the photo in today's world section shows, the other G7 leaders, such as Emmanuel Macron, Angela Merkel and Shinzo Abe, encouragingly stood up against Mr Trump's protectionist instincts, and sought to change his mind.
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  • Updated Jun 11 2018 at 7:00 PM

Costs of Australia's relationship with China are adding up

Even if it's not yet publicly spelled out, there's a growing difference of opinion between Australia's political and business leadership over China.
Australian business leaders are alarmed about the potential impact on Chinese trade and investment due to the ratcheting up of public tension between China and Australia. Australian political leaders are more worried about the potential impact on national security unless they are willing to risk Chinese ire, including some form of economic retaliation.
These contrasting viewpoints are only becoming more obvious as the Australian government presses ahead with legislation aimed at espionage and foreign interference. Naturally, the government insists its bills are not targeting China but all foreign governments attempting to influence Australian democratic processes.
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Pimco predicts recession in the US

  • The Australian
  • 12:00AM June 12, 2018

Adam Creighton

The head of fixed income at ­global bond giant Pimco, ­Andrew Balls, foresees “rude awakenings” over the next few years, including a recession in the US as populist challenges thwart prospects for trade.
Mr Balls said increased “populist risks”, from Italy to Turkey and Argentina, would occur in an environment where central banks, keen to withdraw their stimulus, have less scope to suppress any increase in financial volatility.
“Through most of my life free trade was something of a cornerstone. Clearly that is under threat, and you have political and populist challenges,” Mr Balls told The Australian.
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  • Updated Jun 12 2018 at 11:00 PM

Donald Trump and Kim Jong-Un: From war threats to best friends in just 14 months

'The world will see a major change': Kim
As Donald Trump and Kim Jong-un signed their "historic" agreement – standing side-by-side against a backdrop of North Korean and American flags – the US President said the summit went "better than anybody could have expected".
While the meeting was certainly unexpected and historic, it will take a long time to determine how well it actually went.
The agreement is a starting point but will depend on follow-through from two unpredictable and self-serving world leaders.
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Three reasons why the Singapore summit had to happen

By Sam Roggeveen
12 June 2018 — 11:35pm
President Trump has a special talent for keeping his political opponents in a near-constant state of frenzy. The fact that he even agreed to yesterday’s summit in Singapore was read by his critics as a terrible affront to America’s Asian allies. Donald Trump’s weekend Twitter outburst against another ally, Canadian Prime Minister Justin Trudeau, was the latest outrage, dutifully blown out of all proportion by the media and on social media.
But the critics who say Trump is destroying America’s alliances give him too much credit. And by focusing on the President, they imply that these alliances can return to "normal" when he leaves office. Yes, Trump is doing a lot of unnecessary damage, but the fraying of America’s alliance network pre-dates Trump, and will survive him.
Something like yesterday's Singapore summit had to happen. There are three reasons why.
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Robert Mueller warns of active Russian meddling, seeks disclosure lid

13 June 2018 — 6:16am
Washington: US Special Counsel Robert Mueller warned that Russian intelligence services have active "interference operations" in the US and asked a judge to limit the pretrial evidence provided to a Russian firm indicted over meddling in the 2016 election.
Mueller asked a federal judge in Washington for an order that would protect the handover of voluminous evidence to lawyers for Concord Management and Consulting LLC, one of three companies and 13 Russian nationals charged in a February indictment. They are accused of producing propaganda, posing as US activists and posting political content on social media as so-called trolls to encourage strife in the US.
The threat of public or unauthorised disclosure of evidence would help foreign intelligence services, particularly in Russia, in "future operations against the United States," Mueller's prosecutors wrote in a filing on Tuesday.
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Trump blasts media as America's 'biggest enemy' for North Korea coverage

By John Wagner
13 June 2018 — 9:15pm
Washington: President Donald Trump posted a series of tweets about his meeting with North Korean leader Kim Jong-Un as he arrived back in Washington, blasting the media as "our country's biggest enemy" for its coverage of the historic summit and claiming there is no longer a nuclear threat.
He said that North Korea is no longer the United States' most dangerous problem, as President Barack Obama had characterised it upon leaving office.
President Donald Trump made a sweeping pronouncement upon returning to Washington, saying there is no nuclear threat from North Korea.
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I'll rejoice in Trump's triumph when Kim opens his gulags to scrutiny

By Michael Kirby
13 June 2018 — 4:07pm
Back in 1949, at my local public school in Sydney, my teacher gave everyone in the class a copy of the Universal Declaration of Human Rights.
It had been adopted in the previous December by the General Assembly of the United Nations, with an Australian, Dr HV Evatt, as president of the Assembly. But the chair of the committee that  drafted the declaration was an American, Eleanor Roosevelt, widow of FDR.
She was an internationalist. A humanitarian. A great lady. Our teacher told my class that, unless the world could uphold the declaration, we would go on killing each other. Especially now, with the advent of the atomic bombs that had been used on Hiroshima and Nagasaki just a few years earlier.
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Why Wall Street isn't freaking out about Trump

By Barry Ritholtz
14 June 2018 — 7:14am
Ominous headlines have dominated the news since Donald Trump was elected president. A parade of unprecedented events, ranging from trade wars to mind-bending changes in the western alliances, have many on edge.
But not investors.
If there is a single question that I have heard more than any other during the past few months, it is: "How are markets so blasé about the endless threats to financial stability and order from the president?"
Many theories are tossed around. Some resonate more than others. What follows is a short summary of why markets haven't freaked out over the ongoing spectacle of what used to be called market-moving news, but today merely is the state of the world.
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  • Updated Jun 14 2018 at 6:00 PM

Gerrymandering stacks US mid-term elections against Democrats

by Michael Tomasky
A decade ago, when the Republican Party was paying the price for the various cataclysms brought on by the George W. Bush presidency – the shockingly inadequate response to Hurricane Katrina, the ill effects of the Iraq War, the great economic meltdown – the Democratic Party reached its post-Great Society zenith. It nominated and elected the country's first African-American president – and he won decisively, against an admired war hero. It sent 60 senators to Washington, which it hadn't done in 40 years.
It also sent 257 representatives to the House, its highest number since before the Gingrich Revolution of 1994. Its governors sat in 28 executive mansions, including in such improbable states as Tennessee, Kansas, Oklahoma and Wyoming.
Then came the rise of the Tea Party and the calamitous 2010 elections. The Republicans' net gain of 63 seats in the House of Representatives, giving them control over that chamber after a four-year hiatus, swallowed most of the headlines (the party also had a net gain of six Senate seats). The Democrats, as President Barack Obama put it, took a "shellacking".
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'Let's not underestimate the impact': IMF sends warning on Trump's tariffs

By Lindsay Dunsmuir
15 June 2018 — 5:24am
The International Monetary Fund warned on Thursday that US President Donald Trump's new import tariffs threaten to undermine the global trading system, prompt retaliation by other countries and damage the US economy.
"Let us not understate the macroeconomic impact," IMF Director Christine Lagarde said, saying the tariffs will have a larger economic toll if they prompt retaliation from trading partners like Canada and Germany.
The IMF, in a review of US economic policy, also took a much less optimistic view on America's economic growth potential than that of the Trump administration.
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  • Jun 15 2018 at 11:06 AM

Donald Trump's America: The rogue superpower

by Robert Kagan
Since the end of the Cold War, it has widely been assumed that US foreign policy would follow one of two courses: Either the United States would continue as primary defender of the international order it created after World War II, or it would pull back from overseas commitments, shed global responsibilities, turn inward and begin transitioning to a post-American world. The second approach was where US foreign policy seemed headed under President Barack Obama, and most saw the election of Donald Trump as another step toward withdrawal.
It turns out there was a third option: the United States as rogue superpower, neither isolationist nor internationalist, neither withdrawing nor in decline, but active, powerful and entirely out for itself. In recent months, on trade, Iran, NATO defence spending and perhaps even North Korea, Trump has shown that a president willing to throw off the moral, ideological and strategic constraints that limited US action in the past can bend this intractable world to his will, at least for a while.
Trump is not merely neglecting the liberal world order; he is milking it for narrow gain, rapidly destroying the trust and sense of common purpose that have held it together and prevented international chaos for seven decades. The successes he is scoring – if they are successes – derive from his willingness to do what past presidents have refused to do: exploit the great disparities of power built into the postwar order, at the expense of the United States' allies and partners.
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Pulling down the house

By Nicholas Stuart
16 June 2018 — 12:00am
For the past seventy years, slowly and carefully, the nations of the world have been putting together a robust framework of international relations. The key concept has always been emphasising stability and avoiding risk. Now, within a week, Donald Trump's done his best to demolish that entire structure.
Even before the meeting ended Trump was giving media interviews to proclaim it a “remarkable success”.
The US President had a simple – some would say simplistic – narrative. According to this he went to Singapore, sat down with Kim Jong Un, and obtained an agreement to denuclearise the Korean peninsula, something no other person had been able to achieve since the end of the war.
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A trade war looms as Trump slaps tariffs on 1102 Chinese imports

By Christopher Rugaber
16 June 2018 — 5:09am
Washington: President Donald Trump has brought the world's two biggest economies to the brink of a trade war by announcing a 25 per cent tariff on up to $US50 billion in Chinese imports to take effect July 6.
Beijing quickly responded that it would retaliate with penalties of the same scale on American goods.
The latest round of trade talks between the US and China ended with China warning that all progress between the two economic superpowers could be lost if the US pushes ahead with trade sanctions, including tariffs.
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Curious link between world peace and gender equality

By Matt Wade
17 June 2018 — 12:00am
Whatever comes of Donald Trump and Kim Jong Un’s curious get-together in Singapore it brought a welcome focus: peace.
If the optimists are right the meeting has paved the way for "major disarmament" on the Korean peninsula over the next few years.
But, even if that happens, how much more peaceful would the world really be?
Sadly, not that much.
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I look forward to comments on all this!
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David.

An Interesting Article Regarding How People Search For Health Information On Line.

This appeared list week.

Looking online for info on your child’s health? Here are some tips

June 11, 2018 6.05am AEST
Most parents look online for information about their child’s health. from shutterstock.com

Authors

  1. Karen Scott
  2. Patrina Ha Yuen Caldwell
Many parents can be anxious when their child is sick. So looking online for health information can help them understand their child’s medical condition and take an active role in treatment. Seeking health information can also be a coping strategy for parents coming to terms with their child’s illness.
But parents have reported being worried about whether the online health information they find is reliable and relevant, and are concerned about the possibility of misdiagnosis. They can also feel overwhelmed by the amount of information online, which can be difficult to understand.
Just more than half of the parents we surveyed for a recent study were hesitant to act on, or present the information they found online, to the treating doctor. This was despite the fact 73% believed the information influenced the questions they asked the doctor.
Previous studies have highlighted barriers to parents discussing their online research with doctors. They include finding a suitable time, given the doctor’s high workload, and a fear of being perceived as “bossy”, “a whinger”, “difficult” or “pushy”.
Other difficulties may arise if the doctor lacks interest in the information parents find because they believe it lacks credibility or is irrelevant.
A 2015 study found that, of the 110 parents of children with cancer who searched for online medical information, only 47% shared it with their child’s oncologist, but around 86% would have liked to have done so.
Unlike doctors, parents aren’t trained in how to verify the information they find. When seeking health information online or in parenting forums, it’s important to make sure it’s credible and discuss it with the doctor.

Parents looking for information

Our interviews with parents found online health information can provide reassurance and improve adherence to treatment.
We surveyed 308 parents of sick children at The Children’s Hospital at Westmead. We found 90% of parents searched for health information online. Of these, almost all (95%) looked for information after seeing their child’s doctor and many (63%) did so beforehand.
Some parents, especially those aged under 45, used online parenting forums (29%) or social media such as Facebook (27%) for health information.
Most parents (88%) who went online for health information before seeing the doctor wanted to prepare questions. Most (84%) wanted to find out what their child’s medical condition might be.
Of the parents who searched for information after seeing their child’s doctor, 94% wanted to know more about their child’s condition and 90% had more questions after thinking about what the doctor said.

Where to look

Only some parents (29%) believed the health information they found online was correct and just 61% understood it. Only a little more than half (57%) investigated to see if a website, app or Facebook group was trustworthy before accepting or using the information.
Most parents said they wanted help searching for (69%) and assessing (77%) the trustworthiness of online health information.
The Mayo Clinic features the HONcode logo, showing it’s a trustworthy source of information. Screenshot/Mayo Clinic
Parents can ask their child’s doctor to recommend a website so they can find out more about their child’s medical condition. And they can discuss with the doctor whether the online information they find is trustworthy and relevant.
Some online health information or advice from parenting forums may be untrustworthy, irrelevant to the child’s condition or incorrect. This can lead to misinformation, potentially harming the child and increasing parents’ anxiety and guilt.
When looking up health information online, parents can remember it’s more likely to be trustworthy if it’s on websites that are:
Also look to see if the health information is:
  • written by qualified health professionals
  • based on evidence-based research or the work of an expert panel (it’s helpful if the website cites the source of its information)
  • aimed at giving consumers information (such as Choosing Wisely Australia)
  • balanced, unbiased and unemotional
  • up to date, listing a recent revision date
  • separated from advertising
  • funded and any funding is declared.
The study was conducted by Griffith Medical School student Shruti Yardi while on a University of Sydney summer research scholarship in 2015.
Here is the link to the original.
All this seems more that useful advice and really shows how Dr Google is indeed very widely used.
The only question I have is why the medical student who conducted the research is not credited as an author? Seems odd to me.
David.

Wednesday, June 20, 2018

Magical Thinking Is Given A Whole New Meaning By This Release And Report.

This was released a few days ago:

Digital health to transform Australia’s health system and save lives


MEDIA RELEASE
Australia now has many of the building blocks in place to roll out a digitally enabled health system that could transform care services, an expert report has found.
The report, developed after an expert roundtable initiated by the Consumers Health Forum and The George Institute for Global Health, says “the time is now ripe” to support the expansion of digital health technology in vital areas including chronic care and residential aged care.
The report is based on discussions held by around 40 consumers, clinicians, academics, government and industry supported by the Australian Digital Health Agency.
Roundtable attendees considered four sectors --- chronic care, residential aged care, emergency care and end of life care --- in terms of what is wanted from digital health, the current state of digital health in that sector and how to meet goals for the future.
The report says major progress is being made with My Health Record, e-prescriptions, patient registries, shared care portals, state-based digital health strategies and linked hospital patient information systems.
“The time is now ripe to leverage this maturing digital health capacity in ways that are meaningful to both consumers and providers.  If done well, it has potential to be transformative for Australia’s health system bringing about rapid enhancements in quality, safety, accessibility and efficiency,” the CEO of the Consumers Health Forum, Leanne Wells, said.
“Digital disruption is not coming in health care – it is already here. For too long health has been lagging behind other sectors.
“For Australia to embrace digital health and benefit from its huge potential, we need national leadership. The COAG National Digital Health Strategy provides a foundation but what is needed is stronger, coordinated direction from the federal, state and territory governments.
“It would be good news for consumers to bring health into the 21st century but we need to be mindful that people have differing levels of health literacy and some will need support to embrace a digital health future or we risk inequities of access and knowledge.
“We need to invest in implementation and change management to avoid the risks and pitfalls that can accompany the roll-out of such powerful technology into a complex and sensitive area like health care,” Ms Wells said.
Professor David Peiris, Director of Health Systems Science at The George Institute, said emerging digital health strategies had the potential to transform Australia’s health system for both health care providers and consumers.
“Our report sets out clear recommendations on what is needed to enable people to be much more in control of their own health needs and to make informed choices about the care they choose – from urgent life-saving situations through to respecting their wishes at the end their life.
“We also want to ensure that every health professional in Australia can take full advantage of the digital health eco-system to improve people’s healthcare experience and provide care that can be co-ordinated across the system. Many Australians are tired of having to constantly repeat their story to multiple care providers and it’s vital that we tap into digital technology to ensure we deliver a more person-centred, safer and sustainable healthcare system.
“Australia has made a great start in its uptake of digital health technology and we have identified practical steps in several areas that could be rolled out rapidly. The challenge now is to ensure they are adopted.”
The recommendations identified by the roundtable included:
In chronic care: To trial virtual care teams to support patients with high care needs; and trial a “Patients Like Me” platform to enable patients with chronic and complex care needs to safely connect and share experiences with one another.
In residential aged care: Ensure that residents’ health and social services information is available in a single location, on a platform easily accessible by consumers and providers anywhere, anytime and on any device.  Collate and publicise data that allows patients, their carers and future consumers to compare residential care facilities based on health outcomes and patient experiences.
In emergency care: Develop digital health technologies that leverage My Health Record data to be rapidly accessible to paramedics and other emergency providers; develop a text/image message system to support improved communication between emergency care and other medical teams and assist with referrals to other health care providers for post-discharge care.
In end of life care: Develop and promote existing professional and consumer portals that provider information on care options, medical services and pathways for those nearing end of life; and engage in targeted social media campaigns to encourage consumers and medical professionals to normalise conversations about death.
ENDS
Media Enquiries
Mark Metherell, Communications Director
Consumers Health Forum of Australia
P: +61 429 111 986 E: m.metherell@chf.org.au 
Julia Timms, Senior Media Advisor, Australia      
The George Institute for Global Health
P: +61 410 411 983 E: jtimms@georgeinstitute.org.au

Consumers Health Forum of Australia
The Consumers Health Forum of Australia (CHF) is the national peak body representing the interests of Australian healthcare consumers. CHF works to achieve safe, quality, timely healthcare for all Australians, supported by accessible health information and systems. CHF is committed to being an active advocate in the ongoing development of Australian health policy and practice.
Facebook at CHFofAustralia  Twitter @CHFofAustralia  Web chf.org.au
The George Institute for Global Health
The George Institute for Global Health conducts clinical, population and health system research aimed at changing health practice and policy worldwide. Established in Australia and affiliated with UNSW Sydney, it also has offices in China, India and the UK, and is affiliated with the University of Oxford. 
Here is the link:
First it needs to be said that all this is just totally well intentioned and of value, but when you read the report you are left with the sensation of simply floating in a cloud if impracticality and fantasy.
Early on you read the following:
“The report says major progress is being made with My Health Record, e-prescriptions, patient registries, shared care portals, state-based digital health strategies and linked hospital patient information systems.”
Somehow this is all true but also fails to recognise that we are still on the beginning of these paths and by no means at the end. To reach full implementation of solutions to all these core problems, with the best will in the world, is 5 years off at least I believe!
No one I know is casting about for things to do saying we have got all the basics done and it is time to start working on new things!
Additionally the four proposals seem to me to lack clear cut sponsors and plans beyond the woolliest of motherhood statements.
This report is another poorly formatted .pdf document that needs to stay on the shelf until we have got the basics well and truly bedded down. Sorting out the data quality and usability in the myHR, if we are to have one, is way more important and necessary.  Testbeds that fully fix the basics are much more important than this list!
Heavens I am a depressive Grinch! But I believe I am also reasonable, realistic and practical.
Opposing views welcome!
David.

Digital Health On The Australian Stock Market - A Mixed Bunch Indeed.

This appeared last week.

Digital Health Stocks Win From Technology and Health Care Boom

By Bob Kohut | 11.06.2018
Many Investors with the time and temperament to manage their own portfolios of individual stocks gravitate towards high growth opportunities.  After all, given the effort required to research individual stocks, why not look for outstanding rewards?  For the risk averse with little inclination for individual stock research there are mutual and exchange traded funds.
Business sectors with the proverbial “tailwinds” at their backs and newcomers with business models set to disrupt traditional ways of doing business are prime targets. 
Right now, healthcare and technology are two of the hottest sectors on the ASX, and likely to remain so.  Both sectors were up 26% for calendar year 2017.  
Quality digital health stocks offer the opportunity to benefit from both the technology and healthcare sectors as well as the potential for disrupting the status quo in healthcare.
Digital health is a term encompassing a range of health care offerings, all made possible because of the digital transformation of our society. 
At their core, all are based on software applications ranging from diagnostic and analytic systems to mobile health monitoring and measurement systems.  
Telehealthcare today enables consumers to make appointments and payments as well as view test results all from their computer and in some cases from a mobile phone.
The term “digital health systems” has become somewhat of a buzzword, often limited to the increasing number of wearable health monitoring devices and smartphone apps.  However, a more precise description includes digital diagnostic tools and medical record systems.  The term mHealth is a subset encompassing all digital health offerings available on mobile devices. 
The following chart from market research and strategy consulting firm Global Market Insights forecasts growth in the digital health market by technology through 2024. According to GMI the total “digital health market in the US in 2016 was valued at US$60 million dollars, with more than 26% CAGR (compound annual growth rate) expected from 2017 to 2024.”
No matter how hot the sector or the disruptive potential of a new technology, start-up digital health stocks suffer from the obstacle confronting all early stage companies – the race against time.  Essentially, these companies engage in a struggle to turn profitable before their cash runs out.  Repeated capital raises and borrowings may generate cash needed to continue the struggle but erode investor confidence and can lead to deterioration of the stock price.
A prime example is an early ASX mover in wearable fitness monitoring technology – Catapult Group International (CAT).  The company came on the ASX in late December of 2014, full of promise and high-profile backers like the billionaire owner of the US Dallas Mavericks basketball team, Mark Cuban.
Initially investors were thrilled to see the growing client list of well-known sports teams around the world. In less than two years the stock price shot up 600% before the roof caved in. 
The company’s share price hit its all time high following the first major capital raise to fund two acquisitions, with both later failing to propel revenues as expected.  In its headlong pursuit of growth, the company management kept draining cash as though tomorrow would never come, only it did as investors grew weary of capital raise after capital raise.  The company remains a market leader and some analysts see potential, but Catapult’s FY 2017 Financial Results highlight the problem.  
Despite a massive 249% increase in revenue, the company failed to report a profit, increasing its loss 57% from the FY 2016 loss of $5.9 million to a loss of $13.9 million.  Analysts, however, remain enthusiastic about the stock with a consensus rating of OUTPERFORM and not a single SELL recommendation.  The stock price is down 33% year over year.
Eight other stocks are covered in the linked article:
These are:
1. ResApp Health Limited (ASX: RAP)
2. Alcidion Group (ASX: ALC)
3. dorsaVI Limited (ASX: DVL)
4. Global Health Limited (ASX: GLH)
5. G Medical Innovations (ASX: GMV)
6. LifeSpot Health Limited (ASX: LHS)
7. PainCheck Limited (ASX: PCK)
8. Volpara Health Technologies (ASX: VHT)
With the exception of Volpara, and possibly Catapult none has a market cap. even close to $100M so they are true microcaps!
They are a motley collection with only Volpara looking to me to be a really potential goer (AI Technology in Image Analysis).
One not mentioned in the list but now looking like a real success in ProMedicus (ASX: PME) who do Image Analysis and Transfer and who are winning major contracts in the US. They are a giant in this list with a market cap near to $800M. (Was a 1/10 of that 5 or so years ago.)
Whether any of those about is a possible ProMedicus only time will tell and it is definitely up to the reader to check very carefully before investing – you could do the entire investment with any of them!
For me I think I will stick with the likes of CSL, ResMed, Cochlear, Ramsay and Fisher Paykel Health and forego the speculative excitement!
David.

Tuesday, June 19, 2018

This Might Be Another Reason You Might Want To Stay Out Of The myHR.

This appeared a few days ago.

MBS access on the way?

Pharmacists having access to MBS items may be a step closer, PSA national president Dr Shane Jackson has hinted

Speaking at the opening session of ConPharm 2018, the Annual Consultant Pharmacy Seminar, Dr Jackson highlighted three areas of opportunity for accredited pharmacists – one of which is MBS access.
“Only three weeks ago I wrote to the chair of the MBS Review Taskforce, Professor Bruce Robinson, and highlighted again the glaring disparity where pharmacists are not able to be included on the list of allied health professionals who can deliver services to patients under the chronic disease management items,” Dr Jackson told the conference.
“I’ve received correspondence back from Professor Robinson highlighting that the inclusion of pharmacists will be included as part of the review to be conducted in the second half of this year.
“So I’m really positive that we’ll have an opportunity not only to be delivering services within the general practice environment in the future, but to be able to deliver MBS item services in multiple settings, whether that being on the high street, whether that be in community pharmacy, or whether that be in a general practice in the future.
“I think that there is great opportunity in that area.” 
MBS access and two other key areas clinical pharmacists need to be aware of will transform practice over the next year or two, Dr Jackson said. 
The first of these is the My Health Record, which will bring a range of health information to the fingertips of health professionals – “and that includes accredited pharmacists”.
“I know that some accredited pharmacists have struggled to register with the system – I’m assured by the Digital Health Agency from 1 July 2018, that the process for accredited pharmacists will be much more streamlined, and user-friendly, in signing up for the My Health Record system.”
Dr Jackson also highlighted the Workforce Incentive Program, which for the first time means “significant investment outside of the Community Pharmacy Agreement in pharmacists”.
The program allows general practice to employ a pharmacist to deliver services, from 1 July 2019, in what Dr Jackson called a “massive opportunity” for the profession.
Lots more here:
The point is that unless the patient knows how to and places an access code on the myHR the pharmacist(s) and probably many assistants will be able to see all the contents of the myHR.
Any drug, discharge summary and so on, no matter how unrelated to your present prescription, will be able to be noted (your medical abortion drug, your STI treatment, your anti-depressant and so on) and who knows where it MAY go from there….
Unless you trust all these people to do the right thing, opt-out or place the relevant controls on your myHR and help all your friends to do the same…..
The myHR may be a ‘game-changer’ for your medical privacy, and not in a good way, unless you are very careful.
David.

Older Australians Mostly Comfortable With Sharing Data For Health Research.

This article appeared last week:

Data sharing OK say older Australians, as MyHealth Record extends to all

Two thirds of older Australians say they are comfortable having their de-personalised medical data used for research purposes, according to a new survey.
The survey, published in the Australian and New Zealand Journal of Public Health,  asked 2000 Australians aged 55 and over if they found it acceptable to have data that had been collected during their aged care assessment de-identified, collected and used for health research.
A total of 66.7% of participants replied ‘yes’ with a third of this group indicating they would be comfortable for data sharing to occur without their consent.
A larger proportion (41%) of those who agreed said they would only find it acceptable if they were asked first (opt-in) while one quarter (26%) said they would only be comfortable having their data shared if they were first given the chance to opt out.
Meanwhile, 21.5% of participants said it was not acceptable to have their data utilised, and 11.9% said they were ‘not sure’.
A higher proportion (80%) of respondents who had already completed an aged care assessment found the inclusion of their data in a registry acceptable.
More here:
The link to the full paper – open access – is here:
Useful and interesting research.
David.