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, July 19, 2018

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

July 19, 2018 Edition.
-----
Well Trump has really been on the warpath as an obnoxious bully this last week. He is actually turning out to be worse than I feared. With trade, NATO the UK and Putin what can I say. Loved that 12 Russians have been indicted by a Grand Jury for interfering big time  in the US election, especially as he has now met Putin in Helsinki. He should not have won I believe…. This view is confirmed by what happened next - bare-faced lies and all...
Brexit has gone from bad to worse and Boris is gone to the backbench to plot.
In OZ it is all about energy after the ACCC report on how we have all been ripped off by the Gentailers. Bloody annoying and expensive!
Here are a few other things I have noticed.
-----

Major Issues.

  • Updated Jul 8 2018 at 12:05 PM

As US yield curve flattens, the mystery deepens

The gap between US short- and long-term yields is now at its narrowest in more than a decade, and with rates poised to rise again as soon as September, the prospect of an inverted yield curve has risen.
That would appear to be bad news because an inverted curve has historically had a very high correlation with a recession. Nine of the past nine US recessions started with one, according to LPL Financial.
However, there's not yet a consensus, even among US Federal Reserve policymakers, on why the curve is shrinking and whether history provides a precedent for what lies ahead.
-----
  • Jul 8 2018 at 6:45 PM

Fintech will pose systemic risk as it grows, warns RBA

Shanghai | The Reserve Bank of Australia has warned that fintech companies will eventually pose a systemic risk if they become big enough and regulators must work out standards to set for the technological change sweeping the payments sector.
Reserve Bank assistant governor Michele Bullock told a conference in China on Sunday that regulators globally were focused on protecting consumers and investors from fraudulent schemes as they sought to balance the need for innovation with security risks. But this would change as the role fintech companies played in the economy increased.
"Most of the regulation set for financial institutions is aimed at the stability of financial institutions. It is aimed at prudential supervision, making sure financial institutions don't fail ... that is not the concern by regulators at the moment with fintech. That is not to say, that is not where we are going. If some of these companies get big enough there will be systemic issues. That then raises the issue of what standards will we then impose on them," Ms Bullock told The Bund Summit on Fintech in Shanghai.
-----
  • Updated Jul 9 2018 at 7:54 AM

Alexander Downer: Five lessons for living with Beijing

The government is going through one of those periodic times of diplomatic difficulty with China's government. Don't panic. Every so often Beijing arcs up and demands obedience. It's a good tactic because it elicits a flood of advice from self-interested Australians demanding the government does more to keep China happy. If Beijing is cross with us, it's our fault. I've noticed a fair bit of this in recent weeks. Consultants to Chinese companies tell the government it should downplay the relationship with America – to keep China happy. Exporters attack the government for provoking Beijing by complaining about interference in our domestic politics. Someone even said Beijing would be happier if the Prime Minister sacked the foreign minister.
What sort of a feckless, pusillanimous and gutless country we'd be if we did all that. We need to be grown ups and stand up for ourselves.
-----
  • Jul 9 2018 at 9:43 AM

How I became mortgage-free at 35 (and now enjoy an incredible financial freedom)

Fifteen years after we first signed our lives away, we reached our goal of becoming mortgage free.
We queued at the bank to make that final mortgage payment, and found that with one simple transaction, one signature and the bank teller's words of, "Well done!", the biggest moment of our financial life so far was done.
We still have the queue docket on the fridge to remind us of that momentous achievement.
-----

US stuns world health community by opposing breastfeeding

By Andrew Jacobs
9 July 2018 — 6:52am
New York: A resolution to encourage breastfeeding was expected to be approved quickly and easily by the hundreds of government delegates who gathered this spring in Geneva for the United Nations-affiliated World Health Assembly.
Based on decades of research, the resolution says that mother's milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes.
Then the US delegation, embracing the interests of infant formula manufacturers, upended the deliberations.
-----

Clever tax strategies may be legal, but they aren't productive

By Ross Gittins
9 July 2018 — 12:00am
The developed world’s economists have been racking their brains for explanations of the rich countries’ protracted period of weak improvement in the productivity of labour. I’ve thought of one that hasn’t had much attention.
Productivity isn’t improving as fast it could be partly because of the increasing number of our brightest and best devoting their efforts to nothing more productive than helping their bosses or customers game the system.
That is, helping them find ways around our laws – tax laws, labour laws, even officially supported accounting standards for how profits should be measured and reported.
-----

Calm before the storm: How the trade war between the US and China could turn ugly

By Andrew Mayeda & Jenny Leonard
9 July 2018 — 11:05am
The first shot of the US-China trade war went off without much of a reaction from investors. The calm may be short lived.
For months, financial markets have been bracing for President Donald Trump to follow through with threats of tariffs against China. So it came as little surprise when the US implemented duties on $US34 billion ($46 billion) in Chinese imports on Friday, as planned, and Beijing retaliated proportionately.
Now comes the hard part for forecasters.
-----

Trump’s theft of reason

  • The Australian
  • 6:39AM July 9, 2018

Alan Kohler

The trade war kicked off on Friday with America and China each imposing tariffs on $US34 billion worth of trade between them.
The US fired the first shot of course, exactly three years after Donald Trump announced he was running for President with the words (in an interview with The Economist): “China is killing us. The money they took out of the United States is the greatest theft in the history of our country.”
Trump’s first list of newly tariffed products was 818 long, of which 95 per cent were intermediate inputs or capital goods used in manufacturing. While it’s possible that US parts manufacturers will be able to produce more and add jobs, other manufacturers’ costs will rise which will have the opposite effect.
-----

Geoff Wilson: bull markets don’t last forever

  • The Australian
  • 10:07AM July 9, 2018

Ben Wilmot

Veteran share investor Geoff Wilson is taking a cautious stance on the direction of equity markets, saying the US is in the mature phase of a bull market and the end of quantitative easing would present challenges for central banks.
Despite this prognosis, Mr Wilson said his fund, which focuses on large capitalisation stocks on the Australian Securities Exchange, is well positioned after it outperformed the major sharemarket index last year.
The WAM Leaders Limited announced its investment portfolio had increased 17.8 per cent in the last financial year, beating the S&P/ASX 200 Accumulation Index by 4.8 per cent.
-----

Australia on the front line of clash with China, says Steve Bannon

By Peter Hartcher
9 July 2018 — 6:19pm
Australia, you didn't know it, but you've been at the very forefront of Donald Trump's project.  "I think Australia is in a fight for the ages" that will decide whether the nations of the West can keep their sovereignty against Chinese intrusion, says Trump's former chief strategist, Steve Bannon, now a coach and adviser to populist movements worldwide.
"Australia is at the forefront of the geopolitical contest of our time," he tells me in his first interview with an Australian media outlet. He goes so far as to say that "what's playing out in Australia is more important than what's happening in the US and other places".
"If we continue on this path we're down, China will control all of the countries of South East Asia and they will control Australia," argues Bannon, the chief executive of Trump's victorious election campaign and the man credited with the creation of "Trumpism".
-----
  • Updated Jul 10 2018 at 9:48 AM

Cheaper ETFs entice SMSFs to diversify - but there's a catch

Self-managed superannuation funds (SMSFs) have been doing it tough in the low-yield environment. But there may be a silver lining, experts say, in that the diversification message seems to sinking in – at last.
The relative under-performance of the S&P/ASX 20 has made the past year a difficult one for SMSFs, says Marcus Evans, Head of SMSF Customers at Commonwealth Bank. The traditional SMSF basket, with heavy weighting to banks and Telstra, has delivered lacklustre results.
"The ASX has also underperformed compared to international markets, with the US market in particular strongly outperforming the ASX since the global financial crisis," Evans says.
-----
  • Updated Jul 11 2018 at 8:03 AM

Renewables break records in electricity supply ahead of huge growth

Wind and solar power supplied a record 25.2 per cent of Australia's electricity requirements on June 15 and are driving down carbon emissions from power generation rapidly toward the target needed to meet the country's Paris accord commitments.
The findings from advisory firm EnergyEdge have further underlined the potential for the energy system to contribute to emissions reductions well beyond current national targets and added weight to calls for those goals to be made more ambitious.
EnergyEdge managing director Josh Stabler said that June 15 also broke the record for the maximum supply during the day from renewables, at 34.8 per cent, and for the lowest carbon-intensity of generation on any day.
-----

ACCC calls for major reset of energy sector to drive down power bills

By Cole Latimer
10 July 2018 — 7:14pm
The consumer watchdog has called for a major overhaul of the energy sector, and for the government to back new electricity generation to drive down power prices.
In the Australian Competition and Consumer Commission’s electricity sector report released on Wednesday, it called for regulators to have more power to stop ‘market manipulation’ and said the government must support new generation if it is linked to industry.
The ACCC is calling for a restructure of the energy sector, and for the government to back new electricity generation to drive down power prices.
-----

ACCC pushes for 'big changes' to slash power bills by a quarter

By Cole Latimer & Peter Hannam
11 July 2018 — 10:46am
The consumer watchdog has made 56 recommendations to fix Australia's broken electricity market, pushing for measures that could slash households' power bills by a quarter.
The Australian Competition and Consumer Commission has released a blueprint to repair the energy sector, which has seen historically high costs hitting consumers amid claims electricity and gas companies were price-gouging customers.
 “The National Electricity Market is largely broken and needs to be reset,” ACCC chairman Rod Sims said.
-----

Aged-care providers face ATO scrutiny

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

Rick Morton

The tax office has sounded alarm bells about some of the biggest aged-care providers, warning it has “concerns over the financing arrangements” and company structures of “certain entities” that might be used to minimise profits and tax.
The Australian arm of Bupa, through its parent company headquartered in London, has confirmed it has “unresolved issues” with the Australian Taxation Office involving “cross-border transactions and operations”.
“While the issues are ongoing and the future outcomes remain uncertain, the (Bupa) Group considers the positions it has adopted are in accordance with the tax law and intends to defend its position with respect to these matters,” it says in its latest accounts. “It is not considered that the ultimate outcome of any contingent liabilities will have a significant adverse impact on the financial condition of the Group.”
-----
  • Jul 11 2018 at 11:39 AM

Five ways the energy market is ripping off consumers

The Australian Competition and Consumer Commission certainly didn't pull any punches in its withering assessment of the National Electricity Market, saying high prices are "unacceptable and unsustainable".
ACCC chairman Rod Sims has long had a bugbear about parts of the electricity network, especially a lack of competition in the generation sector to confusing retail offers which make it hard for consumers to get a better deal.
While Prime Minister Malcolm Turnbull has so far resisted the push to establish a royal commission into electricity prices, the ACCC has delivered a fairly comprehensive assessment on how the market is broken and outlining how it can be fixed to lower power prices for households and business which have risen by 56 per cent in real terms over the past decade.
-----
  • Updated Jul 11 2018 at 11:00 PM

Expectations on house prices and credit availability plummet

Confidence in house price growth and the availability of finance has plummeted with a tripling of the number of surveyed property professionals lowering their expectations in those two areas.
The ANZ-Property Council of Australia survey, which covers just less than 1000 respondents from across the country, shows that the number of people who expect the availability of debt finance to worsen over the next 12 months has tripled.
With house prices tightening in Sydney and Melbourne it is no surprise that there was also a tripling in the number of people surveyed who thought house prices would continue to slide.
-----
  • Jul 11 2018 at 11:45 PM

Brisbane has 10,000 more apartments in pipeline than it should: RiskWise

Brisbane's inner-city apartment market has about 10,000 more homes in the pipeline than it should, says property research outfit RiskWise, and the city is expected to face more defaults on settlement.
RiskWise chief executive Doron Peleg said developers and lenders were "failing to properly assess the risks" when it came to supply and demand, and the inner-city Brisbane apartment market was a prime example.
"What we are seeing now is the realisation of the risk that should have been identified at least a couple of years ago. Defaults have been rising and will continue to do so," he said.
-----

Australia volunteers for NATO mission to stop return of ISIS in Iraq

By Nick Miller
12 July 2018 — 4:33am
Brussels: Australia has volunteered to join a new NATO-led mission in Iraq to improve the country’s military academies, aimed at preventing the return of ISIS or a resurgence of terrorism.
The mission, launched at the NATO leaders summit in Brussels on Wednesday, will “train the trainers” who teach Iraqi soldiers how to counter suicide bombers and detect, defuse and dispose of the improvised explosives used by terrorists.
Compared to his meetings with NATO leaders, President Trump says his upcoming summit with Russian President Vladimir Putin may be the 'easiest of all'.
-----

Light bulb moment: How many recommendations does it take to unplug our energy mess?

By Stephen Bartholomeusz
11 July 2018 — 8:17pm
It is a measure of the complexity of the issues, the scale and number of the deficiencies and the difficulty of responding to them that the Australian Competition and Consumer Commission’s inquiry into energy affordability has come up with 56 recommendations.
It is also a pointer to the convoluted nature of our energy policies that, while most of the recommendations appear to be reasonably sensible, even the more obviously beneficial recommendations for consumers will have their critics and the potential to produce unintended consequences and uncomfortable trade-offs.
For instance, it would appear a rational response to the confusion around the "standing offers’’ energy retailers make to consumers and small businesses – which aren’t comparable - and off which they price their discounts to introduce a default offer that is consistent for all retailers. The ACCC envisages the pricing of that offer would be set by the Australian Energy Regulator.
-----

Investors’ dire warning to Labor on franking credits plan

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

Eli Greenblat

The nation’s biggest listed investment companies, which safeguard more than $40 billion invested in local shares on behalf of 400,000 Australians, are warning of dire ramifications for retirees, low-income earners, small business owners as well as broader capital markets as a result of the Labor Party’s planned attack on franking credits.
The collection of specialist equities investors, who have combined their public policy muscle under peak group the Listed Investment Companies Association of Australia, have written to Bill Shorten, alerting the Opposition Leader to the hit to income for a cross-section of people if his government were to implement its radical shake-up of the franking credit regime.
In particular, the industry body has warned that the policy would potentially affect those borrowing to invest in private and public companies, which the listed investment companies believe is not realised by many policymakers. This could strangle a $1 trillion pipeline of equity funding provided by borrowers, self-managed superannuation funds and self-funded retirees to businesses that would ultimately damage the economy and employment.
-----
  • Updated Jul 13 2018 at 4:39 AM

What if the US matched European military spending levels

by Jeff Stein
President Donald Trump excoriated the country's European allies over their defense budgets on Wednesday, demanding they increase their military spending to levels closer to the United States.
But if the United States instead tried lowering its defense spending to mirror Europe's, Trump could safely fund several of his key priorities - including the White House's infrastructure plan, a border wall with Mexico, and a 15 per cent corporate tax rate - and still have additional money left over.
In 2018, the United States spent $US623 billion on national defense, which translates into about 3.5 per cent of its gross domestic product, according to a report recently published by the North Atlantic Treaty Organisation. (Estimates vary depending on what counts as "military spending", and some experts put the number for the United States closer to 3 per cent.)
-----
  • Updated Jul 12 2018 at 6:33 PM

Treasury secretary John Fraser resigns, replaced by Philip Gaetjens

Philip Gaetjens, a long serving advisor to federal and state Liberal governments, will become the nation's next Treasury secretary after John Fraser stepped down saying he'd only ever intended to do two to three-years in the post.
Labor immediately hit out at the selection of Mr Gaetjens, who was until recently Treasurer Scott Morrison's chief of staff before being named named last month as the next OECD ambassador to Paris, saying it would further politicise the department.
Prime Minister Malcolm Turnbull and Mr Morrison announced Mr Fraser's decision to leave as of July 31, and thanked him for his service as the nation's top economic bureaucrat since January 2015.
-----
  • Updated Jul 12 2018 at 9:01 PM

Departing Fraser truth bomb on trade points to the next election

John Fraser loves a truth bomb, and he delivered a ripper this week.
While it no doubt wasn't fully in line with the government's strategy of avoiding open conflict with Donald Trump, the outgoing Australian Treasury secretary has at last belled the cat on the President's deepening trade war.
Fraser – whose delivery resembles that of a friendly, pipe-smoking, if slightly patrician uncle with attitude – said no economist worth his or her salt could stand by and watch what's happening on trade without being "outraged".
"I think it's terrible, it's not in our interest, and one can only hope that common sense will ultimately prevail," Fraser told a gathering of economists in Canberra this week.
-----
  • Updated Jul 13 2018 at 11:03 AM

We need to drop the robots-are-taking our jobs mindset

by Adrian Turner
Wild animals aren't usually paid to appear in ads but if The Lion's Share initiative succeeds, that will change.
Elephants, tigers and other animals could receive more than $100 million in donations from advertisers over the next three years
The Lion's Share Fund was just announced at the Cannes International Advertising Festival with Special Ambassador David Attenborough, and will be launched at the UN General Assembly in September.
Conceived by Australian production company FINCH, it will use a subset of artificial intelligence (AI) to identify animals in ads.
-----

Scott Morrison makes bad situation worse with appointment of new Treasury Secretary

  • The Australian
  • 11:43AM July 13, 2018

Peter Van Onselen

The sudden departure of Treasury Secretary John Fraser isn’t surprising at one level — he was always Joe Hockey’s man, not Scott Morrison’s. Equally, Fraser has always been free and fearless with his advice, publicly and privately. Colleagues of Morrison who have worked closely with him suggest that the Treasurer isn’t exactly welcoming of advice which contradicts his thought patterns.
But the suddenness of Fraser’s departure is intriguing, having given the minimum notice possible. He departs at the end of the month. The government has had to scramble to find a replacement, and that person is Philip Gaetjens — long term former chief of staff to Treasurer Peter Costello as well as more recently to Morrison.
There goes any pretence that the Department of Treasury is at arm’s length from the Treasurer’s political office.
-----

How naivety caused monumental power prices stuff-up

By Ross Gittins
14 July 2018 — 12:05am
The privatisation of the electricity industry may not be the worst of the many stuff-ups perpetrated in the name of “micro-economic reform”, but it’s certainly the one that’s cost the greatest number of Australian households and businesses the greatest amount of money.
Like most of the other stuff-ups, this one is explained by the naivety of the nation’s “economic rationalists”. They underestimated the willingness of governments to sabotage the privatisation process and the susceptibility of econocrats to being “captured” by the business interests they were regulating.
They underestimated the industry’s willingness to search out and exploit any weaknesses it found in the regulations. And they overestimated the willingness of consumers to devote their leisure time to penetrating the thicket of electricity retailers’ deliberately confusing pricing plans.
-----

Symbolic fights make sense when you're losing the real ones

By Richard Denniss
14 July 2018 — 12:00am
Confidence is silent and insecurities are loud. How else could you explain Sky TV commentator Rowan Dean's need to credit "Western values" for the Thai junior soccer team's successful rescue? In case you missed Dean's comments – because, like most people, you never watch Sky News – it's important to note his enthusiasm for the strength of Western culture was as lengthy as it was bizarre.
According to Dean: "Those kids would not be alive if those pumps had been powered by windmills and solar panels, if they hadn't had Western technology in there, if they hadn't had Western expertise. It wasn't a bunch of gender-fluid divers that went down there. It wasn't a bunch of touchy-feely identity politics, diverse and inclusive, unconscious bias that saved those boys lives. It was solid Western know-how and technology."
The operation the world will never forget - expert divers plunge into Tham Luang cave which encased the trapped boys and their soccer coach for weeks.
-----

Scott Morrison names Michael Brennan as Productivity Commission head

  • The Australian
  • 3:00PM July 13, 2018

John Durie

Federal Treasurer Scott Morrison has appointed another former Liberal Party staffer to a key economic role with Michael Brennan to be the chief of the Productivity Commission replacing Peter Harris.
Morrison said Brennan was unanimously chosen after a full merit-based selection process to become the new head of the government’s key advisory body on micro-economic policy and regulation.
-----

Another former Lib staffer lands prime economic job

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

Rick Morton

A long-time Liberal staffer in the Howard government, who ran for preselection for a Victorian state seat, has been ­appointed by Scott Morrison to head the influential Productivity Commission, the second crucial economic selection in as many days.
Michael Brennan, who served as chief of staff to South Australian senator Nick Minchin when he was finance minister, was hand-selected by the outgoing head of Treasury John Fraser.
Mr Fraser resigned on Thursday and will be replaced by Philip Gaetjens, the former chief of staff to treasurer Peter Costello and more recently the Treasurer.
-----

Our mess of an energy market is the fault of both major parties

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

Chris Kenny

If you want proof of how the major parties are letting us down it was there in spades this week. We saw it in the grotesque theatre of political debate and in the clinical and depressing dissection of our energy market by the Australian Competition & Consumer Commission.
When Mark Latham, Graham Richardson and Pauline Hanson went toe-to-toe on television it was tempting to view the scene as a pointless prehistoric battle, reminiscent of those old horror movies with lizards standing in for dinosaurs. But such dismissals risk missing the point and letting contemporary major party politicians off the hook for the decrepit state of national affairs.
Surely the only reason people such as Hanson and Latham — and Tony Abbott for that matter — have salience in public debate is because they dare to address issues that orthodox politicians ignore or skirt around.
-----

It helps to master expression before waging culture wars

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

Peter Van Onselen

Will we ever reach a point where politicians put partisan advantage to one side and truly focus on what our education system needs to improve standards? Probably not, but the challenges involved go far beyond political division and gridlock.
Education ministers are lucky if they understand a small portion of the challenges faced by schools and universities. And even if they do get their heads around the issues that need to be addressed, the task of implementation may be ­beyond them.
But it shouldn’t be. Getting down to the basics of what must happen to improve education standards in this ­country is a simple task.
-----

Regulator resurgence trouble for investors

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

James Kirby

First it was the banks. Now it is the electricity market. For consumers the resurgence of regulation across Australian industry might be useful. But for investors it is going to spell trouble.
Two decades of deregulation are suddenly imperilled as a swing in public opinion galvanises key players from Justice Kenneth Hayne at the banking royal commission to the foot soldiers of our leading consumer and competition police.
For investors the message that deregulation is dead and gone hit home this week, when energy stocks were hit for six by an audacious blueprint from the Australian Competition & Consumer Commission that could up-end the electricity sector as we know it.
Calling for the biggest overhaul we have seen in the electricity market since it was created in Keating-era 1995, ACCC chairman Rod Sims outlined a reform blueprint that could see government-regulated prices and merger restrictions imposed on a sector already deeply immersed in the political battles around fossil fuels versus renewables.
-----

Financial Royal Commission Issues.

  • Updated Jul 8 2018 at 11:00 PM

APRA to probe life insurers over loss-making income protection policies

The prudential regulator is preparing to investigate life insurers after a preliminary review of the sector revealed the "bells and whistles" and cheap pricing associated with loss-making individual income protection insurance is putting the product's long-term viability at risk.
"The Australian Prudential Regulation Authority will pursue close engagement with a select group of primary individual disability income insurance (DII) writers, and the core activity will be a targeted review of their individual DII portfolios in the second half of 2018," said the prudential regulator in an industry update last week.
It further warned insurers that it would consider "more significant supervisory responses" such as potential Pillar 2 capital requirements if it believed progress was "inadequate".
-----
  • Updated Jul 8 2018 at 11:00 PM

Royal commission prepares for super industry showdown

As the royal commission prepares for a showdown with the $2.6 trillion superannuation industry on August 6, it has assigned a team to trawl through submissions, meet key players and comb various reports including the Productivity Commission's landmark draft report into super.
There are a lot of rabbit warrens the royal commission could head down, the most popular being the political wars of industry funds and retail funds.
Retail funds have chronically underperformed industry funds over the past 12 years by almost 2 per cent, according to the Productivity Commission's draft report. But the real scandal is that one in four funds – retail, industry, corporate and government funds – persistently underperform and they have been allowed to get away with it.
-----
  • Updated Jul 9 2018 at 9:01 AM

Royal commission adds pressure to loss-making directors' and officers' insurance

Insurers are refusing to cover big banks and other financial services companies hit by legal action related to the Hayne royal commission after revelations of misconduct and illegal action.
The loss-making directors' and officers' insurance sector, which covers directors, executives and employees involved in the management of a company, has over the past six months lifted premiums by 70 per cent on average and up to 400 per cent as it sees its profits sliced by an increase in class actions, a key cost it covers for Australian public companies.
To minimise potential fallout the corporate insurance sector has begun to insert "royal commission exclusions" into the class action defence policies it provides to ASX-listed companies, as well as the professional indemnity protection provided to top executives.
-----
  • Jul 9 2018 at 9:00 AM

Forget Hayne, here's four ways technology will remake financial advice

Technology's waves have swamped plenty of other industries, so it's hardly a surprise they are washing over the provision of financial advice. So much so, there's talk of yet another "-tech": as in, AdviceTech.
So what's accelerating the pace of digitisation of financial advice? Four key themes come to mind:
First, providers realise the current advice offering does not resonate with customers. It's a poor "experience". Stats suggest only one in five Australians gets financial advice.
-----

Super funds ‘skimming over $700bn in fees’

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

Adam Creighton

For two decades the superannuation industry has extracted more than $700 billion in fees above what typical super funds charge overseas, equivalent to almost 40 per cent of the nation’s annual GDP, ­according to new analysis.
Super funds charged fees more than four times higher than similar funds in Canada, Europe and the US, with workers thousands of dollars worse off each year, the study says.
“If members’ contributions between 1997 and 2016 had been invested in a passively managed fund with typical expenses and allocations, they would now be valued between $700bn and $800bn larger,” University of NSW economist Nicholas Morris said. The total pool of superannuation assets, $2.6 trillion in March, would now be more than $3.3 trillion.
-----

National Budget Issues.

$8 billion in income tax lost each year, Tax Office concedes

By Eryk Bagshaw
11 July 2018 — 11:36pm
If you've ever exaggerated your work expenses to get a bigger income tax return, then you might have contributed to the Federal Government's $8.7 billion loss in 2014-15.
About $8 billion in tax is lost every year through dodgy tax returns, despite a multimillion-dollar crackdown on workers by the Australian Tax Office.
Each year up to $8.7 billion in income tax is estimated to be wrongly claimed or lost because income has not been declared, an ATO briefing with Fairfax Media has revealed. Of that sum, only $500 million each year has ever been successfully recouped.
-----
  • Updated Jul 12 2018 at 12:00 AM

ATO reveals biggest tax avoiders are individuals not multinationals

The scale of profit shifting by multinationals is being dwarfed by tax-avoiding wage earners, according to new figures revealing $8.7 billion has gone uncollected due to dodgy claims.
Tax Office estimates of the gap between the tax collected and what is owed by the country's 9.6 million taxpayers is more than three times the estimated loss from large companies, which was $2.5 billion in 2014-15.
The tax gap for individuals was 6.4 per cent of the total take, well above the 5.4 per cent gap for companies, even though 93 per cent of people comply with the law.
Deputy ATO commissioner Alison Lendon said the main problem was incorrect claims for work expenses and rental properties as well as an estimated $1.4 billion in unreported cash wages.
-----

Tax agent reveals the 10 mistakes that will get your return ‘red flagged’ by the ATO

THE ATO wants to claw back an extra $900 from every Australian — and there are some “red flags” that will catch their attention.
news.com.au July 13, 201811:00am

Don't make these mistakes on your 2018 tax return

FAILING to list your spouse, claiming the maximum “receipt-less” deductions or forgetting to update your personal details are among the 10 things likely to get your tax return “red flagged” by the Australian Taxation Office this year.
That’s according to Liz Russell, senior tax agent with Etax.com.au, who said people making these mistakes could have their tax refunds delayed and potentially face penalty fees and interest charges.
“The early lodgers tend to be a little more caught out than someone who’s prepared to wait a month,” Ms Russell said.
-----

Health Budget Issues.

Johnson and Johnson ordered to pay $742m in talc asbestos cancer case

By Mary Cronin Fisk & Jef Feeley
13 July 2018 — 7:13am
Johnson & Johnson must pay at least $US550 million ($742 million) in damages to women who claimed asbestos in the company's talc products caused them to develop ovarian cancer, a St. Louis jury said.
After reaching a unanimous verdict Thursday to award compensatory damages for 22 plaintiffs that averaged $US25 million apiece, jurors will resume deliberations over how much to award in punishment damages.
The women also sued a unit of Imerys SA, which supplied the talc to J&J. Imerys Talc America settled before trial on confidential terms. The company agreed to pay at least $5 million to settle the claims, according to two persons familiar with the matter.
-----

Doctors could be reported to police by health watchdog

By Aisha Dow
12 July 2018 — 6:44pm
Doctors who are reported to Australia’s health watchdog for alleged sexual assault and other crimes could have their details passed to police, under a new deal announced on Thursday.
The Australian Health Practitioner Regulation Agency, which has been criticised for failures to act on public complaints, has reached a memorandum of understanding with Victoria Police.
The agreement, which has not yet been publicly released, will allow APHRA to give information to police about criminal offences including physical harm, sexual offending, production of exploitative material and drug offences.
-----

How can we prevent thousands of cancer deaths? Drink less

By Aisha Dow & James Hearnes
14 July 2018 — 1:00am

In numbers

·         Australian’s average yearly alcohol in 2016 9.7 litres
·         Australian’s average yearly alcohol in 1935 4 litres
·         Australian’s average yearly tobacco in 1935 1.8 kilograms
·         Australian’s average yearly tobacco in 2014 0.8 kilograms
Thousands of cancer deaths would be prevented each year if Australians slashed their weekly alcohol intake by around five standard drinks, a major study examining almost 80 years of health records has revealed.
Today, the average Australian drinks just under 10 litres of pure alcohol annually, equivalent to about 15 standard drinks a week.
-----

Turnbull asked to help diabetics with monitoring devices

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

Joe Kelly

Bill Shorten has written to Malcolm Turnbull urging the government to improve access to continuous glucose-monitoring devices for those with diabetes.
The Opposition Leader penned the “urgent request” yesterday along with his health spokeswoman, Catherine King, saying Labor promised at the last election to improve funding for the devices.
“While your government has provided free CGM devices to under 21s, which is welcome, you have not yet matched Labor’s commitment to provide access to other at-risk groups,” Mr Shorten wrote.
-----

International Issues.

In a blow for Theresa May, Brexit Secretary David Davis resigns

9 July 2018 — 9:29am
London: Britain's most senior official in charge of negotiating the country's exit from the European Union resigned on Sunday, two days after Prime Minister Theresa May announced she had finally united her quarrelsome government behind a plan for Brexit.
The Press Association news agency, the BBC and others said Brexit Secretary David Davis resigned Sunday.
Davis's late-night resignation undermined May's fragile government. He was a strong pro-Brexit voice in a Cabinet divided between supporters of a clean break with the bloc and those who want to keep close ties.
-----
  • Updated Jul 9 2018 at 4:00 PM

China needs the global trade order, even if Donald Trump does not

by Yiping Huang
There are three things that can be said about the trade war between China and the United States.
One, though it has started small, it's difficult to predict how it will end.
Two, the so-called trade war is actually a broad-based economic and political conflict.
And three, economic and trade tensions between the two countries will likely be a continuing problem.
-----
  • Jul 10 2018 at 12:23 AM

British foreign secretary Boris Johnson quits in protest over May's Brexit plan

by Elizabeth Piper and William James
Prime Minister Theresa May's foreign minister and Brexit negotiator quit on Monday (Tuesday AEST) in protest at her plans to keep close trade ties with the European Union after Britain leaves the bloc, stirring rebellion in her party's ranks.
Foreign Secretary Boris Johnson, the face of Brexit for many, resigned just hours after Brexit minister David Davis, emboldening some in her Conservative Party to mull a plot to unseat her less than nine months before Britain exits in March next year.
The two departures seemed to shatter May's own proclamation of cabinet unity last Friday, when she said she believed she had, after two years of wrangling, secured agreement on Britain's biggest foreign and trading policy shift in almost half a century.
-----

Brexit's 'cakeism' is dead. The question now is what will replace it

By Nick Miller
10 July 2018 — 3:46am
Brexit is becoming an utter disaster. In football terms, the UK is two own goals down with just minutes left in the second half. But, unlike in football, if the UK can’t get its act together, the other team is going to lose as well.
After Foreign Secretary Boris Johnson's spectacular resignation on Monday, Prime Minister Theresa May has to find an ability to score quickly - an ability that she and her government have shown absolutely no sign of to date - or the chaos enveloping British politics will extend to its economy, to most of its businesses, to its borders, and infect the second biggest economy in the world, that of the European Union.
Sterling slides after the resignation of the British foreign minister Boris Johnson heaped pressure on Prime Minister Theresa May.
-----
  • Jul 10 2018 at 12:43 PM

The conservative legal village that raised Brett Kavanaugh

by David Brooks
In the weeks ahead, we're going to spend a lot of time going over new Supreme Court justice Brett Kavanaugh's biography – where he's from and what he's written. But that's not the most important way to understand the guy.
Kavanaugh is the product of a community. He is the product of a conservative legal infrastructure that develops ideas, recruits talent, links rising stars, nurtures genius, moulds and launches judicial nominees.
It almost doesn't matter which Republican is president. The conservative legal infrastructure is the entity driving the whole project.
-----
  • Jul 11 2018 at 10:24 AM

Thai cave rescue: How rescuers pulled off the impossible

Thai volunteers celebrate after cave rescue
by Richard C. Paddock
It began as a misadventure by 12 boys and their soccer coach in a flood-prone northern Thai cave, which soon seemed destined to end in tragedy.
It turned into a nearly three-week-long story of survival, international collaboration and triumph over the impossible – one that was avidly embraced and followed live across the world.
A team of cave divers rescued the last of the boys and their coach Tuesday from deep inside the warren of underground passages near Thailand's border with Myanmar, one of Southeast Asia's more remote regions.
-----

'Reckless': Trump escalates trade war with another $US200b in Chinese tariffs

Updated11 July 2018 — 9:35amfirst published at 7:54am
The Trump administration pushed ahead with plans to impose tariffs on additional $US200 billion ($279 billion) in Chinese products by releasing a list of targets, marking a sharp escalation in a trade war between the world's two largest economies.
The tariffs could take effect after public consultations end on August 30, according to a statement from the US Trade Representative's office Tuesday. The proposed list of goods includes consumer items such as clothing, television components and refrigerators as well as other high-tech items, but it omitted some high-profile products like mobile phones.
The US said it had no choice but to move forward on the new tariffs after China failed to respond to the administration's concerns over unfair trade practices and Beijing's abuse of American intellectual property, according to two senior officials who spoke to reporters. High-level talks between the two countries starting in May failed to deliver a breakthrough to head off a trade war.
-----

Supreme Court pick a big moment for Trump and the West

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

Greg Sheridan

Donald Trump’s nomination of the 53-year-old Brett Kavanaugh to replace Anthony Kennedy on the Supreme Court demonstrates the power and consequence of the presidency. These appointments are for life and Kavanaugh could serve for 35 years or more on what is not only the most powerful judicial body in the world, but in some respects one of the most powerful legislative bodies.
The combination of the US constitution, inspiring document though it is, being written in lofty abstractions, and a powerful left tradition of judicial activism, has meant the court probably makes more laws than the typically gridlocked congress ever does. Thus the questions over any appointee are what are their views on abortion rights, health care, environmental policy. None of these matters should in principle be the concern of judges. Their concern should primarily be to see that the laws are implemented.
-----
  • Jul 11 2018 at 10:37 AM

Donald Trump creates chaos with his tariffs trade war

US tariffs on China kick in as deadline passes
The leader of the world's most powerful country is a dangerous ignoramus. So how should the rest of the world respond? What makes this so difficult to answer is that Donald Trump has created chaos. It is so difficult to negotiate with him because nobody knows what he and his team want. This is just not normal.
The administration's trade actions and announced intentions are, in this context, important in themselves and indicative of the wider dysfunction. The US has imposed tariffs on imports of solar panels, washing machines, steel and aluminium. If one adds two rounds of tariffs on China under Section 301 of the US Trade Act of 1974, the affected trade comes to about 7 per cent of US imports.
If one allows for the threat of retaliation against retaliation, which could affect an additional $US400bn of imports from China, as well as the possibility of tariffs on $US275bn of imports of cars and parts, total affected imports reaches $US800bn, or about a third of US imports of goods. The US actions have already caused retaliation.
-----

The Donalds butt heads before a NATO summit like no other

By Nick Miller
11 July 2018 — 8:46am
Brussels: NATO summits aren’t supposed to start like this. A snoozy exchange of memos, maybe. Some awkward photos, some bilaterals, a few leaden speeches culminating in a bland choreographed statement.
Instead we’ve got the clash of the Donalds. Tusk v Trump getting bitter on Twitter. Allies sniping at each other, while Vladimir Putin probably cannot believe his luck.
And, meanwhile, NATO’s historical opponent has apparently caused the death of a British citizen from a chemical weapon attack on UK soil. NATO’s historical enemy hasn’t appeared this threatening for many years, at the same time the alliance is showing a serious fracture.
-----

When the ranting drunk on the bus is the most powerful man on Earth

By Michael Deacon
Updated12 July 2018 — 8:01amfirst published at 7:59am
Washington: As the harangue thundered on, the representatives of NATO stared at the wall. Sometimes they stared at their plates. Sometimes they stared at their hands. And sometimes they stared at the press.
They stared at anything, in short, but the source of the harangue: Donald Trump.
The NATO summit had just begun, and, at a breakfast meeting in Brussels, the US president was berating his hosts over Germany's alleged dependence on Russian energy.
-----

Man whose youthful protest ignited Syria uprising admits defeat

By Josie Ensor & Joseph Haboush
12 July 2018 — 1:07pm
Beirut: "It's over, we're finished. They're giving up Syria," read the late-night message from a fighter with the Free Syrian Army.
Mouawiya Syasneh had vowed to battle on until victory or death. But the young man credited with helping spark the civil war with a small act of defiance with friends in 2011 - spraying anti-Assad graffiti at his school - was now preparing for defeat.
The rebels in the south-western province of Daraa agreed last weekend to a surrender deal with the Syrian government's Russian allies. Bashar al-Assad's army has since laid siege to the city and says it is poised to regain complete control.
-----

Why the NATO summit was Donald Trump’s worst international performance as president

  • The Australian
  • 7:59AM July 13, 2018

Cameron Stewart

Donald Trump’s European tour is leaving a trail of wreckage, as America’s allies are left bruised and confused by his shambolic handling of the NATO summit and fearful of his forthcoming meeting with Russian president Vladimir Putin.
Trump came to the NATO summit with one single and simple message — to urge NATO members to honour their promise to spend more on defence rather than rely so heavily on the United States.
It is a fair demand. Only 8 of the 29 NATO members are on track to meet pledges of spending 2 per cent of GDP on defence this year.
-----

'China will challenge US naval supremacy within a year'

By Peter Hartcher
14 July 2018 — 12:26am
China's biggest challenge to the supremacy of the US Navy will come within the year, a well regarded Australian strategic analyst predicted in Washington this week.
It will come in the form of the announcement that China's armed forces will hold exercises in the international waters of the South China Sea and that, to protect public safety, it will close the air and sea space in the area, he said.
Even though this would be presented as a temporary measure - a few days, perhaps a week - it would be the end of freedom of navigation and overflight if it went unchallenged.
-----

Mueller indicts 12 Russian officers for hacking Democrats' emails

By Matthew Knott
14 July 2018 — 2:43am
Washington: In a stunningly-timed announcement just three days before Donald Trump's meeting with Vladimir Putin, special counsel Robert Mueller has indicted 12 Russian intelligence officials for conspiring to influence the 2016 US election by stealing emails from Democratic Party officials and hacking into voter registration files.
A US grand jury has indicted 12 Russian military intelligence officers on charges of hacking the computer networks of 2016 Democratic presidential candidate Hillary Clinton and the Democratic Party.
Deputy Attorney-General Rod Rosenstein, who is overseeing the Mueller probe into Russian electoral interference, announced the charges in a surprise press conference on Friday morning (local time).
-----
  • Updated Jul 13 2018 at 11:00 PM

Donald Trump trashes NATO and Theresa May

The UK is hosting US President Donald Trump this weekend. In the past week he has threatened a full-blown trade war with China, berated his NATO allies for not spending enough on defence, stiffed Germany for being under Russia's yoke over a natural gas deal, and after landing in London announced Boris Johnson would "make a great prime minister".
Trump was referring to the same Boris Johnson who, this week, resigned as UK foreign secretary on Theresa May's cabinet over its handling of Brexit negotiations, and who – at least according to Jeni Russell, a columnist in the London Times - has an "ambition and superficial charm" that "far outstrip his ability, judgment or principles."
According to Russell, Johnson is "destabilising the British government and threatening the country's future". Displaying a British penchant for understatement, The Financial Times archly observed that Trump's comments "are very embarrassing for Mrs May".
-----

Trump disrupts NATO summit, criticises Theresa May. Now it’s Putin’s turn

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

Greg Sheridan

Is the West, as a strategic or even a cultural entity, starting to unravel at last?
US President Donald Trump is never so scary to his allies as when he meets a ruthless dictator who can engage in man love, in mutual admiration and hail-fellow-tough-man-well-met bonhomie and outrageous personalised flattery.
So when Trump meets Russia’s Vladimir Putin on Monday, allied hearts will skip a beat, feel a tremble, take up residence in allied leaders’ mouths.
But after this astonishing week of Trump in Europe, it may be that the allied leaders will be happy that Putin has to deal with him.
-----
I look forward to comments on all this!
-----
David.

A Must See DIscussion Of Opt-Out From First Dog On The Moon - Very Well Informed!

Click this link, read and weep!

https://www.theguardian.com/commentisfree/2018/jul/19/opt-out-cassandra-the-information-technology-wobbegong-on-my-health-record

David.

Real Clinical Computer Systems Can Make A Huge Difference - Pity The myHR Is Not One Of Them!

This appeared last week:

Lucile Packard Children's Hospital Stanford automates medication management to reduce adverse drug events

It has seen a 21 percent decrease in missed doses, a 66 percent reduction in wasted doses and zero reportable adverse events in the past 11 months.
July 06, 2018 01:11 PM
Lucile Packard Children's Hospital Stanford initiated various safety interventions for medication administration. Moving from a daily medication cart fill – once every 24 hours – to multiple fills per day – every 2 to 3 hours – and implementing a barcode verification system for all medication dispensing has resulted in a 21 percent decrease in missed doses, a 66 percent reduction in wasted doses and one of the lowest medication error rates according to incident reporting in the Solutions for Patient Safety Collaborative.
"Medication errors in hospitals can occur at any point during the medication use process and may result from the actions of physicians, pharmacists, pharmacy technicians, nurses, other hospital personnel or even the patient," said Melanie Chan, assistant director of pharmacy services at Lucile Packard Children's Hospital Stanford. "In California, hospital pharmacies are required by law to have a 'Medication Error Reduction Plan' that must be reviewed and updated annually, and technology implementation must be part of the plan.”
Safely providing medications in a children's hospital environment presents a number of unique challenges not seen in adult hospitals. Doses are primarily weight-based and medication formulations must be manipulated to provide patient-specific doses. An error in the medication use process has the potential for a catastrophic event when a child is involved.
At Lucile Packard Children's Hospital Stanford, the prevention of medication errors has been a primary focus for more than 30 years.
Lots more here:
This is really a testament to what can be achieved with a concerted long term focus and effort and technology that is purpose designed to make sure, in virtually real time, errors are detected and prevented before they happen.
Introduction of these essentially interactive and real-time technologies in clinical care situations is known to work and to make a real difference, as witnessed above, as opposed to the introduction of non-interactive secondary systems that only not problems after the event. I know where the next $2Billion should be spent. On something that works!
David.

Tim Kelsey Keeps On Repeating An Apparent Fib? I Wonder Why?

This is a re-print of a late May 2018 blog.

He keeps saying there have been no security breaches when the OAIC says there have been. Who do you believe?

-----

Is Tim Kelsey Telling An Untruth Here Or Am I Missing Something?

At the National Press Club last week Mr. Kelsey said the following in his prepared speech:
----- Begin Extract.
Tim Kelsey:                         My Health Record has a range of protocols which mean that all instances of access by a clinician are attributable directly to that person and recorded in real time. Unauthorised access is subject to a custodial prison sentence of up to two years. Trust is the essence of medicine. Digital services can support confidentiality and not undermine it. My Health Record operates to the highest cyber security standards in Australia, and is independently audited on that basis by a number of organisations, including the Australian Signals Directorate. The agency has set up a national cyber security centre to ensure constant multi-layered surveillance of My Health Record. Since the system was launched in 2012, there has been no breach. But, real time vigilance, of course, remains our highest priority. People are quite rightly concerned about the security of their privacy information, and that's why they have a right to make a choice. That's why the Australian government was absolutely right to introduce opt-out into this measure.
----- End Extract.
Here we have the Office of The Australian Information Commissioner (OAIC) Report for 2016-17.

Annual report of the Australian Information Commissioner’s activities in relation to digital health 2016–17

Part 1: Executive summary

From 1 July 2016, national digital health governance arrangements and My Health Record system operations transitioned from the Department of Health and the National E-Health Transition Authority to a new body, the Australian Digital Health Agency (the Agency).
This annual report sets out the Australian Information Commissioner’s digital health compliance and enforcement activity during 2016–17, in accordance with s 106 of the My Health Records Act 2012 (My Health Records Act) and s 30 of the Healthcare Identifiers Act 2010 (Cth) (HI Act), as outlined in the 2016–17 memorandum of understanding (MOU) between the Office of the Australian Information Commissioner (OAIC) and the Agency.
The report also provides information about the OAIC’s other digital health activities, including its assessment program, development of guidance material, provision of advice, and liaison with key stakeholders.
More information about the MOU is provided below in section 2 of this report. The MOU can also be accessed on the OAIC’s website www.oaic.gov.au.
This was the fifth year of operation of the My Health Record system and the seventh year of the Healthcare Identifiers (HI) Service, a critical enabler for the My Health Record system and digital health generally.
The management of personal information is at the core of both the My Health Record system and the HI Service (collectively referred to as ‘digital health’ in this report). In recognition of the special sensitivity of health information, the My Health Records Act and the HI Act contain provisions that protect and restrict the collection, use and disclosure of personal information. The Australian Information Commissioner oversees compliance with those provisions and is the independent regulator of the privacy aspects of the My Health Record system and the HI Service.
The My Health Record system commenced in 2012 as an opt-in system where an individual needed to register in order to get their My Health Record. In March 2016, the Australian Government commenced a trial of opt-out system participation in Far North Queensland and in the Nepean Blue Mountains region of New South Wales. A My Health Record was created for each individual living in those areas, unless the individual chose to opt-out of participating in the trial.
Changes to the My Health Records Act introduced by the Health Legislation Amendment (eHealth) Act 2015 enabled the trial to be undertaken. That amendment Act also introduced a number of other changes across digital health legislation and the Privacy Act 1988 (Privacy Act), including streamlining the personal information handling authorisations, and introducing additional civil and criminal penalties for privacy breaches. An independent evaluation of the trials commissioned by the Department of Health was conducted to look at the outcomes from these trials.
In the May 2017 Budget, the Australian Government announced the creation of a My Health Record for every Australian to begin nationally from mid–2018.
In 2016–17, the OAIC received 35 mandatory data breach notifications. These notifications recorded 140 separate breaches affecting a total of 152 healthcare recipients, 144 of whom had a My Health Record at the time of the breaches. Five of these notifications remain open at the end of the reporting period. The OAIC received two complaints regarding the My Health Record system and no complaints relating to the HI Service. In addition to handling data breach notifications, the OAIC carried out a full program of digital health-related work, including:
  • commencement of one privacy assessment and completion of two assessments from the previous year
  • liaising with the Agency and the Department of Health on the decision for national expansion of My Health Record in 2018
  • making submissions to various stakeholders on matters directly related to or associated with the My Health Record system. This included a submission to the Agency on the development of the National Digital Health Strategy
  • providing advice to stakeholders, including the Agency, on privacy related matters relevant to the My Health Record system
  • developing, revising and updating guidance materials for a range of audiences, including the development of My Health Record related multimedia resources for healthcare providers
  • participation in the Privacy and Security Advisory Committee, one of the advisory committees established by the Agency to support the Agency’s Board
  • monitoring developments in digital health, the My Health Record system and the HI Service.
----- End Extract.
Here is the link:
I am unable to reconcile the two bolded sentences and would be interested to know how they can be reconciled (channeling Rowena Orr QC of the Royal Commission). When is a breach not a breach etc?
Interestingly there were similar findings the previous year:
“In 2015–16, the OAIC received 16 mandatory data breach notifications. These notifications recorded 94 separate breaches affecting a total of 103 healthcare recipients, 98 of whom had a My Health Record at the time of the breaches.”
Here is the link:
I look forward to views on this repeated claim (of a breach free system)  which must make us wonder what else we are told we can take as the full and precise truth?
David.

Wednesday, July 18, 2018

There Are A Few Facts About The myHR That Seem To Have Been Missed.

This very interesting research note appeared a while ago but has some really important implications.

Your Privacy, My Health

Australia May 17 2018
It may be surprising to some that, in Australia at least, there is no fundamental right to privacy. There are laws that protect aspects of your confidential information, including the Privacy Act 1988 (Cth) and associated Privacy Principles, that impose sanctions on those who fail to properly deal with private data. Common law remedies also exist in theory, however there is no readily accessible statutory cause of action that allows a privacy breach victim to claim their emotional distress and other damages. This gap in our law was the subject of a 2014 Australian Law Reform Commission Report, to which the Australian government has never formally responded.
Instead, since late February 2018 we now have a mandatory requirement for various entities including government and larger businesses, to report breaches of privacy. If your data is compromised (accessed by those who are not authorised), you must be notified and suggestions offered on ways to mitigate any impact. If your credit card details are leaked, for example, a suggestion might be to cancel those cards to prevent unauthorised use.
Under this new law, you will know exactly when your privacy was compromised. Cold comfort perhaps, however the intent is that a process of reporting will ultimately lead to better protections.
Of course, not all private information is the same. It is hard to imagine what should be done to mitigate the impact of a breach of personal medical information. Once disclosed, such information cannot simply be cancelled – it remains true, sensitive and open to abuse no matter what is done in response.
Which brings us to yet another crossroads in the privacy debate. As of the end of 2018, all Australians will have their own online e-health record – known as My Health – unless we each take action to opt-out within a specified 3-month window, yet to be announced. Once created, private medical information will be continually uploaded by GPs, pharmacies, medical specialists, pathologists and the like, to create what is intended to be a comprehensive record of your health history. This then becomes accessible by other medical professionals, to assist in providing your improved future health care. The information is also said to be used in a more general sense, to provide data and therefore potential insights into various issues of national significance and beyond.
Of course, the system is said to be protected by various levels of sophisticated security. This claim must be tempered by the view of some IT commentators that true data security is no longer possible – that all data is ultimately accessible to those who seek it. The health sector is currently responsible for over a quarter of all notifiable data breaches, as outlined in the first report under the new disclosure legislation. The federal Health Department itself has also been in direct breach of privacy law, when in mid-2016 it released de-identified health data on 2.9 million people – 10% of all Australians – that was able to be re-identified using information readily available elsewhere.
One thing is clear: the law is not able to physically protect your private information. It can only respond to breaches that have already occurred. Allowing your private information to exist outside of your direct personal control then becomes a question of risk versus benefit.
We advocate that everyone should be aware of the facts on the collection, storage and use of their private information, to enable informed decisions and where possible, the knowledge to control that process.
For more information regarding My Health records and your rights, visit myhealthrecord.gov.au.
Here is the link:
These two paragraphs are the key:
“One thing is clear: the law is not able to physically protect your private information. It can only respond to breaches that have already occurred. Allowing your private information to exist outside of your direct personal control then becomes a question of risk versus benefit.
We advocate that everyone should be aware of the facts on the collection, storage and use of their private information, to enable informed decisions and where possible, the knowledge to control that process.”
So basically this is saying if you hand over control of your information you lose control of it and what happens next is up to those who now control it. Once the information is out, it is out and you can’t legally do much. A legal expert tells me:
“This shortcoming in Australian law is compounded because you cannot take legal action for yourself even after a breach: there is still no way to sue here (despite five law reform reports over 30 years recommending a fix).
This lack of protection for anyone harmed undermines the potential preventive benefits of the fear of legal consequences by those planning to expose you to risk, since it is well known by Australian governments and industry.”
If you don’t totally trust an entity both the secure and properly protect information you want to keep private then you know what to do. Don’t provide the information to that entity.
It is that simple.
David.

What Do Consumers Really Want From Digital Health? A Bit More Than The myHR I Believe.

This appeared last week:

What Do Patients, Consumers Want in Digital Health Tools?

Ninety-two percent of patients said improving consumer experience should be a top goal when deploying digital health tools.

July 12, 2018 - As patients continue to assume the role of healthcare consumer, healthcare providers and payers are beginning to leverage healthcare technology that helps connect patients to their care. Those innovations, when utilized correctly, help drive an overall better consumer experience, according to a recent Black Book survey.
The survey of nearly 650 healthcare consumers – 40 percent of whom self-identified as a younger healthcare consumer – found that the digital consumer experience is of high priority. Ninety-two percent of respondents said improving consumer experience should be a top priority for healthcare organizations, up from 71 percent of respondents who said the same in last year’s consumer survey.
Patients largely have high expectations for the health IT offerings from their providers, the survey revealed.
Ninety-three percent of patients expect to use digital tools that facilitate patient-provider interactions. Eighty-five percent said the same about virtual care access, 97 percent about online scheduling, 92 percent about online payment tools, and 94 percent about online price transparency tools.
But expectations do not always meet reality, the survey showed.
"Despite healthcare becoming more digital and available to consumers, provider organizations still have far to go when it comes to embedding new consumer-centric technology," said Doug Brown, Founder of Black Book.
Per a Black Book survey from Q4 of 2017, only about 9 percent of providers said they have the ability to offer all of the tools patients expect out of them.
This could mean bad news for healthcare providers who lack sophisticated patient engagement suites as patient retention and loyalty come into question. The survey showed that 90 percent of patients feel no obligation to stay with a provider who does not offer a satisfactory digital experience.
Eighty-eight percent of patients under age 40 said they will choose their next provider based on the provider’s online presence.
Much more here:
There is more in this press release:

19 Recent Healthcare Tech Start-Ups Attract Instant Consumer Appeal, Black Book Survey




Press Release - updated: Jul 9, 2018
TAMPA, Fla., July 9, 2018 (Newswire.com) - Providers and payers are confronting consumers' newfound expectations of medical convenience, efficiency, and innovative technologies. Those demands are forcing healthcare delivery to be envisioned differently to drive and retain patient volumes. Nineteen recently-funded companies captured the approval of nationwide health consumers in a review of over two hundred start-ups for their potential to deliver in the advent of healthcare consumerism.
Black Book surveyed 650 health consumers through panel partners in Q2 2018. The mean age of respondents was 37.2 years. 44% of survey participants identified themselves as among the Millennial generation or younger.
92% of healthcare consumers surveyed say that improving customer experience should be a top strategic priority for medical providers over the next twelve months, increasing from 71% last year.
"Despite healthcare becoming more digital and available to consumers, provider organizations still have far to go when it comes to embedding new consumer-centric technology," said Doug Brown, Founder of Black Book.
Consumers report a confidence that advanced technology is available in Q3 2018 to engage them with digital provider tools (93%), as well as offer a variety of virtual access points (85%), online scheduling (97%), online payment options (92%), and/or provide price transparency (94%). However, only 9% of the collective providers reported the ability to offer these consumer demands successfully in a Black Book Q4 2017 survey of hospitals and physicians.
90% of patients no longer feel obligated to stay with healthcare providers that don’t deliver an overall satisfactory digital experience. 88% of respondents under age 40 state they will choose their next medical provider based on a strong online presence.
For their next healthcare purchase, 83% of consumers polled will seek providers that offer four fundamental technologies in demand: digital scheduling, online payment options, portal and engagement capabilities, and results reporting tools.
Black Book’s 2011-2016 marketplace study demonstrated that 77% of all new healthcare products failed. Lack of relevance, lack of distinction, inappropriate pricing and jumbled messaging all factor into a brand’s fight to differentiate between consumers and buyers when launching a new healthcare technology product.
“The ultimate judgment of new health IT products falls to consumers and providers, who, ironically, are often absent from the development process,” said Brown. “That development stage stands the greatest chance of generating transformative ideas early on before the brand has made a significant investment.”
In 2018, Black Book sought out panels of healthcare consumers and presented a diverse range of technologies funded and/or launched in the past twelve months and asked, which application or solutions (from a one sentence product description) would: (1) have immediate demand from them as an active consumer (meaning they had used or interacted with a healthcare technology, product or service within the last six months); (2) would most likely drive an improvement in their healthcare status, choices or delivery in the next six months; (3) is highly innovative and/or disruptive for the healthcare industry, and (4) has immediate value to them.
An alphabetical directory of 210 healthcare consumer-oriented products from companies which each received investor funding in the past twelve months was provided panel members. Black Book culled the products and services that piqued the highest current application curiosity and demand. Each of the nineteen vendors received an average score of 9.0 out of 10.0 across four product capabilities or features.
“Consumer health information technology continues to be one of the top-funded value propositions for global investors,” said Brown.
Digital health startups raised an all-time high of $11.5 billion in 2017.
Each of the nineteen vendors received an average score of 9.0 out of 10.0 across four measurements:
The 19 startups include:
98Point6 – Chat-based Telemedicine
Able To – Online Behavioral Health Support
Amino – Patient/Doctor Matching
Blink Health – Online tool to find the lowest Rx pricing
Carbon Health – Virtual Health Clinic
CirrusMD – Virtual Health Visits
Conversa – Patient/Caregiver Communications
Day Two – Personal Laboratory Analyses
EverlyWell – Online Lab Testing
Kry – App-based Telemedicine
Lemonaid Health – Text-based Telemedicine
Medisafe – Personalized Medication Management
PatientPoint – Engagement & Education Platform
Phil – Rx Filling & Delivery
Policy Genius – Health Insurance Shopping Tool
Practo – Provider locator & matching
Protenus – Patient data protection
Push Doctor – Virtual Visits
Solv Health – Urgent Care Visit Scheduling
Visit Pay – Payment planning & processing

Here is the link:
The capabilities of the top applications build a pretty clear picture of expectations with appointments, results, tele-medicine and results being widely sought.
I fear the myHR simply will not be providing the satisfying digital health experience most will be seeking in a few years.
David.

Another Big Reason To Consider Opting Out While You Can.

On the Drum last night a Panel Member (Dr Suelette Dreyfus, Melbourne Uni. I believe) made the point that those who sign up today are at risk of rule changes in the future.

An example might be, for example, five years from now, it may be decided by Government that employers can have access to myHR records. Or is may be decided that insurance companies can access myHR data. Make up other undesirable scenarios for yourself....

Given that once the data is in the myHR it can't be deleted, the only way you can protect yourself from this sort of regulation change in the future it to opt-out.

Think about it.

David.

Tuesday, July 17, 2018

The ABC Answers Some Questions On The myHR With A Few Points I Had No Idea About!

This summary appeared on Sunday 15 July.

My Health Record: Your questions answered on cybersecurity, police and privacy

Ariel Bogle - Science Reporter – ABC News – 15 July, 2018.
Australians have lots of questions about My Health Record.
Every Australian will soon have a My Health Record — an online summary of their health information — unless they opt out over the next three months.
From Monday, Australians will have until October 15 to tell the Government they don't want one. Otherwise, a record will automatically be created.
The project aims to give patients and doctors access to timely medical information — test results, referral letters and organ donation information, for starters — but there are concerns about the safety of some of our most personal, sensitive data.
We asked for your questions about the project on social media, and they ranged from police access to the platform's cybersecurity.
The ABC sat down with Tim Kelsey, the head of the Australian Digital Health Agency (ADHA) and the man in charge of the initiative, to get them answered.

The way the record works

As a patient, how can I know if my My Health Record information is being maintained by my doctor?

You can choose to opt out and have no My Health Record.
But once you have one, doctors can upload health information into it unless you ask them not to.
When you see a doctor, you can discuss adding (or not) documents such as an overview of your health, a summary of prescribed medications and referral letters.
Remember, it's not a comprehensive picture of your health — it will only contain what you and your doctors choose to upload, and will depend on the quality of those records.
When you first access the system, you'll be asked to decide whether you want two years of Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, Australian Immunisation Register, and Australian Organ Donor Register data to be uploaded.
But if your doctor accesses your record first before you make the selection yourself, this data will be uploaded automatically — unless you've opted to have no record at all.
If you want, you can delete or restrict access to those documents later.
Not all Australian hospitals and health services are connected to My Health Record yet, so that's something to check during your next visit.

When I get a prescription, how do I know whether I need to ask to make an update to my My Health Record? Does this vary by provider?

Doctors can upload information about prescribed medications, but as discussed above, it's worth discussing this each time you see your doctor.

What happens to your My Health Record after you die?

My Health Record information will be held for 30 years after your death. If that date isn't known, then it's kept for 130 years after your birth.

Will any private health insurance companies have access?

Insurers shouldn't be able to access your record — it's reserved for people who work for a registered healthcare provider and who are authorised to provide you with care.
There are plans to use aggregated, anonymised My Health Record data for research and other purposes — this is known as "secondary use".
"My Health Record information can be used for research and public health purposes in either a de-identified form, or in an identified form if the use is expressly consented to by the consumer," a Department of Health spokesperson said.
Currently, users of the platform can tick a box on the web portal to opt out of secondary use.
Secondary uses must be of public benefit and cannot be "solely" commercial, and insurance agencies will not be allowed to participate.
However, "the impact of this exclusion" will be considered when the Department of Health's framework governing secondary use of My Health Record data is reviewed, according to the framework document.
Australian organisations (and some overseas, in certain circumstances), including Australian pharmaceutical companies, will be able to apply to access My Health Record data for approved secondary purposes.
"We don't expect any data to flow until 2020," Mr Kelsey added.

The opt-out period

How can I opt out?

There are three key ways:
  • By visiting www.myhealthrecord.gov.au and opting out using the online portal.
  • Over the phone by calling 1800 723 471.
  • Or on paper by completing a form and returning it by mail. Forms will be available in 2,385 rural and remote Australia Post outlets, through 146 Aboriginal Community Controlled Health Organisations and in 136 prisons.

What happens to the people who end up with a My Health Record, and then decide to opt out?

If you don't opt out between July 16 and October 15, then a record will be automatically created for you.
After October 15, there will be a "one-month reconciliation period" before new My Health Records are registered. These new records will be created mid-November.
You can then cancel that record, but the data it contained will still exist (although inaccessible to you or health providers) until 30 years after your death.

Is a record automatically generated if a doctor uploads a document during the opt-out period, even if you did not create one yourself?

According to the ADHA, doctors can't upload any clinical documents to the My Health Record system unless the patient record exists.

What about children who aren't born yet — can they opt out?

After the opt-out period, newly eligible healthcare recipients, such as newborn children and immigrants to Australia, will be given the chance to elect not to have a My Health Record as part of their Medicare registration.

Protection of your data

Which service provider will manage the infrastructure to ensure it isn't vulnerable to a cyber-attack?

The platform was built by the technology provider Accenture, however the ADHA is starting discussions about "re-platforming" it.
Independent third parties audit the system's security and undertake penetration testing, according to Mr Kelsey, but security experts warn that it's impossible to make any online database entirely bullet proof.
Remember too, that documents created or downloaded by your doctors may be stored in their local IT system too and depend on that system's security.

If a doctor downloads files from My Health Record, what's to stop her from sharing those files within the practice?

By default, your online documents will be accessible to your healthcare providers.
If you have privacy concerns, you can log onto My Health Record and restrict who sees it:
  • You can set a Record Access Code and give it only to healthcare professionals you want to access your record.
  • If you want to restrict certain documents, you can set a Limited Document Access Code.
These controls may be overridden in an emergency.
As mentioned above, if a document is removed from the My Health Record system, it's beyond the reach of your access controls.

If a GP were to allow another staff member to access a record, what is the potential punishment?

If someone accesses your My Health Record without legal authorisation and the person "knows or is reckless to that fact", criminal and civil penalties may apply.

Where can users see information about who has accessed their record?

My Health Record users will be able to see who has looked at their record by checking its access history online.
They'll be able to see when it was accessed, which organisation accessed it and what was done — documents being added, modified or removed, for example — but not the individual doctor who accessed it.
You can also set up an email or SMS alert for when a healthcare organisation accesses your record for the first time.
The privacy commissioner recommends checking regularly for unexpected or unauthorised access. You can call the ADHA on 1800 723 471 if you think something's gone wrong.

Several apps can connect to My Health Record. How will the ADHA ensure they are secure?

Apps such as Healthi and Health Engine, which recently ran into trouble, are authorised by the ADHA to "show" people their health record.
According to Mr Kelsey, third party app developers can only display your My Health Record — "at the moment, it's view-only" — and cannot store that data.
These providers undergo "strict assessment" and must abide by a Portal Operator Registration Agreement, according to the ADHA.
The agreement demands they do not download or store My Health Record information on their own system, or pass that data on to a third party.
"We are not currently planning to provide access beyond 'view-only' to the app community," he said.

Police and law enforcement

Which rules and policies guide the ADHA's decision to grant access to law enforcement?

The ADHA is authorised by law to disclose someone's health information if it "reasonably believes" it's necessary for preventing or investigating crimes and protecting the public revenue, among other things specified under section 70 of the My Health Records Act.
The agency was unable to provide a definition of "protecting the public revenue" by deadline.
When it receives a law enforcement request, the ADHA will need to determine that it's a legitimate request from an enforcement body.
Law enforcement bodies will not be granted direct access to the My Health Record: The ADHA said any disclosure would be limited to what is necessary to satisfy the purpose of the request.

Has the ADHA received any requests from law enforcement to access records?

Mr Kelsey said no police requests have been received yet.

Will users be informed if their data has been released to law enforcement?

If personal information is disclosed to law enforcement, the decision about whether to notify the My Health Record holder will be decided "case-by-case".
Likewise, healthcare provider organisations won't be informed if their patient's data is accessed.
The release to police will be recorded in a written note and stored by the ADHA.
Here is the link:
Among the things I found interesting were:
1. There is a clear admission that leaks and breaches are possible – the first time I have heard the ADHA essentially admit there are risks around the security.
2. That it is possible for health professionals to allow anyone they choose to have access to the myHR – think Doctor / Receptionist, Pharmacist / Pharmacy Assistant etc.
3. Access by police and law – enforcement (Border Patrol etc.?) does not require a warrant apparently and the ADHA does not have to tell you or your doctor they have provided access!!!!
4. The Privacy Commissioner recommends you keep checking you myHR to make sure there has not been unauthorized access – what a joke.
For myself I am not sure I want my records that easily available. As they say – your call about opting out.
David.