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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."

Tuesday, November 19, 2024

Is There Any Legitimate Reason For Wanting To Use Cryptocurrencies?

This appeared last week:

Buoyed by Trump win, US pro-crypto lobby group opens Australian outpost

By David Swan

November 17, 2024 — 9.30am

Pro-crypto lobby group Stand With Crypto is hoping to capitalise on a wave of momentum from Donald Trump’s decisive US election win, launching in Australia to push for crypto-friendly legislation and fight the technology’s “crypto bro” image problem.

Using a flashy drinks event at Melbourne’s National Tech Summit to mark its launch Down Under, the advocacy group has met with MPs and senators over the past week to push for what it says is “sensible” legislation to regulate crypto firms operating in Australia.

The group has been launched by Coinbase, the United States’ largest cryptocurrency exchange, and is hoping that Australian politicians will be spurred into action after witnessing crypto’s role in the recent US poll. The cryptocurrency sector won big in the elections: Trump promised the US would become the bitcoin superpower of the world, and the sector raised more than $245 million from a mix of corporations and individual contributors to elect pro-crypto candidates.

The crypto sector outspent oil companies, banks and Elon Musk on the election. Stand With Crypto developed a grading system for candidates across the country, rating them from F to A on their stances.

“Our goal is to shift the narrative from crypto being viewed solely as a speculative investment to recognising it as the future of finance and the internet,” Tom Duff Gordon, vice president of international policy at Coinbase, told this masthead.

“We want to help prioritise getting sensible and good regulation in this space, and what we’ve done in the US has been really successful. In that election we had 1.9 million advocates sign up, and we had 400,000 in the week before the election.

“It was a huge number of people, it was a big mobilisation and we ran events up and down the country. We’ve launched it in the UK, we’ve launched it in Canada, and we’re now bringing it to Australia because there’s a huge opportunity here.”

Crypto has boomed following the election, with bitcoin surging past its all-time high and now on track to hit $US100,000 within weeks. Its price is up 93 per cent over the year to date.

Some 20 per cent of Australian adults hold some form of cryptocurrency, according to Duff Gordon, but the nation finds itself at a regulatory impasse, preventing further adoption and investment.

“We lack a licensing framework for crypto asset providers, so we’re lacking certainty,” he said. “This government and the previous government have done a lot of work with the industry, so we’re supportive of the direction, but we need it to be actualised.

I don’t really see a role for [crypto] in, certainly in the Australian economy or payments system

“It hasn’t been prioritised by the (Labor) government, so we would love for them to step forward.”

It comes after Reserve Bank governor Michele Bullock this month poured water on cryptocurrency, saying it has no role in the Australian economy or payments system.

“I don’t understand it,” she said last Thursday. “But, you know, I don’t really see a role for it in, certainly in the Australian economy or payments system.”

ASIC chair Joe Longo has also dismissed the recent rally in bitcoin and other crypto assets, saying it was an example of “the bigger fool theory”: the idea that people can make money on overvalued assets if those assets can later be resold at an even higher price to a bigger “fool”.

ASIC has indicated it will regulate crypto under existing financial product laws.

Crypto has commonly been linked with scams, fraud and criminal activity, and Duff Gordon acknowledged crypto’s “image problem” but said that hadn’t stopped major financial institutions globally, including Australian banks, from exploring blockchain technology for more efficient digital payments.

“Yes, there were hiccups, but the industry has matured,” he said.

Michael Chmielewski, head of growth at Australian cryptocurrency exchange Day1x, called crypto’s image problem a classic “few bad apples” situation.

“Much like the early days of the internet and the dotcom bubble, though, the strongest companies who take care of clients the most will ultimately rise to the top,” he told this masthead.

“Crypto’s path forward is through delivering real-world value … The goal is to reach a point where people use crypto and blockchain technologies without needing to understand them, just as they now use the cloud without thinking about the underlying tech.”

The Albanese government’s special envoy for cybersecurity and digital resilience, Andrew Charlton, said the government is “100 per cent committed to delivering reform.”

“I acknowledge and support the crypto industry’s proactivity in helping to shape sensible regulation,” he said.

“Our focus is on regulating exchanges - not specific tokens. It is too big to get wrong, and we’ve been working constructively with industry to get the detail right.

“The Coalition failed to act for a decade and have no policy when it comes to crypto. We’ve taken the time to consult with stakeholders so that we can get this right. Our approach will protect consumers and support innovation.”

Liberal senator Andrew Bragg welcomed the launch and said the crypto sector would benefit from stronger advocacy.

“Labor has dropped the ball and they have been able to get away with it. We need hard timetables to get things done otherwise we will be a crypto backwater,” he said. “Stand with Crypto can help us avoid that outcome.”

While Duff Gordon remained tight-lipped about specific meetings during his visit, he confirmed ongoing discussions with Australian officials.

Here is the link:

https://www.smh.com.au/technology/buoyed-by-trump-win-us-pro-crypto-lobby-group-opens-australian-outpost-20241114-p5kqj2.html

I keep reading these articles and keep wondering just what is the value cryptocurrencies bring – other than allowing people to bypass the traditional financial system for no motive I can see as benign.

Can anyone explain to this elderly crypto-ignorant person just why I need cryptocurrencies and why I should invest in them.

As far as I can tell I am better off making any trading profits I can make in real money! Is there any use-case for crypto that is not trying to subvert and / or hide profits from the Tax Office etc.?

Of have I got this totally wrong?

David.

Sunday, November 17, 2024

It Really Feels As Though Scams Are Just Running Riot!

 This appeared last week:

‘Psychopaths are the best’: Confessions from inside the scam industry

From marketing and retention to catastrophe and recovery, the life cycle of the scam industry is breathtakingly cruel and strikingly consistent.

By Aisha Dow

November 17, 2024+

Professional scammer Mitch says most people in his industry fall into two categories: They’re psychopaths, who enjoy what they do, or they are deluding themselves about the terrible impact of their crimes.

“Psychopaths are the best agents,” he muses. “But I believe any scammer who’s not psychopathic, I honestly believe they will have lasting consequences.”

Mitch is coy on how he wound up managing a scam centre peddling phoney investment schemes in eastern Europe. He also hesitates when asked if he still thinks about people – victims – he had become close to over the years.

“Yes,” he replies. “I’ll leave it at that.” But then, after a short pause, he continues.

Scam agents start by honing their skills on low-value victims, but hoping to move up the food chain, advancing to new departments where there is more money to be made.

These “low-value” targets are people with the smallest incomes, often with the most to lose.

“You’re not gonna get Mark Zuckerberg, billionaire extraordinaires. No, you get everyone who’s sick, who doesn’t have money, who’s on social support and basically has very bad income.

“The main thing you do to prove yourself is take their last money, put them in crippling debt,” he says. “That’s something that you don’t forget.”

This is the breathtaking cruelty of the cyberfraud world. It’s a place where each scam story is slightly different, but there is a familiar pattern.

This masthead’s investigation used accounts from scam group insiders, private investigators and victims to trace the key steps of a typical online investment scam.

People’s journey might begin with a scam advertisement, reach a false high as victims are tricked into believing they are making windfall profits, and then end with their details being passed on to a new set of scammers who falsely claim they can recover the stolen money.

Australia is considered one of the easier targets for scammers, according to industry insiders and cybercrime investigators. Investment scams cost Australians an estimated $1.3 billion last year.

The fraudsters come for people’s savings, their superannuation and the roof over their heads.

“They promise, promise from the bottom of their heart that everything will be right, but it’s just so full of lies,” says Janelle Free, a retired hairdresser from Queensland.

“They’d take your blood, if they could, they’d take your organs, they would literally kill you to get the last out of you, and they’re so good at it.”

Asked how much she lost to the scammers, Free replies: “I sold my house, darling, and gave him my whole house funds.”

“It all starts from marketing, right?” says Mitch, who is using a fake name. Charming and confident, he is one of several scammers this masthead spoke to who effectively act as double agents, working inside scamming syndicates, while also providing information, sometimes through third parties, to cybercrime investigators or governments.

He explains how he has built rapport with victims, telling the people he’s scamming that he has ties to the country they live in, or that they share the same interest or hobby.

“At the end of the day, if you have any common sense and check where the company is located … you will see there is a scam. So what you do is you create a bond with the client, with the victim, so they don’t do that.”

Marketing is typically outsourced to groups called “affiliates”, organisations that specialise in mass marketing campaigns and search engine optimisation. They collect personal details of potential victims by running scam advertisements, videos and other online content that invite clicks and detail registration.

The affiliates sell these “leads” to companies like the one Mitch works for.

He says affiliate companies charged about $1200 to $3000 for a victim’s details if they had registered with a fake investment platform and then put down a small investment or deposit of around $250. The scamming company might pay $100 for someone’s information if they had only registered their details, but were yet to invest any money in a fraud scheme.

According to Mitch, Facebook is the most common source of victims for his call centre, followed by Instagram.

He says scam ads deleted by Meta were quickly replaced with new ones. By running numerous Facebook accounts and spreading their ad spending among them, criminals were able to keep running a steady stream of advertisements.

“What they usually do is they segregate the accounts. Let’s say they have 100 ads running. It’s not going to be under one roof. It’s going to be under 100 roofs. And if one roof gets torn apart, you just change one roof, not all hundreds.”

“It’s a very, very profitable activity,” says New-York based computer security expert Jerome Dangu, who co-founded Confiant, a company that specialises in blocking scam ads.

Dangu says affiliate marketers commonly deployed single-scam ad campaigns that reach millions of viewers globally.

In the recent past, he says scam ads have often mentioned cryptocurrency Bitcoin. These days, the popular theme is artificial intelligence-powered investments.

Often they exploit the images of celebrities, with altered photos or videos that give the impression the famous person is doing or saying something they are not.

“In Australia, it’s typically billionaires, but also political figures. They make them endorse these offers that are scams. Another component is a fake advertorial with the logo of a newspaper or an online news site… The first step is to collect a name, an email and a phone number, and then that information is transitioned from one bad actor to another bad actor.”

Sometimes, this trade happens in plain sight. Dangu points out a website where affiliate marketers sell services and scammers seek to buy “leads”. Affiliate marketers even publish blogs explaining how they successfully scammed people.

“They say, ‘I’m a smart nimble marketer, and I did all these smart optimisations, and that was really profitable’, which means ‘I scammed a lot of people’,” Dangu says.

Now armed with people’s names, emails, phone numbers, and sometimes even the amount of money they are keen to invest, scammers move to the “conversion” stage.

South-East Asian scammer Ramon, who is also using a pseudonym, says the criminal enterprise uses “lead qualifiers” to making the first call to victims, using a variety of scripts.

They might ask people if they remember clicking on an ad, tell them “we have received your inquiry about potential investment opportunities”, or say that they “know you’ve been looking for fixed-term deposits”.

“So most of the time, they [the victims] will just respond and say ‘oh, I remember that, I did go online and click on your ad’... That’s the time they start pitching them.”

During this first step, it’s common for victims to be asked for a small initial payment or first-time deposit, typically about US$250 ($386), to sign up to a fake investment platform.

“It’s a form of bait,” says Mark Solomons, a fraud and cybercrime expert with IFW Global. “The scammers will purport to show the victims that this $250 has magically been turned into $400 or $500 or $600. As a result, they’re an amazing investment scheme.

“The majority [of victims] probably will leave it at that and think ‘oh yeah, it looks a bit dodgy, or ‘I can’t really afford to invest any more’... but then a significant minority will go on to make larger deposits, and some of those will end up losing millions.”

Meticulous spreadsheets kept by a large scamming syndicate and seen by this masthead give a unique insight into this early step of the scamming process. They show, down to the second, when each victim made their first scam payment, and which particular fake investment brand, with names such as ArrowTeks, Aussie Trust and London Gates, was used to swindle them.

In just one month in 2021, a single team of people overseen by a manager was able to get 1465 Australians to part with a deposit – mostly US$250 but sometimes a little less or little more – the documents show.

Among the rows of Australian victims is a woman called Daphne, many Roberts and several Janets. There are also 62 Austrians, 511 Canadians, 14 Swiss people, 159 Germans, 28 Danes, 278 Britons and 65 New Zealanders.

There is a notable column titled: “sales status”. It shows victims who hadn’t answered their phone, or said they weren’t interested in investing.

Some cells have the phrase “in the money”.

This means the fraudsters have extracted information from the victim that gives them reason to think that they’re a juicy target, explains Solomons. He says the scammers get a sense of this by asking how much people can invest, what their investment goals are and by judging the victim’s general level of enthusiasm.

It’s also not unusual for criminals to apply another filter to who they target, screening out citizens of countries whose law enforcement they fear, and focusing on those they don’t.

Dan Halpin, whose company Cybertrace specialises in cyberfraud investigations, says while some syndicates are shutting down their German teams, and explicitly avoid US citizens, they have no such qualms about fleecing Australians. In fact, he says scam industry insiders tell him they have just put more staff onto the “Australian desk” – a team of scammers whose shift aligns with the Australian time zone, typically with good English and sometimes with connections to the country.

“The German police and the American police do a lot of work. They’ll extradite people from foreign countries, they’ll do raids in foreign countries,” Halpin says. “But Australia, they know that Australia will do nothing, so it’s just basically a free-for-all for Australians.”

Mitch said he worked briefly on an Australian desk last year, but quickly gave up the job as the hours were “devastating”. The shift began at 5am and ended at 1pm.

While the early steps of an online investment scam tend to be structured, based on set scripts and automated systems, the next phase, often dubbed “retention”, is different.

“The longer the relationship lasts, the less scripted it becomes, because the brokers are starting to develop relationships with people, and they know what pushes their buttons,” Solomons explains.

“They’ve been able to persuade them to remortgage their house, to get more money out of them, or to release their superannuation.”

Ramon says the strategy he uses to get victims to part with larger amounts of their money usually begins with a call in which he brings “great news” of a promising but time-sensitive investment opportunity.

Potential investors are told that a private company is about to publicly list its shares and they’ll need to get in early, otherwise the offering could be oversubscribed.

“As they say all the time, it’s not what you say, it’s how you say it. So we’re trained to say it with conviction, to make it sound more credible,” says Ramon, who works in a team that focuses solely on Australian victims.

“Once they fill out the application form and send it back to us, [we then] wait a couple of days for approval, sometimes even more, to make it look like it’s real.”

Looking back, Janelle Free says her encounter with investment scammers was more akin to being taken in by a cult than anything else she can describe.

“I feel now like I have been a victim of a religious society where they brainwash you,” she says. “I thought I was a smart person… then to go through this, you just feel so degraded and so humiliated and so stupid, so very stupid.”

For Free, it began with a fake Gina Rinehart scam ad on Facebook in mid-2022 and led to a man who said his name was Steve Fischer and claimed he was a financier based in London, who signed her up to a fake trading platform called Revenue Centre Pro.

But more important was the relationship she developed with the scammer, the so-called Steve Fischer, who wheedled his way into Free’s loving family, became a presence on speakerphone at dinner, and whom she trusted entirely and above the warnings from her own bank.

“How dare the banks block you from investing your hard-earned money?” Fischer would say.

“We are going to give you between 12 and 14 per cent every month on your money. The banks give you, what, 5 per cent a year if you’re lucky?”

Fischer would ask Free to send him photos of the fish she had caught in their dinghy and the pair planned for a day when Fischer would visit Australia, and she could take him fishing and camping, too.

“I just thought he was like God’s gift. To have someone helping me to be more financially secure [so] that I could help my children. I just had such faith in him and such belief.

“I’d said to him, ‘I hope you’re always going to be in my life’. And I said that to him, I think two weeks before he took all of our money.”

Rather than just silently disappearing with their loot, scammers will often fake a catastrophic investment event. There’s a strategy behind this.

“The scammers are constantly trying to stay ahead of any online complaints or official investigations, so the more delay and confusion and doubt they can create at the end of these relationships, the safer they are,” Solomons explains.

“They’ll keep going for as long as they possibly can, and then there’ll be a decision taken, probably at a fairly high level of a syndicate… as to when to pull the pin. Typically, it’s by engineering some sort of fake event, ‘Oh, there’s been a software glitch and we lost all the money’, or ‘we had a rogue trader who stole your money’.”

Free remembers she was told that Fischer was sick the night it all came crashing down. A man called Jacob was in his place.

“It was very different to how I’d ever traded before,” Free recalls. “And he said ‘This is the big one, Janelle. This is where all your children pay their mortgages off’. And I was so excited… I was counting the zeros because I’ve never traded with this much money.”

Yet when she logged back into her account the next day, everything was in the red. Where there had been hundreds of thousands of dollars in profits, there were now thousands of dollars of losses.

Fischer said he was sorry, and promised he could get her money back, if only she could find him another $30,000.

“Another 30,000?” Free replied. “Steve, you know I haven’t got any more money at all.”

Scammers asked Free to take this photo with her driver’s licence to verify her identity. It illustrates the tactics they used to give her the impression they were a legitimate investment company. 

Several months before, in March, Fischer had convinced Free to sell her house, spinning her stories about a looming boom in the cryptocurrency Bitcoin. He said it would bring Free and her family untold prosperity if she took advantage of it.

Free had purchased the land at Pacific Pines on the Gold Coast many years ago, and then borrowed, scrimped and saved to build a house on it. But she’d never been able to afford to live in it.

“The only thing I’ve got left is my house, but that’s what I live off, that’s my income,” she told Fischer, when he asked her if she had anything to sell.

Fischer had replied that if she sold her house, she could buy four houses with the money she was going to earn.

The grandmother of five had more reason to trust him than most. The fraudsters had been paying back Free a proportion of her investment to give the impression of genuine profits.

The house sold for $930,000.

Free estimates that once expenses were taken out, there was about $900,000 left, all sent to Fischer. The scammer also convinced some of Free’s close friends and relatives to invest. Altogether, the seven victims lost more than $2 million.

Even after scammers have robbed their victims of their home and their savings, they’ll still come back for more. This is the next step.

“They call it recovery,” says Maroti, a source based in Europe who gathers intelligence from informants inside scam syndicates.

He explains that once people have been scammed, they are often targeted by fraudsters a second time.

They will fleece them again, perhaps by tens of thousands of dollars, telling them a fake story that they have retrieved their lost funds, and need to pay international tax for the money to be transferred.

A recovery scam advertisement from social media.

Since she realised she was scammed, Janelle Free has been contacted by two individuals promising they will get her money back. One of them goes by the name Daniel Saunders, and is part of the initial group of scammers.

Where Fischer charmed everyone, Saunders is abrasive and rude.

He has asked Free for more than half a million dollars so that she can reclaim the lost money and continue trading.

“Without signing the documents, I can’t give you the money back!” he once yelled. “Is that clear?”

Free had been stringing along the fraudster with false promises her children would take out their superannuation, hoping to gain some information that might help authorities catch those responsible.

Since reporting the scam, Free says she has spoken to someone from the Australian Federal Police twice, but is frustrated they haven’t been able to track down the scammers.

“I don’t feel there’s been enough effort put in,” she says.

Ken Gamble, executive chairman of IFW Global, says he has forensically linked the syndicate that targeted Free and her associates to an Israeli criminal group with call centres in Cyprus, Bulgaria and Serbia.

Mitch says some scammers justify their actions a bit like a drug dealer would. If they weren’t doing it, someone else would. That their victims are stupid, and would lose their money eventually anyway. That they’re “sheeps” [sic] whose wool is for cutting.

Others are somewhat reluctant fraudsters dealing with difficult personal situations.

“You have people who have family members that are on tubes, and they don’t have money to pay for treatment,” he says.

“If I go to them and tell them, ‘Hey you’re going to work for [€] 2000 ($3257) a month’, and they’re working for 300, for example… Would you continue working for 300 and look at your family member die in front of your eyes? Or would you, you know, say ‘F--- it, I’m gonna get my hands dirty and try to save them’.”

Ramon admits that the guilt from his job weighs less heavily on him these days. Part of that is due to his work as an informant. He passes on information to private investigators in the hope it could help victims regain some of their losses. His heart has hardened, too.

“For my first few years, I’m not really having great nights sleeping, but the way these guys actually help us out in being numb with what’s going on is that they always tell us that, ‘Hey, remember, these guys have millions and millions in worth, so they’re OK losing this money’.”

Of course, this is just another one of the scammers’ lies.

Despite her ordeal, Janelle Free appears warm, talkative and bubbly. She’s made a career of cutting people’s hair and “talking to people”, sharing in their worries and stories.

Asked how she has managed to stay so upbeat, Free offers that she is on medication, wracked with guilt for putting the people she loves the most in the path of a charlatan. Her children fret about her and reassure her that it’s “just money”.

“I just wanted to leave them better off than I ever was. I didn’t want a helicopter or a plane, I just wanted to pay off my children’s mortgages. And now I’ve got nothing, nothing for them,” says Free, her voice breaking.

Here is the link:

https://www.theage.com.au/business/consumer-affairs/psychopaths-are-the-best-confessions-from-inside-the-scam-industry-20241113-p5kqey.html

It is hard to think of much to add, other than to say it pays to be very alert when gathering information from the web. Some of it will not be quite as it seems!

David.

AusHealthIT Poll Number 773 – Results – 17 November 2024.

Here are the results of the poll.

Overall Is The Return Of Donald Trump To The White House A Good Or Bad Thing?

A Good Thing                                                              1 (3%)

A Bad Thing                                                              39 (97%)

I Have No Idea                                                           0 (0%)

Total No. Of Votes: 40

A very clear vote with Trump not much favoured here in OZ apparently!

Any insights on the poll are welcome, as a comment, as usual!

Good voting turnout. 

0 of 40 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many special thanks to all those who voted! 

David.

Friday, November 15, 2024

I Think I Said At The Time This Was A Silly Idea. So It Has Proven!

This appeared last week:

08 November 2024

Medical Costs Finder Stagnated, but we’re working on it: DoHAC

By

Laura Woodrow

The $24.2 million project has copped a lot of flak for its poor engagement from doctors. But the department is holding fast that it’s an asset, reaching one million users.


Medical Costs Finder has reached the one million users milestone. But are those users getting any value from the $24.2 million service?

Speaking at Senate Estimates yesterday, the assistant secretary of DoHAC’s health system strategy division Brian Kelleher said the number of people who had visited the website had reached one million, with approximately 60,000 new users a month.

The number of doctors registered remains lacklustre – albeit improved – at 218, with only 73 choosing to publish their costs.

The cost for the website remains a whopping $24.2 million.

Independent Senator for the ACT David Polcock queried how the department was measuring the site’s success.

First assistant secretary for health systems strategy Ross Hawkins said a key success measure was people visiting the website.

Mr Hawkins said 70% of consumers supported the concept of an independent and authoritative website about costs.

When asked whether they had data on whether anyone was actually exploring the website, via bounce rates, for example, Mr Hawkins said they would have to look into their analytics data.

“The feedback we’re getting is that people find having median costs useful,” he said.

“[I] appreciate that the number of specialists [registered] is lower than anticipated, but actually in terms of providing those median prices across 1300 different services, giving people an idea of what that’s like locally, giving them indications around the patient journey, out of pocket costs, it’s a useful tool that people engage with.

“Broadly from the indicators, we see around 60,000 new users tipping in over a total of one million users to date and feedback we’re getting from consumer groups, it’s coming across to us as [a] positive experience engaging with the website.

“But again, we’re always happy to work with groups and take feedback and further refine the experience.”

When asked about the possibility of publishing specialist costs without voluntary doctor registration, Mr Kelleher said this was not the path chosen by the department.

“The numbers are low … but we proceeded down the path of engaging with medical specialists on a voluntary basis, and that was a decision that the government took at the time,” he said.

“The department does not generally publish highly disaggregated fee information for medical benefit services.

“That’s why, at this point in time, information on the website is delivered at an aggregate level.”

Minister for Finance, Women, and the Public Service Katy Gallagher said the department had been engaging with the health minister about how to strengthen the website.

“It was started, and then nothing, [or] very little, was done,” she said.

“Minister Butler is keen to make sure it’s providing as useful a service as it can.

“But the reality in health is you do need to work collaboratively with all stakeholders if you’re going to make something a success. It’s simply the reality of the health system.

“And so that does mean working with specialists, doctors and consumer groups to make sure it’s doing what it needs to do.

“But our view is more transparent, more access to information, the better, and the minister’s working on that.”

Here is the link:

https://www.medicalrepublic.com.au/medical-costs-finder-stagnated-but-were-working-on-it-dohac/112347?utm_source=MC-TMR%20List

Can you please explain to me why a doctor would publicize what he charges for a surgical procedure via a Government web site. There is no reason I can think of unless they want to discourage patients or some other reason even more obscure!

Other ideas welcome!

David.

Thursday, November 14, 2024

It Looks Like We Are Not Processing New Drug Applications Promptly, As We Should

This appeared last week:

Health officials warn of ‘practical limitations’ to medicine subsidies despite ‘triage’

James Dowling

November 08 2024

Questions from the opposition have detailed the timing and policy of a recent controversial delay to the consideration of new drug subsidies.

Fears of ongoing delays to critical new medicine subsidies have been stoked by a Health Department admission that its independent drug assessor will continue to place a “maximum number” on submissions considered at its meetings, despite Health Minister Mark Butler calling an emergency meeting over the decision to indefinitely delay 45 medications.

It has now emerged that Mr Butler knew of the unprecedented decision for almost a month before the crisis became public.

A group of Health Department officials led by Finance Minister Katy Gallagher was questioned on Thursday at Senate estimates over the Pharmaceutical Benefits Advisory Committee’s unprecedented decision to delay the medication recommendations in response to excessive submissions.

The announcement was quickly followed by departmental efforts to “triage” the delay, and the introduction of an additional PBAC meeting to work through the deferred submissions.

However, Senator Gallagher told the panel on Thursday the PBAC would continue to grapple with “finite resources and time”.

“I think you also need to accept the reality of the fact that there is only so much that one PBAC meeting can do,” Senator Gallagher said.

“If you get double the amount of submissions or whatever it is close to that, including complex submissions, there is finite resources and time to deal with that.

“It’s not a mass deferral. There is triaging under way so that a reasonable amount, or the most that can be done at March’s meeting can be done, and then an extra meeting can deal with the other submissions.”

On November 4, Mr Butler first confirmed he was concerned with the response of his assessor, and directed his department “to urgently engage with (industry body) Medicines Australia to examine all potential solutions”. By November 6 he confirmed an additional PBAC meeting for May 2025.

Despite this, documents tabled by the Health Department following questions on notice indicate he was informed of the excessive PBAC demand much earlier, on October 9.

According to the timeline provided by the Health Department, Mr Butler directed his department to inform Medicines Australia of the problem that day, before contacting independent evaluators on October 11 to determine whether they could meet the workload.

An October 16 PBAC triage meeting was held to determine which submissions would be deferred. Less than a week later, Medicines Australia and the relevant applicants were informed of the decision to hold back some submissions.

On October 23, those same applicants were issued invoices despite the delay to services.

The public was made aware of the change in process on October 30.

Since the announcement, health officials have contended there is no intention to defer future submissions, but confirmed in estimates there were internal processes changed in response to the excessive applications.

Health Department deputy secretary Duncan McIntyre said the new submission limit would not be “a hard and fast number”, as staff indicated the measure was not intended to prevent their scaling up of evaluator capacity.

Health resourcing deputy secretary Penny Shakespeare said in estimates there were “practical limitations to what can actually be considered by our external contracted evaluators in future”, while economist Blair Comley called the measure a “way we can practically work through this unprecedented spike”.

Opposition health spokeswoman Anne Ruston, who initially levied the questions at estimates, told The Weekend Australian Mr Butler had dodged responsibility for the debacle.

“The department has belled the cat and admitted that there is an ongoing cap on the number of medicines that can be considered for listing on the PBS under the Albanese government,” Senator Ruston said.

“After deflections and denial from the department and the government, we now have worrying confirmation that there could be ongoing delays in patients’ access to essential new medicines.

“This is the first time in the history of the PBS that a cap of this nature has been put in place.

“The Minister for Health must clarify whether he agreed to this cap being put in place, and whether he will guarantee its immediate removal.”

A spokesperson for Mr Butler said the Health Department was “ensuring patients get access to life-changing medications and treatments as quickly as possible”.

Former Pharmaceutical Benefits Scheme chief and Better Access Australia chair Felicity McNeill said calling a May 2025 PBAC meeting amounted to an “acknowledgment” of a “breach of the community’s trust”.

“The PBAC is his committee and the community needs him to lead on this issue now and moving forward,” Ms McNeill said.

“The fight is not over until this is all resolved, but seeing the system start to move is a great first step.”

Ms McNeill argued the government response still lacked transparency given a list of delayed medicines had not been made publicly available.

Parliamentary documents indicated the number of submissions to be considered across March and May had reduced from 77 to 63 since the announcement of deferrals.

Here is the link:

https://www.theaustralian.com.au/nation/health-officials-warn-of-practical-limitations-to-medicine-subsidies-despite-triage/news-story/1b9cbcb73c102179df7f10eaa6cbd0a7

I guess it is just bad luck if the drug you need is having its approval slowed for no better than bureaucratic delay and slowness. I hope there is some sort of feedback possible from societies that assist various categories of disease sufferers to speed things up!

A bit of a pity if you die because of bureaucratic delay!

David.

Wednesday, November 13, 2024

Vapes Are Loose All Over, Despite The Government’s Plan To Regulate Them!

This appeared last week:

About 1 million Australians use vapes. Chemists dispensed them just 3500 times last month

By Natassia Chrysanthos

November 9, 2024 — 4.45pm

Vapes were dispensed behind-the-counter at pharmacies just 3500 times during the first month of the federal government’s scheme to weed out the black market by making them chemist products, despite an estimated 1 million Australians using the devices.

Data supplied to Senate estimates reveals the uptake of pharmacy vape prescriptions was slow in October, the first month that e-cigarettes could be bought after a consultation with a chemist under Health Minister Mark Butler’s vaping crackdown.

With about 5800 pharmacies across the country, the data suggests thousands of them would not have prescribed a single vape product.

The government’s initial policy analysis assumed about 450,000 people a year would seek out medical vape products once illicit products became harder to get.

But many pharmacists say they are holding back from selling vapes on ethical grounds or because the process is too onerous. Illegal vapes are still widely available but have surged to between $40 and $60 a device as retailers bump up prices to compensate for higher penalties.

Health Department officials quizzed at Senate estimates last week said they were not keeping track of how many pharmacies were selling vapes at present. “It is actually quite difficult to get clear answers on that,” said Chief Medical Officer Tony Lawler.

Department official Chris Bedford provided data on the number of times vaping products had been dispensed by pharmacists after a patient consultation.

“There’s been 3500 of those across Australia ... The pharmacist could dispense more than one vaping good per notification, so the patient would go in and have the conversation,” Bedford said.

But the Health Department does not count how many vapes are sold with a doctor or nurse practitioner prescription – the other avenue that people can use to buy vapes legally.

Coalition health spokeswoman Anne Ruston said it was astounding that the department did not know how many pharmacies were selling vapes “when this is a key component of the government’s policy”.

“The number of vapes dispensed by a pharmacist last month represents a negligible percentage of the estimated vapers in Australia,” Ruston said. “We know that the majority of pharmacists do not want to become tobacconists, and this is clearly represented in the department’s figures.”

No vape products have been listed on Australia’s register of therapeutic goods, meaning pharmacists have to prescribe and sell unapproved products. A spokeswoman from the Pharmacy Guild, which represents business owners, said this made pharmacists reluctant to supply them.

”There is limited evidence of their long-term safety or effectiveness in supporting long-term smoking cessation,” the spokeswoman said.

The pharmacy sector has pointed to anecdotal data indicating levels of uptake in lieu of official figures. An Australian Journal of Pharmacy reader survey found 86 per cent were not stocking vapes.

The Health Department told Senate estimates that about 1000 pharmacists took part in an information session run by the Australian Pharmaceutical Society in September to learn more; at the same time, a Pharmacy Guild poster advising patients that a chemist does not stock vapes has been downloaded more than 2000 times.

Richard Lee, chief executive of Liber Pharmaceuticals, which manufactures one of Australia’s main pharmacy vape products, said Butler’s pharmacy scheme had gotten off to a slow but reasonable start.

He said part of the reason for the slow uptake was that guidelines from the Therapeutic Goods Administration and Pharmaceutical Society of Australia had been released only in the days before the new scheme launched, on October 1.

“Nobody had time to process the changes to the framework or put operating procedures in place in time,” he said. “Most pharmacies are saying, ‘We’re in, but we’re not in yet’, because they take their responsibilities seriously and don’t want to get it wrong.”

Lee anticipated a significant uptake as pharmacies absorbed the changes and understood what they needed to do. “But it’s going to take three to six months,” he said.

Butler said his laws were unapologetically focused on protecting young Australians. “Vape stores around the country are closing, and importantly, young Australians are saying they are finding it harder to purchase vapes,” he said.

“The national laws set a strong and uniform baseline across the country that stamps out recreational vaping, particularly for young Australians, while allowing access for hardened smokers who want to kick the habit.”

Here is the link:

https://www.smh.com.au/politics/federal/australia-has-about-1-million-vapers-chemists-consulted-them-just-3500-times-last-month-20241108-p5kp1g.html

This rather looks like a policy mess to me.

I wonder will we get a report in a few months letting us all know just how the regulations are working?  I suspect then we will see much higher usage than expected.

As for illegal sales – will be very interesting to see how they go over the next six months.

Watch this space!

David.

Tuesday, November 12, 2024

My One Post On The Horror Of The Election Outcome In The USA.

This appeared a day or so ago:

The billionaires in charge of Trump’s White House

His first term was heavily reliant on the party establishment. The inner circle now includes billionaires and is in tune with the ideas of the new right.

Alex Rogers and James Politi

Updated Nov 10, 2024 – 9.13am, first published at 8.27am

Nibbling on crabs, sushi and sugar cookies, some of the richest and the soon-to-be most powerful people in the world waited for the election results last week at Mar-a-Lago, Donald Trump’s gilded fortress on the sea.

At one of the tables, Trump sat with Elon Musk, the billionaire technology executive, and Dana White, chief executive of the Ultimate Fighting Championship.

Hours before the final outcome was established, Musk decided to call the whole race. “Game, set and match,” he posted on X, the platform he owns, to his 200 million followers, at 10.32pm.

The next day, after it was confirmed that the Republican had defeated Kamala Harris, Trump and Musk ate together on the terrace of the resort, with Musk wearing a T-shirt of astronauts walking on the moon with Mars in the distance.

“Novus Ordo Seclorum,” Musk wrote on X, the Latin expression for “a new era is born”.

Amid the jubilant scenes at Mar-a-Lago, there were plenty of signs about how a second Trump presidency might be different from the first one — and, in particular, just how changed his new inner circle will be.

The 78-year-old Republican appears to be even more influenced by his billionaire donors and allies than he was during his first term in office — particularly Musk. He is also more willing to embrace the ideology of the politically ascendant new American right, and more determined to press ahead with his aggressive agenda from his very first day in office.


Eight years ago, Trump was forced to lean on the Republican establishment for counsel: this time, the group of individuals who have his ear are largely MAGA loyalists, ranging from his vice-president-elect J.D. Vance and his eldest son Don Jr to a circle of wealthy allies pitching for plum jobs in the administration.

On Thursday (Friday AEDT), Trump made his first big personnel announcement, tapping Susie Wiles, his top campaign strategist and a longtime political operative in Florida, to be the next White House chief of staff.

It marks the opening move in what is expected to be a flurry of personnel announcements over the coming week that will reveal Trump’s team, including his cabinet, as he prepares to move back into the White House on January 20.

Trump’s goal will be to quickly implement policies ranging from the mass deportation of undocumented immigrants to sweeping tax cuts and across-the-board tariffs on imports that he promised on the campaign trail, along with exacting retribution against his political opponents.

At this stage in 2016, after defeating Hillary Clinton, many in Trump’s entourage were political novices who were unprepared for the task of building a new government. Trump eventually turned to his then vice-president-elect, Mike Pence — a former governor and member of Congress with deep roots in the Republican Party — to run his transition operation.

He also tapped Reince Priebus to be chief of staff, Steven Mnuchin as treasury secretary and Rex Tillerson for secretary of state — all figures who were palatable to traditional business groups and the national security apparatus, but whom he did not know particularly well.

Trump has come to regret those choices for restraining the populist agenda he really wanted to pursue and has been desperate to avoid that scenario again.

“It was a free-for-all. Nobody expected Trump to win,” says John Feehery, Republican former congressional aide now at EFB Advocacy, a consultancy, about the aftermath of the 2016 election.

“People are now understanding that instead of pursuing their own visions, they’re trying to pursue Trump’s vision.”


It is not unusual for chief executives and business leaders to have close access to politicians, especially during a campaign, but Musk’s proximity to Trump has been especially remarkable — and a sign that the next administration may have a distinctively plutocratic element to it.

Musk publicly endorsed Trump, bankrolled a Super Pac that spent $US172 million ($261 million) on the 2024 election, hosted him on X for a lengthy conversation, and canvassed the crucial state of Pennsylvania, which ended up flipping to Trump.

In return, Trump has said he will appoint the Tesla and SpaceX chief to a commission that will roll back regulations and drastically cut government spending. Musk has said the election is crucial for his vision of colonising Mars.

“He actually helped Trump get elected. He got his fingernails dirty and got it done,” says Feehery. “The level of his work . . . gives him tons of loyalty from Trump.”

Their alliance carries big risks in terms of potential conflicts of interest, which Trump allies deny, as well as potential disagreements down the line over policy. But, for now, it seems to be suiting both men.

There are other top executives in Trump’s new orbit. Two billionaires are chairing his transition team. Personnel is being led by Howard Lutnick, the long-standing boss of Cantor Fitzgerald, the financial services firm that lost hundreds of employees in the September 11 attack on the World Trade Center. Lutnick is an old friend of Trump and even once appeared on The Apprentice.

The transition’s policy programme is being led by Linda McMahon, the former chief executive of World Wrestling Entertainment who is also chair of the America First Policy Institute, a think-tank that has been trying to develop an agenda to support Trump’s ideas.

Both are considered potential cabinet picks — Lutnick for treasury and McMahon for commerce — after writing multimillion dollar cheques to the campaign. But other top billionaires in the inner circle are also angling: hedge fund managers John Paulson and Scott Bessent, who was in Palm Beach wearing a pro-Trump pin on his lapel this week, are also in contention for Treasury.


The Trump family will remain influential in the new administration, but this time with a more MAGA flavour.

In 2016, Trump’s daughter Ivanka and her husband Jared Kushner took on senior White House positions. Kushner, who was a Democrat when he was younger, was considered by some foreign governments to be one of the more pragmatic people to deal with amid the chaos of the first Trump term. But neither Ivanka Trump nor Kushner are expected to join this administration.

Now we know who the real players are, the people who will actually deliver on the president’s message, the people who don’t think that they know better

The most influential family member this year has been Donald Trump Jr, the 46-year-old eldest child. He played an important role in persuading his father to back Vance, the Ohio senator, to be his running mate, and he was one of the voices pushing for Trump to engage more with podcasts popular among young men.

Trump Jr also helped build the campaign’s relationship with Robert F. Kennedy Jr — the scion of the Democrats’ most famous family who was at one stage running a third-party bid for the presidency, before swinging behind Trump. During the campaign, donors got the chance to win a day of falconry together with the two men. “A true Renaissance man,” Trump Jr described Kennedy.

“He got his fingernails dirty and got it done. The level of his work . . . gives him tons of loyalty from Trump.”

— John Feehery, Republican former congressional aide, on Elon Musk

Trump Jr has not always appeared to be his father’s favourite. But more than any other family member, he has been an energetic champion of the new right, including on his own podcast.

Although he appears to have little appetite for taking a formal position in the administration, he intends to play an important role in the transition, policing potential appointments for their loyalty. Before the election, he talked about the need to create a “MAGA bench” of potential officials and keeping “bad actors” out of the administration, as he believes happened in 2016.

“Now we know who the real players are, the people who will actually deliver on the president’s message, the people who don’t think that they know better than the duly elected president of the United States,” he told Fox and Friends this week. “I want to make sure that those people are in this administration.”


Vance, 40, will also play an influential role in setting the direction of the White House. As the youngest vice-president since Richard Nixon served in the role seven decades ago, he is in prime position to shape the future of the Republican Party.

He has risen from poverty to become a senator, picking up along the way a Yale Law School diploma, four years in the Marines, Silicon Valley venture capitalist experience under Peter Thiel and a best-selling book, Hillbilly Elegy. He has also helped overturn the GOP’s old country club image.

“We won’t cater to Wall Street. We’ll commit to the working man,” Vance said at the Republican Party’s convention this northern summer.

A person close to Vance said that tech and immigration were two core policy interests; he told the Financial Times in August that Google “ought to be broken up”, but Trump later questioned whether that would be going too far.

According to Oren Cass, chief economist at the think-tank American Compass and also an FT contributing editor, “Vance has been an integral leader within the new right since its formative stages.”

In August, Trump added Kennedy and Tulsi Gabbard — another Democrat turned Trump supporter — to his transition team. Both were at Mar-a-Lago this week, but it was unclear what kind of role they would get. Kennedy is in “meeting after meeting after meeting. And he dislikes meetings,” says a person close to the Trump campaign.

But Kennedy has been speaking to reporters about potential roles in the new administration in the areas of health and science, vowing to review research on vaccines and calling for the elimination of fluoride from drinking water.

Many of the candidates for top jobs have been present in Palm Beach this week. North Dakota Governor Doug Burgum, a potential pick for energy secretary, was standing right in front of the stage at the victory rally on election night, while former acting national intelligence director Ric Grenell and Tennessee Senator Bill Hagerty — rumoured as top State Department picks — were also spotted around town.

Amid the speculation, there is little tolerance for anyone who criticised Trump in the past. Trump adviser Tim Murtaugh says former staffers who turned against Trump are “trying to figure out how to pivot for their own professional betterment”. He adds: “We’re all aware of who those people are.”

Even the wealthiest Palm Beach locals worry about the impact of all the well-to-do people coming to pitch for positions.

Thomas Peterffy, the billionaire chair of Interactive Brokers and a Trump donor, who lives two minutes from Mar-a-Lago, laments that his neighbour’s victory will increase road closures on the island.

“I remember, eight years ago, after he got elected, people kept coming and going because he was constantly interviewing people for ambassadorships and various cabinet positions,” says Peterffy. “So, this traffic jam is going to go on for a while.”

Financial Times

Here is the link:

https://www.afr.com/world/north-america/the-maga-court-inside-trump-s-new-white-house-20241110-p5kpbe

FWIW I believe the return of Trump to the presidency is a very bad thing and I do not believe any significant good will come of it at all.

Trump is a misogynistic arrogant jerk with virtually no re-deeming character attributes IMVHO and I am pretty concerned where he may lead the world.

As there is zilch I can do about it, I will just leave it at that – other than to worry that JD Vance – the VP – is hardly much of an improvement if at all. We face a dangerous four years I reckon.

Great work by the FT in this article by the way!

Back in my hole now!

David.

Sunday, November 10, 2024

We Really Do Have Just An Amazing Amount Of The Politics Of Envy Loose In OZ!

This appeared this morning:

8.28AM 10 November, 2024

Mark Butler says he didn’t ask Qantas for upgrade

Andrew Hobbs

Health Minister Mark Butler says he didn’t ask to be upgraded by Qantas when he flew to Melbourne for a 50th birthday party.

“I was in Melbourne for a colleague’s 50th birthday on the weekend. Obviously, I paid for my flight. It was a quick go over on Saturday afternoon, come back on Sunday morning. I’d booked myself and to the best of my recollection, I simply sort of got to the airport and they had upgraded me,” Butler said on Sky.

“This happens by airlines to shift the load in their airline. If they have a spare business-class seat, generally, they’ll upgrade an economy class passenger up to that so that they can then on sell the economy-class seat, for which there’s always more demand than there is capacity.

“So I didn’t ask anyone for it. I simply arrived at the airport and got handed a ticket that was an upgrade. I declared it in the proper way.”

Here is the link:

https://www.afr.com/politics/federal/australian-mining-ceo-detained-by-mali-junta-20241110-p5kpb5

 Who cares?

Can I suggest concern here is just a trivial expression of misplaced envy?

In another life I used to fly a fair bit for consulting engagements around the country,. Needless to say, being pretty junior then I spent a good amount of time at the back of the plane!

But after about a few months of 2-3 times a month flights I was upgraded occasionally and as time went on upgrades became more and more regular – some great booking computer in the sky seemed to be taking a personal interest – which was nice, and meant I always booked with the same airline as I assume was their plan!!! Needless to say when I stopped regular work flights, regular upgrades also vanished!

There is an algorithm I am sure keeping watch on all this and the more loyal you are the more upgraded you are it seems, and vice a versa..

Flying for work is not fun and as such if you get an upgrade it is just a minor source of pain relief – and nothing more.

To me public envy and frothing at the mouth in anger at upgrades is just adolescent and silly.

Why do others even care I wonder? The world has many more problems than who got upgraded!!!!

David.