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."

Friday, November 29, 2024

I Wonder How Many Organizations Will Actually Be Ready For This In Time?

This popped up a few days ago:

Is Your Hospital Ready for the My Health Record Deadline?

22nd November 2024

Is Your Hospital Ready for the December 1 My Health Record Compliance Deadline?

By December 1, 2024, Australian hospitals are required to have a plan in place to upload clinical information, such as discharge summaries, to My Health Record (MHR). Starting in January 2025, accrediting agencies will be reviewing hospital compliance with these requirements, including monitoring and evaluating the implementation process.

Steps to Prepare for the December 1, 2024 Deadline

Hospitals have been preparing for this transition, and there are several key steps to ensure readiness by December 1:

  1. Audit Your Current Processes
    Begin with an audit of your hospital’s discharge summary workflow. Identify areas where manual processes can be improved or automated to streamline uploads and minimise errors.
  2. Engage Your Technology Providers
    Work with your technology providers to confirm that your systems are compatible with MHR integration. Platforms like Civica’s Dox, a clinical documentation system, automate the discharge summary upload process, reducing workload and ensuring timely submissions.
  3. Train Your Healthcare Team
    Team engagement is critical for a smooth transition. Provide training for both clinical and administrative staff to emphasise the importance of accuracy and timeliness in uploading discharge summaries, highlighting the positive impact on patient care.
  4. Implement Ongoing Monitoring
    Regular compliance checks, including audits of discharge summary uploads, can help detect missed or delayed uploads early. A dedicated compliance team can track your hospital’s status and support continuous improvement efforts.
  5. Keep Stakeholders Informed
    Communication is key. Inform patients about the benefits of having their discharge summaries in MHR and keep external providers like GPs and specialists updated to foster a collaborative, patient-centred approach.

My Health Record: A New Era of Information Sharing

My Health Record is an Australian Government initiative that consolidates Australians' health information in a secure, accessible platform. Since its inception, MHR adoption has expanded, giving healthcare providers from GPs to specialists and hospitals access to critical health information whenever needed. This integration helps reduce risks from fragmented or outdated data, providing a more seamless care experience.

Discharge summaries include essential information about a patient’s treatment, prescribed medications, and follow-up care recommendations, which are vital for continued care. Preparing now will ensure that your hospital meets the requirements smoothly and effectively.

Embracing Compliance as an Opportunity

Meeting this new standard, signals to patients that your hospital prioritises quality and safety. Patients benefit from better-coordinated care, while your hospital stands out as a leader in patient-centred digital healthcare. With the deadline fast approaching, now is the time to finalise preparations and embrace the benefits of a connected healthcare ecosystem.

Email us to learn how we can help you navigate this important transition.

Find out more

Here is the link:

https://www.civica.com/en-au/insights/is-your-hospital-ready-for-the-my-health-record-deadline/

I would love to hear from those who find the level of readiness is not all that might be desired!

I suspect there will be more than one!

David.

Thursday, November 28, 2024

It Is Very Dangerous To Speak Truth Unto Power!

This appeared the other day and is really quite a worry I believe…..

This doctor spoke out about allegations of medical fraud. The next day, she was asked to resign

By Henrietta Cook and Melissa Cunningham

November 22, 2024 — 6.46pm

A respected anaesthetist has been dismissed from her role at a prestigious medical college after saying Australia’s health billing system lacked transparency and was skewed towards profit.

In an email obtained by this masthead, the Australian and New Zealand College of Anaesthetists (ANZCA) accused Associate Professor Joanna Sutherland of tarnishing the reputation of anaesthetists and asked her to stand down as chair of its safety and quality committee.

The college’s response shocked many in the medical community, who perceived her comments to this masthead as “measured and reasonable”.

Sutherland was responding to allegations that dozens of anaesthetists and surgeons on Victoria’s Mornington Peninsula had engaged in fraud, double-dipping and pocketing off-the-book fees. The claims – revealed exclusively by The Age – have sparked investigations by a federal regulator and private health insurers.

“If these allegations are found to be true, in my view, that’s outrageous, unethical and it would be unacceptable,” she was quoted as saying in The Age article. “Consumers are ripe for exploitation.”

But the morning after the article was published, college president Professor Dave Story wrote to Sutherland “to request that you resign as chair of the safety and quality committee of ANZCA”.

In the email, Story said Sutherland’s quotes had concerned and offended many fellows.

“They are angry that their reputation has been slurred by a member of a major college committee,” he wrote.

“No one condones fraudulent practice, but the language you chose to use implied that many anaesthetists are not practicing ethically.”

Story wrote that the college had lost confidence in her “ability to hold this very important role” because she did not notify it of her plans to speak out.

“It does not help our vulnerable patients to have the false idea that the anaesthetist caring for them is fraudulent,” he said.

Sutherland said she was disappointed by the college’s decision and had been speaking out in a personal capacity.

“The response from the college has been to close ranks and protect the profession,” she said.

“There have been allegations about fraudulent billing, including billing by anaesthetists that would appear to be unethical and potentially illegal ... in the absence of a constructive response from the profession, I don’t think these allegations will go away.”

Sutherland, who was appointed chair of the committee in 2022 and has been a fellow of the college since 1992, said that while she believed the majority of anaesthetists did the right thing, unethical and illegal billing were “not insignificant”.

Medical fraud and compliance expert Dr Margaret Faux said the college had forced the resignation of the one person who could have helped them navigate a path out the mess.

“The medical bullies always attack whistleblowers, unfortunately,” she said.

Faux said the college had sent a message that if these allegations were proven, they would not perceive them as unethical, unacceptable or outrageous – the way Sutherland did.

Dr Nick Coatsworth, an ambassador for the Australian Patients Association, urged the college to reconsider its decision, describing Sutherland as “an exemplary contributor to the medical community”.

He said her published comments were “measured and reasonable”.

“This sends a terrible message to publicly minded doctors, particularly anaesthetists, that their desire to reform their profession will be met with hostile action against them,” he said.

Coatsworth said he suspected the usually fair-minded college had come under intense pressure from a small group of largely private anaesthetists.

Rachel David, chief executive of Private Healthcare Australia, said health professionals had a duty to act responsibly and ethically and call out bad behaviour.

“It is profoundly disappointing when the medical culture tries to cover up wrongdoing instead of requiring the highest standards of themselves and their colleagues,” she said, adding that Sutherland should be immediately reinstated.

David said the government needed to look at regulating medical fees and criminalising illegal billing practices.

“Punishing a whistleblower or a truth-teller is completely unacceptable. Shooting the messenger is not the answer, honesty and transparency of medical billing is a basic patient’s right,” she said.

In a statement to this masthead, Story said the role of the safety and quality committee chair was to support safe clinical practice in anaesthesia.

“The committee’s remit does not include billing practices,” he said on Friday.

Story said the majority of anaesthetists operated with integrity and professionalism and made every effort to comply with increasingly complex billing requirements.

He said the college did not condone the alleged billing practices outlined by this masthead and supported calls for regulatory bodies to investigate any claims of fraudulent behaviour.

Here is the link:

https://www.smh.com.au/national/victoria/this-doctor-spoke-out-about-allegations-of-medical-fraud-the-next-day-she-was-asked-to-resign-20241121-p5ksmt.html

On the face of it, a significant degree of over-reaction I reckon suggesting those in power do not have a clear conscience!

What do you think?

David.

Wednesday, November 27, 2024

How Long Do You Think This Ruling Will Last?

This appeared last week:

NSW Chief Justice Andrew Bell bans AI use for evidence documents

Ellie Dudley

3:42PM November 22, 2024.

The top judge of Australia’s largest jurisdiction has issued a sweeping direction effectively banning lawyers from using artificial intelligence to create crucial evidence papers, and requiring them to add a disclaimer declaring they have not used AI to develop the document.

NSW Chief Justice Andrew Bell has also declared judges are not permitted to use AI to formulate reasons for judgments or to edit draft judgments, and has instructed them to remain “astute to identify any undisclosed use of Gen AI in court documents” filed by parties before them.

The Chief Justice made the edicts in two separate practices notes released this week – one for practitioners, and a second for judges. A practice note is a document used to provide directions on particular aspects of how the court expects proceedings to be run.

In the note to practitioners, Chief Justice Bell said artificial intelligence must not be used in generating the contents of affidavits, witness statements, character references or other material that reflects a witness’s evidence or is to be used in cross-examination.

“Affidavits, witness statements, character references should contain and reflect a person’s own knowledge, not AI-generated content,” he said. “Gen AI must not be used for the purpose of altering, embellishing, strengthening or diluting or otherwise rephrasing a witness’s evidence when expressed in written form.”

Australia’s courts have been grappling with the advent of AI over the past 18 months as the technology continues to infiltrate the courtroom.

In February, an ACT Supreme Court judge dealt with the first known case of AI in court, when the brother of a man found guilty used ChatGPT to write a character reference for him.

Last month a Melbourne lawyer was referred to the legal watchdog after he was caught citing fake AI-generated cases in a family court matter, causing a hearing to be adjourned.

In his practice note, Chief Justice Bell said that if AI was used to create written submissions or summaries of an argument, a lawyer must be careful to ensure all citations “exist, are accurate and are relevant to the proceedings”.

NSW is just the latest jurisdiction to release a practice note of this kind, with Victoria and Queensland releasing similar guidelines earlier this year.

In Victoria, parties are required to tell one another of any assistance provided by AI when preparing a case. In Queensland, lawyers are similarly encouraged to disclose any AI involvement.

But Chief Justice Bell will require lawyers to include a disclosure in affidavits, witness statements and character references that AI was not used, including “by way of altering, embellishing, strengthening or diluting or rephrasing a witness’s evidence”.

“For the avoidance of doubt, the deponent of the affidavit, witness statement or character reference is not required to make the disclosure ... where the annexure or exhibit has not been prepared or created for the purposes of the proceedings,” the practice note reads.

Expert reports are not to be prepared using AI, the Chief Justice said, without prior permission from the court.

“Expert reports are required to state the opinion or opinions of the expert, and his or her reasoning process,” the practice note reads. “Gen AI must not be used to draft or prepare the content of an expert report (or any part of an expert report) without prior leave of the court.”

AI 'red flags'

Chief Justice Bell instructed judges to look out for the following "red flags" when checking to see if a document has been created using AI.

  • Inaccurate or non-existent case or legislative citations;
  • Incorrect, inaccurate, out of date or incomplete analysis and application of the law in relation to a legal proposition or set of facts;
  • Case law references that are inapplicable or unsuited to the jurisdiction, both in terms of substantive and procedural law;
  • Case law references that are out of date and do not take account of relevant developments in the law;
  • Submissions that diverge from your general understanding of the applicable law or which contain obvious substantive errors;
  • The use of non-specific, repetitive language; and
  • Use of language, expressions or spelling more closely associated with other jurisdictions.

For judges, AI should only be used for secondary legal research purposes, the Chief Justice said, however judges should be aware of AI “hallucinating” fake case citations.

Judges should also be aware of the fact that “any search requests or interactions or prompts with a Gen AI chatbot may, unless disabled, be automatically added to the large language model database, remembered and used to respond to queries from other users”.

“The product of all Gen AI-generated research, even if apparently polished and convincing, should be closely and carefully scrutinised and verified for accuracy, completeness, currency and suitability before making any use of it,” Chief Justice Bell said. “Gen AI research should not be used as a substitute for personal research by traditional methods.”

The practice notes will come into effect from the beginning of the 2025 law term on February 3.

Here is the link:

https://www.theaustralian.com.au/nation/nsw-chief-justice-andrew-bell-bans-ai-use-for-evidence-documents/news-story/afab357cb23884b46012c4e18d69bed4

Why do I suddenly have an image of King Canute filling my field of vision….

I suspect this practice note will be obsolete pretty much on the day it is published!

David.

Tuesday, November 26, 2024

My Feeling Is That The Government Should We Able To Insist Social Media Warn Citizens If The Are Under Significant Threat……

This appeared last week:

Australian media

Meta is ‘reckless’ in ‘need-to-know situations’, Canada warns Australia as it braces for early bushfire season

Heritage minister says Facebook made ‘room for misinformation’ after turning news off in 2023 as Australia mulls actions that could lead to Meta doing the same

Tory Shepherd

Sun 24 Nov 2024 06.00 AEDT

Twelve months on from Canada’s worst-ever wildfire season unfolding during a news blackout on Facebook, the nation has warned Australia about Meta’s “reckless” behaviour during “need-to-know situations”.

An early start to Australia’s bushfire season is looming for swaths of the country, with large parts of Queensland and the Northern Territory, the south-west of Victoria and south-east corner of South Australia facing higher risk, according to an official assessment in September.

In August 2023, negotiations between the tech giant and Canada’s government broke down as Justin Trudeau’s Liberals doggedly pursued news bargaining deal C-18, known as the Online News Act – similar to the one struck in Australia in 2021 following a seven-day news blackout.

The breakdown in negotiations resulted in Meta blocking all news sources on Facebook in Canada “recklessly and dangerously” as all 10 provinces and three territories in the country burned, Canada’s heritage minister, Pascale St-Onge, told Guardian Australia.

“Facebook is leaving disinformation and misinformation to spread on their platform, while choosing to block access to reliable, high-quality, independent journalism,” St-Onge said.

“Facebook is just leaving more room for misinformation during need-to-know situations like wildfires, emergencies, local elections and other critical times for people to make decisions on matters that affect them.”

Misleading clickbait became prevalent as an area of 15m hectares – larger than England and 2.5 times the second-most destructive wildfire season in 1989 – burned across Canada, killing eight people and displacing hundreds of thousands.

A spokesperson for St-Onge said Facebook had “continued to block news recklessly and dangerously” as the nation entered into another wildfire season in June of this year.

“Canadians now can’t access or share vital information on social media at times when affected Canadians are checking in on loved ones and others are possibly evacuating,” the spokesperson said.

The Australian government is negotiating with Meta after it declined to renew deals made under the news media bargaining code to compensate news publishers for news carried on Facebook and Instagram.

The government may choose to designate Meta (force it into negotiations over compensation or face fines) which could prompt Meta to ban news altogether.

The communications minister, Michelle Rowland, said the government was considering advice about the code and would “have more to say in due course”.

“From local news and current affairs to vital emergency information, a significant and growing number of Australians use social media platforms to access news,” she said.

“Australians should have access to quality sources of information online, including trusted news brands. This is especially important during natural emergencies.”

In June this year, Meta told a parliamentary inquiry into social media “all options are on the table” when asked if it would pull all news from Facebook if it it was designated. The parliamentary committee recommended in its second interim report the government should consider imposing a “digital platform levy” – a kind of big tech tax - on companies such as Meta and Google.

News content on Facebook in Australia has already become far less prominent, and Facebook removed its unsuccessful news tab.

Anthony Albanese has also raised the possibility of a levy, with the prime minister saying the social media companies shouldn’t get a “free ride”.

In early October, in response to questions on notice from the social media inquiry, Meta said only 3% of Facebook views were of news links, arguing that showed “access to news content is not the core reason people use Facebook” and that people could access news elsewhere.

It also argued it combated misinformation with factcheckers, safeguards and measures to reduce its spread and availability, and removed disinformation and harmful misinformation.

A spokesperson for Meta said there was “no change” to publishers’ ability to use Facebook, and no change to its Safety Check product, which allows users to let others know they are safe in a time of crisis.

Other features include “access to authoritative information, including content from official government agencies, emergency services and non-governmental organisations”, the spokesperson said.

Meta has also agreed to “help amplify official information for people in emergency situations like wildfires” and coordinate with the government to spread reputable information.

Prof Dan Angus, director of Queensland University of Technology’s Digital Media Research Centre, said Meta slowly deprioritising news might be undetectable to the average user.

“We’re creatures of habit … if all of a sudden tomorrow those platforms upend their algorithms and what content is featured, people might not necessarily know they need to change something because they’re not getting news in their feed any more,” he said.

Here is the link:

https://www.theguardian.com/media/2024/nov/24/australia-meta-facebook-news-journalism-deals-canada-warning-fire-season

I think the reach of social media is now such that they should be regulated to provide help to Government in letting citizens know of looming significant threats to life and limb! Social media of all sorts operate with a social license and in that there needs to be certainty that they will play their part (as telcos etc. do) in acting as a conduit for urgent life-saving news etc.

Frankly – playing “funny-buggers” is just not on I reckon. If Government needs to use their channels to warn people of threats of any real sort it is “no-contest” I assume that would be the case – but with the Zucks and Musks of the world who can be sure! Does anyone know if laws to insist on co-operation are already in place?

David.

Sunday, November 24, 2024

It Looks Like Th Draconian Censors Have Been Retired For A Little While Longer!

This appeared this morning:

Communications Minister Michelle Rowland confirms Misinformation and Disinformation Bill will be pulled

Proposed laws aimed at targeting misinformation and disinformation proliferating social media have been culled after it failed to garner support.

Jessica Wang

November 24, 2024 - 10:16AM

NewsWire

Sky News can reveal the government will dump its misinformation and disinformation bill after it became clear the Opposition and Greens would oppose the bill in the Senate.

Communications Minister Michelle Rowland has confirmed the government will pull a controversial Bill attempting to combat misinformation and disinformation after the Opposition and the Greens vowed to oppose it.

The Bill, which aimed to combat seriously harmful content on digital platforms will be scrapped in the Senate, with the government acknowledging there was “no pathway” for the Bill to succeed.

The proposed legislation was also opposed by a wide-ranging group of community groups, free speech organisations and religious groups over concerns it would harm free speech, with stakeholders questioning how the definition of truth would be enforced.

However, Ms Rowland accused the Coalition of playing politics.

“The Coalition committed to legislating safeguards when in government, but chose to place partisanship above any attempt to navigate the public interest,” she said.

Despite the setback, Ms Rowland said there needed to be “safeguards” to protect Australians from misinformation and disinformation, and urged MPs and senators to work with Labor on alternative concessions.

“Mis-and disinformation is an evolving threat and no single action is a perfect solution, but we must continue to improve safeguards to ensure digital platforms offer better protections for Australians,” she said.

She listed alternative proposals like legislation to strengthen offences targeting the sharing of non-consensual and sexually explicit deep fakes, a proposal to enforce truth in political advertising for elections, and stronger regulations around artificial intelligence.

Greens’ communications spokeswoman Sarah Hanson-Young said that while the intent behind the Bill was “well-meaning,” the proposed laws were “badly and poorly explained and implemented”.

She’s called for stronger regulation, which would target “dangerous algorithms” and heavy financial penalties for social media companies.

“We’ve got to get back to the real problem, and that is how these companies profit off these dangerous posts. If you want to stop the dangerous posts spreading like wildfire, hit them where it hurts, and that’s the dollar,” she told the ABC.

Shadow attorney-general Michaelia Cash said the Bill was an attempt to “censor free speech”.

“This Bill is not about misinformation and disinformation… This Bill is about the Albanese government giving bureaucrats the ability to say whether what you and I say is misinformation or disinformation,” she told Sky.

Here is the link:

https://www.news.com.au/technology/online/communications-minister-michelle-rowland-confirms-misinformation-and-disinformation-bill-will-be-pulled/news-story/ab4c979eeb1434425d917c2844868e14

I have to say that I think this is a very good outcome and that the Minister should just pop back in her box with this sort of censorious proposal!

Within obvious reason we should all be free to say what we like and let what we say be judged on its merits – just as this post should be!

Clearly there are limits to what can be said – defamatory statements, offensive and dangerous deep-fakes etc. – but outside those limits we should be free to say what we like. We have laws to cover that goes over-the-top and pretty sensible judges to regulate significant offending etc. so it is reasonable to let people have their say – hate crimes, flagrant offensiveness and dangerous untruths etc. will be weeded out rapidly I reckon as they are mostly already illegal!

What limits, for example, do people think should apply to commentary on this blog?

David.

AusHealthIT Poll Number 774 – Results – 24 November 2024.

Here are the results of the poll.

Is The Government Doing Enough To Mitigate The Epidemic Of Scams Being Seen At Present?

Yes                                                                      12 (43%)

No                                                                       16 (57%)

I Have No Idea                                                      0 (0%)

Total No. Of Votes: 28

A close run thing with negative answers just ahead!

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

Poor voting turnout. 

0 of 28 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 22, 2024

And Now For Something Completely Different – A View OF 2500 Years Of History!

I really enjoyed this and so decided to share!

World out of order, on the cusp of catastrophe

Paul Monk

16 November, 2024

Whatever you think of Donald Trump’s return to the White House, come January, the next four years promise to be critical in regard to world order. But what is “world order” and how has it evolved out of an anarchy of states and the rise and fall of empires?

In 1784, a year after the United States won its war of independence, Immanuel Kant wrote his Idea for a Universal History with Cosmopolitan Intent, a brief essay pondering whether world order was in fact evolving in the direction of humanity and rationality. Two hundred and forty years later, we might still ask ourselves that question.

The recent BRICS conference in Kazan, hosted by Vladimir Putin, contemplated an alternative to the American-led world order that has existed since 1945. Xi Jinping’s China plainly aspires to reset world order. Within the US, as the recent presidential election showed, polarisation, populist isolationism and irresponsible fiscal governance imperil the Pax Americana from within.

We need to remind ourselves that “world order” – understood as what we like to call these days a “rules-based order” – is a modern development and Western in origin. Kant was aware of its beginnings when he wrote his essay. He died, in 1804, in the midst of the Napoleonic Wars; an enormous upheaval, part a disruption of what order existed and part the harbinger of radical changes to come.

The Congress of Vienna (1814-15), following the defeat of Napoleon, was a conservative attempt to reset and stabilise the European world. There were no such congresses elsewhere, just variations on conquest and submission. The very idea of such congresses and the idea of “rules-based” orders took centuries to evolve. Let’s briefly retrace that process.

In the West, the Roman Empire is still often seen as emblematic of “world order”, and its fall as a catastrophe. But as Walter Scheidel argues in Escape From Rome: The Failure of Empire and the Road to Prosperity (Princeton, 2019), what slowly emerged out of its ruins was a more dynamic order. It is a dynamic, not a static or imperial, order that is being tested right now.

After Rome fell, the Eastern Roman Empire, with its capital in Constantinople, endured for another thousand years, retreating slowly. That retreat was accelerated by Muslim Arab conquest and colonisation of the Middle East, the whole North African littoral and Spain, between 632 and 732, climaxing with the invasion of France and defeat by the Franks under Charles Martel.

The Arab invasions of the Roman and Persian worlds climaxed in attempts by the Umayyad Arab caliphs, based in Damascus, to finish off the Eastern Roman Empire, which still ruled Greece, the Balkans, the Aegean and parts of Italy, by besieging Constantinople twice: 674-78 and 717-18. They failed both times. There were no congresses to settle things. Constantinople would not fall to Muslim forces (the Ottoman Turks) until 1453.

In 750, black-clad Muslim insurgents, the Abbasids, coming out of Central Asia via Persia and Iraq, overthrew and massacred the Umayyads. They established Baghdad as a new city and the capital of the Arab Caliphate. For a while, Baghdad became the new centre of civilisation. Straddling trade routes linking the Mediterranean with India and China, it became richer, more cultivated and a greater centre of learning than any city in the Europe of the Dark Ages.

If you look at a map of the Mediterranean world at about 800CE, the Caliphate extends from Mesopotamia, via where all the Arab states of our time now sit, across North Africa to the Strait of Gibraltar.

The Emirate of Cordoba, in Spain, was separate. It had been created, in 756, by a scion of the Umayyads, who survived the Abbasid revolution, took over Spain and fought off repeated attempts by the Caliph to destroy his realm. It became the fabled Andalusia.

The Franks, under Charlemagne, had reconstructed a considerable part of the old Western Roman Empire, from Central Italy to the Baltic Sea and from the English Channel to Dalmatia. The Celts, Anglo-Saxons and Vikings were vying for mastery in the British Isles. Russia didn’t exist, though Kievan Rus (Ukraine) would arise, under Oleg the Wise, in the final decade of the 9th century. No congresses settled this as a world order.

The Abbasid Caliphate disintegrated before the storied Crusades, which we grew up hearing about and are now encouraged to deplore. It fell apart due to internal religious schism, dynastic strife and poor governance. Above all, it was subjected, between the 10th and 14th centuries, to invasions by Turkish barbarians and the Mongol armies of Genghis Khan and his progeny, out of Central Asia.

The Seljuk Turks, having conquered the Middle Eastern territories of the Abbasids in the 11th century, invaded what was left of the Eastern Roman Empire. They defeated the Byzantine emperor Romanus IV Diogenes at Manzikert in 1071 and began colonising what would eventually become modern Turkey.

The Great Wall of China has only been pierced by Genghis Khan and the Manchus until recently when two construction workers dug a shortcut, says Sky News host Liz Stoker.

The Seljuk Empire, in turn, came apart, due less to the Crusades (between 1069 and 1291) than to devastating invasions by the Mongols, between 1219 (when Genghis Khan was at his height) and the death of Tamerlane, in 1405.

The Crusades are depicted as symbolic of “imperialism” when they were a response to Muslim imperialism and, in any case, trivial compared to the Turkish and Mongol invasions. One can read of the massacre of thousands by Frankish crusaders in the Holy Land, but the Mongols slaughtered millions and laid waste to whole swathes of fertile country. Hulagu, a grandson of Genghis Khan and a brother of Kublai Khan, sacked Baghdad itself, in 1258.

The Mongols conquered Russia and Ukraine (Kievan Rus), occupying them for centuries. They marauded as far as Poland. But the Ottoman Turks came to pose the greater danger to Europe. Taking what remained of the Eastern Roman Empire from 1300 onwards, they finally captured Constantinople in 1453. They kept advancing into the Balkans for the next 200 years, until defeated outside Vienna, in 1683. All this was done without reference to international law or world order.

The Ottomans took over North Africa from the Arabs and Berbers. Their corsairs ran slave raids in the western Mediterranean and the coasts of Western Europe for centuries, until suppressed by American and European fleets in the 19th century. Their famous defeat at Lepanto, in 1571, by Catholic naval forces didn’t lead to them retreating. They rebuilt their Mediterranean fleet within six months.

But from the late 17th century, the Ottoman Empire began to retreat. It was at that time, also, that (Ming) China was conquered by the foreign Manchurians, who added Mongolia, Qinghai, Xinjiang, Tibet and Taiwan to their empire. But that’s another story.

The Ottomans declined due to technological and military stagnation, as Western Europe underwent a remarkable transformation and, also, outflanked the Ottoman Empire by rounding the Cape of Good Hope and circumnavigating the globe, to access the spices and riches of the Far East (and the Americas). No congresses there ­either.

The Russians, centred on the Duchy of Muscovy from the 16th century, over the years of Western expansion, from the 16th to the 19th century, annexed Ukraine, Poland, the Baltic States and Finland, and colonised immense territories in Central Asia, Siberia and the Caucasus.

It was in that era, however, that the very idea of “world order” and the “law of nations” began to develop – in the European heartland. The Dutch jurist and polymath Hugo Grotius (1583–1645) laid the foundations for international law in his treatises The Freedom of the Seas (1609) and On the Law of War and Peace (1625), as well as initiating the development of the very idea of universal human rights – an idea rejected by Xi Jinping and those who think like him.

Grotius expounded the core idea of an order of states, moderated not by force but by rational laws and a common understanding that force should be used only to uphold those laws. Think Camelot. Hedley Bull, author of The Anarchical Society, saw Grotius as the inspiration behind the 1648 Peace of Westphalia, which ended the Thirty Years War. He dubbed Grotius “the intellectual father of this first general peace settlement of modern times”.

It was on the foundation of the work of Grotius and others that Kant could write what he did. It is that tradition in which we are anchored when we talk, in the 21st century, of an international rules-based order. After Grotius, Realpolitik, under which, in the words Thucydides attributed to Athenian commanders at Melos, “the strong do what they can, while the weak suffer what they must”, slowly and uncertainly began to give way to principles of international law and human rights.

In reality, of course, the convening and the outcome of congresses had much to do with the preponderance of power. The First World War saw the collapse of the Ottoman Empire, along with the defeat of Germany, the collapse of the Austro-Hungarian Empire and the expansion of the British and French empires. But all this was orchestrated through international congresses: at Versailles (1919) and Lausanne (1923).

As Sean McMeekin showed, in The Ottoman Endgame (2015), it was at Lausanne, in July 1923, that the carving-up of the Ottoman Empire and the creation of new Arab states in the Middle East was arranged. Contrary to legend, however, the key figure in planning that carve-up (in 1916) was neither Mark Sykes nor Georges Picot, but the Tsarist Russian foreign minister Sergei Sazonov. And the dominant figure at Lausanne (in 1923) was none of those individuals, but Mustafa Kemal, the new, modernist, secular master of Turkey.

Lausanne was necessary, because war over the fate of Turkey did not end in 1918. The liberal democrat Eleftherios Venizelos, a Cretan and the founder of modern Greece, longed to reclaim for Greece the empire lost to the Turks between the 11th and 15th centuries. Mustafa Kemal had other ideas and expelled the Greeks from Turkey with great violence. Lausanne settled it – more or less.

The Treaty of Versailles, in 1919, saw the creation of the League of Nations, the first truly Kantian attempt at creating an international order of a new kind. Its failures are legendary. But it set an antecedent which, after the Second World War, led to a fresh attempt: the creation of the United Nations. Both marked conceptual and substantive progress. The UN is, of course, notoriously disunited and in need of an overhaul. But it represents the ideals of Grotius and Kant.

“The history of mankind”, concluded Kant, “remains as a constant objection, because its spectacle compels us to turn away our eyes in disgust.” And yet it is only by remembering history, in the long view, and studying its often disheartening lessons, its endless complexities, that we can hope to formulate better and more effective modes of international order. We are clearly in need of ­formulating such new, updated ideas in the 2020s.

Right now, we are likely to be distracted by immediate problems – the war in Ukraine, the multi-front war in the Middle East, the tensions in East and Southeast Asia, uncertainties about the US alliance system, governance in the liberal democracies. But it is very important to put all this in a larger frame of reference.

That frame of reference includes the astonishing technological and scientific developments going on, the population implosion taking place globally, as Nicholas Eberstadt points out in the latest issue of Foreign Affairs, and the fact that global challenges require a dynamic and resilient global order of free states more than ever before. Ignore this and you get same old, same old.

The challenges ahead demand that we re-imagine the current order, finding ways to create one able to avert various possible catastrophes.

As things stand, that’s going to take some doing. Kant hoped that “the play of human freedom” would generate rational order. At immense cost, we’ve made progress. The challenge now is to both freedom and order.

Paul Monk is the author of a dozen books, including The West in a Nutshell: Foundations, Fragilities, Futures (2009), Dictators and Dangerous Ideas (2018) and Thunder From the Silent Zone: Rethinking China (2nd edition, 2023).

Here is the link:

https://www.theaustralian.com.au/inquirer/world-out-of-order-onthe-cusp-of-catastrophe/news-story/07d5abb7d587d42df43e11b1f43bc3fa

This helps keep things in perspective – but it is surely true that Trump’s return is NOT a good thing!

David.

Thursday, November 21, 2024

It Is Sad That Fraud By Doctors Is Becoming A Problem Apparently…

This appeared last week:

Call for cheating doctors to be named and shamed

By Melissa Cunningham and Henrietta Cook

November 17, 2024 — 5.00am

Doctors who overbill patients should be named and shamed on a public register, according to one of Australia’s top health economists, and a class action against a group of Mornington Peninsula doctors allegedly overcharging might be on the cards.

Patients have also been urged to check their Medicare records to ensure they have not been wrongly charged by their doctors.

The calls come after this masthead revealed allegations against dozens of anaesthetists and surgeons on Victoria’s Mornington Peninsula, in a damning confidential whistleblower complaint accusing them of systematic fraud, double-dipping and pocketing off-the-book fees.

The complaint alleges that a group of doctors has been charging patients hidden out-of-pocket costs up to $5000 – disguised as booking or administrative fees – for their own financial gain, while at the same time, the specialists were purporting to participate in no-gap-fee schemes with health insurers.

Medical fraud and compliance expert Dr Margaret Faux, who has previously worked as a solicitor, believes there may be scope for a class action lawsuit to help consumers if the allegations are proven.

“We actually need to get this in front of a judge as soon as possible,” she said. “This whistleblower letter is a gift in so far as it gives prosecutors everything they need to quickly and easily get to the truth of the matter.”

Faux said of concern were allegations that doctors have been charging fees for no service, which is illegal.

She said charging an anaesthetic administrative fee of more than $1000, with no explanation for example, could be deemed “suspicious”, because the law required consumers to be billed using Medicare codes.

“We know the names of all the doctors,” Faux said. “We know exactly where this alleged conduct is taking place, and there are no excuses for inaction.”

Health economist Stephen Duckett – the man widely regarded as the architect of Medicare – said that while the overwhelming majority of doctors strived to do the right thing, there was also evidence of a minority of greedy specialists who sought to game the system.

‘The patient gets screwed, the insurance fund gets screwed, and the doctor goes all the way to the bank.’

Duckett said doctors found to be breaching their contracts with insurers and overbilling patients “should be named and shamed” on a public register to warn consumers.

“Because the system is so complex, patients don’t know what their entitlements are, and they don’t know when they’re being ripped off,” Duckett said.

“Similarly, because the health fund doesn’t know that a booking fee was charged, they can’t police it on behalf of the patient. So, the patient gets screwed, the insurance fund gets screwed, and the doctor goes all the way to the bank.”

He said insurance funds also must tighten contracts with health practitioners to protect consumers and hold doctors to account.

“Insurers must be prepared to name doctors who are chiselling patients,” he said.

According to the whistleblower, during her employment at a Mornington Peninsula medical clinic which spanned a decade, about 90 per cent of patients were stung with out-of-pocket costs, despite the no-gap-fee arrangements.

Rachel David, the chief executive of Private Healthcare Australia, which represents insurers, has called for Australia to follow the United States and enact a “surprise billing legislation”, which mean if a patient is charged with a bill they don’t expect, they do not have to pay it. She cited instances where a specialist has added an assistant without telling a patient in advance.

“Raising a charge while a patient is under duress is unacceptable … if a patient challenged that under consumer laws I think they probably win.”

David has urged people to examine their medical bills for any service not attached to a Medicare item or for statements on bills labelled as “booking” or “administrative” fees.

“If it says that it’s a separate fee that Medicare or the health insurance fund won’t pay, that is a red flag,” David said.

Insurers nationwide are now scrambling to probe the claims of overbilling.

The federal government’s Benefits Integrity Division – which investigates claims of health and Medicare fraud – is also investigating.

Australian Patients Association chief executive Lisa Robins said hidden specialist billing eroded confidence in the system and deterred some people from taking up private health insurance.

“Many Australians have taken out private health insurance to avoid out-of-pocket expenses. These fees are a betrayal of patient trust and it’s incredibly disappointing to see allegations that some specialists are financially exploiting individuals when they are at their most vulnerable.”

She called on health ministers to put an end to unethical billing practices, which she said were putting undue financial pressure on patients during a cost-of-living crisis. She said healthcare providers also needed to be transparent about their billing.

A spokesman for the federal Department of Health and Aged Care said the government was unable to share details of its compliance investigations, including probes which are still under way.

How to check if you’ve been billed incorrectly under no-gap-fee arrangements

If you have private health insurance, call your health fund to examine your bills and ask questions about whether you should be paying out-of-pocket fees or not. They can help you ask the right questions of your provider. If your Medicare records show you were bulk-billed when you were charged a fee, report it to Medicare.

The Australian Society of Anaesthetists and the Royal Australasian College of Surgeons both said they take allegations of financial misconduct seriously, but strongly rejected suggestions unethical practices were commonplace or widespread.

Australians who have had surgery in private hospitals are being urged to scour their medical invoices and specialist doctors’ bills for “red flags” showing they have been charged hidden fees outside their health funds or Medicare.

How to report potential fraud to Medicare:

Here is the link:

https://www.smh.com.au/national/victoria/call-for-cheating-doctors-to-be-named-and-shamed-20241116-p5kr5b.html

I have to say this is really pretty sad – especially given the amounts one can make without resorting to such activity.

I wonder is the incidence rising compared with other professions?

David.