This is really a great 8 minutes of interesting and probably important stuff from a well-known evangelist Dr Eric Topol. This presentation is about what he terms Smartphone Medicine.
Do enjoy - great fun!
David.
Friday, February 27, 2015
Thursday, February 26, 2015
Review Of The Ongoing Post - Budget Controversy 26th February 2015. Now We Are Working On The 2016 One!
Budget Night was on Tuesday 13th May, 2014 and it is still not finalised by any means.
Both major health and education changes as well as pension changes are still stuck and it seems we have only 4 sitting weeks in Parliament before the next Budget..
Thus with the 2014 Budget still not passed we are seeing submissions regarding the 2015 Budget.
As early warning it looks like the 2016 Budget is handed down Tuesday 12th , May 2015.
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Other articles this week.
General Budget Issues.
Is Australia spending over $100m a day more than collected in revenue?
By Expert Panel | 16.02.2015
By Miranda Stewart, Australian National University
“At the moment, we are spending over $100 million a day more than we’re collecting in revenue. Now that’s unsustainable, particularly given we’re spending nearly $40 million a day on the interest on the debt that we have.” – Treasurer Joe Hockey, interview with Alison Carabine on RN Breakfast, February 3, 2015.
Mr Hockey has made similar statements in multiple interviews to support the government’s position that cuts to spending are needed to reduce the deficit.
To get $100 million of “overspending” a day, the Treasurer has relied on the Commonwealth Government fiscal balance recorded in the Mid Year Economic and Fiscal Outlook statement (MYEFO). The MYEFO, released in December mid-way through our financial year, updates the figures from the May Budget – including the deficit.
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Australian economy ‘sliding down the precipice’
Stephen Cauchi
The Australian economy is "sliding down the precipice" due to "glacial" reform efforts, with a weakness in domestic demand that was "recession-like", according to a research note from JP Morgan.
JP Morgan analyst Stephen Walters argued in the note that Australia was failing to make up the lag created by the plunge in mining investment.
Furthermore, the Reserve Bank was trying to mask the economy's structural weakness with monetary stimulus, he said.
"We knew for some time a plunge of mining investment in Australia was fast approaching," said Mr Walters. "The economy now is sliding down the precipice pretty much at the pace expected, as the sector moves from expansion to production."
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Expensive homes could reduce age pension payments
Phillip Coorey Chief political correspondent
The federal government is canvassing the prospect of including the family home in the pension assets test as it strives to keep the retirement system sustainable over coming decades.
Social Services Minister Scott Morrison has discussed the issue in talks with peak seniors groups in recent weeks, while Kelly O'Dwyer, the parliamentary secretary to the Treasurer, said on Monday the matter will "almost certainly" need to be debated following the release of the intergenerational report within weeks.
A taskforce has also been established within Treasury to look at retirement incomes.
The two seniors groups, National Seniors Australia and Council on the Ageing (COTA) Australia, are both amenable to putting the issue on the table, with conditions, which include that other sectors of the economy are prevailed upon to help balance the budget.
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Superannuation tax concessions are valuable, if inflammatory political territory for Treasurer Joe Hockey
Date February 17, 2015 - 12:00AM
Peter Martin
Australia needs a big, untapped revenue stream to balance its books, and superannuation ticks all the boxes.
Joe Hockey may have just let the cat out of the bag.
The Treasurer has an awful problem. Government revenue is falling well short of expectations and is about to slide further. Since his May budget, the iron ore price has slid 40 per cent. The oil price, which sets the price of exported gas, has slid 50 per cent. The lower dollar will not come close to offsetting the hits to export income and tax revenue. They are yet to reach the budget.
The really big dollars have to be found where the government hands out money and where the government forgoes money by handing out tax concessions. The really big dollars are in superannuation.
Already, as Hockey puts it, "the government is spending $100 million more than it collects every day. It has to borrow that $100 million per day just to pay its bills".
The $100 million figure comes from dividing the forecast budget deficit by the number of days in a year. It's accurate, and unless Hockey comes up with something clever it's about to grow.
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Hockey faces gloomy backdrop for budget
By Colin Brinsden, AAP Economics Correspondent
February 18, 2015, 4:27 pm
Joe Hockey will be putting his second May budget together against the backdrop of a still sluggish economy.
The latest Westpac-Melbourne Institute leading index continues to signal an economy growing at 2.75 per cent over much of 2015 rather than a trend pace of 3.25 per cent.
It suggests the jobless rate could be still rising at a time when the federal treasurer is trying to get the budget back in order.
"The economy needs more stimulus and the Reserve Bank, with ample scope to cut, should be acting accordingly," Westpac chief economist Bill Evans says.
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Business ignores Hockey warnings
Shane Wright Economics Editor
February 16, 2015, 12:50 am
Business is ignoring Treasurer Joe Hockey’s warnings about the Budget, calling for tax cuts to help them navigate tough economic times.
Budget submissions from lobby groups all effectively argue for less tax and more spending in their areas of need.
This year’s Budget already faces a deficit blowout which, in December, was forecast to reach $31.2 billion after initially predicted to edge down to $17.1 billion.
But a sharp fall in commodity prices, a lift in unemployment and slower than expected wages growth have punched a hole in Government revenues.
Those declining revenues have not stopped business groups looking for assistance. The Australian Industry Group wants a 1.5 per cent cut in company tax for all businesses. So far the Government has only committed to giving it to small firms.
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Both sides of politics falter in fairness test
- The Australian
- February 18, 2015
Paul Kelly
FAIRNESS as a political idea relating to moral obligations by government has been integral to the near destruction of the Abbott government — yet Australia’s so-called fairness debate has been weak, populist and deceptive.
Neither side of politics satisfactorily meets the fairness test. The Abbott government last year misjudged fairness as a public issue and brought down a budget far too unfair in its redistributive impact.
At the same time the Shorten opposition turned fairness into a populist drumbeat, attacking many budget measures and arguing the budget was unfair because of the hurt it imposed — on pensioners, patients, motorists and students.
The start point is the recognition that Australia has one of the most progressive or fairest tax-transfer systems among OECD nations. This was highlighted this week by the parliamentary secretary to the Treasurer, Kelly O’Dwyer, who provided statistics on personal income tax.
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Strained budget risks AAA rating
- Dow Jones newswires
- 19 Feb, 4:55 PM
Standard & Poor's Ratings Services has backed warnings by Australia's central bank that the federal budget would be vulnerable to a global economic shock, which could put the country's AAA rating at risk.
Australia's budget outlook has weakened sharply in the last six months as commodity prices have plunged, said S&P's sovereign analyst Craig Michaels.
Sliding prices of coal and iron ore, the country's biggest export, are hurting economic growth, denting corporate profits, driving higher unemployment and eroding government tax receipts.
Goldman Sachs recently calculated that Australia could lose $500 billion in national income in the next decade because of the drop in commodity prices, which includes a 50% drop in iron ore.
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Nick Greiner tells Tony Abbott: break super promise to avoid 'train wreck'
Nick Greiner says if the budget stand-off is not resolved, the country will grind towards a 'train wreck.' Fairfax Media Australia -
Andrew Clark
Prime Minister Tony Abbott must bring the states and federal opposition together in a "grand compromise" to end the budget stand-off or risk the country grinding slowly towards a "train wreck", says former NSW Premier Nick Greiner.
Mr Greiner, who was premier of NSW from 1988-93 and is close to so-far-unannounced federal Liberal Party leadership aspirant Malcolm Turnbull, says there's "an imperative and a need to do something" and that the government should break its promise not to change superannuation this term by reversing the overly generous Howard-era superannuation tax concessions.
He sees the current, more contested, political situation – including the leadership tensions – as an opportunity. "The situation is better now that the states are 3-all (Liberal and Labor). That's an opportunity, not a problem, because if it was all Liberal or all Labor, including the federal government, all that means is that whoever is not in government they just don't buy into it."
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Political Instability.
Good government starts today ... er, maybe tomorrow
Date February 15, 2015 - 11:24AM
Jacqueline Maley
"Good government starts today," Prime Minister Tony Abbott declared after Monday's spill motion, which was defeated by a self-esteem damaging 61 votes to 39.
This pronouncement, designed to reset the government as though it was a dicky watch, or a digital Tamagotchi pet which had accidentally been left to die, was itself declared an own goal.
If good government was only to commence now, what had the previous 18 months been? Performance art?
Since then, Abbott/Australia have had a week's worth of good government in which to bask. How have we fared?
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Scary Joe Hockey has cried wolf too often
Date February 20, 2015 - 4:00PM
Michael Pascoe
BusinessDay contributing editor
In a volatile and uncertain world, Joe Hockey had a hot tip for Australians this week: sit on the floor.
That's because he promised that Treasury's looming inter-generational report will make Australians "fall off their chairs".
And so the Treasurer was back in character as "Scary Joe", ready to star in a horror movie cut of the intergenerational report.
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Fairness debate gets traction
- The Australian
- February 21, 2015
THIS week the case for budget repair shifted into new territory. The ABC is finally on board, recognising fiscal consolidation is required as a matter of urgency. The Abbott government, too, is adjusting its strategy, timing and messaging, having blundered its way since winning office. The imminent release of the Intergenerational Report must be used by Joe Hockey to propel the argument, reinforcing the powerful contributions from our top two economic bureaucrats, the Reserve Bank’s Glenn Stevens and new Treasury secretary John Fraser. Their warning is unequivocal. Australia is poorly placed to deal with the next shock the world throws at us.
Fixing the structure of the budget, especially the spending side, is not a new cause for this newspaper. For the past decade we have argued, often as a lone media voice, that the historic gift of a spike in our terms of trade needed to be carefully managed; that the revenue bonanza should go into a sovereign wealth fund; and that we should not build into the budget’s framework spending that could not be sustained when export prices returned to normal. We documented the excesses of John Howard’s handout culture and the unbridled waste of taxpayer funds after the global financial crisis by Labor under Kevin Rudd and Julia Gillard. As a result of this folly, government debt is headed for $667 billion over a decade if nothing is done.
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Does the PM have a political death-wish?
- Samantha Maiden
- The Sunday Telegraph
- February 21, 2015
IT was the leak that rocked the 2010 election, claims that Julia Gillard had opposed an increase to the age pension.
According to Channel Nine’s Laurie Oakes, the woman who ousted Kevin Rudd as Prime Minister was sceptical, telling the budget razor gang that “elderly voters did not support Labor”. The sabotage campaign was later cited in an internal ALP review as not only devastating internally but highly damaging to Labor’s electoral chances.
For Tony Abbott, it was time to pounce on another juicy leak from the divided ranks of the Labor Party.
“There is some terrible malaise at the heart of this Government when you’ve got this kind of leaking going on,’’ Mr Abbott said at the time.
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Health Budget Issues.
For real health reform, turn the spotlight on specialists’ fees
The impact of specialist fees on government and patient budgets has received little reform attention. This is despite the government’s push for controls in health-care spending and growing evidence of the affordability problems faced by sick Australians.
A high-quality specialist sector is an essential component of an effective health-care system; patients rely on specialist doctors when they are sickest and most vulnerable. And when their treatment inevitably involves expensive treatment options. But specialist care in the community is increasingly hard for many Australians to access, due to geography and cost.
In 2011-12, the number of people who reported seeing a medical specialist in the preceding year varied nearly two-fold across Medicare Local populations nationally, from 22% to 42%. But there was no strong association between health status and seeing a specialist. And up to 14% of people reported they had delayed seeing a specialist because of cost.
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Ideology and good health policy do not mix
Date February 18, 2015 - 5:00PM
Brian Owler
The NSW Nurses and Midwives' Association has invented a fictional scenario to push a dangerous health policy.
Claiming that the Baird government is introducing United States-style privatised managed care by stealth in order to promote walk-in clinics, where nurses would do the work normally undertaken by highly-trained doctors, is drawing a very long bow.
General practice is at the core of the sustainability of our healthcare system.
The proposal is bad health policy. Unfortunately, the NSW Labor opposition has embraced it.
The evidence is clear – quality primary care is best delivered by teams led by doctors.
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Pay doctors more but only when they provide the right care say health funds
- 11 hours ago February 19, 2015
- Sue Dunlevy National Health Reporter
- News Corp Australia Network
EXCLUSIVE
Doctors would be paid 30 per cent more by Medicare and health funds but only when they provided quality care under a controversial plan being pushed by private health insurers.
Private Healthcare Australia chief Dr Michael Armitage has presented a plan to the government that shows taxpayers could save billions if Medicare and health funds pay for evidence based care in line with clinical guidelines.
It comes as health funds are poised to this month win approval for a premium rise worth over 6 per cent or three times the inflation rate.
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Medicare system is sicker than the patients
- Simon Benson
- The Daily Telegraph
- February 20, 2015
THE government this week released analysis that revealed why Medicare is in trouble, yet it has come a year too late to have any policy impact.
Like Labor’s failure to make the case for the mining tax, the Abbott government stuffed up Medicare reform by unveiling the cure before alerting people to the presence of disease.
But that doesn’t mean the problem will go away. If anything, it will get worse.
If the headline figures are to be taken at face value, people in Sydney are among the sickest in the western world.
On average, they are now going to the doctor 16 times a year each. That’s right: Once every three weeks.
Health Minister Sussan Ley released the research while visiting doctors in Western Sydney. It showed the value of Medicare claims in NSW had more than doubled in the past decade to more than $6 billion a year. The actual number of Medicare-accessed services — most being visits to the GP — had increased by 52 per cent in 10 years. There are now around 120 million visits to the doctor a year in NSW alone, with the number growing more than four times higher than the rate of the population.
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Sussan Ley’s next big challenge
- Kate Legge
- The Australian
- February 21, 2015
CLAMBERING into the rickety cabin of a single-engine Cessna where new Health Minister Sussan Ley sits at the controls flicking switches and checking dials, my butterflies flutter disconcertingly.
“I’ve got my good-luck scarf,” she jokes of a blue and mauve patterned neck tie worn the day she won Liberal pre-selection for the south-western NSW National Party stronghold of Farrer in 2001. She wriggles free from her black ankle boots for the comfort of socks that have sprung a hole where her big toe with its bright red nail pokes through. “Clear prop” she sings out over her shoulder with the unflappable spirit of a squadron pilot from the Biggles paperbacks that fired her childhood thirst for adventure. She gives me a headset to muffle the roar as we rocket down the runway of Albury’s airport, lifting into a clear blue sky above the political dust storm threatening to bury Prime Minister Tony Abbott.
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Medicare Co-payment Issues.
Axe for Medicare co-payment
- The Australian
- February 17, 2015
Sid Maher
EXPECTATIONS are growing that Tony Abbott will dump the Medicare co-payment as he moves to reset the health debate and win support for his looming families package.
Coalition MPs told The Australian yesterday they expect the Medicare co-payment will be dropped amid continued opposition from medical groups.
Health Minister Sussan Ley is continuing to consult with the medical profession but The Australian understands she has been told by key groups they will not support the policy.
Under the policy, the Medicare payment to doctors will be cut by $5, but the government will make it possible for doctors to charge a contribution from patients to recoup the $5.
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Fee rise backed if GPs keep the cash
- The Australian
- February 18, 2015
Sarah Martin
DOCTORS support charging some bulk-billed patients more for consultations, as long as the “modest” extra fee is kept by GPs to improve services.
Royal Australian College of General Practitioners president Frank Jones said the proposal, which was put to federal Health Minister Sussan Ley in meetings last week, would let the government send a price signal to patients while not penalising doctors.
The government has argued that a price signal is needed to ensure that those who are able to afford to pay for doctor visits are charged accordingly. Its first option of a $7 co-payment announced in last year’s budget was replaced with a $5 cut to the rebate in December.
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Bulk billing: Federal Health Minister Sussan Ley won't guarantee savings will go into medical research fund
By political reporter Eliza Borrello
February 18, 2015, 6:50 am
Federal Health Minister Sussan Ley says she will not guarantee savings from the Government's new bulk billing plan will go towards a medical research future fund.
The federal budget revealed the Government's plan to charge bulk billed patients $7 to see a doctor and put the proceeds in a new medical research fund.
But in December the policy could not pass through the Senate and was dumped in favour of a $5 payment charged at a doctor's discretion.
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Health Minister Sussan Ley hints $20 billion Medical Research Future Fund might not go ahead
- 37 minutes ago February 18, 2015
- MALCOLM FARR National Political Editor
- news.com.au
REMEMBER the Budget that was going to cure cancer? Well the Government’s quest for a miracle medical breakthrough now looks decidedly ill.
Health Minister Susan Ley today said she could not guarantee the $20 billion Medical Research Future Fund — designed to look for cures for a range of illnesses — would go ahead as planned.
“I’m not going to guarantee something that relates to a consultation that I haven’t completed ... that would be duplicitous of me,” Ms Ley told ABC radio.
“The Medical Research Future Fund has money coming into it now and it’s not dependent on one particular policy.”
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'It really is a zombie idea': English health chief slams GP co-payment
Date: February 19, 2015 - 2:57PM
Amy Corderoy
Charging people upfront fees for healthcare is an ideological "zombie idea" that leads to higher costs and worse health outcomes yet is repeatedly brought back to life, the long-serving former head of England's National Health Service says.
David Nicholson, who served as chief executive of the English health system between 2006 and 2013, under both Labour and Conservative governments, said there was clear evidence that charging copayments for GP visits is an ineffective measure for reducing health costs.
The federal government is currently consulting on ways to reduce the number of people receiving bulk-billed treatment from GPs with no upfront costs, after two earlier attempts proved politically unpopular. Health Minister Sussan Ley told Fairfax Media "doing nothing was not an option", as the number of Medicare services provided in Australia had increased by 57 per cent since 2003.
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Health Minister clarifies earlier suggestion of new multi-tiered co-payment system for GP visits
MARK COLVIN: The Federal Health Minister Sussan Ley has tried to clarify comments earlier today that appeared to raise the prospect of a new multi-tiered co-payment system for doctor visits.
The Minister said she was aiming for agreement on a way to ask patients to pay something if they could afford to, with those on high incomes asked to pay more, but she didn't explain how that could be done.
The Minister now says she was reflecting on what already happens in general practice.
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Co-payment need not be a dirty word in restructuring healthcare
- Teresa Gambaro
- The Australian
- February 20, 2015
THE healthcare system is at a crossroads. The system we set up in July 1975 when Medibank officially began almost 40 years ago no longer meets our needs. But when we consider the population in 1975 was 13.9 million as opposed to the 23.7 million we are today then this should be no surprise.
Treasury’s first Intergenerational Report in 2007 forecast government expenditure on health was projected to increase as a proportion of gross domestic product from 3.5 per cent in 2006-07 to 7.3 per cent in 2046-47, with about a quarter of these increased costs coming from an ageing population.
Treasury’s 2010 Intergenerational Report identifies several drivers of the expected rise to extend beyond just an ageing population to include population growth, demographic pressures, demand for higher standards of care, as well as rapid technological innovation.
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No payments, copayments and faux payments
Many thanks to Margaret Faux for this précis of an article published in the Internal Medicine Journal on 4 February 2015 No payments, copayments and faux payments: are medical practitioners adequately equipped to manage Medicare claiming and compliance?
Margaret Faux writes:
In an article recently published in the Internal Medicine Journal, my co-authors and I have summarised a selection of available literature concerning medical practitioners’ understanding of Medicare claiming and compliance.
The seed of the paper originated in a systematic review of literature in this area which found that despite much commentary and opinion, little if any empirical research exists on this topic.
We examined the complexity of day-to-day Medicare claiming, which has become labyrinthine to the point where it is beyond the comprehension of many, including medical practitioners who are largely dependent on Medicare for their livelihoods. The literature proffers that between $1-3 billion is leaked from Medicare each year as a result of inappropriate claiming (approximately 5-15% of total Medicare expenditure), yet no research has ever sought to critically analyse the potential causes of this phenomenon beyond suggestions of deliberate misuse of the system by rogue clinicians.
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Comment:
I also have to say reading all the articles I still have no idea what is actually going to happen with the 2015 (or the 2016) Budget (or the Government) at the end of the day.
One wonders for how much longer this will go on and just what impact a change of leader might have?
Enjoy.
David.
Wednesday, February 25, 2015
Senate Estimates Have Just Totally Ignored E-Health - Not A Peep As Of 6:50pm! - Updated 8.15pm
Hopeless!
David.
Late Update. Sen Di Natale asked some e-health questions 3 hours late.
All of them were parried saying Government still had no clue what it was doing and what was happening.
D.
David.
Late Update. Sen Di Natale asked some e-health questions 3 hours late.
All of them were parried saying Government still had no clue what it was doing and what was happening.
D.
The Australian Healthcare And Hospitals Association Submission On The Upcoming Budget. A Little Gentle On E-Health I Believe.
This was released a few days ago:
The section on E-Health is on page 7 of the 8 page submission:
Commonwealth Leadership on System Integration
The AHHA acknowledges the Commonwealth Government’s continued support for the national implementation of ehealth tools and resources as holding immense potential to support high quality and consistent care, as well as supporting a number of efficiencies and reduction of waste.
The benefit and value of the use of standardised use of electronic health records are well documented: better information sharing and communication between healthcare providers and between patient and provider; reduced duplication or over servicing; more efficient and more appropriate treatment; responds to needs of both clinicians and consumers by being portable and transferrable.
Electronic health resources also stand to better support prescribing and referrals for tests and other procedures and would align with other efforts to reduce inappropriate or unnecessary testing and medication prescription.
Greater use and entrenchment of personal electronic health records would:
- Further integrate and support appropriate care regardless of the point of access in the system.
- Provide a greater focus on a digital healthcare system would also support better performance reporting
- Enhance the capability to allow for performance reporting in real time and across a community through linked data collected and analysis to support quality service provision, achievement of health outcomes and responsiveness in delivery programs and services that meet identified needs.
- Allow for information sharing across health services, both public and private, enabling governments and other funders to identify better utilisation of resources for health.
The establishment of Primary Health Networks provides the opportunity for strong Commonwealth leadership to establish primary health care as the cornerstone of a responsive and strong health system.
It is vitally important that Primary Health Networks are provided with adequate long term funding and supports to establish themselves and adapt to the needs of their communities. Insufficient and uncoordinated primary care services inevitably lead to increased demand on acute hospitals through outpatient clinics, emergency departments and hospital admissions. Funding arrangements should reflect the nature of community needs and should allow for facilitating the right care in the most appropriate environment and supporting unnecessary hospital admissions and presentations.
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I have to say what worries me about all this is the lack of any comment on the lack of clarity about the future funding and purpose, the lack of comment regarding the lack of evaluation of what has been done to date and a distinct sense of the submission being a triumph of hope over experience in the last decade or so.
The AHHA could afford to push a little harder for more concrete outcomes and evaluation!
David.
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