Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
It is amazing how the discussion on the GP Co-Payment just runs and runs. Lots more this week.
Here are some of the more interesting articles I have spotted this fourteenth week since it was released.
Last week we saw Parliament back and it really seemed not much was moving - on the surface at least.
General.
Date August 25, 2014
Political correspondent
The federal government is digging in over unpopular cuts in the budget, with cabinet ministers warning other savings measures will be found if a compromise cannot be reached with the opposition and Senate crossbench.
Finance Minister Mathias Cormann said on Sunday that if the budget spending cuts and savings measures, including the $7 GP co-payment, the rise in fuel excise and changes to university fees, were not passed then "the only alternative to balance the books is to increase taxes".
Education Minister Christopher Pyne said universities could face a "worst case" scenario of research funding cuts if the Senate did not pass his proposed higher education reforms, which will be introduced to the Parliament on Thursday and include deregulated university fees, cuts to course funding by about 20 per cent and increased interest payments on student loans.
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The researchers from Flinders and Monash universities engaged 39 policy-makers, academics, clinicians and consumers in a qualitative study they hope will assist in determining policy and resource allocation.
“Currently policy-makers and health service planners charged with the responsibility for allocating health resources to rural and remote communities do so in the absence of any comprehensive and agreed national listing of what constitutes core or essential PHC services,” they write in BMC Family Practice.
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PUBLISHED: 26 August, 2014
Phillip CooreyChief political correspondent
The federal government’s chances of a budget breakthrough any time soon are bleak, with Senate crossbenchers saying they will not be “bullied” by threats of tax increases.
There was no sign of breakthrough in the standoff a day before Parliament resumed as members of cabinet were advised by Coalition party officials to show more public discipline.
Following a six-week winter break marked by bungles, gaffes and mixed messages on budget and other policy issues, Liberal Party federal director Brian Loughnane and his Nationals counterpart Scott Mitchell spoke to the cabinet on strategy.
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Date August 26, 2014
Chief political correspondent
The six-week parliamentary break has done less to improve the government's parlous reputation with voters than it had hoped.
If anything, the lay-off has exacerbated a sense of drift and occasioned the odd break-out of political desperation.
The next two weeks of parliamentary sittings must be used to turn this around or Tony Abbott's first year will be judged as mediocre, even by his barrackers.
An opening year "fail" grading would not be terminal for Abbott's leadership nor for his government's re-election hopes, but it would make both more problematic.
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Date August 26, 2014 - 5:44AM
Mark Kenny and Latika Bourke
Federal cabinet met on Monday in a bid to reframe its confused budget messaging as Labor confirmed it would not be compromising on stalled measures forcing the government further towards retreat or compromises with the independents.
The talks followed a harsh political reaction to suggestions from senior ministers about possible tax increases or cuts to university research spending if budget savings remained unlegislated.
The otherwise routine cabinet meeting came as even some of the nation's conservative commentators urged the government to regain the initiative, amid confusion over the language being used by senior ministers to describe the budget impasse.
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Date: August 26, 2014 - 6:50AM
Economics Editor, The Age
The finance minister is two-thirds right. He says if the government can't balance its books by cutting spending, "the only alternative to balance the books is to increase taxes".
There's only one other option. It's neither an increase in tax nor a cut in spending. It's an attack on tax expenditures, something the committee drawing up next year's tax white paper would have been asked to examine in any event.
Superannuation is Australia's biggest tax expenditure; the tax breaks given to contribution and to the earnings on those contributions when they are in the funds amount to $36 billion a year on Treasury estimates.
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PUBLISHED: 26 Aug 2014 19:12:00 | UPDATED: 27 Aug 2014 06:14:54
Fleur Anderson
Some federal ministers vomit from nerves before entering the high-stakes arena of question time. Others memorise their answers or perform superstitious rituals to get them through their days under the floodlight of public scrutiny.
For weeks, Treasurer Joe Hockey has been lampooned and attacked for botching the government’s budget sales job, so it was no wonder he looked pale and sweating back on the floor of Parliament on Tuesday.
It was the first parliamentary sitting since July 17 and with the MH17 tragedy and atrocities in Iraq still raw in the public’s memory, the Abbott government turned its focus from budget emergency to national security.
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29 August 2014, 6.48am AEST
Jim Gillespie
Deputy Director, Menzies Centre for Health Policy & Associate Professor in Health Policy at University of Sydney
The Coalition entered the 2013 federal election without a health policy. After a year in government, it remains without one. While there has been activity in the health arena, there’s been little coherent direction.
The government’s first month was spent on an ideological campaign against agencies identified with the “nanny state”. The Alcohol and Other Drugs Council of Australia (established by the Holt government in 1966), for instance, was axed.
The Australian National Preventive Health Agency, which had long been a target for conservative critics, was a more expected casualty. It lost its funding in the Abbott government’s first budget, its functions disappearing within the Department of Health.
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PUBLISHED: 30 August, 2014
Capital idea
Brian Toohey
The Lowy Institute’s Sam Roggeveen recently posted a video on his blog with the comment: “Holy crap, this video is terrifying.”
Called Humans Need Not Apply: An Economic Horror Movie, the video was made for YouTube by CGP Grey. Roggeveen’s response probably reflects a common reaction to Grey’s case for why the workforce burden from ageing populations will be far worse than even the bleak official projections.
Grey’s view is pertinent to the sustainability of the budgetary costs of Australia’s twin retirement income streams, the age pension and superannuation. Even if Grey is wrong, the projections are bad. Despite more optimistic assumptions, they forecast the “dependency ratio” of those between 15 and 65 to those over 65 will fall from 5:1 today to only 2.7:1 by 2050. This means fewer workers will have to fund budget assistance for retirees who will often be able to fend for themselves.
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Health minister Peter Dutton sees smaller medical fund on cards
PUBLISHED: 31 August, 2014
Jemima Whyte and Jessica Gardner
Health minister Peter Dutton has said the government will push through a smaller Medical Research Future Fund if its embattled GP co-payment fails, as business and medical researchers ramp up the pressure to get the proposed $20 billion fund over the line.
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Medicare Sale and GP Trials.
Primary Healthcare chief executive Ed Bateman says the healthcare company intends to create its own private health insurance offerings in response to Medibank Private's attempts to secure less generous contracts ahead of its IPO.
According to The Australian, sources indicate Medibank Private has told healthcare companies it plans to pay 30 per cent less for diagnostic work than it has previously.
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Date August 30, 2014
Peter Martin and Jessica Gardner
Mum-and-dad investors and superannuation funds will soon own the bulk of Australia's biggest private health insurer following the government's decision to dispose of Medibank Private by Christmas.
The decision to sell to the public rather than to a single buyer was announced in April, while the move to bring forward the $4 billion sale was announced on Friday.
The position of Medibank policyholders is uncertain. Hundreds of them have petitioned the government demanding free shares on the grounds that their contributions built the fund from its inception in 1976. The government says it will consider their position in coming weeks.
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Date August 29, 2014
Health and Indigenous Affairs Correspondent
Medibank chief executive George Savvides floated the idea of privately insured patients receiving priority treatment in public hospital emergency departments at a function with doctors in March.
Speaking at a dinner in Parliament House on Wednesday night, Australian Medical Association president Brian Owler said "the CEO of a large private health insurer" who was invited to speak at an AMA function "tried to tell us that they wanted patients with private insurance in a public hospital emergency department to receive priority."
"His question was if your son breaks his arm and goes to the emergency department, and you have private health insurance, why shouldn't little Johnny get priority?"
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PUBLISHED: 29 Aug 2014 15:04:00
Jessica Gardner
Key points
- Mum and dad expected to dive into health insurance company listing.
- Labor says privatising not shown to benefit health system or policyholders.
Retail investors are expected to lap up shares in the $4 billion float of Medibank Private, which will proceed before Christmas.
The timeline for Medibank’s listing on the Australian Securities Exchange, which will be the biggest since the $4.6 billion privatisation of rail freight business QR National in 2010, was outlined by Finance Minister Mathias Cormann on Friday.
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GP Co-Payment.
Who should we be listening to in the debate over co-payments in the health system? Why do Governments take advice from unions, such as the AMA, with clear vested interests, rather than from expert researchers and consumer groups? In the following piece, Anne Cahill Lambert builds on Marie McInerney’s work on the co-payment to question the role of ‘expert’ in the health policy arena. She writes:
I am intrigued about the latest furore about the $7 Medicare co-payment. Aside from the fact that I don’t agree with it, I have been fascinated about who has been consulted or whose views have been reported.
Dealing with my disagreement first, the major claim is that a free public health service is unsustainable. Of course, Medicare is not free. It is a universal health system that is predominantly supported through a levy on taxpayers. I think many commentators, including our Health Minister, are muddling the terms universal and free. The beauty of our Medicare system is that all citizens are covered. It is the centrepiece of Australia’s health system of which I am extremely proud.
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TALKS on the government’s $7 charge on visits to the GP have opened up room for a compromise as Health Minister Peter Dutton negotiates with crossbench senators on the idea of “scaling up” the fee from a lower starting point.
Family First senator Bob Day backed the concept of the $3.5 billion savings measure but called for a shift in the way it was implemented to ease community concerns over paying to see the doctor.
The talks came as government officials countered some of the claims about Australians being burdened by soaring “out of pocket” expenses for healthcare.
Health Department analysis shows one-third of the growth in the out-of-pocket costs is the result of consumer demand for non-prescription medicines including vitamins and supplements.
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Date August 26, 2014 - 6:53AM
Dan Harrison and Latika Bourke
A Nobel prize-winning medical researcher has questioned the federal government's decision to link its proposed medical research fund with unpopular health savings, such as the controversial GP visit fee.
Rolf Zinkernagel, who together with Peter Doherty won the 1996 Nobel prize in physiology or medicine for work on how the immune system recognised virus-infected cells, said the research fund and a fee for visiting the doctor were fine ideas, but linking them was a mistake.
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Australian Broadcasting Corporation
Broadcast: 26/08/2014
Reporter: Tom Iggulden
Clive Palmer says the government's plan to introduce a seven dollar doctor's fee co-payment is dead and the Palmer United Party will do all it can to make sure it is never raised in Parliament again.
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- 10 hours ago August 27, 2014 12:00AM
- Jessica Irvine National Economics Editor
- News Corp Australia Network
Palmer won't support any co-payment
EVERYONE is missing the point on the GP co-payment.
An unfair assault on the sick and the poor?
Hardly.
A device to deter overuse of GP services and expensive, taxpayer-funded, medical testing?
Well, yes.
Economics teaches that we will always over consume things that are free.
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Date August 28, 2014 - 12:00AM
Brian Owler
The government's budget proposal for a general practice co-payment has been universally condemned since it was announced, and deservedly so. It is bad health policy.
At the request of the Prime Minister, the AMA developed an alternative co-payment model. Last week, we released that proposal. It aims to protect vulnerable groups in our community, while suggesting that where people can afford to contribute they should do so.
The AMA proposes a co-payment of $6.15 for concession card holders and those under 16 years of age, which would be paid for by the government, and not from their own pocket. Only non-concession patients over 16 years of age would be asked to make a co-payment of at least $6.15. This amount was chosen on the basis that it is the current GP bulk-billing incentive. The amount would be indexed.
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The AMA has hit out at claims its GP co-payment policy is a cash grab and repeated its opposition to private health intervention in primary care, at a function attended by Health Minister Peter Dutton.
At an AMA parliamentary dinner, president Associate Professor Brian Owler pointedly responded to Mr Dutton’s criticism of its alternative co-payment plan, which calls for a $6.15 co-payment and scrapping the proposed $5 MBS rebate cut.
Mr Dutton is reported to have said: “I note that the current proposal put forward by the AMA with regards to the $7 co-pay will result in a windfall for doctors while wiping out 97% of the government’s estimated savings."
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Motoring Enthusiast Party senator Ricky Muir says his "ears are open" to negotiations on the $7 GP co-payment, a day after his political partner Clive Palmer claimed to have killed off the charge.
Senator Muir (pictured), who has formed a loose alliance with the Palmer United Party, said under its current form the Medicare co-payment was "very hard to support".
However, he was willing to consider an alternative model for the payment.
Pharmacy Related Articles.
With the Government desperately trying to revive a co-payment policy that has been declared DOA by Senate balance-of-power holder Clive Palmer, attention is turning to other areas of health financing that could deliver Budget savings. A senior health policy analyst and regular Croakey contributor who writes under the name of “William Foggin” has provided the following analysis of the current regulatory environment for pharmacy. He proposes a number of reform measures, in particular lifting current ownership restrictions, that would both save health dollars and leave the door wide open for major chain stores and corporations to enter the previously closed pharmacy market.
“William Foggin” writes:
As the Government struggles to find savings to replace those that may be lost in the Senate, it could usefully return to the pharmaceutical benefits scheme. The budget included significant savings to the budget from increasing co-payments under the scheme: a simple cost transfer from taxpayers generally to sick people. But it did nothing to address the cost of the scheme as a whole.
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The National President of the Guild, George Tambassis, and I have just returned from a meeting with six sister organisations representing community pharmacies in English-speaking countries.
As well as Australia, the members of Pharmintercom comprise New Zealand, the United Kingdom, Ireland, South Africa, Canada and the USA.
From the discussions over the three days, it is clear that pharmacies in all these countries face similar pressures to our members in Australia.
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Comment:
It seems the fuss is not yet settled - to say the least.
Lots to browse with all sorts of initiatives going rather pear shaped - think security, sanctions and so on!
One really has to wonder if all this security alarm is not meant to distract from the Budget….
I also have to say reading all the articles I still have no idea what is actually going to happen with the Budget at the end of the day!
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:
Enjoy.
David.
