Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, January 04, 2018

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

January 4, 2018 Edition.

Well, here we are in 2018 and it seems almost nothing has changed.

Trump is still in the Whitehouse having signed the Tax Bill which many are now noticing has a few nasties. I note with some horror Trump is now saying has nuclear button is bigger that Kim-Jong Un's one. What a pathetic child he is!

Keep an eye on what is going on in Iran – it might be really important!

Europe is in a post – festive haze and Australia is all at the beach believing life is good!


Global Risks For 2018

This link of Global Risks for 2018 is a really worthwhile summary of the risks we face:

https://www.eurasiagroup.net/issues/top-risks-2018

Only 25 pages and a really great read!
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Here are a few other things I have noticed.
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Major Issues.

My 2018 checklist for investors

  • The Australian
  • 12:00AM December 16, 2017
Looking out 12 months is never easy, but most investors would agree conditions are as promising as we have seen them in many years. As an active investor the summer break is a good time to review what you have been doing in the last 12 months and, importantly, make some key decisions for the year ahead.
Here’s my checklist for 2018.
Explore borrowing at low rates
Official rates remain at 1.5 per cent. In order to reach levels that central bankers regard as “normal” they would have to double to 3 per cent. In reality banks have tried everything to push the actual rates borrowers pay in the market higher. Home mortgage rates are close to 4 per cent or higher if you are an investor or interested in interest-only loans. Nonetheless, this extended era of low rates means that many investors can remain comfortable with borrowing to leverage their performance in any investment class, and that includes shares. (Remember negative gearing is not just for property).
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Despite the gloomy headlines life has become a lot better across the globe

Tom Switzer
Published: December 25 2017 - 10:00PM
The media feed us a regular diet of doom and gloom. From jihadists and populists to mass poverty and rising living costs, we are all too often told the world is going to the dogs. 
Despair is fashionable. According to the Lowy Institute's annual polls, 79 per cent of Australians say they are dissatisfied about "the way things are going in the world today." The pessimism reflects Western trends. 
I'm not sure if facts will matter in this cacophony, but at least two distinguished scholars have tried to introduce a little reality into the debate about the world's trajectory. Swedish intellectual Johan Norberg and Harvard University's Steven Pinker provide a persuasive antidote to the apocalyptical school of journalism. They inform us that by any measure – poverty, sanitation, malnutrition, literacy, security, child labour, infant mortality, personal liberty – life has improved dramatically for the vast majority of humans.
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Ipsos poll: Only 18 per cent think Turnbull government is doing a good job on climate change

Matt Wade
Published: December 26 2017 - 12:15AM
One in two Australians believe climate change is already damaging the Great Barrier Reef and causing more extreme storms, floods and droughts.
But only 18 per cent think the Turnbull government is doing a good job tackling global warming, a new poll has found.
An annual survey by Ipsos, which has probed public opinion on climate change for the past 12 years, shows eight in 10 agree human activity is contributing to climate change – 42 per cent say humans are mainly or entirely responsible while 38 per cent believe climate change is caused partly by humans and partly by natural processes.
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Coalition close to point of no return

  • The Australian
  • 12:00AM December 26, 2017

Simon Benson

Only a dramatic turn of events is likely to rescue the government and address what appear to be embedded structural problems for the Coalition.
These problems are as deep as they are widespread and are reflected across every state and in key Coalition demographics.
There is little evidence that the government has attempted to address this fundamental problem in any significant way. What it has tried obviously hasn’t worked.
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The truth behind another Boxing Day sales 'record'

Eryk Bagshaw
Published: December 26 2017 - 4:53PM
Another year, another Boxing Day sales "record". If it wasn't, we would really be in trouble.
The $2.4 billion sales prediction from the Australian Retailers Association is in reality a measly improvement on the 2016 results, as is the $17.8 billion figure for the entire post-Christmas period.  After accounting for inflation and population growth, the extra 2.9 per cent, or $500 million, expected to flow into shops is actually a downgrade  – despite NSW Premier Gladys Berejiklian performing her best sales pitch in front of the cameras for a Boxing Day of "bumper trade".  
Much to the frustration of Treasurer Scott Morrison, Australians have not been spending enough in the lead-up to a period when many retailers expect to net up to half their annual revenue and keep 1.2 million people employed in the $310 billion sector.
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What 2018 has in store for interest rates and house prices

Elizabeth Knight
Published: December 27 2017 - 9:02AM
Fraught as it is to make predictions, it’s that time of year, when taking a stab at what 2018 will hold is expected of business columnists.
Rather than forecast  where the stock market will travel in 2018 - because that is way too dangerous - of even where commodities will go - which would be another perilous pursuit - I will confine my crystal-ball gazing to house prices and interest rates.
In 2017, we saw definitive signs of a change in direction on residential dwelling prices. After some false starts there is clear evidence that the property market is cooling.
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'Ongoing erosion of legal rights': Government slammed for ignoring key report for two years

Michael Koziol
Published: December 27 2017 - 7:50AM
The Turnbull government has been slammed for ignoring a major legal report for more than two years, while continuing to enact laws that erode fundamental rights.
The Law Council of Australia and the libertarian Institute of Public Affairs have urged the new Attorney-General, Christian Porter, to curb what the think tank called "the ongoing erosion of legal rights" in Australia.
In its annual audit of the nation's laws, released to Fairfax Media on Tuesday, the IPA identified another 19 breaches contained in statutes passed this year – taking its count to 324.
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The precarious balance between laws, rights and freedoms

Published: December 29 2017 - 12:05AM
The Institute of Public Affairs has done well to highlight the way new laws have been eroding the basic rights of Australians over the past 12 months. The organisation's annual survey of laws passed this year, on which we reported this week, details 19 new infringements during 2017. Added to previous years' examples, this steady erosion has allowed, on the institute's calculation, 324 instances where federal laws breach basic rights and freedoms. Little by little our elected representatives are limiting our freedom of speech, reversing the onus of proof and the presumption of innocence, denying the right to silence, and undermining other foundations of democracy and the rule of law.
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Let's make 2018 about improving our society, politics and business

Nicholas Stuart
Published: December 27 2017 - 12:15AM
By now, hopefully, we're all feeling relaxed and comfortable. Having both Christmas and New Year's Day fall on a Monday seems to work well; the usual pre-holiday rush getting presents organised and wrapped wasn't quite as chaotic this year as usual.
In an ideal world, of course, we'd devote time and effort to these activities rather than simply list them as items on checklists to be ticked off. The real problem is aligning our personal objectives with others' expectations: matching our desires with the way others expect us to behave.
Achieving this is increasingly problematic. It won't become any easier in the coming year, either. The personal sphere – that little bubble in which we exist as masters of our own destiny – is increasingly under threat. Others are shaping, pushing and pulling it, this way and that.
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ETFs: uncover the cracks

Individually sensible protections can increase pressure on traders to sell in a hurry
Doom mongers are drawn to exchange traded funds. They lazily point to the speedy growth of these low-cost retail funds, but fail to identify the detonator for any blow-up. A typical criticism notes the shares can often be bought and sold much more easily than the securities on which the ETF is based. This misses out that some market participants are more susceptible to the risk of a mismatch than others.
“Authorised participants”, such as banks and certain high-frequency trading groups, help create and redeem ETF shares in exchange for cash or baskets of securities. They, along with market makers, conduct trades to keep the ETF value in line with the underlying securities. If the basket is relatively cheaper, then buying it while selling the ETF will tend to narrow the gap as well as guarantee a profit.
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  • Updated Dec 26 2017 at 11:00 PM

AEMO's virtual 'war room' is the NEM's frontline and flank

The Australian Energy Market Operator's head of operations Damien Sanford brandishes a multicoloured chart showing South Australia's projected wind power output for the week. The chart goes up and down like a roller coaster as the wind fluctuates from day to day, hour to hour.
It is the Monday, a week before Christmas. AFR Weekend is with federal Energy Minister Josh Frydenberg on a tour of AEMO's Melbourne virtual control room, or war room, conducted by the market operator's chief executive Audrey Zibelmant.
SA - one of the world's most wind and solar energy-reliant electricity markets - and is expecting 40 degree heat, which will drive up power demand as households and businesses turn up their air conditioners. Victoria is expecting mid-30s heat. 
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The world's wealthiest got $1.3 trillion richer in 2017

Published: December 28 2017 - 6:42AM
The richest people on earth became $US1 trillion ($1.3 trillion) richer in 2017, more than four times last year's gain, as stock markets shrugged off economic, social and political divisions to reach record highs.
The 23 per cent increase on the Bloomberg Billionaires Index, a daily ranking of the world's 500 richest people, compares with an almost 20 per cent increase for both the MSCI World Index and Standard & Poor's 500 Index.
Amazon.com founder Jeff Bezos added the most in 2017, a $US34.2 billion gain that knocked Microsoft co-founder Bill Gates out of his spot as the world's richest person.
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What politicians could do for us in the new year: show some resolve

Jenna Price
Published: December 29 2017 - 12:05AM
I can't recall a politician ever revealing his or her new year's resolutions, unless it was exercising more, drinking less and promising to spend more time with their family.
They are the banal promises to the future I might make. But politicians have an obligation not just to themselves but also to those of us who vote for them.
So here's my wish list of what I would like politicians to do over the next 12 months: some specific requests of particular ministers; some general requests for all of them.
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Keynes or Keynesian isn't a dirty word

Ross Gittins
Published: December 30 2017 - 10:30AM
Whenever you meet someone who uses the words Keynes or Keynesian as a swear word – or as synonyms for socialist – know that their adherence to neoliberal dogma far exceeds their understanding of mainstream economics.
Though John Maynard Keynes' (rhymes with gains) magnum opus, The General Theory of Employment, Interest and Money, was published in 1936, and he died 10 years later at 62, most economists – including many who wouldn't want to be called Keynesians – acknowledge him as the greatest economist of the 20th century.
It's true that the "monetarist" counter-attack on Keynesian orthodoxy led by Milton Friedman in the 1970s and early 1980s led to lasting changes in prevailing views about how the macro economy should be managed – mainly, that the primary instrument used to stabilise demand should be monetary policy (interest rates) rather than fiscal policy (the budget).
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Capitalism in decline as markets go soft

  • The Australian
  • 12:00AM December 30, 2017

Adam Creighton

There’s no agreed definition of capitalism but most people would hazard a guess it’s about entrepreneurs and business owners — people with real skin in the game — being left to their own devices. That’s a nice idea but it’s far removed from what our economies have become.
Take the stockmarket, which, especially in Australia, is starting to look a bit like a casino for unwitting gamblers than a mechanism to attract and allocate savings to new investments. Many see the benchmark S&P/ASX 200 index, which has just had its best annual return in four years, as a barometer of Australia’s economic and corporate success, but the number of firms choosing to list on exchanges has been declining, and the savings attracted and allocated via stockmarkets in general have been drying up.
The huge sums of cash that change hands daily on the ASX, more than $4 billion on average, have little to do with the investment decisions of the underlying firms or the creation of any new ones. Buying shares with a view to making a capital gain is a generous use of the term “investment”. It’s speculating, which is perfectly fine of course, but let’s not gild the lily. And this is before we even examine financial derivatives, whose value dwarfs the value of underlying assets they derive from.
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National Budget Issues.

Australian economic growth predicted to improve international rank

Rob Harris, Herald Sun
December 27, 2017 8:00pm
AUSTRALIA is on track to become the world’s 11th biggest economy within a decade, a new report predicts.
The UK-based Centre for Economics and Business Research has forecast that by 2026 Australia will have risen two places on an economic league table, from its 13th rank.
China will replace the United States as the world’s biggest economy by 2030, it says.
Australia’s growth will be fuelled by its skills-based immigration system, which will help it overcome a decline in natural resources, it says.
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Australia's economy closing in on the world's top 10

Published: December 28 2017 - 10:11AM
Population growth will help propel Australia to become the world's 11th biggest economy within a decade, a report predicts.
The London-based Centre for Economics and Business Research is forecasting Australia will climb two places on its world economic league table by 2026 from its current ranking of 13.
Countries that depend on brainpower to drive their economies will generally overtake those dependant on natural resources, with China tipped to replace the US as the world's biggest economy in 2030, the centre says.
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Central banks hope oil surge spurs inflation

  • The Australian
  • 12:00AM December 29, 2017

Adam Creighton

Central bankers, crossing their fingers for a bit of inflation in 2018, might take heart from the recent jump in the price of oil, the commodity that has the biggest impact on overall prices.
A burst oil pipeline in Libya, constraints on supply announced by oil cartel OPEC and a revival in the global demand have conspired to push black gold back above $US65 a barrel, which is its highest level in 2½ years.
In most developed countries, including Australia, inflation has persistently fallen short of central bankers’ targets, which tend to be around 2 per cent. If this keeps up, it might start to look like the achievement of these targets has had more to do with luck and coincidence than the power of the central banks in controlling expectations.
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Health Budget Issues.

Good news as measles deaths fall to world record low

Donald McNeil Jnr
Published: December 26 2017 - 4:05PM
New York: For the first time in history, annual deaths around the globe from measles have fallen below 100,000 – from 2.6 million a year in the 1980s – according to the World Health Organisation.
The decline, a public health triumph as measles has long been a leading killer of malnourished children, was accomplished by widespread donor-supported vaccination that began in the early 2000s. 
The estimated number of deaths fell to 89,780 in 2016,  the latest WHO figures say.
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Fund members fear fee surges

  • The Australian
  • 12:00AM December 28, 2017

Sean Parnell

Health fund members with the cheapest level of cover would have cautiously welcomed a move to gold, silver and bronze categories but still did not understand the market and worried about being slugged more, according to ­research prepared for a key reform committee.
Since promising an insurance overhaul at last year’s election, the Turnbull government has agreed to introduce a fourth category, basic bronze, to stem the likely losses of members and revenue because of ­reforms.
That is despite former health minister Sussan Ley deriding such low-cost, low-value insurance as “junk policies” that should be banned, amid claims they were often used for public hospital treatment the members were entitled to without charge.
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Health premium rises to be ‘lowest in 15 years’

  • The Australian
  • 12:00AM December 29, 2017

Sean Parnell

Health Minister Greg Hunt is preparing to approve the lowest health insurance premium increases in 15 years, as documents reveal the Coalition’s plan to categorise policies into gold, silver and bronze initially risked further price rises and a decline in members.
Although Mr Hunt announced a reform package in October, more work needs to be done on categorisation over the coming weeks, coinciding with premium announcements due in mid-February. The reforms are to be implemented over the next two years and the industry is expected to factor in some savings in 2018.
The government decided to add a fourth category, basic bronze, to stabilise the low end of the market and provide insurers with the revenue to reduce pressure on other premiums, despite former minister Sussan Ley and Labor having called for “junk policies” to be banned.
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International Issues.

Using Tea Party tactics, left-wing groups attempt to derail Donald Trump agenda

Matthew Knott
Published: December 24 2017 - 12:15AM
Almost one year in to Trump's presidency, a network of grassroots opposition groups have been building up their firepower. But can the resistance make a real difference?
Like little blue dots in a sea of red. That's how Susan Griffin says Democrats like herself have felt living in Alabama, a Republican stronghold in America's Deep South. "Progressive people here often feel intimidated about speaking up," says Griffin, 63, who lives in Huntsville, a city near the Tennessee border. "If you're in a group of 10 people you assume nine will be conservative and Republican."
So it wasn't a surprise that Alabamans voted overwhelmingly for Donald Trump last November. The fact he became President, though: that was a shock. "Even living in a red state in the South, we didn't believe Trump could win," Cindy Allen, Griffin's friend and fellow Democrat, says. "We were horrified."
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2017: West challenged in a spinning world

  • The Australian
  • 12:00AM December 23, 2017

Paul Kelly

Our age of disruption, decay and transformation reached a peak in 2017 and unleashed a shower of contradictions: democracy looks ineffective, politics has surrendered to an era of strongmen and the quest for enhanced individual autonomy now drives the culture.
The globe was framed by two key events — the speech by China’s strongman, Xi Jinping, to the 19th party congress about holding “high the banner of socialism with Chinese characteristics”, announcing, in effect, China’s ideological, strategic and economic challenge to the West, and Donald Trump’s July speech in Poland invoking the Holocaust, the Warsaw Ghetto and pope John Paul II’s homage to God against the Soviets to warn “the fundamental question of our time is whether the West has the will to survive” and the confidence to defend its values “at any cost”.
Xi has pretensions of being his nation’s strongest leader since Mao Zedong and mocks any idea of China as a democratic polity with Western values, while Trump, a truly bizarre figure to become chief upholder of the Western flag, purports to make America great but leads a deeply fractured nation.
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Ex-Donald Trump aide Steve Bannon turns fire on President's family

Ben Riley-Smith
Published: December 25 2017 - 3:52PM
Washington: Steve Bannon has launched a twin attack on Donald Trump's family, dubbing his daughter Ivanka the "queen of leaks" and calling her husband, Jared Kushner, "immature".
Bannon, the former Trump campaign chief and White House aide, said Ivanka Trump was a "fount of bad advice" during the election and once called him a "f------ liar". He also claimed Kushner "doesn't know anything" about Trump's supporters and blamed the President's son-in-law for meetings that left the campaign open to a charge of cosying up to the Russians.
The President himself is not beyond Bannon's ire, according to a 7000-word profile in Vanity Fair magazine of the man credited with helping win him office.
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Russia stops Putin's main critic from running for president

Ivan Nechepurenko
Published: December 26 2017 - 10:20AM
Moscow: Russian election officials have barred the opposition leader Aleksei Navalny from running in next year's presidential election, a decision that prompted him to call for his supporters to boycott the election and take part in street protests.
Twelve members of the 13-member Central Election Commission voted to bar Navalny from registering as a presidential candidate, citing his suspended prison sentence in a fraud case, a prosecution he has denounced as politically motivated.
One member abstained from voting because of a possible conflict of interest.
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Political Disorder

Francis Fukuyama explains why U.S. politics has become so dysfunctional, and how to rescue the American republic.

Listen to “Political Disorder”:
In this rerun of one of the first Good Fight episodes, Yascha Mounk discusses with Francis Fukuyama the degree to which democracy in the United States is under threat, the slow erosion of liberal norms, and the future of American identity.
This podcast was made in collaboration with New America.
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North Korea won't stop its arms tests anytime soon, South Korea warns

Choe Sang-Hun
Published: December 27 2017 - 8:26AM
Seoul: North Korea will keep improving its nuclear and long-range ballistic missile capabilities next year to gain leverage to force Washington to make concessions, such as the easing of sanctions, government and private analysts in South Korea said.
The isolated North has made major strides this year in its nuclear weapons program but has also faced increasingly tough UN sanctions. On September 3, it detonated what it called a hydrogen bomb in its sixth and most powerful nuclear test. It has also launched three intercontinental ballistic missiles (ICBMs) this year, demonstrating rockets powerful enough to deliver warheads to all of the continental United States.
After its last ICBM test, conducted on November 29, North Korea claimed to have completed building its nuclear force. But the country has yet to clear a key technological hurdle: proving that its warheads can survive re-entry into the atmosphere after flying through space, according to western officials and analysts.
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Australia closes in on joint defence force deal with Japan

Published: December 26 2017 - 1:36AM
Tokyo: Japan and Australia are close to agreeing a visiting forces agreement (VFA), which would foster smooth military operations between the two countries, according to the Yomiuri Shimbun newspaper.
Australian Prime Minister Malcolm Turnbull plans to visit Japan and hold talks with his counterpart Shinzo Abe to confirm the agreement ny mid-January, according to sources close to both governments.
With an eye to starting talks on a similar pact with Britain by the end of 2018, Tokyo intends to deepen international security cooperation through multiple avenues by strengthening coordination with "quasi-allies" – in addition to the United States – should circumstances on the Korean Peninsula and in the East and South China seas grow more severe.
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China hopes to have its way without firing a shot

  • Jason Thomas
  • The Australian
  • 12:00AM December 28, 2017
Although Basil Liddell Hart and John Boyd may be considered two of the most brilliant military strategists of the modern era, the father of pure grand strategy is Greek military commander Epaminondas (418-362BC).
A year after the Battle of Leuctra, Epaminondas marched across the Peloponnesian peninsula in Sparta. The Spartans refused to be engaged in the open, so Epaminondas elected to pursue what Liddell Hart called “true grand strategy”. In the middle of Sparta Epaminondas founded a new city at Mount Ithome in Messenia state, then another, Megalopolis, in Arcadia.
Across time this resulted in an infiltration of Sparta’s population, the creation of an insurgency and the loss of most of its workers. Significantly, it established influence over more than half of Sparta’s territory, controlling trade and economic routes. No battle was fought, not an arrow was fired nor a spear thrown.
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President Trump’s Mental Health — Is It Morally Permissible for Psychiatrists to Comment?

Claire Pouncey, M.D., Ph.D.
December 27, 2017DOI: 10.1056/NEJMp1714828
Ralph Northam, a pediatric neurologist who was recently elected governor of Virginia, distinguished himself during the gubernatorial race by calling President Donald Trump a “narcissistic maniac.” Northam drew criticism for using medical diagnostic terminology to denounce a political figure, though he defended the terminology as “medically correct.”1 The term isn’t medically correct — “maniac” has not been a medical term for well over a century — but Northam’s use of it in either medical or political contexts would not be considered unethical by his professional peers.
For psychiatrists, however, the situation is different, which is why many psychiatrists and other mental health professionals have refrained from speculating about Trump’s mental health. But in October, psychiatrist Bandy Lee published a collection of essays written largely by mental health professionals who believe that their training and expertise compel them to warn the public of the dangers they see in Trump’s psychology. The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President rejects the position of the American Psychiatric Association (APA) that psychiatrists should never offer diagnostic opinions about persons they have not personally examined.2 Past APA president Jeffrey Lieberman has written in Psychiatric News that the book is “not a serious, scholarly, civic-minded work, but simply tawdry, indulgent, fatuous tabloid psychiatry.” I believe it shouldn’t be dismissed so quickly.
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  • Updated Dec 26 2017 at 10:30 PM

China will be the big test for PM Malcolm Turnbull in 2018

2018 will not be the year of 'New Malcolm' or indeed 'old Malcolm.' But it could be the year of 'tough Malcolm.'
The cameras may have captured Malcolm Turnbull jiving at a Kings Cross Chapel-organised street party on Christmas Day, but his advisers are using the break to examine 'tough Malcolm' options for 2018. These include ramping up of the political stakes to expose what the Liberals hope is a fatal flaw in Opposition leader Bill Shorten's appeal as we approach the business end of the political cycle.
However, Australia's 'China problem' is looming as the most imminent 'tough Malcolm' test. Ministers are bracing for a possible payback from our most crucial economic partner.
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  • Updated Dec 26 2017 at 11:45 PM

Power, presidents and pretence

by The Australian Financial Review
One year ago, a world still grappling with America's new political language of "alternative facts" and "fake news" braced itself for a fake American president.
Elected as a populist promising to shake up the global order, Donald Trump seemed a hucksterish impostor more likely to wreck it. His creed was America First. Self-interest before global interest, with even America's friends to be left in the lurch on great multilateral concerns like trade, climate change and global security.
Twelve months later, Mr Trump has kept his promises to his isolationist voter base on trade and climate. The strategic parts of Mr Trump's foreign policy seems, so far, conventional if robust Republican internationalism. A former commander of NATO says that the President's new national security strategy could have been written by a Hillary Clinton administration.
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Trump 'disappointed' China allowing oil into North Korea

Published: December 29 2017 - 4:40AM
Washington: President Donald Trump said on Thursday he was "very disappointed that China is allowing oil to go into North Korea" and that such moves would prevent "a friendly solution" to the crisis over Pyongyang's nuclear program.
"Caught RED HANDED - very disappointed that China is allowing oil to go into North Korea. There will never be a friendly solution to the North Korea problem if this continues to happen!" Trump wrote in a post on Twitter.
China earlier on Thursday said there had been no UN sanction-breaking oil sales by Chinese ships to North Korea after a South Korean newspaper said Chinese and North Korean vessels had been illicitly linking up at sea to get oil to North Korea.
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Does Australia face a greater security threat now than at the Cold War's height?

John Blaxland
Published: December 29 2017 - 12:15AM
Malcolm Turnbull is pushing for a significant overhaul of national security laws and ASIO director-general Duncan Lewis has declared that espionage and foreign interference in Australia is "an insidious threat". Lewis has described the threat today as unprecedented.
These are surprisingly strong words, but are they warranted, and is the government overreacting?
It's worthwhile putting these remarks in historical perspective. Lewis' declarations suggest he perceives the threats to be greater than those associated with the Soviet penetration of the Australian government in the 1940s. That was when Soviet penetration of Australia's Department of External Affairs almost broke Australia's security ties with Britain and the United States, and led to ASIO's formation in 1949.
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Trouble spots to watch in 2018

  • The Australian
  • 12:00AM December 30, 2017

David Kilcullen

The year just ending was a complicated one, with increased tension on the Korean peninsula, the territorial collapse of Islamic State’s “caliphate”, a realignment of traditional relationships across the Middle East, a spate of lone-wolf terror attacks in Western cities and controversy over Russian ­interference in last year’s US election. Looking ahead, the key conflicts to watch next year will ­include many of those that dominated this year. But the next 12 months also will bring fresh risks.
Eastern Europe
The first conflict to flare next year may be Ukraine. Russian troop movements, cyberattacks and ­increased subversion in western Ukraine (including assassinations and kidnappings targeting politicians in Kiev) suggest the conflict is about to enter another “hot” phase. Moscow withdrew its representatives from a ceasefire-monitoring body late this month and Kremlin-sponsored media has been accusing Ukrainian ­forces of gearing up for a major push in January-February — a tactic these outlets previously have used to justify Russia’s own planned ­offensives.
US President Donald Trump’s recent decision to supply Ukraine with Javelin anti-tank missiles was partly a response to this threat. Canada also approved arms sales to Ukraine, while several NATO countries expressed support for enhanced assistance. The 2018 US defence budget, signed by Trump in mid-December, includes $US350 million ($450m) in military aid to Ukraine.
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South Korea seizes ship suspected of sending oil to North Korea

Choe Sang-Hun
Published: December 30 2017 - 10:58AM
Seoul: South Korea has seized a Hong Kong-flagged oil tanker accused of transferring 600 tons of refined oil to a North Korean ship in October in violation of United Nations sanctions, South Korean officials said Friday.
Officials revealed that they had impounded the 11,253-ton tanker, the Lighthouse Winmore, and questioned its crew. The revelation came a day after President Donald Trump accused China of letting fuel oil flow into North Korea through illicit ship-to-ship transfers on international waters.
There was no immediate evidence of official Chinese involvement in the Lighthouse Winmore's dealings with the North Koreans.
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World issues to watch in 2018

Peter Apps
Published: December 30 2017 - 10:38AM
Professional forecasters like to say that making predictions is difficult, particularly about the future. As we reach the end of 2017, however, here are some of the key themes — and questions — that look set to shape global events next year.
1. Will Mueller's Russia investigation mark the end of Trump's presidency?
President Donald Trump didn't expect to be Time's "Man of the year" for 2017, but 2018 could be the year that we get a clearer idea of the legacy he will leave.
First, it should become clear just how much mileage prosecutor Robert Mueller's probe into alleged collusion with Russia in the 2016 election really has. Further arrests of high-profile figures might signal that investigators have acquired useful information from key individuals now helping them with their inquiries, particularly former national security adviser Mike Flynn and Trump aide George Papadopoulos. So far we have plenty of rumour, but precious little detail.
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Australian Defence Force on alert after Russian military exercise

Alexandra Smith
Published: December 30 2017 - 6:09PM
Defence personnel were operating under "increased readiness" in Darwin earlier this month after Russian bombers flew out of an Indonesian military base and close to Australia, it has been revealed. 
The ABC has reported that the RAAF Base Darwin was placed on a "brief period" of alert while more than 100 Russian personnel and several aircraft were stationed at the Biak Airbase in Indonesia's eastern Papua province. 
According to the Ministry of Defence of the Russian Federation's website, two strategic bombers carried out "air alert mission over neutral waters of south Pacific Ocean" on December 7. The flight time "exceeded eights hours".
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'Freedom or death': Protests turn political in Iran

Published: December 30 2017 - 4:18PM
Dubai: Demonstrators have chanted anti-government slogans in several cities across Iran, Iranian news agencies and social media reports say, as price protests turned into the largest wave of demonstrations since nationwide pro-reform unrest in 2009.
Police dispersed anti-government demonstrators in the western city of Kermanshah as protests spread to Tehran and several other cities a day after rallies in the northeast, the semi-official news agency Fars said.
What are the causes that sparked anti-regime #protests in #Iran https://t.co/L41PgaItyN pic.twitter.com/DTm0dpcvTV
— Al Arabiya English (@AlArabiya_Eng) December 29, 2017
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In a 30-minute interview, President Trump made 24 false or misleading claims

Glenn Kessler
Published: December 31 2017 - 8:22AM
Washington: President Donald Trump gave an impromptu half-hour interview with The New York Times recently. Reporters combed through the transcript and here's a quick round-up of the false, misleading or dubious claims that he made, at rate of one claim every 75 seconds. (Some of the interview was off the record, so it's possible the rate of false claims per minute is higher.)
  • "Virtually every Democrat has said there is no collusion. There is no collusion. . . . I saw Dianne Feinstein the other day on television saying there is no collusion."
Trump appears to be referring to an interview with Democratic Senator Dianne Feinstein, a member of the Senate Intelligence Committee. She did not flatly say there was no collusion and instead was more nuanced. Asked by a CNN reporter in early November whether she had "seen any evidence that this dirt, these emails, were ever given to the Trump campaign," she replied: "Not so far." Tapper than asked: "Have you seen any communications that suggested that the Trump campaign wanted them to release them through a different means?" She answered: "I have not."
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Almost Everything Is Wrong With the New Tax Law

It’s not the biggest cut in American history, and it blows a large hole in the federal deficit.

By Alan S. Blinder
Dec. 27, 2017 6:15 p.m. ET
Dec. 20, 2017, should go down in political history as a day of infamy or absurdity, probably both. After passing a massive tax bill without a single Democratic vote—something highly unusual in itself—congressional Republicans gathered with President Trump on the White House steps that day to engage in an orgy of self-congratulation.
The president patted himself on the back so vigorously that he might have required physical therapy. One after another, Republican senators and representatives competed for the honor of offering the most unctuous praise for their Maximum Leader. But Sen. Orrin Hatch of Utah, who was previously thought to be level-headed, set a new standard for fawning by declaring that Mr. Trump may be the greatest president ever. Ever? Not Lincoln? Not Washington?
Was this love-fest because Republicans had just passed an economically sound and wildly popular tax bill that was winning praise from tax experts and scoring marvelously in public opinion polls? Not quite. Polls show that Americans hate this bill.
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I look forward to comments on all this!
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David.

Wednesday, January 03, 2018

It’s Amazing To See Just How Much Seems To Have Happened In A.I. in Twelve Months

This appeared last week

It Was a Big Year for A.I.

AlphaGo beat the world's best Go player in May. A few months later, a new version beat the human-defeating version 100 to 0.
2017 has been a booming year for the field of artificial intelligence. While A.I. and data-focused machine learning have been around for decades, the algorithmic technologies have made their presence known in a variety of industries and contexts this year.
Microsoft UK’s chief envisioning officer Dave Coplin has called A.I. “the most important technology that anybody on the planet is working on today,” and Silicon Valley companies seem to have taken that to heart: They’ve been hiring A.I. experts right and left, and with those in short supply, they’ve started teaching employees the fundamentals of A.I. themselves.
Not every A.I. achievement has been met with admiration and applause, though. Some are worried about the human prejudices that are being introduced into A.I. systems. ProPublica found in 2016, for example, that the software algorithms used to predict future criminals were heavily biased against black defendants. And earlier this year, Facebook came under fire for the algorithmically generated categories advertisers could use to target users, which included hateful groups and topics such as “Jew hater.” Situations like these have prompted experts to urge companies and developers to be more transparent about how their A.I. systems work. However, in many other cases—especially of late—A.I. has been used to good end: To make discoveries, to better itself, and to help us expand beyond the limits of our human brains.
A.I. Spotted An Eight-Planet Solar System
Successful astronomical discoveries often center around studying data—lots and lots of data—and that is something A.I. and machine learning are exceedingly good at handling. In fact, astronomers used artificial intelligence to sift through years of data obtained by the Kepler telescope to identify a distant eight-planet solar system earlier this month. This solar system now ties our own for the most known planets circling its star, in this case Kepler-90, located more than 2,500 light years away.
From 2009 to 2013, the Kepler telescope’s photometer snapped 10 pixel images of 200,000 different stars every half hour in search of changes in star brightness. If a star dimmed and brightened in a regular, repeating pattern, that could be an indication that it has planets orbiting. (You can also use that information to estimate the size and length of orbit of a planet circling a particular star.) University of Texas at Austin astronomer Andrew Vanderburg and Google software engineer Christopher Shallue developed the neural network that made the discovery using 15,000 known exoplanet indicators. They zeroed in on 670 stars with known exoplanets, but focused specifically on weak signals—smaller exoplanets previous researchers may have missed. The planet the duo discovered, dubbed Kepler-90i, appears to be the third planet orbiting its star, much like our own Earth.
Beat The World Champion Go Player
Google’s DeepMind researchers developed an A.I. that plays the ancient, complex Chinese strategy game of Go. The initial version defeated the world’s best Go player in May, but that wasn’t enough. A few months later, Google developed a new version of this AlphaGo A.I.: AlphaGo Zero. This A.I. achieved a superhuman-level Go-playing performance—it beat the original AlphaGo A.I. 100 to 0.*
Lots more here:
Well worth a browse – there is a lot going on!
David.

Tuesday, January 02, 2018

Sometimes Things Just Seem To Come Together In A Good Way! Ireland Is Setting An Example Of How To Do It I Believe!

This appeared last week:

Personas and Scenarios for the National Electronic Health Record

Edina Zejnilovic December 29, 2017
Over 500 citizens of Ireland, including clinicians, patients, healthcare workers, carers and others from across the Health Service and broader society, all contributed to the publication of the finalised Personas and Scenarios. The Personas and Scenarios will form a key foundation for the National Electronic Health Record programme and the Clinical Strategy programme. A total of 168 Personas and Scenarios have been created and have been held up as best in class by WHO as a method of engagement.
The user-centred design development of the Personas is truly putting the patient at the centre. This type of collaboration encourages a more open and participatory democracy in our health service. eHealth Ireland worked with patients and healthcare professionals to develop Personas and Scenarios that are specific for Ireland to ensure that the procurement of an electronic health record for Ireland will be specifically designed for Irish citizens and healthcare professionals.
See here - Only about 3 mins but very useful:
Jane Carolan, Interim CIO said:
“While this is a key milestone for the National EHR Programme we will continue to welcome input and participation to ensure that these Personas and Scenarios remain current and complete even further over time. I am personally delighted at the level of clarity conveyed in the Personas and Scenarios and the levels of ambition for our National EHR Programme which we are looking forward to realising in the future.”
IPPOSI a patient-led organisation involved in the creation of the personas, CEO Derick Mitchell said:
“From the patient perspective, these clinically-validated Personas and Scenarios are quite brilliant in making the benefits of Electronic Health Records very real. In IPPOSI, we envisage these as forming the cornerstone of the future engagement and communication processes between Irish clinicians, health service workers & patients which will make a National Electronic Health Record a reality in Ireland.”
More here:
This article describes the very coda of a process to develop the system objectives and functionality for an Irish National EHR System.
The process to get to where they presently are began a few years ago.
You can read all about it here:
A good place to start is to have a browse of this document:
It is really impressive how the consultation processes have operated and how the focus appears to be one of technology being shaped to serve patient and clinician needs.
Ireland is recovering from an economic calamity (the GFC as we call it) and is very much focused on both adoption of the best approaches from all over the world (they are being a slow follower!) and only doing what is demonstrably going to make a difference.
I very much liked their Cloud First Policy.
Browse for yourself but this team seems be a sensible number of adults seeking reasonable outcomes in reasonable timeframes.
David.

Monday, January 01, 2018

Weekly Australian Health IT Links – 1st January, 2018.


Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Well the tiniest collection ever for last week.
The only consolation was the huge number of comments and ideas flowing from Grahame Grieve’s blog. Since it was posted there have been well over 60 comments bearing on the topic in just over a week.
It made me wonder just what really mattered for the future of Digital Health in OZ?
Is it politics causing the whole thing to be stuck, lack of leadership, lack of decent clinical utility and engagement, funding issues, technical difficulties or what?
Have your say below and have a great 2018!
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The co-existence of open data and privacy in a digital world

Australia December 22 2017
Earlier this week researchers from the University of Melbourne released a report on the successful re-identification of Australian patient medical data that formed part of a de-identified open dataset.
In September 2016, the researchers were able to re-identify the longitudinal medical billing records of 10% of Australians, which equates to about 2.9 million people. The report outlines the techniques the researches used to re-identify the data and the ease at which this can be done with the right know-how and skill set (ie someone with an undergraduate computing degree could re-identify the data).
At first glance, the report exposes the poor handling of the dataset by the Department of Health. Which brings into focus the need for adequate contractual obligations regarding use and handling of personal information, and the need to ensure adequate liability protections are addressed even where the party’s intentions are for all personal information to be de-identified. The commercial risk with de-identified data has shown to be the equivalent of a dormant volcano.
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Recent Updates

View and download our latest product releases and related product changes below.
The Clinical Documents Integration Toolkit contains libraries for the creation, packaging and presentation of clinical documents through the use of style sheets.
10-01-2017
EP-2489:2017     Clinical Package Validator v2.5
The Clinical Package Validator (the Validator) is a tool to automate some of the tests needed to assess conformance of clinical documents and clinical packages with eHealth specifications.
29-05-2017
EP-2474:2016     Clinical Terminology v20161130
Product components for SNOMED CT-AU 20161130 inclusive of the AMT.
30-11-2016
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How your social media account could help you get a loan

Clancy Yeates
Published: December 30 2017 - 12:15AM
When signing up to rent a home in Adelaide, Jacquie Lamont was faced with a modern-day decision that is likely to confront more and more consumers.
If she was prepared to let a business trawl through her social media accounts, she could get access to a potentially handy financial product.
In her case, instead of handing over the full $1800 rental bond, the IT worker had the option of paying a non-refundable $250, if she granted a business access to her social media account.
The service is available through Trustbond, a joint venture between Suncorp and Spanish start-up Traity. In order to qualify, a customer must allow Trustbond to look through their Facebook, Twitter and other social media accounts to determine whether they can be trusted to care for the property.
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Oversold fast NBN deals ‘not our fault’

  • The Australian
  • 12:00AM December 27, 2017

Anthony Klan

The National Broadband Network has said it should not shoulder any responsibility for at least 70,000 homes being sold superfast internet packages that were not physically attainable, despite it having detailed net speed estimates for every home in the country.
Although having stood to profit from Telstra, Optus and TPG overselling NBN packages to tens of thousands of homes — and it being in a position to thwart the practice in many cases — NBN Co said it was in no way responsible as it was the telcos who dealt directly with customers.
Telstra, Optus — and last week TPG — have all been called out by the Australian Competition & Consumer Commission for overselling tens of thousands of NBN connections where super-high speeds promised could not be delivered by the underlying physical technology.
The telcos had been selling the packages despite having access to NBN Co’s speed estimates database, which in many cases would have shown those super-high speeds could not be delivered.
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NBN cut-off date approaching for almost 100,000 homes and businesses

Jennifer Duke
Published: December 28 2017 - 12:15AM
Almost 100,000 Australian homes and businesses will be disconnected from their internet and landlines in January if they haven’t moved over to the national broadband network.
Next month, premises across the country will be reaching the 18-month NBN cut-off date, with potentially 95,590 homes and businesses affected if they have not yet made the switch.
Usually, when an area is declared “NBN ready” a resident has a year and a half to choose a provider and a plan and to move onto the network before their home or business is disconnected.
Now, 173 suburbs across the country are reaching this crucial cut-off point.
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Blackout suburbs: where homes have no internet connection

Jennifer Duke
Published: December 27 2017 - 4:54PM
Swathes of suburbs in Sydney and Melbourne are falling behind the internet revolution, with data showing one in 10 households have no connection from home - not even from a smartphone.
More than 190,000 households in Sydney, and 185,000 in Melbourne, said they didn't have access to the internet through any device, including tablets, phones, games consoles, laptops or computers in the 2016 Census.
Mapping out the suburbs to show where there are more disconnected households in both cities shows a clear correlation between low-socioeconomic neighbourhoods and the likelihood that the home has remained internet-free.
In Sydney, these blackout suburbs roughly align with the city's "latte line" - a guideline that shows the split between low-socioeconomic areas in the west and south-west and wealthier areas in the north and east.
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Enjoy!
David.

Sunday, December 31, 2017

A New Year’s Eve Bon-Bon That Says It All – Pull At Your Peril!

Grahame Grieve has given us all a masterful one paragraph summary of where we are at, at the end of 2017, in response to a query about “What is going on?”!

To quote:

“I think it's pretty simple - the first round of development didn't quite meet the original goals, and the lack of consensus around the system - specifically, whether to consolidate or redesign - has prevented the government doing anything to address the actual concerns, so we end up in a situation where we have a half-done system that was baked in a hurry, but at the political level it's being treated as ready for prime-time. We're stuck.”

This is so true and so real it is just bloody painful. Just how the half-done system is going to handle the proposed transition to 'opt-out' must be a more than considerable worry to the bosses at the ADHA. I know I would be worried!

The question is what can we do in 2018 to ‘unstick’ ourselves?

Outside the box inspiration is urgently required! Comments please!

Happy New Year!

David.

AusHealthIT Poll Number 403 – Results – 31st December, 2017.

Here are the results of the poll.

Do You Believe 'Replatforming' Can Solve The Issues That Presently Beset The myHR?

No - It Should Be Scrapped 84% (154)

No - More Fundamental Changes Are Needed 13% (24)

Yes 2% (4)

I Have No Idea 1% (2)

Total votes: 184

Any insights welcome as a comment, as usual. It seems that the vast majority think more than just updating the platform on which the myHR runs is required to save it.

This is consistent with all the discussion that has gone on in the comments last week. It seems there are a range of fundamental questions around the myHR and where it fits / should fit in the Digital Health ecosystem and just what it is for.

There is also pretty clear recognition that there are complex political dimensions to the myHR the realities of which we are stuck with and which, at present, are seemingly insoluble!

Whichever way you look at it is a pretty expensive and much less than ideal mess!

A really great turnout of votes!

We note two respondents who are clueless!

Again, many, many thanks to all those that voted!

David.