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."

Sunday, May 27, 2018

Is Tim Kelsey Telling An Untruth Here Or Am I Missing Something?

At the National Press Club last week Mr. Kelsey said the following in his prepared speech:
----- Begin Extract.
Tim Kelsey:                         My Health Record has a range of protocols which mean that all instances of access by a clinician are attributable directly to that person and recorded in real time. Unauthorised access is subject to a custodial prison sentence of up to two years. Trust is the essence of medicine. Digital services can support confidentiality and not undermine it. My Health Record operates to the highest cyber security standards in Australia, and is independently audited on that basis by a number of organisations, including the Australian Signals Directorate. The agency has set up a national cyber security centre to ensure constant multi-layered surveillance of My Health Record. Since the system was launched in 2012, there has been no breach. But, real time vigilance, of course, remains our highest priority. People are quite rightly concerned about the security of their privacy information, and that's why they have a right to make a choice. That's why the Australian government was absolutely right to introduce opt-out into this measure.
----- End Extract.
Here we have the Office of The Australian Information Commissioner (OAIC) Report for 2016-17.

Annual report of the Australian Information Commissioner’s activities in relation to digital health 2016–17

Part 1: Executive summary

From 1 July 2016, national digital health governance arrangements and My Health Record system operations transitioned from the Department of Health and the National E-Health Transition Authority to a new body, the Australian Digital Health Agency (the Agency).
This annual report sets out the Australian Information Commissioner’s digital health compliance and enforcement activity during 2016–17, in accordance with s 106 of the My Health Records Act 2012 (My Health Records Act) and s 30 of the Healthcare Identifiers Act 2010 (Cth) (HI Act), as outlined in the 2016–17 memorandum of understanding (MOU) between the Office of the Australian Information Commissioner (OAIC) and the Agency.
The report also provides information about the OAIC’s other digital health activities, including its assessment program, development of guidance material, provision of advice, and liaison with key stakeholders.
More information about the MOU is provided below in section 2 of this report. The MOU can also be accessed on the OAIC’s website www.oaic.gov.au.
This was the fifth year of operation of the My Health Record system and the seventh year of the Healthcare Identifiers (HI) Service, a critical enabler for the My Health Record system and digital health generally.
The management of personal information is at the core of both the My Health Record system and the HI Service (collectively referred to as ‘digital health’ in this report). In recognition of the special sensitivity of health information, the My Health Records Act and the HI Act contain provisions that protect and restrict the collection, use and disclosure of personal information. The Australian Information Commissioner oversees compliance with those provisions and is the independent regulator of the privacy aspects of the My Health Record system and the HI Service.
The My Health Record system commenced in 2012 as an opt-in system where an individual needed to register in order to get their My Health Record. In March 2016, the Australian Government commenced a trial of opt-out system participation in Far North Queensland and in the Nepean Blue Mountains region of New South Wales. A My Health Record was created for each individual living in those areas, unless the individual chose to opt-out of participating in the trial.
Changes to the My Health Records Act introduced by the Health Legislation Amendment (eHealth) Act 2015 enabled the trial to be undertaken. That amendment Act also introduced a number of other changes across digital health legislation and the Privacy Act 1988 (Privacy Act), including streamlining the personal information handling authorisations, and introducing additional civil and criminal penalties for privacy breaches. An independent evaluation of the trials commissioned by the Department of Health was conducted to look at the outcomes from these trials.
In the May 2017 Budget, the Australian Government announced the creation of a My Health Record for every Australian to begin nationally from mid–2018.
In 2016–17, the OAIC received 35 mandatory data breach notifications. These notifications recorded 140 separate breaches affecting a total of 152 healthcare recipients, 144 of whom had a My Health Record at the time of the breaches. Five of these notifications remain open at the end of the reporting period. The OAIC received two complaints regarding the My Health Record system and no complaints relating to the HI Service. In addition to handling data breach notifications, the OAIC carried out a full program of digital health-related work, including:
  • commencement of one privacy assessment and completion of two assessments from the previous year
  • liaising with the Agency and the Department of Health on the decision for national expansion of My Health Record in 2018
  • making submissions to various stakeholders on matters directly related to or associated with the My Health Record system. This included a submission to the Agency on the development of the National Digital Health Strategy
  • providing advice to stakeholders, including the Agency, on privacy related matters relevant to the My Health Record system
  • developing, revising and updating guidance materials for a range of audiences, including the development of My Health Record related multimedia resources for healthcare providers
  • participation in the Privacy and Security Advisory Committee, one of the advisory committees established by the Agency to support the Agency’s Board
  • monitoring developments in digital health, the My Health Record system and the HI Service.
----- End Extract.
Here is the link:
I am unable to reconcile the two bolded sentences and would be interested to know how they can be reconciled (channeling Rowena Orr QC of the Royal Commission). When is a breach not a breach etc?
Interestingly there were similar findings the previous year:
“In 2015–16, the OAIC received 16 mandatory data breach notifications. These notifications recorded 94 separate breaches affecting a total of 103 healthcare recipients, 98 of whom had a My Health Record at the time of the breaches.”
Here is the link:
I look forward to views on this repeated claim (of a breach free system)  which must make us wonder what else we are told we can take as the full and precise truth?
David.

AusHealthIT Poll Number 424 – Results – 27th May, 2018.

Here are the results of the poll.

Is The ADHA Doing Enough (Media, Mail-outs etc.) To Alert The General Public Of The Opt-Out Period For The myHR And Its Implications?

Yes 16% (32)

No 71% (144)

I Have No Idea 13% (28)

Total votes: 204

A considerable vote of no confidence I would suggest on a very large number of votes. It seems there is little confidence the ADHA is doing enough.

Any insights welcome as a comment, as usual.

A really, really great turnout of votes!

It must have been a really hard question as just 28/204 readers were not sure what the appropriate answer was.

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

David.

Saturday, May 26, 2018

Weekly Overseas Health IT Links – 26th May, 2018

Here are a few I came across last week.
Note: Each link is followed by a title and 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.
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EHR market revenues approach $30B in 2017, Kalorama reports

Published May 18 2018, 6:02pm EDT
The electronic health records market reached $29.7 billion in annual revenue 2017 and will rise to $39.7 billion by 2022, according to a new annual report from Kalorama Information, a research firm.
The EHR market includes computerized physician order entry systems and services such as installation, training, servicing and consulting. Picture archiving and communication systems and hardware are not included in Kalorama’s market projections.
“We believe adoption and upgrading activities will still be stimulating growth in 2017-2022,” says Mary Ann Crandall, author of the report.
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Critical-Care Group Updates TeleICU Standards

Jennifer Thew, RN, May 18, 2018

The American Association of Critical-Care Nurses' consensus statement reflects current evidence and best practices in TeleICU nursing.

Telehealth is a growing segment in the healthcare industry, thus providing nurses with new settings and opportunities in which to practice. The American Association of Critical-Care Nurses recognized the need for guidance in this area and issued the first authoritative document to define practice guidelines specifically for the emerging telenursing practice in critical care in 2013
Telehealth continues to evolve and so must nursing practice standards.
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Sutter Health back online after 24 hours of systemwide EHR outage

The activation of a fire suppression system of one of the health system’s data centers on Monday shut down its Epic EHR and other information systems.
May 16, 2018 01:21 PM
Sutter Health faced more than a day of downtime of its Epic EHR and an outage of internal communications this week after the activation of a fire suppression system in one of its data centers, officials said.
All systems currently are back online.
The outage began late Monday night and impacted all 24 hospitals in the California-based health system, according to an internal memo obtained by the Press Democrat. The outage affected certain information systems, the service desk and some of its phone systems.
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Johns Hopkins unveils new computational method for precision oncology

Hospitals could use the math-based technique to make it easier to tailor treatments for patients.
May 17, 2018 10:06 AM
One of the ongoing dilemmas faced by provider organizations with precision medicine is that for all the advances made in genomic research, sometimes it can still be hard to translate into routine clinical practice: Physicians don't always know how best to turn genetic-based data into appropriate treatments.
A key challenge for clinicians is that each primary form of cancer, such as breast or prostate, may have multiple subtypes, each of which responds differently to a given treatment.
Healthcare IT News is reporting this week from the HIMSS Precision Medicine Summit in Washington, D.C. Also this week, researchers at nearby Johns Hopkins announced what they say is a new computational strategy that can help translate complex precision medicine data into a more simplified format that keeps the focus on patient-to-patient variation in the molecular signatures of cancer cells.
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CMS Accepting New Promoting Interoperability Measure Proposals

CMS will accept proposals from stakeholders for new Promoting Interoperability measures until June 29.

May 16, 2018 - CMS recently announced it is accepting proposals for new measures stakeholders would like to see included in the Medicare Promoting Interoperability (PI) program.
The federal agency will accept proposals until June 29.
CMS is encouraging stakeholders to submit measure proposals as part of its annual call for measures for eligible hospitals and critical access hospitals (CAHs) participating in the newly-minted PI program — formerly known as meaningful use. Submitted measures will be considered for inclusion in 2019 rulemaking.
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VA finally pulls trigger and awards Cerner $10B EHR contract

Published May 17 2018, 6:24pm EDT
After nearly a year of negotiations with Cerner, the Department of Veterans Affairs on Thursday finally awarded the vendor a $10 billion electronic health record modernization contract to replace the VA’s decades-old legacy EHR system.
“I am pleased to announce we have signed a contract with Cerner today that will modernize the VA’s healthcare IT system and help provide seamless care to veterans as they transition from military service to veteran status, and when they choose to use community care,” said Robert Wilkie, the VA acting secretary. “This is one of the largest IT contracts in the federal government, with a ceiling of $10 billion over 10 years. And with a contract of that size, you can understand why former Secretary Shulkin and I took some extra time to do our due diligence and make sure the contract does what the President wanted.”
In June 2017, then-VA Secretary David Shulkin announced his decision to award a sole-source contract to Cerner in order to replace the legacy Veterans Health Information Systems and Technology Architecture with a single common EHR system with the Department of Defense based on Cerner’s Millennium platform. However, President Trump’s recent firing of Shulkin and the resignation of the VA’s acting chief information officer Scott Blackburn cast doubt on the agency’s EHR efforts.
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Why EHR data interoperability is such a mess in 3 charts

Hospitals have a complex web of electronic health record vendors but once data sharing broadens it will open the door to innovation.
May 16, 2018 10:07 AM
The thorny matter of interoperability in healthcare, as it is or has historically been in other industries, is almost all-consuming among technology vendors and their clients. 
Indeed, a big part of the problem is exactly how many EHR companies are out there and, more specifically, the average number of platforms hospitals are running today.
It’s 16. That’s right: 16 distinct electronic health records platforms, according to statistics HIMSS Analytics pulled from its Logic database looking at 571,045 providers affiliated with 4,023 hospitals.
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Cyberattackers Exploiting Weaknesses in Healthcare Data Security

Cyberattackers are exploiting inherent weaknesses in healthcare data security, making the sector the most targeted industry in the first quarter of 2018, according to Rapid7’s quarterly threat report.

May 15, 2018 - Cyberattackers are exploiting inherent weaknesses in healthcare data security, making the sector the most targeted industry in the first quarter of 2018, according to Rapid7’s quarterly threat report released May 15.
The Rapid7 research found that the leading attack vectors in healthcare were remote access, such as  suspicious logins, access attempts from disabled accounts, and account leaks, as well as phishing and ransomware.
There are several factors that attract attackers to the healthcare sector, according to researchers.
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State health departments face government barriers to interoperability, report says

May 16, 2018 1:10pm
State health departments can harness data analytics to inform policy and improve outcomes for large populations—but there are a number of hurdles to fully taking advantage of the technology, according to a new report. 
Researchers at Leavitt Partners interviewed officials at state health departments in Utah, Oklahoma, Washington, Colorado and Idaho to gather a cross-section of states at different points in the journey to a robust and interoperable analytics program. 
Through those interviews, the authors were able to identify several pain points for health officials looking to expand their abilities to gather and use data. In particular, governance and legal challenges, such as the Health Insurance Portability and Accountability Act (HIPAA), pose a significant barrier to data sharing for these agencies. 
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New program aims to ensure identities in exchanging health data

Published May 16 2018, 7:21am EDT
The Electronic Healthcare Network Accreditation Commission, which accredits industry stakeholders for meeting best business practices that include privacy and security protections, now is focusing on a new accreditation program to ensure identity verification and authentication of stakeholders conducting health information exchange, as well as supporting blockchain and cloud hosting services.
Organizations collaborating with EHNAC to develop the new Trusted Exchange Accreditation Program include the Workgroup for Electronic Data Interchange, SAFE-BioPharma Association, eHealth Initiative and the EP3 Foundation which facilitates secure identity to support data sharing for research and clinical trials without revealing personal or sensitive information.
The goal of Trusted Exchange is to offer the industry third-party accreditation for a wide range of healthcare entities.
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$148 for a PDF? Patient Access to Medical Records Hit or Miss

Steven Porter, May 16, 2018

A watchdog agency cites egregious cases as the federal government promotes interoperability of health data.

The fees patients pay for copies of their own medical records vary drastically, sometimes running afoul of the restrictions written into federal law, according to a Government Accountability Office report released this week.
The watchdog agency's report provided a list of egregious cases, including one in which a patient was charged $148 for a digital copy of her medical record. Two others were charged more than $500 apiece for a single request, the report said, citing an unnamed patient advocacy organization.
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GAO: Patient access to medical records remains a challenge

Published May 15 2018, 7:20am EDT
Despite the widespread adoption of electronic health records by providers, patients continue to face challenges in accessing their healthcare information, according to a new audit by the Government Accountability Office.
Under HIPAA, consumers have the right to inspect, review and receive a copy of their medical records, while providers are authorized to charge a reasonable cost-based fee when patients request copies of their medical records or request that their records be forwarded to another provider or entity, such as an insurer or lawyer.
However, according to the GAO, the fees for third-party requests are generally higher than the fees charged to patients—which can vary significantly across states—while high fees can adversely affect patients’ access to their medical records.
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Precision medicine: 'We want to make sure people feel respected,' clinical ethicist says

As hospitals collect patient data they must characterize it well, apply new technologies – and practice what Cleveland Clinic’s Paul Ford calls "human medicine."
May 14, 2018 11:44 AM
While precision medicine continues picking up momentum it’s going to change many aspects of healthcare, notably shared decision making in the doctor-patient relationship, confidentiality and data privacy.
Managing those is going to require a human touch. If physicians and caregivers just focus on genetics and genomics without taking into account who the patients are as people to better understand their activity and behavior then they will be missing a big part of what drives an individual’s health.
“We want to make sure that precision medicine continues to be human medicine – person-centered – as in treating the whole person,” said Paul Ford, a clinical ethicist and Director of the Center for Bioethics at the Cleveland Clinic Foundation. “We want to make sure people feel respected. In some ways, making things personalized – tailors it, makes them feel less like a whole mass.”  
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Cerner has almost double EHR global market share of closest rival Epic, Kalorama says

But Epic leads in the physician office sector, according to the new report, and GE is now among the top four electronic health record vendors.
May 15, 2018 09:32 AM
Cerner leads the worldwide EHR market with Epic taking the second spot, Allscripts in third and GE Healthcare at fourth. 
“In the competition for large healthcare systems, it's the top four EHR companies mainly participating with some exceptions,” Mary Anne Crandall, a senior analyst at Kalorama Information, wrote in the firm’s annual report on the state of EHRs.
For 2017, Cerner earned 17.3 percent market share, while Epic has 8.8 percent. 
Allscripts, thanks to mergers and acquisitions of Misys and Eclipsys, rose to 6.1 percent. 
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Large hospitals more likely to use Cerner, small hospitals opt for Epic: 4 report insights

Written by Julie Spitzer | May 14, 2018 |
With 17 percent of the global market share, Cerner is the most used EMR, according to Kalorama Information's annual EMR industry report.
For its report, EMR 2018: The Market for Electronic Medical Records, Kalorama analyzed the global EMR market and the trends affecting it through a statistical review of industry influences, demographics, life expectancy and company strategies.
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One Hospital's $1M Savings in CDI Transcription Costs

Alexandra Wilson Pecci, May 15, 2018

Phoenix Children's CMIO reveals the IT-clinical collaboration behind its ambulatory disease-specific clinical documentation templates.

For many years, the ambulatory clinics at Phoenix Children's Hospital lagged in their EHR use.
"The ambulatory was a little step behind," says Vinay Vaidya, MD, vice president and chief medical information officer at Phoenix Children's. "Everything was on paper or dictation."
Now, the clinics not only use a clinical documentation platform in all 30 divisions of its ambulatory clinics, but the organization is in the process of building disease-specific templates that are part of a larger quality improvement initiative for chronic diseases.
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Cybersecurity: Nightmare scenarios and guiding principles

From legacy infrastructure to potential medical device hacks, some of the industry’s leading voices opened up about how the industry can begin to combat the inevitable breach.
May 11, 2018 03:07 PM
Some clinicians share their passwords with nurses in order to complete charts with the idea of “a care efficiency: rather than a risk.
By now, the healthcare sector is fully aware of the looming target placed on its back by hackers. The issue is that legacy infrastructure, staffing shortages and insider threats can make it tough to tackle these issues.
The biggest threats lie within the legacy infrastructure of healthcare itself. This includes medical devices operating on outdated platforms, along with IoT devices. We have not have seen it happen frequently but, if those devices are hacked cybercriminals can actually put patient lives at risk.
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New cloud-based machine learning tools offer programmatic approach to security

After years of wariness from healthcare providers about off-premise data, new AI capabilities from Amazon, Google, IBM and Microsoft could make cloud storage easier and more trustworthy than ever.
May 14, 2018 08:40 AM
For years, many healthcare organizations tended to be skeptical and resistant (if not outright hostile) to the idea of storing their data, particularly protected health information, in the cloud. IT and security decision-makers had deep reservations about stashing such sensitive data anywhere but their own on-premises servers, safe under their own watchful eyes.
But not too long ago that changed, and seemed to change quickly. To the surprise of many, over the past few years, it appears that many healthcare providers have been getting markedly more comfortable putting their trust in the cloud.
"If you had asked me in 2011, I would have predicted that healthcare would still be one of the slower moving industries," said Jason McKay, chief technology officer of Logicworks, a managed hosting company that helps organizations in many sectors build and manage cloud infrastructure. "We were surprised at the uptake."
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Next-gen analytics: Here's what's coming in the future

Hospitals should expect orders of magnitude more data – but will also see emerging tools such as artificial intelligence and 5G connectivity helping to put both structured and unstructured information to work.
May 14, 2018 09:11 AM
The healthcare analytics market is booming and will be worth close to $54 billion worldwide by 2025, according to a March 2018 report from Grand View Research.
Given the need to achieve the Triple Aim, along with the rise of precision medicine and the move toward value-based care, data analytics have never been more important to healthcare provider organizations.
As the technology continues to grow and mature, here's the pressing question for healthcare and IT leaders: How will analytics tools evolve – and what should they expect to come next?
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Cerner EHR Ranked Highest for 3rd Year in Nursing EHR Satisfaction

Black Book research showed that nursing EHR satisfaction levels continue to rise, with the majority of nurses not wanting to return to paper records.

May 11, 2018 - There has been a definite shift in nursing EHR satisfaction levels over the past few years, showing the perceived value in EHRs in delivering higher quality care, according to recent Black Book research.
Cerner EHR received top rankings from a nursing functionality and usability perspective for the third consecutive year, with a mean satisfaction ranking of 93 percent, the poll found. MEDITECH and Allscripts both had mean satisfaction rankings of 88 percent, while McKesson had an 85 percent mean product satisfaction ranking.
Approximately 15,000 registered nurses from 40 states were interviewed for three separate surveys, discussing how they implemented hospital EHRs over the past four years.
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HIT Think How telehealth can improve medication management and patient safety

Published May 11 2018, 5:47pm EDT
Medication errors account for at least one death each day and injuries to an estimated 1.3 million people annually. But while implementing new workflows can put a dent in this problem, making a significant impact requires a huge dedication of resources.
What’s not typically part of the discussion? How telehealth can improve medication safety.
While telehealth’s power to enhance acute-care programs is undisputed, its ability to improve the less-prominent (but equally important) medication reconciliation and safety processes is largely untested, and potentially eyebrow raising.
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'Stigmatizing' language in EHRs may negatively affect patient care for years

Written by Jessica Kim Cohen | May 12, 2018 | Print  |
Including nonessential, "stigmatizing" notes in a patient's health record may lead them to receive inadequate care in the future, according to a study out of Baltimore-based Johns Hopkins University School of Medicine and published in the Journal of General Internal Medicine.
For the study, the researchers developed a series of chart notes, half of which employed "neutral language," and half of which employed "stigmatizing" language. The researchers enrolled 413 medical students and internal and emergency medicine residents to review these notes and suggest next steps, in an effort to assess whether stigmatizing language affected providers' attitudes toward patients.
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FDA Turns to AI and Digital Health, So Why Are There Still Fax Machines?

MAY 10, 2018
Recently, FDA Commissioner Dr. Scott Gottlieb, spoke discussed how he sees digital health playing out and where the agency stands in a speech titled "Transforming FDA's Approach to Digital Health." Some things he said are worth exploring in more depth.
Gottlieb started out by saying that the digital health space has really matured and is the time for regulation.
"Digital health tools have vast potential improve our ability to accurately diagnose and treat disease and to enhance the delivery of health care for the individual, making medical care truly patient centric -- empowering the individual," Gottlieb said.
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DOD report blasts MHS Genesis rollout, citing inaccurate patient information and safety concerns

May 14, 2018 3:42pm
A scathing report from the Department of Defense says its MHS Genesis EHR is “neither operationally effective nor operationally suitable,” highlighting concerns that the system’s failures jeopardize patient safety.
The April 30 report (PDF), released by the DOD last week, describes a system rife with critical problems impacting patient care and clinical usability. Robert Behler, the DOD’s director of operational test and evaluation, reviewed the Cerner implementations at three facilities in Washington state and found that 156 incident reports were of “critical deficiencies” that included potential patient safety concerns.
The report was released shortly after Politico reported that the system was riddled with errors that could lead to patient deaths.
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U.S. doctors’ clinical notes 4 times as long as those in other countries

May 10, 2018 1:40pm
Regulations that require doctors to document patient care may be responsible for the fact that U.S. physicians’ clinical notes are, on average, four times as long as those in other countries.
Those regulations may be causing U.S. physicians, who commonly complain about the time they spend on electronic health records (EHR), to overdocument when compared to their overseas counterparts, according to an opinion piece in the Annals of Internal Medicine.
"Documentation in other countries tends to be far briefer, containing only essential clinical information," the authors said. "It does not contain much of the compliance and reimbursement documentation that commonly bloats the American clinical note."
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DoD rollout of Cerner EHR deemed not operationally effective or suitable

Published May 14 2018, 7:22am EDT
While the Department of Defense contends that its initial deployment last year of MHS GENESIS—a new Cerner electronic health record system—at four military sites in the Pacific Northwest was a success, the EHR is “neither operationally effective nor operationally suitable,” according to a new report from DoD’s director of operational test and evaluation.
DOT&E’s initial test and evaluation report, dated April 30 and released by DoD on Friday, is based on an assessment of three of four military sites in Washington State that were part of the rollout.
“MHS GENESIS is not operationally effective because it does not demonstrate enough workable functionality to manage and document patient care,” wrote Robert Behler, director of operational test and evaluation, in a letter to senior Pentagon officials accompanying his report. “Users successfully performed only 56 percent of the 197 tasks used as measures of performance. MHS GENESIS is not operationally suitable because of poor system usability, insufficient training and inadequate help desk support. Survivability is undetermined because cybersecurity testing is ongoing.”
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FHIR information exchange capability now coming of age

Published May 14 2018, 7:31am EDT
2018 is shaping up as a pivotal year for Health Level 7 International’s Fast Healthcare Interoperability Resources application programming interface. Significant momentum continues to build as a growing number of use cases indicate FHIR has reached a tipping point as a mature standard for the electronic exchange of health information.
In March, Apple launched an enhancement to its Health app—which leverages FHIR—enabling patients at 39 participating U.S. healthcare organizations to view their medical records on their iPhones after updating to the iOS 11.3 mobile operating system.
The enhanced Health Records section within the Health app allows patients to see medical data— encrypted and protected with their iPhone passcodes—gathered from various institutions and presented in a single, aggregated view. Patients also receive electronic notifications when their records are updated by providers.
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HIT Think Why it's important to give nurses the data they need

Published May 14 2018, 5:49pm EDT
Florence Nightingale, widely recognized as the founder of the nursing profession, could also be considered the first informatics nurse. The definition of nursing informatics is drawn from the IMIA Special Interest Group on Nursing Informatics, which uses this description: "The science and practice [that] integrates nursing, its information and knowledge, with information and communication technologies to promote the health of people, families, and communities worldwide."
A study completed by Nightingale, done on note cards, used a huge set of data collected between 1854-1855 that changed our knowledge of—and had an enormous impact on—hospital sanitation. Her insights were based on detailed analyses of the cause of death of the British soldiers stationed in Crimea.
She used data to identify trends that allowed her to look at the root cause of the deaths, and from that insight, suggested changes in care. Her reforms in Crimea, including the introduction of mandatory hand-washing, cut the death rate in military hospitals from 42 percent to 2 percent. We still leverage that knowledge and advice on patient care, which remains relevant for hand hygiene protocols in hospitals globally.
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Electronic medical records are a burden or the future, depending on who you ask

BY JON O'CONNELL, STAFF WRITER / Published: May 13, 2018
Dr. Kevin Olsen spends up to 12 hours most weekends hunched over a laptop doing something he hates.
The Scranton cardiologist updates his patients’ electronic medical or health records, often called EMRs or EHRs.
They’re made to reduce redundancy and errors and give doctors a complete picture of care for each patient by showing them how other doctors are treating them.
On the flip side, independent doctors like Olsen, who have small staffs and who have practiced medicine using paper records for decades, are duly burdened by them.
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Foreign experts find error slowing down e-health system in Latvia

BC, Tallinn, 14.05.2018.
International experts have found the main error in one of the e-health system's modules that was slowing down the entire system, Health Minister Anda Caksa (Greens/Farmers) told Latvian Television this morning, cites LETA.
Caksa did not specify how much repairing the system would cost, she only said that the Health Ministry's budget section for the e-health system would not be exceeded, and that the experts were paid on an hourly basis.
According to Caksa, it became clear in two or three months after the launch of the e-health system that something was slowing it down each day around noon. International experts were hired to find out what was wrong, and last week they found the main error in one of the e-health system's modules that was slowing the system down. The experts said that repairing the system would take two months.
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Foreign experts find 'bug' in national "e-health" system

Today, 11:29 | Health Authors: eng.lsm.lv (Latvian Public Broadcasting)
International experts probing the country's "e-health" system have found a bug that had caused it to slow down. It should be fixed within two months, said Latvia's Health Minister Anda Čakša, reported LTV May 14.
"We found, after it had been working for two to three months, that there are slow-downs...especially during midday when there's a peak in the number of active users. 
"Understanding there's an error somewhere in the core [of the code], we invited international experts who have identified the main problem," she said.
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Vietnam to issue electronic health insurance cards

It is expected to help boost supervision and avoid fraudulent activities in medical examinations and treatment under the health insurance policy.

Devdiscourse News Desk 13 May 2018, 03:27 AM Vietnam
Vietnam’s insurance sector will issue electronic health insurance cards in 2018 to facilitate the management of information regarding medical examinations and treatment.
According to the Vietnam Social Security (VSS), people with e-cards visit health facilities for examinations and treatment or visit relevant agencies to solve their social insurance interests, their information can be clearly displayed by using card reader chips.
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Enjoy!
David.

Friday, May 25, 2018

Are We Seeing The Bipartisan Support For The myHR Begin To Fracture?

This appeared last week:

 ‘This is a Government with a woeful track record on IT security and privacy.’

Catherine King, Shadow Minister for Health

Catherine King has challenged the Turnbull Government on whether it can roll out the My Health Record system without getting it wrong

It’s been heralded as a “game changer” by the PSA’s Shane Jackson and “strategically very valuable” for pharmacy by the Guild’s David Quilty… but the Shadow Minister for Health and Medicare has suggested that the Government may not be able to implement the system with effective privacy controls in place.
This week the Health Minister, Greg Hunt, announced that Australians who want to opt out of having a My Health Record can do so between 16 July and 15 October 2018.
Ms King says that Labor supports e-health: “Implemented by a competent Government, e-health could deliver tangible health care improvements and save the health system up to $7 billion a year through fewer diagnosis, treatment and prescriptions errors,” she said.
“But given this is the same Government that gave us census fail, stuffed up robodebt, and allowed Australians’ Medicare data to be sold on the darkweb, we have concerns about their ability to properly implement this reform.
“Put simply, this is a Government with a woeful track record on IT security and privacy. And now they’re asking all Australians to trust them with their most personal information.”
Ms King also accused the Government of making “no real effort” to explain the opt out process to the community.
More here:
Since the PCEHR / myHR was a Labor idea (in 2009-2010) it is interesting to see only luke warm support, even though they still seem to think it is a good idea in general and are probably just trying for a political point or two.
Time will tell where they land as the election approaches.
David.

Thursday, May 24, 2018

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


May 24, 2018 Edition.
Two main themes last week. One, is all of Trumps bets seem to be falling apart. Kim is being cute and Trump has now cancelled the Summit, the Middle East is in flames and so it goes.
Two, gradually people are seeing more and more issues in the budget that rather feel to be a bit of sleight of hand - and we now have a slew of bye-elections on July 28!
For the entertainment of the week we are having a new session of the Financial Services Royal Commission which has been yet another train-wreck for some poor witnesses.
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Here are a few other things I have noticed.
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Major Issues.

  • Updated May 13 2018 at 11:00 PM

Calls for delay to 'comprehensive credit reporting' amid discrimination concerns

Consumer law groups are calling for a delay to one of the government's flagship policies for lifting competition in the banking sector, and will tell a Senate committee on Tuesday vulnerable customers are at risk of discrimination.
Under the "comprehensive credit reporting" regime banks will have to report customers who have negotiated rescheduled repayments as being late on their repayments.
The Financial Rights Legal Centre is preparing to launch a wave of cases at the financial services ombudsman if the reporting of "repayment history information" (RHI) is not pushed back until after the Attorney-General's department confirms how hardship cases should be reported under the regime, which exposes the banks to big fines for non-compliance.
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Do interest rates affect business investment? Evidence from Australian company-level data

9 May 2018
Description
We examine the distribution of borrowing rates paid by companies, and the relationship between corporate borrowing rates and fixed capital investment, using a unique hand-collected dataset. We find a high degree of heterogeneity in companies’ cost of debt. Also, since the global financial crisis, the spread between the rates paid by companies at the top and bottom of the distribution has widened. Borrowing rates for a large portion of companies, including smaller and riskier ones, have remained high in recent years, despite falls in aggregate indicators of interest rates. This heterogeneity in borrowing rates enables us to find a significant inverse relationship between the cost of debt and corporate investment, which is generally not evident in aggregate data. We argue that this relationship may be due to credit supply effects, as a relaxation of lending standards leads to lower credit spreads and encourages more investment. These findings shed new light on the link between monetary policy and business investment in Australia.
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How we arrived at budgets we can't trust

By ROSS GITTINS
13 May 2018 — 12:16pm
After last week’s appalling effort, the resort to misleading practices in the budget is reaching the point where the public’s disrespect and distrust of politicians are spreading to the formerly authoritative budget papers.
We’re used to spin doctors with slippery words. Now it’s spin doctors with slippery numbers. They’re not just gilding the lily, they’re creating an unreal world where the truth is concealed.
It gives me no joy to be telling people not to believe what they read in the budget papers. I’d rather tell them that of course the budget figures can be trusted, and they should heed the advice of the nation’s most senior and respected economists.
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  • Updated May 13 2018 at 8:04 PM

People are fed up with capitalism

by John Authers
"The facts are clear: all the evidence is that process-driven CEOs are prioritising the bottom line and treating earnings as a key metric. That's capitalism."
These lines are a summary of the news from the corporate sector in the past few weeks. Yet they will read to many Americans like red rags to a bull.
As we have been reporting, the first quarter of this year saw a fantastic rise in corporate profits. In the US, according to Thomson Reuters, S&P 500 companies managed to raise their earnings by more than 26 per cent compared with a year ago. European members of the Stoxx 600 are on course for a much more sedentary 4.1 per cent rise.
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Why do politicians refuse to believe decades of polling and research?

By Peter Hartcher
Updated14 May 2018 — 7:11amfirst published at 12:00am
Today's poll proves anew something that only politicians refuse to believe.
Voters generally care more about the health of the nation than about themselves.
It's a fact that political scientists have long known.
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  • May 14 2018 at 11:15 AM

Australia should not blindly follow Trump on China's ZTE

Donald Trump has thrown ZTE a lifeline. The Chinese telecommunications company was heading rapidly towards bankruptcy until the US President took to Twitter on Sunday night.
Trump revealed he was working with Chinese President Xi Jinping on a way for ZTE "to get back into business, fast".
"Too many jobs in China lost. Commerce Department has been instructed to get it done," he tweeted.
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Science-nonfiction: Robotics author says AI will affect all children

By Danica Streader
14 May 2018 — 11:33am
A Brisbane robotics expert who says the children of today will interact with A.I. in some point in their lives is putting 1000 textbook guides to artificial intelligence in classrooms around the country.
Queensland University of Technology robotics professor Michael Milford, the author of The Complete Guide to Artificial Intelligence for Kids, said limited resources were available for children to learn about intelligent machines.
 “The thing about artificial intelligence is we don’t know what is going to happen, which ends up being the most exciting and scary aspect of this industry,” he said.
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Federal budget: What’s in it for investors

  • The Australian
  • 12:00AM May 12, 2018

James Kirby

As the dust settles we come to ­realise this year’s budget key objective was to promise a series of elongated tax cuts and to shorten the pathway to a budget surplus. Under long-term and politically improbable plans the Coalition would introduce a flatter tax system. As the political reality of those objectives play out, investors might concentrate on the changes that actually should come to pass.
One theme is the government’s decision to try to optimise the tax-free status of the family home by adding initiatives on reverse mortgages and at-home aged care. There is also some tweaking of the complex — but still useful — self- managed super fund system and a grab bag of measures aimed at ­either alleviating red tape or policing the system. For the investor, here’s what really happened.
Maximise the value of your home
Your home is a tax shelter and neither the ALP nor the coalition appears willing to challenge this reality. So Scott Morrison offered two measures in the budget that aim to take advantage of existing home values.
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  • Updated May 14 2018 at 11:00 PM

Extreme risk in $89b navy ship building plan: Auditor-General

Taxpayers are paying billions of dollars more and face further blowouts because of the "high to extreme" level of risk in building new ships and submarines in Australia in the Turnbull government's rush for voter-friendly announcements to get projects started, the Auditor-General has warned.
Demanding the Defence Department provide an update on the cost of the $89 billion naval shipbuilding plan, the Australian National Audit Office issued a scathing report on Monday attacking key elements of the government's drive to establish a local industry and shore up jobs in Adelaide and Perth.
Auditor-General Grant Hehir's report slammed the government for approving a new fleet of patrol boats without any firm idea of their running costs, while no cost-benefit analysis was conducted on the decision to bring forward start of construction to keep shipbuilding workers in jobs.
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Banking royal commission: JPMorgan fears big job losses

  • The Australian
  • 8:50PM May 14, 2018

Michael Roddan

There are renewed fears of economic fallout stemming from the royal commission into the banking sector, as regulators and the government look to overhaul the way fees are paid across the financial services sector.
A crackdown on financial advice — including killing off problematic trailing commissions that were grandfathered in 2013 — could end a significant money spinner for the largest banks and wealth managers as the fallout from the royal commission continues to build.
JPMorgan analyst Sally Auld said the financial sector could face a stunning crash in employment worse than the last ­financial crisis.
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  • May 15 2018 at 9:10 AM

RBA's Guy Debelle flags housing risk from tighter lending standards on bank probe

Reserve Bank of Australia deputy governor Guy Debelle has warned a further tightening of lending standards would primarily hit the housing market even as he downplayed the dangers of the coming wave of resets to interest-only loans.
In a speech that again reiterates the central bank's forecast is for a "gradual" pickup in economic growth and inflation, as well as fall in the jobless rate, Dr Debelle emphasised that the official cash rate was likely to remain steady this year and into next.
"If the economy continues to evolve as expected, higher interest rates are likely to be appropriate at some point," he said. "Notwithstanding this, the board does not currently see a strong case for a near-term adjustment in the cash rate. "
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An Aussie Trump is not such a remote possibility

By Peter Hartcher
15 May 2018 — 12:00am
The rise of the "strong man" political leader continues to gather force, part of the trend to authoritarianism across the world.
Even when democracy appears to be being rescued – as in Malaysia last week – the rescuer is himself a strongman.
Mahathir Mohamad might have defeated the ruling United Malay Nationals Organisation for the first time since the country's independence in 1957, but Mahathir was the most important figure in entrenching its long dominance. Until he decided to end it now.
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Jobless rate needs to go lower for wage pressures to emerge: RBA

15 May 2018 — 10:01am
Wages growth has troughed and there are some tentative signs of pressure emerging, but there is a risk it may take a lower unemployment rate than currently expected to generate a sustained move higher, the Reserve Bank of Australia says.
Wage growth is crawling near a record low pace of around 2 per cent annually, even as the labour market tightens. Data out on Wednesday is likely to show wage growth stuck at that level, half the rate enjoyed by workers during the mining boom.
"How much longer is wages growth going to remain at its current low rates?" RBA deputy governor Guy Debelle said in a speech in Sydney on Tuesday. "The experience of other countries with labour markets closer to full capacity than Australia's is that wages growth may remain lower than historical experience would suggest."
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Reserve Bank’s Debelle issues new warning on mortgage debt, sees no pressure to raise rates

  • The Australian
  • 10:46AM May 15, 2018

Michael Roddan

Australia’s heavily indebted households and the likelihood of higher mortgage repayments remain a key risk to Australia’s economic outlook, warns Reserve Bank deputy governor Guy Debelle.
In a speech this morning, Mr Debelle reiterated warnings about the “large amount of mortgage debt” held by local households.
He also said although Australia’s economy was on a slowly improving trajectory, it did not make a case for raising interest rates in the near term.
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Australians give income tax cuts thumbs up

Consumer confidence has jumped to a 14-week high in response to last week's federal budget which included personal income tax cuts.
Colin Brinsden, AAP Economics Correspondent
Australian Associated Press May 15, 20183:22pm
It may only be $10 a week but the budget's tax cut has been enough to make Australians happy.
Consumer confidence jumped to the highest level since early February in response to Treasurer Scott Morrison's third budget released a week ago which had personal income tax cuts as its centrepiece.
The three-stage tax plan kicks off with a $530 cut for the average earner and comes at a time of slow wages growth.
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  • Updated May 15 2018 at 11:00 PM

Why investors should take notice of rising bond rates

by Mark Draper
Are the bond market ghosts of 1994 coming back to haunt us, or is this as high as long-term interest rates rise? That's unknowable at this stage, but investors should ensure their portfolios can weather rising interest rates.
Investment strategies that worked well while interest rates fell are unlikely to be rewarded when rates rise.
Long-term interest rates, particularly the 10-year US bond rate (also known as the risk-free rate of return), are important to investors as an anchor point against which asset prices such as property and shares are measured. Generally speaking, a higher long-term interest rate results in lower asset prices, in the absence of earnings growth.
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'Rich whingers' not as hard done by as Morrison would have you think

By ROSS GITTINS
15 May 2018 — 2:07pm
As a boy I was interested in magic tricks, reading lots of books and learning to do a few. It taught me two terms that have proved invaluable to me as an economic journalist: “prestidigitation” and “sleight of hand”.
The trick is to draw the audience’s attention towards something else so they don’t notice you palming the coin or grabbing the rabbit you’ll supposedly produce from your top hat.
Politicians and their spin doctors are always trying to divert our attention from some embarrassing stuff-up, but it’s come to something when a treasurer produces a budget as tricksy as Scott Morrison’s effort last week.
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Airport ID checks 'authoritarian' and won't improve safety: critics

By Patrick Hatch & Fergus Hunter
15 May 2018 — 5:19pm
New powers allowing police to order anyone in an airport to produce identification has been criticised as an "authoritarian" step that will do little to improve Australia's counter-terrorism efforts.
Prime Minister Malcolm Turnbull conceded on Tuesday that the new powers were a significant step, but necessary for the "dangerous times" in which we live.
Australian Federal Police will be able to ask anyone for ID, with or without reason to suspect them of wrongdoing, and eject them from an airport as part of a security overhaul that will also see the introduction of advanced bag and body scanning machines in terminals across the country.
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Three ships but only two options

By Nicholas Stuart
15 May 2018 — 4:50pm
Hold your breath, close your eyes tight, make a supreme effort of will. Is it really is possible to believe the dodgy assumptions and bask in the rosy glow accompanying the budget’s out year projections? Surplus? Sure thing!
Of course it will never happen, certainly not in the projected timeframe anyway, but that’s not really the point, is it? Fairy tales have a greater intersection with reality. Treasury forecasts are simply bedtime stories, designed reassure children and put us to sleep. So let’s leave all that and worry about something real.
Shipbuilding.
This is where the government will splash the cash and spend your money. It also has the prospect of making a significant and real change to the future of our country along the way. Or not. The point is this $35 billion program will not just construct ships: it’s emerging as a critical factor that will shape the future of industry in this country.
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Something will have to give in financial advice

By John Collett
15 May 2018 — 3:44pm
Revelations from the banking royal commission concerning financial advice will see changes in the way that advice is delivered.
The vertical integration business models of the banks, the "wealth" managers like AMP and some of the independently owned financial planning businesses, will likely be the focus of the royal commission's recommendations concerning financial advice.
This is where the financial institution makes the financial products and also employs the advisers, or is aligned to the advisers who distribute the products.
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'We have a lot more work to do': Facebook has disabled 583m fake accounts in 2018

Updated16 May 2018 — 6:50amfirst published at 5:36am
Facebook revealed Tuesday that it removed more than half a billion fake accounts and millions of pieces of violent or obscene content during the first three months of 2018, pledging more transparency while shielding its chief executive from new public questioning about the company's business practices.
The findings, its first public look at internal moderation figures, illustrate the gargantuan task Facebook faces in cleaning up the world's largest social network, where artificial-intelligence systems and thousands of human moderators are fighting back a wave of offensive content and abuse.
"My top priorities this year are keeping people safe and developing new ways for our community to participate in governance and holding us accountable," wrote Facebook CEO Mark Zuckerberg in a post, adding: "We have a lot more work to do."
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Wages growth in first quarter smaller than forecast

  • James Glynn
  • Dow Jones
  • 11:33AM May 16, 2018
Australian wages rose by a seasonally adjusted 0.5 per cent in the first quarter from the final three months of 2017, and rose by 2.1 per cent from a year earlier, according to the Australian Bureau of Statistics.
Wages growth remains largely flat despite strong job additions across the economy in 2017.
Spare capacity in the job market remains elevated, with strong increases in participation preventing a fall in the unemployment rate over recent months.
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  • Updated May 16 2018 at 8:09 AM

David Graeber's new book 'Bullshit Jobs: A Theory' calls time on your career

by Miranda Purves
If you voted for Bernie Sanders, have sea-punk green hair, and wear a pin declaring "Capitalism Is the Crisis", you may already be familiar with David Graeber's writings on the takeover of our lives by bullshit jobs.
Graeber, an anthropology professor at the London School of Economics, was a mover and shaker in the Occupy Wall Street movement and is well known for his approachable critiques of neoliberal free market ideology. His new book, Bullshit Jobs: A Theory (Simon & Schuster; $US27), sprang from a shorter essay he published in 2013 in a feminist-activist magazine called Strike, which quickly struck a nerve. (One that kept thrumming: on a Monday morning in 2015, an anonymous group plastered the London Underground with quotations from the writings.)
"Huge swathes of people spend their days performing jobs they secretly believe do not really need to be performed," Graeber writes. The rise of automation has meant that fewer humans are needed in manufacturing and farming, but instead of this freeing up our time, we've seen those jobs replaced by "the ballooning of the administrative sector up to and including the creation of whole new industries like financial services or telemarketing, or the unprecedented expansion of sectors like corporate law, academic and health administration, human resources and public relations."
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  • Updated May 16 2018 at 11:00 PM

Labor's franking policy ignores behavioural response

Labor's franking credit policy will raise $550 million a year less than what Bill Shorten anticipates because of changes in investor behaviour, claims an alliance of shareholders, seniors and self-managed retirees.
The grand alliance, which includes the Australian Shareholders' Association, National Seniors Australia and SMSF Association, cites new Rice Warner analysis that suggests revenue gains will be weaker than the $10.7 billion that Labor expects in the first two years.
"There is going to be a strong behavioural response so I have concerns the tax revenue projections the ALP has done may not stand up," said alliance spokeswoman Deborah Ralston, who is chair of the SMSF Association, a non-executive director with Mortgage Choice and a professorial fellow at Monash University.
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ASIC vows to use 'every inch' of its powers to ramp up bank scrutiny

By Clancy Yeates
17 May 2018 — 10:33am
The corporate watchdog will ramp up its surveillance of the wealth management arms of Australia’s major banks and AMP as it slammed the industry for failing to act in customers' interests and manage conflicts of interest.
After shock revelations at the royal commission in recent weeks, Australian Securities and Investments Commission chair James Shipton said the inquiry had highlighted “unacceptably poor” behaviour.
In a strongly-worded speech in Sydney, Mr Shipton said the finance sector’s failure to deal with conflicts of interest was “verging on a systemic issue,” and this lay at the heart of many of the finance sector’s problems.
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Here's my big dangerous tax idea: let us keep our money

By Peter Martin
16 May 2018 — 9:32pm
Suddenly we’ve wised up. As far back as any of us can remember, all the way back to the beginning of income tax, we’ve been easy to bribe.
Here’s how it has worked in every election and in almost every budget: “You’ve been working hard and paying too much tax. We feel your pain. We’ve magically found some money from somewhere. We’re pulling a tax cut out of a hat. You can thank us later.”
That the rabbit was our own money, taken from us in ever-increasing amounts through an automatic process known as bracket creep, and then only partly returned, was the trick we weren’t invited to dwell on.
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'Dangerous times, Neil': Turnbull's two-word explanation for impingement on our liberty

By Jacqueline Maley
18 May 2018 — 11:00am
It’s safe to assume Malcolm Turnbull has never been on the wrong side of an encounter with police.
If a radio interview he gave on Tuesday is any indication, our Prime Minister has a delightfully rosy understanding of police operations, in which coppers extend to persons of interest the same sort of courtly regard you might find among patrons of a gentleman’s club.
On Tuesday, Turnbull and his Home Affairs Minister Peter Dutton announced new powers allowing police to stop people at airports and demand identification.
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Ciobo makes 'symbolic' China address as businesses face difficulties

By Kirsty Needham
18 May 2018 — 4:50am
Shanghai: Trade Minister Steven Ciobo delivered a conciliatory speech overnight on the relationship between Australia and China, but businesses working China are complaining that the strains were evident.
Ciobo's address to 500 business people came as tension in the bilateral relationship was blamed for causing a slow-down in customs clearances for Australian products.
"When there is tension in the relationship, there is tension at the port," said an Australian business executive in Shanghai with several decades experience in China.
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  • May 18 2018 at 4:00 PM

RBA taps into inflation fears in the US by going back to the 1960s

In the mid-1960s the Beatles were top of the pop charts, US President Lyndon Johnson was fighting the Vietnam War and the world's largest economy was heading for inflationary trouble.
Reserve Bank of Australia deputy governor Guy Debelle this week invoked the aforementioned era to signal some striking economic similarities to today that pose risks.
Over the six years to 1964, US inflation had been dormant.
Today inflation has been persistently tame since the 2008 global financial crisis, with only tentative signs of a recent firming.
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Morrison's tax cuts aim way above the middle

By ROSS GITTINS
18 May 2018 — 11:04pm
One thing to be said in favour of Scott Morrison’s complex three-step, seven-year tax plan is that his small tax cuts for the deserving middle income-earners are more likely to actually happen than the huge tax cuts for the undeserving high income-earners.
For the latter to eventuate, Malcolm Turnbull will have to be re-elected at least twice before July 2024. By contrast, the smaller cuts will start in six weeks’ time. For once it’s the rich who’re being promised pie in the sky (hopefully) before they die.
This means it’s wrong to simply compare the $530-a-year saving for people on middle incomes with the $7225-a-year saving for all of us struggling to get by on more than $200,000 a year.
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Forget fixing corporate culture: here are four ways to curb misconduct

  • The Australian
  • 12:00AM May 19, 2018

Adam Creighton

If I hear about culture, leadership or trust one more time I think I’m going to tear my hair out. The royal commission into financial misconduct has unleashed a barrage of calls for better, stronger and more resilient leadership and culture at the nation’s major financial institutions.
The new chief of the corporate regulator, James Shipton, gave a speech on Thursday emblematic of this trend, suggesting the “trust deficit” in finance could be improved by “rebuilding culture from deep within”, more “sustained engagement” and “active stewardship of assets by investors”, alongside “more intensive and dedicated supervision”.
“It’s time for Australia’s financial services sector to remember its purpose,” he declared, in words unlikely to ruffle a feather anywhere.
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Simple piece of technology saving lives

By Patrick Walker & Daniel D'Hotman
20 May 2018 — 12:01am
Radiology has always been a highly skilled area of medicine; these doctors spend thousands of hours reading scans to identify health issues that no one else can see. However, they now have a new competitor: artificial intelligence.
Enlitic, run by Australian data scientist Jeremy Howard, has created AI that can diagnose lung cancer more accurately than board-certified radiologists. The best of the best are no longer just that.
This is only one example of the way technology is disrupting healthcare. Rapid technological advances in medicine recently led public intellectual Aubrey De Grey to state that the first person to live to 1000 years has already been born.
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Is talk of Australia's 'anti-China' bias a weaponised narrative?

By Chris Zappone
20 May 2018 — 12:15am
Since the Turnbull government flagged plans to implement new national security laws last year, talk of Australia’s "hostility" to China and Chinese people has risen.
Just last month, China’s ambassador Cheng Jingye warned that trade with China could be affected and cited worries that Chinese students in Australia had been subjected to “irresponsible and malicious allegations” and “security and safety incidents”.
Julie Bishop hits back at former Australian ambassador to China, Geoff Raby, who claimed that relations with Beijing can only improve with the foreign minister's sacking.
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National Budget Issues.

Budget tax cuts the worst piece of tax policy design in recent history

By Jessica Irvine
14 May 2018 — 12:01am
Let’s not beat around the bush. The package of income tax cuts announced in last week’s budget is the worst piece of tax design in recent history. It’s not tax reform. Far from it.
In the early years, it’s a retrograde piece of policy design that adds to the complexity of the system and produces new disincentives to work, particularly for part-time working women (Happy Mother's Day, by the way).
In the out years, it is the most seriously regressive assault on Australia’s highly targeted tax and transfer system in many a decade – a fundamental reshape of our social contract, sprung out of nowhere on an election eve.
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Morrison’s budget ‘to leave us better off’

  • The Australian
  • 12:00AM May 14, 2018

Simon Benson

Scott Morrison’s third budget has been strongly backed by voters, according to the latest Newspoll, which found more people ­believed it would leave them ­financially better off rather than worse off.
This is the first time since Peter Costello’s final budget, delivered in 2007, that more people than not believed their own circumstances would be improved.
However, the Turnbull government has ground to make up with its own voter base, with ­retirees and pensioners declaring that they stand to be worse off, with little in the budget for them.
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Compare Labor and Liberal personal tax plans

By Caitlin Fitzsimmons
12 May 2018 — 4:22pm
The political battle lines have been drawn over tax.
You've no doubt heard the federal budget handed down on Tuesday includes personal tax cuts. You may also have heard Labor is backing some of it but has its own plans as well.
So how do the two tax policies stack up side by side?
The Coalition has dropped plans to fund the National Disability Insurance Scheme through a permanent increase in Medicare levy and unveiled an ambitious schedule of tax cuts to take place in three stages over seven years.
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Labor’s plan to restore ‘lost’ hospital funding

  • The Australian
  • 11:09AM May 15, 2018

Sean Parnell

Bill Shorten’s $2.8bn public hospitals pledge does not commit a future Labor government to alter the underlying funding formula that sparked the Opposition’s ongoing attacks on the Coalition.
Instead, the extra money — which Labor calculates is the difference between the Commonwealth funding 50 per cent of growth, as it once promised, or 45 per cent as occurs now — will be set aside. It is still unclear where that money will be spent.
As Mr Shorten visited the Logan hospital in Queensland yesterday, Opposition health spokeswoman Catherine King would only say Labor remained committed to activity-based funding, not that it would alter the Commonwealth’s contribution to growth.
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Budget tax cuts not enough to boost consumer sentiment

Shane Wright, Economics Editor The West Australian
Wednesday, 16 May 2018 11:17AM
Consumer confidence fell in the wake of Scott Morrison’s third Budget, with a majority of Australians expecting it to do nothing or even hurt their own finances.
The Westpac-Melbourne Institute measure of consumer sentiment edged down by 0.6 per cent in May. It was its second consecutive drop in the measure.
Respondents were asked about the expected impact of the Budget on family finances.
Just 10 per cent said they expected their own finances to improved, 58 per cent said it would have no impact while 19 per cent said it would worsen their overall finances.
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Chris Bowen ‘pleads guilty’ to paying for policies following Scott Morrison’s retirees claim

  • The Australian
  • 9:23AM May 16, 2018

Rachel Baxendale

Labor treasury spokesman Chris Bowen says he “pleads guilty” to paying for his policies, after Treasury and Parliamentary Budget Office estimates suggested about a third of his party’s proposed new tax revenue will come from scrapping dividend imputation credit refunds.
As The Australian revealed today, the scrapping of franking credit refunds form the biggest revenue raiser in Labor’s $30 billion short-term tax measures, prompting Treasurer Scott Morrison to accuse the opposition of using older Australians to fund a spending splurge.
Mr Bowen, who will today outline Labor’s plan to match the government’s early return to surplus and tackle national debt in an address to the National Press Club, said Mr Morrison’s claims showed he was now accepting Labor’s figures on the dividend imputation policy.
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Moody's just cast doubt over the Australian government's plan to deliver an earlier budget surplus

May 16, 2018, 3:37 PM
  • Australia’s federal government expects to deliver a budget surplus in the 2019/20 fiscal year, 12 months earlier than previously forecast.
  • Moody’s Investors Service says an earlier return to surplus is unlikely, citing concerns about the government’s expenditure and revenue projections.
  • It still believes the budget underscores Australia’s fiscal strength, noting this is a key support for retaining Australia’s Aaa sovereign credit rating with a stable ratings outlook.
Treasurer Scott Morrison delivered Australia’s federal budget last week, including news the government now expects to deliver a budget surplus in the 2019/20 fiscal year, 12 months earlier that projected 12 months ago.
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$3 billion in lost super to be reunited in NSW and Victoria

By Eryk Bagshaw
19 May 2018 — 12:01am

In numbers

·         People impacted by fee and administration cost ban in NSW 1.64 million
·         People impacted by fee and administration cost ban in Victoria 1.25 million
·         Reduction in insurance premiums Australia-wide $3 billion
·         Number of people to have super accounts reunited in NSW and Victoria 1.5 million
·         Amount to be reunited Australia-wide $6 billion$6 billion
More than 1.5 million workers in NSW and Victoria will have multiple superannuation accounts combined into one as part of a major revamp of the sector that will force Labor to decide if it will support powerful union-backed industry funds.
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Health Budget Issues.

Pneumococcal vaccination: acts of omission

Authored by Robert Menzies, Heather Gidding, Anthony Newall
ACTOR Bob Hoskins died from pneumonia aged 71 years in 2014, as did ABC Radio National presenter Alan Saunders (57) in 2012, actor/singer Brittany Murphy (32) in 2009, the “godfather of soul” James Brown (73) in 2006, cricket legend Sir Donald Bradman (92) in 2001, American cosmologist Carl Sagan (62) in 1996 and actor Fred Astaire (88) in 1987. While some of these identities had other concurrent illnesses, others did not. Some were elderly, some were not.
Far from “the old man’s friend”, pneumonia ends lives prematurely, even in wealthy countries in the 21st century with access to the best health care. The most common cause of pneumonia – Streptococcus pneumoniae or pneumococcus – is estimated to cause around 20% of pneumonia in Australia and more than 15 000 GP visits, 8000 hospitalisations and 2000 deaths in Australians aged 65 years and over each year
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ACCC renews pursuit of Medibank over out-of-pocket charges

  • The Australian
  • 12:00AM May 16, 2018

Sean Parnell

The consumer watchdog will today launch a renewed bid to prosecute health fund Medibank over changes to its coverage of in-hospital pathology and radiology services, amid an ongoing debate over the value of insurance.
The Australian Competition & Consumer Commission has ­accused Medibank of making false, misleading or deceptive representations and engaging in unconscionable conduct by failing to adequately inform members of changes.
But Federal Court judge David O’Callaghan last year concluded there had been no sufficient requirement for, or commitment by, Medibank to notify members beforehand.
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High costs, big gaps driving Australians away from health insurance

By Esther Han
16 May 2018 — 1:46pm

In numbers

·         Australians who decided not to renew their private health insurance 256,000
·         Those with no insurance who said it was too expensive 53%
·         Cumulative premium price hike since 2008 70%
A quarter of a million Australians did not renew their private health insurance in the past year, a new survey shows.
An ongoing Roy Morgan survey involving 50,000 face-to-face interviews every year found 256,000 Australians who had health insurance at some point in their lives chose not to renew it in the year to March 2018.
This won't hurt a bit: More than 250,000 Australians didn’t renew private health insurance over the past year.
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Private health insurance figures look sickly

  • The Australian
  • 12:00AM May 18, 2018

Sean Parnell

Private hospital insurance coverage has fallen to its lowest level since June 2011, with not even a seasonal increase in health fund members enough to stop the ongoing decline.
According to the Australian Prudential Regulation Authority, 45.5 per cent of the population had hospital cover in the March quarter, down from a high of 47.4 per cent three years ago, with value-for-money issues still a major concern.
While a net increase of 10,481 members kept the decline to 0.1 per cent, it was half the quarterly surge experienced in previous years.
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Autism to face cutbacks in NDIS as secret plan revealed

  • The Australian
  • 12:00AM May 19, 2018

Rick Morton

A secret plan to restrict the access of autistic people to the $22 billion National Disability Insurance Scheme would prevent them from qualifying “automatically” for taxpayer-funded support as part of a sweeping overhaul to rein in costs.
The Weekend Australian has confirmed bureaucrats have been working on a strategy since late last year to pare back the number of people with autism receiving funding packages.
The agency running the NDIS accidentally published part of its plan to restrict access for autism cases on Monday when it updated a list of pre-qualifying conditions for the scheme. It later suggested it had “incorrectly” posted the wrong document.
A mid-ranking National Disability Insurance Agency staff member, without the knowledge of the deputy chief executive ­responsible, altered a list of conditions for autism spectrum disorders, which was not meant to be made public.
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International Issues.

Trump set toughest test yet for Europe

By Andrew Hammond
13 May 2018 — 3:06pm
London: Federica Mogherini, the European Union’s foreign policy chief, says Europe is “determined to keep the Iran deal in place”, in complete contrast with US President Donald Trump's determination to scrap it.
Germany is ready to help its firms continue doing business in Iran, its economy minister said on Friday, as the US envoy to Berlin called into question the morality of such transactions.
The clash between the United States and the EU is exacerbating  transatlantic tensions that may  be difficult to manage, not least with separate bilateral battles over trade issues in play too.
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Donald Trump's freewheeling deals are starting to hurt the economy, say analysts

By Tim Wallace
Updated14 May 2018 — 10:10am first published at 10:00am
Donald Trump's freewheeling policies are beginning to damage the American economy as exuberance over tax cuts turns to fear on trade and oil prices, it is claimed.
Crude costs are approaching $US80 per barrel, their highest level since 2014, and analysts fear the US withdrawal from the Iran nuclear deal will make the situation worse. "If a new Iran deal is not reached in the next six months or Opec/Russia extend production cuts into 2019, global oil markets would likely tighten further," said Francisco Blanch at Bank of America Merrill Lynch.
Oxford Economics has raised its forecast for oil prices to an average of $US72 for 2018, which it fears could have serious repercussions for the economy.
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Indonesian church attack family had returned from Syria: police

By Amilia Rosa
14 May 2018 — 11:47am
Jakarta: The family suspected of the trio of church suicide bombings in Indonesia had recently returned from Syria before the attack, Indonesian authorities said.
Motorbikes in a parking lot went up in flames after suicide bombers attacked churches in Indonesia's second-largest city of Surabaya, killing at least six and wounding more than 35 others.
Indonesia's police chief, Tito Karnavian, said the family of six suspected in the attacks on three Christian churches in Indonesia's Surabaya city on Sunday morning had recently returned from the war-torn Middle Eastern nation.
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  • Updated May 14 2018 at 5:30 AM

US secret report: China 'debt trap' on Australia's doorstep

Chinese loans worth hundreds of billions of dollars are saddling Australia's smaller regional neighbours with unsustainable debts and giving Beijing crucial economic leverage to gain strategic and military power, warns a new independent report written for the US State Department.
The US report identifies 16 states vulnerable to China's so-called "debtbook diplomacy" and economic coercion, including Vanuatu, the Philippines, Cambodia, Laos, Thailand, Malaysia, Sri Lanka, Tonga and Micronesia.
The paper, obtained by The Australian Financial Review, says Papua New Guinea has "historically been in Australia's orbit" but there is alarm that PNG has been "rapidly taking on Chinese loans it can't afford to pay and offers a strategic location in addition to significant LNG and resource deposits".
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  • Updated May 14 2018 at 11:00 PM

China relations can only be unfrozen with Julie Bishop's sacking

Once again Australian foreign policy seems to be missing in action. As events unfold at remarkable speed in our area of most strategic interest – north-east Asia – Australia finds itself unable to engage with the key participant at the centre of those events: namely China.
Since Australia decided to adopt a policy of strategic mistrust towards China, any semblance of influence has waned to the point where relations are now in the freezer.
In terms of Australia's geopolitical interests, the freeze on our relationship with China could not have come at a worse time. It was once widely understood in Canberra, but apparently no longer, that we need to have good and close relations with China not just for trade and commercial reasons but because China is critical to all the major international issues of interest to Australia and none more so than peace and stability in north-east Asia.
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Hillary Clinton's warning to Australia on Chinese influence

By Jenny Noyes
14 May 2018 — 9:03pm
Hillary Clinton has issued a warning to Australia not to be complacent about foreign interference, especially from China.
Appearing on ABC's 7.30 on Monday night, the former US presidential candidate spoke about the issue of Russian interference in the election she lost to Donald Trump in 2016.
Ms Clinton was pressed by host Leigh Sales on what she would do differently, and what advice she would give to the next Democratic presidential candidate. Her answer: "I would not let anything go unanswered" – meaning, in particular, the proliferation of fake news propaganda being spread via Facebook and "paid for in roubles".
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Fully loaded pigeons have come home to roost

  • Clive Williams
  • The Australian
  • 12:00AM May 15, 2018
Three church bombings in Surabaya during Sunday services, killing at least 18 people and wounding more than 40, and the bombing of a police station in the same city yesterday killing 10 are merely the latest manifestations of an increase in terrorist ­activity in Indonesia.
Attacks on two other churches were planned for Sunday, but those bombs failed to detonate. The church attacks apparently were carried out by members of one family. Yesterday’s attack involved members of another family.
Churches are targeted by Indonesian extremists who oppose the practising of other religions there. But this is the first attack on places of worship since 2011. The worst attack on churches in the past 20 years was on Christmas Eve 2000, when co-ordinated bombings of churches in Jakarta, Pekanbaru, Medan, Bandung, Batam Island, Mojokerto, Mataram and Sukabumi killed many worshippers.
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  • Updated May 15 2018 at 8:09 AM

Italy's new coalition government sets up a 'eurozone accident waiting to happen'

by Ambrose Evans-Pritchard
If followers of Italy's neo-anarchist Five Star Movement, popularly known as Grillini, had combined with anti-euro Lega nationalists two or three years ago to form an insurgent government, it would have set off panic in the bond markets.
At the weekend, Luigi di Maio, head of the Five Star Movement that garnered more than 30 per cent of the vote in Italy's March election, and Matteo Salvini, head of the Lega, or League, said they were working to form a coalition government. 
Bow that this twin-headed populist hydra is upon investors, risk spreads have barely moved. Yields on two-year Italian bonds ended last week at minus 0.10 per cent.
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Unintended consequences: How Trump is threatening the US dollar

By Stephen Bartholomeusz
15 May 2018 — 2:38pm
The erratic nature of policy-making in the Trump era may produce unintended consequences.
Trump’s fixation with America’s trade deficit and the nature of the sanctions imposed on Russia and Iran could, for instance, aid China’s long-term ambition to erode the status of the US dollar as the world’s reserve currency.
Today, the US dollar is used on one side of nearly 90 per cent of all global foreign exchange transactions and the world’s central banks hold about 63 per cent of their reserves in US dollars. About 40 per cent of global trade is denominated in US dollars. US trade deficits are an outcome of the world’s demand for US dollars – the need to acquire US dollars because it is the primary global medium of exchange.
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  • Updated May 16 2018 at 11:45 PM

Democracies no longer have a strategy

by William Hague
To be Britain's foreign secretary is to live in a whirl of rushed meetings, urgent calls, fast-moving cavalcades and waiting aircraft. You become adept at trying to hold a calm phone conversation with one foreign counterpart while another one sits next to you in a car lurching around with sirens blaring and yet another presidential palace recedes in the mirror.
Eventually, you crave discussing what matters most with people you really trust, and with no agenda or deadline. So it was a relief to me when sometimes the foreign ministers of Australia or Canada would say "Let's have a bottle of wine and discuss the strategy of the Western world", which we would proceed to do. In my time in office, which was pre-Trump, this was a discussion I could also have with the US secretary of state. I recall Hillary Clinton, another one who sometimes proposed the quiet chat and glass of wine, vehemently advocating a strong lead from America to defend Western values with a unifying approach - all with more passion and animation than the voters ever got to see in her.
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Anwar walks free from prison and into political limelight

By James Massola
16 May 2018 — 1:46pm
Kuala Lumpur: Anwar Ibrahim, the man who has been a symbol of hope for Malaysian anti-corruption and democracy campaigners for 20 years, walked free from custody on Wednesday and vowed to support newly elected Prime Minister Mahathir Mohamad and his own wife, Deputy Prime Minister Wan Azizah.
Anwar, 70, left a Kuala Lumpur hospital at 11.30am local time, after receiving a long-awaited royal pardon just an hour earlier.
The former Malaysian opposition leader had been imprisoned on politically-motivated sodomy charges.
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  • Updated May 18 2018 at 7:58 AM

Gina Haspel confirmed by US Senate as first woman CIA director

The US Senate confirmed Gina Haspel to be director of the CIA, ending a bruising confirmation fight centred on her ties to the spy agency's past use of waterboarding and other brutal interrogation techniques.
Haspel, who will be the first woman to lead the CIA, is a 33-year veteran at the agency currently serving as its acting director. The tally was 54-45 in favour of her nomination in the 100-member chamber, where a simple majority was required for confirmation.
Six Democrats joined President Donald Trump's fellow Republicans in voting for Haspel, and two Republicans voted no.
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Truth and post-truth appear to be on brink of collision in Trump saga

By Nick O'Malley
17 May 2018 — 1:53pm
Truth and post-truth appear to be at the brink of collision.
New details about Alexander Downer’s accidental role in launching the Mueller investigation into possible collusion between the Trump campaign and Vladimir Putin have emerged at a critical time for the ongoing inquiries into the 2016 election and its aftermath.
US President Donald Trump's attorney, Rudy Giuliani, says Special Counsel Robert Mueller's probe into the 2016 election needs to end.
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Trump personally pushed postmaster general to double rates on Amazon

By Damian Paletta & Josh Dawsey
19 May 2018 — 9:14am
President Donald Trump has personally pushed US Postmaster General Megan Brennan to double the rate the Postal Service charges Amazon.com and other firms to ship packages, according to three people familiar with their conversations, a dramatic move that probably would cost these companies billions of dollars.
Brennan has so far resisted Trump's demand, explaining in multiple conversations occurring this year and last that these arrangements are bound by contracts and must be reviewed by a regulatory commission, the three people said. She has told the president that the Amazon relationship is beneficial for the Postal Service and gave him a group of slides that showed the variety of companies, in addition to Amazon, that also partner for deliveries.
Despite these presentations, Trump has continued to level criticism at Amazon. And last month, his critiques culminated in the signing of an executive order mandating a government review of the financially strapped Postal Service that could lead to major changes in the way it charges Amazon and others for package delivery.
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I look forward to comments on all this!
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David.