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, August 02, 2018

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

August 2, 2018 Edition.
It has been a big week in Trump land with the EU visiting and ongoing plans regarding just where Trump and Putting will have a natter next. Amazingly the Administration has now found $12B to compensate the farmers who have lost sales due to the Trade War Trump started – what goes around does indeed come around! And now 25% tariffs on $200B of Chinese Exports - Where will it end?
In the UK the Brexit mess seems to be just getting messier and where it will end no one really knows.
In OZ we have has our Super Saturday bye-elections and it seems Malcolm is the big looser. Under lots of pressure with the NEG, Tax Cuts and Opt-Out!
Soonish (next week) the FSRC kicks off again doing over the Super Industry – which will be agonising I suspect – as the last sessions have been.
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Here are a few other things I have noticed.
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Major Issues.

Future prosperity depends on addressing inequality

By Jessica Irvine
23 July 2018 — 12:02am
How time flies. In less than two months, it will be time to commemorate the 10th anniversary of the collapse of US investment bank Lehman Brothers. A decade since that shocking event, which brought the reality of the global financial crisis home to most Australians, policymakers continue to grapple with popular discontent that the Western liberal economic system does not work in the interests of most citizens.
In recent weeks, some of Australia’s most senior policymakers have highlighted the importance for future prosperity of focusing on trends in inequality - that is, whether or not the fruits of our economic progress are being shared fairly.
In a speech to the Australia-UK leadership forum, our most senior mandarin, Martin Parkinson, located the source of popular discontent as "the failure of some Western democracies to acknowledge and plan for the impact of an increasingly globalised economic system and rapid technological change on various groups and regions”.
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Budget office fills gap left by politicised Treasury

By Ross Gittins
23 July 2018 — 12:15am
I see the federal Auditor-General has been less than complimentary about the Turnbull government’s cashless welfare card. The cheek! I say the man should be removed and replaced by a Liberal Party staffer forthwith.
Always provided the staffer has done at least a year or two of accounting at uni, of course. Wouldn’t do for voters to gain the impression his chief qualifications were his years of loyal service as a ministerial flunky.
If this ironic scenario seems over the top, it’s not way over. If the present Auditor-General actually had incurred the government’s serious displeasure, it would be more likely to wait until his statutory term had expired before replacing him with someone less likely to provide it – and us – with critical advice.
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Stronger ties to India can reduce unhealthy dependency on China

By Peter Hartcher
24 July 2018 — 12:05am
With Julie Bishop and Marise Payne sitting down for two days of talks with their US counterparts, you can be certain that they're spending much of the time discussing a big, shared problem.
Yes, they've already announced that they'll be conferring on the hardy perennials – North Korea, terrorism and the Middle East – in their talks on Tuesday and Wednesday.
But the big, shared problem that is not actually named in the official announcement of the annual AUSMIN talks is China. The fact that Bishop and Payne couldn't bring themselves to name it is an indicator of just how sensitive it is for Australia.
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We need to talk about Amazon, but Trump keeps hijacking the conversation

By Joe Nocera
24 July 2018 — 7:04am
Imagine you're Lina Khan.
In January 2017, you wrote an influential article for the Yale Law Journal titled "Amazon's Antitrust Paradox," in which you argued that the current framework in antitrust "is unequipped to capture the architecture of market power in the modern economy."
You wrote: "We cannot cogniae the potential harms to competition posed by Amazon's dominance if we measure competition primarily through price and output" - which is precisely how market power is now measured. You concluded your article with a series of ways antitrust should be rethought to curb the dominance of Amazon.com and other "platform companies" like Alphabet's Google and Facebook.
"Amazon's Antitrust Paradox" could not have been better timed. Google was facing antitrust challenges in Europe. Facebook would soon be embroiled in the Russian election scandal. Amazon was preparing to jump into the grocery business, the pharmacy business, and who knows what else. Its dominance was scaring more than just internet companies. People were talking about whether the major platform companies needed to be regulated or maybe even broken up.
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Trade wars: Australia could get badly hurt if giants collide

By Stephen Bartholomeusz
23 July 2018 — 1:34pm
Over the past six weeks, both the Australian dollar and China’s renminbi have been depreciating significantly against the US dollar. It’s no coincidence.
The shifts in currency do, however, coincide with the escalation in the rhetoric, and actions, of the Trump administration on trade, with last week’s outburst from Donald Trump adding a fresh note of uncertainty and a new bout of volatility to the currency markets.
On Friday, Trump said China and the European Union were manipulating their currencies and interest rates lower, and repeated a threat to slap tariffs on all $US505 billion ($680 billion) of Chinese imports into the US.
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  • Jul 24 2018 at 11:45 AM

This trade war could end in a Trump slump by 2020

by Nouriel Roubini
How does the current global economic outlook compare to that of a year ago? In 2017, the world economy was undergoing a synchronised expansion, with growth accelerating in both advanced economies and emerging markets.
Moreover, despite stronger growth, inflation was tame – if not falling – even in economies like the United States, where goods and labor markets were tightening.
Stronger growth with inflation still below target allowed unconventional monetary policies either to remain in full force, as in the eurozone and Japan, or to be rolled back very gradually, as in the US.
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  • Updated Jul 25 2018 at 12:30 AM

Magellan's Hamish Douglass lifts cash weighting to 18pc as uncertainty mounts

Magellan boss and Rich Lister Hamish Douglass is preparing for the possibility that the US 10-year Treasury yield breaks through 4 per cent in 12 to 18 months' time, sparking a 30 per cent sell-off in global equities, should the US Federal Reserve find itself surprised by resurgent inflation.
While that sounds dramatic, it's just as likely in the fund manager's view that the Fed keeps tightening methodically and bond yields rise to 4 per cent, but in an orderly fashion and without an inflationary scare.
Even so, Mr Douglass believes there is a strong case for being more tactical. He has increased his cash weighting in the Magellan Global Fund to 18 per cent, the highest since 2009.
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  • Updated Jul 24 2018 at 11:08 PM

Just what the doctor ordered: Super Saturday boils down to economy versus health

by Andrew Tillett
Prime Minister Malcolm Turnbull has tackled Labor's campaign on health front on,  frequently accusing the opposition of lying over cuts to hospitals and Medicare.
Mr Turnbull's determination to avoid a repeat of the damage Labor's "Mediscare" campaign caused at the 2016 election sees him regularly armed with budget figures on just how much federal taxpayers' money is going into local health services when he does a radio interview or press conference.
A large feature of the government's political messaging in the campaign for Braddon and Longman has been on the improving economy under the Coalition, while Labor represents a threat to that with its higher taxes. In an interview with the local ABC radio station on Tuesday, Mr Turnbull talked up the creation of 2100 jobs in Tasmania last month.
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Electricity plan would all but hit emissions goal before it starts

By Peter Hannam
24 July 2018 — 6:56pm
The Turnbull government’s National Energy Guarantee - the centrepiece of its climate change and electricity policy - would help cut an average household’s power bills by $50 in its first year but do little to cut carbon emissions over the decade to 2030.
The final design report, produced by the Energy Security Board and sent to state governments this week, projects an emissions target that would be 97 per cent fulfilled before the NEG policy starts in 2021, leaving it with little work to do.
The study found that power prices will drop sharply, with or without the NEG policy in place, before starting to rise again towards 2030.
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The simplest of ideas can sting your enemy

  • Jason Thomas
  • The Australian
  • 12:00AM July 25, 2018
There is an urban myth that the US spent millions inventing a pen that could write in space while the Russians used a pencil.
In war and most other contests for survival, it is often the simplest tools or actions that pierce the defences of an opponent, as is demonstrated by Hamas protesters in Gaza who, since March, have been sending kites with flaming payloads into Israeli farms, burning more than 900ha.
While unlikely to inflict a devastating blow, the kites are an example of asymmetric warfare, frustrating the Israeli Defence Forces, one of the best trained and equipped in the world. The imagination of the kite builders is also a lesson for Australia with its acquisition of frigates, submarines and F-35 joint strike fighters; simple isn’t stupid. We need to ask ourselves, what are the simplest ways our opponents can ruin our day, because it may not be with a nuclear weapon or a battleship.
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Good reasons to sign up to the National Energy Guarantee

  • The Australian
  • 9:04AM July 25, 2018

Peter Van Onselen

Forget the GetUp! Campaign to thwart the negotiations, there are good reasons for the states and territories to sign up to the National Energy Guarantee.
Yes, the aims of the various parties are somewhat different. Energy minister Josh Frydenberg wants a deal to move on from the internal wars within his own party. For too long rational positioning on energy and emissions policies inside the Liberal Party have been held captive to anti-climate change activism by reactionaries who either see (false) political advantage in rejecting pricing carbon or a zealots when it comes to questioning the science. They have added zealotry for new coal fired power stations — despite the business cases against such engineering — to their grab bag of unrealistic policies.
States and territories, certainly Labor governments in Victoria and the ACT, are largely interested in emissions reductions, and they rightly worry that the NEG offers nothing on that score. But what it does provide is the framework for a future federal government to ramp up emissions targets. Which presumably is what federal Labor will do if it wins the next election.
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Nationals must accept and adapt to climate change

By Robert Lee
26 July 2018 — 12:17am
As the Minister for the Environment and Energy, Josh Frydenburg, attempts to get his National Energy Guarantee accepted, it astonishes me that resistance is coming from the party purporting to represent regional Australia.
The Nationals obviously don’t understand the implications of climate change and what it is doing to Australian farmers right now.
I am grappling with the third 1-in-100-year drought that has struck my farm in central-west NSW in the past 16 years. In 2009, the river we rely on dried up for the first time in recorded history. It flooded the very next year to the highest level recorded by white fellas.
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Government risks clash with states under plan to cement emission targets in law

By David Crowe & Peter Hannam
26 July 2018 — 12:00am
The Turnbull government is holding out against a new call for concessions on its controversial energy guarantee in a stance that risks another clash with states and territories on the scale of Australia’s cuts to greenhouse gas emissions.
The federal government is heading off attempts to inject more flexibility into the flagship National Energy Guarantee to adjust a 26 per cent cut to carbon emissions by 2030, insisting the target will be cemented in federal law.
The federal stance will set up a crucial hurdle to any changes to the target despite Canberra's offer of an “olive branch” to the states and territories on Wednesday to allow a review of the target in 2024, five years earlier than expected.
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Dick Smith Foods to close as Aldi kills competitiveness

  • The Australian
  • 11:00AM July 26, 2018

Nick Tabakoff

Entrepreneur Dick Smith has today shocked the retail industry by announcing he will close his eponymous Dick Smith Foods business, claiming that the rise and rise of German discount supermarket chain Aldi in Australia has “basically destroyed us”.
In an interview with The Australian, Mr Smith said he had no choice but to close the Australian-sourced products business which he started nearly two decades ago, which has donated all of its $10 million-plus in profits to charity.
“We’re now at a point where the only way we can get sales is make a loss,” Mr Smith said in the interview. “Right now, we’re making a profit which we give away. But I can say within two years, we’ll go broke.
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$168 billion lost in a day: Facebook's plunge could rewrite history

By Adam Haigh & Vibhuti Sharma
27 July 2018 — 6:48am
Facebook has racked up plenty of milestones in its pioneering journey. Now the social-media giant has added another one that it would have rather avoided: the biggest stock-market wipeout in American history.
The social media giant's shares tumbled as much as 20 per cent on Wall Street on Thursday as sales and user growth disappointed investors. This translates to a $US124 billion ($168 billion) decline in market capitalisation, which is the largest ever loss of value in one day for a US traded company - and nearly four times the entire market capitalisation of Twitter.
Shares of Facebook tumbled 25 per cent as the fallout from a massive data breach led to a surprise warning and erased roughly $203 billion from the social network's market value.
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Leaked documents show reef charity directors 'unavailable' for Senate scrutiny

By Nicole Hasham
27 July 2018 — 12:00am
Three directors of a Great Barrier Reef charity entrusted with almost half a billion dollars in public money have refused to give evidence to a Senate inquiry scrutinising the controversial deal, raising the prospect they will be forced to appear.
Confidential Senate committee documents seen by Fairfax Media show that despite being offered five dates at which to attend the inquiry, the directors of the Great Barrier Reef Foundation say they are unavailable for questioning, variously citing overseas travel commitments, medical appointments, board meetings and other unspecified engagements.
The inquiry was launched following the Turnbull government’s decision to grant the small, business-focused charity $443 million to help rescue the reef.  The foundation has previously said it would “fully co-operate” with the probe.
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With wage growth on the blink, it's time to restore union bargaining power

By Ross Gittins
27 July 2018 — 6:50pm
Can you believe that many economists were disappointed by this week’s news from the Australian Bureau of Statistics that consumer prices rose by only 2.1 per cent over the year to June?
Why would anyone wish inflation was higher than it is? Well, not because there’s anything intrinsically terrific about fast-rising prices, but because of what a slow rate of increase tells us about the state of the economy.
It’s usually a symptom of weak growth in economic activity and, in particular, of weak growth in wages. Prices and wages have a chicken-and-egg relationship. By far the most important factor that pushes up prices is rising wages.
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Labor wins and Coalition reels in Super Saturday byelections

By David Crowe
28 July 2018 — 9:29pm
Labor has secured a major victory over the Turnbull government in a marathon political contest across five byelections, gaining ground in key seats in a show of strength ahead of the next general election.
Labor held its four electorates while the Coalition failed to regain one of its old strongholds, in an outcome that dashed government hopes of turning the tables on its rivals.
Opposition Leader Bill Shorten used the victory to intensify pressure on Prime Minister Malcolm Turnbull by claiming the outcome in two key battlegrounds, Braddon in Tasmania and Longman in Queensland, was a message from voters on issues like Medicare and school funding.
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Financial Royal Commission Issues.

  • Updated Jul 22 2018 at 11:00 PM

Time to debate $1m minimum cap for SMSFs

The $700 billion self-managed super fund (SMSF) sector – which represents almost one third of our super system – is outside the royal commission's terms of reference, but as scrutiny moves to retail and industry funds it will be hard to avoid this opaque and increasingly influential sector.
On July 17, Westpac put self-managed super funds in the news when it announced it was pulling the plug on new lending to SMSFs for property investment, effective at the end of the month. Other banks have already taken the plunge.
Weeks earlier, the Productivity Commission's landmark draft report into super highlighted a well-kept secret about the performance of SMSFs: those with less than $1 million in assets perform "significantly" worse than institutional funds. "It is not clear how many of these will perform better in future as they grow in size," the report warns.
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ALP tax slug on retirees ‘risks SMSF exodus’, warns AFIC

  • The Australian
  • 12:00AM July 24, 2018

Cliona O’Dowd

The nation’s largest and oldest listed investment company, the $7.4 billion Australian Foundation Investment Company, has warned that Labor’s proposal to axe franking credit cash refunds will hit low-income retirees hardest and could trigger an exodus from self-managed super funds as retirees defend against the attack on their savings.
Labor’s policy, which would ban cash tax refunds for excess franking credits, has not been well thought out, AFIC managing director Mark Freeman said.
He warned it would come to a head this year as retirees started to make more noise about the issue.
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Super funds, ASIC under pressure to bring transparency on fees, costs

  • The Australian
  • 12:00AM July 25, 2018

Michael Roddan

The corporate watchdog is under pressure to bring more transparency and rigour to the fees and costs being charged to superannuation members, after a review found consumers were being dudded by the wealth management industry’s poor disclosure of fees.
The Australian Securities & ­Investments Commission released the long-awaited review of the disclosure rules, known as RG97, which was combed over in fine detail by the architect of Hong Kong’s pension regulation system, Darren McShane. ASIC was forced late last year to backflip on the introduction of the controversial new laws after The Australian raised concerns about the exemption of certain costs from the ­regime, which potentially allowed companies to hide high fees for certain investments, such as ­unlisted property.
The report, at more than 200 pages, finds fee disclosure in the superannuation and managed ­investment scheme industry has been haphazard, opaque and open to gaming by funds managers looking to minimise their published fees.
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We need to switch off these superannuation rorts

  • John Daley, Brendan Coates
  • The Australian
  • 12:00AM July 26, 2018
For all the political noise about rising energy bills, Malcolm Turnbull and Bill Shorten would do well to focus more on the obscene superannuation fees paid by Australian savers if they want to save households some real money.
Australians pay more than $30 billion a year in super fees, ­almost 2 per cent of Australia’s annual gross domestic product. That’s much more than the $23bn we spend on energy. A household nearing retirement pays average superannuation fees of $3700 a year, about the average energy bill. Turning the heater on for longer can hit the household budget for the winter months, but super fees that cut into retirement savings have a lifelong effect on retirees’ finances.
So why are we paying so much for the sector to manage our money? The recent Productivity Commission inquiry into the superannuation sector was scathing. It found there were too many unwanted accounts, too many ­underperforming funds and too many funds charging exorbitant fees. One-third of all super fund accounts (about 10 million) are unintended multiple accounts. ­Almost half of Australians aged 40 to 45 have two or more super ­accounts. These erode members’ balances by $2.6bn a year in unnecessary fees.
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  • Jul 27 2018 at 8:21 AM

AMP provides $290m for compensation, downgrades half-year profit

by Alice Uribe
AMP has set aside $290 million to compensate customers who suffered because of poor financial advice, as part of a wider "reset" designed  win back customer trust.
The company told the ASX on Friday that it would also plough $35 million into an upgrade of its risk management and compliance systems over the next two years, and cut fees on its My Super products in the third quarter of  2018
"Today's announcement reflects our commitment to take decisive action to reset AMP and establish a platform from which the business can recover rapidly," said acting chief executive Mike Wilkins.
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'Indefensible': ASIC slams super funds ahead of commission hearings

By Sarah Danckert
26 July 2018 — 11:45am
Australian Securities and Investments Commission chairman James Shipton has warned Australia’s trillion-dollar superannuation sector that it has a trust deficit, is exploiting members and has lost sight of the fact that it's the custodian of other people’s money.
Mr Shipton’s criticism of the superannuation sector comes ahead of the fifth round of hearings for the banking royal commission that will focus on superannuation.
“To be blunt, there has been too much focus in many parts of the superannuation sector on exploiting opportunities to make money from Australians instead of focussing on the responsibilities that come from being the custodians of other people’s money,” Mr Shipton said.
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National Budget Issues.

Treasury analysis warned of dividend imputation costs blowing out

By Eryk Bagshaw
23 July 2018 — 6:16pm

Talking points

  • Under dividend imputation rules, Australians are given franking credits on the dividends they receive for the shares they own in order to avoid company profits being taxed twice.
  • Because the company has already paid tax on its earnings, its dividend payments to shareholders come with credits that reduce the individual’s tax bill every year.
  • Most workers have incomes that are high enough to ensure they still pay tax after the dividend credits are counted.
  • But when the individual has little or no income other than dividends, he or she ends up being owed money by the Australian Tax Office and then receiving it as a cash refund.
Treasury had concerns about the surging cost of dividend imputation before Labor announced a $55 billion plan to clawback tax refunds from 1 million retirees, new government advice marked "protected" has revealed.
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Health Budget Issues.

Federal Health Minister Greg Hunt has ordered his department to stop paying social media influencers

Updated Sat 21/7/2018  at 2:43pm
Federal Health Minister Greg Hunt has ordered his department to stop paying social media influencers.
The Daily Telegraph revealed on Friday the Health Department had spent more than $600,000 in taxpayer funds on the #girlsmakeyourmove social media campaign over the past 18 months.
"At my request, the department is pausing and reviewing any use of influencers," Mr Hunt said in a statement.
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Existing legislation puts Shorten’s health premium cap on notice

  • The Australian
  • 12:00AM July 25, 2018

Sean Parnell

A public interest test written into existing health legislation would compel a Shorten government to prove its proposed 2 per cent cap on premium increases would be worth the risk of insurers slashing benefits and coverage in ­response.
The Department of Health’s initial analysis of Labor’s proposal for a two-year cap on premiums also reveals any minister who denied a proposed increase would be required to give an ­explanation to parliament.
The cap would be roughly half this year’s average weighted increase of 3.95 per cent, which only came about after cost-cutting reforms. The government aims to contain increases to less than 4 per cent in the short-term.
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GPs to cut back aged care visits: survey

4:22pm Jul 25, 2018
A third of doctors are planning to cut back or completely end their visits to patients in aged care homes within two years.
The Australian Medical Association's aged care survey shows one-in-three doctors are planning to reduce visits because the Medicare rebates are inadequate for the amount of time and work involved.
AMA president Tony Bartone says he wants aged care to be an election issue, just months after the federal budget delivered $1.6 billion for the sector.
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Doctors’ new code of conduct acts like the ‘thought police’

  • The Australian
  • 12:00AM July 28, 2018

Joe Kelly

The Medical Board of Australia is drafting a revised code of conduct for doctors that is being ­attacked for “thought policing the medical profession” and ­raising a barrier to free speech.
The code will affect all registered doctors in the country and breaches will result in disciplinary action, including the prospect of deregistration.
Health Minister Greg Hunt is being sent letters of complaint over a key section of the proposed code.
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Fears health premium cap may threaten insurers viability

  • The Australian
  • 12:53PM July 27, 2018

Sean Parnell

The health insurance industry regulator and Department of Health have privately raised concerns that Labor’s proposed cap on premium increases would threaten the financial viability of some insurers.
The Australian this week revealed a departmental analysis for Health Minister Greg Hunt concluded that enforcing a two per cent, two-year cap, and the flow-on ­effects, were likely to require a public interest test and explanation to parliament.
“If a premium change is not approved, it is possible that the organisation will have to restructure their investment strategy, renegotiate funding arrangements with doctors (possibly resulting in a higher out-of-pocket expense for consumers), lower dividend payments to investors, or restructure their products to remove high cost items,” the analysis states.
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International Issues.

  • Updated Jul 22 2018 at 3:13 PM

Treasury Secretary in damage control over Donald Trump's comments on Fed

by Alan Rappeport
US Treasury Secretary Steven Mnuchin sought to clarify remarks by President Donald Trump last week, insisting that the administration would not interfere with the decisions of the Federal Reserve or move to manipulate the value of the dollar.
The comments, made on the sidelines of the Group of 20 gathering in Argentina on Saturday (Sunday AEST), came a day after Mr Trump lashed out at China, the European Union and the Federal Reserve, saying they were all putting the US at an economic disadvantage.
Mr Mnuchin was preparing to address currency concerns with his counterparts at the meeting, which is expected to be tense because of an escalating trade war. But he first sought to defuse any tension between the Fed and the President, who a day earlier had criticised the central bank for raising interest rates.
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  • Updated Jul 22 2018 at 11:45 PM

Henry Kissinger: 'We are in a very, very grave period for the world'

by Edward Luce
It was not hard to entice Henry Kissinger to meet for lunch. Though he is 95, and moves very slowly, the grand consigliere of American diplomacy is keen to talk.
He hops on and off planes to see the likes of Russia's Vladimir Putin and China's Xi Jinping with as much zeal as when he played the global chess game as Richard Nixon's diplomatic maestro. He loves to be in the thick of things.
Persuading him to say what he actually thinks is another matter. Kissinger is to geopolitical clarity what Alan Greenspan was to monetary communication – an oracle whose insight is matched only by his indecipherability. It is my mission to push him out of his comfort zone. I want to know what he really thinks of Donald Trump.
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After Helsiniki, Congress faces a new charge with Trump: complicity

By Nicholas Fandos and Sheryl Gay Stolberg
23 July 2018 — 6:09am
Washington: In the nearly two years since Russia attacked the US democratic process, congressional Republicans have played conflicting roles in the drama: Some have pressed to impose sanctions on Russia and quietly pursue investigations, but they have been outshouted by Republicans who have obfuscated and undercut efforts to uncover the Kremlin's plot.
Now, as they grapple with the political and foreign policy fallout from President Donald Trump's disastrous summit in Helsinki with President Vladimir Putin of Russia, all Republicans, regardless of their stance so far, are facing a charge that goes beyond the White House: complicity.
"We have indulged myths and fabrications, pretended it wasn't so bad, and our indulgence got us the capitulation in Helsinki," Senator Jeff Flake, said in an impassioned speech on Thursday on the Senate floor, just before a fellow Republican shot down a bipartisan resolution to put the chamber on record as backing the intelligence agencies.
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  • Jul 26 2018 at 6:04 AM

EU agrees to buy more US goods to avert trade war

by Toluse Olorunnipa and Margaret Talev
Washington | President Donald Trump and European Commission President Jean-Claude Juncker agreed to suspend new tariffs while negotiating over trade, pulling the US and Europe back from the edge of a transatlantic trade war.
The leaders pledged to expand European imports of US liquefied natural gas and soybeans and both vowed to lower industrial tariffs, excluding autos. The US and European Union will "hold off on other tariffs"' while negotiations proceed, as well as re-examine US steel and aluminium tariffs and retaliatory duties imposed by the EU "in due course", Juncker said.
"We had a big day, very big," Trump said during a press conference with Juncker at the White House on Wednesday. "We are starting the negotiation right now, but we know where it is going." Trump hailed "a new phase" of trade relations.
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Trump, Juncker announce deal pulling back from US-EU trade war

By David Shepardson & Steve Holland
26 July 2018 — 6:55am

Talking points

  • Trump, Juncker try to ease trade tensions in White House meeting
  • Agree to expand European imports of US liquified natural gas and soybeans
  • The US and European Union will "hold off on other tariffs" while negotiations proceed
US President Donald Trump has reached an agreement with European Commission President Jean-Claude Juncker aimed at averting a transatlantic trade war, easing tensions stoked by Mr Trump's threat to impose tariffs on car imports.
The two sides agreed to expand European imports of US liquified natural gas and soybeans and lower industrial tariffs on both sides, Mr Trump said. The US and European Union will "hold off on other tariffs" while negotiations proceed, Mr Juncker said.
"We had a big day, very big," Mr Trump said at a joint statement with Mr Juncker at the White House on Wednesday, US time. He hailed "a new phase" of trade relations.
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  • Updated Jul 26 2018 at 5:26 AM

Donald Trump delays White House meeting with Vladimir Putin until 2019

by Steve Holland
Washington | US President Donald Trump will postpone a second meeting with Russian President Vladimir Putin until next year after the federal probe into Russian election meddling is over, national security adviser John Bolton said.
"The president believes that the next bilateral meeting with President Putin should take place after the Russia witch hunt is over, so we've agreed that it will be after the first of the year," Bolton said in a statement.
Trump weathered fierce criticism after his summit last week with Putin in Helsinki after he appeared to give credence to the Russian leader's assertion that Moscow did not interfere in the 2016 US presidential election.
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Imran Khan claims win in Pakistan with vows on poverty, US ties

27 July 2018 — 6:45am
Saying winning the election is a "dream come true", Imran Khan prepares to become the Pakistan's new prime minister.
Islamabad: Former cricket star Imran Khan declared victory on Thursday in Pakistan's parliamentary election and vowed to run the country "as it has never before been run" by fighting corruption, seeking regional cooperation and forging a new relationship with the US that was not "one-sided."
TV stations reported Khan and his Tehreek-e-Insaf party, or PTI, maintained a commanding lead from Wednesday's balloting. But his leading rival, Shahbaz Sharif, rejected the outcome, citing allegations of vote-rigging.
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Iran army chief warns Trump: 'If you begin the war, we will end it'

By Parisa Hafezi
27 July 2018 — 9:26am
Ankara: A powerful commander of Iran's elite Revolutionary Guards said on Thursday Donald Trump should address any threats against Tehran directly to him, and mocked the US president as using the language of "night clubs and gambling halls".
The comments by Major-General Qassem Soleimani, who heads the Quds Force of the Guards, were the latest salvo in a war of words between the two countries.
Iran, its friends and its foes explained.
"As a soldier, it is my duty to respond to your threats ... If you wants to use the language of threat ... talk to me, not to the president (Hassan Rouhani). It is not in our president's dignity to respond to you," Soleimani was quoted as saying by Iran's semi-official Tasnim news agency.
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  • Updated Jul 27 2018 at 12:08 PM

For Trump, hell hath no fury like an attorney scorned

For the past decade, Michael Cohen worked as Donald Trump's personal lawyer and fixer. He was an eager supplicant, executing the wishes of his celebrity boss and forever seeking his attaboy affection. He said he would take a bullet for Trump and, even after the president passed him over for a White House job, Cohen still professed his eternal loyalty.
But in Trump's world, eternity has limits.
By releasing audio of his covertly recorded conversation with Trump about purchasing the rights to a Playboy centrefold's story of an extramarital affair, Cohen made a decisive break from his longtime client. The move punctuates the steady deterioration of a relationship between Cohen and Trump, and raises concerns in the White House that the former could spill secrets about the latter to the FBI.
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US economy surges by fastest rate since 2014 - but it comes with a warning

28 July 2018 — 3:07am
Washington: The US economy surged in the April-June quarter to an annual growth rate of 4.1 per cent. That's the fastest pace since 2014, driven by consumers who began spending their tax cuts and exporters who rushed to get their products delivered ahead of retaliatory tariffs.
President Donald Trump told reporters at the White House that he was thrilled with what he called an "amazing" growth rate and said it wasn't "a one-time shot".
The International Monetary Fund (IMF) is warning world economic leaders that the recent wave of trade tariffs would significantly harm global growth.
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The West might be losing it - but China is far from winning

By Tom Switzer
28 July 2018 — 12:02am
For more than two centuries, the Western world has dominated international affairs. Is that epoch coming to an end? After all, the West’s share of global economic output is shrinking. All those wars in the Middle East since September 11 have damaged American credibility and influence. And as Brexit, Donald Trump’s rise and the populist explosion across Europe shows, there is widespread distrust of Western elites.
Meanwhile, the rise of China, India and the rest – thanks to capitalism and technological innovation – continues unabated. So, has the West lost it? The answer, according to a new thesis by that title, is yes. If I were asked to nominate a brief, readable critique of the West today, this book would top the list.
Kishore Mahbubani, one of Asia’s most distinguished foreign-policy intellectuals, argues that although the West has won, it is now losing and will be need to come to terms with its decline. How so?
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I look forward to comments on all this!
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David.

The COAG Health Meeting Held Today Has Taken "Head In The Sand Outcomes" To A New Level.

Here is what they said - Meeting 2 August, 2018:

Digital health

Jurisdictions reaffirmed their support of a national opt out approach to the My Health Record. Jurisdictions noted clinical advice about the benefits of My Health Record and expressed their strong support for My Health Record to support patient’s health.

Ministers acknowledged some concerns in the community and noted actions proposed to provide community confidence, including strengthening privacy and security provisions of My Health Record.

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What a pathetic ill-informed cop-out. They seem to think it has all been fixed, but the issue is really that the Ministers don't really understand the complexities and risks!

David.

It Is Important To Note That, While Being Late, The Mainstream Press Now Says The myHR Has Been Multiply Breached!

So much for "Military Grade" security.
There are reports here:

REVEALED: Controversial My Health Record system with 'military-grade security' has ALREADY been hacked nine times

  • The controversial My Health Record system has already been hacked nine times 
  • Health Minister Greg Hunt claimed the system boasted military-grade security 
  • Revelation comes amid huge concerns regarding the My Health Record system
  • Concerns over the system's privacy prompted 20,000 to opt out on the first day
The controversial My Health Record system has already been hacked nine times.
Health Minister Greg Hunt claimed the system boasted military-grade security, saying this week, 'the advice that I have, no data breaches'. 
But contrary to Mr Hunt's claims, the Australian Digital Health Agency, which runs the system, admitted to nine breaches since the network was established.
More here:
and here:

Data breaches linked to My Health Record kept secret

by Sue Dunlevy
2nd Aug 2018 3:28 AM
A NEWS Corp investigation can reveal there has already been nine data breaches involving the Federal Government's My Health Record system.
The revelation comes as Health Minister Greg Hunt bowed to mounting public pressure and strengthened privacy provisions relating to accessing the record.
Mr Hunt also announced there would be changes to the deletion of records and also extended the opt-out period after meeting with doctors from the Australian Medical Association and College of General Practitioners on Tuesday night.
The opt-out period will be extend for a month until November 12.
News Corp can also reveal Australians who want to opt out of the My Health Record using a paper form can't unless they live in a rural area.
A survey of 471 doctors by industry magazine Australian Doctor has found eight in 10 doctors plan to opt out of the record because they do not trust it will be useful or kept up to date.
The results come amid News Corp findings that claims there has never been a data breach of the My Health Record are not true.
Health Minister Greg Hunt has been claiming the record has military grade security and said: "the advice that I have, no data breaches and no releases to any law enforcement agencies after six years."
However, in its own question and answer publication sent to doctors, the Australian Digital Health Agency, which runs the record, admits there have been nine data breaches associated with the record.
"In the 2016-17 financial year, there were six data breach notifications within My Health Record, and three notifications in the previous financial year," the agency admitted.
"Of the six data breaches reported by the Agency, four were the result of alleged fraudulent Medicare claims," the agency said.
"The remaining two breaches were the result of a consumer accessing a My Health Record that was not their own due to a processing error by the Department of Human Services."
There were no financial or jail penalties applied as a result of the breaches even though the agency says there are penalties of up to $126,000 or a two-year jail terms.
More here:
I blogged about this months ago – heck they are slow on the uptake!
David.

Wednesday, August 01, 2018

When Wondering What Is Going On It Is Always Wise To “Follow The Money”.

This popped up over last weekend.

My Health Record money trail: Questions raised over health lobby groups ‘on payroll’

Sue Dunlevy, National Health Reporter, News Corp Australia Network
28 July, 2018
EXCLUSIVE
IN the wake of a growing public backlash and increasing scrutiny of the My Health Record, key health lobby groups backing it are declaring themselves to be on the payroll of the agency rolling it out.
We can reveal the Australian Digital Health Agency has spent millions of dollars of taxpayers money trying to co-opt the support of leading health and consumer groups for the government’s online My Health Record.
A News Corp investigation of government tender documents has found
* The Consumers Health Forum has received over $105,000;
* The Royal Australian College of General Practitioners nearly $2 million;
* The Australian Health and Hospitals Association $1.2 million;
* The Pharmacy Guild $194,000;
* Australian Council Of Social Service $32 500.
The Australian Medical Association and the Royal Australian College of General Practitioners both signed contracts with the government to promote the record to doctors in return for a $910 million increase in Medicare rebates.
In most cases the money was for educating their members or consumers about the record, mailing out letters and setting up a secure messaging system between doctors.
All the groups say they had in principle support for an electronic health record before they received the money, that the money did not change their view and some have been critical of aspects of the My Health record after receiving the money.
Every Australian will get an online My Health Record that will reveal if they have had an abortion, a mental illness, a sexually transmitted disease or a drug addiction unless they opt out by October 15.
Former AMA president Professor Kerryn Phelps says any individual or group that has received money from the ADHA needs to declare it.
“I have a very strong and unequivocal view that advocacy organisations like the AMA and other groups should not do deals with government in exchange for supporting programs,” she said.
“They need to be presenting a completely unbiased view on behalf of their members, we are not an arm of the government.”
The Australian Digital Health Agency has taken forthright approach in the last week.
Professor Phelps revealed after she spoke out about privacy problems with the record she received a phone call from Australian Digital Health Agency boss Tim Kelsey.
“What he tried to do was reassure me on privacy and security and I said I would have to proceed with my concerns,” she said.
“It was unusual to get a phone call like that,” she said.
Earlier this week a Parliamentary Library paper critical of privacy aspects of the My Health Record was removed from the library’s website and later a more anodyne version replaced it.
Queensland MP Bob Katter who shares privacy concerns has suggested the record is Orwellian.
“I read George Orwell’s 1984 and it scares me still. Big Brother is watching,” he said in a media release on his constituents concerns about the record.
The agency said it was collaborating with a wide range of clinical and consumer leaders and had 17 agreements with peak consumer organisations and informal agreements with another 15 organisations — to undertake collaborative communications activity around My Health Record.
“No stakeholder has been asked, as part of any contractual arrangements, to present a particular view point on having a My Health Record. Additionally, organisations are open and free to have their own views on My Health Record,” the agency said.
“These organisations are committed to the system and are encouraging healthcare providers to adopt use of the My Health Record system into daily practice,” the agency said.
More here:
Sue Dunlevy has been doing a sterling job letting Newscorp subscribers (sadly it is behind a paywall) know just what is going on with the myHR and the current opt-out process.
Most who have been watching all this closely have been rather surprised with the rather one-eyed support for the program being offered by the organisations listed and have always assumed this was due to funding from the ADHA having an influence. It is nice to see some specific numbers around the amounts spent. (Note the CHF does understand the myHR contending issues quite well as indicated from this blog post here:
and so it is even harder to follow the why they are not more balanced in their media releases.)
It is clear that, at least to some degree, ‘money talks’!
I will note, in passing, that Prof Phelps is by no means the only one to have had phone calls from Tim Kelsey (or his chief of staff) to try and have their views changed. Just so you know there is a fair bit of it going on behind the scenes, according to some very trustworthy sources.
David.

This Is Really Important And Relevant Information On The myHR For The Young.

This appeared a few days ago and needs more exposure:

Freezing out the folks: default My Health Record settings don’t protect teens’ privacy

July 27, 2018 3.28pm AEST
There are measures teenagers can take to protect sensitive details in their My Health Record. From shutterstock.com

Authors

  1. Melissa Kang
Associate professor, University of Technology Sydney
  1. Lena Sanci
Interim Head, Department of General Practice, University of Melbourne
As the opt-out period for the My Health Record continues, so too does the debate surrounding issues of confidentiality. While possible data breaches have generated widespread concern, for one group – teenagers – it may not just be hackers they want to keep out. It may be their parents.
Consider this scenario:
Katy is 16 years old and, after a couple of months of dating another 16-year-old, Tom, they start having sex. Katy’s regular GP has looked after her asthma since she was six but she feels awkward seeing him. Katy visits a GP that her school friend recommends to ask about contraception and to get a pregnancy test. The GP offers and does a chlamydia test, as recommended by the Australian guidelines for STI testing. She really doesn’t want to discuss this with her mother just yet.
There are options for 14 to 18-year-olds like Katy to keep their medical records private under the My Health Record scheme, but teens must be proactive and change their settings or ask their health providers not to upload this data.

Remind me, what is a My Health Record?

My Health Record stores and manages each individual’s health information – such as blood tests, prescriptions, diagnoses, vaccinations and allergies – online. Every Australian will have a My Health Record generated unless they choose to opt out before October 15.
Parents may opt out their children, and those aged over 14 are able to opt out themselves.


Some information will be automatically uploaded as soon as a My Health Record is created. This includes Medicare claims for things like GP visits, and Pharmaceutical Benefits Scheme (PBS) claims for subsidised medications.
Other My Health Record information such as what is recorded by a GP when you see them, or letters from specialists to your GP, could be uploaded by them. Any test results and X-ray reports might get uploaded by the laboratories and X-ray centres directly, rather than through your GP.
Medicare and PBS claim information will not be visible on the record to parents of teenagers aged 14 and over, even if they are on the family Medicare card. It has long been the case in Australia that parents cannot see Medicare information for children aged 14 and over, and this recognises the rights of young people to confidentiality as they become more independent.


But this is not currently the case with other information on the My Health Record. Parents or legal guardians act as authorised representatives of their under-18 child’s record.
The parent can see other documents such as the health summary, medications prescribed, any test results, and specialist’s letters. At 18, parents’ access to the young person’s record is cancelled.
However, if you are between 14 and 18 years old you can choose to take control of your own My Health Record.

How teens can protect their confidentiality

Teenagers can have control over what is uploaded onto their My Health Record. They can ask their doctor and any other health professional they see not to upload the information about their health visit they wish to keep confidential.
Teens can also ask the doctor to tick the “MHR opt out” box on pathology requests and prescriptions so these are not uploaded. Or they can ask the pharmacist not to upload medication dispensing information.
Doctors, pharmacists and other health professionals should also remember to ask all young people whether they want their test results, prescriptions or health summaries uploaded or not.
If either party doesn’t request an opt-out, pathology tests and prescriptions will be automatically uploaded.

Problems with this system

Young Australians have the legal right to confidential health care. This means they can visit a health professional on their own, and the information shared must be kept confidential unless there is a risk of suicide or if the young person is under 16 and being abused.
Confidentiality has been shown to improve young people’s willingness to seek help early and thereby prevent unwanted consequences of behaviours or mental health issues. Katy, for example, has obtained an STI test and contraception which will help prevent unwanted sexual health issues.


This current system for protecting the confidentiality of teenagers’ information on their My Health Record has obvious flaws. It relies on busy health professionals – some of whom may not be experienced in the My Health Record – remembering to ask every teenager whether they want information uploaded or not.
It also places the onus on teenagers, who in many cases may not be fully versed in the health care system. It relies on them to remember, and have the confidence, to ask for information not to be uploaded.
Let’s go back to Katy again. In Katy’s situation, the information she shares with her friend’s GP must legally be kept confidential. Because Katy is under 18, the doctor must decide whether she is mature enough to consent to treatment, such as contraception, on her own.
Katy had a My Health Record created for her when she was 13 and didn’t take much notice of the laws around this at the time. She doesn’t know that she can take control of her own record and even if she did, she would be worried about offending her mother. Katy doesn’t ask this GP not to upload today’s visit information and the GP, who isn’t her usual GP, doesn’t remember to ask her.
The My Health Record default settings won’t permit her mother to access her Medicare and Pharmaceutical Benefits Scheme data, so the record of her pregnancy test and visit to the GP isn’t visible to her mother. But the doctor’s summary that mentions a prescription for contraception and an STI screen is. If Katy’s mother decides to check her My Health Record, Katy’s confidentiality will be breached.

Teen-friendly My Health Records

The overwhelming concern is that young people will forgo important and timely health care because of concerns about confidentiality. We should be progressing the confidence of young people to take charge of their health, not driving them back.
At the same time, young people may not have the benefits that accrue with an electronic health record if they continuously choose not to have health events uploaded for fear that others will find out.
The Australian Digital Health Agency must urgently redesign the My Health Record program to respect young people’s right to autonomy and confidential health care.
The My Health Record must be automatically shifted to the control of the young person once they turn 14, with no obligation for parental access.
The uploading of pathology tests and prescriptions should be opt-in, not opt-out. This would mean health care providers must ask each time whether information gets uploaded.
An official communication campaign is needed for young people aged 14 to 18 to explain what the My Health Record will mean for them and how they can have the benefits of a record, without losing their rights to confidential health care. Communications must be targeted at young people and designed in collaboration with young people.
These important steps will enable young people to feel secure in managing their own health care and their My Health Record.
Here is the link:
Who ever knew it could be so complicated.
The ABC also has a go at working through this and some other issues.

My Health Record undermines teens' right to medical privacy, critics fear

ABC Science
By technology reporter Ariel Bogle
The digital health project My Health Record could undermine the ability of young people to access confidential medical care, critics have warned.

How parents can manage a child's My Health Record:

  • Parents can opt children under 18 out of My Health Record until October 15
  • Children aged 14 and over can also opt themselves out until this date
  • If no one opts out, a My Health Record will automatically be created by the end of 2018
  • When a parent creates a child's My Health Record, they are its authorised representative and are responsible for managing the record
  • If a child is not opted out and a My Health Record is created, parents can apply to be an authorised representative
  • More than one authorised representative can manage a child's My Health Record
  • If two parents have a child on separate Medicare cards, both cards link back to one version of the child's My Health Record
  • From age 14, children can apply to manage their own My Health Record
  • If they do not, the authorised representative will continue to manage it until age 18
  • Parents of newborns will be able to opt them out as part of the Medicare enrolment process
Source: Office of the Australian Information Commissioner and the Australian Digital Health Agency
When a teenager turns 14 they must typically give consent for parents to access their Medicare information, but now parents can register their child for a My Health Record and potentially view and administer it until age 18.
The Australian Association for Adolescent Health (AAAH) has called for the Government to automatically seek consent from young people aged 14 to 17 years before granting access to any part of their My Health Record to parents or legal guardians.
"Those people are vulnerable to having to, unwittingly perhaps, or not so unwittingly, share [health information] with people who they may not wish it to be shared with," AAAH president Melissa Kang said.
In line with Department of Human Services policy, Medicare data stops flowing into My Health Record once a teen turns 14.
But advocates are concerned that other information such as health status summaries or medication lists uploaded by doctors could remain visible to a carer, potentially exposing sensitive issues such as mental and sexual health.
Once they turn 14, teenagers can also take control of their record, delete documents, administer Medicare data and turn on access settings, but this does not occur automatically.
"Should a child be concerned about the confidentiality of their record, they can take control at 14 in which case their authorised representatives will be removed from the record," an Australian Digital Health Agency (ADHA) spokesperson said.
"A child who takes control can also appoint their parents as a Nominated Representative if they wish to have their parents help in managing their record and health care."

Teens need medical privacy: social workers

Until October 15, parents can opt children under 18 out of My Health Record, otherwise one will be automatically created.
Children aged 14 and over can also opt themselves out online using their Medicare number, according to the ADHA.
There is a lot more here:
All I can say is that some good souls have worked hard to make it all clear and the more I read the more certain I am that the ADHA have totally failed with education. This should have all been worked through and discussed before the opt-out period.
David.

Surely It Is Now The Opportunity To Fully Re-Consider The Path Forward With The myHR.

Small thought.

Now we see that flexibility is possible, how about we get a full competent strategic review of the myHR with review by the Auditor General, a proper review (evidence-based) of what is actually needed in a National EHR System (if anything), and a proper business case and privacy impact statement of any final design.

We have wasted $2 Billion doing this with evidence free dogma - time for a change! Isn't it funny to see all those organisations who said the myHR was wonderful as it, was welcoming change!

David.