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."

Friday, September 28, 2018

There Is An Open Secret At The Heart Of Why The myHR Is Looking Worse Every Day.

This appeared last week:

Improving data quality can lead to better health outcomes: RACGP expert

Doug Hendrie 17/09/2018 2:15:19 PM
Speaking ahead of this week’s RACGP eHealth Forum 2018, Dr Rob Hosking has called for a greater focus on improving the quality of patient data in general practice.
How can GPs improve the quality of their data?
Dr Rob Hosking, incoming Chair of the RACGP Expert Committee – eHealth and Practice Systems (REC– eHPS), said a widespread issue with poor-quality data is often a result of busy GPs inputting text into the incorrect fields in practice software.

‘Anecdotally, the problem of low-quality data is fairly high. It’s mainly a misunderstanding amongst GPs that it might be useful to enter it in the right place at the time of seeing the patient,’ he told newsGP.

‘People are busy, so they just do what they have to do with the patient in front of them. They don’t think that what they record will be potentially useful in future.’

Dr Hosking said low-quality data represents a missed opportunity to boost internal research and even a clinic’s bottom line.

He will raise the issue at the RACGP’s eHealth Forum 2018, to be held on Thursday 20 September, which will focus on the power of data in general practice.

‘If we can get high-quality data in GP clinics, we get better information for use in our own practices,’ Dr Hosking said.

Data extraction tools applied to high-quality data could, for instance, show a GP that their practice is not hitting immunisation goals for people over the age of 65.

Dr Hosking said there is also a financial incentive for GPs to keep high-quality data.

‘If they analyse their data, they might find they’re not billing the way they should be and missing out on certain interventions like managing diabetes. Or they might not be billing appropriately,’ he said.

Dr Hosking said there is currently renewed interest in general practice data from university researchers, Primary Health Networks and organisations like NPS MedicineWise. This has been particularly true since the end of the long-running BEACH program, which collected general practice data over 18 years.

‘Everyone is trying to get hold of general practice data – they’ve finally figured out that 98% of general practice clinics are fully computerised with a wealth of information stored in those systems,’ Dr Hosking said.

‘Someone might want to pay for de-identified data in the future. But some is of good quality, some is dubious.’

A common question raised by GPs interested in giving researchers access to their data is how they could be sure patient data had been thoroughly de-identified. Dr Hosking said the major data extraction tools broadly do a good job, with the best tools de-identifying and aggregating data before sending it outside the clinic.

Dr Hosking believes that high-quality data is ultimately beneficial to practices, whatever use they may intend for it in the long-term.

More here:
I have to say Dr. Hosking is spot on here. It is in the interests of everyone to have the highest data quality, especially if clinical decision making is to rely on it.
To date I believe we have profoundly underinvested in systems that assist in data quality maintenance and that until this changes the quality of data in any shared systems will be less than ideal.
David.

Thursday, September 27, 2018

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

September 27, 2018 Edition.
Another week and we see even more madness from the Trump Administration with more tariffs and a new lot planned if China responds which it has already done. Somehow US markets  seem to be ignoring all this and there must come a time when there is a real economic impact and an impact in markets. His efforts at the UN Gen Assembly have been lamentable!
In the UK Theresa May is having a terrible time trying to get any sort of deal on Brexit and it is hard to know where it will land with both sides seemingly digging in and Ireland in the middle.
In OZ we are having the Strawberry Panic as well as all sorts of rapid fire announcements on Aged Care Royal Commissions, more funding for Catholic Schools etc. There are also some worries about just where our relationships with the Pacific Countries are going  as a bulwark against China influence.
A more politically active Government than we have seen in a while – especially with the Wentworth bye-election looming. I wonder how this will impact the polls?
Also I am told the interim report of the Financial Services Royal Commission is published tomorrow. What that holds will be a worry I suspect…especially after the fiasco that has sadly overtaken the ABC. Dear what a mess!
-----

Major Issues.

Kerryn Phelps to stand as an independent in Wentworth by-election

  • AAP
  • 12:07PM September 16, 2018
High-profile Sydney doctor Kerryn Phelps will stand as an independent in the by-election for the seat left vacant by former prime minister Malcolm Turnbull.
Dr Phelps, a local GP, Sydney City Councillor and AMA president, announced her decision at a press conference on Sunday morning in the heart of the blue ribbon eastern suburbs seat that the Liberal party has never lost.
She says she was prompted to stand because of “the revolving door of leadership in Canberra” over the past decade had weakened the standing of politicians and the major parties.
-----

'Rise above bitterness': Kerryn Phelps to run as independent in Wentworth

By Peter Hannam
Updated16 September 2018 — 12:04 pm first published at 9:22am
Kerryn Phelps, the first female head of the Australian Medical Association, will put civil rights and action on climate change at the forefront of her bid to claim the federal seat of Wentworth as an independent.
Dr Phelps, a GP and Sydney City councillor, on Sunday joined other candidates including Dave Sharma, pre-selected by the Liberals in a marathon session early on Friday morning, and Labor's Tim Murray.
Voters will go to the polls on October 20 in the waterside seat vacated Malcolm Turnbull after he resigned following his ouster as prime minister last month.
-----

Fairfax-Ipsos poll: Scott Morrison ahead of Bill Shorten on leadership qualities but lags behind Malcolm Turnbull

By David Crowe
16 September 2018 — 6:53pm
Australian voters have given Prime Minister Scott Morrison the edge on key leadership qualities like trust and economic management, rating him ahead of Opposition Leader Bill Shorten in a personal contest that will shape the outcome of the next election.
Mr Morrison is considered trustworthy by 49 per cent of voters compared to 39 per cent who favour Mr Shorten, while the new Coalition leader's grasp of economic policy is backed by 66 per cent of voters compared to 47 per cent who prefer his rival.
But an exclusive Fairfax-Ipsos poll also shows Mr Shorten enjoys a convincing lead in the most decisive contest, with Labor ahead of the Coalition by 53 to 47 per cent in two-party terms.
-----

Fairfax-Ipsos poll: One key finding proves the Liberals have made a calculation that defies logic

By David Crowe
16 September 2018 — 11:45pm
The danger for Scott Morrison and his government is laid bare in one of the key findings in this latest poll.
But a closer look shows that Morrison has added nothing to the government on this measure since the toppling of Malcolm Turnbull.
In fact, Morrison has gone slightly backwards. Turnbull led by 48 to 36 per cent.
-----

Experts warn of ‘debt bomb’ as housing downturn worsens

EXPERTS have issued a grim warning for homeowners, claiming up to two-fifths of your home’s worth could be wiped out in 2019.
Alexis Carey
news.com.au September 17, 201811:46am
AUSTRALIA is facing a “debt crisis” — and the property market and our entire economy are at risk as a result.
That’s according to the sobering 60 Minutes segment Bricks and Slaughter which aired last night, revealing the country’s property downturn was just the tip of the iceberg.
According to reporter Tom Steinfort, the current slump is actually “more like falling off a cliff”, with a number of real estate and finance experts claiming houses could plummet in value by up to 40 per cent in the next 12 months.
-----

Why Western Christianity has a death wish

By Tim Stanley
18 September 2018 — 8:00am
London: There's nowhere more relevant to the modern world than Grace Cathedral, San Francisco. This Episcopal church advertises yoga and is totally non-judgmental (there's a photo on its website of a man dressed as a nun), and I bet a fun time was had by all at last week's Global Climate Action Summit Multi-Faith Service.
You can watch a video online: down the aisle come clerics, musicians and men on stilts dressed as trees. Notice though, as the camera pans out, that the congregation is a bit thin at the back. And old. It's in desperate need of some new sap.
The wider US Episcopal church is facing extinction: just 500,000 attend its services on a Sunday, which an internal report calls a "profound and shocking decline". Its sister church in England isn't doing much better.
-----

Payday loans: our hidden debt crisis

By Shireen Morris
17 September 2018 — 11:56pm
Something is going wrong in this country if we can’t stand up for our most vulnerable fellow Australians. Yet it seems many politicians are more interested in plotting and infighting than doing their jobs and standing up for justice.
On Friday I attended a roundtable with locals in Ringwood, together with community organisations and financial advisers who were concerned about the way some payday lenders are exploiting struggling people. What I heard shocked me. The payday-loan industry is raking in profits at the expense of the vulnerable.
Here are the facts. Payday loans are almost exclusively used by people on low or very low incomes. For such people, these small loans can help them survive until the next pay cheque. But often, people are getting sucked into loans they can’t afford. They end up in helpless situations of ever-increasing debt.
-----

How market forces have failed the nation

By Ross Gittins
19 September 2018 — 12:00am
How will the era of “neoliberalism” end – with a bang or a whimper? With a royal commission – or three. But don’t worry. Royal commissions always make a lot of noise.
With the memory of the government’s embarrassing delay in yielding to public pressure for a royal commission into banking still fresh, Scott Morrison got in before the Four Corners expose to announce a royal commission into aged care.
Who’s to say this will be the last? A royal commission into electricity and gas prices is mooted. Maybe sometime in the future we'll see a royal commission into problems with the National Disability Insurance Scheme.
-----

We're doubling down on the errors that caused the financial crisis a decade ago

By Juliet Samuel
19 September 2018 — 11:00am
Everyone has their favourite theory about the financial crisis. It is now ten years since Lehman Brothers failed and most interested parties have decided what they think. It was deregulation, they claim, or bankers' bonuses, low interest rates, US government housing policy or moral hazard. There is very little hard evidence that any of these popular theories actually caused the particular disaster we experienced in 2008. Yet we continue to overlook an alternative account of the crisis that does explain some of its mechanics.
Ten years since Lehman Brothers collapsed, we look at the subsequent global financial crisis that changed the world economy.
This alternative account, which for shorthand could be dubbed "regulatory error", does not result in easy policy prescriptions, it is geeky and it ascribes an annoyingly large role to that underrated driver of human history: ignorance. These are all reasons why it has been mostly ignored. But ten years on, it is surely time to release ourselves from the politics of it all and consider 2008 as an intellectual conundrum.
-----

Imagine a world where debt doesn't exist

By Marcus Padley
18 September 2018 — 12:31pm
I have just paid off my daughter’s Afterpay and Zip Pay accounts. It cost me $345.
As a Baby Boomer, I have spent my life in debt. It all started in the 1980s when the investment bank I worked for offered me a discounted mortgage rate on 95 per cent of the value of any property I desired, and they also, in case I didn’t feel rich, offered me a new company car on a novated lease. Debt had arrived and suddenly I felt wealthy, although I later learnt that leasing vehicles was one of the most profitable industries in the world and I had spent at least 15 years giving them a significant portion of my salary just so I could show off driving a car I couldn’t afford.
It was Einstein who said “Compounding is the eighth wonder of the world. He who understands it earns it. He who doesn’t, pays it”, yet for all my financial sophistication, my masters in applied finance and my 36 years telling people how to make money in the stock market, I have spent my life on the wrong end of compounding.
-----

Should we worry about the slump in savings?

By Clancy Yeates
18 September 2018 — 11:26am
As we mark a decade since the global financial crisis, Australian households appear to be slipping back into a pre-GFC habit: saving an increasingly skinny slice of their incomes.
Although the latest national accounts figures showed economic growth humming along, the household savings ratio slipped to just 1 per cent in the latest quarter, its lowest since late 2007.
On face value, that might sound worrying. It gives the impression of more Australians raiding their savings accounts to cover bills - which would be an alarming trend if that were the case. So should we be concerned about the low level of saving?
-----

Climate: The looming threat to Queensland's health

By Fahim Tonmoy, David Rissik & Fiona Armstrong
18 September 2018 — 5:02pm
Queensland’s biggest industry and the nation’s largest employer - the health and social services sector - is under threat like never before.
As the state braces for continuing hot, dry weather and an early start to bushfire season, more and more evidence points to the growing impacts of climate change on human health and wellbeing.
Unpredictable and extreme weather events exacerbate existing health problems (both physical and mental) and create new public health challenges.
-----

Scientists identify the cane toad’s deadly enemies

  • 1:00AM September 20, 2018
A scientific breakthrough could finally curb the explosive numbers of Australia’s cane toads, the feral pest that has spread across the continent.
After years of work, the cane toad genome has been sequenced, leading to the discovery of three cane toad-specific viruses that have the bio-control potential to halt the seemingly unstoppable spread of the toxic amphibians.
Originally from South America, cane toads have so successfully adapted to the Australian environment that they now number in the hundreds of millions across the nation. They are a threat to native animals, fatally poisoning the northern quoll, freshwater crocodiles and several species of lizards and snakes.
-----

RBA’s Chris Kent explains how banks make money ... literally

  • 12:00AM September 20, 2018
Banking is a licence to create money out of thin air, the Reserve Bank says, exploding the myth that banks make loans by “lending out customer deposits”.
In a landmark speech, assistant governor Chris Kent moved in Sydney yesterday to clear up the “degree of confusion” about how money is created, explaining that banks create deposits when they make loans — in contrast to what textbooks say and most people ­believe.
“Concerned citizens might be worried about what they see as the ability of private banks to create money via the extension of credit, seemingly at will,” he said.
-----
  • Updated Sep 21 2018 at 12:16 AM

One in five interest-only borrowers could run into mortgage repayment arrears: UBS

One in five interest-only loan borrowers will struggle to make mortgage repayments when their interest-only loan expires, the latest UBS housing and banking survey reveals.
The Reserve Bank previously indicated almost half a trillion dollars in interest-only mortgages - or about 30 per cent of all outstanding mortgages - will convert to principal and interest loans over the next four years, jacking up monthly repayments for almost 1.5 million borrowers and cooling housing markets further.
"This last finding is quite concerning, in our view, as it implies that 18 per cent of interest-only customers will not be able to afford to pay their monthly mortgage repayment when their Interest-only period expires," the 2018 UBS Evidence Lab Mortgage Survey said.
-----

A mogul and a PM's fall

By David Crowe
20 September 2018 — 11:25pm
It took several days for Malcolm Turnbull and Rupert Murdoch to set up a phone call in the middle of the week that gave Australia a new prime minister.
The News Corp executive chairman had been in the country since Friday, August 10, when he flew into Sydney on the company’s Gulfstream jet, diverted from Canberra by the morning fog in the capital.
This put Turnbull and his government on alert to watch for any shift in coverage by News Corp newspapers and its Sky News channel, as editors competed to impress the company founder with muscular news stories – some of them, no doubt, at Turnbull’s expense.
-----

Proof that trying to avoid the next market crash will cost you money

By Robin Bowerman
21 September 2018 — 11:00am
Anniversaries are occasions when success can be celebrated and lessons reflected on when times were tough.
It is no surprise that the collapse of Lehman Brothers 10 years ago and the catalyst it provided for the global financial crisis has prompted major amounts of public discussion and reflection.
And certainly there are lessons to be taken from such a major systemic event. It was life-defining for a generation of investors.
-----

Big data is an unguarded corner of democracy

By Julia Thornton
22 September 2018 — 11:31pm
When political parties collect campaign data on their potential voters, it can provide forensic clarity of detail for politicians on how to influence the vote. But for voters, it draws a new curtain obscuring their view of how politics is influenced.
The fact that political campaign methods are in the midst of a digital revolution is not news. It's glaringly apparent that "old" media no longer has the reach to voters it once commanded. But new access by parties to new forms of political influence demand scrutiny and regulation if they are to fit with our principles of democratic process.
Most voters are unaware of the exemptions from the Privacy Act for political parties and related entities, and the hole in the reporting of how parties pay for such software. The links between the designers of the software and other political entities based in the US are also of concern.
-----

What will spark the next financial crisis? Here is one candidate

22 September 2018 — 8:30am
Now that everything has been said about the 10th anniversary of the Lehman Brothers bankruptcy, it's worth asking how close we are to the next crisis. In the market for corporate loans, investors have fulfilled at least one prerequisite: They're dropping their guard.
The financial cycle has a lot to do with inattention. When something bad happens, people are careful for a while. Then if all is fine for long enough, they forget that bad things can happen. This false sense of security leads to precisely the kind of behaviour that precipitates the next crash.
The corporate debt market has a sort of proxy for inattention: the prevalence of covenants. When lenders are being vigilant, they require that borrowers avoid taking on too much debt or generate ample cash for interest payments. When they loosen up or get desperate for someone to take their money and pay interest, such covenants disappear.
-----

Companies would have to reveal their gender pay gap under Labor

By Latika Bourke
23 September 2018 — 12:00am
Companies with more than 1000 employees will be forced to publicly reveal their gender pay gap, named and shamed if they fail to comply, and excluded from lucrative government contracts, under a Labor government.
Fairfax Media can reveal the Opposition is preparing legislation that would also force companies to reveal the difference in pay between managerial and non-managerial staff, and would ban “secrecy clauses” that prevent employees telling colleagues how much they get paid.
While companies already report their gender pay gap to the Workplace Gender Equality Agency, Labor would make that data publicly searchable, as well as the pay gap between managers and their employees.
-----

Financial Services Royal Commission Issues.

  • Sep 17 2018 at 9:49 AM

Andrew Hagger departs NAB, Mike Baird to run retail bank

The financial services royal commission has claimed another senior executive scalp, after National Australia Bank said its head of consumer and wealth Andrew Hagger will leave the bank.
Former NSW premier Mike Baird will replace him, moving from head of NAB's corporate and institutional bank, to become chief customer officer of consumer banking. 
"I take accountability for what has occurred on my watch, and accept that alongside successes were failures, including instances where we did not act with the pace required," Mr Hagger said in a statement. "I leave NAB with confidence that we are creating a better bank."
-----

Long way to go to get banks back in their box

By Ross Gittins
17 September 2018 — 12:05am
Have we learnt from the mistakes of the global financial crisis, now 10 years ago? Yes, but not nearly as much as we should have.
Of course, the answer is different for the Americans and the other major advanced economies to what it is for us, who managed to avoid bank failures and the Great Recession.
Globally, much has been done under the Basel rules to strengthen requirements for banks to hold more capital and liquidity, reducing the likelihood of them getting themselves into difficulties.
-----

NAB pay revamp makes it much harder to reward bad behaviour

By Stephen Bartholomeusz
20 September 2018 — 12:05am
National Australia Bank has provided the first insight into what bank remuneration schemes might look like in the wake of reforms to bank executives’ accountability prompted by the wave of finance sector scandals.
At a superficial level it appears similar but perhaps simpler than the structure of the scheme it replaces. In reality, for bank non-executive directors it should be far more complex and demanding.
Once the Banking Executive Accountability Regime (BEAR) was enacted, and once the Australian Prudential Regulation Authority’s inquiry into Commonwealth Bank and a separate APRA review of remuneration practices within large financial institutions were published, it was obvious that bank remuneration schemes had to change.
-----
  • Sep 21 2018 at 9:33 AM

Josh Frydenberg vows insurers to face tougher laws after banking royal commission

Treasurer Josh Frydenberg has vowed to press ahead with tougher new laws on the insurers, in the wake of damning findings into general and life insurers uncovered by the royal commission.
Mr Frydenberg has faced criticism from Labor for delaying a planned roll out of the new laws, since Kenneth Hayne's probe uncovered allegations of wrong doing by insurers in unfairly assessing and paying out claims, including Allianz, Suncorp and Youi.
The Treasurer told The Australian Financial Review the government had previously flagged changes and was awaiting recommendations from the royal commission before finalising the new rules.
-----
  • Sep 21 2018 at 11:00 PM

The banking royal commission is a risk insurers cannot dodge

It was just hours into the royal commission's round of hearing on insurance when ClearView Wealth's chief actuary and risk officer, Greg Martin, let slip one of the industry's sales secrets.
"I would struggle to explain it, but it would be a mild level of disturbance to engage a customer in a … discussion," he said, looking more than a little uncomfortable.
"It's like people doing their wills ... People know they should do it but it's not something that they willingly run off and do without usually a bit of motivation."
Martin is right, of course. The process of buying insurance is partly logical, but also naturally emotional – it is, after all, protection against bad events that may or may not happen.
-----

Insurance companies can't escape reforms

By Elizabeth Knight
22 September 2018 — 12:00am
The insurance industry was ripe for a regulatory overhaul well before the extent of its damning practices were exposed by the royal commission into financial services.
Insurance more than any other financial services sector has avoided a lot of scrutiny thanks to being partly self-regulated. This is surely set to change.
Yet again, galvanised by the embarrassment of being shown up for inattention to the insufficient regulation around insurance, the government is now chest-beating about its desire to clean up the industry and introduce tougher laws.
-----

'Stop being bastards': how the royal commission could reform banks

By Jessica Irvine
22 September 2018 — 12:00am
Graeme Samuel is in no mood for beating around the bush.
Australia’s former competition tsar, now a professorial fellow at Monash Business School, recalls a meeting with bank executives, in which they quizzed him on how to stop the relentless public mantra of “banks are bastards”.
“The first thing I said was: ‘stop being bastards’,” Samuel told Fairfax Media this week, reflecting on six sensational rounds of public hearings of the royal commission into misconduct in the financial services sector which, he says, revealed “horrific” case studies and examples of “crass stupidity” by executives.
“Some of us who have been in public service and dealing with these companies look at it and say what is going on?”
-----

Everything you need to know about the royal commission so far

By Sarah Danckert, Clancy Yeates & Ruth Williams
22 September 2018 — 12:00am
After more than 100 witnesses, thousands of submissions and six rounds of hearings the royal commission has covered a lot of ground.
Here the Fairfax Media team present what you need to know across consumer lending, financial advice, superannuation,  and insurance.
We also flag what the likely outcomes could be ahead of Commissioner Kenneth Hayne's interim report which is due with the government on September 30 and what action has already occured.
-----

National Budget Issues.

Housing: It's time for the lucky to share some of their good fortune

By Peter Mares
16 September 2018 — 1:10pm
The real estate boom has peaked, and house prices have begun to slide in Sydney and Melbourne, but the declines so far are no match for the gains of previous years. We’d better hope it stays that way, because the only thing that will really bring house prices down sharply is a deep recession and mass unemployment. Barbecue-stopping debates about whether we, or our kids, will ever be able to afford to buy a home look set to continue.
Yet this is not the real locus of our housing crisis. The real crisis is a lack of affordable rental accommodation for people on low incomes.
One in every two low-income households renting in the private market is in housing stress. That is about 600,000 households spending at least 30 per cent of their disposable income, and often much more, on rent. As a result, they may skimp on essentials such as food, heating or healthcare.
-----
  • Sep 20 2018 at 8:52 AM

Reserve Bank of Australia says $A could jump 6pc in all-out trade war

by Sarah Turner
The Australian dollar could rise as much as 6 per cent, which would shrink the economy by as much as 3.5 per cent in the worst case scenario of a global trade war, Reserve Bank of Australia research shows.
The RBA painted a picture of the Australian economy in the event of an all-out trade war - what it termed a retaliatory scenario - in research dated March this year.
In this scenario, with a fixed real exchange and an unchanged cash rate, the level of GDP would be around 1 per cent lower by a 2021 trough, the unemployment rate would rise a quarter of a percentage point and inflation would move lower by around 0.2 percentage points.
-----

Scott Morrison's $1.2 billion bonus for private schools slammed as a 'slush fund'

By Michael Koziol & Jordan Baker
20 September 2018 — 11:00pm
The Morrison government will create a special $1.2 billion fund for private schools and pay it directly to Catholic and independent school authorities to distribute as they see fit.
The "choice and accessibility fund" is in addition to a separate $3.4 billion cash injection announced by Prime Minister Scott Morrison to help private schools adjust to a new model for determining socioeconomic disadvantage.
The new funds will be phased in over a decade and be distributed on the basis of the socio-economic status of each school.
-----

'Political fix': Why Morrison's school funding deal is a dud

By Adrian Piccoli
22 September 2018 — 12:33am
This week’s school funding announcement is not just bad policy and contrary to the national interest of improving our education performance but is outrageous in its bald-faced audacity. All those who care about equity and fairness should be outraged, but it is poorer Catholics who should be especially upset about this deal.
The first egregious element of this package is that it is completely partisan. No mention of the public school sector other than to say it is getting increased funding. Well, the non-government sector is also getting more money so nothing new there. This is purely a political fix to shut down a powerful lobby group.
Second, neither the Commonwealth nor the Catholic sector are even pretending this is fair or needs-based or that any of the extra money is going towards improving student outcomes. There has been no mention of how any of this extra money would help schools like St Joseph’s Catholic School in Hillston in the state's west or children from poor or disadvantaged backgrounds.
-----

Health Budget Issues.

PM Scott Morrison warns of ‘bruising’ abuse tales

  • 12:00AM September 17, 2018
The nation needs to brace itself for some “bruising” revelations of abuse in the $18 billion aged-care sector, Scott Morrison warned yesterday, as he launched a sweeping royal commission in a move to outflank Labor on the issue, head off more damaging ­reports and recapture the vote of older Australians.
Just weeks after dumping a long-planned rise in the pension age to 70 and days after announcing some reforms from this year’s budget will begin immediately ­instead of in the outlying years, the Prime Minister will establish a royal commission that will begin as soon as possible and not report until “at least the second half of next year”.
“I think we should brace ourselves for some pretty bruising ­information about the way our loved ones have experienced mistreatment,” Mr Morrison said yesterday. “I think that is going to be tough for us all to deal with but you can’t walk past it, you can’t not look at it and that is what the government is ensuring that we don’t do.”
-----

Australian men twice as likely to get cancer as rest of the world

By Maani Truu
16 September 2018 — 5:03pm
One in two Australian men will suffer from cancer in their lifetime, according to new data from the World Health Organisation's International Agency for Research on Cancer (IARC).
Released last week, the Globocan 2018 database, which estimates the number of incidents of cancer around the world, showed that the Australian and New Zealand region had the highest risk of cancer in the world.
In 2018, Australia will have an estimated 197,876 new cases of cancer, with 120,034 of these found in men.
-----

Aveo offers alternatives to its 'Aveo Way' retirement village contract

By Rachel Lane
Updated16 September 2018 — 9:25am first published at 12:00am
Last week, Aveo announced it would be following its competitors to provide payment options to its retirement village residents. Aveo’s three contract options include the current contract, known as “Aveo Way”, and two alternatives, called “Certainty” and “Essentials”.
The move to offer choice follows similar moves by first Lendlease, then Stockland.
What remains the same? Well, the options don’t change the price you pay upfront or what you pay while you live in the village. And for all three, there is a deferred management fee (DMF) of 35 per cent (25 per cent in new villages) calculated based on the purchase price, there is no sharing in capital gain (or loss) and the operator covers refurbishment costs and selling fees.
-----

The simple question MPs opposed to pill testing should ask themselves

By Alex Wodak
16 September 2018 — 4:30pm
Two young people died on the weekend after attending Defqon.1, a youth music event in Penrith. Another three young people attending the same event are now struggling for their lives in hospital. As many as 700 people sought medical assistance during the event.
After two people died and another three were left in a critical condition, NSW Premier Gladys Berejiklian vowed to stop the festival from being held in NSW.
Were these deaths and illnesses really from drugs? Or were they the result of an obstinate refusal by governments to allow pill testing in Australia?
-----

Health system struggling with organ donation success

  • 12:00AM September 17, 2018
An increase in organ donors and transplant recipients has put the health system under “significant pressure” and exposed cracks ­between the states that may put patients at a disadvantage.
In 2017, about 30 per cent of retrievals and 20 per cent of organs transplanted occurred across ­jurisdictions, yet policies and practices in relation to waiting lists differed, according to documents obtained by The Australian.
Amid concerns over bottlenecks and inequity, particularly for indigenous people, the federal government has launched a ­review of organ donation, ­retrieval and transplantation which will also examine the states’ concerns over resourcing.
-----

Daily aspirin won’t help to reduce risk of heart attack or stroke

  • By Kat Lay
  • The Times
  • September 17, 2018
Taking aspirin every day does not significantly reduce the risk of heart attack or stroke in healthy people over 70, a study has found.
It also fails to extend life free of disability or dementia and might even increase the risk of dying early, researchers said.
There is evidence that aspirin can help to prevent heart attacks and strokes in people with heart problems, and doctors had hoped that the same would be true for the general population. However, studies in younger people showed that the risks outweighed the benefits and the new research confirms that the same is true for the elderly. The study, involving more than 19,000 people, found that the medicine was linked to a greater risk of serious bleeding.
-----

Even the optimists are bracing for aged care carnage

By Elizabeth Knight
18 September 2018 — 12:03am
It wasn’t until the banking royal commission got underway that it dawned on most investors that potential financial damage to banks could reach tsunami proportions. Even the optimists are now bracing for the carnage.
When Prime Minister Scott Morrison announced a royal commission into aged care providers over the weekend, investors already knew the drill - they dumped shares in these companies the moment they started trading on Monday morning.
By lunchtime Estia Healthcare had plunged 18.4 per cent, Japara Healthcare slumped 15 per cent and Regis Healthcare had tanked by 17 per cent.
-----

Has the federal government cut funding to aged care?

By Eryk Bagshaw
17 September 2018 — 8:00pm
The Coalition has increased funding to aged care in dollar terms, as a proportion of all government expenses and as a fraction of the economy, dispelling Labor's claims that Prime Minister Scott Morrison cut funding to the sector when he was treasurer.
Funding per person in 24-hour aged care has also increased, up by $6000 between 2012 and 2015, but has fallen once retirement homes - which receive some aged care services - are taken into account, as the royal commission prepares to investigate whether funding pressures have exacerbated systemic issues in the sector.
Both sides of politics will be watching to see if conditions, wages and regulators have had a role in exposing Australians to elder abuse, opening the government to a multibillion-dollar bill if the commissioner finds the sector must be cleaned up.
-----

Health of the nation: The RACGP takes Australia’s pulse

Morgan Liotta 19/09/2018 8:22:31 AM
The RACGP launched its second annual Health of the Nation report in Canberra in this morning.
Health of the Nation presents unique data and interpretations, painting a clear picture of the contemporary Australian general practice.
‘As the only comprehensive sector-led annual study of Australian general practice, Health of the Nation tracks the pulse of general practice, providing a diagnosis for the future of the profession, Australian GPs and their patients,’ RACGP President-elect Dr Harry Nespolon told newsGP.

The General Practice: Health of the Nation 2018 report brings together general practice data and evidence from robust sources to compare features of general practice in Australia and paint an overall picture of the sector. It is designed to provide a snapshot of contemporary Australian general practice, as told by GPs via specifically commissioned research.
-----

Ken Wyatt admits funding freeze hit older Australians in care

  • 12:00AM September 20, 2018
Aged Care Minister Ken Wyatt has conceded there really was a funding freeze in a crucial government measure that subsidises the medical and nursing needs of older Australians in residential homes, days after denying a cut.
Mr Wyatt confirmed in parliament yesterday that the Coalition had “capped” spending on the Aged Care Funding Instrument while funding more places in both residential and home care over successive budgets.
“The funding instrument was capped at a time in which there were claims that were much higher than the trajectory and all governments have a responsibility to live within their means and within the budget that is established,” Mr Wyatt said.
-----

The dangers of mixing modern miracles

  • 12:00AM September 21, 2018
If there were a tablet for it, we’d probably take it, maybe even before we knew what “it” was. Not necessarily illicit substances, mind you, but evidence-based pharmaceuticals that promise to prevent, treat, heal and cure our many real and imagined ailments. These medicines are addictive enough and, unlike so-called party pills, you don’t have to listen to “doof doof” music (or hear politicians debate pill testing).
People are accustomed to going to a doctor or pharmacist, relaying their concerns and being sold a packet or bottle of modern miracle cures. They take it and expect to be able to take it again and again. Yet, for medicine not to be snake oil, it needs to be evidence-based, tried and tested, with a clinical diagnosis prompting a well-considered professional response. This requires an expert medical opinion and an understanding that your condition or circumstances may not justify tablets on this occasion, or may need to be reviewed and reconsidered across time. Otherwise, that tablet you’re swallowing may be at best a costly toilet additive, and at worse a poisonous concoction that can do you harm.
-----

The 'marketisation' of aged care

By Matt Wade
22 September 2018 — 12:00am
When Prime Minister Scott Morrison called his surprise royal commission into the aged-care sector on Sunday one of the most striking reactions was on the stockmarket.
Shares in the four largest listed aged-care companies plunged amid fears the commission’s probe will result in more regulation on the sector and reduced profitability.
It’s one marker of how much the aged-care sector has changed over the past 25 years. Another is the emergence of “Uber-style” online platforms that connect aged-care consumers with mobile home-care workers.
-----

Cruel reality hits home

  • 12:00AM September 22, 2018
There is a reckoning due in this nation. Our aged-care system is broken. It has been eroded by moral and political failures, aided by a collective delusion that the network of care could withstand the forces of demographic change without substantial intervention.
Right now, more than 3.8 million Australians are older than 65. That’s 15 per cent of the country. In less than a decade that figure breaks through five million, or 18 per cent of the entire population. In less than 20 years, we are talking about 6.5 million people over 65, a fifth of the population.
This is the story of most Western nations, but these are the raw numbers. What living longer does to the tail end of those figures is just as important. Forty-three per cent of those older than 65 are aged 75 and over. In three decades this proportion rises to 55 per cent. The group aged 85 and older balloons from 13 per cent of all over-65s to 20 per cent. The absolute numbers are in the many millions.
-----

International Issues.

Supreme Court nominee accuser comes forward

17 September 2018 — 5:28am
Washington: A California woman who has accused Supreme Court nominee Brett Kavanaugh of sexual misconduct when they were in high school has come forward, alleging in an interview that Kavanaugh pinned her to a bed at a Maryland house party and clumsily tried to remove her clothing.
Christine Blasey Ford says in the interview with The Washington Post that Kavanaugh and a friend - both "stumbling drunk," she says - corralled her into a bedroom during the party in the early 1980s. She says Kavanaugh groped her over her clothes, ground his body against hers and tried to take off her one-piece swimsuit and the outfit she wore over it.
Kavanaugh covered her mouth with his hand when she tried to scream, she says.
"I thought he might inadvertently kill me," says Ford, 51, and a professor at Palo Alto University in California. "He was trying to attack me and remove my clothing."
-----

'We don't have any strategy to deal with it': experts warn next recession could rival the Great Depression

By Ambrose Evans-Pritchard
17 September 2018 — 11:11am
The world's major economies are skating on dangerously thin ice and lack the fiscal, monetary, and emergency tools to fight the next downturn.
A roster of top crisis veterans fear an even more intractable slump than the Lehman recession when the current ageing expansion rolls over. It has grave implications for liberal democracy. "We have no ability to turn the economy around," said Martin Feldstein, president of the US National Bureau of Economic Research.
"When the next recession comes, it is going to be deeper and last longer than in the past. We don't have any strategy to deal with it," he said.
Professor Feldstein, a former chairman of the White House Council of Economic Advisors, described a bleak scenario more akin to the depressions of the 1870s or the Thirties than anything experienced in the post-war era.
-----
  • Sep 18 2018 at 8:34 AM

China to be 'Tariffed!' again, 'filling US coffers': Donald Trump

Washington | Donald Trump has dramatically escalated his tariff war with Beijing, slapping a 10 per cent impost on roughly $US200 billion ($279 billion) of imports that will rise to 25 per cent within months unless China capitulates.
In an announcement that is set to deepen swings on financial markets, Mr Trump also warned that any retaliation by China to the latest attack would "immediately" trigger preparation into tariffs on another $US267 billion in imports.
While the latest announcement covers a vast array of agribusiness, technology, consumer electronics and toys, Mr Trump's ultimatum would ultimately see the equivalent of a tax on every item imported into the US by the world's second-largest economy and Australia's number one trading partner.
-----

How India and China have become a billionaires' paradise

By Peter Hartcher
18 September 2018 — 12:00am
One of history's little pranks is the countries that were Asia's leading exponents of communism and socialism are now the most unequal and unfair.
In Mao's China, power was wielded ruthlessly to enforce the communist ideal of perfect equality. It was a poor country, and the poverty was shared pretty fairly.
Today in Xi's China, power is wielded ruthlessly to stoke growth amid a system of gross inequality comparable to that of American capitalism, red in tooth and claw. "To get rich is glorious," Deng Xiaoping said. Everyone else is invited to keep up as best they can.
-----
  • Updated Sep 18 2018 at 10:40 AM

New allegations about Brett Kavanaugh will poison Washington

by Edward Luce
America's culture wars have just taken a nosedive. Whether Brett Kavanaugh, Donald Trump's Supreme Court nominee, sexually assaulted Christine Blasey Ford in the early 1980s is probably unknowable. Some automatically believe Ms Ford's allegations that she was held down on a bed by a drunken Mr Kavanaugh, now 53, and his friend. Others unquestioningly accept Mr Kavanaugh's categorical denial that any such incident took place. The first tend to be Democrats, the second Republicans.
But justice is the last thing on Washington's mind. Regardless of what happened, Mr Kavanaugh and Ms Ford now personify opposite sides of a #MeToo fight that is likely to poison Washington.
Mr Trump has made it clear that Ms Ford's allegations redouble the need to confirm Mr Kavanaugh. "If somebody can be brought down by accusations like this, then you, me, every man, should be worried," a Trump lawyer told Politico. All men, by implication, should back Mr Kavanaugh's swift confirmation. With just 50 days before US midterm elections, both parties have every incentive to escalate.
-----
  • Updated Sep 19 2018 at 6:06 AM

Trump says US has lost out to 'everyone' on trade as markets shrug

Washington | Donald Trump says his tariff war against China has only "just started" as the president bemoaned previous administrations for allowing "everyone" in the global economy to take advantage of the US.
Mr Trump lashed out at Beijing for "ripping off" America, which he said has been abused by the world as a "piggy bank".
Australia's dollar surged back above US72¢ and US stocks rebounded, a sign investors have discounted growing warnings the trade dispute will continue to worsen, drive up costs for consumers and force companies to rework supply chains.
-----
  • Sep 19 2018 at 10:10 AM

Donald Trump has gravely misjudged China

by Ambrose Evans-Pritchard
If Donald Trump and his close advisers think China's economy is tottering on the brink and acutely vulnerable to pressure, they are sorely misinformed.
The Chinese labour market is as tight as a drum. The ratio of job openings to job seekers is at a record high of 1.24, and it is the abundance of jobs for teeming urban migrants that matters for the Communist Party.
Construction is picking up after a slowdown earlier this year. Industrial profit margins are at a seven-year high of 7 per cent, despite a spate of high-profile defaults - which merely means that China is willing to let them default.
-----
  • Sep 19 2018 at 10:49 AM

Trade war with US could last 20 years, Jack Ma warns Alibaba, China

by Lulu Yilun Chen
Hong Kong | Alibaba Group co-founder Jack Ma cautioned China's business and political leaders to prepare for the trade war with the US to last longer and have a bigger impact than most people think.
China's richest man said the dispute could last 20 years and persist beyond the presidency of Donald Trump, as the world's two strongest economic powers battle for global supremacy. China needs to strengthen its economy to deal with the conflict and shift trade relations from the US to regions like South-east Asia and Africa, Mr Ma said during a speech at the company's investor day conference in Hangzhou.
"Short term, business communities in China, US, Europe will all be in trouble," Mr Ma said, pacing a stage in an open white dress shirt and punctuating his remarks with forceful jabs. "This thing will last long. If you want a short-term solution, there is no solution."
-----

Does Trump want a trade divorce from China? Some think so

By Kirsty Needham
Updated18 September 2018 — 5:13pmfirst published at 5:11pm
Beijing: There is a growing view in Beijing that US President Donald Trump has no intention of doing a deal with China on trade. Instead, Trump wants to force American companies out of China and decouple the two nations' economies, some political analysts say.
How else to explain Trump ignoring more than 300 American companies who protested that imposing tariffs on $US200 billion ($277 billion) in Chinese consumer goods would hurt their business, and raise prices for US consumers?
The fear is there has been a major shift in US policy on China, so that trade is no longer the ballast in the relationship, but rather another US weapon to contain China.
-----
  • Updated Sep 19 2018 at 11:00 PM

Donald Trump's trade war with China has only just started, says Kevin Rudd

Washington | Kevin Rudd has issued a stark warning to Washington that Beijing won't buckle under the worsening US-China trade clash, which the former prime minister described as a "slippery slope" towards a cold war that could one day descend into a military conflict.
In an interview with The Australian Financial Review on Tuesday (Wednesday AEST), Mr Rudd said the Trump administration's demands for change in China have escalated to a point where they can no longer be easily resolved
While the actions of the US president – who this week followed through on his long-telegraphed threat to slap tariffs on $US200 billion ($277 billion) of Chinese imports to the US – have blown the whistle on China's unfair "mercantilist" and predatory approach to trade, the administration's ever-changing demands and internal strife mean Beijing cannot concede ground without a politically dangerous loss of face at home.
-----

What Donald Trump's trade war with China means for you

By Jessica Irvine
20 September 2018 — 12:00am
It's fair to say free trade has received some pretty bad press in recent decades.
The very mention of the phrase now seems to conjure an image of workers being exploited in foreign sweat shops – just so you can have a fancy pair of sneakers - or video footage of the sombre faces of Aussie manufacturing workers, hanging up their overalls and walking out the factory gates for the last time.
Concern over free trade seems to have leapt the political fence, uniting both left wing radicals and right wing conservative to produce a toxic political brew.
-----

Brexit going badly? Would another Brexit referendum help?

By Nick Miller
Updated20 September 2018 — 10:29amfirst published at 6:18am
London: Newsflash: Brexit continues to be a mess.
There is a growing call in the UK for another referendum to sort it all out. To go back to the people and say something like "ok, you asked for Brexit when everyone was making contradictory claims about what it would mean. After two years of negotiations we’ve settled what it means. Still want it?"
Outrageous, say the Brexiters. An affront to democracy. We voted for Brexit. Your job is to do it, not backpedal.
Get over it, say the so-called "People's Vote" Remainers. If one referendum is democratic, why wouldn’t another one be? Surely you’re getting twice the democracy?
-----
  • Sep 21 2018 at 6:27 AM

EU rejects Theresa May's Brexit plan, gives a four-week deadline to reach agreement

by Elizabeth Piper and Gabriela Baczynska
Salzburg | European Union leaders will push for a Brexit deal next month but warned Prime Minister Theresa May on Thursday (Friday AEST) that if she will not give ground on trade and the Irish border by November they are ready to cope with Britain crashing out.
"Don't worry, be happy," joked EU chief executive Jean-Claude Juncker after telling reporters after a summit in Austria that the Europeans had full plans in place in the event there was no deal before Britain leaves next March.
May promised new proposals to reassure Dublin that it would not get a "hard border" with the British province of Northern Ireland but warned she too could live with a no-deal outcome -- though many round the summit table in picturesque Salzburg see that as more of a negotiating tactic than a credible threat.
-----

'It won't work': EU leaders eviscerate May's Brexit plan

By Nick Miller
21 September 2018 — 3:10am
Europe’s leaders have delivered a humiliating blow to the UK’s plan for a frictionless, business-friendly Brexit, declaring that Prime Minister Theresa May’s so-called Chequers blueprint “will not work”.
The news lands Brexit – and May’s leadership and government - in fresh peril, though May was defiant on Thursday that her deal was still the only one on the table, and the EU’s hard line was just a negotiating tactic.
Sterling slid on Thursday as the government stepped up its plans for a no-deal Brexit, once again reviving concerns about the currency's fate if Britain left the European Union without having agreed new trade arrangements.
-----

US-China tariffs: what's behind them, and who stands to be hurt?

By Paul Wiseman
18 September 2018 — 11:40pm
Washington: By imposing tariffs on $US200 billion ($277 billion) more in Chinese goods starting next week, President Donald Trump has intensified his trade war with Beijing and triggered the likelihood of price increases for many American companies and consumers.
Beijing has said it will swiftly retaliate against American exporters — a move that stands to hurt US farmers and other companies that sell their products to China. Beijing may also raise obstacles for US companies to do business in China.
Here's a look at what's happening and its likely impact.
-----

'Send help': May's extraordinary Brexit speech reveals her unusual tactic

By Nick Miller
22 September 2018 — 4:54am
Stripped of its R.E.S.P.E.C.T. rhetoric, British Prime Minister Theresa May’s extraordinary speech in 10 Downing St on Friday sounded suspiciously like the flutter of a white flag.
To paraphrase what it said, in a nutshell: “We chose Brexit. I’m out of ideas on how to make it work the way I want. Send help.”
Anything could happen from here. It could be a bump in the road, or it could lead to the fall of the British government and/or economic chaos. These are all real, not remote possibilities.
-----
  • Updated Sep 21 2018 at 11:00 PM

Beware of Russia and China's soft power plays: BBC World Service boss

Western democracies should be concerned about a "global information war" being waged in the international English-language news space, the head of the BBC World Service said.
Russia and China are spending hundreds of millions of dollars to grow their international news services as part of efforts to bolster their soft power influence in key strategic regions of the world.
BBC World Service Group director Jamie Angus told AFR Weekend "huge resources" were being mobilised by these countries, and to a lesser extent Turkey, to influence the international debate.
-----
I look forward to comments on all this!
-----
David.