One of the reasons Mediscare worked, if it did, was because of the Abbott government’s record on broken promises. After being in government for eight months, by May 2014, the Abbott government had chalked up at least nine broken promises. Abbott had promised no cuts to the ABC or SBS, no cuts to education, no cuts to health, no shutting any Medicare locals, no one’s personal tax will go up, no changes to pensions, foreign aid would go up in line with the CPI, on Indigenous affairs Closing the Gap activities would be sustained at former levels, and ARENA (the Australian Reneweable Energy Agency) would have over $2.5 billion in funds to manage. Continue reading Moving beyond Mediscare
Back on 22 May I did a post Labor makes health central in its election bid:
- In revving up his election spiel Shorten said spending on health was an investment, not a cost. He says investment in health is basic to economic growth. It would be an important battleground if Turnbull would engage. The pointy end is that Labor is choosing to invest in Medicare and the Pharmaceutical Benefits Scheme rather than spending money on company tax relief. Continue reading The giant Medicare scare campaign
In revving up his election spiel Shorten said spending on health was an investment, not a cost. He says investment in health is basic to economic growth. It would be an important battleground if Turnbull would engage. The pointy end is that Labor is choosing to invest in Medicare and the Pharmaceutical Benefits Scheme rather than spending money on company tax relief.
Turnbull just says it’s unfunded, which is a lie, and he knows it. Continue reading Labor makes health central in its election bid
1. Protect your plastic money
If you haven’t heard about it you will. And if you think it won’t happen in Australia, you’re wrong.
Thieves can use RFID technology to empty your card. Seems they can steal your details with a cheap credit card reader, which they hold near you wallet or purse. It could be on public transport, or standing next to you in a supermarket. Continue reading Saturday salon 21/5
An open thread where, at your leisure, you can discuss anything you like, well, within reason and the Comments Policy. Include here news and views, plus any notable personal experiences from the week and the weekend.
For climate topics please use the most recent Climate clippings.
The gentleman in the image is Voltaire, who for a time graced the court of Frederick II of Prussia, known as Frederick the Great. King Fred loved to talk about the universe and everything at the end of a day’s work. He also used the salons of Berlin to get feedback in the development of public policy.
Fred would only talk in French; he regarded German as barbaric. Here we’ll use English.
The thread will be a stoush-free zone. The Comments Policy says:
The aim [of this site] is to provide a venue for people to contribute and to engage in a civil and respectful manner.
Here are a few bits and pieces that came to my attention last week.
Groups that provide aid to homeless people are set to start making thousands of their staff redundant from next month due to uncertainty over federal funding.
The National Partnership Agreement on Homelessness, a funding agreement between the states and territories and the federal government, is set to expire on 30 June, with no assurance from Canberra that the arrangement will continue.
Homelessness agencies have warned that dozens of programs will be axed if the $115m in federal funding ceases, potentially putting the lives of rough sleepers and women fleeing domestic violence at risk.
Canberra public servants can’t even to provide a date for a decision on the funding arrangements.
More than 3,000 staff, who provide support for more than 80,000 homeless people, will be affected. Redundancy notices will start to flow from the end of March.
Above we saw that the Government has no heart. It also has no brains. Christopher Pyne in an indescribably venal move has tied research infrastructure funding to the passage of his higher education reforms.
For reasons that are unclear, the government has singled out the research infrastructure part of the annual A$9 billion science and research budget and is threatening to kill it for the sake of the A$150 million earmarked to keep the infrastructure afloat.
Without looking at the cutting-edge science that the facilities produce, the research facilities support just about every sector of the Australian economy from agriculture, to mining to drug design and medical research.
There are more than 35,000 researchers who use our major research facilities, and these will be progressively locked out as the facilities go off-line. More than 1,700 skilled scientific and support jobs are under threat if the facilities are mothballed. Even now we are seeing the signs of losing the corporate knowledge and erosion of the skilled professional workforce as staff seek more secure career opportunities.
And perhaps worst of all is the sheer waste of more than A$3 billion in capital investment as well as the hard work that has gone into building up new capacity over decades.
Some innovative companies will take their research overseas.
The universities are on their knees begging. Adam Bandt has called it “parliamentary blackmail”. It’s beyond stupid. Words fail!
That’s what Abbott assured us this week. Medicare is still unsustainable, according to the Government, though this is questioned by experts.
Health Minister Sussan Ley says the Government still wants people who can afford to contribute to the cost of their healthcare to do so. Presumably this would mean a rebate indexed according to affordability. Is this practical?
The Government will continue its pause on indexation of Medicare rebates, for GP and non-GP items. This must be wearing thin with doctors. It started with Labor in 2013 and there is no indexation for inflation.
So far bulk billing rates have held up pretty well.
In another exercise in barnacle scraping, the Government relented partially on defence force pay at a cost of $200 billion over the forward estimates. Jacqui Lambie says they’ve still been dudded by one per cent, it’s still an insult and she is considering her embargo on supporting government legislation.
Australia is to send about 300 more troops to Iraq, to help train the Iraqi army in its fight against Daesh, also known as Islamic State.
Mr Abbott says the contribution is prudent and proportionate and it’s in Australia’s national interest to stop the militant group from inspiring supporters around the world.
The new deployment was quickly supported by Labor, but opposed by the Greens and the Independent MP Andrew Wilkie.
Abbott was boasting that he sweats with the troops. He tries to have physical training with them when he is on their bases. He’s certainly pushing the national security issue hard.
Like Wilkie, Bernard Keane at Crikey doesn’t agree with the deployment. He says we are doing what ISIS wants us to do, we are endangering our home security, and in any case the Iraqi armed forces don’t do fighting, they do torturing, murdering and raping Sunni prisoners.
I wonder how much this exercise will cost!
The federal Government’s forays into health policy show no signs of becoming realistic. The 2014 budget foreshadowed that the Commonwealth might get out of the funding of hospitals in favour of the states accepting a higher and broader GST.
The problem here, as Gillard pointed out in her book, is that health expenditure expands faster than the GST revenue.
Then we had $7 co-payments for GP visits in an effort to keep poor people out of doctors’ surgeries.
This was followed by the fiasco of proposing and dumping the $20 cut to the rebate for short GP visits. According to recent news reports, the plan was originally opposed by Joe Hockey and then health minister Peter Dutton. Abbott insisted and then unaccountably backflipped.
Now Joe Hockey reckons we are living too long. Some kid just born somewhere is bound to live to 150.
John Dwyer, Emeritus Professor of Medicine at the University of NSW, has long been an advocate for preventative health care. He says in a paywalled article in the AFR that many hospital admissions (costing $5000 each) could be prevented by primary care intervention in the three weeks prior to admission.
Medicare expenditure of $19 billion each year is dwarfed by hospital expenditure of $60 billion.
There is now an abundance of evidence that a focus on prevention in a personalised health system improves outcomes while slashing costs. Some systems have reduced hospital admissions by 42 percent over the last decade.
The Brits have just been presented with a review that concluded that an extra $132 million (in our money equivalent) spent on improving primary care would save the system $3.5 billion by 2020.
Worth a look, I would think!
There is another problem in the works. Only 13% of young doctors express any interest in becoming a GP.
The discrepancy in income potential for GPs when compared to that of other specialists is now huge. Young doctors looking at the professional life of our GPs are uncomfortable with the current “fee-for-service” model that encourages turnstile medicine that is so professionally unfulfilling. Many GPs join corporate primary care providers preferring a salary.
New Zealand has facilitated 85% of GPs away from fee-for-service payments. The same is true in the US for 65% of primary care physicians.
Finally, says Dwyer, we could take the $5 billion cost of the private health insurance rebate and spend it on all of the above.
Once again we are embarrassed by the incompetence of our politicians.
Before the recent backflip on plans to cut the rebate for short GP visits by $20 Tim Woodruff made a comment on the plans. There were three parts to the proposed changes:
The first is a direct cut of $5 to the Medicare rebate for everyone except pensioners and health care card holders. The ALP, Greens, and some crossbenchers have indicated they disagree with this so it may never happen as it must pass the Senate.
The second is to freeze the rebate until 2018 which means that because of inflation, this will amount to a $3 cut to the rebate for everyone by 2018. This can’t be stopped as it doesn’t require parliamentary approval.
The third part of the proposal, however, is to reduce by $20 rebates for visits less than 10 minutes in duration. The Government claims that this is intended to reduce “6 minute medicine”…
Only the third of these has been abandoned.
There are two points to be made about this.
First, the Government’s aims have not changed. They want the poor to go to the doctor less to ‘save’ Medicare, or as Woodruff suggests to institute a two-tiered medical system.
The Federal Government wants a two-tiered health system where credit cards decide what level of care one receives. This is the American way. The next proposal may be to replace our flag with the Stars and Stripes.
Secondly, the politics is just awful. As Norman Abjorensen points out, new minister Sussan Ley was sent out to dump proposals that Abbott had robustly defended not 24 hours earlier.
Was Abbott rolled? What does Julie Bishop think? Why did they get themselves into this mess in the first place? Clearly they didn’t sound out the senate cross bench.
Abjorensen says the question now is not whether Medicare will survive Abbott, but whether Abbott will survive Medicare. No wonder he looks worried:
Photographers can be cruel!
Tim Woodruff is currently the vice-president of the Doctors Reform Society and a specialist physician working in private rheumatology practice in Melbourne.