Thursday, 19 May 2016

The Macro View - Budget And Health News Relevant To E-Health And Health In General.

May 19  Edition
With the Budget on the Third of May what we have seen is as follows in the articles below. In broad terms there seem to have been some pretty tough stuff in the sectors such as health and education. Comments welcome on what you thought of the Budget.
Note: A hell of a lot of all this has not been legislated - and now we are in an election mode they may or may not come about depending on the election outcome.
With the Election now formally announced for July 2 we will need to keep a close eye out for any health and e-Health impacts.
As we move further into the campaign I am sure it will become more interesting - with the polls as tight as they are at present.

General Budget Impacts.

  • May 8 2016 at 11:45 PM
  • Updated May 9 2016 at 5:09 AM

Election 2016: Voters gives thumbs down to Turnbull budget

The Turnbull government's first federal budget has received a generally negative reception from the voting public, but it is nothing like the politically disastrous 2014 offering which sent Tony Abbott and his government into freefall.
The latest Fairfax/Ipsos poll finds that the budget, a critical document given it was released less than a week before the federal election campaign, was perceived as fair by 37 per cent of voters while 43 per cent disagreed. Another 20 per cent had no view either way.
In the 14 budgets polled by Fairfax since the tough 1996 Howard/Costello budget, last week's budget is second only to 2014 in terms of perceived unfairness.
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Updated May 10 2016 at 12:27 AM

Election 2016: Labor promises quick mini-budget

A federal Labor government would release a mini-budget within three months to calm concerns among the ratings agencies that Australia is not doing enough to preserve its AAA credit rating.
With the economy dominating the start of the election campaign, shadow treasurer Chris Bowen will use his reply to last week's budget to claim the government's path back to surplus was a risk to the rating because it was based more on hope and unrealistic assumptions, such as a high iron ore price, than concrete action.
"None of it can be relied upon," he will tell the National Press Club on Tuesday.
Mr Bowen will say a Labor government needed to be brave enough to raise taxes and cut spending to make an impact on the deficit and assuage the ratings agencies.
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Is this really a disgusting Budget?

Is this really a “disgusting Budget?” That’s how my barista described it to me on the day after Scott Morrison’s first fiscal effort, so I promised Andre that I’d evaluate his assessments.
So let’s start with why a generally well-balanced barista would be disgusted by this Budget.
If he was planning to retire soon and had plans in place, he could be disgusted with the super changes. For the first time ever, I threw the phone lines open on my TV show last night, as I’d received an avalanche of emails about how many of my viewers, readers and listeners have been affected by these proposed super changes.
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Signs of a problem for Malcolm Turnbull in post-budget sentiment

Date May 14, 2016 - 12:15AM

Malcolm Maiden

Columnist

My prediction a week ago that Scott Morrison's Budget was unlikely to be a election liability is not looking good. Wednesday's consumer sentiment result and other feedback suggests that the budget isn't helping, and might be doing harm. The fact that it was actually even-handed is being lost in the election ruckus.
People began being contacted for the May edition of the Westpac Melbourne Institute consumer sentiment survey on Monday, May 2, the day before Scott Morrison unveiled his first budget, and the Reserve Bank met and cut its cash rate. The survey of 1200 people was completed on Saturday, May 7, so both events are in the weave of the results.
Compared with April, sentiment improved by a solid 8.5 per cent, to 103.2 points, comfortably above the 100 point plimsoll line that divides a positive mood and a negative one. By way of comparison, the index sank from 99.7 points to 92.9 points in May 2014 after Joe Hockey's heavy-handed first budget.
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Health Budget Issues.

1:31pm May 8, 2016

GPs to launch targeted Medicare campaign

By  AAP
Doctors will ask patients to join their fight against the government's freeze on Medicare rebates in a widespread campaign planned to coincide with the election.
From Monday, GPs will move to warn patients about the budget measure and encourage them to lobby against it.
Last week's budget extended by two years to 2020 a four-year indexation freeze on the Medicare rebate the federal government pays for services like GP visits.
The government expects the move will save almost $1 billion, but the Royal Australian College of General Practitioners says it will leave patients worse off, especially the disadvantaged.
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Election 2016: Doctors launch campaign against extended freeze on Medicare rebates

Date May 8, 2016 - 2:40PM

Jane Lee

Legal affairs, health and science reporter

EXCLUSIVE
The federal Coalition is facing an early election headache with thousands of GPs set to urge their patients to lobby against the extended freeze on Medicare rebates.
The Royal Australian College of General Practitioners will launch its campaign against the government's decision to continue to freeze current rebates until 2019/20, which it says will force more doctors to start charging their patients a co-payment. The government expects the move will save it about $925.3 million.
From Monday, the 32,000 members will hang posters in their waiting rooms that warn: "Danger. You and your family's health is being targeted. The extended freeze on Medicare rebates means you will pay more!"
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Robbing sick Peter to pay healthy Paul

Lesley Russell
Monday, 9 May, 2016
THE 2016-17 Budget is described by the Prime Minister as a national economic plan focused on the long term. That does not ring true for the health budget, which presents more as a statement of politics and short-term fixes.
The subtext is that there is no vision or commitment to necessary health care reforms in primary care, clinician payments, mental health and Closing the Gap on Indigenous disadvantage.
The big spending commitments were already known. The additional $2.9 billion over 3 years to public hospitals and the commitment to activity-based funding is welcome, although this represents less than half the funding cut in the 2014-15 Budget. There are references to associated initiatives to improve quality and safety and to tackle avoidable hospital admissions and readmissions, but there is no further information in either the Council of Australian Governments communiqué or the Budget papers.
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Tunneling for Budget health nuggets

Cate Swannell
Monday, 9 May, 2016
TUNNEL down deep enough into the 2016-17 Budget papers and a couple of health care nuggets emerge, buried under the increases to the tobacco excise, the Health Care Homes trial and the Healthier Medicare package.
One such shiny morsel is the $20.4 million to be poured into improving the regulation of therapeutic goods in Australia, which will be spent via the Therapeutic Goods Administration (TGA) from 2016–2017 to 2019–2020.
The measure is a response to the Sansom review (Expert panel review of medicines and medical devices regulation) which reported to the government back in July 2015 with a list of 58 recommendations.
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Getup maps $57bn in Abbott-era health cuts hospital by hospital

Cuts budgeted since 2014 will cost big hospitals like Royal Melbourne more than $1.3bn over 10 years, lobby group says
Voters more concerned with hip replacements than the hip pocket might want to look at a new map launched by GetUp that offers a projection of what $57bn of health cuts would do to hospitals in their local area.
According to the progressive campaign group, the Coalition government’s policies amount to a $57bn cut over 10 years, equivalent to 37,000 hospital beds that can’t be funded, or 68,000 nurses or 33,000 doctors that can’t be paid.
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Federal election 2016: funding tweaks shear $1.2bn

  • The Australian
  • May 10, 2016 12:00AM

Rick Morton

The federal government’s decision to shave $1.2 billion from care funding for the aged-care sector was prompted by an astonishing over-classification of complex ­resident needs in most states, particularly in Queensland, South Australia and Tasmania.
While the overall aged-care budget jumped $17.8bn — almost 8 per cent — the government will build on Labor efforts to restrict the Aged Care Funding ­Instru­ment which has, intentionally or not, been improperly applied.
The ACFI governs funding for the care needs of residents in homes but is only one element of the sector’s overall funding.
Data obtained by The Australian shows almost 18 per cent of ACFI reviews in Queensland aged-care homes for the nine months to the end of March led to a downgrade in funding — because of over-egging of complex care needs — and almost 22 per cent in Tasmania and 22 per cent in South Australia.
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Election 2016: Where the parties stand on the big issues

Here's what you need to know about how the parties' policies stack up.

Health

The Coalition went into the 2013 election "on a unity ticket" with Labor, to neutralise a campaign that Tony Abbott would begin cutting health funding once elected.
However the 2014 budget saw the ticket torn up, with hospital funding agreements the states and territories made under former Labor prime minister Kevin Rudd to be wound back from 2017, saving a massive $50 billion over eight years.
Also announced was a $7 co-payment to visit the GP, which became one of the least popular measures in Joe Hockey's 2014 budget, and was eventually scrapped.
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Aged care investment will stall due to funding cuts

Date May 13, 2016 - 12:15AM

Tim Binsted

Reporter

Funding cuts to the aged-care sector threaten to kill much needed investment in new beds and push sick and frail residents into hospitals, industry players warn.
There are also private mutterings that the redesigned funding formula for complex healthcare  – in some cases cutting funding from $46 a day per resident to just $16 a day from July 1 2017 – could drive some businesses out of the aged care industry altogether.
In the May budget Treasurer Scott Morrison unveiled $1.2 billion of cuts to aged care. The latest cuts came after $600 million was stripped in the mid-year update last December.
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Bulk-billing rates have continued to rise under the Coalition

  • The Australian
  • May 13, 2016 8:33AM

Sean Parnell

Bulk-billing rates have continued to rise, undermining a campaign by Labor and health groups concerned a prolonged freeze on Medicare rebates will force more patients to pay to see a doctor.
The Coalition government extended the freeze in the recent budget, meaning doctors and other practitioners will have no change in government income for at least seven years.
While Labor initiated the freeze when last in government, the Opposition has made Medicare a key election issue, aided by doctors putting up posters and writing prescriptions on pads warning patients they will pay more under the Coalition.
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  • May 13 2016 at 8:56 PM
  • Updated May 13 2016 at 8:58 PM

Election 2016: Turnbull backpedals on health cuts but Shorten wins debate

Malcolm Turnbull has moved to take the sting out of Labor's attacks over health funding by announcing a partial reversal of a contentious policy that would have seen pathology costs rise.
During Friday's leaders' debate, the first of the election campaign,  Mr Turnbull partly reversed a $650 million savings measure announced in last year's mid-year budget update which removed bulk billing for pathology tests.
The debate, a close and civil affair, was held in front of an audience of 100 undecided voters in the Liberal-held marginal seat of Macquarie, in western Sydney. Despite Mr Turnbull's policy olive branch, the audience awarded the contest to Mr Shorten by 42 votes to 29 while another 29 were undecided..
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Medical groups still concerned about bulk billing amid Turnbull pathology deal

By political reporter Francis Keany
Doctors' groups say they have concerns about the Prime Minister's pathology deal because the proposed cuts to bulk-billing incentives are still on the table.

Key points:

  • PM declares breakthrough in bulk-billing dispute
  • Government gets to keep proposed cuts, pathologists to absorb costs
  • AMA concerned about future changes
  • Changes would save budget $650 million over four years
Yesterday Malcolm Turnbull used a leaders' debate in western Sydney to declare a breakthrough in the stoush over bulk-billing incentives for blood tests — a deal which had been a source of long-running funding dispute.
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6:10am May 14, 2016

Bulk-billing for pathology to continue after government makes deal with practitioners

By AAP
May 14, 2016: In a bid to win the hearts and minds of Australian voters, Prime Minister Malcolm Turnbull and opposition leader Bill Shorten have taken to a People’s Forum in western Sydney.
The federal government has brokered a peace deal with angry pathologists in a major win for patients who will continue to access bulk billed medical tests.
Changes to bulk-billing incentive payments due to come into force from July 1 will save the budget $650 million over four years.
Pathologists were up in arms when the announcement was made in the budget review last December, warning they were unable to absorb the costs and would have to pass them on to patients.
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14 May 2016 - 4:08pm

Win on medical tests but not scans

The federal government will postpone making changes to bulk-billing incentive payments for pathology services for three months.
Source: AAP 14 May 2016 - 4:08 PM  UPDATED 28 MINS AGO
While patients will continue to be bulk-billed for pathology tests people could still be left hundreds of dollars out of pocket for x-rays and scans.
Prime Minister Malcolm Turnbull has called a truce with pathologists over changes to bulk-billing incentive payments which were due to come into force from July 1.
They were slated to save the budget $650 million over four years.
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AMA slams bulk-billing deal

Updated: 9:09 pm, Saturday, 14 May 2016
The Australian Medical Association (AMA) is on the attack over a peace deal between the federal government and Pathology Australia.
The government has delayed changes to a bulk-billing incentives, which were slated to save the budget $650 million over four years, until after the election.
The AMA has warned the deal would still mean cuts to bulk-billing incentives for pathology services.

Health Insurance Issues.

Complaints up as health fund members struggle: Ombudsman

  • The Australian
  • May 9, 2016 12:00AM

Sean Parnell

Complaints about private health insurance have risen 24 per cent as the office of the Ombudsman, Colin Neave, joins calls for the federal government to provide more support to members struggling with rising costs.
The Ombudsman’s latest report on the industry, quietly published on Friday, noted that there were 4265 formal complaints last year as more members found themselves caught without cover when they needed it most.
Premiums rose by an average 5.9 per cent last month, a trend exacerbated by erosion of the insurance­ rebate because of changes made by Labor and ­Coalition governments.
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Boom in after-hours GPs raises concerns about Medicare cost blowout

Date May 12, 2016 - 9:54AM

Harriet Alexander and Julia Medew

EXCLUSIVE

How to make the most of your health cover

SMH's Harriet Alexander's hot tips to save you money and optimise your private health insurance in 2016.
Home visits by mobile GPs are booming in Australia, causing some doctors to question whether the "Uberisation" of medicine is ripping off Medicare.
New data shows the growth in private companies offering "free", bulk-billed home doctor consultations in people's homes out of business hours has cost Medicare $662.1 million since 2010, challenging traditional "family doctor" GP clinics.
The services have been a boon for people who want a doctor to visit them at home between 4pm and 8am during the week and on weekends and public holidays. In some cases, the doctors will provide pharmaceutical treatments such as anti-nausea drugs, saving people a visit to a pharmacy.   
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Canberra warns health funds on clinical decisions

  • Sean Parnell Health Editor
  • The Australian
  • May 12, 2016 1:41PM
Health Minister Sussan Ley has told a doctors’ group her department warned health funds not to interfere in clinical decision-making when trying to keep costs down.
The Australian revealed in February that Australia’s two largest health funds, Medibank and Bupa, were requiring eye surgeons to sign declarations that procedures they had booked in for members were clinically necessary and not purely cosmetic.
The Australian Society of Ophthalmologists alerted Ms Ley who recently informed them “senior officers” of the department had held meetings with major health insurers and written to other funds on the issue. The department advised the industry that there was no requirement for any pre-approval process where members were due to receive hospital treatment attracting a Medicare rebate and covered under their policy.
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Pharmacy Issues.

Employing naturopaths in chemists akin to McDonalds style ‘do you want fries with that?’ marketing

May 8, 2016 5:00pm
JANE HANSEN News Limited
PHARMACISTS have blasted attempts by the vitamin and supplement industry to employ naturopaths in chemists as a sales gimmick and fear it will diminish the credibility of their profession.
Ian Carr, a Taree-based pharmacist, said he was dismayed by the trend of naturopaths employed by supplement companies and pharmacists to work as in-store ­consultants. He said many supplements were not evidenced-based and didn’t do what they claimed.
“I’m going to campaign against the placement of naturopaths in store because its message is contrary to the dispensing side and I don’t want to mislead clients with nonsense like naturopathy.
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Naturopathy: ‘If it wasn’t so serious it would be funny.’

Taree pharmacist and Friends of Science in Medicine member Ian Carr is stepping up a campaign against naturopathy in pharmacy, the Daily Telegraph reports.

Reporter Jane Hansen spoke to Carr, who has written in the past for the AJP criticising homoeopathy, as well as Blackmores’ Lesley Braun and the Pharmacy Guild’s Greg Turnbull, after Blackmores advertised last week for naturopaths to work in Sydney pharmacies as part of an “in-store health and wellbeing team”.
Carr told Hansen that he plans to campaign against the placement of naturopaths in pharmacies because “its message is contrary to the dispensing side”.
“I think there’s a real undercurrent, a lot of consumers out there who want to be dealt with in an honest and science-based manner,” Carr told the AJP today.
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Superannuation Issues.

Turnbull and Morrison risk losing the federal election if they proceed with changes to superannuation

Rowan Dean The Courier-Mail
PRIME Minister Malcolm Turnbull and Treasurer Scott Morrison have 54 days to scrap their superannuation changes or risk losing the election.
It’s an ominous figure – it’s the same number of Liberal MPs who overthrew Tony Abbott to install a man who treats the Coalition’s most loyal supporters with contempt.
It also happens to be the age of many Liberal voters who may well vote Labor on July 2 unless the Coalition’s disgraceful superannuation caps are ditched.
In fact, anyone a decade either side of 54 who has worked all their life to save for their own and their family’s future will think twice about voting Liberal if the super rules, sprung like a booby-trap on Budget night, are still there on election eve.
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In Scott Morrison’s 1 per cent? Too bad for you

  • The Australian
  • May 10, 2016 12:00AM

Judith Sloan

One of the most idiotic and ill-judged statements in Scott Morrison’s budget speech was this: “The transfer balance cap, the lifetime non-concessional cap and the 30 per cent contributions tax will each affect less than 1 per cent of superannuation fund members.”
Doubling down on this mistake, the Treasurer went on to tell us that “a concessional contributions cap of $25,000 per annum will affect just 3 per cent of superannuation fund members, particularly those who pay the top rate of income tax”.
Now I’m not sure how these figures should be added up: is it 4 per cent in total? Of course, the Treasurer couldn’t be less interested in the answer because all he wants to do is get away with announcing bad policy that can be dressed up as “fair”, even if it’s nothing of the sort.
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Can Australia afford Morrison's super changes?

Analysis

The Federal Government's proposed changes to superannuation reduce incentives for people for fund their own retirements - and that could cost the country dearly, argues Andrea Michaels.
Andrea Michaels
Tuesday, May 10
For middle-income earners in their 50s and 60s, waking up last Wednesday morning to read about the budget – specifically the raft of superannuation changes – probably caused some indigestion over breakfast.
Between the usual headlines of ‘winners and losers’ (something the Treasurer had been at pains to avoid), it must have become clear that any plans to save for a comfortable retirement were looking shaky.
Tax experts wondered how much some of these super changes might actually cost the country in the longer term. Financial Services Council chief executive Sally Loane was quoted in The Australian Financial Review last week saying the test will be if we create more pensioners or more self-funded retirees. At this stage, it doesn’t seem like the last group will be the winners.
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Institute of Public Affairs plans aggressive superannuation campaign

Conservative think tank says its members are furious about 2016 budget changes limiting contributions and tax-free income.
Treasurer Scott Morrison and finance minister Mathias Cormann with the 2016 budget papers, which included new limits on tax-free income from superannuation. Photograph: Stefan Postles/Getty Images
The Institute of Public Affairs is preparing to run an aggressive public campaign against the Turnbull government’s superannuation changes similar in style to its anti-18C and climate change campaigns.
IPA executives held a meeting on Tuesday morning to plan their campaign, saying their members were furious at the raft of super reforms revealed in Scott Morrison’s budget.
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Federal Budget 2016: super tax hit seemed good idea at the time

  • The Australian
  • May 14, 2016 12:00AM

Terry McCrann

Tinkering with superannuation pre-election was bad timing
The government’s — rather importantly, proposed — changes to superannuation are not retrospective. To claim they are requires a suspension of reason or a simple failure to understand the meaning of the word.
The proposed changes are certainly a direct breach of multiple promises by this government not to increase the taxation of superannuation. And worse, they are a major stupidity nestling within an even broader stupidity.
They are, quite simply, a total trainwreck. They have become Treasurer Scott Morrison’s deficit levy — a measure aimed only at the top end of town but stoking fear and loathing across Middle Australia.
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Super changes set to hit more than government suggests

  • James Kirby
  • The Australian
  • May 14, 2016 12:00AM
Scott Morrison has managed to pull off that rarest of political acts … he’s managed to upset just about everyone with his superannuation changes. But what really matters is that the Treasurer has not just upset, but embarrassed the nation’s wealth advisers and for that sin he will not be easily forgiven.
Investment is after all a matter of making plans and sticking to them, but now many plans are off … or at the very least in jeopardy.
As Will Hamilton of Hamilton Wealth Management puts it: “A blanket rule has been introduced which has produced extreme anger and an erosion of trust.”
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I look forward to comments on all this!
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David.

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