Thursday, February 02, 2017

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

February 2  Edition.
After about 10 days of the Trump administration we certainly have had some action! Just how it will all play out is hard to know but at least on Nobel Laureate does not see much good coming from it all!

Making the Rust Belt Rustier

Donald Trump will break most of his campaign promises. Which promises will he keep?
The answer, I suspect, has more to do with psychology than it does with strategy. Mr. Trump is much more enthusiastic about punishing people than he is about helping them. He may have promised not to cut Social Security and Medicare, or take health insurance away from the tens of millions who gained coverage under Obamacare, but in practice he seems perfectly willing to satisfy his party by destroying the safety net.
On the other hand, he appears serious about his eagerness to reverse America’s 80-year-long commitment to expanding world trade. On Thursday the White House said it was considering a 20 percent tariff on all imports from Mexico; doing so wouldn’t just pull the U.S. out of NAFTA, it would violate all our trading agreements.
Why does he want this? Because he sees international trade the way he sees everything else: as a struggle for dominance, in which you only win at somebody else’s expense.
His Inaugural Address made that perfectly clear: “For many decades we’ve enriched foreign industry at the expense of American industry.” And he sees punitive tariffs as a way to stop foreigners from selling us stuff, and thereby revive the “rusted-out factories scattered like tombstones across the landscape.”
Unfortunately, as just about any economist could tell him — but probably not within his three-minute attention span — it doesn’t work that way. Even if tariffs lead to a partial reversal of the long decline in manufacturing employment, they won’t add jobs on net, just shift employment around. And they probably won’t even do that: Taken together, the new regime’s policies will probably lead to a faster, not slower, decline in American manufacturing.
-----
Enough said – this won’t end well I fear.
-----
Here are a few other things I have noticed.
-----

Trump Material.

With Donald Trump in the White House, what now for the Asia-Pacific?

Brendan Taylor
Published: January 23, 2017 - 12:00AM
As Donald Trump enters the Oval office, speculation is rife regarding what his presidency will mean for stability in Australia's Indo-Pacific region.
Will Trump slap tariffs on Chinese imports, sparking a trade war between the world's two largest economies? Will he forge a new great power alignment with Moscow, leaving Beijing out in the cold strategically? Will he abandon free-riding Asian allies and encourage them to develop their own nuclear arsenals? Or is all of Trump's bluster geared toward putting Beijing off balance as he seeks to strike a better "deal" for America with a rising China?
The truth is that we simply don't know what a Trump presidency will mean for Indo-Pacific stability. And we probably won't know until the incoming Trump administration confronts its first major crisis here.
-----

China eyes opportunity as US pulls out of Trans-Pacific Partnership

Justin Sink and Toluse Olorunnipa
Published: January 24, 2017 - 6:36AM
Washington: President Donald Trump's formal withdrawal from a long-planned trade deal with Pacific Rim nations creates a political and economic vacuum that China is eager to fill, offering a boost for beleaguered US manufacturing regions while damaging American prestige in Asia.
The move is a sledgehammer blow to former President Barack Obama's attempt to recentre US foreign policy from the Mideast to Asia.
As the Trump administration retreats from the region by ending US participation in the Trans-Pacific Partnership, China's Communist leaders are ramping up their globalisation efforts and championing the virtues of free trade.
-----

Wall Street Questions If Trump Can Turn His Promises Into Policy

Increasing doubts about corporate taxes, infrastructure spending
by Julie Verhage
24January,2017, 2:06 am AEDT
It's a lot easier to say you'll do something in Washington than to actually get it done. 
A number of Wall Street analysts are becoming increasingly concerned that President Donald Trump won't be able to follow through on several key proposals that he campaigned on, such as lowering corporate taxes and increasing infrastructure spending. If he doesn't, or aspects of the reforms are pared back, their outlooks would become much less optimistic.
Stocks in the U.S. have rallied more than 8 percent since Trump was elected, but all of those gains were made between Nov. 8 and Jan. 6. Since then, markets have stalled as has consumer confidence.
-----

Now that Trump is US president, world braces for Trumpnomics

Professor Carmignani
Published: January 23, 2017 - 4:52PM
If Australia does indeed catch a cold when the US sneezes, should we be preparing for a crippling dose of influenza when Trumpnomics takes hold?
In the months following the end of the US presidential campaign, the rhetoric of Donald Trump moved from boisterous statements on (mostly undoable) plans to build walls and ban Muslims to more practical announcements about economic policy.
This rhetoric reflects Trump's understanding that the way to make America great again is through economic prosperity. Hence the need to articulate an economic plan, which, with this weekend's inauguration, will soon become reality.
-----

Donald Trump turns his back on the world

Peter Hartcher
Published: January 24, 2017 - 5:37AM
Donald Trump's America does not exist in a vacuum. Other nations are calculating and positioning to take advantage.
Much has been said about Russia. But the rising great power competing with the US for leadership in the Asia-Pacific and for authority worldwide is China.
Strikingly, Beijing has decided that Trump represents a great opportunity to win power and influence at America's expense.
-----

TPP: Australian dollar breaks through US76c on 'global trade war' fears

Jens Meyer
Published: January 24, 2017 - 2:09PM
The Australian dollar has topped US76¢ for the first time in more than two months as the greenback continues to weaken on worries that the Trump administration's protectionist stance will include seeking a weaker currency.
Talk of trade wars pushed the Aussie as high as US76.09¢ early Tuesday afternoon. Overnight, the US dollar spot index, which measures the greenback's value against a basket of major currencies, dropped below the mark of 100 for the first time since early December, falling as low as 99.89 before recovering slightly to 100.16.
US President Donald Trump has targeted trade policy in his first days in office, pulling America out of the Trans-Pacific Partnership on Monday as well as threatening a "very major" border tax for companies who shift production out of the US.
-----

We’re with Donald Trump in uncharted territory

  • The Australian
  • 12:00AM January 25, 2017

Paul Kelly

Donald Trump’s inaugural ­address, playing to a dark age of US “carnage” that he pledges to extinguish, should leave nobody in doubt: the President is a populist reactionary and radical, not a conservative, whose transformation agenda is hostile to the traditions and principles of US conservatism.
The essence of his politics is the enshrinement of victimhood at the hands of a corrupt ruling order. Exploiting the stagnation of real wages over a generation and huge inequities in US society, Trump blames the Washington establishment, foreigners, rival nations and companies that have exploited US riches, stolen its jobs, enticed its corporates, plundered its middle-class wealth and left its heavy industry in ruins.
He paints a dark past from which he will liberate America. Yet he arrives as an outsider with few institutional allies in the US system, a compulsion to create enemies, and an almost reckless addiction to creating huge expectations for his presidency. He declares the “empty talk” is over and the “hour for action” is at hand. He tells his legions of voters not to countenance talk of failure, to reject the naysayers, to believe the long era of politicians who practice “all talk and no action” is finished. He declares America stands “at the birth of a new millennium”.
-----

Donald Trump's economic package unlikely to match rhetoric

Jessica Irvine
Published: January 25, 2017 - 9:04AM
Sharemarkets will likely shrug off Donald Trump's decision to withdraw from the Trans-Pacific Partnership trade deal. On best estimates, the deal would have delivered only minor benefits for the US and Australian economies.
What really matters is what becomes of the rest of his ambitious economic agenda.
The Aussie bourse surged more than 10 per cent after the US election, spurred by Trump's election night promise of a huge infrastructure spending spree, along with massive tax cuts.
-----

Donald Trump's America has Malcolm Turnbull scrambling in a changed world

Daniel Flitton
Published: January 25, 2017 - 8:29PM
In three ways - and in just three days - Donald Trump's "America First" mantra has profoundly unsettled Australia's assumptions about the world.
Trump hasn't provoked a crisis in foreign policy but there is a new intensity that will especially challenge Malcolm Turnbull in the coming weeks on vexed political questions ranging from refugees to China.
US forces get the nod?
An unnamed official from the Trump team has flagged expanding or adding new bases in Australia as part of a wider strategy to counter China's influence in the region.
-----

Australia is investing billions in madman Donald Trump

Michael Pascoe
Published: January 27, 2017 - 1:19PM
There are several hundred Australian defence personnel deployed in Iraq. The Commander in Chief of the nation controlling their action has just told Iraqis that the US should have taken their oil after invading their country in 2003. He then left the door open to have another crack.
This wasn't a second-hand report of a private conversation: it was an in-depth one-on-one interview with America's ABC News' 20/20 program. President Trump repeatedly said the US should have taken or "kept the oil."
"We should've taken the oil," he told ABC anchor David Muir. "And if we took the oil you wouldn't have ISIS. And we would have had wealth."
-----

Donald Trump’s election a rejection of identity politics

  • The Australian
  • 12:00AM January 28, 2017

Paul Kelly

As Donald Trump’s new presidency surges across our politics, creating chaos and uncertainty, there is one element in his victory where most Australian politicians remain in ideological denial — the revolt against identity politics.
Trump, in effect, was given permission to win the election by the US progressive class despite his narcissism, his coarseness and his smashing of the orthodox bounds of political and policy behaviour.
In retrospect, the 2016 US election story is a grand joke — enough voters in Middle America decided to tolerate Trump’s juvenile viciousness because they felt the narcissism of prevailing closed-minded progressive ideology was no longer to be tolerated. In the end, the alternative was worse than Trump. Is this too difficult an idea to grasp?
-----

National Budget Issues.

Scott Morrison looks to London to solve housing affordability crisis

Michael Koziol
Published: January 22, 2017 - 5:18PM
The Turnbull government appears to be moving toward establishing a government backed-bond vehicle for affordable housing as Treasurer Scott Morrison heads to Britain to seek guidance on Australia's housing affordability crisis and Prime Minister Malcolm Turnbull prioritises the issue.
Similar to the Clean Energy Finance Corporation, which the former Abbott government wanted to abolish, a housing bond aggregator would give affordable housing providers access to cheaper and longer tenor debt for the construction of new homes.
It was the leading recommendation of bureaucrats in a report handed to state and federal treasurers in December, who agreed to establish a taskforce to design the model by mid-2017. The report made an exemplar of Britain's Housing Finance Corporation, which in 2014-15 issued more than £4 billion ($6.55 billion) in loans to housing agencies.
-----

Sydney has the second least affordable housing in the world: study

Latika Bourke
Published: January 24, 2017 - 5:19AM
Australia is a world leader in "severely unaffordable" housing, a study of global housing markets has found, with Sydney the second most unaffordable major housing market in the world, coming behind only Hong Kong.
Sydney and Melbourne are among the top 10 least affordable major housing markets, according to Demographia's 13th annual International Housing Affordability Survey.
The survey found that of Australia's 54 housing markets, just four, including Karratha, Port Hedland and Kalgoorlie in Western Australia and Gladstone in Queensland, are considered affordable. However the survey says these markets are heavily reliant on the resources sector and without it could also be ranked unaffordable.
-----

Automated Centrelink a fast track to Turnbull's demise

Ross Gittins
Published: January 24, 2017 - 10:58PM
Of the loads of films I saw last year, the most memorable was Ken Loach's I, Daniel Blake. I go to the movies for escapist entertainment, not to give my emotions a good workout but, even so, it left a lasting impression.
It was the story of a 59-year-old carpenter in Newcastle, England, whose cardiologist told him not to go back to work for a few months after he'd had a heart attack on the job.
What we saw was Blake's mistreatment at the job centre he went to for social security payments at the height of the Cameron government's austerity spending cuts.
-----

Consumer price index: Rates on hold as inflation bottoms

Peter Martin
Published: January 25, 2017 - 6:47PM
The Reserve Bank has been given licence to leave interest rates on hold at its first board meeting for the year, after the delivery of a low inflation result in line with its expectations and signs it will lift.
Australia's inflation rate was just 0.5 per cent in the December quarter, down from 0.7 per cent in the September quarter. But the more closely watched measure of "non-tradables" inflation climbed from 0.5 per cent to 0.8 per cent.
Non-tradables inflation excludes goods and services that can be traded overseas, providing a measure of movements in prices that are domestically generated.
-----

Turnbull's fearful, pessimistic, ageing vision for Australia

Peter Martin
Published: January 25, 2017 - 11:45PM
Malcolm Turnbull and Donald Trump might be at loggerheads over the Trans-Pacific Partnership, but in other respects they're in sync.
Trump's inaugural address focused on what he was against: elites, Islamic terrorism, crime and gangs.
Turnbull's remarkably dark new year message was about economic challenges, international conflict and "Islamist terrorists". It was about fighting things rather than doing things.
-----

What Scott Morrison Will Learn From London About Housing Affordability

Australia is unique when it comes to negative gearing.

25/01/2017 10:02 AM AEDT | Updated 25/01/2017 10:03 AM AEDT
  • Doug Cameron Shadow Housing Minister. Labor Senator for New South Wales
LONDON, ENGLAND - JANUARY 24: British Chancellor of the Exchequer Philip Hammond greets Scott Morrison (R) outside Number 11 Downing Street on January 24, 2017.
After three and a half years of policy chaos, mistakes and inaction, Scott Morrison is heading to London to seek guidance on how the Turnbull government might tackle Australia's housing affordability and related homelessness crises.
The first thing he will learn is that, in the UK, there is no combination of negative gearing and capital gains tax concessions that distort the housing market by providing perverse and unfair incentives for investment in existing property.
-----

Cut tax or we’ll be stranded, warns Scott Morrison

  • Simon Benson
  • The Australian
  • 12:00AM January 27, 2017
Scott Morrison has warned that Australia is now facing the real risk of being globally stranded by crippling taxes that would erode the nation’s living standards if the government continues to be blocked politically from its company tax reforms.
In a speech today to business leaders in London, the Treasurer will lay down the challenge to parliament that unless Australia follows the example of Britain, which cut its tax rate to 20 per cent while in a worse budget position, then it will rapid­ly lose its competitive place in the world.
In a bid to escalate pressure on the Senate crossbench to support the government’s plan to cut the company tax to 25 per cent, Mr Morrison said Labor would have to wear the responsibility for Australian businesses left behind as other countries moved to a lower tax environment.
-----

Health Budget Issues.

Doctors go public over fears of Medicare levy hike

- on January 22, 2017, 6:37 pm
Doctors have gone public with their fears of a Medicare levy rise in the federal budget.
They’re worried taxpayers will be forced to hand over even more for health care; potentially costing families hundreds more a year.
The incoming health minister Greg Hunt say his commitment to Medicare is a personal one.
“I have, and we have, a rock solid commitment to the future of Medicare,” he said.
-----

Big pharma should have to come clean

Published: January 22, 2017 - 7:19PM
Everyone with an email address has received them – messages publicising a petition that seeks government recognition in some form for a medical condition; recognition of the condition itself, or for a particular treatment, or a Pharmaceutical Benefits Scheme subsidy for a new drug.
They tug at the heartstrings, with pictures of photogenic sufferers and an emotional plea for assistance for some individual in need. The issues seem so simple. Why won't the government help? How can it be so cruel?
As we reported last week, the issues are rarely as simple as they are made to seem. Behind the one publicised individual battling a rare condition is most likely a patient support group – a collection of former and current sufferers, medical professionals, researchers and perhaps drug company representatives.
-----

Specialists’ fees drive up out-of-pocket costs for patients

  • The Australian
  • 12:00AM January 23, 2017

Sarah-Jane Tasker

Australian patients are increasingly being forced to pay higher out-of-pocket costs for common procedures, with some specialists boosting their fees more than 300 per cent above the federal government rebate.
New data released by health ­insurance giant Medibank reveals that for common overnight procedures, such as childbirth and knee replacements, the average out-of-pocket cost to private patients has jumped, despite the insurer also increasing the average benefit it paid.
Medibank’s chief medical officer Linda Swan said in many cases the insurer was paying for its ­customers’ healthcare at rates that were well above the fees set by the federal government’s Medicare Benefits Schedule.
-----

Can GPs expect anything different from Greg Hunt?

23 January 2017
EDITORIAL
If he succeeds on even a fifth of the things he promises, people will think him a healthcare revolutionary, writes political editor Paul Smith.
It has become almost obligatory for those with designs on becoming a Federal Health Minister to speak of GPs, prevention and mental health. And then, when hard politics begins, to fall victim to amnesia.
When news of his new job came, Greg Hunt was before the media declaring: “I want to re-establish [GPs’] value, their role, their importance, their trust in the community ... I want to be their health minister.”
-----

Is 'big food' political lobbying helping shape health policies at the public's expense?

Daniel Burdon
Published: January 23, 2017 - 8:00PM
Lobbyists for 'big food' are potentially swaying health policies in favour of their corporate bottom line in Australia, new research has claimed.
A Deakin University study published Monday has reported finding "direct evidence" of food industry political tactics that had the potential to shape public health-related policies, at the expense of public health.
The research conducted interviews with 15 former politicians, current and former public servants and senior executive officers with non-government organisations over a four month period who had exposure to the industry's "corporate political activity".
-----

Medicare levy increase on the table as Turnbull budget speculation begins

Adam Gartrell
Published: January 22, 2017 - 12:15AM
Doctors believe the Turnbull government could be contemplating another increase in the Medicare levy.
The Australian Medical Association has used its pre-budget submission to plead with the government to return any extra revenue raised by the tax to health rather than using it to fix the deepening deficit.
"It is equally important to understand that any increase in the Medicare Levy does not absolve governments from the critical need to continue to reinvest in Australia's health, including lifting the MBS freeze," the peak group says in its submission to the government ahead of the May 9 budget.
-----

Complementary medicines: A $4.2 billion dollar question

23 January, 2017 Tessa Hoffman 
On a busy shopping strip on Sydney’s north shore lies a pharmacy where you won’t find a homeopathic product for sale.
The owner, Nick Logan, simply refuses to stock them.
“They’re proven beyond a shadow of a doubt not to work and my customers expect me to not stock bogus products,” says Mr Logan, who was named PSA Pharmacist of the Year in 2009.
-----

Health Insurance Issues.

Tens of thousands of patients using health insurance in public hospitals

Julia Medew
Published: January 24, 2017 - 1:57PM
Tens of thousands of Victorian patients are using their health insurance in public hospitals without any guarantee it will get them faster care, a choice of doctor or a private room.
And some people are getting stung by unexpected bills for more than $1000, an insurer says.  
New data shows the number of patients using their insurance in Victoria's biggest public hospitals has been creeping up for the past three years to reach an expected rate of about 15 per cent this financial year.
-----

Bupa warns health insurers face unsustainable cost increases

Bupa has warned the Turnbull government the sector is at a tipping point
  • The Australian
  • 12:00AM January 26, 2017

Sarah-Jane Tasker

Bupa has warned the Turnbull government that affordability con­cerns have driven the private health insurance sector to a tipping point, as it calls for a new lifetime cover discount for young people and an increase in the Medicare levy surcharge for high-income earners.
In its pre-budget submission, sent this week to the government, the insurance giant states that membership growth will probably fall this year and it asks the government to promote public awareness of the benefits of private health insurance.
Dwayne Crombie, the Australian boss of Bupa’s health ­insurance arm, said that as well as recommendations outlined in its pre-budget submission, he had come to the view that the freeze on Medicare payments should be lifted for primary care and ambulatory procedures.
-----

Health insurers, customers hope for a win on premium increases

  • The Australian
  • 1:45PM January 27, 2017

Sarah-Jane Tasker

New health minister Greg Hunt could look to score a “win” with consumers and approve the lowest average health insurance rate increase in a decade.
As insurers wait for the new health minister to sign off on this year’s annual premium increase, analysts have suggested a new minister taking on the portfolio at such a late stage in the process had the potential to complicate the outcome.
“It is possible that a new minister may want to minimise political attention at this time but he could also try to use this opportunity to score a win for consumers by approving the lowest average rate increase in a decade,” Citi analyst Nigel Pittaway said.
-----

Just what the doctor ordered

index&t_product=HeraldSun&td_device=desktopJeff Whalley, Herald Sun
January 28, 2017 12:00am
AFTER taking the helm of a company losing customers and racking up record numbers of complaints, Craig Drummond knows he needs to shake Medibank Private out of its malaise.
Now six months into his posting as chief executive of Australia’s biggest private health insurer, Drummond is well versed in the challenges it faces as the industry rapidly evolves.
And he believes the solution for the group lies in better understanding the needs of its customers.
-----

Federal Health Minister Greg Hunt could hit health insurers, Citi warns

Jeff Whalley, Herald Sun
January 28, 2017 12:00am
HEALTH insurance premiums could grow this year by the smallest amount in a decade as the Federal Government tries to “score a win” for consumers, an industry expert believes.
In a blow for insurers such as Medibank Private and Bupa, new Federal Health Minister Greg Hunt could try to appease fund members amid a climate of weak wage growth and increasing healthcare costs, according to investment bank Citi.
The forecast comes after Mr Hunt stepped into the portfolio last week, succeeding Sussan Ley, who stood down amid a scandal over travel expenses.
-----
I look forward to comments on all this!
-----
David.

7 comments:

Anonymous said...

re Is 'big food' political lobbying helping shape health policies at the public's expense?

Lobbyists for 'big food' are potentially swaying health policies in favour of their corporate bottom line in Australia, new research has claimed.

Replace Big Food with eHealth consultants and pseudo experts - same old, same old.

Anonymous said...

Or CEO's who spend a great deal of time in front of the media pontificating about ‘disruption’ and other buzzwords who clearly have no idea where they’re leading the organisation or its funders

Anonymous said...

Could not agree more, the ADHA is running around like a chicken looking for a date, it is clear the leadership has failed to construct an operating business and I think it needs to be called out as being unqualified technically or commercially to build and operate systems on behalf of tax payers. Through them we are being taken to the cleaners.

Certain Senior roles have done their role and the spruking was done well, everyone feels loved again, however continue and the degree will start to happen, replace now with someone who knows how to construct an organisation.

Anonymous said...

Too late, the horse has bolted - ADHA is locked in to a $522K contract for 5 years. Terminate or buy out might cost $1.5M.

Anonymous said...

5 years? ADHA is only funded for 2 years

Anonymous said...

Real improvements will not happen if the ADHA is focused on the promotion, public relations and expensive 3rd party analysis of fact free research. You need to build the infrastructure to create and measure a baseline and then test the implementation to verify/disprove your expectations. An evidence free vacuum can easily consume all available money while supporting the idea that "if we spent lots of money then it must be good".
You can't increase knowledge by asking a larger population of unknowledgeable people; instead ask fewer but more knowledgeable people. You can't create more accurate statistics from bad data by increasing the sample size; instead use a representative sample focused on higher quality data collection. Their current focus has been to prioritise the size of the samples instead of improving the methods.
They still think that just be adding computers you can increase efficiency and improve outcomes but there are no guarantees. Paying for and using peer reviewed research is essential to improving the health system efficiency and outcomes.

~~~~ Tim

Bernard Robertson-Dunn said...

Tim "They still think that just by adding computers you can increase efficiency and improve outcomes but there are no guarantees."

My point, exactly.

Everyone is still believing the outrageous claims from the RAND report "Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs" by Richard Hillestad, et al, published September 2005

I contacted RAND and asked "Has any followup work been done by the RAND corporation to ascertain if the predictions/forecasts or expectations have been realised and if not why not?"

The reply I got was: "Unfortunately, RAND has not conducted an evaluation like the one you proposed. We would be very interested in the answer to this question, but
have not to date obtained research funding to study it. I am aware of many hypotheses as to why health IT implementation has not achieved the productivity gains hoped for, but not rigorous measurement of actual productivity changes or tests of the hypotheses."

Guess what? Nobody in the business of computerising the health sector is interested in facts that would disadvantage them. Not now that the Kool-Aid has been mixed and drunk by the ignorant. If they were interested, somebody would have funded new research.

At least they had the good grace to admit "health IT implementation has not achieved the productivity gains hoped for".

As an aside, that Health IT has failed to live up to expectations is not in much dispute. What is harder to explain is why. IMHO, the answer will not be found by medical professionals, IT techos, management consultants, historians, nor project managers.