Medicare: what a difference two years, two unpopular budgets and a close run federal election make to ministerial attitudes

THEN it was a bad, bad thing….

The Sydney Morning Herald, 4 January 2014:

Health Minister Peter Dutton has predicted an overhaul of Medicare, saying spiralling costs will make the system ''unmanageable'' without change.

In an interview with Fairfax Media, Mr Dutton gave the strongest signal yet that the Abbott government may adopt a politically explosive proposal to charge a $6 fee to visit the doctor…..

Annual spending on Medicare climbed from $8.1 billion in 2002-03 to $17.8 billion, an increase of 120 per cent. Growth in Medicare spending was faster than growth in the total health budget of 104 per cent over the decade, and Pharmaceutical Benefits Schedule spending, which rose 79 per cent over the same period.

News.com,au, 18 March 2015:

A NEW report has found 880,000 Australians see their GP more than 20 times a year and account for 17.1 per cent or $2.8 billion of the nation’s non hospital Medicare spend.

These people receive more than $3,200 a year each in non hospital Medicare payments and nearly half of them were also admitted to hospital, the National Health Performance Authority says.

There are 2.3 million Australians who see their doctor more than 12 times a year and they are eating up forty one per cent (16 billion) of the Medicare budget.

These patients received on average $1,850 in non hospital Medicare payments.

NOW it is something to celebrate….

Liberal MP for Farrer and Australian Minister for Health and Aging, Sussan Ley, media release, 28 August 2016:

An extra 17 million GP services were bulk billed under the Coalition last year compared with Labor following another year of record Medicare investment by the Turnbull Government, as Bill Shorten’s Mediscare lies “crumble around him” and leave the credibility of his leadership in tatters.

Minister for Health and Aged Care Sussan Ley today revealed a record 123 million out of 145 million GP services were fully-funded by the Turnbull Government at no cost to patients through Medicare during 2015-16.

This saw GP bulk billing hit a historic high of 85.1 per cent under the Turnbull Government – up from 84.3 per cent in 2014-15 – and follows the Coalition’s record $7.1 billion investment in general practice via Medicare last year.

The number of Australians accessing Medicare-funded GP services was also up by nearly half-a-million to 20.9 million last year, while the average number of services and spend per GP patient grew to 6.9 and $344 respectively…..

Overall, the number of Medicare services increased to 384 million in 2015-16 – more than one million per day – at a total cost of $21,107,750,246 – an increase of nearly $1 billion on 2014-15 – with the overall Medicare bulk billing rate also increasing to 78.2 per cent in 2015-16 from 77.6 per cent the year before.

I suspect that  a number of government MPs will be making appointments with their local chiropractor after repeating this spectacular backflip.

Turnbull Government about to walk back superannuation changes and cost federal budget bottom line up to $335 million over first four years?

ABC News, 23 August 2016:

Independent costings suggest the Federal Government could end up losing money out of its proposed overhaul of superannuation changes if a key measure is watered down.

The Government has proposed a $500,000 limit on after-tax contributions to superannuation, in a move it says will save $500 million over four years.

The changes have upset a number of Coalition MPs, with some pushing for the $500,000 limit to be increased.

Analysis conducted by the Parliamentary Budget Office (PBO) — commissioned by the Greens before the Government's proposal was put in place — suggest any increase of that limit could see those budget savings evaporate.

The PBO document from last year modelled the impact of hypothetical caps on superannuation after-tax contributions, ranging from $500,000 to $800,000.

According to the PBO, placing a $500,000 lifetime cap — which the Government is proposing — will see an additional $165 million put into government coffers over four years.

Increasing that cap to $600,000 would see those savings disappear — and end up costing the Government $85 million over the same period.

An $800,000 cap would cost the Government $335 million.....

The analysis did not look at the impact of back-dating the measures to 2007, which is a key part of the Coalition's proposal……

Mr Morrison announced the cap in non-concessional contributions as part of an overhaul of the superannuation system, forecasting it would save $550 million, starting from July 1, 2017.

Mr Morrison has been negotiating with the backbench following concerns raised within the Coalition about aspects of the policy.

On Monday, Mr Morrison resisted rolling-back on superannuation unless savings were found from elsewhere.

"I would find it pretty hard to look my kids in the eye and tell them they have got to saddle a higher debt because someone who had a very big income wanted to pay less tax," Mr Morrison told 2GB.

The changes are yet to pass through Federal Parliament.

ADVOCATES URGE LABOR & CROSS BENCH TO VETO PLEBISCITE / TURNBULL'S "PLAN B" SHOULD BE FREE VOTE IN PARLIAMENT

just.equal

www.equal.org.au

MEDIA RELEASE

28 August 2016

 

ADVOCATES URGE LABOR & CROSS BENCH TO VETO PLEBISCITE

TURNBULL'S "PLAN B" SHOULD BE FREE VOTE IN PARLIAMENT

"If the Prime Minister is really concerned about achieving marriage equality as quickly as possible he will have a back-up plan should a plebiscite be vetoed, and that 'Plan B' should be to allow a free vote in parliament."

- Rodney Croome

Advocates have dismissed a renewed call by the Prime Minister for a marriage equality plebiscite and urged the Senate to veto it.

Malcolm Turnbull has said a plebiscite is the quickest path to marriage equality but Labor is hardening its position against the plebiscite because of the harm and cost.

Long-time marriage equality advocate, Rodney Croome, said,

"I reject the Government's rhetoric about a plebiscite being the quickest or the only way forward for marriage equality, and call on Labor and the Senate cross bench to unconditionally block plebiscite enabling legislation."

"If the Prime Minister is really concerned about achieving marriage equality as quickly as possible he will have a back-up plan should a plebiscite be vetoed, and that 'Plan B' should be to allow a free vote in parliament."

"If a plebiscite is vetoed by the Senate the political landscape changes and I expect the issue to return to the Liberal Party room and for Liberals who support marriage equality to push for a free vote or cross the floor."

"The risk there isn't a free vote is a risk the LGBTI community is willing to take to avoid the hurt, harm and indignity of a plebiscite."

"This was confirmed by a recent scientific survey of the LGBTI community that was the largest of its kind ever conducted in Australia with over 5,500 respondents."

On Friday the Greens announced they will vote against plebiscite enabling legislation. The Nick Xenophon Team and Derryn Hinch say they also oppose a plebiscite, meaning if Labor opposes it too it cannot pass.

Turnbull Government to sell off public access to Australian Securities and Investment Commission (ASIC) corporate database

Access to the national database containing the corporate history of all companies, trusts and business names registered in this country to be controlled by an Australian or foreign-owned company – what could possibly go wrong?

GetUp! Petition here

The Guardian, 18 August 2016:

More than 20 civil society organisations and unions have made a last-minute call for the Turnbull government to stop the sale of the Asic’s corporate registry to a private company.

The Panama Papers scandal demonstrated that governments need to take action against shell companies with concealed ownership, they argue, and the corporate watchdog’s registry of business data must remain in government hands to help in that fight.

The Australian Council of Social Service, the Tax Justice Network, the Uniting church, and GetUp!, among other groups, have sent a joint letter to the treasurer, Scott Morrison, asking him to stop the sale of the registry.

“We are writing to seek your assurance that the Asic corporate register will not be privatised to become a private monopoly,” says the letter, seen by Guardian Australia.

“The Asic corporate register is currently relied upon by law enforcement agencies, such as the Fair Work Ombudsman and the Australian Tax Office, in identifying company ownership and location.

“Placing this register in private hands risks undermining a range of law enforcement activities as well as Australia’s attempts to curb money laundering and the financing of terrorism.”

Asic’s corporate registry is a critical database of information on more than 2m companies in Australia, including business names, histories, financial records, and backgrounds of directors.

It can be used by the public to search millions of companies – and their documents – not listed on the Australian Securities Exchange. Only about 2,000 companies are listed on the ASX.

The Abbott government announced plans in the 2015-16 budget to undertake a competitive tender process for the registry business, believing it would be better run in private hands.

The government says it will retain ownership of the data once the registry is sold, but software upgrades of the register will be undertaken by its private owner.

The sale is supported by Greg Medcraft, the Asic chairman.

But the group warns the Turnbull government its plan to introduce a “public register of beneficial ownership” – which will reveal the identities of the beneficial owners of shell companies in an effort to stamp out tax avoidance by multinational companies – will be undermined by the registry sale.

“The obvious starting point for a register of beneficial ownership would be the existing Asic corporate register, so selling off the register into private hands closes off important options in the consideration of a register of beneficial ownership,” the letter says.

“There are already problems with Asic not having the resources to ensure the accuracy of the database, as the Fair Work Ombudsman has encountered labour hire companies on the register that are registered at false addresses with front people as directors.

“It is difficult to believe that a private owner of the database will be able to put in the same level of resources as Asic to ensure the accuracy of the database, making it even easier for criminals to register businesses with front people as directors and registered at false addresses.”

Morrison could not be contacted for comment. Final bids for the tender process are due by 29 August.

Failing To Meet Aspirational Health Targets: childhood immunisation rates on NSW North Coast lowest in Australia

There was only four Primary Health Network Areas in Australia which came near to meeting the aspiration health target of 95 per cent full childhood immunisation of all children by 5 years of age.

None of those areas were on the NSW North Coast. In fact North Coast Primary Health Network Areas had the lowest percentages of fully immunised children in Australia in 2014-15 – achieving only 89.2% by 5 years of age.

From the Clarence Valley to the Tweed there were 2,100 children (aged 1 to 5 years of age combined) who were not fully immunised. Only 167 of these children were Aboriginal-Torres Strait Islanders as the childhood immunisation percentage in this cohort is 95.1% by 5 years of age.

NSW Far North Coast

http://www.sbs.com.au/news/map/immunisation2014-15

NSW North Coast

Healthy Communities: Immunisation rates for children in 2014–15 - In Focus report released 18 February 2016:

In late 2014, the Australian Chief Medical Officer and all state and territory chief health officers agreed to an aspirational target for 95% of children to be fully immunised in line with the National Immunisation Program Schedule. The report shows that for 1-year-old children, rates are below 95% in all PHN areas, although this fact does not reflect on the performance of PHNs as they were set up after the period to which the data relate.

The report finds:

*90.9% of all children aged 1, 2 and 5 years were fully immunised and 9.1% (84,571) were not fully immunised, though rates vary across local areas

*89.2% of Aboriginal and Torres Strait Islander children aged 1, 2 and 5 years were fully immunised and 10.8% (4,922) were not fully immunised, though rates vary across local areas

*Immunisation rates for all 1 year olds ranged across PHN areas from 93.6% to 87.7% with a total of 26,671 children not fully immunised nationally. None of the 31 PHNs had immunisation rates of 95% or higher for this age group

*Immunisation rates for 2 year olds ranged across PHN areas from 92.3% to 86.7% with a total of 33,681 children not fully immunised nationally. None of the 31 PHNs had immunisation rates of 95% or above for this age group, although rates for 2 year olds may have been lower due to a recent change in the number of vaccines counted in the definition for ‘fully immunised’ 2 year olds

*Immunisation rates for 5 year olds ranged across PHN areas from 95.6% to 89.2% with a total of 24,219 children not fully immunised nationally. Only two of the 31 PHN areas had immunisation rates of 95% or higher for this age group

*Across smaller local areas (SA3s), among all 1-year-old children, 39 out of 324 local areas (SA3s) recorded a significant increase in immunisation rates, while only one area showed a significant decrease. Among 5 year olds, 16 SA3s showed an increase and six a decrease

*Immunisation rates for 1-year-old Indigenous children significantly increased in seven out of 49 geographic areas (SA4s) where data were available, and decreased in none.

Immunisation helps protect individuals and the community generally against vaccine-preventable diseases such as measles, polio, tetanus and whooping cough (pertussis). To be considered fully immunised, children need to have completed the immunisations appropriate for their age as set out in the National Immunisation Program Schedule by the time they turn 1, 2 and 5 years of age.

This release also includes a new interactive web tool that allows users to build their own graphs on immunisation data that interests them.

Quote of the Week

“That east coast low the other week was just the ticket to show the dreamers what can happen to the ocean and the coast in only a few hours during one of Mother Nature's tantrums. Those massive movements of wind, water and sand are why we'll never see big offshore wind farms hereabouts and, hopefully, why that greedy, crazy grab for a Clarence River mega-port will never get off the drawing board. This is a very exposed coastline that doesn't have a great deal of respect for human engineering.” [The Northern Star, 19 August 206]

Tweets of the Week

This tweet is by a journalist with The Age & The Guardian newspapers

This tweet is by an ABC TV journalist/news & current affairs presenter