The American Resistance has many faces - this is just one of them

ACLU PETITION FOR WRIT OF HABEAS CORPUS AND COMPLAINT FOR DECLARATORY AND INJUNCTIVE RELIEF, 28 January 201... by clarencegirl on Scribd

https://www.scribd.com/document/337805663/ACLU-PETITION-FOR-WRIT-OF-HABEAS-CORPUS-AND-COMPLAINT-FOR-DECLARATORY-AND-INJUNCTIVE-RELIEF-28-January-2017

One of the temporary restraining orders granted 28 January 2017:

The Economist, 29 January 2017:

In her brief and unequivocal ruling on the evening of January 28th, Ms Donnelly wrote that Mr Alshawi and Mr Darweesh “have a strong likelihood of success” in showing that their deportation would violate their rights to due process and equal protection. There is “imminent danger”, she wrote, that “there will be substantial and irreparable injury to refugees, visa-holders and other individuals from nations” targeted by Mr Trump’s executive order, should it be fully implemented. Ms Donnelly thus “enjoined and restrained” the government from deporting refugees or “any other individuals from Iraq, Syria, Sudan, Libya, Somalia and Yemen legally authorised to enter the United States”.

The ruling, along with similar non-removal orders from judges in Virginia and Seattle, means that nobody who was told they didn’t belong in America when they arrived on January 27th can be deported—for now—though there were reports from several cities on the night of January 28th that customs officials were disregarding the judges' orders and arranging for individuals to be sent home. It also bears reminding that these rulings are stays, not final determinations. Further judicial hearings in February will determine if the stays should be lifted. And the rulings do not come close to erasing Mr Trump’s executive order; the ban remains in effect for refugees and others who were planning to come to America in the coming days, weeks and months.

Another temporary restraining order can be found here.

Oi, Malcolm! Where's our NBN?

With only three years of borrowed money left to complete roll out of the National Broadband Network (NBN) and still not yet at the halfway mark, serious questions about this increasingly sub-standard telecommunications infrastructure are being asked.

Australian Medical Association, media release, 17 January 2017:

Better Access to High Speed Broadband for Rural and Remote Health Care - 2016

1

10 Jan 2017

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1.  Introduction

Approximately 30 per cent of Australia’s population lives outside the major metropolitan areas[1]. Regional, rural and remote Australians often struggle to access health services that urban Australians would see as a basic right. These inequalities mean that they have lower life expectancy, worse outcomes on leading indicators of health, and poorer access to care compared to people in major cities.

In 2016 the AMA conducted a Rural Health Issues Survey, which sought input from rural doctors across Australia to identify key solutions to improving regional, rural and remote health care. The survey identified access to high-speed broadband for medical practices as a key priority.

This result reflects not only the increasing reliance by medical practices on the internet for their day to day operations, but also the increasing opportunities for the provision of healthcare services to rural and remote communities via eHealth and telemedicine. For the full potential of these opportunities to be realised, good quality, affordable, and reliable high-speed internet access is essential.

The AMA recognises that technology-based patient consultations and other telehealth initiatives can improve access to care and can enhance efficiency in medical practice, but the need for better access to high speed broadband goes beyond supporting rural and remote health. In today’s world, it is a critical factor to support communities in their daily activities, education, and business, and has the potential to drive innovation and boost the rural economy.

This position statement outlines the importance of better access to high speed broadband for medical practices, other healthcare providers and institutions, and patients, to improve regional, rural and remote health care in Australia, and highlights key solutions for achieving this.

2. Internet access in regional rural and remote Australia

Despite its tremendous growth, internet access is not distributed equally within Australia, and internet use by country people has yet to reach the level of use in capital cities, for a wide range of reasons.

In many country areas the internet connection is still very poor.^[2] In 2015, 80 percent of non-urban Australians had an internet connection at home compared with 89 percent of those in capital cities^[3]. Internet use via mobile phone was much lower in non-urban areas, at 37 percent, compared to 60 percent for capital cities^[4]. This reflects the patchy, unreliable or absent mobile coverage in many rural and remote areas. While mobile broadband use was highest in non-urban areas, at 29 percent, compared to 25 percent in capital cities, mobile broadband is currently not a good solution for business or eHealth, due to the relatively small amounts of data on the relatively costly plans available.

Internet services, particularly in more isolated areas, only make available relatively small download allowances and these come at a much higher cost and slower speed than those services available in metropolitan areas.

3. Supporting regional rural and remote health

3.1   The need for better access for health services

The health sector needs telecommunications connectivity for health service delivery and management, doing business with Government and complying with Government requirements, continuing professional development, online education, mentoring, and clinical decision and other support.

Health was identified in the Regional Telecommunications Review report[5] as one of the particular segments of the community requiring special consideration. To effectively leverage telecommunications technology to deliver better health outcomes at lower cost in regional, rural and remote areas and to implement new models of health care, both mobile and broadband technology must be reliable, affordable, and supply adequate capacity.

However, the utilisation of telehealth and telemedicine in rural and remote Australia remains patchy and is not used to full potential, because of no, or inadequate internet access. As noted in the Regional Telecommunications Review report[6], the ability of hospitals and clinics to support remotely located clinicians and patients via video conferencing and remote monitoring could be severely limited in areas serviced by satellite, which may not be able to consistently and reliably deliver the necessary capacity and technical capability.

The AMA Rural Health Issues Survey received many comments from rural doctors on the problems encountered with poor internet access. For example:

• High-speed broadband [is the] single most critical issue to run practices now, many areas not getting the best from NBN.
• Internet services by satellite are slow and time consuming. Reliable internet services at reasonable speed and reliability is critical.
• Internet services are a critical area [of concern]. The NBN has been deficient in providing a comprehensive coverage even in areas that are under 25km from a major regional centre i.e. Orange and Dubbo. 

As mainstream healthcare provision becomes increasingly technology based and requires more and faster broadband services to operate, there is a real risk that regional, rural and remote areas of Australia will be left further and further behind in their ability to provide quality health services.

3.2. The benefits of high speed broadband for rural and remote health care

High-speed affordable broadband connectivity to the Internet has become essential to modern society, and offers widely recognised economic and social benefits, with numerous studies showing a strong link between broadband growth and rapid economic development^[7]. Affordable and reliable broadband access can support the development of new content, applications and services that allow people to work in new ways, changing business processes in ways that stimulate productivity and potentially increase labour-force participation^[8].

3.2.1  Economic benefits

It has been estimated that in New Zealand, the benefits from broadband-enabled health care could reach around $6 billion over a 20-year period^[9]. These benefits come from reduced hospital, travel and drug costs and improvements in care. A case study by Deloitte Access Economics shows savings to a single older Australian of $7,400 per year, with savings to the Government, through reduced health and service provision costs, of over $14,500^[10].

3.2.2 Driving greater efficiency and reducing costs

Telehealth practice will be one of the most important online services in the broadband future, enabling significant changes to work practices to drive greater efficiency and reduce costs^[11].

If sufficiently supported, telehealth services, such as video-conferencing, could become more effective in complementing local health services. They could be used to expand specialty care to patients in areas with shortages of health care providers as well as extend primary care to remote areas, reducing the need to travel, and increasing the frequency of patient and primary care provider interactions. By providing timely access to services and specialists, telehealth could improve the ability to identify developing conditions, and thereby reduce the need for more costly treatments and hospitalisations in the future. Telehealth could also help to educate, train and support remote healthcare workers on location and support people with chronic conditions to manage their health.^[12]

A CSIRO report on home monitoring of chronic disease[13], for example, shows that a modest investment in home monitoring technology, allied to risk stratification tools and remote monitoring, could save the healthcare system up to $3 billion a year in avoidable admissions to hospital, reduced length of stay and fewer demands on primary care.

3.2.3 Supporting eHealth solutions now and into the future

eHealth encompasses patient access to doctors via online consultation, remote patient monitoring, online tools and resources for patients and doctors, clinical communications between healthcare providers, and professional’s access to information databases and electronic health record systems. If sufficiently supported with affordable, high-speed broadband services, eHealth has potential to improve health outcomes at all levels, from preventative health, specialist and acute care and self-management of chronic conditions, through to home monitoring for people living with disabilities[14].

Advances in information technology will act as a catalyst for the development of a range of potential eHealth solutions to some of the challenges faced by rural and remote communities. If available and accessible, improved connectivity will facilitate new and emerging best practice models of health care, such as those which incorporate high definition video conferences, data exchange and high resolution image transfer[15].

Technological advancements in health care that could become the way of the future, if affordable and sufficient access to broadband services becomes available, include better point of care diagnostics, resulting in faster, cohesive patient care; biosensors and trackers to allow real time monitoring; 3D printed medical technology products; virtual reality environments that could accelerate behavioural change in patients; and social media platforms to improve patient experience and track population trends^[16].

3.2.4 Supporting education and training

The internet also plays a big part in the lives of doctors and their families, assisting with education and social cohesion. It enables rural doctors to learn from the most current resources, explore treatment options, watch demonstrations of procedures and attend live discussions with experts.

Access to high speed broadband has the potential to change the way medical education, training and supervision is delivered in rural and remote areas [17]. As pressure on access to prevocational and vocational training places increases, harnessing this technology to support training is a viable strategy to create additional training places in rural and remote locations and ultimately improve access to specialist services for rural and remote patients.

The use of telehealth and telesupervision as an adjunct to face-to-face teaching will allow doctors in training to remain in rural and remote settings to complete their training, and enhance the likelihood that they will choose to work long term in a rural areas. Improved information and communications technology will enhance the learning experiences for trainees at rural sites and during rural rotations, provide exposure to innovative models of care, and improve supervisor capacity by allowing supervisors to transfer knowledge, supervise and mentor trainees remotely. 

Improved telehealth and communication technology infrastructure to support teaching and training at rural sites will also enhance professional collaboration between rural and remote medical generalist practitioners and other specialists in the provision of shared care, skills transfer and education.

The requirement for doctors to maintain their skills is a fundamental component of medical registration. It is important that processes mandated by the Medical Board of Australia, including in revalidation proposals, do not discriminate against medical practitioners working in rural and remote Australia. Access to high speed broadband is an essential support for rural and remote practitioners who must comply with these requirements.

4. What can be done to improve broadband access for country Australians?

The AMA is of the view that high-speed broadband should be available to the same standard and at the same cost to all communities, businesses and services across the whole of Australia. The platforms used must be able to accommodate future developments in information and communications technologies and provide connectivity through suitable combinations of fibre, mobile phone, wireless, and satellite technologies. For rural practices, in order to be incorporated routinely in everyday practice (clinical, educational and administrative), network connectivity must be sufficient, reliable, ubiquitous and dependable.

The Government must ensure that broadband services are affordable in regional, rural and remote Australia. Lack of affordability is regarded as one of the most important barriers to good internet access for country people whose incomes, on average, are 15 per cent lower than those of city people[18].

Government policies play a tremendous role in bringing internet access to underserved groups and regions. Unless issues around equitable and affordable access to telecommunications in regional, rural and remote Australia are addressed, the potential benefits of the digital economy for non-urban Australians will go unrealised.

The AMA urges the Government to consider the following actions:

·       Fully consider the recommendations of the 2015 Regional Telecommunications Review, and, in particular, adopt Recommendations 8, 9, and 12, to:

o    Develop a new Consumer Communication Standard for voice and data which would provide technology neutral standards in terms of availability, accessibility, affordability, performance and reliability.

o    Establish a new funding mechanism, the Consumer Communication Fund to replace the existing telecommunications industry levy and underwrite over the longer term, necessary loss-making infrastructure and services in regional Australia.

o    Collect benchmark data on availability and affordability of broadband data and voice services (including mobile services), to be reported annually, in order to improve the understanding of the changing circumstances of regional telecommunications.

·       Extend the boundaries of the NBN’s fibre cable and fixed wireless footprints and mobile coverage wherever possible.

·       Begin an incremental process of terrestrial network expansion over the longer term to address increase in usage over time.

·       Develop measures to prioritise or optimise the broadband capacity available by satellite for hospitals and medical practices, such as exempting or allocating higher data allowance quotas, or providing a separate data allowance (as is the case with distance education[19]).

·       Create universal unmetered online access to government, hospital and health services for people and businesses in rural and remote areas.^[20]

·       Establish an innovation budget for development of local infrastructure solutions for rural and remote areas.^[21]

·       Engage with state and local government and related stakeholders who wish to co-invest or coordinate planning to achieve the optimum overall infrastructure outcome for their area. This could involve public-private partnerships or the leveraging of philanthropic infrastructure funding through, for example, tax concessions.

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^[1] Australian Institute of Health and Welfare (AIHW) (2015), Australia’s Welfare 2015

^{[2] Curtin J (2012), A digital divide in regional and rural Australia.}

^[3] Australian Communications and Media Authority (2016), Regional Australians Online

^[4] Ibid

^[5] Australian Government Regional Telecommunications Review (2015)

^[6] Ibid.

^[7] Alcatel-Lucent (2012), Building the Benefits of Broadband. How New Zealand can increase the social & economic impacts of high-speed broadband

^[8] Centre for Energy-efficient Telecommunications (CEET)(2015), Economic Benefit of the National Broadband Network

^[9] Alcatel-Lucent (2012), op.cit.

^[10] Deloitte Access Economics (2013), Benefits of High-Speed Broadband for Australian Households. Commissioned by the Australian Department of Broadband, Communications and the Digital Economy

^[11] CEET (2015), op.cit.

^[12] National Rural Health Alliance (2013), eHealth and telehealth in rural and remote Australia. Accessed October 2016

^[13] Prof. Branko Celler et al (2016), Home Monitoring of Chronic Disease for Aged Care, CSIRO Australian e-Health Research Centre.

^[14] National Rural Health Alliance (2013) op. cit.

^[15] National Rural Health Alliance (2016), website accessed October 2016

^[16] Deloitte (2016), Design, service and infrastructure plan for Victoria’s rural and regional health system discussion paper, commissioned by the Victorian Department of Health and Human Services.

^[17] Wearne S M (2013), Using telehealth infrastructure for remote supervision could create medical training places where they are needed. Medical Journal of Australia, 198 (11): 633-634. 17 June 2013.

^[18] AIHW (2016), Are things different outside the major cities? Accessed October 2016.

^[19] Australian Government (2016), Australian Government Response to the Regional Telecommunications Independent Review Committee Report: Regional Telecommunications Review 2015.

^[20]Broadband for the Bush Alliance (2016), Broadband for the Bush Forum V: Digital Journeys Communiqué

^[21]Broadband for the Bush Alliance (2014), Broadband for the Bush Forum III: Building a Better Digital Future Communiqué

Related document (Public): 

 Better access to high speed broadband PS_Final.pdf

Quote of the Week

CBS Confirms Trump Brought His Own Studio Audience To Clap For Him At CIA Speech

CBS News confirmed reports that President Donald Trump brought a studio audience to his visit with the CIA on Saturday. The news agency reports that an official said the visit left a wake of "unease," “made relations with the intelligence community worse," and was “uncomfortable.” [Politicususa, 23 January 2017]

Classic Inaugural Week Tweet

I have taken REAL Donald Trump headlines from the past 24 hours and changed ONE, SUBTLE thing about them #SpicerFacts pic.twitter.com/tCtOXfnGDJ

— Oliver Willis (@owillis) January 22, 2017

Headline of the Week

Donald Trump inauguration speech dark, dangerous and dystopian

[The Sydney Morning Herald, 21 January 2017]

Disadvantage, discrimination, disability, despair and distance still negatively impact on health outcomes for Australians - but as a population we are living longer

Excerpts from AIHW Australia's Health 2016, In Brief and Elective Surgery Waiting Times 2015-16:

# People living in the lowest socioeconomic areas are more likely to have poor health and to have higher rates of illness, disability and death than people who live in the highest socioeconomic areas. If all Australians had the same death rates as the 20% of Australians living in the highest socioeconomic area, there would have been about 54,200 fewer deaths in 2009–2011.

# On a range of health measures, people living in the lowest socioeconomic areas (that is, areas of most disadvantage) tend to fare worse than people living in the highest socioeconomic areas (that is, areas of least disadvantage). For example, according to AIHW analysis of the ABS Australian Health Survey, in 2011–12, people living in the lowest socioeconomic areas were 1.6 times as likely to have chronic kidney disease and 2.2 times as likely to have coronary heart disease as people living the highest socioeconomic areas.

# There have been some improvements in Aboriginal and Torres Strait Islander health in recent years, including decreases in smoking and infant mortality and in avoidable deaths from circulatory and kidney diseases. However, there is still a significant gap in health outcomes, including life expectancy at birth, between Indigenous and non-Indigenous Australians. The causes of this gap are complex, and include differences in the social determinants of health, risk factors, and access to appropriate health care.

# In 2013, 29% of the Australian population lived in regional and remote areas: 18% in Inner regional areas, 8.9% in Outer regional areas, 1.4% in Remote areas and 0.9% in Very remote areas. Australians living outside Major cities tend to have higher rates of disease and injury than people in Major cities, and they are also more likely to engage in health behaviours that can lead to adverse health outcomes.

# Australians living in rural and remote areas tend to have lower life expectancy and higher rates of disease and injury than people living in Major cities (see 'Chapter 5.11 Rural and remote health').

In 2009–2011, people living in Remote and Very remote areas had mortality rates 1.4 times as high as people living in Major cities. For nearly all causes of death, rates were higher for people living outside Major cities, with people in Remote and Very remote areas faring the worst. For example, the rate of dying due to a land transport accident was more than 4 times as high in Remote and Very Remote areas as in Major cities.

People in regional and remote areas are more likely to die prematurely than their Major city counterparts. While fewer than 3 in 10 people (29%) live in regional and remote areas, deaths in these areas accounted for almost 2 in 5 (38%) of premature deaths in 2011–13.

The premature mortality rate among people living in Remote areas was 1.6 times as high as the rate among people in Major cities, and in Very remote areas it was 2.2 times as high (see 'Chapter 3.2 Premature mortality').

Disease prevalence is generally higher in rural and remote areas of Australia than in Major cities. In 2014–15, based on self-reported data from the NHS, people living in Inner regional and Outer regional/Remote areas of Australia were more likely than people in Major cities to have arthritis, asthma, COPD, and a number of other chronic health conditions (ABS 2015e).

People living in rural and remote areas are, on average, also more likely than their urban counterparts to engage in lifestyle behaviours that can lead to adverse health outcomes (such as smoking, insufficient physical activity, and risky alcohol consumption). These poorer health outcomes may also reflect a range of social and other factors that can be detrimental to health, including a level of disadvantage with regard to educational and employment opportunities; income; and access to goods and services.

# Just under 1 in 5 Australians (4.2 million people) reported having a disability in 2012. People with disability experience significantly poorer health than people without disability. Over half (51%) of people aged 15–64 with severe or profound limitation(s) in communication, mobility or self-care reported 'poor' or 'fair' health compared with 5.6% of those without such limitations. A higher proportion of people aged 15–64 with these limitations had mental health conditions (50% compared with 7.7% for those without).

# Unemployed people have a higher risk of death and have more illness and disability than those of similar age who are employed (Mathers & Schofield 1998). The psychosocial stress caused by unemployment has a strong impact on physical and mental health and wellbeing (Dooley et al. 1996). For some, unemployment is caused by illness, but for many it is unemployment itself that causes health problems through its psychological consequences and the financial problems it brings.

# In 2014–15, 50% of patients were admitted within 35 days of being placed on the elective surgery waiting list, 90% were admitted within 253 days and 1.8% waited more than 1 year. The median waiting time is lower than it was between 2010–11 and 2013–14 (36 days).

The median waiting time for Indigenous Australians (42 days) was higher than for other Australians (35 days), and a higher proportion of Indigenous Australians waited more than a year for elective surgery than other Australians (2.3% and 1.8%, respectively).

The longest median waiting times were for the surgical specialties Ear, nose and throat surgery; Ophthalmology; and Orthopaedic surgery (73, 70, and 64 days, respectively). Cardio-thoracic surgery had the shortest median waiting time (18 days).

# Hospital elective surgery waiting lists…. 2015-16…uncontactable/died [before hospital admission] 7,295…Excludes data for the Australian Capital Territory, which were not available at the time of publication.

Not contactable/died:

NSW 2,234

VIC 2,234

QLD 703

WA 1,003

SA 611

TAS 361

ACT n.a.

NT 141

# In 2013, more than 1 in 3 deaths (34%) in Australia were 'premature' (that is, they occurred before the age of 75)—substantially lower than the 43% in 1997 (AIHW 2015b).

The three leading causes of premature death for all Australians were coronary heart disease, lung cancer and suicide. Nearly 1 in 5 deaths (18%) among people aged 25–44 were due to suicide (AIHW 2015b).

The rate of premature deaths among Indigenous Australians is higher than among non-Indigenous Australians for both males and females across every age group. Between 2009 and 2013, 81% of all Indigenous deaths were of people aged under 75, compared with 34% for non-Indigenous Australians (ABS 2015b) (see 'Chapter 3.2 Premature mortality').

# after adjusting for differences in age structure, in the period from 2009 to 2013, the mortality rate for Indigenous Australians who died from all potentially avoidable causes was more than 3 times the rate for non-Indigenous Australians (351 and 110 deaths per 100,000 population, respectively) (see 'Chapter 5.7 How healthy are Indigenous Australians?').

# The rate of premature mortality varied considerably between states and territories in 2011–2013 (Figure 3.2.3). After adjusting for diff­erences in age structure, the Australian Capital Territory had the lowest rate (173 deaths per 100,000 people aged under 75), followed by Victoria (192) and Western Australia (205). The age-standardised premature mortality rate in the Northern Territory (388) was more than twice as high as the rate in the Australian Capital Territory. The Northern Territory has the highest proportion of Indigenous residents (about 30%) of all Australian states and territories and the majority of the Northern Territory's land mass is classified as remote (Taylor & Bell 2013). The following section, 'Inequalities in premature mortality', describes the impact of remoteness of residence and Indigenous status on premature death.

# The majority of Australians live in Major cities, with fewer than 3 in 10 people (29% of the population) living in Regional and Remote areas (see 'Chapter 5.11 Rural and remote health'). Despite this, in 2011–2013, deaths in Regional and Remote areas accounted for 38% of premature deaths. Premature mortality rates increased with remoteness. The premature mortality rate among people living in Remote areas was 1.6 times as high as the rate among people in Major cities, and in Very remote areas it was 2.2 times as high.

# Nearly 2 in 5 people (39%) who died in 2013 were aged 85 and over….The most common cause of death in 2013 for people aged 85 and over was coronary heart disease (17%), followed by dementia (12%).

# Life expectancy at birth in Australia has climbed steadily over time, and is now more than 30 years longer than it was in the late 1800s (Figure 1.3.1). For example, life expectancy for males and females born in 2014 was 80.3 years and 84.4 years respectively (ABS 2015c), whereas males and females born in 1890 could expect to live to 47.2 years and 50.8 years respectively (ABS 2014b)…..

In 2012, a newborn boy in Australia could expect to live 62.4 years without disability and another 17.5 years with some form of disability, and a newborn girl 64.5 years without disability and 19.8 years with some form of disability (see Glossary) (AIHW 2014b). Between 1998 and 2012, the disability-free life expectancy for males rose by 4.4 years, which was more than the gain in male life expectancy over that period (4 years). However, the increase in years free of disability for females was 2.4 years, compared with a 2.8 years gain in female life expectancy (AIHW 2014b).

#A man turning 85 in 2013 could expect to live another 6.1 years, and a woman the same age could expect another 7.1 years.