Wednesday, November 06, 2019

Another grim week leaves private health insurance in Australia on life support (?)

The Leftist moan below has a point but there is no threat to the continued availability of private health insurance.  The increasing costs of medical procedures are probably unfixable so the cost of private insurance must increase. No government fiddling will alter that. And, yes, that will freeze out some people.  But those who can continue to afford it will do so.  The opportunity to avoid government medicine is compelling.

Government medicine is good enough and sometimes excellent but getting access to it is the problem. You can die on a waiting list and nobody even says "Sorry".  And government hospitals face a double whammy.  They too have to fund the increasing costs of procedures and on top of that they will face an influx of former private patients driven into their arms by those same costs.

So the future for private hospital insurance will remain strong but it will service fewer people.  It will be confined to a mostly affluent clientele, which it is not now.  Middle income people can and do afford it at the moment.

There is no doubt that the situation is politically unpalatable so what is likely to happen?  Restrictions.  Government hospitals will simply refuse some care to some people.  An early candidate for that would be to offer very limited service to people with self-inflicted illnesses -- principally smokers and the obese.  That already happens informally but will almost certainly increase -- no hip jobs for the obese and no lung resections for smokers, for instance.

I can speak from personal experience about one of those strategies.  A high-tech procedure of relatively recent origins is the PET scan. It is the best way of detecting cancer in you.  I gather that there is some access to them in public hospitals but it is very limited so you mostly have to go to a private laboratory to get one.  I did. I had it very promptly and it cost me $700 with NO Medicare rebate.  You can see why there is no rebate.  If there were it would be widely prescribed. And what would 100,000 prescriptions at $700 each cost?  It would break the bank.  So restricting availability of the procedure is both necessary and opens it up only to the well-off

So two-tiered medical care is inevitable. It already exists and will get worse.  Government medicine aims to prevent that but it cannot.  Medical innovations will continue and will continue to be ever-more costly

In April this year, the health minister, Greg Hunt, introduced reforms the government said would make private health insurance easier to understand and more affordable.

The changes, described by the federal government as the most significant reforms to the private health insurance system in a decade, included classifying the some 70,000 private health insurance policies available into gold, silver, bronze and basic categories, and discounts for young people.

A review from the consumer advocacy group Choice published on Wednesday found the opposite. More than 215 “silver” and “silver plus” policies cost more than “gold” policies, the report found, leaving consumers as confused by their options as ever. An Australian Medical Association report published one day later warned private health policies remained unaffordable and non-transparent.

The other cornerstone of the reforms – lower premiums for people under 30 – has failed to stop the exodus of young people from the system, Australian Prudential Regulation Authority [Apra] data shows. The financial authority in May issued a directive to the private health industry to take responsibility for the decline in affordability and uptake of insurance rather than rely on government reforms.

The situation has several health economists and policy experts questioning whether the private health insurance industry, far from being salvageable through reform, is worth saving at all.

Apra executive board member Geoff Summerhayes said it was “frustrating to see little evidence that insurers are taking actions that reflect their own assessment of the heightened risks in this challenging environment”.

“Apra recognises the industry has been under duress for some time, and the main factors, such as rising demand for health services and the soaring cost of treatments, are beyond insurers’ direct control,” he said. “But that’s not an excuse for doing nothing and hoping the government will fix everything.”

According to the Consumers Health Forum and the Australian Healthcare and Hospitals Association [AHHA] the only way forward is for the federal government to order an independent Productivity Commission review of the whole healthcare system, both public and private components. Unlike previous examinations of the private health insurance industry, this review should not be ordered from the starting point that the private health insurance must be saved, rather would question whether it should be.

AHHA acting chief executive Dr Linc Thurecht said the review should also investigate the public policy objectives that are being served by government support or private health insurance through publicly-funded subsidies.

“While there is a cost associated with holding such a review, this must be seen in the context of the latest data we have showing that Australia spent $185bn a year on healthcare,” he told Guardian Australia.

“AHHA would not say that the death of private health insurance is inevitable. But we need to hold all levels of government to account in reforming our healthcare system to better coordinate the delivery of healthcare, to take a longer-term view of individual’s healthcare journey, to remove low value care, to stop some healthcare providers charging exorbitant fees, to remove inequities in access to healthcare and health outcomes, and to improve transparency on outcomes and costs that matter to people.

“Private health insurance is seen by virtually all as being too expensive, too complicated and opaque, and not offering value for money.”

Grattan Institute health economist Dr Stephen Duckett said the death of the private health industry was inevitable. But he said while it was in a “death spiral, it’s a slow death spiral”.

“So do we arrest the death spiral and are there ways to do it without costing more money?” Duckett said. “The private health insurance industry says the answer is to give them another billion dollars. The answer from the industry always seems to be around forcing more people into private health insurance or undermining Medicare.

“The industry should be told enough is enough. That even if we keep the rebate for taking out private health cover, you must stand on your own two feet. It is crazy that people are forced into private health cover through rebates.

“Can you imagine any other product where we say ‘you don’t want to buy it, we think you should though, so you’re forced into it? It’s the most amazing policy for an economy where we value choice.”

At a presentation to the Actuaries Institute conference in Melbourne in October, the Private Healthcare Australia chairman, John Hill, said insurers would find it challenging not to pass on the rising costs of medical devices through premium increases come April.

“Inflated prices for established medical technologies must come down in line with the rest of the world,” Hill said. “One of the most commonly used implants, cardiac stents, are five times the price in Australia as they are in New Zealand.” It was a claim the chief executive of the Medical Technology Association of Australia, Ian Burgess, rejected as “absurd”. He accused the private health insurance industry of “an increasingly desperate attempt” to rein in costs and maintain profitability “by pointing the finger at everyone else”.

The chair of the Australian Healthcare Reform Alliance, Jennifer Doggett, said all of the reforms implemented to salvage private health insurance to date had been cosmetic. She said while reviews of the system had been done before, the benefit of a productivity commission review would be its scope.

“We haven’t had a review yet that includes the premise that we might not need private health insurance at all,” she said. “The reviews we’ve had so far have not examined what is best for Australia. We need a review that looks at consumer needs, not the needs of the private health insurance sector or doctors who want to keep their fees high, or the private sector, or some other interest group.”


Greenie destruction of lots of power generators is wiping out Australia's aluminium producers

Mining giant Rio Tinto says its Australian Aluminium smelters, which employ more than 2,600 workers, are not sustainable at current power prices.

The company runs three smelters in Australia, which are under financial pressure due to the high price of electricity, which makes up about a third of their costs, and the low price of aluminium due to a flood of cheap supply coming from Asian competitors.

The resources minister, Matt Canavan, has recently championed the industry, saying Australia was “one of the best aluminium producers in the world” and claiming it needed a continued supply of “cheap baseload” electricity from coal.

“If we turn our back on coal, you turn out the lights on aluminium, it’s as simple as that,” he told ABC Radio last week.

However, speaking in London on Thursday night, the chief executive of Rio Tinto’s aluminium division, Alf Barrios, issued a blunt warning that current prices from coal-fired power were too high.

He said this was despite “fantastic work” done by the team at the Australian smelter division, Pacific, to improve the performance of the plants.

“However power accounts for about a third of the global cost of the smelters and the smelters at Pacific do lack internationally competitive energy prices, which undermines the viability of these assets,” he said.

“We are working very closely with the power suppliers and the governments to find a solution to this challenge. “I’m not going to speculate on the outcome but clearly the current situation is not sustainable.”

The warning comes after Rio Tinto boss Jean-Sebastian Jacques warned in August that Australian smelters were “on thin ice” and follows the company flagging last week that it might close its New Zealand smelter.

Barrios was speaking to reporters ahead of a quarterly update to investors that listed “low-carbon technology” as a priority for its aluminium business.

The company’s head of economics, Vivek Tulpule, said the profitability of aluminium was “challenged by the quick and cheap expansion of supply to meet growth in demand”.

“This underlines the value of our position in Canada with operating costs in the bottom decile of the cost curve supported by hydro power which will become increasingly important in a carbon-constrained world,” he said.


Feminist poison on the ABC

Since they endorse violence in pursuit of their aims, perhaps I can respond in kind by saying that I would be happy to see the lot of then burn at the stake

The ABC has come under fire after Q&A panellists called for rapists to be killed, labelled Scott Morrison a 'white supremacist' and said police forces should be abolished in an extraordinary programme on Monday night.

The show, featuring a panel of five women and host Fran Kelly, provoked outrage on social media, with hundreds of viewers calling for the ABC to have its funding cut.

The controversy began when a member of the audience asked if aggression and violence were the best ways for feminists to achieve equality.

Outspoken Egyptian-American writer Mona Eltahawy, who dominated the show, replied by endorsing violence and saying that women should kill rapists.

She said: 'I want patriarchy to fear feminism… how long must we wait for men and boys to stop murdering us, to stop beating us and to stop raping us? How many rapists must we kill until men stop raping us?'

Host Fran Kelly then referenced a tweet by Spectator Australia which asked: 'Why is the ABC justifying violence?'

She said: 'So Mona... Spectator Australia is already saying Mona's promoting violence. Is that what you're doing?'

Ms Eltawahy replied: 'What I'm doing is saying that that violence has been owned by the state… exactly how long do I have to wait to be safe?'

The person who asked the question challenged the panel by suggesting that violence was not the best approach, saying: 'Bullying begets bullying and violence begets violence'.

Journalist and author Jess Hill then chimed in to support Ms Eltawahy's argument that violence is necessary.

She said: 'If anyone's shocked by what Mona's suggesting, you just have to look back to history, and a certain faction of the suffragettes… they used violence. They thought what they were fighting was a civil war between the sexes.'

Indigenous writer and activist Nayuka Gorrie also appeared to advocate violence, saying: 'When you say violence begets violence, it's almost sounding like it's a level playing field which it's not.'

'It's absolutely not… I wonder what our kind of tipping point in Australia's going to be when people will start burning stuff? I look forward to it.'

Commenting on Australia's colonial history, she added: 'We've tried for 230-plus years to appeal to the colonisers' morality, which just doesn't seem to exist.

'I think violence is OK because if someone is trying to kill you, there's no amount of, "But I'm really clever. I'm really articulate". No amount of that is going to save you. Let's burn stuff.'

The comments immediately sparked fury on social media as hundreds of viewers were left shocked by such brazen support for violence.

One viewer wrote: 'Violence is never an option and if the ABC insists on pushing violent rhetoric, I will have to insist Scott Morrison pulls funding from the ABC and rescind's their broadcasting licence.'

Another added: 'The ABC is promoting violence? It wouldn’t be first time.'

In another shocking section of the show, Ms Eltawahy called the Prime Minister a white supremacist. 'Your Prime Minister here is a mini version of Donald Trump - because we're talking about white supremacists capitalists,' she said. 'Your Prime Minister is a white evangelical Christian like Mike Pence in the US so you're on a parallel path here.'

Ms Eltawahy then attacked the government over Mr Morrison's proposal to outlaw environmental boycott campaigns.

'When you start talking about banning boycotts, you have to ask what is happening to your so-called democracy,' she said.

Another controversial moment came when the panel discussed Tanya Day, an aboriginal woman who was arrested for being drunk in public and died in a police cell in 2017.

Responding to a question about how institutions can be better held to account for racism, Ms Gorrie said the police service should be shut down. 'Its very formation was to serve the interest of white sovereignty in this country,' she said.

'When we're talking about accountability, I'm not sure how far we can go in keeping an organisation like the police to account because it is there to be violent'. 'It's patriarchal, it's overwhelmingly white. I think it shouldn't exist.'

The show also came under fire for repeated use of foul language, which prompted Kelly to say: 'We are trying to keep the language under control. If you're offended by the profanity, maybe leave now.'

Shortly afterwards, in the section about police racism, Ms Eltawahy made no effort to moderate her words, saying: 'You're asking the person here who travels the world to say f*** the patriarchy.'


Australia to 'fast-track' permanent residency for highly-skilled tech migrants

A change from useless refugees

Seven "future-focused fields" targeted under new visa scheme.
A newly established permanent migration scheme for highly-skilled technologists will target seven “future-focused fields”, including cyber security, fintech and quantum computing, in a bid to maintain Australia’s competitiveness.

The ‘Global Talent Independent Program’ (GTIP), which was first flagged in June to attract the best talent from around the world, was launched by Minister for Immigration, Citizenship, Migrant Services and Multicultural Affairs David Coleman on Monday.

The program aims to lure up to 5000 high-income earners working “at the top of their field” to Australia between July 2019 and June 2020 with the offer of a “fasttracked process to permanent residency”.

It sits separately to the ‘global talent – employer sponsored program’ (GTES), which was made permanent in August after a 12-month pilot.

Only migrants working in one of seven “future-focused fields”, who are likely to earn more than $149,000 per year in Australia, are eligible to for permanent residency under GTIP.

The fields are AgTech, space and advanced manufacturing, fintech, energy and mining technology, medtech, cyber security, and quantum information/advanced digital/data science and ICT.

Normal character, security and integrity checks undertaken for any migration will also apply.

However, instead of waiting for migrants to apply, GTIP intends to actively seek out talent using ‘Global Talent Officers’ from the Department of Home Affairs.

These officers – which have already been deployed in Berlin, Washington DC, Singapore, Shanghai, Santiago, Dubai and New Delhi, and will work across countries in their regions – will guide applicants through the application process.

The Australian Financial Review has reported Coleman as saying this fast-tracked process would take "weeks, not months".

Migrants will also be able to access the program with a referral from “an organisation or an individual with a national reputation in the same field as the candidate”, according to Home Affairs.

Coleman said the GTIP was deliberately targeting the “world’s most highly-skilled migrants” in order to best position Australia for competiveness.

“We want to position Australia at the forefront of major growth trends in the world economy. By enabling local businesses to access the world’s best talent, we will help to grow high growth industries in Australia,” he said.

“Over time, the Global Talent program has the potential to have a transformative impact on the Australian economy.”

While the program is focused on bringing in external talent, Home Affairs expects the scheme will also, by extension, create “opportunities for Australians by transferring skills, promoting innovation and creating job opportunities”.

Minister for Industry, Science and Technology Karen Andrews said local job creation, in addition to the 5000 GTIP placements, would “drive growth in the Australian technology industry”.

 “For our domestic tech industry to grow, businesses need to be able to hire skilled Australian workers as well as access the capabilities of specialists from across the world,” she said.

“We can create high-paying local jobs by making Australia a global technology hub and the global talent program is a signal to tech companies that we’re open for business.”


 Posted by John J. Ray (M.A.; Ph.D.).    For a daily critique of Leftist activities,  see DISSECTING LEFTISM.  To keep up with attacks on free speech see Tongue Tied. Also, don't forget your daily roundup  of pro-environment but anti-Greenie  news and commentary at GREENIE WATCH .  Email me  here

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