# Health Reform: Where is it heading?



## noco (14 April 2010)

There has been much debate on Health Reform, which nobody can deny is long over due.

After listening to John Brumby on The National Press Club today, it would appear very evident that Kevin Rudd's proposal  has no real substance or plan to really improve our ailing health system and in fact it  has been dubbed a failure by many experts in the field of health. There is little doubt, Rudd's proposal has a political agenda to aid  his bid to retain office. A political agenda to make him look like he is doing something to reform health. A major diversion away from the Labor Party failures over the past 2.5 years.

As John Brumby states, Rudd will recycle 30% of the states GST and increase Federal bureaucracy without any initiative to improve the health system in general. Brumby has stated there will only be 1% added in 10 years and nothing whatsoever in the next 4 years. He wants to see a 50/50 deal starting immediately or there will be no agreement.

Rudd has used bullying tactics on the states and threatens a referendum if he does not get his own way. Different spokespersons have stated he already has the constitutional power to take over the health system. He threatened to do just that  prior to the 2007 election if the states did not improve their hospital system by July 2009. So why did he renege? I'll tell you why, because he feared another debacle like every thing else he has touched. He now has the option of blaming the states if things go wrong.

The concern of many Australians is, if Rudd does call a referendum, how will he word it as I posted on another thread a few days ago?

It will be tricky, make no mistake, for everybody wants to see health reform and he will word it so as to acheive the required outcome.


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## trainspotter (14 April 2010)

Kevin Rudd's health reforms are teetering on collapse with WA Health Minister Kim Hames accusing the Prime Minister of stinginess and Victorian Premier John Brumby angrily digging in his heels.

Mr Rudd cannot move ahead with his health plan unless all the premiers agree at a meeting in Canberra next week, but Mr Brumby, who has devised a rival plan, insists he will not be held hostage to take-it-or-leave-it tactics last seen under Queensland's autocratic premier Joh Bjelke- Petersen.

"You've got to go back a long way, probably to the Bjelke-Petersen government in the 70s, for the last time I can remember that a Government held the States to ransom and said 'Oh, if you don't do things the way I tell you, I'm going to take money off you'," Mr Brumby said.

http://au.news.yahoo.com/thewest/a/-/newshome/7057492/health-plan-on-verge-of-collapse/


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## matty77 (14 April 2010)

The scary thing is this, if he doesnt get his way he just turns all "communist" then throws a bit of "shadow cash" the states way to make the general public believe that if the reforms dont go ahead its not his fault.

More spin than win thats for sure, lets hope the public dont fall for this crap yet again and elect this government again, does anyone really trust the federal government to manage our hospitals when they cant even manage insulation?


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## noco (14 April 2010)

matty77 said:


> The scary thing is this, if he doesnt get his way he just turns all "communist" then throws a bit of "shadow cash" the states way to make the general public believe that if the reforms dont go ahead its not his fault.
> 
> More spin than win thats for sure, lets hope the public dont fall for this crap yet again and elect this government again, does anyone really trust the federal government to manage our hospitals when they cant even manage insulation?




It sure makes one wonder how his health reform will turn out if ever he gets it passed by the states. But then again, it has to also be passed by the Senate which would appear most unlikely at this point in time.

The wording of a referendum is what I fear most of all.


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## Julia (14 April 2010)

Noco, I absolutely share your concern.  I've sent a message via the ABC to Antony  Green, their political analyst, asking about the criteria for a Referendum, and whether the Opposition is given the opportunity to have a say in the wording.  (I'd doubt it.)

I couldn't find a direct email address for Mr Green so will hope the ABC forwards the message and Mr Green takes the time to reply.

I really admire John Brumby and the W.A. leaders for so forthrightly standing up to Rudd.  The pressure has also been mounting exponentially from the medical experts, plus people like Roger Corbett.  Hard to see that Rudd won't be forced to either change his terms or back down.

Some constructive input from the Opposition would be nice, but that's probably too much to expect.
At the very least they need to insist that Mr Rudd explains exactly how his plan will benefit the consumer.  So far there has not been even a mention of mental or dental health!


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## So_Cynical (14 April 2010)

Almost all the usual suspects having a Labor bash again, GG will be along shortly  anyway lets have a look at how the 2010 election betting is going as of last Friday....Oh dear its the usual bad news for the Right wing of the ASF. 

http://blogs.crikey.com.au/pollytics/2010/04/09/betting-market-friday-9/
~


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## Whiskers (14 April 2010)

So_Cynical said:


> Almost all the usual suspects having a Labor bash again, GG will be along shortly  anyway lets have a look at how the 2010 election betting is going as of last Friday....Oh dear its the usual bad news for the Right wing of the ASF.
> 
> http://blogs.crikey.com.au/pollytics/2010/04/09/betting-market-friday-9/
> ~




lol, yes I don't know if it's just me, but there seems to be quite a disparity between labour and lib/nat bashing. 

But on a serious note I'm waiting for some decent technological innovations in health administration. From my experience this is where there is probably the most scope for efficiencies in the system. Things like centralised or portable patient (and health staff) records to avoid delays and duplication of processes etc when patients are referred to or processed to different sections of the system. 

Maybe a centralised database like our tax and centrelink records easily available to all authorised personell, to minimise wasted time, duplication, expense and the bureaucracy of administritive paper shufflers.

There are still doctors out there who don't use computerised patient files, just the old paper copy including srcipts, referrals, blood test, xray requests and results etc.


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## RamonR (15 April 2010)

In regards to waiting for innovations in health admin.
Speaking from Qhealth perspective.

The systems they eventually buy are so antiquated and non user friendly.
You can not imagine how non-user friendly.

Had a system introduced in the last few years, which was probably developed in the 80's, gauging by the interface.

It would be understandable if they got them cheap but pay good price for sub par systems.


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## noco (15 April 2010)

The Labor Party did not release their policy on Health untill 2 weeks before the 2007 election, so I don't see why the Coalition should reveal their policy on health untill the time is right.

Under the Rudd proposal, little will be done to stop the blame game between the Federal and State Governments if things go belly up.

IMHO, the Federal Government should go the whole hog like they threatened to do in 2007, and that is to take over the whole system nationally. They have the constitutional power to impliment it without going to a referendum.
But do you know something, (sounds of Kevvie), firstly he does not have the confidence to do it (no guts, no glory) and secondly he fears another big debacle like evrything else he has touched. So he has opted to go half way and if things do go wrong, he has the states to blame. Smart man our Prime Minister??????????????????


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## noco (15 April 2010)

So_Cynical said:


> Almost all the usual suspects having a Labor bash again, GG will be along shortly  anyway lets have a look at how the 2010 election betting is going as of last Friday....Oh dear its the usual bad news for the Right wing of the ASF.
> 
> http://blogs.crikey.com.au/pollytics/2010/04/09/betting-market-friday-9/
> ~




WTF has this got to do with the tread which is about health.

If you don't have anything constructive to add to the debate Cynical, I suggest you stay away from this thread full stop.


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## noco (15 April 2010)

Whilst it is common knowledge that Rudd and the Labor Party were not happy about the introduction of the GST and the fact that they were going to roll it back when they got into  power, would it not solve all their health problems if they raised the GST to 12.5%? At least everyone would know they would be contributing 2.5 cents in the dollar on everything that was purchased.

To raise money from an ETS, which would be passed on to consumer goods, one would not know how much goods would be costing extra and would it not be open to rorting by unscrupulous manufacturers?

But whether Rudd has the fortitude to raise the GST is another question. It was raised by the states before the 2007 election, but Rudd did not want a bar of it, probably fearing a back lash from voters. 

The Labor Party keeps talking about fairness to working families, so it would probably be fairer to raise the GST where it is all out in the open. No more hidden costs like we had with the sales taxes and I recall sales tax was often raised when Governments needed money and no one was any the wiser.


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## So_Cynical (15 April 2010)

noco said:


> WTF has this got to do with the tread which is about health.
> 
> If you don't have anything constructive to add to the debate Cynical, I suggest you stay away from this thread full stop.




WTF has this thread got to do with health reform...you started it as a political, Labor bashing exercise so you and the ASF right could do the usual, whiny, end of the world, Rudd bashing demolition job on all things Labor.

Seriously have a look at your opening post with the few neutral sentences removed. 



noco said:


> it would appear very evident that Kevin Rudd's proposal  has no real substance or plan[/B] to really improve our ailing health system and* in fact it  has been dubbed a failure by many experts in the field of health. There is little doubt, Rudd's proposal has a political agenda to aid  his bid to retain office. A political agenda to make him look like he is doing something to reform health. A major diversion away from the Labor Party failures over the past 2.5 years.
> 
> 
> Rudd has used bullying tactics on the states and threatens a referendum if he does not get his own way. Different spokespersons have stated he already has the constitutional power to take over the health system. He threatened to do just that  prior to the 2007 election if the states did not improve their hospital system by July 2009. So why did he renege? I'll tell you why, because he feared another debacle like every thing else he has touched. He now has the option of blaming the states if things go wrong.
> ...



*

The above is all political content and your right wing opinion...all talk back radio, no facts or figures just political spiel...what i did was cut thru the crap and got down to the real issue, the fact that the coalition is going to get smashed at this years election. *


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## Julia (15 April 2010)

So Cynical, usually we see what we want to see.
So you view Noco's intial post as propaganda against the government.
I viewed it as a fairly reasonable summary of the situation on the proposed health 'reforms' to date.

I have put 'reforms' in quotes because I can't for the life of me see how Mr Rudd's suggested moving around of the dollars is going to in any way at all benefit patient care, or remove any of the stress on healthcare staff.

Obviously you as an ardent fan of the Prime Minister will have clearly understood what I'm missing here, i.e. how Mr Rudd's suggested changes (I can't bear to say 'reforms') will improve our health system.  You will be able to counter the warnings from Professor Dwyer et al, very experienced medical professionals, who say Mr Rudd's suggestions are nothing short of disastrous and absolutely should not be pursued.
Isn't it reasonable to assume that the people at the coalface of Health will actually appreciate what would be useful and what would not?

So I look forward to your explanation of exactly how the proposed Rudd changes will bring benefits to all of us who participate in the health system, whether as patients or healthcare professionals.
You'll need to give a justification, amongst your explanation, of a whole new level of bureaucracy to administer this new system.


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## snowking (15 April 2010)

Loosely related the Health care debate but i thought this little snippet from The Australian highlighted the 'his way or the highway' mentality that Rudd is taking with this health policy. 




> How a busy Prime Minister keeps abreast with the news of the day
> 
> The Nine Network's Today show, October 3, 2007:
> 
> ...




http://www.theaustralian.com.au/new...ing-in-the-world/story-e6frg6zo-1225853798229


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## drsmith (15 April 2010)

noco said:


> Whilst it is common knowledge that Rudd and the Labor Party were not happy about the introduction of the GST and the fact that they were going to roll it back when they got into  power, would it not solve all their health problems if they raised the GST to 12.5%? At least everyone would know they would be contributing 2.5 cents in the dollar on everything that was purchased.
> 
> To raise money from an ETS, which would be passed on to consumer goods, one would not know how much goods would be costing extra and would it not be open to rorting by unscrupulous manufacturers?
> 
> ...



If the Rudd government proposes to raise the GST then it will have lost the plot politically as well as economically.

These idiots should be spending it more wisely, not raising taxes.


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## moXJO (15 April 2010)

So_Cynical said:


> WTF has this thread got to do with health reform...you started it as a political, Labor bashing exercise so you and the ASF right could do the usual, whiny, end of the world, Rudd bashing demolition job on all things Labor.




Hey how did I miss this thread, nothing like a good labor bash(luckily you pointed it out). Let’s face it labor = fail on so many levels. You don't need that many facts and figures, as all of their policies seem to turn to brown. I'm beginning to wonder if they could organize flies on $hit.

But alas, I unfortunately agree with cyn  libs will lose next election unless Rudd bumbles early.


As far as the health reform goes, it sure does have the stink of the ETS rush job on it. Why are all of Rudds polices pressured rush jobs with no detail for anyone to analysis, but must be done right absolutely now? 
Election time all my policies failed blues


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## noco (18 April 2010)

moXJO said:


> Hey how did I miss this thread, nothing like a good labor bash(luckily you pointed it out). Let’s face it labor = fail on so many levels. You don't need that many facts and figures, as all of their policies seem to turn to brown. I'm beginning to wonder if they could organize flies on $hit.
> 
> But alas, I unfortunately agree with cyn  libs will lose next election unless Rudd bumbles early.
> 
> ...




moXJO, you are absolutely right, but what I can't understand is his rush to push this through before the budget without the finer details for all to understand. Does he have a hidden agenda to set up Health Reform before the Henry Tax review, is it to make him look like he is doing something which he knows is a major concern on everyone's minds or is it just another diversion from all his failings? He knows how to push the right buttons and the naive fall for it every time.

As Julia says, The Architect of Medicare, John Deeble has not been very flattering of Rudd's health agenda. Rodger Corbett has labelled Rudd's health reform as bizarre and a formula for disaster. 

In addition to these medical academics, Ken Baxter is suggesting an increase in the GST to 12.5% would solve the problem for the states to seek more money for health reform, but Rudd says over my 'dead' body. He would sooner raise monies by other devious means which one can be assured will hurt the Mum's and Dad's and the working families, you know the one's he is so passionate about, more than the GST. Let's face it, health care is now costing a lot more than it did 20 or 30 years ago and with the increase in life expectancy with modern medical care, we are all living a lot longer and the money has to come from somewhere. Who knows with modern medical research and stem cell developement, humans could be living to the age fo 120 years and beyond by 2050. What impact will that have on the population growth and the capacity to take care of them? I have not heard one comment from any of our so called political experts from either side. Is it a possibility? It is not only a possibilty but  inevitable! At least some of the journos are tyring to work out what the question wil be put to the public if we have a referendum.

Yes, we need health reform, but it has to be implimented correctly with a lot of thought and common sense, but the way Rudd is going about it may prove to be of no benefit to anyone.


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## So_Cynical (18 April 2010)

noco said:


> what I can't understand is his rush to push this through before the budget without the finer details for all to understand. Does he have a hidden agenda to set up Health Reform before the Henry Tax review, is it to make him look like he is doing something which he knows is a major concern on everyone's minds or is it just another diversion from all his failings? He knows how to push the right buttons and the naive fall for it every time.
> 
> As Julia says, The Architect of Medicare, John Deeble has not been very flattering of Rudd's health agenda. Rodger Corbett has labelled Rudd's health reform as bizarre and a formula for disaster.
> 
> ...




Do a google search for "Australian health care reform" and you will find many papers, articles and submissions on the subject going back over a decade...this isn't rushed or new to the majority of the health industry, just surprising in that a Fed Govt has the guts to try and do something positive about it.

Health reform is a little like tax reform and emission's trading/global warming in that the right side of the Australian political spectrum don't know much about it and are somewhat surprised its on the Labor party agenda...that's what a decade in the Howard wilderness will get ya.

The Howard Govt buried all these issues preferring to put them in the politicly 'to hard basket' and move on to issues closer to there heart..immigration discrimination, industrial relations reform, introduction of a GST and supporting Hanson and the far loony right as a distraction from there own gutless, do nothing agenda.

Howard's greatest achievement was probably the Firearms law reform as it required political guts, just like Rudd's health reform also requires political guts, because success will be fairly easy and quick to measure...the ASF right should be all for this reform as its a huge political risk for Labor and could easily be the issue that sinks them in the election after next...if they get it wrong.


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## IFocus (18 April 2010)

Julia said:


> So Cynical, usually we see what we want to see.
> So you view Noco's intial post as propaganda against the government.
> I viewed it as a fairly reasonable summary of the situation on the proposed health 'reforms' to date.
> 
> ...





Hope you caught the insiders program today they covered it quite well.

They showed a NSW reporter taking Brumby apart on his claims of Vic health.

Really the 1st part of reforming the health system is having a secure funding  method, you might notice states are only talking about money and the method of funding not new beds etc. 

This really is only the 1st step 

WA and Victoria already have many or most of the required practices deployed or being deployed i.e the 4 hr rule etc.

Getting the states to agree on any thing is really mission impossible but they actually do agree on reform even  WA Liberal Kim Hames has praised many parts of Rudds plan

As for Rudds position its just part of the negotiations interesting if a deal gets done as there are meeting today between Rudd and premiers.


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## IFocus (18 April 2010)

So_Cynical said:


> Almost all the usual suspects having a Labor bash again, GG will be along shortly  anyway lets have a look at how the 2010 election betting is going as of last Friday....Oh dear its the usual bad news for the Right wing of the ASF.
> 
> ~




Agree, to me looks more like Liberal Party members pushing the party line with the hate message. I say this simply because of the absence of any balance in the comments.


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## noco (18 April 2010)

So_Cynical said:


> Do a google search for "Australian health care reform" and you will find many papers, articles and submissions on the subject going back over a decade...this isn't rushed or new to the majority of the health industry, just surprising in that a Fed Govt has the guts to try and do something positive about it.
> 
> Health reform is a little like tax reform and emission's trading/global warming in that the right side of the Australian political spectrum don't know much about it and are somewhat surprised its on the Labor party agenda...that's what a decade in the Howard wilderness will get ya.
> 
> ...




It is sad that you have fallen for Rudd's line of pretending to be doing something about Health reform. The average JOE BLOW with half a brain knows it is just a diversion away from  the real failures of the the Rudd Government. Rudd certainly knows how to push your buttons old mate.

Rudd's 2007 pre election  promise was to take over running of the whole hospital system in July 2009 if the states had not improved their efficiencies in surgery waiting time, emergency, mental care, the provision of the number of beds and more doctors and nurses. So why did he break his 2007 election promise? 10 + years ago the Queensland led Labor Government built a new hospital in Townsville smaller than the one they knocked down. Townsville's population is increasing 8% per year. Not very good planning at all.

Now please don't come back and tell me it's all Howard's fault, because you and I know it is, and always has been, a state resposibilty. The GST was to be the provider and was sufficient at the time, but unfortuneatly it is now not enough to cover the increase in costs of health care and one of the solutions is to increase the GST to 12.5%. But I can't see Mr. Rudd having the fortitude to do it.


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## So_Cynical (18 April 2010)

noco said:


> Now please don't come back and tell me it's all Howard's fault, because you and I know it is, and always has been, a state resposibilty. The GST was to be the provider and was sufficient at the time, but unfortuneatly it is now not enough to cover the increase in costs of health care and one of the solutions is to increase the GST to 12.5%. But I can't see Mr. Rudd having the fortitude to do it.




And that's my point..Rudd and Labor are going out on a limb that the Liberals & Nationals just weren't interested in, way to much political risk for them....takes real guts and visionary thinking to do what Labor is doing...if they can pull this off they could Govern for more than a decade and by then the NBN will be kicking in along with the Tax reform to come out of the Henry review out this month.

This could just be a game changing, visionary point in Australia's political, social and development history...looking big picture: what's Abbott and the Coalition hierarchy doing to win this coming election? all there offering is opposition, there outa ideas.


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## Calliope (18 April 2010)

IFocus said:


> Really the 1st part of reforming the health system is having a secure funding  method, you might notice states are only talking about money and the method of funding not new beds etc.




Sure. But are we supposed to take on trust that juggling the funding around with smoke and mirrors tricks will translate into shorter waiting lists for hospital beds and elective surgery, and will it improve conditions in the wards for patients, doctors and nurses?

Billions have been thrown at the hospital system. Keneally says that NSW spends over a third of the GST on health now. The money just disappears into a bottomless pit of bureaucratic waste.

We have already seen that of the billions poured in the BER and home insulation, a large percentage of it disappears in graft, waste, lack of control and gross mismanagement.

 Are you satisfied that the Commonwealth bureaucrats will get it right this time and give us an efficient hospital system?


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## noco (18 April 2010)

Calliope said:


> Sure. But are we supposed to take on trust that juggling the funding around with smoke and mirrors tricks will translate into shorter waiting lists for hospital beds and elective surgery, and will it improve conditions in the wards for patients, doctors and nurses?
> 
> Billions have been thrown at the hospital system. Keneally says that NSW spends over a third of the GST on health now. The money just disappears into a bottomless pit of bureaucratic waste.
> 
> ...




Calliope, this is history being repeated all over again. Labor Governments whether State of Federal just do not how to manage money without waste.

If Rudd does get his own way either by agreement with the states, a referendum or with constitutional powers which he can use to take over the whole hospital system, I just hope he gets it right. But with his recent performances, IMHO it will be a debacle and he will blame the states if things go wrong and that is why he has not got the fortitude to take over the hospital system completely like he said he would.


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## noco (18 April 2010)

So_Cynical said:


> And that's my point..Rudd and Labor are going out on a limb that the Liberals & Nationals just weren't interested in, way to much political risk for them....takes real guts and visionary thinking to do what Labor is doing...if they can pull this off they could Govern for more than a decade and by then the NBN will be kicking in along with the Tax reform to come out of the Henry review out this month.
> 
> This could just be a game changing, visionary point in Australia's political, social and development history...looking big picture: what's Abbott and the Coalition hierarchy doing to win this coming election? all there offering is opposition, there outa ideas.




I'm pleased you said 'IF' they can pull it off. You don't sound  very confident about your spin doctor leader old mate.


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## IFocus (18 April 2010)

Calliope said:


> Sure. But are we supposed to take on trust that juggling the funding around with smoke and mirrors tricks will translate into shorter waiting lists for hospital beds and elective surgery, and will it improve conditions in the wards for patients, doctors and nurses?
> 
> Billions have been thrown at the hospital system. Keneally says that NSW spends over a third of the GST on health now. The money just disappears into a bottomless pit of bureaucratic waste.
> 
> ...




You misunderstand the policy on the table

Its not about the commonwealth running the health system it never has been.

Again the 1st step is to secure funding agreement between the states and commonwealth which is what all the argee bargee is currently about.


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## So_Cynical (18 April 2010)

noco said:


> I'm pleased you said 'IF' they can pull it off. You don't sound  very confident about your spin doctor leader old mate.




I'm a realist (unlike so many ASFers)...and this its health reform and political bravery on a major scale, and Rudd has ownership of it so will get the kudos if it goes well and the blame if it fails.


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## noco (18 April 2010)

So_Cynical said:


> I'm a realist (unlike so many ASFers)...and this its health reform and political bravery on a major scale, and Rudd has ownership of it so will get the kudos if it goes well and the blame if it fails.




Now Cynical, the Victorian Labor Premier John Brumby has already found a $1.6 billion hole in Rudd's costing. He is going to recycle 30% of the states GST in which 3 states are reluctant to give up.

Beacuse Rudd let 9 months pass from his due date of July 2009 for a complete take over of the hospital system, he was pushed into doing something in 6 weeks on the back of an envelope with very little detail. He has bullied the states ie. if you don't agree with me I (Rudd) will take it to a referendum. As I said before, he does not have to go to a referendum because he has the constitutional power to take over the whole system. So why does he not do what he said he would do pre 2007 election. I thought you said he is a political brave man on a large scale!!!!! You know the old saying " no guts, no glory". He is afraid to do a complete take over because he does not have any confidence in being able to do it. He would sooner pretend he is doing something by recycling the GST. He now has an out to blame the states if it all falls flat.

Do you know how it is all going to work or will it be like Anna Bligh says, "we'll work our way through it all as we go". That's the reason why these Labor people get themselves in such a fix. 

Everyone wants health reform, but it must be implimented with good planning and strong debate. If Rudd is going to be PIG HEADED about it, he will fail, full stop.


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## So_Cynical (18 April 2010)

noco said:


> Now Cynical, the Victorian Labor Premier John Brumby has already found a $1.6 billion hole in Rudd's costing. He is going to recycle 30% of the states GST in which 3 states are reluctant to give up.
> 
> Beacuse Rudd let 9 months pass from his due date of July 2009 for a complete take over of the hospital system, he was pushed into doing something in 6 weeks on the back of an envelope with very little detail. He has bullied the states ie. if you don't agree with me I (Rudd) will take it to a referendum. As I said before, he does not have to go to a referendum because he has the constitutional power to take over the whole system. So why does he not do what he said he would do pre 2007 election. I thought you said he is a political brave man on a large scale!!!!! You know the old saying " no guts, no glory". He is afraid to do a complete take over because he does not have any confidence in being able to do it. He would sooner pretend he is doing something by recycling the GST. He now has an out to blame the states if it all falls flat.
> 
> ...




noco with that post you have now made it clear to everyone that you have a right wing political agenda and no interest at all in genuine health reform..so in future threads please drop the pretence and just be upfront about your agenda.


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## IFocus (18 April 2010)

noco said:


> Now Cynical, the Victorian Labor Premier John Brumby has already found a $1.6 billion hole in Rudd's costing. He is going to recycle 30% of the states GST in which 3 states are reluctant to give up.
> 
> Beacuse Rudd let 9 months pass from his due date of July 2009 for a complete take over of the hospital system, he was pushed into doing something in 6 weeks on the back of an envelope with very little detail. He has bullied the states ie. if you don't agree with me I (Rudd) will take it to a referendum. As I said before, he does not have to go to a referendum because he has the constitutional power to take over the whole system. So why does he not do what he said he would do pre 2007 election. I thought you said he is a political brave man on a large scale!!!!! You know the old saying " no guts, no glory". He is afraid to do a complete take over because he does not have any confidence in being able to do it. He would sooner pretend he is doing something by recycling the GST. He now has an out to blame the states if it all falls flat.
> 
> ...




Either you are a Liberal party hack or naive on prime minister / states negotiations


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## noco (18 April 2010)

So Cunical and Ifocus, looks like I have hit a nerve with you fellows when you resort to personal attacks. That is a sure sign you are both rattled.

I don't belong to any political party and have voted Labor on occassions. For all you fellows know I could be Green, a Climate Sceptic Party suppoter or an independant supporter if I thought any were  on the right track.

This is a debate about an extremely important situation involving health care and after listening to various medical academics and John Brumby I have come to my own conclusions about what is right and what is wrong. 

You fellows seem to have a one track mind and that is what ever Rudd says, he must be right and everyone else is wrong. You are cynical!


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## Julia (18 April 2010)

So_Cynical said:


> Do a google search for "Australian health care reform" and you will find many papers, articles and submissions on the subject going back over a decade...this isn't rushed or new to the majority of the health industry, just surprising in that a Fed Govt has the guts to try and do something positive about it.



If the health care professionals are so au fait with what you suggest have been ongoing discussions, why are front line people like Professor Dwyer and Dr Deeble (the architect of Medicare) making their disapprobation so crystal clear?   They have both indicated that what has been suggested will be at best counter-productive.
Then you have Roger Corbett, one of Australia's most successful businessmen, and a Reserve Bank Board member, telling us it would be a complete disaster.

If I have to choose an opinion to accept, then I'll sure as hell take that from these successful people, before that of a bureaucrat with no business experience whatsoever, who has overseen two of the most disastrous policies ever seen in Australia with the insulation and BER fiascos.



> Health reform is a little like tax reform and emission's trading/global warming in that the right side of the Australian political spectrum don't know much about it and are somewhat surprised its on the Labor party agenda...that's what a decade in the Howard wilderness will get ya.



What absolute nonsense.
What is it with people who are so rusted on to their party political views that they lose any sense of objectivity?
And yes, both sides can be equally guilty of this.




IFocus said:


> Agree, to me looks more like Liberal Party members pushing the party line with the hate message. I say this simply because of the absence of any balance in the comments.



I don't think that's fair, IFocus.  I'd be more than happy to accord appreciation to Rudd & Co. if it genuinely appeared the proposed 'reforms' were actually going to achieve any improvement in either patient care or healthcare staff stress.  Being unhappy with suggested policy from one side does not automatically translate into support for the other side, for heaven's sake!
So far all I can see is a shifting around of who does what with what money.
Perhaps you could explain how this is going to actually benefit either patient care or staff stress?




So_Cynical said:


> I'm a realist (unlike so many ASFers)...and this its health reform and political bravery on a major scale, and Rudd has ownership of it so will get the kudos if it goes well and the blame if it fails.



I'm still waiting for you to explain the exact nature of these reforms and how they are going to benefit Australians?
Also, why is there so much urgency to have the States sign up?
Why is Rudd unprepared to release the Henry Tax Review before the States sign up to his health 'reforms'?

These are very reasonable questions, and do not mark me or anyone else asking them as 'anti government' because of being either an opposition supporter or simply a Rudd hater, as you and others have observed.

Since you and IFocus are obviously keen to see all the States sign up, then you should have no problem in explaining to the rest of us just what they will be signing up for, and why I or any other voter should be supporting whatever is planned.

If my understanding that what has been clearly suggested so far is a shifting of proportions of funding paid by the States and the Feds, and an assurance that this will result in better care for emergency departments, aged care, and elective surgery (note:  no mention of mental health or dental care???) is incorrect, then I'm very happy to be corrected and to be informed about how Australian consumers of the health system will be better off.

And please don't ignore these questions a second time, while continuing to criticise those who are not falling over themselves with admiration for anything from the Rudd Design Corporation.


----------



## Calliope (18 April 2010)

Julia said:


> Since you and IFocus are obviously keen to see all the States sign up, then you should have no problem in explaining to the rest of us just what they will be signing up for, and why I or any other voter should be supporting whatever is planned.




It is obvious Julia that IFocus and So Cynical are not taxpayers. If they were, they certainly wouldn't trust the Rudd government to be able to get anything right after all the scandalous and costly bungles they have made in the last two years. 

They can't be trusted to manage anything, and why should they? They are all bureaucrats or ex-union bosses. All they can do is spend other peoples' money.

It is ironic that a person who calls himself So Cynical could be so naive as to allow himself to be so trusting of Rudd. who is such an obvious liar and fake. For a man who flaunts his cynicism on most other threads it is surprising that he is so taken in by Rudd's spin. Or is it just his left wing agenda?


----------



## So_Cynical (18 April 2010)

The sheer political naivety displayed by some people on this forum is absolutely stunning. 

Absolutely stunning ...but hang on, maybe its simply that some people are just not used to a PM having balls and sticking his neck out, PM's are supposed to be meek and mild, go jogging on a Sunday morning, respect the status quo and take no political risks....deny everything with political risk and appeal to the lowest common denominator.

Health Reform: Where is it heading? LOL..its heading where the elected Govt decides to take it, that's what happens when you win elections...you get to decide stuff.


----------



## Calliope (19 April 2010)

So_Cynical said:


> The sheer political naivety displayed by some people on this forum is absolutely stunning.




Rudd with balls? Yes he is the master of balls-ups.
A whiff  of of Rudd spin and your much vaunted cynicism turns to jelly.


----------



## noco (19 April 2010)

Without having a snipe at who is right and who is left, it comes down to the question set up by the Neilson poll today which indicated an average of 60% of the Australian population, including me, want health reform. The question was:-
"Do you want health reform". 

Of course we all want health reform, but that poll does not necessarily give Kevin Rudd the right to think the citizens of Australia support his ideas about the way he wants to go about it.

The Premiers are going into the COAG meeting this morning not knowing how their 30% GST contribution will be distrbuted. There does not seem to be any detail to his so called plan. Even Cynical and IFocus can't seem to answer Julia's questions.

Most of the states say they can't wait for reform untill 2014 and even Rann from SA wants it to start in 2010/2011.


----------



## Calliope (19 April 2010)

noco said:


> Without having a snipe at who is right and who is left, it comes down to the question set up by the Neilson poll today which indicated an average of 60% of the Australian population, including me, want health reform. The question was:-
> "Do you want health reform".
> 
> Of course we all want health reform, but that poll does not necessarily give Kevin Rudd the right to think the citizens of Australia support his ideas about the way he wants to go about it.
> ...




Yes I am surprised it was only 60%. I have never met anybody who doesn't want health reform. It was however the wrong question. 

If the question had been,

*Would you trust this government to implement a cost efficient health reform plan?*

Rudd would have got whacked.


----------



## noco (19 April 2010)

As pointed out before, the majority of Australian citizens wants health reform and I would say most people would agree the cost of health care has exploded, which means more money is required to fix a broken system in all states and territories.  

We must all face reality, health reform is going to cost JOHN CITIZEN one way or the other, whether by direct tax of indirect tax. Unfortunately, no body wants to admit it.

Based on the 10% GST receipts for 2009/2009, which was something like $43.48 billion, an increase in the GST to 12.5% would have netted $54.35 billion in that same year; an increase in revenue of $10.87 billion. If this increased figure was included into the poole of 30% of the states contribution now under discussion, is it not a solution to the problem of more money for health? 

Without bringing politics into the deabte, I would like to hear other peoples views on the matter. How should the extra revenue be raised?


----------



## Calliope (19 April 2010)

So_Cynical said:


> ..but hang on, maybe its simply that some people are just not used to a PM having balls and sticking his neck out, PM's are supposed to....deny everything with political risk and appeal to the lowest common denominator.




Can you tell me what political risks Rudd what has ever taken? What courageous decisions?  And he certainly appeals to the common denominator..those who thrive on his extravagant  splurging of the taxpayers' money.

There was certainly no risk for him in switching attention away from all his failures by making health reform his central re-election focus, as today's poll shows

Perhaps you should change your title to So_Naive.:bunny:


----------



## Julia (19 April 2010)

Julia said:


> I'm still waiting for you to explain the exact nature of these reforms and how they are going to benefit Australians?
> Also, why is there so much urgency to have the States sign up?
> Why is Rudd unprepared to release the Henry Tax Review before the States sign up to his health 'reforms'?
> 
> ...






So_Cynical said:


> The sheer political naivety displayed by some people on this forum is absolutely stunning.
> 
> Absolutely stunning ...but hang on, maybe its simply that some people are just not used to a PM having balls and sticking his neck out, PM's are supposed to be meek and mild, go jogging on a Sunday morning, respect the status quo and take no political risks....deny everything with political risk and appeal to the lowest common denominator.
> 
> Health Reform: Where is it heading? LOL..its heading where the elected Govt decides to take it, that's what happens when you win elections...you get to decide stuff.



So Cynical, your post here in no way answers my questions.   I can only assume you have no idea how the 'reforms' will actually benefit patients or staff, and that you are simply babbling your unthinking admiration of Mr Rudd without having a clue what he's actually suggesting.


----------



## trainspotter (19 April 2010)

I can hardly wait for the first patient to wake up with a pair of scissors still left inside them after an operation. I wonder if there is enough monies left in the grab bag to payout the malpractice suit? Rudd offers another 15 billion to sweeten the deal to get the Premiers to sign on the dotted line. Where is the money coming from again? Anyone seen any forecasts or details as to how the GST is funding this parallel commonwealth bureaucracy gone mad? How is is it decided that the GST funds are split up? Let's say that WA contributes a majority of GST revenue due to mining etc but has the least amount of population. Does this mean this state is worse off or better off under Herr Rudds health plan? Is there a surplus of GST revenue and if so where does it go? STILL NO DETAILS other than 30% of GST taken away from state control and allegedly being placed back into health ?? 

"As Prime Minister, I was elected with a mandate to deliver better health and hospital services for all Australians," Chairman Rudd thundered. OOoooooer ... sounds like the Supreme Leader has spoken.


----------



## noco (19 April 2010)

Calliope said:


> Yes I am surprised it was only 60%. I have never met anybody who doesn't want health reform. It was however the wrong question.
> 
> If the question had been,
> 
> ...




Yes Calliope, that is the question I would like to see in a referendum, but there is no way it will happen.

The thing I cannot understand is why Rudd needs a referendum in the first place. He has the constitutional power to take over the whole system. He said he would do it in July 2009 if the states did not improve. Why has he reneged?


----------



## trainspotter (19 April 2010)

Just received this email.

Subject: Kevin Rudd's Health Plan

As a rule, I don't pass along these "add your name" lists that appear in emails, BUT this one is important.  

*It has been circulating for months and has been sent to over 20 million people.*

We don't want to lose any names on the list so just hit forward and send it on.

Please keep it going!

To show your support for Kevin Rudd's health care reform, please go to the end of the list and add your name.


1.  Wayne Swan.

2.


----------



## noco (19 April 2010)

trainspotter said:


> Just received this email.
> 
> Subject: Kevin Rudd's Health Plan
> 
> ...




1. Wayne Swan
2. So Cynical
3. I Focus.


----------



## Calliope (19 April 2010)

Rudd is using his tried and true methods to gain support from the premiers. If bribes work on the electorate why shouldn't shelling out billions of the taxpayers' money work on the premiers? The gutless Bligh, Rann and Bartlett have already folded. Apparently they are just getting rewarded.



> In an attempt to ease tensions, NSW will be handed the lion's share of an unprecedented national funding package, worth an extra $15.6 billion, under which the Commonwealth will lock in cast-iron health funding increases of 8.3 per cent a year.
> 
> Victoria, where political resistance is strongest to the reforms, is to be offered an extra $3.8 billion, Queensland an extra $3.4 billion and South Australia $1.1 billion. The remaining billions are to be shared out between the ACT, Western Australia, Tasmania and the Northern Territories.




http://www.news.com.au/national/kev...xtra-health-cash/story-e6frfkvr-1225855245959


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## trainspotter (19 April 2010)

noco said:


> 1. Wayne Swan
> 2. So Cynical
> 3. I Focus.




LOL@noco ... too funny


----------



## noco (19 April 2010)

One can't help feeling suspicious that our Prime Minister Kevin Rudd has a hidden agenda for wanting to push his undetailed health reform before the release of the Henry tax reveiw and the budget.

We may well be in for some surprises leading up to the election.


----------



## Julia (19 April 2010)

noco said:


> One can't help feeling suspicious that our Prime Minister Kevin Rudd has a hidden agenda for wanting to push his undetailed health reform before the release of the Henry tax reveiw and the budget.
> 
> We may well be in for some surprises leading up to the election.




Yes, I agree.   The millions (?billions) he's throwing around to bribe the Premiers appear at this stage to be unfunded, other than that which is to be clawed back from the States' GST.

I'll be very surprised indeed if the release of the Henry Tax Review (or parts thereof, given our Prime Minister seems to have a predilection for feeding out little bits at a time of everything) does not contain some politically unpalatable new taxes.

If the Premiers sign up to Rudd's Plan before they know the content of the Henry Review, they're even greater fools than they've so far demonstrated.


----------



## IFocus (19 April 2010)

Seems I struck a nerve  

So I take it none of you have read the policy just the media headlines!


----------



## Whiskers (20 April 2010)

trainspotter said:


> I can hardly wait for the first patient to wake up with a pair of scissors still left inside them after an operation. I wonder if there is enough monies left in the grab bag to payout the malpractice suit? Rudd offers another 15 billion to sweeten the deal to get the Premiers to sign on the dotted line. Where is the money coming from again? Anyone seen any forecasts or details as to how the GST is funding this parallel commonwealth bureaucracy gone mad? *How is is it decided that the GST funds are split up?* Let's say that WA contributes a majority of GST revenue due to mining etc but has the least amount of population. Does this mean this state is worse off or better off under Herr Rudds health plan? *Is there a surplus of GST revenue *and if so where does it go? STILL NO DETAILS other than 30% of GST taken away from state control and allegedly being placed back into health ??
> 
> "As Prime Minister, I was elected with a mandate to deliver better health and hospital services for all Australians," Chairman Rudd thundered. OOoooooer ... sounds like the Supreme Leader has spoken.




*Intergovernmental Agreement on Federal Financial Relations.*

*NO.*

Talk about half-cocked Rabble-Rousers! 

Don't even know the basics that are enshrined in the system.


----------



## Whiskers (20 April 2010)

noco said:


> One can't help feeling suspicious that our Prime Minister Kevin Rudd has a hidden agenda for wanting to push his *undetailed health reform *before the release of the Henry tax reveiw and the budget.
> 
> We may well be in for some surprises leading up to the election.




Maybe, many politicans do, *but the state premiers obviously have a lot more detail than is available to the public and equally, counter propositions which they're also not revealing (maybe because it may embarrass them or highlight their grand-standing)*... and it's reasonable as has often happened at COAG meetings under all political persuasions to thrash out agreements albeit at the last minute so they can be factored into the Fed budget. 

Doesn't seem anything unusual in that respect.


----------



## Whiskers (20 April 2010)

Julia said:


> If the Premiers sign up to Rudd's Plan before they know the content of the Henry Review, they're even greater fools than they've so far demonstrated.




Why so?

From the little info available, the main thrust is are not about takeing over the day to day management of health services, but about  some sort of standardisation of services, and funding of health services across the country, particularly to attempt to rectify the imbalance in some regional areas, by taking 30% of current state GST and putting into some fund specifically for health delivery services.

The gov may impliment some of the Henry Review recommendations re the spread of wealth in terms of income tax and welfare, but how could the Henry Review adversly affect state budgets, since the GST cannot be changed without the states agreeing?


----------



## Calliope (20 April 2010)

Whiskers said:


> Talk about half-cocked Rabble-Rousers!
> 
> Don't even know the basics that are enshrined in the system.




Talk about gullible fools. 

Whatever happened to health system reform? They are certainly not discussing it in Canberra. It is on the back burner.

As with all COAG meetings it has descended into a bun fight over money. Like vultures they are fighting over their share of the taxpayers' carcase. Brumby says they can't discuss reform until until they sort the money out.

The aged, the infirm and the mentally ill should be very worried.

Every time Rudd opens his mouth to put another "sweetener" on the table, Swan has to rule a line under his Budget proposals and start again. The allocation for Rudd's bribes is reaching massive proportions.


----------



## Whiskers (20 April 2010)

Calliope said:


> Talk about gullible fools.




Yes they are. Have a bit of a read. http://www.coag.gov.au/intergov_agreements/federal_financial_relations/index.cfm



> Whatever happened to health system reform? They are certainly not discussing it in Canberra. It is on the back burner.




Well you may be right there. It seems a couple of states are now complicating things and want to change at the last moment the previously agreed IGA on the GST distribution, before discussing anything else.

But the states have been in discussion with the fed for two previous years over health reform at COAG. You can't tell me they are completely ignorant on what the fed is looking for. Time to get something on the ground at least in the way of standardisation of services. I suspect the states are still baulking on tying up funds in Specific Purpose Payments.



> As with all COAG meetings it has descended into a bun fight over money. Like vultures they are fighting over their share of the taxpayers' carcase.




So what's new there!



> Brumby says they can't discuss reform until until they sort the money out




Well from my accounting experience you have to have a plan before you can fund it... or is he one wanting to go right back to changing the IGA formula at the last moment.



> The aged, the infirm and the mentally ill should be very worried.




Why so? 



> Every time Rudd opens his mouth to put another "sweetener" on the table, Swan has to rule a line under his Budget proposals and start again. The allocation for Rudd's bribes is reaching massive proportions.




Again what's new here. Every gov does that at COAG negotiations. That's what COAG is all about.


http://www.abc.net.au/news/stories/2008/03/26/2199066.htm


----------



## Calliope (20 April 2010)

Whiskers said:


> Why so?




Because health system reform seems to have disappeared from the agenda.

The gullibility of you and the other  usual suspects on this thread is a mystery to me. After all Rudd's lies, broken promises, foul-ups and squandering our economic base, you still have faith in his promises. You accept Rudd-spin as gospel.

I can only assume that you, along with the other true believers, have a vested interest and are a beneficiary of the loot that Rudd has raided from the public purse.

You say you have accounting experience. Well it's about time you did your sums, and see if you can balance the books. Swan has no chance.


----------



## noco (20 April 2010)

IFocus said:


> Seems I struck a nerve
> 
> So I take it none of you have read the policy just the media headlines!




Is that the one Rudd wrote on the back of an envelope a couple of weeks ago. Can you give us a link?


----------



## Whiskers (20 April 2010)

Calliope said:


> Because health system reform seems to have disappeared from the agenda.




 What!

I believe I saw Brumby on early morning TV saying discussions have been positive and we might get an agreement today. Quite a turnaround from yesterdays rethoric.


----------



## noco (20 April 2010)

Whiskers said:


> Yes they are. Have a bit of a read. http://www.coag.gov.au/intergov_agreements/federal_financial_relations/index.cfm
> 
> 
> 
> ...




Yes, like everything else this Government does, TALK! TALK! SPIN!SPIN! AND NO ACTION. They won't even get half way like all their other promises.


----------



## Whiskers (20 April 2010)

noco said:


> Yes, like everything else this Government does, TALK! TALK! SPIN!SPIN! AND NO ACTION. They won't even get half way like all their other promises.




BUT... the fed gov isn't managing the day to day delivery of health services. That is still in the hands of the States. 

Isn't the main jist of these negotiations to secure health funding probably as a larger SPP, that can't be redirected to other areas eg leaving health supplies low because of unpaid suppliers as in NSW, BUT still managed and delivered by the states, but to some sort of national standard?

Surely once agreement on the standards and funding is agreed, it's all up to the states to deliver/manage as usual as per the agreed standards and funding.


----------



## Calliope (20 April 2010)

Whiskers said:


> Isn't the main jist of these negotiations to secure health funding probably as a larger SPP, that can't be redirected to other areas eg leaving health supplies low because of unpaid suppliers as in NSW, BUT still managed and delivered by the states, but to some sort of national standard?




No the "main jist (sic)" is about the Commonwealth imposing another layer of bureaucracy on the system. Whoever controls the funding will call the tune. 

Nothing will change. Commonwealth bureaucrats always bungle management, and running a cost effective health system is beyond them. Pouring in more money doesn't help. It just goes down the gurgler as in the BER.


----------



## Whiskers (20 April 2010)

Calliope said:


> No the "main jist (sic)" is about the Commonwealth imposing another layer of bureaucracy on the system. Whoever controls the funding will call the tune.




They may call the tune but as I expect the major changes will be in 'standards' and the funding arrangements probably in the form of a SPP like many other that already exist, what aspect of reform is going to cause another layer of bureaucracy?



> Nothing will change. Commonwealth bureaucrats always bungle management, and running a cost effective health system is beyond them. Pouring in more money doesn't help. It just goes down the gurgler as in the BER.




So it's the "Commonwealth bureaucrats" fault, not the politicans eh!

There's a lot of things that Commonwealth bureaucrats and quasis generally manage pretty well, such as Tax collection, Australia Post, Medibank and Medicare. 

With regards to health it's arguable that anyone could manage it better than Qld and NSW bureaucrats and politicans for example has done lately.


----------



## trainspotter (20 April 2010)

Whiskers said:


> Why so?
> 
> From the little info available, the main thrust is are not about takeing over the day to day management of health services, but about  some sort of standardisation of services, and funding of health services across the country, particularly to attempt to rectify the imbalance in some regional areas, by taking 30% of current state GST and putting into some fund specifically for health delivery services.
> 
> The gov may impliment some of the Henry Review recommendations re the spread of wealth in terms of income tax and welfare, but how could the Henry Review adversly affect state budgets, since the GST cannot be changed without the states agreeing?




Do you have a direct line to the document proposal? Still no detail other than the 30% GST to be taken away from the states. *"Into some fund"* ??? WTF ?? Is this some new Laborite terminology that I don't know about? 

*"Talk about half-cocked Rabble-Rousers!" *Asking questions which you have no answer for makes me a Rabble - Rouser than so be it Whiskers !! LOLOL - Still no detail on the table other than Feds are going to take 30% GST from the states and place it directly to hospital boards. Apparently this will only cover 60% of the running costs and the states STILL have to fund the other 40% or the patient does by paying charges !!!  

*Don't even know the basics that are enshrined in the system?* Then enlighten me with your omniscient wisdom Oh wise one ........ please !


----------



## noco (20 April 2010)

Whiskers said:


> BUT... the fed gov isn't managing the day to day delivery of health services. That is still in the hands of the States.
> 
> Isn't the main jist of these negotiations to secure health funding probably as a larger SPP, that can't be redirected to other areas eg leaving health supplies low because of unpaid suppliers as in NSW, BUT still managed and delivered by the states, but to some sort of national standard?
> 
> Surely once agreement on the standards and funding is agreed, it's all up to the states to deliver/manage as usual as per the agreed standards and funding.




The main "jist" of Rudd's pre 2007 election policy was a complete take over of the National Hospital system if the states did not improve by July 2009.

Nine months had elapsed before he decided to do something after he was shamed into it. He watered it down to make it look like he was doing 'something'. All talk and no action again. It was all put in the too hard basket for a complete take over, so  he choose to smash and grab 30% of the GST and recycle it as Federal assistance, That's our Prime Minister.


----------



## Whiskers (20 April 2010)

trainspotter said:


> Do you have a direct line to the document proposal? Still no detail other than the 30% GST to be taken away from the states. *"Into some fund"* ??? WTF ?? *Is this some new Laborite terminology that I don't know about?*




Probably, but most of us are aware that it's been mooted for ages in the press and again in this mornings papers.

Also, if you bothered to look at the IGA link you would see that SPP's have been used by fed gov's for ages.



> The meeting resumed at 5pm and Mr Rudd added another $316 million - $200 million more for emergency departments and $116 million more for mental health. The states accepted, clearing the decks for the fight today over GST revenue and the states' demand for all revenue to be put into, and administered by, a single funding pool.
> .
> 
> While Mr Rudd could agree to the latter, he is refusing point-blank to allow the states to keep the GST. He wants to keep the money and spend it directly on local hospital networks.
> http://www.brisbanetimes.com.au/national/showdown-over-gst-will-be-like-ok-corral-20100419-spe7.html







> *"Talk about half-cocked Rabble-Rousers!" *Asking questions which you have no answer for makes me a Rabble - Rouser than so be it Whiskers !!
> 
> *Don't even know the basics that are enshrined in the system?* Then enlighten me with your omniscient wisdom Oh wise one ........ please !




I led you to the water, but you have to drink for yourself.

PS: Just now the news is that NSW has agreed to a deal just leaving Brumby and WA on the outer.


----------



## Whiskers (20 April 2010)

noco said:


> The main "jist" of Rudd's pre 2007 election policy was a complete take over of the National Hospital system if the states did not improve by July 2009.
> 
> Nine months had elapsed before he decided to do something after he was shamed into it. He watered it down to make it look like he was doing 'something'. All talk and no action again. *It was all put in the too hard basket for a complete take over*, so  he choose to smash and grab 30% of the GST and recycle it as Federal assistance, That's our Prime Minister.




I suppose the GFC and the states refusing to hand over full control all at once had something to do with that... but at the end of the day I just hope they can all agree on some constructive reform to get the ball rolling now.


----------



## trainspotter (20 April 2010)

I may need to enlighten you Whiskers !

KEVIN Rudd has made his final offer to the states on his health reform package. What remains between now and the April 19 Council of Australian Governments meeting is a final funding offer from the Prime Minister. 

The commonwealth-state divide boils down to money, perhaps a mere billion dollars or so. Victorian Premier John Brumby's claim that the states should retain the 30 per cent of GST revenue Rudd proposes to withhold from them seems to be regarded even by his peers as out there.

A small matter of principle crept in from the premiers' Monday night teleconference: *that all the hospital funding should be pooled, presumably to be distributed by some independent authority. It's a silly idea that has been floating around for years and has been vehemently discredited by the states previously.* The likely outcome is an agreement broadly in line with the commonwealth's various policy statements.

Funding will switch from states to commonwealth via a withholding of sufficient GST revenue to allow the commonwealth to lift its public hospitals contribution from 35 per cent of total to 60 per cent. The commonwealth will establish 150 local hospital networks to which it will make its hospital payments and which will be accountable for meeting national standards for access and quality.

The commonwealth's payments will be made on an efficient price, or casemix, formula for in-patient episodes, set by an independent statutory commission, with variations for small rural and remote hospitals.

Similar arrangements for hospital emergency attendances and outpatients will be introduced later, with the commonwealth committed to eventually meeting 100 per cent of these costs.

*States will meet approximately 40 per cent of public hospital costs and will be responsible for planning and co-ordination within their systems. Significantly, states will meet those costs that are above the efficient price.*

Growth in operating costs after 2014 and future capital requirements of public hospitals will be a federal responsibility.

The commonwealth will take full responsibility for primary healthcare funding, with most details yet to be announced.

A network of primary healthcare organisations, separate from the hospital network, is planned. This seems to be a revamp of the network of divisions of general practice that have existed for more than a decade. *What, if any, role they'll have in funding and governance of primary health care is unclear, although they'll play a key role in the delivery of new diabetes care arrangements.*

A hint of further changes for primary health care lies in the new arrangements announced for managing diabetes patients, including voluntary patient enrolment with a practice for continuing care and payment of a single annual fee to the practice for that care rather than episodic fees.

The commonwealth will take full responsibility for funding aged care, including community, sub-acute and residential care. *Details are yet to be announced. *But aged-care networks will be set up to better integrate aged care with primary and acute care.

Then there's a list of "next steps" to pick up areas not included in the announcements, including mental health, dental health, obesity, tobacco and alcohol misuse, and e-health. *With so much detail yet to be revealed, it's difficult to know if there'll be real and positive reform as distinct from rearranging and churning. *Regardless, there are risks for disruption of services even in what's been announced. For example, what games will the various jurisdictions get up to between now and implementation to maximise their benefit?

Assuming the states sign up to the plan in principle, implementation will be fraught. *Groups of officials will be established to sort out the detail and will move at a glacial pace. *A detailed commonwealth legislative program will be required to make any of it happen and, no doubt, there'll be close Senate scrutiny of the bills. New local governance networks will have to be established to encompass federal and state requirements.

Finally, change on the ground will require significant rearrangement of public service jobs, their locations and working conditions. One estimate suggests 10,000 people could be affected.

Once these preliminary hurdles are overcome, the present working arrangements of healthcare providers will need to change to achieve the desired service improvements and efficiencies.

*Reactions of leading medical and nursing professional and industrial groups haven't been promising in this regard.*

The progress in e-health is instructive. After more than a decade of joint commonwealth-state "strategies" and "action plans", and government investments worth more than $1 billion, e-health has produced little more than a piece of legislation that's languishing in parliament after intense criticism from industry and privacy advocates.

*The Rudd plan, while exciting and visionary, is full of blank spaces. *Implementation will severely test the commonwealth's legislative and administrative capacity.

Existing federal arrangements will be pressed to adapt to the rearrangement of a sector that constitutes 10 per cent of economic activity.

_Robert Wells is director of the Menzies Centre for Health Policy and the Australian Primary Health Care Research Institute at the Australian National University and former first assistant secretary in the Department of Health and Ageing._

The devil is always in the detail. When Wayne Swan was questioned as to HOW he was going to pay for the EXTRA billions Rudd is throwing into this catstrophe he replied "All will be revealed in the May Budget which is several weeks away from announcement" Pressed further on the funding matter he let it slip that the extra funds have been achieved by "cost cutting" ??? Cost cutting what exactly .... can't tell you .. ner ner ner .. wait for the budget.


----------



## Whiskers (20 April 2010)

trainspotter said:


> I may need to enlighten you Whiskers !




Nothing enlightening there mate. That's all old hat now... t'was just idle speculation.

As I originally pointed out you were fundamentally lacking to be in any position to be too critical.   

But as I said before the states have been in negotiation for two previous COAG's so they obviously know more than they are telling us too. That's what I'm interested in... what they are not yet telling us.

So if the states agree to something this COAG, then some responsibility for the success or failure of any agreement must rest with the states also, since they went into it in the best interests of their citizens.


----------



## noco (20 April 2010)

Whiskers said:


> I suppose the GFC and the states refusing to hand over full control all at once had something to do with that... but at the end of the day I just hope they can all agree on some constructive reform to get the ball rolling now.




Don't blame the GFC or the states, that had nothing to do with the National take over of hospitals. Rudd has the constitutional power to take them over and does not need approval from the states. He was afraid of another debacle like all fo the other projects he touches. Now he has the states to blame if things go belly up. That's our Prime Minister.


----------



## trainspotter (20 April 2010)

Whiskers said:


> Nothing enlightening there mate. That's all old hat now... t'was just idle speculation.
> 
> As I originally pointed out you were fundamentally lacking to be in any position to be too critical.
> 
> ...




So it's all in the detail? Which there isn't any? So it's all been worked out at previous COAG's? With no information forthcoming? So it's all in the Budget? Which will not be revealed for several weeks? So it's all in the Henry Tax Report? Which the Labor Govt will not release until after the May budget?

And you say I am fundamentally lacking to be too critical?? LOLOL ... you funny.


----------



## Whiskers (20 April 2010)

noco said:


> Rudd has the constitutional power to take them over and does not need approval from the states.




Yes via a referendum if successful... BUT if they did completely take over 'hospitals' they would ALSO obviously need to recoup some of the GST currently going to the states via the IGA to be spent on hospitals. 

The only way they can alter that is via a re-negotiated IGA which typically happens at COAG and presumably going on now.


----------



## Whiskers (20 April 2010)

trainspotter said:


> So it's all in the detail?




Trainspotter, this is what I mean by half-cocked Rabble-Rouser...  seeking support by appealing to popular passions and prejudices. 

Obviously... as I said before, that the fed and states have a lot more info than you or I and neither are sharing much. 

You can get your nickers in as big a knot as you like but it won't change anything cos you are not party to the negotiations, luckily, or I could see them going nowhere fast.



> And you say I am fundamentally lacking to be too critical?? LOLOL ... you funny.




Not funny, just realistic. :


----------



## trainspotter (20 April 2010)

Ohhhhhhhhhh Whiskers, Whiskers, Whiskers, play the ball and not the man for a change will you. Take the emotion out of your context and try and have a meaningful debate. There is no detail on Health Reform (which I have posted), Where is the money coming from? Savings in the Budget (which will not be revealed for several weeks) You referred to the Henry Report (which ALSO will not be revealed until AFTER the budget) 

You really cannot see that this is going to be another Rudd monumentous stuff up? Surely you of all people would have to entertain the thought that Rudd is trying to reform a health system but without any overall policy structure in place? Once again ... I repeat  ... NO DETAIL.

I am all for Health reform in it's purest form, but chucking more money at something does not instantly make it work? Another layer of bureacracy has to be levelled over the top under Rudd's plan (which has not been worked out who will actually be running the show) and as per my previous post UP TO 10,000 helath workers and administrators will be affected by this vague and wishy washy, visionary, lack of detail attempt to fix something he knows nothing about.

I beseech you Whiskers to open your eyes, or better yet, hand over the information rather then this policy on the fly, popular vote grabbing palava we are seeing unfolding right here, right now in front if us!

P.S. - Not seeking support with popular passions and prejudices (whatever this means?) Just trying to obtain some CLARITY and FACTS on the situation rather than an opinion


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## Julia (20 April 2010)

Alan Kohler's take on what this is all about:

http://www.businessspectator.com.au...economy-pd20100420-4NSGE?OpenDocument&src=kgb


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## Whiskers (20 April 2010)

Julia said:


> Alan Kohler's take on what this is all about:
> 
> http://www.businessspectator.com.au...economy-pd20100420-4NSGE?OpenDocument&src=kgb




Not sure I'd go so far as to say John Howards GST deal was reckless, politically expedient maybe.

But the following is clearly a thorn in the states side that could get pretty sore if they went to a referendum.



> The states, meanwhile, are in breach of contract. They have ignored the bargain struck in 1998 to cut small state taxes like payroll tax and stamp duty, and have instead used the money to grow fat.
> 
> Specifically, they have blown the GST on employing public servants.


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## trainspotter (20 April 2010)

Deadlock ! Great link btw Julia. It would appear there is more to this than meets the eye !

Speaking after NSW agreed to allow Canberra to retain 30 per cent of its GST revenue to fund hospitals, Victorian Premier John Brumby indicated he was willing to pay an equivalent amount into a pooled fund.

Mr Brumby said this arrangement would not require legislative change and preserved the integrity of the intergovernmental agreement.

Mr Brumby framed the compromise as a shift of position for Victoria. However, he said it was still "hard to tell actually how today will turn out".

Presenting a united front with Mr Brumby, Mr Barnett said the compromise position handed Mr Rudd "a deal on the table".

"Everyone has given some ground here," Mr Barnett said. "And now Victoria and Western Australia are saying we will provide the money, exactly the same amount of dollars, *but we will pay it directly into the pool.*

"It is within the Prime Minister's grasp to achieve his health reform very quickly he will achieve everything he set out to do so long as he doesn't try and retain one third of the GST."


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## Calliope (20 April 2010)

Julia said:


> Alan Kohler's take on what this is all about:
> 
> http://www.businessspectator.com.au...economy-pd20100420-4NSGE?OpenDocument&src=kgb




So the Health Reform charade was just a Trojan Horse to get past the States' defences, and snatch back some ot the GST. It's no wonder we were never told any details about it. Rudd is as cunning as a sewer rat.


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## Calliope (20 April 2010)

Promises, promises, promises, but no time scale. A lot of people will be dead and buried before this golden age of health care kicks in;



> "This, ladies and gentlemen, is a very, very big reform of the health and hospital system of Australia," he said.
> 
> Work will begin in July to deliver Australians five key changes in health care, Mr Rudd said.
> 
> ...




http://www.smh.com.au/national/rudd-strikes-deal-with-labor-leaders-20100420-sra1.html


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## Beej (20 April 2010)

Calliope said:


> So the Health Reform charade was just a Trojan Horse to get past the States' defences, and snatch back some ot the GST. It's no wonder we were never told any details about it. Rudd is as cunning as a sewer rat.




Why should the states be allowed to keep GST revenue anyway??? They all waste it massively anyway! Read the Kohler article posted above and note the bloating in the NSW state bureaucracy since the intro of the GST!


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## IFocus (20 April 2010)

Julia said:


> Alan Kohler's take on what this is all about:
> 
> http://www.businessspectator.com.au...economy-pd20100420-4NSGE?OpenDocument&src=kgb




Thanks for the link Julia hence WA's *Liberal* premier Colin Barnett wont part with our GST (WA gets ripped of as it is) which I agree with but note he  agrees with pretty much every thing else.

Also note it didn't take much to buy Brumby.


----------



## IFocus (20 April 2010)

Whiskers said:


> Not sure I'd go so far as to say John Howards GST deal was reckless, politically expedient maybe.
> 
> But the following is clearly a thorn in the states side that could get pretty sore if they went to a referendum.




Nice commentary Whiskers, Howard did buy the states over by handing out to much but I think the up side beats the down side.


----------



## JimBob (20 April 2010)

I think Kevin Rudd should have talked over his plan with his Labor state premiers before announcing it to the public as it wasnt a good look when his plan was immediately opposed by a Labor premier.  Bringing the state premiers on board has already lead to the plan costing billions more than it did a few days ago.  

An interesting day or two ahead now with only one premier not signed up.


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## Julia (20 April 2010)

Calliope said:


> So the Health Reform charade was just a Trojan Horse to get past the States' defences, and snatch back some ot the GST. It's no wonder we were never told any details about it. Rudd is as cunning as a sewer rat.



Yep, I was a bit taken aback when I read Alan Kohler's article, but on reflection it does make sense.



Calliope said:


> Promises, promises, promises, but no time scale. A lot of people will be dead and buried before this golden age of health care kicks in;



Yes, exactly.  It's noticeable that there has been no timeline offered for when all these miracles will come to pass.
*And what blows me away most of all is that there has been no explanation of how all these promises are to be funded.  I just can't believe that no journalist has asked this fundamental question!!!*



IFocus said:


> Also note it didn't take much to buy Brumby.



Indeed it did not.  After all his dramatic rhetoric, he seems to have simply caved in.




JimBob said:


> I think Kevin Rudd should have talked over his plan with his Labor state premiers before announcing it to the public as it wasnt a good look when his plan was immediately opposed by a Labor premier.  Bringing the state premiers on board has already lead to the plan costing billions more than it did a few days ago.
> 
> An interesting day or two ahead now with only one premier not signed up.



JimBob, I doubt very much that this was thoughtlessness on Mr Rudd's part.
On the contrary.  He presented the wonderful notion of "Health Reform" to the public, in the certain knowledge we would all jump for joy at the hope of diminished waiting lists, enough doctors and hospital beds etc.  And that's exactly the response his public announcement received.

How much harder then is it for the State Premiers to disagree with what the public overwhelmingly wants?
And don't kid yourself that the ultimately offered bundle of money wasn't already in Mr Rudd's plan.  It just gave him more leverage over the Premiers if they appeared to have been achieving multiple victories in extracting more and more money from the Feds.  They fell for it absolutely.  Except for Mr Barnett, at this stage, though Mr Rudd assured Kerry O'Brien this evening with a very smug smile that he was quite sure Mr Barnett would eventually fall into line also. 

As Calliope observed, Mr Rudd is as cunning as a sewer rat.


----------



## Calliope (20 April 2010)

Julia said:


> Indeed it did not.  After all his dramatic rhetoric, he seems to have simply caved in.




Both Rudd and Roxon turned up with their riding boots on (and spurs) to rope, tame and ride this maverick Brumby. But all they needed was a little bit of sugar, a pat on the rump and they had him eating out of their hands. 

You will notice Swan is not as happy as Rudd. He has the big job of having to trash his Budget and start again.


----------



## Whiskers (21 April 2010)

Calliope said:


> So the Health Reform charade was just a Trojan Horse to get past the States' defences, and *snatch back some ot the GST*.




Such loose inaccurate language! More like ensure that it was dedicated to health funding via Special Purpose Payments (SPP's).



> It's no wonder we were never told any details about it.




Why? The Health reform report and the general thrust of what Rudd wanted was available for ages. Obviously, the states had more details of what was offered and what they wanted that they weren't sharing also. I'm not surprised that few specific details were going to be available to us mere political pawns untill after COAG and they all did a bit of arge-barge.



Calliope said:


> Promises, promises, promises, *but no time scale.* A lot of people will be dead and buried before this golden age of health care kicks in;






Julia said:


> It's noticeable that there has been no timeline offered for when all these miracles will come to pass.




Well, not exactly. They aparently have agreed to start funding some of these SPP programs from July.

*A little logical deduction can easily provide some paramaters.*

Obviously, since the main limiting factor (since Howards time) to the full implementration of all these programs will be the training of about 6,000 new doctors. *How long does it take to train a doctor!* That is clearly a firm timeline for a number of aspects of some programs to be fully implimented.



Julia said:


> *And what blows me away most of all is that there has been no explanation of how all these promises are to be funded.  I just can't believe that no journalist has asked this fundamental question!!!*




I think they have recognised long ago that Rudds priority was getting some systemic changes made and the funding was a lower priority as opposed to Howards years where the priority was on 'saving'.



Calliope said:


> You will notice Swan is not as happy as Rudd. He has the big job of having to *trash* his Budget and start again.




While some of the colourful language is handy rhetoric the simple fact is that one has to settle on a plan before it can be budgeted and funded.

*Like, are you going to build a one bedroom house cos thats all the cash you have and then realise, oh dear I have two children and want another one ( Plan) and need at least two extra bedrooms (budget)... gees I should have borrowed (Fund) a bit to properly accomodate my family.*

*It's called (Project) Management and Due Process.*

Budget Draft -> Funding Paramaters -> Program Negotiations -> Budget Review (including Henry Report) -> Funding Implementation -. Approve Budget Programs for Implementation.



Julia said:


> And don't kid yourself that the ultimately offered bundle of money wasn't already in Mr Rudd's plan.




Quite so. It's basic negotiation ABC that you don't play your full hand up front. Nothing political about that, just simple skillful negotiation like previous strong leaders like Howard.

We'll probably kave to await the budget for the full specific detail of the funding arrangements and program timelines of the IGA and any other fed funded initiatives.


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## Calliope (21 April 2010)

Nice try Whiskers.

However all the spin that you put on it doesn't answer the question of whether all the billions that Rudd is pouring into the plan will ever filter down to the work face and translate into improved hospital service. Only time will tell, but probably not in this decade. I will judge it a partial success when the majority of our mentally ill people get effective and compassionate treatment, and don't have to live on the streets.

This government is notoriously lax in checks and balances to prevent  public money being hived off in corruption, rorting and waste.

I would like to hear how your Rudd inspired spin excuses how billions have been wasted on;

. A BER that does nothing to lift the education standards of our children, but is reputed to been drained of $4 billion by rorting builders and pathetically inefficient bureaucrats. 

. An insulation scheme that was supposed to create jobs and lower  electricity use. It actually lost jobs, burned houses and killed workmen and wasted billions.

. An aboriginal housing scheme that until recently hadn't built a single house and yet most of the funding has disappeared into thin air.

Need I go on? Rudd and Gillard justify this waste by saying "we needed to spend the money and spend it fast to save our economy. Where it ended up is not our problem We achieved our aim". And of course the old cop out...Howard did nothing. Do you accept their spin?

I think it is about time you let the scales fall away from your eyes.


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## Whiskers (21 April 2010)

Calliope said:


> ... answer the question of whether all the billions that Rudd is pouring into the plan will ever filter down to the work face and translate into improved hospital service.




The short answer is ask the states.

As you should know, the states insisted and got the right to continue to manage the funds. The fed is now earmarking more funding including for specific purposes as, or like previous Special Purpose Payments (SPP's), as opposed to open grants to the states.

So the bottom line is when the full plan and funding  is provided in the fed budget, come July when the money starts to flow, *you can only continue to blame the states who manage the daily running of the health system* for the success or failure of the delivery of services... I repeat it has always been their domain and continuues to be under the new COAG agreement.

Personally I would have preferred to have seen the de-centralisation of management from state ministers and bureaucrats (here in Qld) and more authority given to regional hospital boards or equivilant to manage local services.

The AMA on this mornings TV news have said that they are also dissapointed that regional hospital boards didn't get to be more involved in the management of health services. They blame the state for being power hungry and insisting on managing all the funds and services from the capital. But the states can still delegate to regional hospitals, but again it may take a change of state gov to achieve that.


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## noco (21 April 2010)

Calliope said:


> Nice try Whiskers.
> 
> However all the spin that you put on it doesn't answer the question of whether all the billions that Rudd is pouring into the plan will ever filter down to the work face and translate into improved hospital service. Only time will tell, but probably not in this decade. I will judge it a partial success when the majority of our mentally ill people get effective and compassionate treatment, and don't have to live on the streets.
> 
> ...




Well put Calliope. I too shall wait with baited breath to see it all happen. But then a again I may be long gone before it does.
Will be interesting to see what hits the road come July1 and hitherto there after. More talk, spin and no action, that's our Prime Minister.


----------



## noco (21 April 2010)

Whiskers said:


> The short answer is ask the states.
> 
> As you should know, the states insisted and got the right to continue to manage the funds. The fed is now earmarking more funding including for specific purposes as, or like previous Special Purpose Payments (SPP's), as opposed to open grants to the states.
> 
> ...




As I have quoted before, if things go 'belly up' Rudd will blame the states and that is why Rudd would never have the fortitude to take over the National Hospital system from July 1 2009 as per his pre 2007 election promise. He has no confidence in himself or his ministers to impliment such a change, particularly following all the other debacles.

Such a big deal to make him like he is doing something. Everyone wants health reform and he is playing games with peoples minds once again. All spin, talk and no action, that's our PrimeMinister.


----------



## trainspotter (21 April 2010)

Stick to your guns WA ... don't let those filthy swines from Canberra get their grubby little mitts on the 30% GST .... Bwahahahahhahahaahhhaaaaaaaaa


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## Calliope (21 April 2010)

Whiskers said:


> The short answer is ask the states.




I didn't expect that you could give a rational answer to my questions. There isn't one.

You claim to be an accountancy expert. You of all people should know that you can't balance the books with spin. You must be a worry to the auditors.


----------



## Calliope (21 April 2010)

trainspotter said:


> Stick to your guns WA ... don't let those filthy swines from Canberra get their grubby little mitts on the 30% GST .... Bwahahahahhahahaahhhaaaaaaaaa




Rudd will be sending the jack-booted Nicola Roxon (or is it Rocala Nixon?) over to WA to "arm wrestle" with Colin Barnett. She has become Rudd's health rorts enforcer. Barnett better hide the silver ware.


----------



## trainspotter (21 April 2010)

Am I missing something here? The states have given up 30% of GST revenue only to have it funnelled back into health via the FEDS but the states now have full control of the 30% GST expenditure to go back to the hospitals?? WTF? What was the point really?


----------



## Whiskers (21 April 2010)

I think I'm starting to waste my time replying to Right Fighter, rabble-rousings. 

You'll excuse me if I ignore many ignorant and unintelligable comments and analysis cos I'm trying my best to stay focused on the issue and usual course of events for you.



noco said:


> As I have quoted before, *if* things go 'belly up'




Well, when you become obsessed with a thought you tend to get, or at least perceive, what you want.



> Rudd will blame the states




Rudd was proposing to direct more funding to local hospitals BUT as has been widely reported the states insisted on maintainimg TOTAL management control.

The states only have themselves to blame cos they INSISTED on maintaining full control of management of health services.

Rudd would be to blame if he didn't provide the funding as agreed, but I suspect he will and be looking for state management ****-ups to try to get more control later.



> and that is why Rudd would never have the fortitude to take over the National Hospital system




Huh, what nonsense... if the states had agreed to what Rudd originally wanted he would have pretty well taken over the 'National Hospital System'.




trainspotter said:


> Am I missing something here? The states have given up 30% of GST revenue only to have it funnelled back into health via the FEDS but they now have full control of the 30% GST expenditure to the hospitals?? WTF? What was the point really?




The point is to preserve that state funding for special purpose health spending as opposed to previously going into state consolidated revenue where the states had total control over where the funding was allocated often displacing from health and other essential services to pork barrel other projects into elections etc.

State GST revenue is growing exponentially and many argue that the states are squandering the GST. 

The whole idea of the 30% of current GST being preserved for health spending is to avoid a situation when the fed starts providing more funds for health, that the states don't relocate some of their existing health funding elsewhere and scream poor for more from the fed.


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## noco (21 April 2010)

trainspotter said:


> Am I missing something here? The states have given up 30% of GST revenue only to have it funnelled back into health via the FEDS but the states now have full control of the 30% GST expenditure to go back to the hospitals?? WTF? What was the point really?




It's all part of Rudd's magic hands;  Take it with the left hand, switch it the right hand around your back and hey presto you have money to fix the health system.

Rudd is like little Jack Horner who sat in the corner eating his Christmas pie,
he put in his thumb and pulled out a plumb and said, What a good boy am I.

Thta's our Prime Minister!!!!!!!


----------



## Calliope (21 April 2010)

Whiskers said:


> I think I'm starting to waste my time replying to Right Fighter, rabble-rousings.
> 
> You'll excuse me if I ignore many ignorant and unintelligable comments and analysis cos I'm trying my best to stay focused on the issue and usual course of events for you.




You can't seem to get it into you head that we ignorant and unintelligent rabble-rousers are not interested  in your spin. And what makes you think you are superior. Your words are those of a party hack.

If you refuse to provide rational answers you are indeed wasting your time. Save your spin for your Young Labor party meetings.


----------



## trainspotter (21 April 2010)

Whiskers said:


> I think I'm starting to waste my time replying to Right Fighter, rabble-rousings.
> 
> The point is to preserve that state funding for special purpose health spending as opposed to previously going into state consolidated revenue where the states had total control over where the funding was allocated often displacing from health and other essential services to pork barrel other projects into elections etc.
> 
> ...




Or is that Right rousing rabble fighters? Rabble rousing Right fighters perhaps? LOLOL ... we not allowed to have a point of view? If I went fishing and the fish bite this hard there, as they do in here, I would have enough fish to put Jesus to shame.

Thanks for clearing the GST hokey pokey Health Reform up for me Whiskers .. I was bewildered and confused that they had 30% GST revenue and then gave it to the FEDS who then gave it back to them under the strict instructions that it must go to health. LMAO ... do you think that this is going to resolve anything? SO the states decide where and whom the money goes to ?? Don't they do that now? The only difference is they may or may not have more to spend as THERE IS NO DETAIL or figures.

I remember reading in a newspaper that WA Govt was offered another 74 million per year to try and get them to sign ... I think the response was "You have got to be joking me? .... WA spends this much on health in 10 days!" Pfffffffffffffftttttttttttt


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## Whiskers (21 April 2010)

Oh dear... so many questions and so little effort to research and listen to the news.

Just for you trainspotter, I'll walk you through it slowly. :



trainspotter said:


> Thanks for clearing the GST hokey pokey Health Reform up for me Whiskers .. *I was bewildered and confused *that they had 30% GST revenue and then gave it to the FEDS who then gave it back to them under the strict instructions that it must go to health.




Obviously! 



> do you think that this is going to resolve anything?




Well according to the AMA at least it provides secure funding for 6,000 more doctors. That's the fundamental place to start for long term health planning cos as has been highlighted for years now there is a shortage of doctors.

It also provides more available beds in the current infrastructure. The AMA is also on record as saying that there is some spare capacity in health professional personell but there is a lack of beds for patients. 

So that has to be a good thing.



> *SO the states decide where and whom the money goes to ??*




*NO!*

If you read anything you would see that *the funding will be purpose specific.* 

The fed will provide funding for specific purposes like training more doctors, new hospital beds, mental health services etc and that is how it must be spent by the states according to the COAG contract that the states agreed too.



> Don't they do that now? (decide where and whom the money goes to)




Yes.



> The only difference is they may or may not have more to spend as THERE IS NO DETAIL or figures.




There is not a lot of detail yet, but clearly there's quite a bit more than you are able to grasp. :

Simple maths, and the AMA have said there is quite a bit more funding agreed to be provided.


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## trainspotter (21 April 2010)

Thanks for clearing that up Whiskers. "There is not a lot of detail yet," WHEW ... for a second there I thought that the states were in control of the 30% GST to go back to the hospitals as long as they are funded specifically for a purpose. I would have thought the money that the states are placing into the health problem already would have been used to train more doctors, new hospital beds, mental health services etc. Oh well ... my mistake. :bonk:


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## Calliope (21 April 2010)

Whiskers said:


> Oh dear... so many questions and so little effort to research and listen to the news.
> 
> Just for you trainspotter, I'll walk you through it slowly.




You still around? I'm surprised that a guy of your superior intellect would waste his time casting pearls of wisdom to rabble-rousing low-lifes on this thread.


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## trainspotter (21 April 2010)

Hey Whiskers .... wasn't it you who said "I have led you to water but I can't make you drink" ? 

_NO!

If you read anything you would see that the funding will be purpose specific. 

The fed will provide funding for specific purposes like training more doctors, new hospital beds, mental health services etc and that is how it must be spent by the states according to the COAG contract that the states agreed too._

Point me in the right direction to this library of knowledge on this topic please.

Everything I have read is not evidencing this statement from yourself. More along the lines that the extra funding will be soaked up with duopoly and bureacrats sucking the system dry to try and overlay this wonderful new scheme.

AS Mary Poppins sang "Just a spoonful of sugar makes the medicine go down, the medicine go down"


----------



## trainspotter (21 April 2010)

GOSH - So under this new helalth reform system we will have a Federal bureaucracy, A state bureaucracy, local hospital networks, a pricing authority and a national hospitals fund. No duplicity there ?

"Kevin Rudd needs to explain where the money is coming from, he needs to explain what is old money, what is new money and what has been rebadged as part of this package" The mad monk uttered.

Mr Rudd says "Means testing the private health insurance rebate would save 2 billion over the next 4 years" and "All the detailed funding arrangements will be clearly outlined in the May 11 Budget" he squeaked.

What happens if the Opposition blocks passage of these reforms within the Budget? ALSO ... the funds will only flow if WA and Canberra can strike a deal as under the Commonwealth GST Act that ALL states and Territories MUST agree for any tinkering of the GST revenue. PM Rudd dismissed this claim as a mere "accounting measure". 

Amazing what you learn when you read up on things Whiskers?


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## trainspotter (21 April 2010)

Coming soon to an operating theatre near you !


----------



## Julia (21 April 2010)

Whiskers said:


> I think they have recognised long ago that Rudds priority was getting some systemic changes made and the funding was a lower priority as opposed to Howards years where the priority was on 'saving'.



Hmm, well, Australian taxpayers may not be so thrilled about this dubious plan when the Budget begins to detail some of the services that will be lost and the additional taxes applied so the cash handed out with such largesse by Mr Rudd in the last two days may be funded.

I may be doing you an injustice, Whiskers, but I'd suspect that if Mr Abbott put up an alternative proposal for health reform, you'd be amongst the first to cry "but how is he going to pay for it?"



Whiskers said:


> The states only have themselves to blame cos they INSISTED on maintaining full control of management of health services.



Yes, they may have failed to consider the potential adverse effects of this when all is not as rosy as presently being painted.


> The point is to preserve that state funding for special purpose health spending as opposed to previously going into state consolidated revenue where the states had total control over where the funding was allocated often displacing from health and other essential services to pork barrel other projects into elections etc.
> 
> State GST revenue is growing exponentially and many argue that the states are squandering the GST.
> 
> The whole idea of the 30% of current GST being preserved for health spending is to avoid a situation when the fed starts providing more funds for health, that the states don't relocate some of their existing health funding elsewhere and scream poor for more from the fed.



Agreed that this does make more sense, as does the activity based funding model, though it's difficult to see how this is going to work for chronic diseases such as psychoses, cardiovascular disease, diabetes etc.
Sure, have a specific payment for a basic appendectomy, but I can see lots of bureaucratic wrangling in the less clearly defined areas.




Whiskers said:


> Well according to the AMA at least it provides secure funding for 6,000 more doctors. That's the fundamental place to start for long term health planning cos as has been highlighted for years now there is a shortage of doctors.



True, and much of the reduced funding for training of doctors can be attributed to the Howard/Abbott years.


The following is an extract from today's editorial in "The Australian":



> The problem is that these funding and governance changes, while significant, leave the nation far short of the comprehensive health reforms Mr Rudd promised before the 2007 election.  More than two years on, it is still not clear how the new model will transform the current patchwork of programs and services across the country into an integrated health system appropriate for the 21st century.






> Mr Rudd's message was that if Canberra pays for 60% of hospital funds and 100% of everything else, we would end up with a better health system.  That looked like a leap of faith in a government that has so comprehensively botched delivery of the home insulation program, to name just one area




That final paragraph seems a pretty good summary of why so many of us are less than convinced the events of the past few days will provide us with a future health nirvana.


----------



## Whiskers (21 April 2010)

Julia said:


> Hmm, well, Australian taxpayers may not be so thrilled about this dubious plan when the Budget begins to detail some of the services that will be lost and the additional taxes applied so the cash handed out with such largesse by Mr Rudd in the last two days may be funded.




Yes, I'm expecting increased tobacco and maybe alcohol taxes to start with although that is probably a good thing. I'm struggling to find many opportunities for them to increase tax revenue or cut back services in light of all the things they have increased and promised.

I think they are also probably budgeting for increased tax receipts from the mining boom picking up again and borrow the balance.



> I may be doing you an injustice, Whiskers, but I'd suspect that if Mr Abbott put up an alternative proposal for health reform, you'd be amongst the first to cry "but how is he going to pay for it?"




No, I believe there is, or at least was, scope to spend or borrow a little money for improved health services in particular. I'll wait for the budget forcasts before I worry too much.

I've already stated on another thread that I like Abbotts idea of reverting back to local hospital boards to manage or at least have a say in some of the day today affairs of local health delivery. I think that's an important safeguard to have in the system again.

Since Rudds idea of local/regional hospital management has been loudly rebuked by the states and traded away at COAG, I'm interested now to see if or how Abbott can still accomplish that.


----------



## noco (21 April 2010)

I have always beleived, the training of doctors and nurses and the administration of universities  were a state responsibility. Correct me if I am wrong and the Labor Party have been in power in Queensland since Joh; lost count of the number of years. 15+

The building of new hospitals was also a state responsibility and for years,  hospitals were administrated by boards consisting of doctors, senior nurses and financial wizards. I believe that was all changed when Dr. Death was  the state director general in the Goss Government in Queensland. Now Dr. Death, as he was known, the one who reduced the number of hospital beds in Queensland by some 2000, says hospital boards should be reintroduced. 

As I mentioned before, Townsville with a population growth of 8% per annum, had a new hospital constructed 15 years ago, smaller than the one the state Labor Government demolished and that was when Rudd and Swan worked for Wayne Goss. I hope Rudd has a bit more foresight than he did under Goss. Now Rudd is talking about another 6000 beds Nationally, but of course when is the question!!!!!!!! Maybe Wiskers can enlighten us on that one.


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## trainspotter (21 April 2010)

Whiskers wrote "Since Rudds idea of local/regional hospital management has been loudly rebuked by the states and traded away at COAG, I'm interested now to see if or how Abbott can still accomplish that."

Ummmmm Whiskers old chap ... How can Abbott change what has already been done? PM Rudd has agreed to the deal with the Premiers of each state (less WA of course) and it looks as if this will be set in stone. If and it is a BIG if, the Libs win the next election (or even the one after that) what do you believe Abbott should do about this conundrum? Rudd has created this mess, why does Abbott need to get involved in trying to mend something he did not break?


----------



## trainspotter (21 April 2010)

*THE Federal Government has left the door open to changing the amount of GST it takes back from the states and territories as part of its health and hospital reforms. *

In the National Health and Hospitals Network Agreement, signed with the leaders that were on board with the deal, no GST amount is specified.

The agreement also states: "There will be a review of the level of GST dedicated once the system has transitioned to an efficient price."

http://www.coag.gov.au/ for the FACTS and FIGURES ... at last Whiskers !

My favourite bit is "Western Australia has not agreed to either the retention of the goods and services tax (GST) or the associated funding governance arrangements. Western Australia and the Commonwealth have agreed to continue discussions."

Should it read "Western Australia has not agreed to being a signatory to the National Health and Hospitals Network which has been setup to provide seamless care across sectors of the National health system."

Hmmmmmmmm .... GST grab ...... LMAO


----------



## Whiskers (22 April 2010)

noco said:


> I have always beleived, the training of doctors and nurses and the administration of universities  were a state responsibility. Correct me if I am wrong.




Happy too... pretty simple really.

I'm not a medical person, but like many Uni positions there are quotas on the number of positions available. There has traditionally been a pretty tight limit on the number of doctors to maintain quality by picking of the best high school score's and also to protect the financial stability of doctors professions.

If I recall correctly Bligh funded some additional positions a few years ago for Qld, but I think it's normally mostly a federal funded thing as it's a national accreditation scheme.

When Rudd and Swan worked for Goss, Goss was the boss and called the shots. Surely that one is obvious.



> Now Rudd is talking about another 6000 beds Nationally, but of course when is the question!!!!!!!! Maybe Wiskers can enlighten us on that one




As I mentioned previously the AMA has said there is spare capacity in some areas of health professionals that can be utilised as soon as there are beds available. It would seem that at least some beds should be able to be made available come July when the first money is available.



trainspotter said:


> Ummmmm Whiskers old chap ... How can Abbott change what has already been done?




The same way it was done... renegotiate it or an alternative.



> PM Rudd has agreed to the deal with the Premiers of each state (less WA of course) and it looks as if this will be set in stone. If and it is a BIG if, the Libs win the next election (or even the one after that) what do you believe Abbott should do about this conundrum?




At this stage, until the full details are available after the budget, probably not much, except press on with more detail for his local hospital management idea.



> Rudd has created this mess, why does Abbott need to get involved in trying to mend something he did not break?




It seems generally recognised that the system did start to become 'broken' under his term as health minister for Howard and a long period of funding stagnation.

If he wants to win the next election he needs to come up with something better.


----------



## Whiskers (22 April 2010)

trainspotter said:


> *THE Federal Government has left the door open to changing the amount of GST it takes back from the states and territories as part of its health and hospital reforms. *
> 
> In the National Health and Hospitals Network Agreement, signed with the leaders that were on board with the deal,* no GST amount is specified*.
> 
> ...




*Wrong! So ignorantly and carelessly Wrong!*


*If you read the correct detail http://www.coag.gov.au/ further down the page under National Health and Hospitals Network Agreement RTF 1.05 MB | PDF 406KB and Schedule C, it spells it all out.*


----------



## Calliope (22 April 2010)

Whiskers said:


> Wrong! So ignorantly and carelessly wrong!
> If you read the correct detail http://www.coag.gov.au/ further down the page under _National Health and Hospitals Network Agreement RTF 1.05 MB | PDF 406KB_ and Schedule C, it spells it all out.




(I have deleted all your silly shouting)

You are having a hard time trying to sell this package. I know that in your eyes we are ignorant rabble rousers. This is the same view that Rudd takes and you are hoping to get noticed by the Party Machine. I suspect that you are part of it already, or are in receipt of largesse from their lax money management.

Your fine print contains nothing of substance. All we have so far are vague promises of more beds, more doctors, reduced waiting lists, maybe improved mental care, at some vague time in the future.

Sure, there will be some sweeteners in the budget before the election. But this is only to keep the health pot boiling until they get re-elected . After that the whole edifice will come crashing down.

It's only today that the Government has admitted that it can't manage the home insulation scheme. I think the hospital mess would be much more difficult to sort out.

You should give up. The Party Machine will give you marks for trying.


----------



## Whiskers (22 April 2010)

Talking about silly! 

Just for you Calliope, the gist of my conversation that you jumped into was to correct some profoundly incorrect statements of fact in trainspotters post. 

It has nothing to do with party politics (which I am not), plain and simply using the correct data and information to make informed specific judgements as opposed to loose, generalised waffle. 

Let me further demonstrate.



Calliope said:


> Your fine print...




It is clearly not my fine print. 

It's part of the detail of the CAOG Agreement of which you know I had no part of.



> ...contains nothing of substance.




How silly again!

So if the COAG agreement contains nothing of substance you tell me what is more substantive.

Whether we agree or dissagree with what was agreed to, that is the total substance of the progress of health reform to date. It's a legal binding contract between the fed and states. 

In fact there is quite a few $billion of extra substance in it to be scrutinized. 

I'm certain I'd rather rely on that for my critique of COAG agreements and health reform in particular than most of your useless analysis and commentry.

................

Meanwhile, on a brief read of the agreement, it seems Rudd has also secured full control of GP training from the states in the future.

That may be a good thing to have a one stop control of GP training... but it also means the fed effectively has the health system by the proverbial Ba!!s in terms of future staffing and ultimately expansion of the system. Potentially, no agree with fed at future COAG's, no new doctors, system shrinks.


----------



## trainspotter (22 April 2010)

Whiskers said:


> *Wrong! So ignorantly and carelessly Wrong!*
> 
> 
> *If you read the correct detail http://www.coag.gov.au/ further down the page under National Health and Hospitals Network Agreement RTF 1.05 MB | PDF 406KB and Schedule C, it spells it all out.*




Ummmmmmmm Whiskers ... it does not give a GST amount? Read it again there old chap. It says the amount of GST dedicated to health care will be fixed blah blah blah .... oooooopsies ! Devil in the details again perhaps?

Which part of this is ignorant and wrong Whiskers? Please stop using the colour and the bolding ... it hurts my eyes and it means you are struggling to get your point across.

Read here   http://www.wabusinessnews.com.au/en-story/1/79977/Health-deal-leaves-GST-door-open-   if you want some factual reporting on the subject matter at hand.


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## trainspotter (22 April 2010)

Whiskers wrote "Just for you Calliope, the gist of my conversation that you jumped into was to correct some profoundly incorrect statements of fact in trainspotters post. "

What part of NO GST AMOUNT do you not comprehend? Read it again Whiskers for the love of BEER ! Your rhetoric is like Japanese water torture to my brain. You are forcing words and attributing them to me is growing unbearable to read. Take the emotion out of your context and have a meaningful discussion on this thread please.

Again just for comedy purposes only - http://www.wabusinessnews.com.au/en-story/1/79977/Health-deal-leaves-GST-door-open-

Announcing his original plan in early March, Mr Rudd flagged the GST clawback would be around one-third of revenues.

*But in the National Health and Hospitals Network Agreement, signed with the leaders that were on board with the deal, no GST amount is specified.*

*The agreement also states: "There will be a review of the level of GST dedicated once the system has transitioned to an efficient price."*

It does, however, again commit that no state government will be worse off in the short-term and "all will be better off in the long-term".

The language has also shifted to reflect the greater role the states will have in managing the system.

Mr Rudd has consistently stated his reform plan is all about creating a system that is "funded nationally and controlled locally".

But the new intergovernmental agreement, released publicly on Wednesday, now makes clear the national health and hospitals network "will be a nationally unified and locally controlled health system".

In order to get NSW and Victoria onside, Mr Rudd had to agree that federal and state funding would be pooled in state-based "funding authorities".

The prime minister had wanted the commonwealth to directly fund the networks.


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## Whiskers (22 April 2010)

trainspotter said:


> Ummmmmmmm Whiskers ... it does not give a GST amount? Read it again there old chap. It says the amount of GST dedicated to health care will be fixed blah blah blah .... oooooopsies ! Devil in the details again perhaps?
> 
> Which part of this is ignorant and wrong Whiskers? Please stop using the colour and the bolding ... it hurts my eyes and it means you are struggling to get your point across.




You apparently don't know how to read reports.

If you had read the document in context ie the parts that the afforementioned Schelule refers too, (below) you would see that there is no 'open door', *the states have agreed to a process and formula for the GST over the next few years*.
:




> Read here   http://www.wabusinessnews.com.au/en-story/1/79977/Health-deal-leaves-GST-door-open-   if you want some factual reporting on the subject matter at hand.




What... factual Reporting! Dramatic reporting more like. 

*PS*: For the love of mike, trainspotter... read the definition and what the agreement says about "efficient price". That transition process has been agreed to.


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## trainspotter (22 April 2010)

So you agree then Whiskers there is NO GST AMOUNT specified other than a formula that cannot be quantified due to no end point? WTF?


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## Whiskers (22 April 2010)

trainspotter said:


> So you agree then Whiskers there is NO GST AMOUNT specified other than a formula that cannot be quantified due to no end point? WTF?




Fair dinkum mate! How dumb is that statement! The GST amount is and always was dynamic, you know what that means... changing every year. 

There is a 30% of current GST specified and there is an agreed process and formula to workout the amount for following years.

If you want to work out the exact amount of $ simply find the lastest GST revenue and apply the agreed process and formula and you will have an end point, quantified for one particular year.

What do you want... someone to say the GST amount is fixed at $x for this year and ever after. 

Obviously it's not... it's a dynamic amount!


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## Calliope (22 April 2010)

Whiskers said:


> Just for you Calliope, the gist of my conversation that you jumped into was to correct some profoundly incorrect statements of fact in trainspotters post.




At least you got "gist" right this time. So you're learning. Good boy.



> It has nothing to do with party politics (which I am not), plain and simply using the correct data and information to make informed specific judgements as opposed to loose, generalised waffle.




Rubbish.

Why don't you get a job? Or are you paid to spread party propaganda?


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## trainspotter (22 April 2010)

Whiskers said:


> Fair dinkum mate! How dumb is that statement! The GST amount is and always was dynamic, you know what that means... changing every year.
> 
> *There is a 30% of current GST specified and there is an agreed process and formula to workout the amount for following years.*
> 
> ...




Show me WHERE in the document this is stated? The 30% that is? Nup .. nowhere ! Please stop the character assasinations and name calling please as it reflects poorly on your ability to communicate.

I completely understand the funding is open ended and is indexed to the GST amount and that the  GST revenue can rise or fall of each state etc ad infinitum. I get that Whiskers .. that was never a moot point. You raised this issue NOT ME. I am merely asking for you to evidence the 30% of GST in the document you prescribe to. Nup, nowhere is it written? It has been widely reported in the media that the number is 30% but not factual in the COAG document. You will note that it does say in the document that the GST injection is dependent on efficiencies and it GUARANTEES that no state will be worse off. 

It appears that what we have here is a failure to communicate.

Trainspotter out.


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## Whiskers (22 April 2010)

trainspotter said:


> Show me WHERE in the document this is stated? The 30% that is? Nup .. nowhere ! Please stop the character assasinations and name calling please as it reflects poorly on your ability to communicate.
> 
> I completely understand the funding is open ended and is indexed to the GST amount and that the  GST revenue can rise or fall of each state etc ad infinitum. I get that Whiskers .. that was never a moot point. You raised this issue NOT ME. *I am merely asking for you to evidence the 30% of GST in the document you prescribe to*. Nup, nowhere is it written? It has been widely reported in the media that the number is 30% but not factual in the COAG document. You will note that it does say in the document that the GST injection is dependent on efficiencies and it GUARANTEES that no state will be worse off.
> 
> ...




The 30% is a nominal average amount that the states already spend on health that the fed wanted to quarantine for health permenantly.

It is implied in the words of par 14 particularly  "as outlined in this Agreement", in other words state funding will continue as per current SPP's and, normal proportion of GST, nominal 30%, plus additional fed funding as specified through the transition period and 'efficient price' establishment.

You will note that there is a requirement for the interchange of documents and statistics through the transition period... so if anyone tries to significantly sway their spending to distort the transition calc's they will not only face the wrath of the fed, but the other states.


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## Julia (22 April 2010)

This writer to "The Punch" has a good point about paying for private health insurance.
If we are to believe Mr Rudd's assurance that waiting times for elective surgery will be magically reduced, if necessary by utilising private hospitals, then why would we continue paying the ever increasing private health premiums, along with subsidising our fellow citizens who choose to have no private cover?



> Brenda  Posted at 7:48 AM Today
> 
> I wish someone would stop this man. He's out of control. Rudd's health plan, meant to take pink batt deaths off the front pages, is already floundering. At the least, if it eventuates (and I doubt it) that very soon we can all be guaranteed a public hospital bed within 4 weeks or taxpayers will further subsidise us into a high cost private hospital bed, I will be able to drop private hospital insurance. No point in paying big premiums if private hospital care will be taxpayer funded. Therein lies the next monumental stuff-up.


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## Calliope (23 April 2010)

Julia said:


> This writer to "The Punch" has a good point about paying for private health insurance.
> If we are to believe Mr Rudd's assurance that waiting times for elective surgery will be magically reduced, if necessary by utilising private hospitals, then why would we continue paying the ever increasing private health premiums, along with subsidising our fellow citizens who choose to have no private cover?




It will be interesting to see Whiskers weasel his way out of this one. I doubt he will even try...probably more small print.

I am still waiting for his answer to my question;



> Why don't you get a job? Or are you paid to spread party propaganda?


----------



## noco (23 April 2010)

Julia said:


> This writer to "The Punch" has a good point about paying for private health insurance.
> If we are to believe Mr Rudd's assurance that waiting times for elective surgery will be magically reduced, if necessary by utilising private hospitals, then why would we continue paying the ever increasing private health premiums, along with subsidising our fellow citizens who choose to have no private cover?




Julia, would you really expect Rudd to think that far down the track and if he had, he would not worry about cost or the consequences hitherto so long as he thinks he has conned the public; that's his game.
Rudd says the buck stops with him on health reform, but inevitably the Hospital Boards will be resposible, which in turn, will release the Feds and the states from any blame.
I keep asking the question,"why did Rudd not take over the National Hospital system in July 2009 like he said he would"?  Whiskers answers with his usual Rudd like rhetoric, that Rudd can't do without a referendum. Rudd has the constitutional power but is frightened to use it in case he defaults.
I just cannot see his so called plan being carried out with any efficiency.
It's bound to finish up another Labor Party bungle far worse than the BER and Home Insulation debacle.


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## Whiskers (23 April 2010)

Julia said:


> ...why would we continue paying the ever increasing private health premiums, along with subsidising our fellow citizens who choose to have no private cover?




Good point. I asked myself that question mant years ago and being a healthy person (never smoked and very light drinker) decided to cancel private health insurance and keep some emergency funds available for unforseens and try to further improve my healthy lifestyle.

I have had one elective surgery a few years ago where I paid out of my own pocket for my private doctor in his private hospital and more recently one relatively urgent proceedure that was done in the public system.

While still miles in front of paying ever increasing private health premiems I have had another look at private insurance recently, but decided to continue my emphasis on prevention rather than cure.

I know increasing numbers of people who have left private insurance or are seriously considering it because of the expense even though they are a bit worried about emergency care in the public system.

It's interesting how people become more conscious of their lifestyle when they start to consider what if I drop private health insurance.

That WA young woman with kids who was a drug addict, had a previous organ transplant due to drug abuse and continued to abuse and was funded by the public to go overseas for another (but died anyway) is the sort of thing that gets up my nose and I think contributes to overly expensive health costs and insurance.

*I wish the premium reduction for non smokers and non or light drinkers was greater and extended to other healthy lifestyle markers. *

In other words more incentives for people to live healthy lifestyles rather than just paying an insurance premium and carelessly enjoying oneself in the expectation that you can be patched up whenever you need one. 

Cholesterol levels and obesity, for example, seems to be other important health markers and easy enough to monitor and quantify. I'd score very well on the former and pretty well on the later, so I think people like me should be given further benifits in insurance premiums or the others penalised more.

While the increased tax on cigarettes and alcohol goes some of the way towards that catch phrase 'user pay', it doesn't help the average person when it comes to insurance premiums that are surely still scued towards the healthy subsidising the unhealthy lifestyles.



Calliope said:


> It will be interesting to see Whiskers weasel his way out of this one. I doubt he will even try...probably more small print.




What is there to weasel out of! 



> I am still waiting for his answer to my question;




I've said repeatedly, but maybe it's time to repeat since some of you are very short on reading and research and long on useless comments... I'm not aligned nor particularly interested in any political party. 

I thought some of you might have been initially, maybe you are, but as I said before, regardless, I gave up responding to useless and silly comments.

So lets see if we can get some usefull commentry.

Calliope, how much of a burden are you on the health system, ie do you smoke, drink alcohol, have high colesterol and are you obese etc?

Do you think someone like this should pay higher private health insurance and regardless, be pushed to the back of public hospital waiting lists or even refused in extreme cases like the repeat drug addict aforementioned?


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## trainspotter (23 April 2010)

Whiskers said:


> *The 30% is a nominal average amount that the states already spend on health that the fed wanted to quarantine for health permenantly.*
> 
> It is implied in the words of par 14 particularly  "as outlined in this Agreement", in other words state funding will continue as per current SPP's and, normal proportion of GST, nominal 30%, plus additional fed funding as specified through the transition period and 'efficient price' establishment.
> 
> You will note that there is a requirement for the interchange of documents and statistics through the transition period... so if anyone tries to significantly sway their spending to distort the transition calc's they will not only face the wrath of the fed, but the other states.




I couldn't resist correcting this utterance. WA spends 5.4 billion on Health every year. Rudds Health reform offer was to give up 30% GST state revenue and WA's share is only 1.7 billion in return?? This seems at odds with the statement that the 30% (which is still not in writing ANYWHERE on the COAG agreement) nominal or outlined or otherwise is the "nominal average amount that the states spend on health" ?? Small shortfall of 3.4 billion certainly seems odd to say the least?

So we now have to create 2 new Departments to handle the pooled funds, in other words another layer of Bureaucracy which will fill the hospitals with desks and not beds IMO 

I am sure you have the best intentions Whiskers of trying to elucidate your thought process's into writing BUT perhaps it is you who is slightly short on the reading and comprehending skills?


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## Whiskers (23 April 2010)

Trainspotter, I believe the west has a bit of a perculiar problem in that the Commonwealth Grants Commission penalised WA because of the state's booming resources industry revenue. 

To that extent I can understand that some variation needs to be worked out there. 

But the basic general concept is that Rudd wanted to quarantine about 30% of existing GST going to the states for health, ie so they couldn't divert GST based health funding to other areas and squeeze the fed for more health funding above the GST take.

I mentioned 'implied'... as I understand, the 30% principle, ie current commitments to health by the states and fed is implied in all that transitional proceedure, formula stuff... so you may not find 30% specified in the final agreement, but the implication of the agreement in it's entirety is that current commitments and levels of funding especially by the states (Rudds original nominal and whatever the actual implied value by the agreement) will continue through the transition and not be reduced as the fed increases it's funding.

I've still only had a quick read but the gist in numerical terms seems that the fed is committing to 60% of health funding plus continuing those areas that it already funds (appears to imply about 10%) and the states commit to the other implied about 30%.


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## trainspotter (23 April 2010)

Thank you Whiskers ! Very eloquently put and I am very happy to take on board such information. It has completely cleared up the murkiness in the detail for me now. Once again thank you for bearing with the topic.


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## Calliope (23 April 2010)

Whiskers said:


> I gave up responding to useless and silly comments.
> 
> So lets see if we can get some usefull commentry.
> 
> ...




A question is not a comment. I am merely curious how anyone who can waste so much time proselytising on this thread, could actually be in gainful employment.

I have a DVA Gold Card so I guess in a way I am as big a burden on society as you. It is nice to see you take an interest in my health even though it is none of your business.

However for you information I  am healthy and place very little strain on medical or hospital resources.

Although retired I get no pension and still pay sizeable taxes for your hero Mr Rudd to waste on his support base, which you are obviously part of.


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## Julia (23 April 2010)

Whiskers said:


> I know increasing numbers of people who have left private insurance or are seriously considering it because of the expense even though they are a bit worried about emergency care in the public system.



Not just emergency care in the public system, any care at all, such as it is.




> That WA young woman with kids who was a drug addict, had a previous organ transplant due to drug abuse and continued to abuse and was funded by the public to go overseas for another (but died anyway) is the sort of thing that gets up my nose and I think contributes to overly expensive health costs and insurance.



Agree completely.  It was an insult to all the other people on the waiting list who have not even been offered an initial transplant.  She made her decisions.
She should have lived (or died) as a result of those decisions.




> In other words more incentives for people to live healthy lifestyles rather than just paying an insurance premium and carelessly enjoying oneself in the expectation that you can be patched up whenever you need one.
> 
> Cholesterol levels and obesity, for example, seems to be other important health markers and easy enough to monitor and quantify. I'd score very well on the former and pretty well on the later, so I think people like me should be given further benifits in insurance premiums or the others penalised more.



It's a bit of a stretch to assume that everyone paying for private cover is doing so in order that they may take no responsibility for their own health outcomes!!  What nonsense.
As above, I think I'm fairly typical of people with private cover in that the reason is lack of faith in the public system.  Just reflect on the Jayant Patel saga for a start.

I and most people I know are very conscientious about healthy diet and good exercise.  That doesn't necessarily guarantee you will not have the need for medical treatment, for heaven's sake.





> While the increased tax on cigarettes and alcohol goes some of the way towards that catch phrase 'user pay', it doesn't help the average person when it comes to insurance premiums that are surely still scued towards the healthy subsidising the unhealthy lifestyles.



How could you satisfactorily offer price advantages for people who don't smoke, drink excessive amounts of alcohol and eat rubbish?
How hard would it be (especially given the basic lack of honest disclosure in so many people) to declare on some form that the claimant is a paragon of healthy living?  And who is going to go and sit on their shoulder for a year to determine otherwise?
Let's at least be a bit realistic here.


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## Julia (27 April 2010)

Earlier I linked to an article by Alan Kohler suggesting recent negotiations were less to do with health and much more to do with clawing back the GST.

It seems Dr Rosanna Capolingua, ex President of the AMA, feels similarly.

http://www.thepunch.com.au/articles...nl&emcmp=Punch&emchn=Newsletter&emlist=Member


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## Calliope (29 April 2010)

Where is it heading? In the same direction as all Rudd's other failed schemes. When it goes belly up Rudd will say "Yes, but we had to spend the money fast".

*Former ally David Penington savages Kevin Rudd's 'status quo' health reforms
*
ONE of the nation's eminent medical experts has turned against the Rudd government's health reforms, declaring they will make little difference to how hospitals are run.



> David Penington, a senior fellow at Melbourne's Grattan Institute who initially backed the deal Kevin Rudd struck with the states, said yesterday he was "appalled at the lack of any agreement on governance that differs from the status quo", and had little faith any real change would be forthcoming from the reforms.
> 
> He also deplored the fact there was no commitment to the key issue of "a vastly better interface" between the hospital sector and primary care, or aged care and mental health - "all issues of critical importance for the longer term"



.

http://www.theaustralian.com.au/pol...o-health-reforms/story-e6frgczf-1225859644876


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## noco (29 April 2010)

Calliope said:


> Where is it heading? In the same direction as all Rudd's other failed schemes. When it goes belly up Rudd will say "Yes, but we had to spend the money fast".
> 
> *Former ally David Penington savages Kevin Rudd's 'status quo' health reforms
> *
> ...




Caliope, Health Reform is old hat now, Rudd has diverted our attention to stop smoking so we can save money on Health Reform.

What Rudd did not tell you is there is a News poll out this weekend and the diversion is to help boost his ratings. That's our Prime Minister with his historical monotonous beguiling behaviour.


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## Calliope (29 April 2010)

noco said:


> Caliope, Health Reform is old hat now, Rudd has diverted our attention to stop smoking so we can save money on Health Reform.
> 
> What Rudd did not tell you is there is a News poll out this weekend and the diversion is to help boost his ratings. That's our Prime Minister with his historical monotonous beguiling behaviour.




Noco,
A certain poster to this thread accused you and me and trainspotter of being 
"ignorant rabble-rousers" when we dared question his superior intellectual grasp of Rudd's scheme.

I suppose he will now brand Dr Penington as an "ignorant rabble-rouser", who hasn't read the fine print.


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## noco (29 April 2010)

Calliope said:


> Noco,
> A certain poster to this thread accused you and me and trainspotter of being
> "ignorant rabble-rousers" when we dared question his superior intellectual grasp of Rudd's scheme.
> 
> I suppose he will now brand Dr Penington as an "ignorant rabble-rouser", who hasn't read the fine print.




That poster your refer to is a monomaniac. I think he has been reading too many incunabula books.


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## noco (29 April 2010)

noco said:


> Caliope, Health Reform is old hat now, Rudd has diverted our attention to stop smoking so we can save money on Health Reform.
> 
> What Rudd did not tell you is there is a News poll out this weekend and the diversion is to help boost his ratings. That's our Prime Minister with his historical monotonous beguiling behaviour.




The new packaging idea on cigarettes was raised by Senator Fielding 10 months ago and Rudd put it aside to conveniently bring out now as a Labor Party initiative  before the weekend poll. That's our Prims Minister!!!!!!


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## trainspotter (29 April 2010)

Read somewhere the other day AMA also wants the Medicare Levy increased to cover costs. What happened to the so called 30% GST black hole funding arrangements between the states and the Feds? Apparently Govt is considering a 1% increase to assist funding??? WTF?


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## Calliope (29 April 2010)

noco said:


> The new packaging idea on cigarettes was raised by Senator Fielding 10 months ago and Rudd put it aside to conveniently bring out now as a Labor Party initiative  before the weekend poll. That's our Prims Minister!!!!!!




He's desperate for diversions;


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## Whiskers (29 April 2010)

Julia said:


> *It's a bit of a stretch to assume that everyone paying for private cover is doing so in order that they may take no responsibility for their own health outcomes*!!  What nonsense.
> As above, I think I'm fairly typical of people with private cover in that the reason is lack of faith in the public system.  Just reflect on the Jayant Patel saga for a start.




No, noo... that's not what I said at all. My point was that people who don't look after themselves by smoking and drinking excessively, should pay more for insurance premiums than those who do look after their lifestyle. 




> How could you satisfactorily offer price advantages for people who don't smoke, drink excessive amounts of alcohol and eat rubbish?
> How hard would it be (especially given the basic lack of honest disclosure in so many people) to declare on some form that the claimant is a paragon of healthy living?  And who is going to go and sit on their shoulder for a year to determine otherwise?
> Let's at least be a bit realistic here.




Realistic! The US (and I think maybe some other countries) charges premiums by health status including higher health insurance premiums for smokers. http://www.usinsuranceonline.com/health-insurance/articles/health-insurance-for-smokers.php



Calliope said:


> Noco,
> A certain poster to this thread accused you and me and trainspotter of being
> "ignorant rabble-rousers" when we dared question his superior intellectual grasp of Rudd's scheme.




Yes, and you are still rabble-rousing, ie stirring up passions for your stated hatred and objective to do whatever you can to get rid of Rudd. As I also said previously, crititism for crititism sake is futile... especially when you exaggerate, overly generalise and even condemn attempts to decipher the  economic and legal detail and implications that we are going to have to live with and make the most of.

You can continue in a hypercritical mode with your heart full of hatred and head up your @rse and fail to try to understand the economic implications of it or find anything that you can use to improve your lot if you like, but I think most people would like to try to get an objective understanding for what it all means for them.

To trainspotters credit, he acknowledged a misunderstanding of what I/he was trying to say and I respect him for that.


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## drsmith (29 April 2010)

Calliope said:


> He's desperate for diversions;



On the front of that cigarette packet there should still be the usual health warning and on the back "Go ahead. Make the national budget balance".


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## Calliope (29 April 2010)

Whiskers said:


> As I also said previously, crititism for crititism sake is futile.




What the hell is "critiitism"? Your superiority doesn't extend to spelling or grammar.




> You can continue in a hypercritical mode with your heart full of hatred and head up your @rse .




My goodness! What a rant! I certainly hit the target If you are trying to provoke me to match your nastiness you have failed.



> but I think most people would like to try to get an objective understanding for what it all means for them.




Which they won't get from you. They will have to go to someone who  knows what he is talking about, like Dr Penington, for that.

Why don't you get a job?


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## Whiskers (29 April 2010)

Calliope said:


> What the hell is "critiitism"? Your superiority doesn't extend to spelling or grammar.




Sure I miscued and mispelt 'criticism' as 'crititism', but I've never purported to be an authorative exponent of grammar... and anyway people know what I meant.  

You on the other hand fall over your own feet in your haste to criticise and nit-pick anyone that gets up your nose and what's worse *you obviously don't bother to get your facts right before you put hypercritical mouth/mind into gear* (you misquote - two 'i's) .

I rest my case!


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## moXJO (29 April 2010)

New tax on ciggies and correct me if I am wrong, but wasn’t this Malcolm Turnbulls idea


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## Whiskers (29 April 2010)

moXJO said:


> New tax on ciggies and correct me if I am wrong, but wasn’t this Malcolm Turnbulls idea




Dunno, but I applauded the idea when Howard increased it and I'll applaud it again now (whoever's idea it is) since some smokers are price sensitive and it seems a small percentge give up after each price rise.

Also heard the Brisbane city council was going to have another go at abolishing smoking in the Queen Street Mall. Don't know if they have this time, but I hated going into the mall and being sufficated by all the smokers ducking outside into the mall for a quickie and poluting the air.


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## Calliope (29 April 2010)

moXJO said:


> New tax on ciggies and correct me if I am wrong, but wasn’t this Malcolm Turnbulls idea




You are probably right. He and Rudd are both millionaires, and they couldn't care less that the heavier smokers are in the lower socio-economic groups; the ones who can least afford a higher tax slug.


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## Buckfont (29 April 2010)

This might help,

http://www.theaustralian.com.au/new...tobacco-tax-hike/story-e6frg6no-1225712787592


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## Calliope (29 April 2010)

Whiskers said:


> You on the other hand fall over your own feet in your haste to criticise and nit-pick anyone that gets up your nose and what's worse you obviously don't bother to get your facts right before you put hypercritical mouth/mind into gear..




That description fits you perfectly. Couldn't have described you better myself. Well done. And it's good to see that you can rave on without resorting to your usual gutter language.


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## Whiskers (29 April 2010)

Calliope said:


> You are probably right. He and Rudd are both millionaires, and they couldn't care less that the heavier smokers are in the lower socio-economic groups; the ones who can *  least afford *a higher tax slug.




I think you have your priorities all wrong and looking at it the wrong way there Calliope.

Surely what they (smokers) can least afford, for the best interests of their family, is higher medical expenses, higher medical insurance and shorter life expectancy.

Surely what the country can least afford is all these self inflicted and easily avoidable extra medical conditions from smoking clogging up our emergency and hospital system.


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## Calliope (29 April 2010)

Whiskers said:


> I think you have your priorities all wrong and looking at it the wrong way there Calliope.
> 
> Surely what they (smokers) can least afford, for the best interests of their family, is higher medical expenses, higher medical insurance and shorter life expectancy.
> 
> Surely what the country can least afford is all these self inflicted and easily avoidable extra medical conditions from smoking clogging up our emergency and hospital system.




I have no priorities in this matter at all. Like Rudd, Turnbull and you I lose little sleep over what their addiction costs them.


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## moXJO (29 April 2010)

Whiskers said:


> Dunno, but I applauded the idea when Howard increased it and I'll applaud it again now (whoever's idea it is) since some smokers are price sensitive and it seems a small percentge give up after each price rise.
> 
> Also heard the Brisbane city council was going to have another go at abolishing smoking in the Queen Street Mall. Don't know if they have this time, but I hated going into the mall and being sufficated by all the smokers ducking outside into the mall for a quickie and poluting the air.




I agree. It's annoying being in a room or in a car with smokers. Imo a good way of pushing more people to quit. Not to mention extra revenue which I hope is used wisely


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## bunyip (29 April 2010)

*The medicos attitude to Rudd's proposed health care legislation *

The Australian Medical Association has weighed in on the new Rudd health care proposals .........

The Allergists voted to scratch it, but the Dermatologists advised not to make any rash moves. 
The Gastroenterologists had sort of a gut feeling about it, but the Neurologists thought the Administration had a lot of nerve.

The Obstetricians felt they were all laboring under a misconception. Ophthalmologists considered the idea shortsighted.
Pathologists yelled, "Over my dead body!" while the Pediatricians said, "Oh, Grow up!"

The Psychiatrists thought the whole idea was madness, while the radiologists could see right through it. 
Surgeons decided to wash their hands of the whole thing. The Internists thought it was a bitter pill to swallow,and the Plastic Surgeons said, "This puts a whole new face on the matter...." 

The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea. 
The Anesthesiologists thought the whole idea was a gas, and the Cardiologists didn't  have the heart to say no.

In the end, the Proctologists won out, leaving the entire decision up to all the a**holes in Canberra.


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## Whiskers (29 April 2010)

You have excelled, bunyip. lol 

An excellent prognosis


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## noco (29 April 2010)

bunyip said:


> *The medicos attitude to Rudd's proposed health care legislation *
> 
> The Australian Medical Association has weighed in on the new Rudd health care proposals .........
> 
> ...




Bunyip, a master piece of literature. LOL.


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## trainspotter (30 April 2010)

Sums it up pretty well I would have thought?


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## Calliope (30 April 2010)

bunyip said:


> *
> In the end, the Proctologists won out, leaving the entire decision up to all the a**holes in Canberra.*



*

A good summation Bunyip. As they usually do, the Proctologists gave it the finger.*


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## Whiskers (6 May 2010)

Whiskers said:


> lol, yes I don't know if it's just me, but there seems to be quite a disparity between labour and lib/nat bashing.
> 
> *But on a serious note I'm waiting for some decent technological innovations in health administration.* From my experience this is where there is probably the most scope for efficiencies in the system. Things like centralised or portable patient (and health staff) records to avoid delays and duplication of processes etc when patients are referred to or processed to different sections of the system.
> 
> ...




Well, looks like it's coming... but, lets hope this e-tag thing works properly (better than the new Qld payroll system at least) and it's rolled out properly by the gov.

http://www.news-mail.com.au/story/2010/05/06/patients-doctors-to-be-e-tagged-report/


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## SirRumpole (18 July 2017)

*The Australian health care system is one of the best in the world- US report.*



The Brits beat us, but at least we are ahead of NZ. 
	

		
			
		

		
	








http://www.abc.net.au/news/2017-07-...ranked-second-best-in-developed-world/8716326


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## moXJO (18 July 2017)

SirRumpole said:


> *The Australian health care system is one of the best in the world- US report.*
> 
> 
> 
> ...




Our doctors are a bit sketchy though. A lot can't diagnose basic illnesses. A lot of bad practices as well.


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## SirRumpole (18 December 2017)

Think your health data is safe ?



Think again...



http://www.abc.net.au/news/science/...can-identify-patients-researchers-say/9267684

--


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## greggles (18 December 2017)

SirRumpole said:


> Think your health data is safe ?
> 
> 
> 
> ...



Privacy is a thing of the past (if it ever really existed). There is too much data out there on all of us and the collection and storage of it will only increase and expand. The only way to ensure your information remains private in this digital age is not to surrender it in the first place; something it is virtually impossible to do.


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## sptrawler (8 February 2018)

I find the medicare debate interesting, due to my personal experience, in a lot of ways i feel the introduction of medicare just started the medi cost snowballing.
Pre medicare, health insurance was relatively cheap, as soon as medicare was introduced the costs just keep ballooning.
Some would say pre medicare, the poor didn't have access to medical attention, however from my understanding that isn't true the cost was just a part of consolidated revenue.
Since the intervention of medicare, the costs have gone stupid and I would think some could be attributed to the " I've paid for it, I'll use it mantra".
The reason I've thrown this up, is due to this ABC report.
http://www.abc.net.au/news/2018-02-...ime-to-scrap-rebates/9405542?section=analysis
I've paid private health since leaving school, it currently costs me about $4,700/yr, I certainly am weighing up the benefit ATM.


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## luutzu (8 February 2018)

sptrawler said:


> I find the medicare debate interesting, due to my personal experience, in a lot of ways i feel the introduction of medicare just started the medi cost snowballing.
> Pre medicare, health insurance was relatively cheap, as soon as medicare was introduced the costs just keep ballooning.
> Some would say pre medicare, the poor didn't have access to medical attention, however from my understanding that isn't true the cost was just a part of consolidated revenue.
> Since the intervention of medicare, the costs have gone stupid and I would think some could be attributed to the " I've paid for it, I'll use it mantra".
> ...




Look into the US system where it's mainly private insurers. Their costs, to the consumers, is twice the developed economies... 

We all paid for medical insurance in either system, just with Medicare, it's a whole lot cheaper because everyone's covered. So the young and sick who aren't earning enough would still be covered. The able and earning but aren't often sick, are still covered... yes, they're "disadvantaged" in that they have to pay when they don't even use it. But we all grow old and we can get sick or injured at any moment.

Don't go the privatisation route. It'll make insurers insanely rich, the majority of the population either sick or dying or paying through the nose. Often it's both.


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## PZ99 (8 February 2018)

I'll make a deal with the fed & state Govts.

Reduce the exorbitant cost of car rego / insurance (which was also cheap prior to medicare) and the money saved can fund my private health care, which I've never had because I can't afford it.

Or... the dollar value of my unused sickies at work can contribute to my private health every year instead of being forfeited to my employer when I quit my job.


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## SirRumpole (8 February 2018)

PZ99 said:


> Or... the dollar value of my unused sickies at work can contribute to my private health every year instead of being forfeited to my employer when I quit my job.




That's a very good idea. I had about 100 days of unused sick leave when I retired and lost them all. People in the Senior Executive Service were able to cash them in.

Health Insurance should be provided by government on a cost recovery basis. Having a profit perogative makes it prohibitively expensive for most people these days.


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