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Rudd is nationalising the hospital system

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bellenuit said:
I only heard a brief interview on the radio this morning, but I was under the impression that funding will be "activity" based. So the more procedures a hospital does, the bigger its funding. That would seem an equitable way to allocate between states and hospitals within states, if it can be achieved.
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While this approach seems "reasonable" in theory, in practice it could be wide open to administrative abuse by hundreds of hospital boards scrambling to increase their share of the cake unless massive Federal oversight is implemented.

There has been plenty of evidence in media over the years about widespread "cooking" of Hospital inventories, procedure lists and bed vacancy rates under the current system for the purposes of achieving higher levels of "accreditation", since that benchmark currently ties into funding. How would this be any different then? Surely, they will have to employ hundreds (nay thousands?) of new "Hospital Inspectors" with Special Powers (at great cost) to continuously police the day to day accounting practices of the myriads of aforesaid hospital board's to ensure no rorting, otherwise this new scheme will fail dismally.

I'm also not sure how in smaller (but rapidly growing) regional communities (Albury-Wodonga etc) the local hospitals that perform relatively few procedures will be able to increase their funding under this new scheme in order to purchase new equipment for expansion - leading to more procedures, but only AFTER the purchase of new equipment/facilities? It's a chicken before egg problem for them?

Oh well. Plenty of years left for KRuddy to get it right. System will be well broke by then!

;)
 
bellenuit said:
I only heard a brief interview on the radio this morning, but I was under the impression that funding will be "activity" based. So the more procedures a hospital does, the bigger its funding. That would seem an equitable way to allocate between states and hospitals within states, if it can be achieved.
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Aussiejeff said:
While this approach seems "reasonable" in theory, in practice it could be wide open to administrative abuse by hundreds of hospital boards scrambling to increase their share of the cake unless massive Federal oversight is implemented.
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Yes, AJ this is what I've been thinking about too. It was a significant part of the problem with Bundaberg Hospital during the reign of Dr Jayant Patel. The more surgical procedures that were pushed through in order to gain additional funding for the hospital resulted in many patients undergoing unnecessary and inappropriate surgery.

We are being told that the announcement yesterday is just the first part of the whole deal on Health. Wouldn't it have been more reasonable to deliver the whole plan, so that the detail can be examined?

Until we hear how this brave new world of health is going to provide more doctors, nurses, and hospital beds, I can't see too much enthusiasm being generated for it.
He has also to explain how the private system will be affected, if at all.

Remember the policy of having "GP Super Clinics"? These were supposed to be up and running in various areas. To date apparently two have been implemented and I can't find any information as to how useful they are.
If staff for these clinics are being paid a salary, I'm not sure that the most competent doctors will be attracted to working there and would prefer to be in charge of their own working environment and income.
 
Something similar to GP super clinics operate in Tasmania. They seem to have no issues maintaining doctor numbers. Along the NW of Tasmania doctors seem to be migrating to similar systems instead of working alone. Some of the setups have managed to get various grants.
 
Reminds me of the song :

"There's a hole in the bucket, dear Liza, dear Liza,
There's a hole in the bucket, dear Liza,
There's a hole.

Then fix it dear Henry, dear Henry, dear Henry,
Then fix it dear Henry, dear Henry, fix it."​

Herr Rudd is playing chase the dragon on this one me thinks. By taking 30% GST revenue from the states to fund this pie in the sky, vote grabbing agenda, he has singlehandedly destroyed the health and economic sytems in Australia. WA Treasurer Troy Buswell is already asking how the commonwealth can be trusted to run the nation's hospitals when it can't deliver an insulation program. Also it seems that the helath funds like HBF and Medicare premiums will be raised thusly allowing a mass exit of the punters into the public systems as they let go of their private coverage. The bottom line is that the states have to agree to losing a large chunk of their GST revenue for this to work. Hmmmmmmmm .... Peter Garrett in charge of your Mum in hospital. I think not ! Small byline .... would this also add another layer of bureacracy over the top of the already top heavy health system? :eek:
 
If Rudd takes out 1/3 of the states GST, I wonder how much he will hold back to help pay for his big spending stimulas debt? After all,he is desperate for money.
I don't trust the man and I hope the Senate Estimates Committee keeps him honest if he ever has his way. He is a champion at selling ideas but has no idea how to impliment them.
He could sell refrigerators to Eskimos, but then conveniently forgets to tell them that in some parts of Alaska there is no electricity.
 
noco said:
If Rudd takes out 1/3 of the states GST, I wonder how much he will hold back to help pay for his big spending stimulas debt? After all,he is desperate for money.
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Well you may ask!

Will there be a totally transparent, fully accountable, iron-clad written-in-stone guarantee that for EVERY year the scheme operates, for EVERY $1 taken back from the states in GST, that NO LESS than $1 WILL be spent back on hospital or health services?

Or, will the GST grab be seen as a "windfall", to disappear into the Fed gummint's "general revenue" coffer, with unspecified (but typically much reduced) amounts being distributed back into health services "as they see fit" - while the rest is spent on "more pressing" matters.

Well, if I were a betting man......

:cool:
 
Mr Rudd has proudly stated that his scheme will not involve any new taxes in, I think he said, the next four years.
Unless I have quite misunderstood, the plan is not even supposed to start within the next four years.

Unfortunately, Nicola Roxon spoiled his sales pitch later today when - in answer to a question from an ABC journalist about new taxes - she said additional taxation to fund the new health system could not be ruled out.

In "PM" this evening comments from Mr Rudd directed to the State Premiers were broadcast. These were incredibly aggressive and antagonistic, before the Premiers really have had time to absorb and consider the plan.

Yet only a few days ago, Mr Rudd was contrite, self critical, humble (everything he really is not) all over the media.

What is going on with him? Such inconsistency seems not to be the stuff good leaders are made of.
 
Julia said:
This article from "Business Spectator" seems to be a good summary so far:

http://www.businessspectator.com.au...-reform-pd20100303-3766S?OpenDocument&src=kgb
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Thanks for the link Julia.

Will there be a referendum on the issue? I really doubt it IMHO!

Here's an objectively written article

Federalism turns on financial carrots and Canberra's big stick
March 5, 2010
BY Michelle Grattan

http://www.theage.com.au/opinion/po...g-stick-20100304-ploe.html?rand=1267711249682

There are a couple of iron laws of Australian federalism. First, whatever the rhetoric from either side of politics, power is moving inexorably towards Canberra. Second, whatever prospects are held out for ''co-operative'' approaches, there will always be stoushes between Canberra and the states.

Kevin Rudd arrived in government preaching harmony and an end to the ''blame game''. He moved to give the states more say in how they spent their money by loosening the ties on their ''earmarked'' grants.

Now Rudd is treading the centralist road, releasing this week a national curriculum and his bold bid to move much of the funding and the policy planning for the hospital system into federal hands. If the states won't agree, Rudd will get out the big stick: he'll run a referendum. So take that, premiers!

The Liberals used to be the party of federalism, but no more. John Howard had centralist inclinations and put in place a unified industrial relations system. Tony Abbott, as health minister, was itching to seize control of the hospitals. He's critical of the Rudd plan, but if he could have won Howard's support for such a scheme, you can bet he would have loved it.
 
I'm still puzzled by Rudd's newly aggressive attitude over the Health policy, following his abject apologies about being such a failure.

He's swinging wildly from one extreme to another which is hardly a good look.

Wouldn't it be in his interests to adopt a reasonable and conciliatory approach to the States on this, rather than saying if they don't 'move out of the way' he will take it to the people with a referendum?

Apparently 80% of referenda fail, so he would seem to be on pretty shaky ground here.
According to "The Weekend Australian" today there is increasing discomfort amongst his own Cabinet about his behaviour.
 
Julia said:
I'm still puzzled by Rudd's newly aggressive attitude over the Health policy, following his abject apologies about being such a failure.

He's swinging wildly from one extreme to another which is hardly a good look.

Wouldn't it be in his interests to adopt a reasonable and conciliatory approach to the States on this, rather than saying if they don't 'move out of the way' he will take it to the people with a referendum?

Apparently 80% of referenda fail, so he would seem to be on pretty shaky ground here.
According to "The Weekend Australian" today there is increasing discomfort amongst his own Cabinet about his behaviour.
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I willing to bet within anyone on ASF that a referendum on the issue will fail.

:blbl:
 
Julia said:
Wouldn't it be in his interests to adopt a reasonable and conciliatory approach to the States on this, rather than saying if they don't 'move out of the way' he will take it to the people with a referendum?
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What Rudd is running here is a very cunning blame game with the next election in mind. Now everybody wants hospital reform. Who wouldn't, when we have an army of 450,000 administrators supervising 290,000 doctors and nurses in the wards?

This won't pass the Senate. After all, it is the States' House. And without the States on side any referendum would fail.

This will suit Rudd down to the ground. He will go to the next election blaming the Coalition for the failure of Health Reform to get off the ground. This is a winner.

It was only a week ago that Rudd was admitting that this scheme was bogged down because it was too hard. He already had the report from the National Health and Hospitals Reform. He and his spin team worked busily for a few days to cobble this package together with the election in mind, and with plenty of blame to spray around.

Brilliant;) Machiavelli would be proud of him.
 
Rudd's re-election strategy is going nicely with the Nielson survey showing79% of the electorate favoured his health reform plan. While you would have to be an idiot not to favour health reform, Rudd is counting on the Senate to knock his plan back.

As a ploy to go to the election blaming the States and the Coalition for rejecting health reform, it is a winner. He will throw in a bit of Work Choices scare- mongering just for good measure.

The survey found strong support for Mr Rudd's changes to health funding, with 79 per cent of voters backing his plan for the Federal Government to become the dominant funder of hospital services.

Support for the plan was strongest in New South Wales
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http://www.abc.net.au/news/stories/2010/03/08/2838969.htm
 
Brilliant? More like desperate. He'd be better off finding some boat people to pick on. If it fails & if his plan is for the bill not to pass, he looks like he can't get anything done. His best bet is for it to pass & buy him time before it comes into effect, & before people discover that all it means is:

-An extra 5 desks per hospital bed on top of what there already is

-bunch of bureau speak

-taxes raised by the states to make up for GST they're going to lose

-nothing ultimately changing

That will take years. But in the meantime he'll have a slick ad campaign, which will give the impression they're doing something meaningful, (& not to mention which will pump $quillions into the networks to cozy up to them for positive coverage. When anyone mentions the obscene cost of the ads, they'll bring out the coalition excuse of "needing to inform people of new policies".)

Who knows, even a new stimulus, buy everyone an even bigger TV.

And of course the coup de grace, changing the ALP brand to a less reviled new face, aka Julia Gillard.
 
Ways to save billions :

1. Deregulate pharmacy .Chop the margins to shreds and let the big box discounters have a field day.

2. Make doctors follow prescribing regimens eg prescribe thiazide diuretics for hypertension ( $10 for 3 months ) before moving to AT2RA ( $30 per month ) etc.

3. Make any practitioner who utilises medicare rebates have to charge that level. Gaps are not necessary ( non-medical practitioners can survive without gaps )

4. Add a small government co-contribution to medical visits, but make the safety net easier to reach.

5. Close or streamline some smaller hospitals and amalgamate departments of some larger hospitals.

6. Scrap state government involvement in anything. Divide into regions and have the federal government fully fund it. I have seen millions of dollars wasted in shifting the drug cost for public hospital patients to private pharmacy suppliers as they are federally funded.

7. Scrap private procedures from accessing medicare subsidies. Make private practice private practice.
 
Calliope said:
Rudd's re-election strategy is going nicely with the Nielson survey showing79% of the electorate favoured his health reform plan. While you would have to be an idiot not to favour health reform, Rudd is counting on the Senate to knock his plan back.

As a ploy to go to the election blaming the States and the Coalition for rejecting health reform, it is a winner. He will throw in a bit of Work Choices scare- mongering just for good measure.



http://www.abc.net.au/news/stories/2010/03/08/2838969.htm
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I agree Calliope, Rudd is playing on people's minds. They call this type of character a SCHRICK (not sure that is the right spelling; nothing in my dictionary). He knows everyone wants a Hospital System shake up, so yes he gets his 79% support.

Tony Abbott will have to be very careful how he handles this as it could well back fire on him if he opposes this reform outright. If the states oppose it, it may let Abbott off the hook to a certain degree. I hope Abbott asks a lot more question in order to bring out the sting in the tail. What's it going to cost us mug tax payers!!!!
 
Calliope said:
Rudd's re-election strategy is going nicely with the Nielson survey showing79% of the electorate favoured his health reform plan. While you would have to be an idiot not to favour health reform, Rudd is counting on the Senate to knock his plan back.
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Well, I'd like to have a look at the questions and methodology of the Nielsen questionnaire. How can any respondent say that they are in favour of Rudd's plan when we simply don't know anything about it, other than he is proposing a shift in some of the funding. It's not even as though he is proposing a complete funding by the Feds. It will still be partly funded by the States and partly by the Commonwealth. How is that going to change the usual quarrelling about who pays for what?

There has been zilch about how he intends to provide more actual service delivery, i.e. beds, doctors, nurses. Instead he is going to give us a whole new layer of bureaucracy. How can anyone say they approve of this unless they stand to personally benefit in some way.

I wouldn't mind betting the question to phone respondents went something like "Would you be in favour of a reform of the Australian health system?"
Given the shoddy state of most State Health systems (I understand Victoria is an exception here), obviously respondents are going to say yes.

With every passing day, our Prime Minister seems to lurch from an unsolved problem or unfulfilled promise on to his next "absolute priority". Until that also falls in a heap. But no worries, he will soon dream up the absolute next absolute priority to which he will "step up to the plate" and "make absolutely no apology".

Heaven help us.
 
Newspoll results to appear in The Australian tomorrow:

Kevin Rudd's approval at lowest point: Newspoll

* Dennis Shanahan, Political editor
* From: The Australian
* March 15, 2010 10:10PM



KEVIN Rudd's personal approval is at its worst since he became Prime Minister and his satisfaction with voters is at its worst since he became Leader of the Opposition in December 2006.

After taking the blame for Government mistakes and broken promises and releasing his public hospital plan Kevin Rudd’s satisfaction rating has dropped three points to 48 per cent, in the last two weeks according to Newspoll, the first time he’s below 50 per cent as Prime Minister and dissatisfaction with Mr Rudd is at a new high of 41 per cent.

Read more in Tuesday's The Australian.
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trainspotter said:
Peter Garrett in charge of your Mum in hospital. I think not !
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Don't worry...

She'll be nice and warm (wrapped in surplus roof insulation since Garett canned that scheme), offset by a daily cold shower (because they messed about too much with the solar hot water scheme) and given the occasional electric shock in the event she grabs hold of anything metal. Then she'll be evacuated when the hospital catches fire whilst "beds are burning" plays loudly in the background and doctors do a funny dance in the hallway. :rolleyes:
 
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