Health Reform: Where is it heading?

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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

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.

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:

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.

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"

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