The Abbott Government

[SirRumpole]

The only other deterent that works, is to pay employees for a proportion of unused sickies when they leave.

I would be a lot richer if that happened

The thing that really made me sick when I left my last job in the NSW Public Service was that some bloke in the Senior Executive Service got his unused sick leave fully paid out while the rest of us just lose it.

 

[sptrawler]

I would be a lot richer if that happened

The thing that really made me sick when I left my last job in the NSW Public Service was that some bloke in the Senior Executive Service got his unused sick leave fully paid out while the rest of us just lose it.

Actually a lot of employers do it, the unions don't like it.

A mate who works for a council told me they have it in their EBA, the problem is, with the consolidating of councils, he's worried he will lose his banked up sickies.

I worked in power generation for most of my career, and was involved in negotiating many EBA's, we always tried to get it implemented.
Management were o.k with it, but we couldn't talk our unions into supporting it.

Senior executives probably incorporate it in an individual contract.

 

[sptrawler]

Well Syd, you should be starting to warm to 'smoking Joe', he is starting to say a lot of your quotes.

http://www.abc.net.au/news/2014-12-12/joe-hockey-more-cuts-myefo-budget-update/5964148

"They're modest savings overall because our expenditure is very modest," Mr Hockey said.

"New spending - we're offsetting with new savings.

He also dismissed raising the Goods and Services Tax (GST) to cover the budget woes.

"I don't see broadening the GST or increasing the rate of the GST as a silver bullet for the economy at all," Mr Hockey said.

"I don't have any desire to increase the cost of living for everyday Australians without being able to properly compensate for it and the budget has limited capacity to do that."

 

[sptrawler]

I would be a lot richer if that happened

The thing that really made me sick when I left my last job in the NSW Public Service was that some bloke in the Senior Executive Service got his unused sick leave fully paid out while the rest of us just lose it.

What made me sick, was I attended tertiary education to obtain qualifications, this enabled me to apply for a position with higher accountability and responsibility.
The benefit was a 40% increase in salary, however it was a shift work.
When individual contracts came in, the the position I left negotiated individual contracts, and recieved the same wage as I was recieving for shift work.

 

[Julia]

If that is the attitude, then just increase the Medicare levy.

I'm sure you wouldn't mind doing your bit even if it doesn't directly benefit you.

I have already said so. I would just like others to be similarly disposed. I'm just absolutely sick of the endless whining about paying for this or that. Australians have been over-indulged by successive governments buying votes. It simply can't go on in the same way.

And I don't think increasing the levy is the full answer: people on benefits can perfectly well afford the small sum of $5 or $7 to see a GP. If it were $70 capped for the year that is a mere 19 cents per day, and it would weed out some of the social visits.

Seems to be a fairfax push of bull$hit reporting. Looks to be a big push the last couple of days too with articles popping up every hour.Best way to take down a government is through instilling disunity and looks like this is their best bet. Fairfax is just pizzed at Hockey sticking it up them.

+1.

Where is the evidence of abuse ?

Do people really want to waste their time at the doctor's for no reason ?

Yes. Can you, asking for the second time, provide evidence to the contrary. Elderly people in particular enjoy the reassurance of a regular visit to their doctor. My own father used to rock up about once a week, nothing at all wrong with his health, just said he liked having a chat. And I've seen the same hundreds of times in running a medical centre.

I think it's more likely to be new and costly treatments that put up the cost of health care rather than abuse by individuals, and maybe some fraud and over servicing by doctors.

I think fraud is minimal, audits are regular and thorough. But there is a fine line between fraud and over-servicing. Easy enough to note on patient record that patient is anxious, needs regular reassurance yada yada.

If a doctor wants to ramp up his income for the week, all he needs to do is a round of the local nursing homes, saying hello, how are you, to each individual. Or work a weekend with out of hours rates from Medicare.
There will always be patients ready to come.

At least make it an option.

No. Absolutely not. Chemists are not doctors. They do not have the training to diagnose any illness.

If you have a problem with the requirements of your workplace, take it up with your superiors. The answer is not to provide some "tick the box" system where unqualified people certify an illness without the appropriate training.

sptrawler has also pointed out how easily such a system could be rorted. Next thing we'd have someone withdrawing from opiates with the typical symptoms of runny nose, sneezing, general misery etc, being diagnosed by a chemist as having a cold, when in fact the underlying problem needs to be addressed. Similarly an allergy can often be mistaken for the common cold, but the management is entirely different.

Re Mr Stevens: I've already suggested you offer him your expert opinion. Afaik you're employed in the IT industry. So I'm not sure what qualifies you to know better than the Governor of the Reserve Bank how to manage the monetary system.

 

[sptrawler]

I

Yes. Can you, asking for the second time, provide evidence to the contrary. Elderly people in particular enjoy the reassurance of a regular visit to their doctor. My own father used to rock up about once a week, nothing at all wrong with his health, just said he liked having a chat. And I've seen the same hundreds of times in running a medical centre.

.

Yes Julia, my mum has been told by the doctors, if she doesn't turn up when she books a visit, she will be charged.

 

[SirRumpole]

Yes. Can you, asking for the second time, provide evidence to the contrary. Elderly people in particular enjoy the reassurance of a regular visit to their doctor. My own father used to rock up about once a week, nothing at all wrong with his health, just said he liked having a chat. And I've seen the same hundreds of times in running a medical centre.

The elderly people I know visit the doctor quite often, but that is because the doctor keeps telling them to come back for reassessments etc. If patients just want a "chat", maybe their families should get more involved and find them some activities to occupy them.

I think fraud is minimal, audits are regular and thorough. But there is a fine line between fraud and over-servicing. Easy enough to note on patient record that patient is anxious, needs regular reassurance yada yada.

Here is just one case. How many others are going on ?
http://www.abc.net.au/news/2014-12-05/doctor2c-accountant-charged-over-2416m-medicare-fraud/5948106

If a doctor wants to ramp up his income for the week, all he needs to do is a round of the local nursing homes, saying hello, how are you, to each individual. Or work a weekend with out of hours rates from Medicare.
There will always be patients ready to come.

Exactly. Plenty of ways to defraud the system. Nursing home patients are captive audiences who may not ask for a doctor but find that one descends on them for a couple of minutes and charges for the priviledge.

If the patients didn't request a doctor, why should they pay, and what audits are there to prevent this ?

 

[sptrawler]

Exactly. Plenty of ways to defraud the system. Nursing home patients are captive audiences who may not ask for a doctor but find that one descends on them for a couple of minutes and charges for the priviledge.

If the patients didn't request a doctor, why should they pay, and what audits are there to prevent this ?

Exactly.
You wouldn't need an audit if there was a $5 co payment, the nursing home would only have the doctor, when required. The patients wouldn't be too interested in a chat either.

The doctor would then have more time available to see sick people.

 

[SirRumpole]

Exactly.
You wouldn't need an audit if there was a $5 co payment, the nursing home would only have the doctor, when required. The patients wouldn't be too interested in a chat either.

The doctor would then have more time available to see sick people.

Maybe we should have a co-payment for politician's travel too ?

Point is a co-payment automatically assumes that patients know the difference between trivial and serious conditions.

While it may deter a few patients who want a chat it also deters a lot more who actually need a consultation, which if ignored creates more expenses later on.

It's a case of the government shooting itself in the foot by only responding to one issue without any evidence that it is a major factor when a more intelligent assessment involves consideration of a wider range of factors contributing to health costs.

 

[sptrawler]

Maybe we should have a co-payment for politician's travel too ?

Point is a co-payment automatically assumes that patients know the difference between trivial and serious conditions.

While it may deter a few patients who want a chat it also deters a lot more who actually need a consultation, which if ignored creates more expenses later on.

It's a case of the government shooting itself in the foot by only responding to one issue without any evidence that it is a major factor when a more intelligent assessment involves consideration of a wider range of factors contributing to health costs.

I think that the cost is minimal and being blown out of proportion, just for political mileage. Hawke and Keating had the same problem when medicare was first introduced, they wanted a co payment also.
What people have to realise is, we have a great welfare system, but it is unaffordable in its current form, no different from the problems with the super system.

It is much better IMO, to make small adjustments, than to leave things go. Then have to make major cuts, or take large amounts of money off others, to support the unaffordable.

The deficit isn't improving, so the debt and associated interest cost keep growing. We have to broaden the tax base and reduce spending IMO.
To just increase taxes, adds costs, to whatever you are taxing. That makes that service or goods dearer therefore less competitive.

As Syd says there are several things that can be taxed or the existing tax rules changed. The problem is the welfare costs are increasing with the aging population, and the tax base is shrinking.

Unless the health and welfare cost growth is slowed, they will outstrip the tax base even if you broaden it.IMO

 

[Julia]

I think that the cost is minimal and being blown out of proportion, just for political mileage. Hawke and Keating had the same problem when medicare was first introduced, they wanted a co payment also.
What people have to realise is, we have a great welfare system, but it is unaffordable in its current form, no different from the problems with the super system.

And that is the whole point, one which the government has failed to properly convey when instead talking about creating a research fund.
I've never heard any pensioner complain about the very small charge they pay for prescriptions. A co-payment to see a doctor should be even more acceptable.
All the fuss is being created by Labor and the Greens purely for political mileage.

 

[trainspotter]

The toe cutters have moved in:-

A TOTAL of 175 government agencies will be scrapped in a bid to make budget savings and streamline the public service.
Finance Minister Mathias Cormann will announce the cuts on Monday as part of the budget update alongside rules to stop the creation of new agencies that clog the bureaucracy and slow down decisions.
It says working groups will be shut down and expensive agencies dismantled in a bid to streamline the public service, saving more than $500 million over four years and taking staff numbers back to the levels of seven years ago

http://www.news.com.au/national/government-to-scrap-175-agencies-report/story-fncynjr2-1227154755940

Public service unions to be screaming blue murder next.

 

[SirRumpole]

As someone who never gets bulk billed I don't care if people have to pay a co payment as long as it doesn't unfairly impact the chronically ill or aged and the payment goes into public hospitals instead of something for which we may never see benefits.

Also there has to be a remedy for the long term ills of obesity and alcoholism which cause a lot of strain on our health system. The Coalition has never been interested in tacking these issues, surprisingly of course since no doubt Coca Cola and the breweries are donors to them.

 

[sydboy007]

Don't you think the reason you have to get a doctors note, for more than two days absence, is to stop workers abusing the system and having a week off?
The very reason you have to fork out $65 and go to a doctor is a deterent, if you could just go to a chemist, Australias productivity would plummet.
The only other deterent that works, is to pay employees for a proportion of unused sickies when they leave. The unions are not in favour of this approach, they say it discourages workers from taking sick leave when sick.

Actually it works a bit like the doctor co payment was meant to.

When the person on free medical, decides they have a bit of a sore throat, they then have to choose, if it's bad enough to warrant missing out on a latte and scone. If it is then they go to the doctor, if it isn't that bad they spend it on something else.

At the moment, they just drop in and see the doctor anyway and might as well stock up un some cheap prescriptions as well, on the way.

Bill $20 for getting an MC at the pharmacy. Monitor the stats to ensure the odd dodgy pharmacist with a reputation for writing an MC when a person is clearly not sick are picked up.

There's still a $ incentive not to get the MC, but it also saves me money as it would be cheaper than the gap between medicare and what a GP visit costs, medicare saves over $30, and GP resources are available for those genuinely ill.

One the one hand you're arguing the copayment is not that much and designed to cut down on oversue of the health system, but at the same time you're not willing to think outside the box to try and minimise the costs without doing to much harm to those who genuinely need to see a doctor.

If you're worried about abuse of the system let employees use it twice a year then further MCs need to be done by a GP. Something has to give because the aged pension and health costs are what is going to bankrupt the country if we don't work out ways to cope with the escalating costs.

Possibly the Abbott Govt nees to have a read of this article

https://hbr.org/2014/12/how-to-stop-the-overconsumption-of-health-care

Doctors and patients in the United States must work together to minimize waste in health care. The millions of health care decisions made each day ”” to see a provider, complete a medical test, fill a prescription, or undergo a procedure ”” come with benefits, risks, and costs. Many of the choices are well informed by clinical evidence and expertise. But all too often they are driven by habit, hunches, or misaligned economic incentives, leading to substantial overuse of unnecessary, even harmful, services. The Institute of Medicine estimates that unnecessary services represent about 10% of all U.S. health care spending ”” nearly $300 billion a year.

Other examples of overuse, however, are subtler. For example, an estimated 25% of Medicare beneficiaries undergo an imaging test for uncomplicated low-back pain. That may seem harmless on its face, but almost all patients with this symptom recover without an invasive procedure ”” and, in response to the imaging results, some patients undergo additional procedures they don’t actually need. Similarly, more than half of antibiotics prescribed for common colds and coughs may be unnecessary.

Putting quantity in the context of quality. Choosing Wisely helps patients and doctors see that more care is not always better care. Doctors have long known about some of the opportunities for reducing the quantity of care without compromising quality, such as not getting an imaging test for uncomplicated low back pain or not ordering an annual cardiac stress test in patients without symptoms. In these instances, Choosing Wisely can help educate patients about why an unnecessary test could wind up being bad for them so that doctors and patients can have more constructive conversations about the tests.

Educating the public takes longer and is not easy, but it does provide the best overall return when you have a long term view. Killing off the myth that antibiotics will help with a cold would be one worth really fighting for.

If we don't put resources into this now then the below article offers the stark reality of our global future

http://www.project-syndicate.org/commentary/global-economics-drug-resistance-by-jim-o-neill-2014-12

By 2020, if we allow resistance to rise by 40%, global GDP will be 0.5% smaller than it otherwise would have been. By 2030, it will be 1.4% smaller. By 2050, the economic shortfall will reach 3%. The accumulated loss of global output over the next 35 years will total $100 trillion – more than one and a half times annual world GDP today.

 

[sydboy007]

Well Syd, you should be starting to warm to 'smoking Joe', he is starting to say a lot of your quotes.

http://www.abc.net.au/news/2014-12-12/joe-hockey-more-cuts-myefo-budget-update/5964148

"They're modest savings overall because our expenditure is very modest," Mr Hockey said.

"New spending - we're offsetting with new savings.

He also dismissed raising the Goods and Services Tax (GST) to cover the budget woes.

"I don't see broadening the GST or increasing the rate of the GST as a silver bullet for the economy at all," Mr Hockey said.

"I don't have any desire to increase the cost of living for everyday Australians without being able to properly compensate for it and the budget has limited capacity to do that."

They're expenditure is modest?? Then why the oncoming $40B deficit?

What new savings?

Raising the GST is one of the more efficient ways to tackle the lack of revenue and the distortions in our tax system. It would certainly help with the fiscal imbalance between the feds and states, and would also allow the feds to step back from providing money for state responsibilities. The other option is to allow the states to have their own sales taxes like int he USA, though I'd prefer a uniform policy as it makes the costs of the system a lot cheaper.

The fact he's still trying to pretend we can fix the budget without losers pretty much means we're stuffed. No Joe, the confidence fairy ain't real, and no Santa doesn't exist either. How about some economically rational choices for a change??

So if the savings they're going to announce through the week "..are not going to have a negative impact on the Australian economy" then why weren't they done at the last budget, or even earlier at the Dec 13 MYEFO? Why wait so long introduce them?

 

[sydboy007]

No. Absolutely not. Chemists are not doctors. They do not have the training to diagnose any illness.

If you have a problem with the requirements of your workplace, take it up with your superiors. The answer is not to provide some "tick the box" system where unqualified people certify an illness without the appropriate training.

It's not really my employer per se, though they do seem to enforce their rights far more strictly than other employers I've worked for

http://www.fairwork.gov.au/leave/si...-carers-leave/notice-and-medical-certificates

Employers can ask an employee to give evidence to confirm why they have been away from work at any time. This includes even if an employee has only been off sick for 1 day.

An employee who doesn't give their employer evidence when asked may not be entitled to be paid for their sick or carer’s leave.

So the system is designed to force overuse of GP visits to get an MC. There has to be a cheaper way to keep employers happy that staff are not wagging work than forcing them to go to a GP or if the cost is prohibitive for them, sit in an emergency department for hours. I had to do that once when I got a very debilitating stomach bug. Once again unable to get in to see any local doctor (3 clinics) and had to spend nigh on 4 hours at RPA emergency to get an MC for a couple of days to recover. I was told by the doctor that usually it will clear in 24-48 hours but if not to see my GP for some antibiotics. She was right. I was feeling a lot better the next day, though still not great.

You must know very different elderly people to myself. I don't know one of them that goes to the doctor unless they absolutely have to.

 

[Smurf1976]

He;s basically setting himself up as the dupe who has to resolve the stagnating economy by lowering interest rates, but as has been shown around the world, that's not a path to a bright economic future.

Declining manufacturing, outsourcing, a shift to a "service" economy, austerity particularly by government, and interest rates declining toward zero.

Hasn't worked too well in most countries that have gone down this track and I can't see why Australia would be any different really.

 

[SirRumpole]

Raising the GST is one of the more efficient ways to tackle the lack of revenue and the distortions in our tax system. It would certainly help with the fiscal imbalance between the feds and states, and would also allow the feds to step back from providing money for state responsibilities. The other option is to allow the states to have their own sales taxes like int he USA, though I'd prefer a uniform policy as it makes the costs of the system a lot cheaper.

Fiscal imbalance could also be rectified by the Feds taking over some state responsibilities.

The prime target would be the public hospital system which represents about 40% of state expenditure. Considering the Feds already manage every other aspect of the health system, then having an integrated public hospital system would make sense.

There is no need to further complicate the tax system by giving the states more taxing powers, or by raising/extending the GST. Rudd tried to do this, but they got rid of him first.

It's time for a forward looking Federal government to have another go. Abbott/Hockey won't do it, perhaps the next Labor government will.

 

[Julia]

Also there has to be a remedy for the long term ills of obesity and alcoholism which cause a lot of strain on our health system. The Coalition has never been interested in tacking these issues, surprisingly of course since no doubt Coca Cola and the breweries are donors to them.

And what exactly did Labor do to address the enormous problem of obesity?

Obesity alone is a massive cost to the health system with all the diseases it leads to. Almost everything that can go wrong with us is caused by or exacerbated by obesity.

Raising the issue of Coca Cola is a bit of a red herring. Are you going to remove from the market place all products containing sugar? All fried foods? Shut down all the fast food outlets which appear to provide the foundation diet for some families?

Of course not. Nothing wrong with any of those things in very small quantities, ditto alcohol.

It's human behaviour that has to change. Perhaps some intensive advertising campaign along the lines of the successful "Slip, Slop Slap" idea and the anti-smoking campaign. They both largely worked.

As it is, obesity is becoming the new normal which is shocking. Ambulances are being modified to accommodate the reality of obese patients, ditto hospital beds and gurneys, operating tables. Aircraft seats forcing either reduced profits for airlines or more cramped positions for all.

Bill $20 for getting an MC at the pharmacy. Monitor the stats to ensure the odd dodgy pharmacist with a reputation for writing an MC when a person is clearly not sick are picked up.

You are apparently refusing to acknowledge that a chemist is simply not qualified or trained in any way to make medical diagnoses.

 

[sptrawler]

The toe cutters have moved in:-



http://www.news.com.au/national/government-to-scrap-175-agencies-report/story-fncynjr2-1227154755940

Public service unions to be screaming blue murder next.

Well they can't cut spending, because the recipients can't afford it, so know they cut jobs. I hope the ones who lose their jobs, can afford it.