Health
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David Isaacs. As bad as Guantanamo
If I liken the immigration detention centres on Nauru and Manus Island to the US facility on Guantanamo Bay, even passionate advocates for those seeking asylum such as human rights lawyer Julian Burnside dismiss my concerns: “Oh we’re not as bad as that.” I will argue that we are indeed as bad as that, possibly Continue reading »
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Kerry Goulston. Postcard from Vietnam. Health and medical cooperation with Vietnamese doctors and nurses.
In 1998, Dr Phillip Yuile visited Professor Ton That Bach, Rector of Ha Noi Medical University, with a letter of introduction from Professor Kerry Goulston, Associate Dean of Medicine at the University of Sydney who had been appointed by the then Dean, Professor John Young, to explore possible links between the two universities. Subsequently Professor Ton That Continue reading »
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Renee Bittoun. Postcard from Hanoi. Smoking in Vietnam
Unlike Australia today where the prevalence of smoking is about 15%, Vietnam remains a country where smoking is widespread. About 60% of the men smoke and about 5% of women. The burden of diseases related to smoking is therefore extremely high. On visiting a Hanoi hospital respiratory ward last week, most of the 100s of Continue reading »
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Stephen Duckett. Blood money: pathology cuts can reduce spending without compromising health
The Mid-Year Economic and Fiscal Outlook (MYEFO) set the cat among the pathology pigeons late last year. One of the government’s flagged changes, estimated to save around A$100 million a year, was to abolish the bulk-billing incentive Labor introduced in 2009. The industry mobilised, threatening to charge consumers significant out-of-pocket co-payments for pathology tests for Continue reading »
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Which country has the world’s best healthcare system?
On 9 February, the Guardian published a report on health systems around the world. It drew particularly on analysis of ratings by the Commonwealth Fund and its correspondents around the world. The UK’s national health service was ranked number one in the world. Australia was ranked number four. For Guardian article, see link below: http://gu.com/p/4f6vb/sbl Continue reading »
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John Menadue. Making the Federation work better.
The Abbott Government decided that over the next decade commencing in 2017 the Commonwealth Government would reduce grants to the states for education and health by $80 b. This is likely to produce a major and concerted campaign by the states to protect their hospitals and schools. It does provide an opportunity for more effective Continue reading »
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Alex Wodak. Endgame in the protracted drug policy debate: are we there yet?
The long running debate about illicit drugs policy has moved a great deal in the last five years. But social policy reform is a different matter from a debate. Actual reform usually takes many decades. The recent growing consensus regarding the abject failure of a criminal justice dominated approach to drugs is very encouraging. Retired Continue reading »
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Peter Gibilisco. Neoliberalism and its Perceptions
Politics has changed so much over the years; our political climate is unstable, since 2007 we have had five different prime ministers. A person in my position would ask how does this affect people with severe physical disabilities? Neoliberalism has its aim to put into question all collective structures capable of obstructing the logic of Continue reading »
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Jonathan Page. The Inspiration of Vietnam
Postcard from Hanoi: I have been an oncologist for some 35 years, treating adults with advanced cancer. Despite a far greater understanding of the disease, with the discovery of quite remarkable “targeted” therapies, most patients still die of this disease. Many are not suitable for these treatments, many don’t respond or respond poorly and briefly, Continue reading »
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John Menadue. Postcards from Hanoi.
I will be in Hanoi from February 17-26, attending a Hoc Mai Foundation workshop on learning from each other about health issues in Vietnam and Australia, and assisting in the learning of English in the health field. Hoc Mai means ‘forever learning’. The foundation was established in the late 1990s. University of Sydney was a Continue reading »
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John Menadue. Hoist with their own petard
Private health insurance funds like NIB are complaining about high specialist fees. But these very same funds are major contributors to the problem. And it is a problem. In the last 30 years we have seen a dramatic increase in specialist fees. A major contributor to this increase in specialist fees is the ‘gap insurance’ Continue reading »
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John Menadue. Part 2. How we deliver healthcare is as important as the funding of healthcare. Medicare has degenerated into a payments system.
In Part 1 I focussed on the importance of improving the delivery of health care and not just funding. In Part 2 I will focus on specific areas where costs should be reduced. Part 2 Getting costs down The government should abolish the subsidy for private health insurance which costs all up about $11 Continue reading »
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John Menadue. Privatising Medicare’s payments system and the erosion of Commonwealth Public Service capability.
The government has apparently accepted the advice of the Commission of Audit that Medicare’s payments system should be reviewed with the possibility of privatisation. The payments system includes Medicare, the Pharmaceutical Benefits Scheme, Aged Care Services and Veterans’ Affairs. It sounds like another expression of neo liberalism, that only the private sector can be efficient Continue reading »
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John Menadue. Part 1. How we deliver health care is as important as the funding of health care. Medicare has degenerated into a payments system
Part 1 of these articles will focus on the inefficient way we deliver health care, the many perverse incentives and the power of vested interests to resist reform in health care delivery. Part 2 will focus more particularly on examples of waste and inefficiency in health care delivery Part 1 We have been told many Continue reading »
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John Thompson. Fiona Nash and private health insurance for rural Australians
A few nights ago on Q&A, the Minister for Rural Health, Fiona Nash, undertook to drop out of private health insurance while she was in office. Ms Nash lives in Crowther, a small town about midway between Wagga Wagga and Bathurst. Foregoing private health insurance makes a lot of sense for her because, like most Continue reading »
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Michael Gracey AO. Grappling with the Indigenous health gap.
By most recognised markers of socio-economic status, Indigenous Australians fare badly compared with their non-Indigenous counterparts. This is certainly the case where health standards are concerned. For example, rates of infections and hospitalisation for these and many other illnesses are much higher; chronic diseases like heart disease, stroke and diabetes are more prevalent; and Continue reading »
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David Isaacs. Secrets and lies and bad morality: Australia’s policy on people seeking asylum
The latest episode in the long, sorry saga of how badly we can treat people seeking asylum was played out in the High Court in February 2016. Long because the story started in 1992 when the Paul Keating Labor government introduced mandatory detention ‘as a temporary measure’ in reaction to a handful of people arriving Continue reading »
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Stephen Duckett. Health in 2016: a cheat sheet on hospitals, Medicare and private health insurance.
We start 2016 as we started 2015 – with big challenges for the health system and uncertainty as to how governments will meet them. The health care headaches in 2016 are, in fact, the same ones we faced a decade ago, albeit different in severity and symptoms. They include population growth, ageing and the rise Continue reading »
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Ian McPhee. Let’s talk about dying.
What does it mean to die well? We must acknowledge divergent views on assisted dying and start framing laws that will enable it, writes Ian McPhee. I am a medical specialist with advanced cancer. In a career begun more than 35 years ago, I have seen death in all its guises: in homes, at the Continue reading »
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Ian McAuley Private health insurance – does the lady protest too much?
Sussan Ley, the Commonwealth Health Minister, has hit out at private health insurers’ bid for a six per cent price increase. In view of the strong support the Coalition has always given private health insurers, such public criticism from a Liberal Party minister may surprise us. As one-time Prime Minister Tony Abbott said “private health Continue reading »
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Ian Webster. Alcohol and Sport.
The facts about alcohol should stop politicians in their tracks. But they are unmoved. A quarter to a third of the work of a general hospital is alcohol-related. On Australia Day one in seven ED attendances were caused by alcohol; in some EDs it was one in three. The Senior Australian of the Year, Gordian Continue reading »
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John Dwyer. ‘Health’ products and treatments that are often unproven and sometimes dangerous.
Health Care Advertising and Consumer Protection There are far more irritations than pearls available currently to those of us trying to champion the importance of having our health care underpinned by credible scientific evidence of clinical effectiveness. Though we live in the most scientific of all ages it is cause for concern that practices Continue reading »
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Brad Chilcott. I donated a kidney to my son. Don’t tell me not to make it ‘political’.
In early December, I went into surgery to give my eight-year-old son Harrison my left kidney. He heard me groaning in recovery as the anaesthetist put him to sleep a few hours later so that he could receive it. The operation was the first of my life and Harrison’s 13th. He’d experience his 14th general Continue reading »
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Robin Room and Michael Livingston. Alcohol companies target the 20% of Australians who drink 75% of the alcohol.
Researchers have known for a long time that alcohol consumption is quite concentrated in a small part of the population. They argue about the exact distribution, but there is substantial agreement that, so long as alcohol sales are not heavily restricted, consumption is distributed in a quite predictable way. That is, there are many light Continue reading »
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Michael Thorn. Caught Out: How Cricket Australia maintains Aussies high drinking average.
The runs are coming thick and fast in the current Victoria Bitter One Day International Series between Australia and India, bested only by the onslaught of alcohol advertising both on and off the pitch as well as in the commercial breaks in between the on field action. That barrage of alcohol ads on the Continue reading »
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Kim Oates. Excuse me doctor, have you washed your hands?
Imagine you are a patient in hospital. The doctor draws back the bed sheet to examine your abdomen. Before you are touched, you say “Excuse me doctor, have you washed your hands?” Would you dare? Would you be too embarrassed, awkward or even afraid to ask? Would you worry that it would be rude to Continue reading »
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The policy scandal of a $11b taxpayer subsidy to private health insurance.
I don’t think that I can recall a domestic policy that is so outrageous as the $11 b. annual cost to the taxpayer of the subsidy to private health insurance (PHI) companies. The subsidy is paid to policy holders, but it really means that PHI companies receive the benefit of the subsidy. For further explanation Continue reading »
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John Duggan. Advice from expert clinicians or the AMA
For those interested in the cost of health care the recently released interim report by the Medical Benefits Schedule (MBS) Review “obsolete MBS items track one” demonstrates the dawning recognition that there are procedures and tests that do not justify their existence or federal funding. The story begins with the decision of Ms Sussan Ley, Continue reading »
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Ian McAuley, Jennifer Doggett, John Menadue. Private Health Insurance companies are price takers. Prices are set by doctors and hospitals.
Repost from 22/10/2015 On Tuesday the Australian Competition and Consumer Commission (ACCC) released its report on private health insurance. Private health insurance (PHI) was also in the news a day later with the standing down of the CEO of Medibank Pte, the largest PHI company. The ACCC report has been a regular report since 1999, when Continue reading »
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Jennifer Doggett, Ian McAuley, John Menadue. Four Corners: No wonder we’re wasting money in health care – we got the incentives wrong
Repost from 06/10/2015. A recently-aired ABC Four Corners program aptly titled “Wasted” exposed three areas of unnecessary, ineffective and outright dangerous health interventions, in knee, spinal and heart surgery. The show’s host, Norman Swan, presumably extrapolating from the findings in those three areas, claimed that waste could be as high as 30 percent of all Continue reading »