December 8, 2019

KEN HENRY. The political economy of climate change

Myopia, loss aversion and free-rider problems undermine the provision of public goods, including global public goods like climate change mitigation. Its easy to understand why climate policy has been a failure in Australia. But what happens when the central case of long-term projections, something outside of the bounds of what has been considered probable in the near-term, comes crashing into the present? Thats what our politicians were dealing with through 2006, following several years of drought. Eventually, entrenched positions were abandoned. Could we see this happen again?

July 30, 2018

LAURIE PATTON. Sticks and stones Attempted coup at auDA flounders on disinterest.

The proposition that theres widespread member concern at the state of auDA the company managing our Internet domain names has been dealt a definitive blow. The vote at a Special General Meeting to decide the fate of three directors, including independent chair Chris Leptos, saw them retain their positions.

February 17, 2016

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 billion p.a. This welfare subsidy is one of the fastest growing areas of Commonwealth government health expenditure. We have never had high income welfare recipients on such a scale before .PHI is the Damocles sword hanging over our health system. PHI is the reason for the disastrous American health system. High levels of private health coverage in Australia are achieved not through the attractiveness of the products on offer but mainly through the carrot of the tax subsidy and through the stick of penalising the uninsured. The subsidy favours the wealthy, is inefficient, has underwritten rising specialist fees through gap insurance, has not taken the pressure off public hospitals and has weakened Medicares ability to control costs. PHI discriminates against country people where there are few private hospitals. The immediate abolition of this subsidy would do more to improve our health system than anything else. This is welfare big time- far more than the welfare we used to pay to the motor industry. The abolition of the $11 b. subsidy would more than fund a universal dental scheme. Alternatively, say $5 b. of the saving by abolishing the subsidy could be paid directly to private hospitals through an activity based funding arrangement. It is absurd that public funds should be churned through high cost private health insurance rather than being paid directly to hospitals. Before the Howard government, Commonwealth government funds were paid directly to private hospitals, but this was discontinued. Direct Commonwealth funding for both public and private hospitals would also substantially improve the integration of hospital care. But private hospitals would oppose this because they find it much easier to twist the arms of private health insurance companies. And some of the major hospital groups, particularly Ramsay, are generous donors to the Liberal Party.
We need a more productive workforce. Health is the largest and fastest growing sector in the Australian economy. Despite all the talk of improving productivity in Australia no-one has been game to take on the entrenched privileges in the health workforce.Where is the honesty and consistency here? The blue collar workforce is fair game but not doctors and lawyers. We need expanded roles across the board particularly for nurses, pharmacists, allied health workers and ambulance officers. The Productivity Commission in its February 2007 report estimated that a 5% improvement in the productivity of health services would deliver savings of about $3 billion p.a. This is a very conservative estimate. The health sector in Australia is rife with demarcations and restrictive work practices. eg 5 % of normal births in Australia are delivered by mid wives. In the Netherlands it is 70%, in the UK 50% and in NZ 95%. We have a few hundred nurse practitioners when there should be thousands. The work practices in most industries are light years ahead of the work practices in the health sector.
Fifteen years ago 45% of doctors were GPs. It has fallen to about 35% yet we know that care is most equitably and efficiently delivered by GPs. Specialists are reactive and we all know they have become very expensive thanks to gap insurance provided by private insurance companies.
We could save about $2 billion p.a. in drug costs if we paid drug suppliers the same prices that are paid in NZ. We also pay a high price for the protection of pharmacists through the 5000 limit on the number of community pharmacies and the restrictions on where new pharmacies can be located. Pharmacies cannot be established in supermarkets.
We need to raise productivity in our hospitals. The Productivity Commission suggests that the productivity gap in best practice in public hospitals ranges from 3% to 89%. In private hospitals the range is 22% to 37%. There are major governance problems in many hospitals with a dis- connect between management and clinical functions. Running hospitals is very difficult with clinicians coming and going from private practise like the cottage industries of old.
The Commonwealth/State fragmentation in healthcare results in blame-shifting, the evasion of responsibility and higher costs. If for example the Commonwealth Government or a joint Commonwealth/State body had responsibility for all health care funding in a state or region, there would be a clear incentive to focus on treatment in the community and in homes to ensure that the high cost hospitals are really a last resort. The National Health Performance Authority found that in 2013/14 over 600,000 hospital admissions for 22 conditions could have been avoided with timely interventions in the community, mainly by GPs. But the problem in doing this is that the Commonwealth government funds general practice and state governments operate hospitals.
The real elephant in the room in health care cost reduction is avoidable mistakes, including deaths. They are euphemistically called adverse events. But Ministers, clinicians and managers do their best to avoid the issue. Based on earlier surveys in NSW and SA I estimated, very conservatively the cost of avoidable mistakes in our health sector at $5b pa (see my blog of June14, 2013). Despite a great deal of money and effort there is no sign of improvement. Insiders wont solve the problem Good people are caught in a bad system.
Only last week, Medibank Private said that $800 m. p.a. could be saved if a reference pricing system with Australian and global benchmarks was introduced for prostheses such as for hip and knee replacements, plates and pacemakers. Medibank Private said that prices for identical products could be 45% lower in the public system compared with the private system. With differentials like that it is no surprise that private health insurance premiums have increased at three times the rate of inflation.

The quality of our health care is generally good but waste and inefficiency is deep and widespread.

December 4, 2018

IAN McAULEY. The National Electricity Market is a mess. Morrison wants to make it messier.

The National Electricity Market needs re-design involving re-nationalisation of networks and retailers because privatisation and structural separation have failed.

February 21, 2019

MEKERE MORAUTA. Australia Should Come Clean on Intentions Behind Paladin Contract.

The money spent by Australia on Manus is not aid, In fact it disadvantaging PNG because it’s helping corruption.

Public Statement by Rt Hon Sir Mekere Morauta, former Prime Minister and Member for Moresby North-West Port Moresby, 19 February 2019

May 9, 2019

JOHN DWYER The "Canterbury Model" in health

Australias health care system needs restructuring to see it meet the contemporary and future needs of its citizens. A consensus view has emerged which argues that a long term (perhaps ten year ) plan is required for the full implementation of the desired changes. The status quo is unacceptable as the system is not resourced or organised to improve the health of the nation and is not cost effective. Its also unfair as Increasingly personal financial well-being, not need, is determining health outcomes.As a Federal election is focussing our attention on the health care initiatives envisioned by our politicians do they address the need for structural reforms?

November 15, 2018

JOHN KERIN. Trump Economics.

Not being aware of what is being written in economic journals by the profession_I find it difficult to understand why more of our commentating economists and academic economists are not publicly calling out Trumps economic policies. Are we to believe that what many commentators say about the US and its economy only currently applies to the US or should we re-write our economic text books?_

December 27, 2017

2017 in review: The nuclear landscape.

The past 12 months were proof that the threat of nuclear weapons persists in the post Cold War world. However, when nuclear threats need not be broadcast over Red Square but merely typed over Twitter, it seems arms control procedures have failed to keep up.

March 5, 2019

George Pells conviction and fragmentary memory

Many people dismiss any element of testimony that is thought to be guided by emotion. Court proceedings are based on rational argument. If holes can be picked in the verbal narrative of the witness, the allegations remain unproven. A new book explains that two people who have experienced the same phenomenon will often have completely different memories of it. The verdict of the Pell jury suggests that the form or demeanour of a testifying witness can be more telling than the verbal content of his or her testimony.

September 6, 2018

RAMESH THAKUR. Indias VIP culture: Forget Lincolns definition of democracy. Indias government is of VIPs, by VIPs and for VIPs (Times of India, 04.090.18)

Last week, the Madras high court ordered the National Highways Authority of India to separate ordinary citizens from VIPs at toll gates, with a dedicated lane for the latter. Of course, high court judges are included in the list of VIPs. The court held it to be disheartening and very unfortunate that judges are compelled to wait in the toll plaza for 10 to 15 minutes.

January 2, 2018

LUKE FRASER. Is Sydney in thrall to an infrastructure cargo cult? (Part 3 of 3)

In the first two posts, the vast scale of Sydney major transport projects was estimated at $85 billion - a figure larger than all European spending on transport public private partnerships for the last five years; the posts also examined apparent strategic flaws in Sydneys Westconnex and Metro projects which threaten poor returns and unhelpful operational impacts. How did Sydney get here? Can things be improved?

August 26, 2018

FRANK BRENNAN. Consolations from the Liberal Party mess.

What a mess! Poor Fellow My Country. Today is not a day for reckoning about any big policy issues, because none of them was in play when members of the Liberal Party cast their votes in the party room.

September 19, 2016

MICHAEL McKINLEY. The unmooring of our national defence from our national interest. Part 2 of 4.

Australia is currently courting offence rather than, as governments so often assert, defence - a transformation which might only charitably be attributed to absent mindedness if the alternative, stealth, is excluded. It is, moreover, a change wrought, in the first instance, as a consequence of the ways in which Australia thinks about its national defence, but also of both the logic and the inherent dangers arising from and within the Australia US alliance. While an extraordinary number of avenues of inquiry are possible, there are four which are pursued, the drift to offence itself, followed by, second, the emergence of the post-democratic military and security complex in the US; third, the strategic dimension to the Trans-Pacific Partnership Agreement, and fourth, Australias developing relationship with NATO.

Part 2. Reflections on Australia and the Post-Democratic Military of the United States

October 25, 2018

SHAUN HANNS. There is no clear empirical basis for the current policy against resettling those on Manus and Nauru in Australia.

The following policy piece by Shaun Hanns has been sent to all Federal Members of Parliament. (John Menadue)

I am writing to you as a concerned private citizen using publicly available data. However I was, until recently, an officer of the Department of Home Affairs and that this has informed my views. I have spent the past five and a half years working as a protection obligations decision maker. Essentially my role was to interview asylum seekers, assess the risk they faced and decide if they were entitled to refugee status. This has impacted my views in two ways. The first is that I understand just how high the death toll from attempted trips between Indonesia and Australia is. A two percent death rate for a population simply isnt replicated many places around the world. It is my view that the vast majority of people I have interviewed were never in more mortal danger than when they were on that boat. The second is that I have spent hundreds of hours across from asylum seekers talking to them about their lives. This makes the weight of so many individuals unnecessarily losing their lives in such a tragic way sit heavily with me.

April 21, 2019

FIONA ARMSTRONG. Who will address the health emergency of climate change?

Climate change causes many health problems and will have enormous impacts on Australias health system. Yet most Australian governments have been slow to prepare the health services for the inevitable challenges. Fifty health, social welfare and conservation groups, representing over one million Australians, have issued an open letter to all political parties and candidates in the forthcoming election, calling for the next government to develop and implement a National Strategy on Climate, Health and Well-being.

November 27, 2017

MUNGO MACCALLUM. Tax cuts, religious freedom and Turnbull's other distractions

A vague and uncosted promise of tax cuts and a debate on religious freedom are Turnbulls tactics to push serious policy issues off the Parliamentary agenda, and to distract public attention from the Coalitions troubles.

July 22, 2018

EU, Japan put Trump on defensive with historic trade deal (Asia Times, 17.07.18)

The two countries were expected to sign deal on Tuesday, sending a message that free trade lives on despite US protectionism.

June 1, 2018

RYAN DAGUR. Indonesia won't revoke list of approved Islamic preachers.

Indonesia’s Ministry of Religious Affairs has ignored the protests of Muslim groups and continues to list and publish the names of preachers who are qualified to give religious instruction, in a bid tocounter rising radicalism.

Mastuki, the ministry’s spokesman, told ucanews.com on May 29 that they would not change their policy as it was designed for “the good of Muslims and the nation.”

“We will not revoke [it] but will evaluate the mechanism after getting public feedback,” he said, adding that it has now placed over 500 preachers on the recommended list.

May 18, 2018

TSEEN KHOO. What Anzac Day meant for Asian Australians.

This year, just before ANZAC Day, I read a poignant, insightful piece by Nadine Chemali about what new migrants to Australia really thought about Anzac Day.

November 6, 2018

Joseph Stiglitz: 'America should be a warning to other countries'

In the lead-up to his Australian visit, the renowned economist warns of the triple threat of rising inequality, the undermining of democracy and climate change.

This article was published by The Guardian on the 5th of November 2018.

February 2, 2017

GEOFF DAVIES. Brexit, Trump and a Rigged System. Part 2 of 2.

Neoliberalism let loose the anarchic forces of free markets just at the time when we most needed them to be restrained and redirected so as not to wreck our planetary home.

May 16, 2019

KOBI MAGLEN. Improving the outcomes for older women at risk of homelessness

Older single women are the fastest growing cohort of people experiencing homelessness in Australia, though their plight remains for various reasons invisible to many. Designing solutions to this problem involves first understanding the root causes of the problem, including structural gender inequality, and then identifying the drivers of better outomes for such women. Not least amongst these is the need for more social and affordable housing, appropriate to their needs.

December 4, 2018

ANDREW GLIKSON. The 2018 Queensland and California firestorms: there is no Planet B.

It takes only a spark, from a lightning or human ignition, to start a fire, but it involves high temperatures, a period of drought, a build-up of dry vegetation and strong winds to start a bush fire, such as is devastating Queensland and recently California. When all these factors combine firestorms ensue, enhanced by strong winds from the hot interior of the continent, overwhelming the desiccated bush and human habitats. This is the face of global warming, which on the continents has reached an average of 1.5oC (http://berkeleyearth.org/summary-of-findings/)

March 6, 2019

JOHN MENADUE. Some Coalition legacies that a new government must confront

There are several major issues that dominate public life today and require resolution. Those issues are the growing existential threat of climate change, the dire consequences following the Iraq invasion, tax cuts during the mining boom that result in continuing budget deficits and debt increases, the NBN debacle, hostility to refugees and asylum seekers, and problems with foreign influence and political donations .

March 20, 2018

SPENCER ZIFCAK. Government Policies globally and the Torture of Refugees

Nils Melzer is the UN Special Rapporteur on Torture and Cruel, Inhuman and Degrading Treatment. Recently, he presented a damning report to the UN Human Rights Council on the subjection of refugees across the world to torture. Melzers fundamental contention was this. The primary cause for the massive abuse suffered by refugees globally is neither migration itself nor organized crime. Instead, it is the inexorable trend amongst States to base their official refugee policies on deterrence, detention and criminalization rather than on protection, human rights and non-discrimination.

I am a measured person. Reason is my first strategy. But, nevertheless, I think its time for the nation to consider the probability that this country is responsible for torture and cruel, inhuman and degrading treatment not only directly domestically but also indirectly internationally. A noticeable number of the 7 million torture victims worldwide is likely down to us.

May 9, 2018

TIM LINDSEY. Post-Reformasi Indonesia: The Age of Uncertainty.

Twenty years ago, the Soeharto era ended with reformation. Todays post-Reformasi Indonesia is full of uncertainty, with profound implications for its foreign relations.

October 16, 2019

IAN McAULEY. Reclaiming the ideas of economics: Regulation and deregulation

To those who are frustrated by petty restrictions getting in the way of their plans, the term deregulation has appeal, but it makes no sense, and can be economically irresponsible, to consider markets in terms of more or less regulation.

August 2, 2018

NY TIMES EDITORIAL BOARD. A New Batsman for Pakistan.

Imran Khan, cricket-star-turned-politician, promises a new path for Pakistan. But his ties to the military, and his own at-times erratic behaviour, may stand in the way.

February 22, 2018

JOAN STAPLES. Bill weak on stopping foreign donations, but strong on silencing NGOs.

The current Bill before parliament to reform electoral donations is the most comprehensive attempt I have seen at silencing public advocacy in 30 years. It does not succeed in its supposed aim to restrict foreign donations - an aim that is supported by NGOs. Instead, it is a convoluted, excruciatingly complicated maze that will undoubtedly silence a wide range of charities, NGOs and public interest institutions.

November 27, 2019

IAN McAULEY. Reclaiming the ideas of economics: Socialism

Its unfortunate that the term socialism has become a weapon in the armoury of those who stop government from performing its economically-justified functions.

July 30, 2018

GEORGE MONBIOT. Invisible Hands (Guardian 19.07.18)

Dark money is undermining our democracies, and its never darker than when channelled through lobby groups masquerading as think tanks.

(We could readily substitute the Institute of Economic Affairs in the UK for the sham ’think tank’ in Australia the Institute for Public Affairs…John Menadue)

June 23, 2019

The Facts About School Funding in Australia

Australia has an inequitable school funding system that continues to discriminate against public schools and disadvantaged students. Government funding has been badly mis-directed over many years with massive increases for the more privileged, better-off school sectors and students and far less for public schools.

May 27, 2019

BILL MOYERS. Telling the truth. What if we covered the climate crisis like we did the start of the second world war? (The Guardian 22 May 2019)

In the war, the purpose of journalism was to awaken the world to the catastrophe looming ahead of it. We must approach our climate crisis the same way.

March 31, 2019

MICHAEL KEATING. The True State of the Economy

As usual the state of the economy and its management are likely to play a central role in the forthcoming election. With the election now only six weeks away and the Budget tomorrow, it is timely to consider the true state of the economy and its management.

May 21, 2019

CHRIS MILLS. Australians Electricity Transition Plan: Coal to Renewables.

Climate scientist across the world have proven beyond reasonable doubt that anthropometric heating of the planet is a grave and imminent danger to humanity, often described as an existential threat. In Australia, our politicians have dithered for decades while the world burns. The claim is that Global Warming is a wicked unsolvable problem, but is it? Does it just require new thinking?

May 29, 2020

MICHAEL KEATING.. What should we do with the $60 bn left over from JobKeeper?

_The discovery of an error of $60 bn in the costing of JobKeeper raises the issue of what should be done with this money? However, as JobKeeper was always incomplete these deficiencies should be the first call on this extra money.

May 22, 2019

BERNARD MOYLAN A bold but courageous platform.

I have been wondering why last weekend’s election result has affected me so deeply. I suppose that the many polls led me to think that the Coalition Government had been so discredited after three prime ministers in six years , constant internal bickering , inaction over energy policy and climate change and an almost policy-free agenda , save for tax cuts directed mainly towards the rich, that a Labor victory was an almost lay down misere. Labor had been working on its own visionary agenda for the future over the past six years and had deliberately put it out early for all to consider. It was a bold but courageous platform.

December 27, 2017

Worries about Malaysia's 'Arabisation' grow as Saudi ties strengthen

Malaysia’s growing ties to Saudi Arabia - and its puritan Salafi-Wahhabi Islamic doctrines - are coming under new scrutiny as concerns grow over an erosion of traditional religious practices and culture in the multi-ethnic nation.A string of recent events has fuelled the concern. Hostility toward atheists, non-believers and the gay community has risen.

April 8, 2019

RICHARD BROINOWSKI. The Competence of our Intelligence Agencies

On 6 April, the ABC’s Geraldine Doogue interviewed Nick Warner, head of the Office of National Intelligence (ONI), which coordinates the activities of Australia’s intelligence agencies. During the interview, Warner ventured the opinion that President Trump did the ‘right thing’ in walking away from Kim Jong-un at the US-North Korean Summit in Hanoi at the end of February 2019. Coming from someone whose job is to tell the government ‘how we see the world’, this value-judgement observation casts doubt on the objectivity of the information he gives ministers.

May 30, 2018

LAURA TINGLE. Here's what Peter Dutton's Home Affairs super-department looks like.

When Prime Minister Malcolm Turnbull announced the creation of the massive new Home Affairs portfolio in July last year, he called it “the most significant reform of Australia’s national intelligence and domestic security arrangements and their oversight in more than forty years”.

November 10, 2019

MICHAEL KEATING . Economic Growth ,Redistribution and Climate Change.

Many pundits are arguing that if Labor is to become competitive at the next election it must focus on economic growth and jobs and abandon or at least downgrade its policies for income redistribution and to combat climate change. The evidence, however, is precisely the reverse. It is these policies that are the key to future economic growth and jobs.

August 7, 2019

HOWARD FRENCH. US at war with itself over China (World Politics Review, 31 July 2019)

Americas foreign policy establishment is at war with itself over the shape of the countrys approach toward a steadily rising China. For now, it is only an epistolary war. But as the debate deepens, its outcome will go far toward deciding how the United States responds to its most serious global rival for economic and geopolitical power for decades ahead.

December 2, 2019

JOHN MENADUE. China Series

China is in the ’news’. But it is not always well informed news. In addition much of our news and views about China are shaped in Washington and London.We don’t really know much about China, our major trading partner by far and the rapidly rising power in our region. This is occurring as US influence is declining.

Tomorrow Jocelyn Chey will introduce a twelve part series,What,Why and How about China.The twelve parts will be written by informed Australian experts.

November 19, 2019

PAUL KEATING. Australia's security agencies and 'pious' media lead the anti-China rhetoric

Former PM Paul Keating has accused institutions of failing to grasp the magnitude of shifting power in the Asia Pacific and has warned Australias approach to China has been supplanted by the phobias of security agencies and the hysteria of pious and do-gooder journalists.

April 13, 2019

PETER SAINSBURY. Sunday environmental round up, 14 April 2019

Different pasts, presents and challenges but the UK and Indonesia are both making significant progress toward sustainable futures while Australia continues to fiddle and fume, albeit comically on occasions. No laughs associated with large increases in the numbers of people exposed to malaria, dengue and Zika as a result of changing climate patterns though, and whats a concerned shopper to choose for carrying the weekly groceries: paper or plastic? On a (literally) brighter note, pictures of Australias wrens.

August 24, 2018

DENIS MULLER. How the right-wing media have given a megaphone to reactionary forces in the Liberal Party.

The polarisation that is devouring Australias politics is reflected in the increasingly stark polarisation of the countrys professional mass media.

December 9, 2019

Adversarial journalism in the coverage of China

Australian medias coverage of China has shifted to adversarial journalism. To change this status quo requires leadership and serious action.

January 7, 2020

BOB DEBUS: OUR LAND AND OUR WAY OF LIFE

Between late 2001 and early 2003, during the so-called Millennium Drought, eastern Australia experienced unprecedented periods of bushfire.

October 28, 2019

JACK WATERFORD. Soon we wont recognise the face of Australia.

National government is becoming more authoritarian and much less accountable

Pearls and Irritations

John Menadue's Public Policy Journal