Analysis and discussion of elections and opinion polls in Australia
Morgan: 60.5-39.5
Roy Morgan’s first face-to-face poll of the Rudd era shows Labor with a predictably bloated two-party lead of 60.5-39.5. Read all about it here.
Author: William Bowe
William Bowe is a Perth-based election analyst and occasional teacher of political science. His blog, The Poll Bludger, has existed in one form or another since 2004, and is one of the most heavily trafficked websites on Australian politics.
View all posts by William Bowe
PS: the problem with the last year of life, is that it can’t be predicted. Its only in the aftermath you can pinpoint that it really was the last year of life, like cancer victims mostly.
Chemotherapy, palliative care medicines, radiotherapy – are very costly, but with improvements in cancer diagnosis, management and treatments generally, more are living longer, or going into remission for longer periods, and hence costing more… the diagnosis of *terminal* is becoming more fuzzy.
And of course, patient expectations, we expect the system to “leave no stone unturned” on the possibility that this treatment may be the miracle for our loved ones. Same with some surgical techniques, really is it worth giving a 95-yr old their 4th hip-replacement? But Aussies do scream if you don’t do it…
This was the issue with herceptin for breast cancer, herceptin costs a freaking fortune, it works for *some*, but not for most, but Australians kick up a big stink if its just not free for everybody.
Same with pathology and diagnostics, patient expectations are that we must not leave any stone unturned, must all have every scan, blood test, MRI, CT, prod and poke, going, do you know how much MRI scanners cost? *shudder*
Adam @ 344
Thanks for the link to Professor Pompous’s article on El Rodente pissing down his leg.
I recommend to all “Poll Dancing” by Mungo. Funny, brilliant commentary on the year-long election campaign from the eternal Labor-voting pessimist and truly brilliant wordsmith.
On health care. I’ve never been a health professional, just humble statistician for Medicare/PBS.
I have had two instances of emergency care in my adult life. Both back related and I can only commend the Canberra Hospital and the Winchester (UK) Hospital for removing/reducing my misery. My complaint on both occasions was slight in the greater scheme of things was slight, but extremely blo*ody painful On both occasions I was struck by their professionalism and their caring nature.
Anyone who wants to have a “laugh” about political interference in the health system should read Chris Brookmyre’s satirical novel “Country of the Blind”
Red cordials are NOT condusive to cutting and pasting 🙁
Rain is completely right about the last year of life. Doctors NEVER use cost as an argument not to provide a treatment to an individual patient. The treatment may not be available due to cost, but once it is it’s open slather.
Rain- I’ve been reading that the problems of obesity is have been wildly exaggerated. Except for the morbidly obese and those with complications like diabetes and osteoarthritis, most overweight people do just fine from a morbidity and mortality point of view. Is this not true economically? http://www.sciam.com/article.cfm?chanID=sa006&colID=1&articleID=000E5065-2345-128A-9E1583414B7F0000
I am being slack,can someone tell me the actual seats for the winners and seats for the jokes, in the house of Reps and Senate .
Turning Worm #350
Is it wrong to blame a private entity for not being able to run itself at a profit or to at least fund it’s own activities? If this private entity was running at a profit would they be offering a share to the federal government?
Why don’t the Federal government take over the little local hospital? It would cost only $2.5 million and would put some substance behind the mantra of ending the “blame game”. Aren’t the people at PI entitled to a public hospital like everyone else? In fact aren’t they entitled to any hospital.
PI is also a very popular tourism centre. The motorcycle GP & the penguins are but two of the major attractions down there. I would have thought it was in the public interest to have a functioning hospital down there.
Yes Roxon is organising for people to be moved. To the nearest public facilities 50km away. Pretty tough on elderly relatives and those with limited transport. But thanks anyway.
An opportunity lost. She had the power to put into practice what she was spruiking in opposition. In the end it was just too difficult.
Good on her.
Diogenes – its more the long-term epidemiological adjustments on age-group, so exctraolating out 5,10, 15 years etc, and secondly lack of consistency on available clinical risk-assessment tools.
Thirdly, our economic models also go beyond just health system economics – but general economic markers, and include things like work-related illness (eg sick-days), workforce participation rates, injury, and mental health (eg depression)
Its going down the age-ranges, baby-boomers are generally very healthy, but health status is clearly dropping down each 10-year age group, down to the kids, Obesity is just one of the health ‘risk factors’ or ‘markers’ of poorer health status. More risk factors you have, up goes the probabilities, even on injury rates, days off work, depression etc.
Well if the good people of PI don’t like the way the fed government is treating them then they should vote liberal in 2010….oh, that’s right, their fed member is a liberal….I wonder why he didn’t do anything about their plight.
Steve K, this was a chance for Labor to win some votes by ‘ending the blame game’…the whole issue here is whether a moderate sized rural community deserve a functioning hospital regardless of whether it is public or private??
Roxon’s mantra of ending the blame game i guess was just a non-core policy….
Either Roxon doesnt understand her own policy or she is gutless…either way not a flash start as Health Minister.
Steve K it didn’t go belly up until now! The Brumby government could of done something but ideologically they decided not to and buck pass to Roxon who then buck passed back to Brumby.
This example of Labor in government wont win them any votes in PI i can tell you that.
Steve K Says: “Well if the good people of PI don’t like the way the fed government is treating them then they should vote liberal in 2010….oh, that’s right, their fed member is a liberal….I wonder why he didn’t do anything about their plight.”
45-60 minutes to alternative high-quality well-equipped services isn’t a drama, even got a choice of alternate services… *sheesh*, talk about spoiled!
GPs with a practice-nurse and after-hours service would be fine, pick up a locum or a registrar or two, for the tourist season. Along with the red-and-gold caps, whats your problem?
Another option, give the good Liberal folk some OTDs, the poor rural areas accept their share of Paki doctors with hard-to-understand English (but very impressive qualifications), with very good grace for the most part, and are grateful to have anybody who knows one end of a stethoscope from the other, and whether they vote Liberal or not.
If you save that one, the good folk of many areas across the whole continent who are 2, 4 and 5 hours, and more from a hospital of any description, and have seen their little 20-bedders close down over the years, (whether they voted Liberal or not) would probably be quite justified in crying unfair.
The problem with single seat per electorate systems is that if you live in a safe seat then your vote counts less because the major parties allocate most of their electoral persuasive power on seats that are likely to change hands.
So to make most votes count multi-member electorates with PR (or or whole of jurisdiction PR) are needed.
It is unacceptable that in our country a community of several thousand can be left without a hospital.
I don’t care who stuffed it or who is to blame. Just fix it.
Yes, it was a private hospital. But why did a succession of governments bludge on their responsibilities and not have a proper public health system in place? Instead the politicians blame the little private hospital when it loses money and can’t keep trading.
The new health minister then pretends to provide a sympatheric ear, refuses to help, but generously assists in facilitating the transfer of patients 50km away.
It stinks.
So much for ending the blame game and protecting the rights of rural communities to have access to a local hospital. If the federal government, a new labor government, can’t intervene here then when can they?
Maybe in a marginal seat closer to an election?
How much would it take each year to keep that unprofitable hospital going?
$2.5 million. The population is about 2,500.
Rain (#351) has cited the MRI (Magnetic Resonance Imaging) as an example of how government costs can blow out in the medical system.
I offer my families experience as evidence that the equations are not necessarily self evident.
By way of background I provide the following context. I am 51, my wife is 49 and, as we were both lucky enough to receive free tertiary education in the late 1970s, thanks to the initiatives of the Whitlam Government, we both have professional jobs and earn just over $100k gross combined a year.
We have always kept up private health insurance – even when on one income due to young kids and during periods of unemployment. Our two children are 17 and 12 years of age. We are fairly typical ‘tail end baby boomers’.
In late 2005 my wife had a single mastectomy, followed by radiation and chemotherapy during 2006, and a breast reconstruction in Dec. 2006. As her lymph nodes had been clear when removed at part of the mastectomy, and scans following treatment were clear, we were confident that all that could be done had been done, and were hopeful of a positive outcome. (Being ‘triple negative’ in terms of hormone responsiveness, Herceptin was not a treatment option in my wife’s case.)
Unfortunately, early this year my wife was diagnosed with secondary metastatic cancer in her bones – principally spine and hips. This is the classic manifestation for breast cancer. Further radiation treatment and a surgical procedure to strengthen one leg followed.
Through all of this we have been fortunate to be able to access timely services due to private health cover. The one exception to this is MRI scans.
As the radiation treatment did not appear to be ‘holding its own’, my wife went into hospital for tests and observation in the middle of the year. This included 2 MRI scans (as the spread is too great to cover with a single scan.)
Bloggers may recall the ‘scandal’ in the early 2000s of alleged leaked details of changed arrangements to funding of MRI and additional machines apparenty being brought into the country by the private system in advance of the changes. The political ‘solution’ to avoid ‘over-servicing’ was to not allocate medicare ‘item numbers’ to many machines in private hospitals.
Apparently the machine in the large western suburbs (Melb.) private hospital attached to the radiation oncology service my wife attends is one such machine.
As an ‘in-patient’:
* IF the machine had an item number, we would have received a rebate from our health fund and paid the difference ourselves – i.e. no cost to Medicare.
* WITHOUT an ‘Item Number’ we had to meet the full cost.
If my wife had been an ‘out-patient’:
* IF the machine had an ‘item number’, even if we had received no rebate, the cost would have at least been recognised for the $1,000 Medicare ‘Safety net’.
* WITHOUT an ‘item number’, not only did we have to pay the full cost – approx. $500 – but this cost was not recognised for the purposes of the ‘safety net’.
Notwithstanding my obvious personal bias, this situation seems ridiculous to me.
Where is the ‘downside’ in allocating an ‘item number’ for limited use of ‘private’ MRI services by patients with advanced cancer – but without Medicare rebate – on a ‘twice yearly basis’? This would at least ensure that those with private insurance would use the private machines, rather than extend the waiting lists for public machines.
This year we were able to afford to meet the full cost. Next year, by which time my wife will have resigned from work and we will be on a single income, we will not be able to afford the $500 and so will be in the queue for the public machine as a day patient, even though we have private insurance.
In the case of secondary breast cancer the average life expectancy is 3-4 years from diagnosis, less if the cancer has progressed to the organs. My wife’s oncologist states that the primary diagnostic tool is one question: “How are you feeling?” In that context, an MRI scan can identify in a timely way the extent of spread of the cancer (e.g. to organs) when the patient reports that they are feeling consistently poorly. The sooner the spread of cancer to organs is identified the sooner modified treatment can be commenced, quality of life maintained and life prolonged.
Surely an item number to allow those in our situation to obtain a rebate from private medical insurers at no cost to Medicare is not unreasonable. If it resulted in shortened waiting lists for public MRI machines, as I am certain it would, a net saving would result for the public system.
Our age group in many respects ‘fell through the gaps’ relative to the older baby boomers.
(While we did get free tertiary education we received no ‘first home buyers grants’ – fell between the old and new schemes – and paid for our house at 18%+ interest during the massive inflation of the Rodents period as Treasurer, prior to bank de-regulation. Likewise, we missed out on the various ‘baby bonuses’ of recent years, as well as the child tax incentives of the 1980s.)
We have pretty much ‘done it on our own, although I acknowledge that, in other respects, many of ‘genX’ have also had it tough.
All I am asking is that a service so many women in the 45 – 55 age cohort need to access is recognised with an ‘item number’, so that their families can receive whatever reimbursement that this would entitle them to from their health funds. Reimbursement that would come at a time when they both face many unavoidable costs and reduced income resulting from the same disease.
No doubt this item number would also be of use to those suffering other forms of cancer, which would similarly reduce the public waiting lists.
If the government propped up this private hospital what would stop other private hospitals asking for the same help and where would it end? Wouldn’t these private hospitals just become public hospitals if government money propped them up?
Some people take the point of view that governments purposely neglect the hospital system but what would be one sure way to get yourself as a government much kudos and re-elected the following election? By fixing the bloody the health system. Not one state or federal government has done so. Ever thought the task might just be too difficult or that the money needed is just too way out there? Of course you may have the answer, if so please tell the government, any government what it is.
Gary #366
In some communities some private hospitals compete with other public hospitals. We are not talking about assisting these private hospitals.
We are only referring to private hospitals where there are no public hospitals available.
In the case of PI the only hospital in town is a private hospital. Governments have saved a fortune over the years not providing public health services into this area. Rather they have bludged off the presence of the private hospital and not invested in public health as they should have.
Now that the private hospital can’t continue the government should be obliged to fill the void and provide health services to a significant population, regardless of the political persuasion of that population.
Rather the new health minister flicks the problem to the nearest health facility 50km away.
Sceptic,
Any chance you could explain why two Private Hospitals were forced to close in my town in the last six years?
We still have a public Base Hospital and a Mater, but due to financial considerations the other two closed.
Funnily enough, wasn’t that under a Coalition, Federal Government? I can’t remember any hugh and cry for Federal intervention in these closures or any offer by the Libs to help out to keep them running at considerable loss!
The new Labor Government seems to have to operate under different principles to it’s predecessor. I wonder why?
Much better for all concerned than 12 single member electorates.
currently 37 Victorian electorates.
11×3 member electorates + 33members (quota = 25%+1)
1×4 member electorate (based on Melbourne / C.B.D.?) (quota=20%+1)
All voters are winners – even the Greens in Melb.)
Polies mightn’t like it though!
How many private hospitals in Australia are in the same position as PI ie are not in a community where the private hospital competes with a public hospital?
Scorpio consider this you live on PI, the nearest public hospital is 50km away how would you feel if the only hospital close to you was being closed down because State and Federal Health Ministers were buck passing???
Forget private/public it’s bull butter and you know it, the fact is there is no public hospital on PI why isnt there why has the State government failed to provide one??? These people have no choice they dont care whether its a private or public hospital closing the fact is its their hospital and its closing because Roxon and the State Minister wont stop it!
Any reasonably sized rural area deserves a hospital whether public or private, this clap trap from Labor is just ideological IMHO.
These people will have no hospital within 50km of them!
The whole point of this end the blame game (non-core promise) was to stop this kind of buck passing!
gary bruce wrote: “If the government propped up this private hospital what would stop other private hospitals asking for the same help and where would it end? Wouldn’t these private hospitals just become public hospitals if government money propped them up?”
behold the perils of a govt. subsidised private health system. the market can look after itself. after years of diverting taxpayer money to shareholders pockets the private health industry should finally get its chance to prove howard and abbott right and show the hidden hand of the market can provide the best health care. the public system can spend the billions of dollars saved on infrastructure and allied health salaries. in tandem with the announcement of an ending of subsidies, holders of private health insurance should be mailed a pamphlet on how to start a class action lawsuit and directions to a local public hospital, just in case. 😉
So the answer to PI’s hospital problem is for a government to take it over? Would that be the answer to other private hospitals in a comparable situation?
glen wrotr: “Scorpio consider this you live on PI, the nearest public hospital is 50km away how would you feel if the only hospital close to you was being closed down because State and Federal Health Ministers were buck passing???”
oh oh! i know the answer to this one! is it blame a 3 week old labor government!? i mean the other lot were only around for 11 years, how could they or the local liberal member have known that the only hospital for 50km was on its last legs?
So we should have a policy of “no person shall live more than 50 kms from a hospital in Australia”
Cardster @ “On health care. I’ve never been a health professional, just humble statistician for Medicare/PBS”
Aww..wouldn’t say *humble*, somebody has to monitor the trends 🙂 A shitty job, but somebody has to do it *hugs*
I too am Canberran, and spent many visits to Canberra Hospital, with a family it tends to be one of those places that you end up at sooner or later, and more often than you might choose.
My own most recent visit in 2002, was a complete statistical outlier though.
Or thats what I keep telling myself.
Must have been a really bad month. I had a bad fall at home, broke ankle badly and tore the knee ligaments. Had to have the ankle surgically re-constructed.
Had no problem getting a bed, or into theatre, No ‘Access Block’,
but had big problems in staying in the bed –
also :
had bad reaction to general anaesthetic,
the old lady in the next bed with a broken arm was also a severe senile dementia case, (and a danger to herself, staff and other patients),
and a car accident victim with horrific multiple fractures was screaming in full body traction all night..
so, I was kicked out too early, cos of severe staff and bed shortages, had to steal a wheelchair to go find some crutches lying around.
8 days later rushed back at 4am on a freezing winter week night, emergency triage 1, wasn’t breathing too well, convulsing with shocking lower chest/upper abdominal pain (and a torn knee/broken ankle in a cast). I saw a silly 5th year med student or intern who suspected it was an ectopic pregnancy and wanted a full ob/gyn history between convulsions.
The more experienced nurse gritting her teeth at my next set of convulsions, found a more senior ED doctor, who took one look at the leg, asked about my surgery and sent for my previous case-file. As I blacked out, the last I heard was “Suspected PE”.
I woke up a little going into the mini-ICU with all the blinken-lights and beepy-beeps, and then imagining I’m Seven-of-Nine with Borg implants.
The morphine had kicked in… nice stuff that…
Multiple bilateral PE, must have been an interesting case, had all these arrogant consultants/specialists hovering for awhile there, (and when they found out where I worked, gave me a stern lecture on *what should be done* with Medical Indemnity), and then, they seriously considered sending me on HITH because they needed the bed?
and I had to argue with the hospital casemix coder that I was NOT a “new admission”, but an “unplanned readmission; complications arising from previous admission”,( I believe in accurate statistical coding *grin*).
but I ensured I was NOT discharged early that time, and got the full treatment including my first month supply of rat-poison, cool painkillers, physio, home-help and home-nursing followup, and full papers for my GP.
Who like all GPs, then spent most of the over-priced non-bulk-billed consult, complaining about all those incompetent hospital specialist doctors, and then got all huffy when I insisted the blood-testing should go to my preferred path lab, and not his.
But I still maintain it must have been an aberration on the stats.
Besides, it worked out in the end.
but if I never see the inside of that hospital again, It’ll be way too soon 🙂
377
gam – read the Constitution the States are responsible for Health!
Details of the meeting emerged yesterday as Ms O’Donoghue backed a push for a $1billion compensation fund to be established for the Stolen Generation, saying an apology without compensation “won’t settle anything”, while compensation would head off the potential for “a litany of court cases”.
It was endorsed yesterday by Ms O’Donoghue and alliance co-chair Christine King, who said it was “absolutely” appropriate to describe Australia’s child separation policies as cruel and evil.
“Aboriginal people will not move on until this matter is resolved,” Ms O’Donoghue said. Without compensation, the Government would be faced with “a litany of Trevorrows, a litany of court cases”.
What was ‘cruel’ and ‘evil’ were the living conditions of some of those aboriginal children back then, sure many were taken care of well but others werent.
In hindsight it wasn’t correct but back then people genuinely thought they were doing what was best for the children.
Thanks Prime Minister Rudd for saying ‘sorry’ for something we didnt do, you’re going to cost us 1b + or a litany of lawsuits…that money would be better spent on Aboriginal health and education and employment opportunities for young aboriginals IMHO.
glen 380: “gam – read the Constitution the States are responsible for Health!”
so that means the federal health minister is responsible for nothing? explains the last 11 years…
glen 381: “Thanks Prime Minister Rudd for saying ’sorry’ for something we didnt do, you’re going to cost us 1b + or a litany of lawsuits…”
why is doing the right thing so difficult for liberals? if i say sorry your grandmother died does it mean i killed her? also what on earth makes you think any compensation would be in the form of cash handouts? seriously, ever since your side of politics discovered indigenous australians existed a couple of months ago you think you know all there is to know about them don’t you?
Geeez…only a few weeks and it is obvious we are going to get three years of Glen slagging off at Labor on anything and everything, whining and whinging and nit picking on everything simply because they are Labor… meanwhile Howard’s 11 years of self serving rule, wasting Australia’s prosperity…well that was a good thing no doubt.
See you all in three years…when I turn the channel on again..no doubt like a cheap soap opera the same whining will be going on.
Thanks Prime Minister Rudd for saying ’sorry’ for something we didnt do.
Glen you can argue we won a war, get over it, but you can’t argue it didn’t happen.
That really is the Liberal parties problem at the moment, reality denial, it does get tiresome.
Thanks to the reasoned commentators in this thread for their input on the health issue (interspersed by the rabid barking of Glen).
It is obvious to me that we need to move to one level of administration for Health, and Federal seems to be the most logical choice. We have the medicare levy in place, so funding could be made transparent and adjustable to meet needs. The duplication in the system now must be wasting millions of dollars, coupled with the lack of uniformity across state boundaries. Memo to pollies “No more blame games please”
On further consideration, get rid of the States altogether!
Re: the PI private hospital
If it were my decision I would want to know a lot more about the PI hospital before I committed public funds as a bail out. The argument that Fed labor could win votes by bailing out a private hospital in a liberal seat is too cynical for me to contemplate. I am pleased to see that so far neither state nor federal governments have jump at that opportunity. The previous Fed government had plenty of time to address the issues relating to this matter yet they did nothing other than make promises during an election campaign.
I would insist that a full independent audit of the finances of the hospital take place. If it is found that it has been poorly run then that must be dealt with. If it is determined that with good management the hospital could operate soundly without a LARGE injection of public funds then I would offer support. Personally I think that a distance of 50k to the nearest hospital is reasonable. If every community of 2,500 were to receive their own hospital then I’d imagine the health budget would blow out completely.
I hope that both the state and federal governments continue to reject the call for some knee jerk intervention as, if they cave in, there could follow many other cries for cash from other private operators (who after all are in it to make a profit) across the country.
The more striking note of the article posted by Adam at 344
“ON the morning of Tuesday, September 4, at Phillip Street in Sydney, John Howard began to brief Alexander Downer on the terms necessary for him to quit the prime ministership in a few days.”
Since February bloggers have been speculating about how Howard would try and avoid personally facing defeat.
The most favoured option was an illnes for either Howard and/or Jannette forcing an early exit, undefeat from the battlefield.
This option was discounted by Howard, either did not want to tempt fate or could not trust any doctor to be in on the ruse.
After almost a year of throwing mud at Rudd, launching his aboriginal Tampa and tryiong the Haneef terror scare option Howard realised he was gone,as the article notes.
So, this quivering mass of jelly asked his party to dispatch him as he lacked the courage to fall on his own sword. Above all he wanted his reputation preserved. The article paints it as the party not prepared to risk Costello at such a late stage.
More likely those in the party were so repulsed by this act of self serving interest and lack of courage that that none were able to take up the sword.
I’m sure there have been similar instances in history where a general/ leader has asked his followers to dispatch him to save his reputation. Dpending on their reputation some have had their last wish fulfilled others have seen their troops turn away in disgust.
380 [gam – read the Constitution the States are responsible for Health!]
Glen, here is the constitution, which bit pins responsibility for health on the states?
“blame game”
n. In Australian politics, the term applied to the practice by federal and state governments of blaming each other for failures to meet public expectations, particularly in health sevices.
Of course it was inevitable that the first time Nicola Roxon decided not to give a handout to any hospital that wanted one she would be accused of breaking the “blame game” promise, however inappropriately the term applies. In the first place, I haven’t heard Roxon actually blame anyone for the closing of the PI hospital. She has simply declined to prop up a hospital that’s losing money. Secondly, there is no dispute between the federal and Victorian governments over the PI hospital.
It is likely that there will be many opportunities for “blame game” to be thrown back at Labor in the years ahead, but this isn’t one of them.
Glen, the constitution was changed in 1946 as follows:
“Originally the only Commonwealth health power was in quarantine matters. However, in 1946 the Constitution was amended to enable the Commonwealth to provide health benefits and services, without altering the powers of the States in this regard. Consequently the two levels of government have overlapping responsibilities in this field.
The Commonwealth currently has a leadership role in policy making and particularly in national issues like public health, research and national information management.”
# 367 –
Now the Victorian Liberals’ own internal reporting shows they “stand for nothing” (which I think to be rather true)? Is there a state Liberal party that is not in turmoil at the moment?
While some are saying this may be the end of the Nationals, they seem to be maintaining a level of grace in the face of the Liberals’ chaos. In fact, they have a great deal of respect in Victoria. I have strong memories of Peter Ryan (the Nationals’ leader) and his impassioned “Survivor Spring Street” speech at the last state election, where the Nationals actually went on to gain seats.
We have an hour break from study sessions here at the re-education camp. Was a very gruelling day yesterday, the Comrade Leader led us in a discussion about the Bali Conference.
We were asked to discuss the conference and Minister Wong’s role in it. It was very illuminating and educational. Initially I started with my reactionary pig-dog views that the conference was a classic UN junket with lots of hangers on and spivs who saw climate change as the next nuclear disarmament gig with lots and lots of trips and conferences and absolutely no real commitment to change anything.
After a very physical session followed by an intense self-criticism session in the workgroup I now see the error of my ways. Thank God we have Minister Wong selflessly giving of herself for all of us!
I am at peace now!
ESJ St Penny will become your guiding light. You can have the last laugh when she makes Swannie and Smith’s jobs effectively obsolete.
392 [I am at peace now!]
Well ESJ’ you could have knocked me over with a feather. Another miracle cure. I thought it took a year of re – education for every month spent in the groupthink of a conservative cult. Why do I remain sceptical that we won’t see you revert to the revolving door syndrome and finish up exactly where you started?
379 Rain- You are a bit of an aberration statistically. The incidence of PE post-knee reconstrustion is very low. The mortality from multiple bliateral PEs is very high and we are lucky to have you with us! (Watch out for venous leg ulcers in the future but otherwise you should be fine). A little birdie told me Canberra’s last Department Health CEO who is now SA’s Health CEO (with the sobriquet Napoleon) might be heading back to Canberra Federal Health. He would not be sadly missed here.
Re the PI hospital. The health of Victorians is managed by the Victorian Government according to the Australian Health Care Agreement between the Commonwealth and State of Victoria which I’ve linked. It states that the range of services provided by the PUBLIC hospitals must not be decreased, but does not cover private hospitals. The Feds and State of Vic are not obliged to take over a private hospital. I’m not saying that means they shouldn’t but they don’t have to. http://www.health.gov.au/internet/wcms/publishing.nsf/Content/B02C99D554742175CA256F18004FC7A6/$File/victoria.pdf
Re the Phillip Island hospital saga. Buckpassing is in evidence here but a bit of lateral thinking would sort it out. There is no need for a hospital providing the services that this private hospital has been for many years. It is an old fashioned concept which has outlived its usefulness in this age of emergency helicopters etc. PI has a small population and most residents can travel the 50 klms to Wonthaggi for routine treatment. Most emergencies could be handled by locating at least two ambulances on PI and calling in a choper when required. The Commonwealth should fund one of its ‘mega medical centres’ there to provide adequate 24 hour GP and some on-call specialist services. When the big motor racing events are held there, the organisers should, and do, make their own medical emergency arrangements.
Thanks Diogenes, I was very aware of the high mortality, confirmed by the fascinated stares and glares of the constant stream of med students, registrars etc following like acolytes in the wake of the revered consultants…look at scan on the light-box, look at patient, look at scan, look at patient…
Please dont wish Napoleon on us at federal level, we have enough problems with Janie-Grrl and her baggage-train.
I understand the PI hospital is a not-for-profit? Some of those, eg church-owned ones, are contracted by state health depts to provide public hospital services, but on an individual hospital contract basis. If the contract has expired, and the state has determined that its not cost-effective then the hospital is on its own.
Its quite right that the federal govt does not generally intervene in state decisions on how and where they provide services. The whole Mersey thing, was as much an attack on state rights as it was an attempt to buy votes in a key federal seat.
federal responsibilities are primarily in funding, and national leadership in hospital funding and clinical policy, eg assistance in national roll-outs of best practice in evidence-based medicine. Its meant to be 50/50 funding split between CW and States.
The argument about CW funding, is at its simplest – based on the bigger states always say they have more population, therefore they should get more.
The CW has always weighted the calculations on *need*, eg including weightings for rural services (which cost more because of access, transport issues), high rates of aged, or disadvantaged populations (low income ghettos, Indigenous communities etc), disabled and so on. eg, SA has that distinctive statistical *peak* in Elizabeth/Gawler popping up on the maps, Tasmania loses much of its healthiest, younger population to the mainland, and so on.
But, it is true that under the Howard/Costello leadership that both funding in *real* terms, and discussions in practice were dropped in reality.
Roxon was right when she said that in the last rounds of discussions, Abbott waited until just before the agreements expired, dropped a punitive arrangement on the table to the states and said “Take it or Leave it”.
Usually the AHCAs are a forum for reforms and roll-outs in clinical practice as well as management, eg improved integration and coordination of services with community health services (home nursing, mental health, mother and baby post-natal care, with aged care services.. etc etc etc) and of course the primary care sector with GPs — all in addition to the funding bucket.
That was the big thing that was also dropped under the Howard/Costello years, and something the states have been (rightly, in my view) very concerned about.
I see people on this blog continue to give credence to Glen by responding to his verbage.
Can I start another game please.
We all hide behind the anominity of “the blog” and I don’t suppose i am the only one who tries to guess who/what lies behind the pen name of some of the players.
Can we start with Glen– I visualise this of him
About 23 years old
A failed member of THE YOUNG LIBERALS– wanted to be President of that Group but only got his own vote
Studied dentistry at Uni for 2 years but found it too exciting
Moved on to study accounting but also found Auditing raised the blood pressure and adrenalin to unacceptable levels.
Yet to have his first real date but his mother lives in hope he will leave home one day.
Has pin ups in his bedroom of Margaret Thatcher,Bronwyn Bishop,Janette Howard and Amanda Vanstone ( almost forgot Sir Robert Menzies and The Rodent)
Life member of Hillsong
Developed his expertise in the art of aerial warfare and asociated technical knowledge by reading every volume of Biggles.
Pines for the GOOD OLD DAYS
Looks under his bed every night( immediately after prayers on his knees)– looked for REDS in the GOOD OLD DAYS but now fearful of BIG BURLY UNION OFFICIALS weaing firemens braces.
Secretly wishes he had been born differently or raised by others (heredity vs environment debate) so that he could be like most ordinary people and have a heart, compassion for his fellow man and vote Labor
Gus ‘Ouch’ I reckon for some fun you could do a few of the others!!
397 Rain- The new ACHA will be a huge test of the Rudd/Roxon Government. It is their big opportunity to help fix Health and it could make or break the longevity of the Rudd train. If Rudd can improve Health significantly and visibly, he can write his own ticket on almost anything else. Health is almost always first or second in the list of important issues to voters. But if Health continues to get worse, due to aging, expense etc he could have a real problem. When he said “The buck stops with me”, the Libs would have seen a huge opportunity. I thought it was the only time in the campaign Rudd took a leap of faith into the great unknown. On climate change, Slave Choices, tax cuts, defense etc he was on very steady ground.
PS: the problem with the last year of life, is that it can’t be predicted. Its only in the aftermath you can pinpoint that it really was the last year of life, like cancer victims mostly.
Chemotherapy, palliative care medicines, radiotherapy – are very costly, but with improvements in cancer diagnosis, management and treatments generally, more are living longer, or going into remission for longer periods, and hence costing more… the diagnosis of *terminal* is becoming more fuzzy.
And of course, patient expectations, we expect the system to “leave no stone unturned” on the possibility that this treatment may be the miracle for our loved ones. Same with some surgical techniques, really is it worth giving a 95-yr old their 4th hip-replacement? But Aussies do scream if you don’t do it…
This was the issue with herceptin for breast cancer, herceptin costs a freaking fortune, it works for *some*, but not for most, but Australians kick up a big stink if its just not free for everybody.
Same with pathology and diagnostics, patient expectations are that we must not leave any stone unturned, must all have every scan, blood test, MRI, CT, prod and poke, going, do you know how much MRI scanners cost? *shudder*
Adam @ 344
Thanks for the link to Professor Pompous’s article on El Rodente pissing down his leg.
I recommend to all “Poll Dancing” by Mungo. Funny, brilliant commentary on the year-long election campaign from the eternal Labor-voting pessimist and truly brilliant wordsmith.
On health care. I’ve never been a health professional, just humble statistician for Medicare/PBS.
I have had two instances of emergency care in my adult life. Both back related and I can only commend the Canberra Hospital and the Winchester (UK) Hospital for removing/reducing my misery. My complaint on both occasions was slight in the greater scheme of things was slight, but extremely blo*ody painful On both occasions I was struck by their professionalism and their caring nature.
Anyone who wants to have a “laugh” about political interference in the health system should read Chris Brookmyre’s satirical novel “Country of the Blind”
http://www.brookmyre.co.uk/book2.htm
I’m sure some Hospital Administrator’s have similar wishes to the baddie’s.
Sorry, the link should be to
http://www.brookmyre.co.uk/book1.htm
and to “QUITE UGLY ONE MORNING”
Red cordials are NOT condusive to cutting and pasting 🙁
Rain is completely right about the last year of life. Doctors NEVER use cost as an argument not to provide a treatment to an individual patient. The treatment may not be available due to cost, but once it is it’s open slather.
Rain- I’ve been reading that the problems of obesity is have been wildly exaggerated. Except for the morbidly obese and those with complications like diabetes and osteoarthritis, most overweight people do just fine from a morbidity and mortality point of view. Is this not true economically?
http://www.sciam.com/article.cfm?chanID=sa006&colID=1&articleID=000E5065-2345-128A-9E1583414B7F0000
I am being slack,can someone tell me the actual seats for the winners and seats for the jokes, in the house of Reps and Senate .
Turning Worm #350
Why don’t the Federal government take over the little local hospital? It would cost only $2.5 million and would put some substance behind the mantra of ending the “blame game”. Aren’t the people at PI entitled to a public hospital like everyone else? In fact aren’t they entitled to any hospital.
PI is also a very popular tourism centre. The motorcycle GP & the penguins are but two of the major attractions down there. I would have thought it was in the public interest to have a functioning hospital down there.
Yes Roxon is organising for people to be moved. To the nearest public facilities 50km away. Pretty tough on elderly relatives and those with limited transport. But thanks anyway.
An opportunity lost. She had the power to put into practice what she was spruiking in opposition. In the end it was just too difficult.
Good on her.
Diogenes – its more the long-term epidemiological adjustments on age-group, so exctraolating out 5,10, 15 years etc, and secondly lack of consistency on available clinical risk-assessment tools.
Thirdly, our economic models also go beyond just health system economics – but general economic markers, and include things like work-related illness (eg sick-days), workforce participation rates, injury, and mental health (eg depression)
Its going down the age-ranges, baby-boomers are generally very healthy, but health status is clearly dropping down each 10-year age group, down to the kids, Obesity is just one of the health ‘risk factors’ or ‘markers’ of poorer health status. More risk factors you have, up goes the probabilities, even on injury rates, days off work, depression etc.
Well if the good people of PI don’t like the way the fed government is treating them then they should vote liberal in 2010….oh, that’s right, their fed member is a liberal….I wonder why he didn’t do anything about their plight.
Steve K, this was a chance for Labor to win some votes by ‘ending the blame game’…the whole issue here is whether a moderate sized rural community deserve a functioning hospital regardless of whether it is public or private??
Roxon’s mantra of ending the blame game i guess was just a non-core policy….
Either Roxon doesnt understand her own policy or she is gutless…either way not a flash start as Health Minister.
Steve K it didn’t go belly up until now! The Brumby government could of done something but ideologically they decided not to and buck pass to Roxon who then buck passed back to Brumby.
This example of Labor in government wont win them any votes in PI i can tell you that.
Steve K Says: “Well if the good people of PI don’t like the way the fed government is treating them then they should vote liberal in 2010….oh, that’s right, their fed member is a liberal….I wonder why he didn’t do anything about their plight.”
45-60 minutes to alternative high-quality well-equipped services isn’t a drama, even got a choice of alternate services… *sheesh*, talk about spoiled!
GPs with a practice-nurse and after-hours service would be fine, pick up a locum or a registrar or two, for the tourist season. Along with the red-and-gold caps, whats your problem?
Another option, give the good Liberal folk some OTDs, the poor rural areas accept their share of Paki doctors with hard-to-understand English (but very impressive qualifications), with very good grace for the most part, and are grateful to have anybody who knows one end of a stethoscope from the other, and whether they vote Liberal or not.
If you save that one, the good folk of many areas across the whole continent who are 2, 4 and 5 hours, and more from a hospital of any description, and have seen their little 20-bedders close down over the years, (whether they voted Liberal or not) would probably be quite justified in crying unfair.
The problem with single seat per electorate systems is that if you live in a safe seat then your vote counts less because the major parties allocate most of their electoral persuasive power on seats that are likely to change hands.
So to make most votes count multi-member electorates with PR (or or whole of jurisdiction PR) are needed.
It is unacceptable that in our country a community of several thousand can be left without a hospital.
I don’t care who stuffed it or who is to blame. Just fix it.
Yes, it was a private hospital. But why did a succession of governments bludge on their responsibilities and not have a proper public health system in place? Instead the politicians blame the little private hospital when it loses money and can’t keep trading.
The new health minister then pretends to provide a sympatheric ear, refuses to help, but generously assists in facilitating the transfer of patients 50km away.
It stinks.
So much for ending the blame game and protecting the rights of rural communities to have access to a local hospital. If the federal government, a new labor government, can’t intervene here then when can they?
Maybe in a marginal seat closer to an election?
How much would it take each year to keep that unprofitable hospital going?
$2.5 million. The population is about 2,500.
Rain (#351) has cited the MRI (Magnetic Resonance Imaging) as an example of how government costs can blow out in the medical system.
I offer my families experience as evidence that the equations are not necessarily self evident.
By way of background I provide the following context. I am 51, my wife is 49 and, as we were both lucky enough to receive free tertiary education in the late 1970s, thanks to the initiatives of the Whitlam Government, we both have professional jobs and earn just over $100k gross combined a year.
We have always kept up private health insurance – even when on one income due to young kids and during periods of unemployment. Our two children are 17 and 12 years of age. We are fairly typical ‘tail end baby boomers’.
In late 2005 my wife had a single mastectomy, followed by radiation and chemotherapy during 2006, and a breast reconstruction in Dec. 2006. As her lymph nodes had been clear when removed at part of the mastectomy, and scans following treatment were clear, we were confident that all that could be done had been done, and were hopeful of a positive outcome. (Being ‘triple negative’ in terms of hormone responsiveness, Herceptin was not a treatment option in my wife’s case.)
Unfortunately, early this year my wife was diagnosed with secondary metastatic cancer in her bones – principally spine and hips. This is the classic manifestation for breast cancer. Further radiation treatment and a surgical procedure to strengthen one leg followed.
Through all of this we have been fortunate to be able to access timely services due to private health cover. The one exception to this is MRI scans.
As the radiation treatment did not appear to be ‘holding its own’, my wife went into hospital for tests and observation in the middle of the year. This included 2 MRI scans (as the spread is too great to cover with a single scan.)
Bloggers may recall the ‘scandal’ in the early 2000s of alleged leaked details of changed arrangements to funding of MRI and additional machines apparenty being brought into the country by the private system in advance of the changes. The political ‘solution’ to avoid ‘over-servicing’ was to not allocate medicare ‘item numbers’ to many machines in private hospitals.
Apparently the machine in the large western suburbs (Melb.) private hospital attached to the radiation oncology service my wife attends is one such machine.
As an ‘in-patient’:
* IF the machine had an item number, we would have received a rebate from our health fund and paid the difference ourselves – i.e. no cost to Medicare.
* WITHOUT an ‘Item Number’ we had to meet the full cost.
If my wife had been an ‘out-patient’:
* IF the machine had an ‘item number’, even if we had received no rebate, the cost would have at least been recognised for the $1,000 Medicare ‘Safety net’.
* WITHOUT an ‘item number’, not only did we have to pay the full cost – approx. $500 – but this cost was not recognised for the purposes of the ‘safety net’.
Notwithstanding my obvious personal bias, this situation seems ridiculous to me.
Where is the ‘downside’ in allocating an ‘item number’ for limited use of ‘private’ MRI services by patients with advanced cancer – but without Medicare rebate – on a ‘twice yearly basis’? This would at least ensure that those with private insurance would use the private machines, rather than extend the waiting lists for public machines.
This year we were able to afford to meet the full cost. Next year, by which time my wife will have resigned from work and we will be on a single income, we will not be able to afford the $500 and so will be in the queue for the public machine as a day patient, even though we have private insurance.
In the case of secondary breast cancer the average life expectancy is 3-4 years from diagnosis, less if the cancer has progressed to the organs. My wife’s oncologist states that the primary diagnostic tool is one question: “How are you feeling?” In that context, an MRI scan can identify in a timely way the extent of spread of the cancer (e.g. to organs) when the patient reports that they are feeling consistently poorly. The sooner the spread of cancer to organs is identified the sooner modified treatment can be commenced, quality of life maintained and life prolonged.
Surely an item number to allow those in our situation to obtain a rebate from private medical insurers at no cost to Medicare is not unreasonable. If it resulted in shortened waiting lists for public MRI machines, as I am certain it would, a net saving would result for the public system.
Our age group in many respects ‘fell through the gaps’ relative to the older baby boomers.
(While we did get free tertiary education we received no ‘first home buyers grants’ – fell between the old and new schemes – and paid for our house at 18%+ interest during the massive inflation of the Rodents period as Treasurer, prior to bank de-regulation. Likewise, we missed out on the various ‘baby bonuses’ of recent years, as well as the child tax incentives of the 1980s.)
We have pretty much ‘done it on our own, although I acknowledge that, in other respects, many of ‘genX’ have also had it tough.
All I am asking is that a service so many women in the 45 – 55 age cohort need to access is recognised with an ‘item number’, so that their families can receive whatever reimbursement that this would entitle them to from their health funds. Reimbursement that would come at a time when they both face many unavoidable costs and reduced income resulting from the same disease.
No doubt this item number would also be of use to those suffering other forms of cancer, which would similarly reduce the public waiting lists.
If the government propped up this private hospital what would stop other private hospitals asking for the same help and where would it end? Wouldn’t these private hospitals just become public hospitals if government money propped them up?
Libs stand for nothing: report
http://www.theage.com.au/news/national/libs-stand-for-nothing/2007/12/16/1197740090743.html
Some people take the point of view that governments purposely neglect the hospital system but what would be one sure way to get yourself as a government much kudos and re-elected the following election? By fixing the bloody the health system. Not one state or federal government has done so. Ever thought the task might just be too difficult or that the money needed is just too way out there? Of course you may have the answer, if so please tell the government, any government what it is.
Gary #366
In some communities some private hospitals compete with other public hospitals. We are not talking about assisting these private hospitals.
We are only referring to private hospitals where there are no public hospitals available.
In the case of PI the only hospital in town is a private hospital. Governments have saved a fortune over the years not providing public health services into this area. Rather they have bludged off the presence of the private hospital and not invested in public health as they should have.
Now that the private hospital can’t continue the government should be obliged to fill the void and provide health services to a significant population, regardless of the political persuasion of that population.
Rather the new health minister flicks the problem to the nearest health facility 50km away.
Sceptic,
Any chance you could explain why two Private Hospitals were forced to close in my town in the last six years?
We still have a public Base Hospital and a Mater, but due to financial considerations the other two closed.
Funnily enough, wasn’t that under a Coalition, Federal Government? I can’t remember any hugh and cry for Federal intervention in these closures or any offer by the Libs to help out to keep them running at considerable loss!
The new Labor Government seems to have to operate under different principles to it’s predecessor. I wonder why?
At least you’ve still got a hospital Scorpio.
The population of PI don’t have anything.
Tom the 1st @ #361
Totally agree.
Some examples:
1. Multi-Member Electorate: Wannon, Corangamite & Ballarat.
2. M-M E: Mallee, Bendigo & Murray,
3. M-M E: Indi, McEwen, Casey
4. M-M E: Gippsland, McMillan, LaTrobe
Still 12 members, but 3 to each of 4 electorates.
Much better for all concerned than 12 single member electorates.
currently 37 Victorian electorates.
11×3 member electorates + 33members (quota = 25%+1)
1×4 member electorate (based on Melbourne / C.B.D.?) (quota=20%+1)
All voters are winners – even the Greens in Melb.)
Polies mightn’t like it though!
How many private hospitals in Australia are in the same position as PI ie are not in a community where the private hospital competes with a public hospital?
Scorpio consider this you live on PI, the nearest public hospital is 50km away how would you feel if the only hospital close to you was being closed down because State and Federal Health Ministers were buck passing???
Forget private/public it’s bull butter and you know it, the fact is there is no public hospital on PI why isnt there why has the State government failed to provide one??? These people have no choice they dont care whether its a private or public hospital closing the fact is its their hospital and its closing because Roxon and the State Minister wont stop it!
Any reasonably sized rural area deserves a hospital whether public or private, this clap trap from Labor is just ideological IMHO.
These people will have no hospital within 50km of them!
The whole point of this end the blame game (non-core promise) was to stop this kind of buck passing!
gary bruce wrote: “If the government propped up this private hospital what would stop other private hospitals asking for the same help and where would it end? Wouldn’t these private hospitals just become public hospitals if government money propped them up?”
behold the perils of a govt. subsidised private health system. the market can look after itself. after years of diverting taxpayer money to shareholders pockets the private health industry should finally get its chance to prove howard and abbott right and show the hidden hand of the market can provide the best health care. the public system can spend the billions of dollars saved on infrastructure and allied health salaries. in tandem with the announcement of an ending of subsidies, holders of private health insurance should be mailed a pamphlet on how to start a class action lawsuit and directions to a local public hospital, just in case. 😉
So the answer to PI’s hospital problem is for a government to take it over? Would that be the answer to other private hospitals in a comparable situation?
glen wrotr: “Scorpio consider this you live on PI, the nearest public hospital is 50km away how would you feel if the only hospital close to you was being closed down because State and Federal Health Ministers were buck passing???”
oh oh! i know the answer to this one! is it blame a 3 week old labor government!? i mean the other lot were only around for 11 years, how could they or the local liberal member have known that the only hospital for 50km was on its last legs?
So we should have a policy of “no person shall live more than 50 kms from a hospital in Australia”
Cardster @ “On health care. I’ve never been a health professional, just humble statistician for Medicare/PBS”
Aww..wouldn’t say *humble*, somebody has to monitor the trends 🙂 A shitty job, but somebody has to do it *hugs*
I too am Canberran, and spent many visits to Canberra Hospital, with a family it tends to be one of those places that you end up at sooner or later, and more often than you might choose.
My own most recent visit in 2002, was a complete statistical outlier though.
Or thats what I keep telling myself.
Must have been a really bad month. I had a bad fall at home, broke ankle badly and tore the knee ligaments. Had to have the ankle surgically re-constructed.
Had no problem getting a bed, or into theatre, No ‘Access Block’,
but had big problems in staying in the bed –
also :
had bad reaction to general anaesthetic,
the old lady in the next bed with a broken arm was also a severe senile dementia case, (and a danger to herself, staff and other patients),
and a car accident victim with horrific multiple fractures was screaming in full body traction all night..
so, I was kicked out too early, cos of severe staff and bed shortages, had to steal a wheelchair to go find some crutches lying around.
8 days later rushed back at 4am on a freezing winter week night, emergency triage 1, wasn’t breathing too well, convulsing with shocking lower chest/upper abdominal pain (and a torn knee/broken ankle in a cast). I saw a silly 5th year med student or intern who suspected it was an ectopic pregnancy and wanted a full ob/gyn history between convulsions.
The more experienced nurse gritting her teeth at my next set of convulsions, found a more senior ED doctor, who took one look at the leg, asked about my surgery and sent for my previous case-file. As I blacked out, the last I heard was “Suspected PE”.
I woke up a little going into the mini-ICU with all the blinken-lights and beepy-beeps, and then imagining I’m Seven-of-Nine with Borg implants.
The morphine had kicked in… nice stuff that…
Multiple bilateral PE, must have been an interesting case, had all these arrogant consultants/specialists hovering for awhile there, (and when they found out where I worked, gave me a stern lecture on *what should be done* with Medical Indemnity), and then, they seriously considered sending me on HITH because they needed the bed?
and I had to argue with the hospital casemix coder that I was NOT a “new admission”, but an “unplanned readmission; complications arising from previous admission”,( I believe in accurate statistical coding *grin*).
but I ensured I was NOT discharged early that time, and got the full treatment including my first month supply of rat-poison, cool painkillers, physio, home-help and home-nursing followup, and full papers for my GP.
Who like all GPs, then spent most of the over-priced non-bulk-billed consult, complaining about all those incompetent hospital specialist doctors, and then got all huffy when I insisted the blood-testing should go to my preferred path lab, and not his.
But I still maintain it must have been an aberration on the stats.
Besides, it worked out in the end.
but if I never see the inside of that hospital again, It’ll be way too soon 🙂
377
gam – read the Constitution the States are responsible for Health!
Apology ‘must say removals were evil’
http://www.theaustralian.news.com.au/story/0,25197,22934597-601,00.html
Details of the meeting emerged yesterday as Ms O’Donoghue backed a push for a $1billion compensation fund to be established for the Stolen Generation, saying an apology without compensation “won’t settle anything”, while compensation would head off the potential for “a litany of court cases”.
It was endorsed yesterday by Ms O’Donoghue and alliance co-chair Christine King, who said it was “absolutely” appropriate to describe Australia’s child separation policies as cruel and evil.
“Aboriginal people will not move on until this matter is resolved,” Ms O’Donoghue said. Without compensation, the Government would be faced with “a litany of Trevorrows, a litany of court cases”.
What was ‘cruel’ and ‘evil’ were the living conditions of some of those aboriginal children back then, sure many were taken care of well but others werent.
In hindsight it wasn’t correct but back then people genuinely thought they were doing what was best for the children.
Thanks Prime Minister Rudd for saying ‘sorry’ for something we didnt do, you’re going to cost us 1b + or a litany of lawsuits…that money would be better spent on Aboriginal health and education and employment opportunities for young aboriginals IMHO.
glen 380: “gam – read the Constitution the States are responsible for Health!”
so that means the federal health minister is responsible for nothing? explains the last 11 years…
glen 381: “Thanks Prime Minister Rudd for saying ’sorry’ for something we didnt do, you’re going to cost us 1b + or a litany of lawsuits…”
why is doing the right thing so difficult for liberals? if i say sorry your grandmother died does it mean i killed her? also what on earth makes you think any compensation would be in the form of cash handouts? seriously, ever since your side of politics discovered indigenous australians existed a couple of months ago you think you know all there is to know about them don’t you?
Geeez…only a few weeks and it is obvious we are going to get three years of Glen slagging off at Labor on anything and everything, whining and whinging and nit picking on everything simply because they are Labor… meanwhile Howard’s 11 years of self serving rule, wasting Australia’s prosperity…well that was a good thing no doubt.
See you all in three years…when I turn the channel on again..no doubt like a cheap soap opera the same whining will be going on.
Glen you can argue we won a war, get over it, but you can’t argue it didn’t happen.
That really is the Liberal parties problem at the moment, reality denial, it does get tiresome.
Thanks to the reasoned commentators in this thread for their input on the health issue (interspersed by the rabid barking of Glen).
It is obvious to me that we need to move to one level of administration for Health, and Federal seems to be the most logical choice. We have the medicare levy in place, so funding could be made transparent and adjustable to meet needs. The duplication in the system now must be wasting millions of dollars, coupled with the lack of uniformity across state boundaries. Memo to pollies “No more blame games please”
On further consideration, get rid of the States altogether!
Re: the PI private hospital
If it were my decision I would want to know a lot more about the PI hospital before I committed public funds as a bail out. The argument that Fed labor could win votes by bailing out a private hospital in a liberal seat is too cynical for me to contemplate. I am pleased to see that so far neither state nor federal governments have jump at that opportunity. The previous Fed government had plenty of time to address the issues relating to this matter yet they did nothing other than make promises during an election campaign.
I would insist that a full independent audit of the finances of the hospital take place. If it is found that it has been poorly run then that must be dealt with. If it is determined that with good management the hospital could operate soundly without a LARGE injection of public funds then I would offer support. Personally I think that a distance of 50k to the nearest hospital is reasonable. If every community of 2,500 were to receive their own hospital then I’d imagine the health budget would blow out completely.
I hope that both the state and federal governments continue to reject the call for some knee jerk intervention as, if they cave in, there could follow many other cries for cash from other private operators (who after all are in it to make a profit) across the country.
The more striking note of the article posted by Adam at 344
http://www.theaustralian.news.com.au/story/0,25197,22926587-5013871,00.html
is how it highlights Howards cowardence.
“ON the morning of Tuesday, September 4, at Phillip Street in Sydney, John Howard began to brief Alexander Downer on the terms necessary for him to quit the prime ministership in a few days.”
Since February bloggers have been speculating about how Howard would try and avoid personally facing defeat.
The most favoured option was an illnes for either Howard and/or Jannette forcing an early exit, undefeat from the battlefield.
This option was discounted by Howard, either did not want to tempt fate or could not trust any doctor to be in on the ruse.
After almost a year of throwing mud at Rudd, launching his aboriginal Tampa and tryiong the Haneef terror scare option Howard realised he was gone,as the article notes.
So, this quivering mass of jelly asked his party to dispatch him as he lacked the courage to fall on his own sword. Above all he wanted his reputation preserved. The article paints it as the party not prepared to risk Costello at such a late stage.
More likely those in the party were so repulsed by this act of self serving interest and lack of courage that that none were able to take up the sword.
I’m sure there have been similar instances in history where a general/ leader has asked his followers to dispatch him to save his reputation. Dpending on their reputation some have had their last wish fulfilled others have seen their troops turn away in disgust.
380 [gam – read the Constitution the States are responsible for Health!]
Glen, here is the constitution, which bit pins responsibility for health on the states?
http://www.aph.gov.au/senate/general/constitution/
“blame game”
n. In Australian politics, the term applied to the practice by federal and state governments of blaming each other for failures to meet public expectations, particularly in health sevices.
Of course it was inevitable that the first time Nicola Roxon decided not to give a handout to any hospital that wanted one she would be accused of breaking the “blame game” promise, however inappropriately the term applies. In the first place, I haven’t heard Roxon actually blame anyone for the closing of the PI hospital. She has simply declined to prop up a hospital that’s losing money. Secondly, there is no dispute between the federal and Victorian governments over the PI hospital.
It is likely that there will be many opportunities for “blame game” to be thrown back at Labor in the years ahead, but this isn’t one of them.
Glen, the constitution was changed in 1946 as follows:
“Originally the only Commonwealth health power was in quarantine matters. However, in 1946 the Constitution was amended to enable the Commonwealth to provide health benefits and services, without altering the powers of the States in this regard. Consequently the two levels of government have overlapping responsibilities in this field.
The Commonwealth currently has a leadership role in policy making and particularly in national issues like public health, research and national information management.”
http://www.health.gov.au/internet/wcms/publishing.nsf/Content/healthsystem-overview-1-Introduction
# 367 –
Now the Victorian Liberals’ own internal reporting shows they “stand for nothing” (which I think to be rather true)? Is there a state Liberal party that is not in turmoil at the moment?
While some are saying this may be the end of the Nationals, they seem to be maintaining a level of grace in the face of the Liberals’ chaos. In fact, they have a great deal of respect in Victoria. I have strong memories of Peter Ryan (the Nationals’ leader) and his impassioned “Survivor Spring Street” speech at the last state election, where the Nationals actually went on to gain seats.
We have an hour break from study sessions here at the re-education camp. Was a very gruelling day yesterday, the Comrade Leader led us in a discussion about the Bali Conference.
We were asked to discuss the conference and Minister Wong’s role in it. It was very illuminating and educational. Initially I started with my reactionary pig-dog views that the conference was a classic UN junket with lots of hangers on and spivs who saw climate change as the next nuclear disarmament gig with lots and lots of trips and conferences and absolutely no real commitment to change anything.
After a very physical session followed by an intense self-criticism session in the workgroup I now see the error of my ways. Thank God we have Minister Wong selflessly giving of herself for all of us!
I am at peace now!
ESJ St Penny will become your guiding light. You can have the last laugh when she makes Swannie and Smith’s jobs effectively obsolete.
392 [I am at peace now!]
Well ESJ’ you could have knocked me over with a feather. Another miracle cure. I thought it took a year of re – education for every month spent in the groupthink of a conservative cult. Why do I remain sceptical that we won’t see you revert to the revolving door syndrome and finish up exactly where you started?
379 Rain- You are a bit of an aberration statistically. The incidence of PE post-knee reconstrustion is very low. The mortality from multiple bliateral PEs is very high and we are lucky to have you with us! (Watch out for venous leg ulcers in the future but otherwise you should be fine). A little birdie told me Canberra’s last Department Health CEO who is now SA’s Health CEO (with the sobriquet Napoleon) might be heading back to Canberra Federal Health. He would not be sadly missed here.
Re the PI hospital. The health of Victorians is managed by the Victorian Government according to the Australian Health Care Agreement between the Commonwealth and State of Victoria which I’ve linked. It states that the range of services provided by the PUBLIC hospitals must not be decreased, but does not cover private hospitals. The Feds and State of Vic are not obliged to take over a private hospital. I’m not saying that means they shouldn’t but they don’t have to.
http://www.health.gov.au/internet/wcms/publishing.nsf/Content/B02C99D554742175CA256F18004FC7A6/$File/victoria.pdf
Re the Phillip Island hospital saga. Buckpassing is in evidence here but a bit of lateral thinking would sort it out. There is no need for a hospital providing the services that this private hospital has been for many years. It is an old fashioned concept which has outlived its usefulness in this age of emergency helicopters etc. PI has a small population and most residents can travel the 50 klms to Wonthaggi for routine treatment. Most emergencies could be handled by locating at least two ambulances on PI and calling in a choper when required. The Commonwealth should fund one of its ‘mega medical centres’ there to provide adequate 24 hour GP and some on-call specialist services. When the big motor racing events are held there, the organisers should, and do, make their own medical emergency arrangements.
Thanks Diogenes, I was very aware of the high mortality, confirmed by the fascinated stares and glares of the constant stream of med students, registrars etc following like acolytes in the wake of the revered consultants…look at scan on the light-box, look at patient, look at scan, look at patient…
Please dont wish Napoleon on us at federal level, we have enough problems with Janie-Grrl and her baggage-train.
I understand the PI hospital is a not-for-profit? Some of those, eg church-owned ones, are contracted by state health depts to provide public hospital services, but on an individual hospital contract basis. If the contract has expired, and the state has determined that its not cost-effective then the hospital is on its own.
Its quite right that the federal govt does not generally intervene in state decisions on how and where they provide services. The whole Mersey thing, was as much an attack on state rights as it was an attempt to buy votes in a key federal seat.
federal responsibilities are primarily in funding, and national leadership in hospital funding and clinical policy, eg assistance in national roll-outs of best practice in evidence-based medicine. Its meant to be 50/50 funding split between CW and States.
The argument about CW funding, is at its simplest – based on the bigger states always say they have more population, therefore they should get more.
The CW has always weighted the calculations on *need*, eg including weightings for rural services (which cost more because of access, transport issues), high rates of aged, or disadvantaged populations (low income ghettos, Indigenous communities etc), disabled and so on. eg, SA has that distinctive statistical *peak* in Elizabeth/Gawler popping up on the maps, Tasmania loses much of its healthiest, younger population to the mainland, and so on.
But, it is true that under the Howard/Costello leadership that both funding in *real* terms, and discussions in practice were dropped in reality.
Roxon was right when she said that in the last rounds of discussions, Abbott waited until just before the agreements expired, dropped a punitive arrangement on the table to the states and said “Take it or Leave it”.
Usually the AHCAs are a forum for reforms and roll-outs in clinical practice as well as management, eg improved integration and coordination of services with community health services (home nursing, mental health, mother and baby post-natal care, with aged care services.. etc etc etc) and of course the primary care sector with GPs — all in addition to the funding bucket.
That was the big thing that was also dropped under the Howard/Costello years, and something the states have been (rightly, in my view) very concerned about.
I see people on this blog continue to give credence to Glen by responding to his verbage.
Can I start another game please.
We all hide behind the anominity of “the blog” and I don’t suppose i am the only one who tries to guess who/what lies behind the pen name of some of the players.
Can we start with Glen– I visualise this of him
About 23 years old
A failed member of THE YOUNG LIBERALS– wanted to be President of that Group but only got his own vote
Studied dentistry at Uni for 2 years but found it too exciting
Moved on to study accounting but also found Auditing raised the blood pressure and adrenalin to unacceptable levels.
Yet to have his first real date but his mother lives in hope he will leave home one day.
Has pin ups in his bedroom of Margaret Thatcher,Bronwyn Bishop,Janette Howard and Amanda Vanstone ( almost forgot Sir Robert Menzies and The Rodent)
Life member of Hillsong
Developed his expertise in the art of aerial warfare and asociated technical knowledge by reading every volume of Biggles.
Pines for the GOOD OLD DAYS
Looks under his bed every night( immediately after prayers on his knees)– looked for REDS in the GOOD OLD DAYS but now fearful of BIG BURLY UNION OFFICIALS weaing firemens braces.
Secretly wishes he had been born differently or raised by others (heredity vs environment debate) so that he could be like most ordinary people and have a heart, compassion for his fellow man and vote Labor
Gus ‘Ouch’ I reckon for some fun you could do a few of the others!!
397 Rain- The new ACHA will be a huge test of the Rudd/Roxon Government. It is their big opportunity to help fix Health and it could make or break the longevity of the Rudd train. If Rudd can improve Health significantly and visibly, he can write his own ticket on almost anything else. Health is almost always first or second in the list of important issues to voters. But if Health continues to get worse, due to aging, expense etc he could have a real problem. When he said “The buck stops with me”, the Libs would have seen a huge opportunity. I thought it was the only time in the campaign Rudd took a leap of faith into the great unknown. On climate change, Slave Choices, tax cuts, defense etc he was on very steady ground.