Extended Medicare safety net review report
These fee increases have resulted in considerable leakage of government benefits towards providers’ incomes, rather than reduced costs for patients. A conservative estimate is that, for every dollar spent on the EMSN in 2008, providers received 43 cents and patients received 57 cents. However, for Medicare services that are associated with high out-of-pocket costs (that is greater than $50), this estimate is as high as 78 cents for providers and 22 cents for patients. Services in this group include those associated with assisted reproductive technologies as well as procedures to treat varicose veins and vision impairments.
Sunday, May 31, 2009
Friday, May 29, 2009
Lou Irving talks sense
Lou Irving on ABC radio 27/5/09 gave three good reasons why all the effort is being put into trying to contain the imminent spread of the new H1N1.
1) Allows more chance of promoting basic health education re preventive behaviours.
2) It will be at least 3 months before a vaccine is available and the best outcome is to have the most people vaccinated before conditions for mass transmissions.
3) Slower infection rate allows health system to cope with increased load.
1) Allows more chance of promoting basic health education re preventive behaviours.
2) It will be at least 3 months before a vaccine is available and the best outcome is to have the most people vaccinated before conditions for mass transmissions.
3) Slower infection rate allows health system to cope with increased load.
Tuesday, May 26, 2009
Coughs and sneezes spread diseases
Virologist Alan Hampson stated on ABC TV's Stateline of May 22nd, "If there are people out there who are unwittingly spreading influenza, maybe because they have very low grade symptoms or no symptoms at all, then there’s no telling how many people they may have passed it on to in the interim." (transcript available at http://www.abc.net.au/stateline/vic/content/2006/s2578513.htm)
While perhaps technically correct, it is that kind of unqualified expert opinion that drives fears through the community. It conjures images of perfectly well people going about their ordinary business of the day, while mysteriously exuding highly infectious particles from every pore of their skin. It ignores the simple fact that respiratory infections are transmitted when people cough and sneeze, that is, while they most certainly do have symptoms, even if they do not want to be labelled as ill. The number of influenza viruses dispersed by an unguarded cough or sneeze is incomparably greater than any released by talking or laughing before symptoms are present.
Perhaps it is that kind of misinformation that underlies some of the anxiety surrounding issues of management at Clifton Hill Primary School. If parents have been told that the virus is highly contagious before symptoms erupt, as Tracie Winch ('Struck down by a bad case of bureaucracy', 24/5) wrote, "over a two-day period during the girl's potentially most infectious time", it's no wonder she was bemused by the different responses to her queries.
If parents have been given to believe that influenza is highly infectious in the interval of one or two days between the minute when transmission occurred and the beginning of symptoms, then it's no wonder they are frightened and confused. The propagation of untruths is a serious matter, especially in a setting where members of the community do not have a grasp of the basic scientific facts.
People may volunteer for prolonged isolation (quarantine) while they are not infectious, especially if they are scared out of their wits. But it is not 1347, the current wave of new influenza strains will not cause an outbreak of the Black Death, and most responsible members of the community will heed advice that is based on current knowledge.
The fact is that we do not take seriously our responsibilities to our fellows when we are coughing and sneezing. While blithely ignorant of the cause, we don't care where our secretions end up. We need always to be conscious of the potential for infecting others, not just when the vapours of Swine Flu are wafting through the air.
While perhaps technically correct, it is that kind of unqualified expert opinion that drives fears through the community. It conjures images of perfectly well people going about their ordinary business of the day, while mysteriously exuding highly infectious particles from every pore of their skin. It ignores the simple fact that respiratory infections are transmitted when people cough and sneeze, that is, while they most certainly do have symptoms, even if they do not want to be labelled as ill. The number of influenza viruses dispersed by an unguarded cough or sneeze is incomparably greater than any released by talking or laughing before symptoms are present.
Perhaps it is that kind of misinformation that underlies some of the anxiety surrounding issues of management at Clifton Hill Primary School. If parents have been told that the virus is highly contagious before symptoms erupt, as Tracie Winch ('Struck down by a bad case of bureaucracy', 24/5) wrote, "over a two-day period during the girl's potentially most infectious time", it's no wonder she was bemused by the different responses to her queries.
If parents have been given to believe that influenza is highly infectious in the interval of one or two days between the minute when transmission occurred and the beginning of symptoms, then it's no wonder they are frightened and confused. The propagation of untruths is a serious matter, especially in a setting where members of the community do not have a grasp of the basic scientific facts.
People may volunteer for prolonged isolation (quarantine) while they are not infectious, especially if they are scared out of their wits. But it is not 1347, the current wave of new influenza strains will not cause an outbreak of the Black Death, and most responsible members of the community will heed advice that is based on current knowledge.
The fact is that we do not take seriously our responsibilities to our fellows when we are coughing and sneezing. While blithely ignorant of the cause, we don't care where our secretions end up. We need always to be conscious of the potential for infecting others, not just when the vapours of Swine Flu are wafting through the air.
Thursday, May 14, 2009
Making a fat buck
From the newsletter:
The Role of Obesity Surgery in Diabetes Management
This is an opportunity for GPs to hear from a number of experts in obesity surgery: two world renowned professors from Victoria, experienced local bariatric surgeons and specialist physicians, together with diabetes educators conducting research in local divisions.
Date: Wednesday 27th May.
Time: 6:30pm Registration and refreshments; 7:00pm–9:00pm Presentations and Discussion.
Venue: Moonee Valley Racecourse, The Chairman’s Room, Level 4 of Main Grandstand, McPherson St, Moonee Ponds.
For enquiries and RSVP contact Collean Fahy at PivotWest on Tel. 9689 4566.
QA&CPD: 4 x Category 2 RACGP points.
The Role of Obesity Surgery in Diabetes Management
This is an opportunity for GPs to hear from a number of experts in obesity surgery: two world renowned professors from Victoria, experienced local bariatric surgeons and specialist physicians, together with diabetes educators conducting research in local divisions.
Date: Wednesday 27th May.
Time: 6:30pm Registration and refreshments; 7:00pm–9:00pm Presentations and Discussion.
Venue: Moonee Valley Racecourse, The Chairman’s Room, Level 4 of Main Grandstand, McPherson St, Moonee Ponds.
For enquiries and RSVP contact Collean Fahy at PivotWest on Tel. 9689 4566.
QA&CPD: 4 x Category 2 RACGP points.
Saturday, May 09, 2009
The world through the prism of The Age
Another half million or so refugees on the road, World trembles as Pakistan teeters.
The Age flogs the share-price of CSL-Merck, by boosting the power of the HPV vaccine to prevent genital warts. How long before we are told tax-payers have to pay to vaccinate 12yo boys?
The Age flogs the share-price of CSL-Merck, by boosting the power of the HPV vaccine to prevent genital warts. How long before we are told tax-payers have to pay to vaccinate 12yo boys?
Wednesday, May 06, 2009
O, Caroline.
Dare you
Well, I see it that she is rehearsing for a part in a little drama and we should be patient and wait for the curtain.
You see, Ms Roxon has heard how innocent people can pay their (tax-payer subsidised) private health insurance, and never having had to call on it until the knee finally gives out. They go into a private hospital, with the surgeon of their GP's choice, for a knee replacement. But it gets infected and she has to hobble round in a go-cart. However, it's not all bad news, because the private doctor and the private hospital and the private pharmacy all keep getting paid at top rates, for the extra length of stay, the extra procedures and the expensive antibiotics. But there's a gap to pay, there's always a gap. Ms Roxon is finding out what it's like to pay extra for a bad outcome.
Hmmm, maybe that's what she means, about paying doctors on their performance. I think the AMA is in for a good, old-fashioned hiding, and it's about time. But first, the highly ethical doctors will seek to blame the patients, the nurses, the ward cleaners, anybody else, rather than take responsibility for bad outcomes as well as reduced income.
It's Rosa Capolingua who'll be needing the little red golf-cart.
Here's a suggestion for anyone with the enthusiasm for investigative journalism, and the guts to stand up to the most powerful union in the land, go out and find out how much those bad procedural outcomes are costing the nation. Or, ask around your friends and relatives what they had to shell out for exorbitantly priced chemo drugs for their breast cancers. If Ms Roxon can beat down on the doctors and the pharmaceutical companies (O, Vioxx!) to get a fair go for women who have cancer, then she can ride around on a broomstick, for all I care.
Well, I see it that she is rehearsing for a part in a little drama and we should be patient and wait for the curtain.
You see, Ms Roxon has heard how innocent people can pay their (tax-payer subsidised) private health insurance, and never having had to call on it until the knee finally gives out. They go into a private hospital, with the surgeon of their GP's choice, for a knee replacement. But it gets infected and she has to hobble round in a go-cart. However, it's not all bad news, because the private doctor and the private hospital and the private pharmacy all keep getting paid at top rates, for the extra length of stay, the extra procedures and the expensive antibiotics. But there's a gap to pay, there's always a gap. Ms Roxon is finding out what it's like to pay extra for a bad outcome.
Hmmm, maybe that's what she means, about paying doctors on their performance. I think the AMA is in for a good, old-fashioned hiding, and it's about time. But first, the highly ethical doctors will seek to blame the patients, the nurses, the ward cleaners, anybody else, rather than take responsibility for bad outcomes as well as reduced income.
It's Rosa Capolingua who'll be needing the little red golf-cart.
Here's a suggestion for anyone with the enthusiasm for investigative journalism, and the guts to stand up to the most powerful union in the land, go out and find out how much those bad procedural outcomes are costing the nation. Or, ask around your friends and relatives what they had to shell out for exorbitantly priced chemo drugs for their breast cancers. If Ms Roxon can beat down on the doctors and the pharmaceutical companies (O, Vioxx!) to get a fair go for women who have cancer, then she can ride around on a broomstick, for all I care.
Sunday, May 03, 2009
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