Following on from the previous blog on primary health care... Secondary prevention is a smart and essential part of health care also.
Secondary prevention is about early detection, early treatment and effective long term management. It saves patients a great deal of money and suffering, not to mention saving them from premature death. Early detection occurs in part through education – the Cancer council has recently been running ads that encourage people to keep an eye out for suspicious signs.
Doctors surgeries have their walls covered with posters encouraging people to keep an eye on their weight (by looking at which hole on their belt buckle that they are using), and encouraging men in particular to have regular checks.
There are the screening services like those provided by Breastscreen, endoscopy procedures that look for early danger signs, and simpler and less invasive procedures like the blood pressure and blood sugar checks we should all have after the age of 50.
The reason why we have these education and screening services is that early detection means simpler, less expensive treatment and better outcomes. It helps us detect a problem before we experience symptoms (like bleeding, pain, or even lumps), which can be critical. And it helps us overcome our natural complacency… if we feel well, we assume there is nothing wrong, when sometimes there is. Screening gives us the peace of mind we are well, and just in case we aren’t it puts on the road to early treatment and recovery… keeping us well.
It promotes wellness, it keeps us happy and healthy, and it is relatively inexpensive. At the same time, it is the kind of service that governments can cut without people noticing too much. And sadly, that is what short sighted governments who focus on election cycle time frames do.
The Abbott/Turnbull government’s move to introduce GP co-payments undermines secondary health care because it discourages people going to the doctor early and getting screening done. The freezing of the Medicare rebate (slowly) undermines secondary health care in the same way. Limiting people’s access to affordable medications through undermining the PBS has the same effect. And even providing funding windows for specific and emerging health problems undermines long term secondary prevention. Because when the special funding runs out… the service stops, regardless of its effectiveness.
In contrast, the Green believe that secondary prevention is exactly where we need to invest our health dollars. Greens leader Dr Richard Di Natale has today announced a proposal to expand the cover Medicare provides for a significant and growing health problem for Australia in general and Townsville in particular … better treatment for diabetes. And of course, there are other emerging health risks which we need to address now… mental health, oral health, dementia and aged care.
The Greens have the major parties worried because they understand the issues that matter to most Australians and they have workable solutions.
But it is not just about spending, it is also about saving.
Medicare currently funds many procedures for which there is limited clinical evidence that they are best practice. Last year Four Corners highlighted many areas of waste in health funding.
You can watch that episode of Four Corners by clicking this link.
But despite that, the government has not sought to address wasteful spending, just to restrict access to health for people who can’t afford to pay.
The Greens support a great deal more spending on primary and secondary health care, and believe that in turn good health will be affordable for all. We also believe that good health for us all is tied to managing the health of both our built and our natural environment.
When we draw all those threads together... our nation and our citizens will prosper as a result.
by Wendy Tubman
The take home message from the recent budget was jobs and growth. We know this because Scott Morrison repeated this mantra 13 times in a 30 minute speech. He also repeated the word plan 21 times, as if to reinforce the idea that economic thought bubbles (like giving States taxing powers) were a thing of the past. And following the speech, Liberal MPs dutifully followed their talking points and repeated key words Ad Nauseum, without actually saying very much.
The only plan the government seems to have is to cut tax for small business and the wealthy, and, over the next 10 years, cut tax to bigger and bigger businesses.
But where is the evidence that this approach leads to more jobs?
And, setting aside for a moment the significant problems of advocating for never-ending growth on a resource-constrained planet, where is the evidence that it leads to growth?
Mike Seccombe pulls the ‘tax cuts leads to more jobs and growth’ approach apart in The Saturday Paper.
In 2012, the US Congressional Research Service looked at the effect of reducing income tax rates since 1945.
It found that, in 1945 the top marginal tax rate was 90% but by 2012 it was 35%, and stated: “Analysis of such data suggests the reduction in the top tax rates have had little association with saving, investment or productivity growth.”
It also found that “the top tax rate reductions appear to be associated with the increasing concentration of income at the top of the income distribution”.
The Research Service also found that the approach increased growth in inequality (an issue we touched on in a previous blog).
But what about the Australian experience?
Investment - Bureau of Statistics data show that, since 1960, private business investment in Australia has trended slowly down as a share of GDP. Before the late 1980s, corporate tax rates averaged well above 40%. Since then, have been progressively reduced to 30%. But there has been no increase in investment as a result.
Economic growth - Up to 1988, the economy grew, on average, by 3.8% a year. Following reductions in corporate tax rates, growth dropped to 3% and is currently forecast at 2.5%.
Employment and Wages - The data show unemployment rates were lower when corporate taxes were higher, and that, since company tax rates have been lowered, the share of GDP going to wages has declined.
This government has asked as a part of its re-election pitch… who do you trust on the economy?
A sane person certainly wouldn’t trust the Coalition, given the deterioration we have seen since they took charge.
I would suggest putting more faith in a Nobel prize-winning economist such as Joseph Stiglitz who says it is “Those at the top spend far less than those at the bottom, so that as money moves up, demand goes down.”
Numerous Coalition policies are shifting wealth towards the top… to those who won’t spend. It doesn’t take a rocket scientist (or a Nobel Prize winning economist) to tell you that their plans will have disastrous economic outcomes for most Australians.
It’s a recipe for more job losses, less growth, more inequality and social problems, growing deficits, and even more tax cuts for the wealthy.
Who can we trust on the economy… not Scott Morrison for one. And although you wouldn't know it if your only news was from the mainstream media... the Greens do have an economic plan.
by Wendy Tubman
Life is complex – socially as well as biologically.
The current, devastating, coral bleaching event Is primarily the result of ongoing warm seawater associated with the climate change happening around us. But climate change also increases the acidity of the ocean, another problem for the coral.
Then again, stresses like nutrient-rich run-off and coastal development, also decrease the extent to which the coral is able to cope with the warm water And the bleaching isn't just an issue for the coral itself but for everything that depends on it.
These dependents are not only fish and other sea creatures which depend on the coral reefs for food and protection, but also many groups of people, including commercial and recreational fishers and those who sell and consume fish, fishing rods and boats; the tens of thousands working in reef-related tourism; those who travel to the reef and experience transformative joy at seeing its beauty, and those who fly them there; those who research the coral looking for things with medical benefits; and those who live on the coast and depend (whether they know it or not) on the coral reef to protect the coastline from cyclones and tsunamis.
To make matters even more complex, the impacts of climate change stretch further than to the reefs around the world and the issues linked to that.
It is estimated that, as a result of the adverse effects of climate change, 400,000 people die every year
The Climate and Health Alliance in their latest report has described climate change as both the “defining health issue” and the “greatest global health threat” of the 21st century.
Worsening levels of health impose financial burdens on individuals, the community and the economy. For example, there are limited funds for health care and, as more funds need to be allocated to dealing with the direct fallout from climate change, less can be spent on the most efficient form of health care: preventative health.
Reduced health has productivity outcomes – from reduced output at work, to chronic illness and work absences, and on to early death, which means skill sets are lost forever.
Poor health also leads to poorer educational outcomes – for children as well as adults.
Lower levels of education not only mean reduced productivity, less innovation, and a reduction in high value work, it also leads to poorer health choices, which in turn mean poorer health outcomes.
As you can see, environmental outcomes affect economic outcomes, they affect health outcomes, which affect educational outcomes, which in turn affect economic and health outcomes. And as we live in the global village, this all has an effect on foreign affairs, and immigration.
Everything is co-dependent and interconnected. What this should mean is that policy frameworks are likewise interconnected. As we develop educational policy, we must have an eye to economic policy and health policy; as we develop health policy we should be mindful of how this might affect or be affected by environmental policy, education policy, economic policy, foreign policy. Etc, etc.
You get the picture... interconnectedness.
But does government policy take this into account? When the health minister announces policy changes (like the $7 co-payment) do they mention the impact this will have on workplace productivity, educational outcomes, or economic outcomes (outside of the direct savings they believe this change will drive).
They don't. Not just because they don't know (the modeling is never that robust) but because it hasn't been a consideration in the policy development process. Instead, policy has been developed by adhering to particular philosophies – like 'living within our means'; 'small government'; 'only doing for people what they can't do themselves'.
You hear the philosophies repeated again and again... which is symptomatic of the problem with the major parties.
The budget will be delivered soon. It will outline where the spending priorities lie. It will present all the expected benefits of addressing those priorities. But will it be a coherent statement that highlights the interconnectedness of our everyday lives?
It may, but the signs aren't good.
Ewen Jones appeared on Q&A on Monday. Ewen can be relied upon to repeat the governments talking points, push their key themes, and, at the same time, say as little as possible. On Monday Ewen was asked about youth unemployment and the future for North Queensland.
You can watch his answer by clicking on the video below
Basically... mining, coal, coal fired power, poles and wires, dams... if you build them the jobs will come (including for youth), and the country towns will thrive.
Very narrow. Possibly it represents where the government's thinking is. But don't take my word for it. Decide for yourself when the budget is released
by Wendy Tubman
We have been told for many years that the Coalition are better economic managers, without being provided with any evidence to support this bold claim.
Hindsight is a wonderful thing, and distance gives you the perspective and the ability to take a more dispassionate assessment of many things, but that is especially true of government performance. The Howard government is now far enough behind us to take a look at their economic record and that of the former Treasurer Peter Costello. And in recent months a great many experts and commentators have been doing this
According to Crispin Hull in the Canberra Times the structural deficit we currently have in the budget belongs wholly to Peter Costello and his hopeless performance as Treasurer. An excellent article by Mike Seccombe highlights the fact that a number of very wealthy Australians essentially pay no tax – surely that’s revenue problem (as well as a problem of equity). Mike also goes on to outline how many Howard-era policies shifted the tax burden from the big end of town to those at the bottom of the economic pile… the exact template Abbott spectacularly failed to implement in 2014.
Despite the assertions of Scott Morrison, our latest non-performing Coalition Treasurer, that the only problem we have is a spending problem, analysis by the ABC suggests we have a revenue problem also. And despite recent claims by the budget office that we do have a spending problem, Greg Jericho demonstrates things are more complex than that.
Howard himself was treasurer, appointed following the removal of Phillip Lynch for dodgy land deals while in the Fraser government. During this stint many consider Howard to have been inept. In 1982-83 Howard personally oversaw the worst recession since the Great Depression.
All damning stuff, and a long history of blunders and ineptitude.
In addition to all the poor report cards on so many Howard and Costello policies, it is worth looking at additional spending (the baby bonus) and revenue (fuel excise) initiatives.
The Baby bonus was largesse at the height of the mining boom, introduced by Costello, but poorly targeted and always completely unsustainable. It took a Labor government to pare it back and better target it to actual need rather than middle and upper class pork barrelling. The change introduced in 2013 by the Gillard government is projected to save $2.4B over 4 years. Given that the bonus was introduced in 2002, and based on these numbers the wastage as a result of poor Coalition policy and loose economic management around this issue alone is likely over $6B.
Fuel excise was cut and frozen in March 2001 – at a time (in an election year) when the Howard govt was deeply unpopular. As Bernard Keane explains it worked a treat politically by turning Howard’s political fortunes around, but has been something of an economic disaster. The Australia institute found that up to June 2015, this desperate move by Howard cost $46B in lost revenue. Keeping Howard and Costello in their jobs was very expensive for us all.
Malcolm Turnbull came to the top job by promising better economic leadership. At the time anyone looked better than Hockey and Abbott. Things moved slowly because everything was on the table and was being considered carefully by the government.
But that was a lie. Malcolm Turnbull had already decided to keep the baby bonus unchanged (in order to get the National’s support for his Coup) -this will cost $1.4B over the next 10 years.. Clearly a spending problem.
When negative gearing and superannuation entered the public conversation Turnbull insisted he wanted to have, Malcolm and the Coalition tried to shut it down by suggesting house prices would both rise and fall in the same 24 hour period as well as rents going through the roof. Economist Saul Eslake believes there is no evidence to support the claims of those running the scare campaign.
It seems yet again that the Coalition is willing to sacrifice economic improvement for political gain.
Further evidence of the Coalition’s economic credentials - there has in fact been a turnaround since the Coalition took charge of the Treasury benches. Australia has gone from the stand-out economy through the global financial crisis (GFC) to the worst performer in terms of growth trajectories among the world’s wealthiest nations, according to new OECD data from the last quarter of 2015.
The Turnbull government is currently sinking like a stone for many reasons – infighting and division, poor leadership and communication, a continued haphazard approach to government, and significantly… economic mismanagement.
But to be fair the Turnbull government is no different than the Abbott, Howard and Fraser governments… they were all terrible economic managers.
by Mark Enders
You know how the saying goes.
Today's post is a number of images from which you can draw your own conclusions
The Townsville Greens will publish blogs considered to be of merit. The opinions expressed are those of the Author.