Friday, May 16, 2014

Smokin' Joe just doesn't get it

The Federal Budget announced on Tuesday night can be attacked on philosophical grounds - because it does target the weaker members of society and barely touches the privileged. But we can expect that - that is his party's ideological position.

More concerning is that the Treasurer fails to understand how what Keating used to call "the levers" work. His budget is based on an incompetent understanding of how decisions today affect the outcomes tomorrow.

This becomes clearest in his answer to a question without notice in the House on Thursday. In response to a question about the doctor visit fee Mr Hockey said, in part:

Labor has not yet said whether it supports the Medical Research Future Fund, because the only way the Medical Research Future Fund can be created is if there is a co-contribution when people go to visit the doctor. That is because every dollar of savings over the next six years in the health portfolio is going into the Medical Research Future Fund. It is the biggest medical research fund of its kind in the world.

Why we doing this? We are doing this because only through—cure and discovery are we going to ensure that the health system Australians want and deserve over the next 50 years is going to be delivered. That is, finding a cure for cancer, finding a cure for dementia and finding a cure for Alzheimer's, and the Labor Party does not support that. The member for Chifley says that they do not support the medical research that is going to find a cure for cancer, dementia or Alzheimer's. Why?

That is because the Labor Party has never, ever paid it forward. They have never invested for the future. They have never understood that if you really want to build something that is going to improve the quality of life of everyday Australians you have the start investing now.

Medical research doesn't always reduce the health care bill. While some research finds easy to implement cures, or procedures that dramatically reduce periods of hospitalisation, the bulk of them just create new ways to spend money.

The unpalatable truth is that medical research makes the Budget position worse every year. Australia's "ageing population" is not just because of the demographic bubble of the baby boomers - it is that the life expectancy of every Australian is increasing year by year.

The ageing population isn't as much of a challenge if it is a healthy ageing population, but it isn't. The consequence of the combination was highlighted in a recent article in the SMH that started:

Australia needs to rethink how it keeps sick, elderly people alive in hospitals and stop overtreating them at the end of their lives, the outgoing director of St Vincent's Hospital's Intensive Care Unit says.

Bob Wright, AM, a pioneer of intensive care medicine, said older patients are being treated more intensively and expensively than ever before and ''sometimes you wonder whether it's the right thing''.

Medical and legal experts have backed his call for greater discussion of the issue, warning that politicians and doctors are hamstrung by a system geared to save as many lives as possible. New figures show over 65s are the most expensive age group to treat in intensive care, costing more than complicated neonatal cases.

I am not arguing against investing in medical research, I am just saying The Treasurer is wrong to assert that investment in medical research improves the long term budget outlook.

The Treasurer also asserts that Labor never invested in the future at all.

That is also untrue. Firstly Labor invested in the National Broadband Network, and intentionally chose the technology that would meet our needs for broadband now and in the future.

Broadband can and will play a critical role in managing our healthcare and aged care costs in the future. The ABC's Nick Ross has put together a comprehensive list of studies that demonstrate the real and enduring savings that can be made to the Budget through telehealth.

Interestingly the Coalition's 40 page brochure on Infrastructure investment didn't mention communications infrastructure once - and unlike roads, health or education - it actually is a Federal constitutional responsibility. Opposition Leader Bill Shorten highlighted the absence of any reference to "digital infrastructure" in his budget reply.

Thankfully the Budget only reduced the Government equity contribution to NBN Co by less than one billion dollars (less than 3%). If NBN Co management take off their blinkers, look at the costs they identify in the redesigned FTTP scenario and recognise that they have been too pessimistic about revenue they might well use the technology agnostic approach to build an all FTTP network.

But the other thing that can reduce the burden of the health care budget  is an active investment in preventative health.  The Budget went in the other direction and abolished the Australian National Preventative Health Agency and terminated the National Partnership Agreement on Preventative Health.

When you really want to dig into the background of these types of decisions just realise that the people who benefit from the Government's health decisions are vendors - drug companies, medical equipment supplies and private health care providers like Ramsey Health. Good investigative journalists might like to look at which parties these companies contribute to - and whether they are members of the North Sydney Forum.

And Smokin' Joe Hockey needs to be reminded that real investment in the future was what Labor did - not his farce of a budget.

PS I also note that Feros healthcare has just been funded to extend a telehealth service initially trialled over the NBN. The extended service accepts the fact that the NBN is not complete but instead uses 3G and 4G networks. However the announcement also says the long term is still tablets connected using fixed line. This is one of the important but forgotten features of FTTP. A client can be given both the tablet AND a simple WiFi router preconfigured to plug into the second port of the NTD. The telehealth services are not dependent on what actual service the household is paying for, nor are they captive of the contention ratios in CVC and back haul.  

If the Coalition was taking eGovernment, and eServices, seriously they would understand that. 

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