Doctor and activist


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Tag: Politics

Power, Injury and Awards

26 November 2016 Power, Injury and Awards.  I work in medicine, treating mostly third party motor vehicle injuries and workers compensation injuries.  There are much fewer of the latter because there are less employees.  Many people working as couriers are ‘self employed’ contractors.  One man had to pay $75,000 for the right to deliver parcels […]

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Trump’s Win- why? 9/11/16

Here is my theory.  Basically democracy in English speaking countries has been taken over by private entities.  There are only two entities who can win power in the UK, USA and Australia.  They are called political parties.  They are not in the constitution, but because they vote as a bloc, they control the parliament.  Because they are private entities they do what their donors want.  Few citizens want privatisation, but the donors to the parties do- so we get privatisation.  Few want to go to war, but for some reason the parties do, so we go to war.  We want universal health cover- Medicare, but it gets rolled back and we have to buy private health insurance, which suits that lobby.  Unemployment is rising and the government fiddles the figures and no longer takes responsibility for the problem, it just talks about ‘the market’.  What the people think or want does not actually matter.  The parties continually put their interests and power ahead of what the people want.  The rich are getting richer, the poor are getting poorer and the political parties do not seem to care.  They get donations from the rich, and run campaigns to convince the poor to vote for them.

Faced with this situation and two political parties, people are accustomed to voting for the lesser of two evils, or making a protest vote, which is what they did.  Trump was anti ‘the system’, so although he was deeply flawed personally that was enough.  The Democrat Party machine had got rid of Sanders, the leftist challenger to the status quo, so it became status quo Clinton v. Non status quo Trump.  Then the polls got it totally wrong. How come?  Part of the same thing- the whole polling establishment obviously had a large segment of the population missing from their sample, but did not know it- like the government really.  So if some people did not vote for Clinton because they were disgusted and thought it would not matter, they were wrong.

But if the level of disgust in the process of government is enough to turn a US Presidential election, one must also wonder about the effect of the media.  For years, news has been replaced by infotainment.  What is important is replaced by what is titillating or exciting.  News is trivial, what is important is often not covered, particularly things like falling middle class jobs and stagnating wages.  The media is the message.  If you are not in the media, the message is that you do not matter.  But also note the rise of ignorance.   Quiz shows used to ask historic or scientific facts.  Now it is TV trivia.  And ‘shock jocks’ on commercial media are there to shock and to push products.  They do not have to be consistent or informed- just entertaining enough to rate and bring in advertising dollars.  So the non-expert, pontificating and criticising overcomes the expert discussing sensibly- how many of those are on TV?  The shock jock has become more important than the politician.  So why are we surprised when it now happens in real life?  The shock jock beat the politician.  And the pollsters got it wrong again- just like in Brexit.

What will happen with Trump in charge? He will destroy Obamacare, the relatively minor improvements made towards a universal health system, appoint Conservative Supreme Court judges and officials in public policy such as Climate Change, and boost gun ownership.  More significant changes to corporate power will take the approval of Congress and the House, now both Republican-controlled.  Obama was elected on the slogan, ’Change is possible’.  Obstruction by the Republicans ensured it was not.  Now Trump will try, but the same obstructers now have even more power and are not about to let one of their own damage their interests.  So Trump is unlikely to be a force for good unless he has unexpected foreign policy triumphs.

So what is the long-term solution to government ruling for the rich by buying political parties?  Democracy has to be taken back to the people.  The Parliament is controlled by parties and they are private entities and so can be bought by other private interests.  This has ever been the case in systems that evolved in Westminster.  It is Anglo-Saxon arrogance that makes us think that our democracy is best.  Quite simply, it isn’t. Our political power structures, like our corporate structures concentrate power at the top.  Swiss democracy involves power being moved down as low as possible with politicians merely enacting what public referenda decide, and with no opportunity for individual politicians to get long-term power structures assembled for themselves.  It is time we looked at these models and worked for constitutional change based on a real change of philosophies, priorities and power.

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Trump’s Win- Why?

9 November 2016 Here is my theory.  Basically democracy in English speaking countries has been taken over by private entities.  There are only two entities who can win power in the UK, USA and Australia.  They are called political parties.  They are not in the constitution, but because they vote as a bloc, they control […]

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Medicare- Did the Liberals try to abolish it? 21/6/16

This is a current question with Shorten claiming that the Liberals are trying to privatise it and Turnbull calling this a Labor lie. What is the truth? 

The answer is in the history of Medicare funding.  Medibank was set up by the Whitlam government and the bulk billing frees were set at 85% of the AMA ‘Most Common Fee’. The 15% was a discount but saved doctors a lot of costs and all their bad debts. They got slightly less, but the clerical and hassles saved by simply sending the paperwork, and later the computer message to the Medicare computer was felt to be a good deal.  But ever since then both major parties have not raised the Medicare same rate as inflation, in fact at about half the inflation rate.  This has resulted in the Medicare rebate being about half the AMA fees.  Specialists often will not see patients on Medicare unless they have a Health Care card, and GP practices simply cannot survive if all their patients are bulk billed.  GP practices have survived by having pathology companies rent a room where they collect bloods for a relatively high price. This has allowed the government to keep the GP Medicate rebates low. Recently the government tried to change the pathology rebates, and the companies resisted, but the treat was that the pathology companies would stop subsidising GP rental and a whole fuss would have erupted re the uneconomic nature of General Practice.  The government did not want this just before an election, so the pathology system was left as is.  But can we trust the Turnbull government? I don’t think so. A couple of other pointers:

The Emergency Departments (EDs) have recently been in the news as having a hugely increased workload and there was a request for funds, also recently seen as a question to Turnbull on Q&A.   EDs get busier if people do not go to GPs, who are far cheaper, and generally pick up problems earlier than EDs.  So the rise in ED use is likely to be a reflection of the lack of funding of GPs by Medicare.

There have been a lot of rather convoluted plans to deal with chronic illness. As the population ages, and as it gets problems with obesity and diabetes, there are more visits, more prevention is needed.  GPs are the cheapest medical intervention, so one might have expected that they would be the key element in the strategy to deal with it, perhaps supplemented by practice nurses or other slightly cheaper options based around GP-type community health centres.  But instead of this there was a bemoaning of the difficulties and lot of convoluted nonsense trying to avoid raising GP payments to a viable level.  It looked very like the object was not to find a solution to the problem, so that Private Heath insurers and the profit sector could get a look in at the problem and start to make some money.

Now we hear that there has been $5 million to look at outsourcing, just the payments part of Medicare.  Well Medicare is Just a payments system, so that is the guts of it. 

So it is very likely that the Libs want to privatise Medicare and take us to a US model of the health care. The public do not want this, but big business does, a powerful lobby in Canberra does, party political donors do, and the government can lessen the  amount it pays for health, even though the total cost will rise dramatically.

Labor also has historically a very bad record. They have allowed the Medicare rebate to fall with inflation, had a rebate ‘freeze’ of their own, and their only promise is to stop the freeze, which still leaves most doctors either unwilling in the case of specialists or unable in the case of GPs, to survive.

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