Doctor and activist


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Tag: Accountability

CTP Insurers Pay 6.3% of Premiums to Injured People. They keep the rest.

28 May 2021

This is a huge corporate scam. Why do people think that only little people are rip-off scammers? Also the idea that most people claims are ‘accepted’ is a nonsense. Insurers accept the claim, which means that they pay for a few GP visits and some physio. But they refuse to pay for scans that might find diagnoses. Then they refuse to pay for referrals to specialists who might need to operate. Then they refuse to pay for recommended operations. Then they use tame doctors (IMEs = Independent Medical Examiners) who either say that the condition does not need the treatment or that the problem was there before the accident so the insurer is not liable.

So the government introduced the PIC (Personal Injury Commission) to arbitrate all the claims that the insurers had refused. Now the waiting time for the PIC is over a year, which suits the insurers fine as the doctors and patients will use Medicare or private heath insurance to get the treatments and the insurers will either pay less or not have to pay at all.

If you thought the banks were bad, you have not dealt with insurers. NRMA refuses a considerably higher percentage of treatments than anyone else in my statistics, and SIRA declines to keep statistics on the ‘industry’ as a whole, and no insurer has ever been prosecuted for refusing a treatment.

This is why we need Medicare- a single, just, efficient, universal health insurance scheme.

www.youtube.com/watch?v=Sp8R856f7cM

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NSW Politics- the Upper Hunter Farce Continues.

27 May 2021

I was going to write about the farce of the Upper Hunter by-Election, as there was plenty to say about that, so I will start there, but now there is more!

The first thing to say is that the National Party vote fell 2.8% to 31%, which is less than a third of primary votes, yet they claimed a victory!  They claimed that this was because they supported coal mining, yet a lot of farmers and those no directly depended non coal though that this was a bad idea, and it is not clear that this overblown endorsement  of coal is justified.  Labor lost 7.5% to get 21.2% and are now tearing themselves apart- see below for more.  The Shooters lost 10.1%, but this may because One Nation entered the race and got 12.3%. Independents did quite well with a total of 16.8%, with Kirsty O’Connell who was anti-coal being endorsed by Malcolm Turnbull and getting 8.8%. These are all primary votes, because almost two thirds of voters did not give preferences, being encouraged to ‘Just Vote 1’ which means that effectively the Primary vote will determine the outcome, creating a massive advantage to the major parties, which translates into a NSW gerrymander where the Major parties get a much higher percentage of the seat than they got of the primary votes.  It makes a farce of democracy .

Labor should have benefited from the fact that the by-election was rendered necessary by the incumbent Michael Johnsen being accused of raping a sex worker in Parliament House and denying it but still resigning!   But Labor looked very weak because it sits on the fence with coal mining, wanting the current coal miners vote, but also pretending to be the party of progress against climate change.  Their sitting on the fence which was disastrous in Queensland in the last Federal election was disastrous again.  They should have had a plan to transition out of coal with environmental jobs plan, but they seem incapable of such a strategy.  Arguably the State was punished for the Federal deficiency, but NSW State Labor has plenty of incompetence of its own. 

Labor, having lost in a by-election where they are supposed to increase their vote seems keen to do a lot of blood-letting.  After the years of domination by Obeid and the Right and a history of corruption and nepotism there is a very shallow talent pool.  The colourless Jodi Mckay seems to have had no impact on Gladys Berejeklian, despite scandals about sex and asset misallocation, and personal deliberate ignorance.  McKay had apparently cobbled together the numbers to survive, and people moved against her.  The plausible Chris Minns looked likely to be standing up, but John Barilaro, himself no stranger to questionable land deals in Queanbeyan, released a ‘dirt file’ to stop Minns’ ascent.  The file was called ‘Why Chris Minns and Jamie Clements can never run the NSW Labor Party’.  Jamie Clements was accused of sexual assault by a former staffer, and of taking improper donations from a Chinese property developer, Mr Huang.  Presumably there was also something in the file of substance about Minns also, as he resigned from Shadow Cabinet.  It might be noted that he was Shadow Transport Minister yet has not had his voice heard despite the fact that the Liberal strategy of funding underground freeways and selling them as monopolies to the private sector seems to have come from the Los Angeles town planners of the 1960s who recommended getting rid of trams to have private cars as the main means of transport, with a dash of Thatcherite privatisation thrown in. 

Labor’s corruption scandals have sapped their talent and seemingly discouraged good people.  Carmel Tebbutt, John Watkins and Graham West were very good people who resigned before they might have been expected to. 

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Amateur Hour in Management and Politics.

16 April 2016

When friends discuss why the world of politics seems to be going downhill, they mention that there seems to be no respect for knowledge any more.  Because information is so available it is not valued.  But this is not the key.  The problem seems to stem from two sources;

Firstly the two wars last century were over markets and at Bretton Woods at the end of WW2 the key to preventing wars thought to be free markets, where there would be unrestricted trade and countries could rise on fall on their relative advantages, or harder work.  The second item was the notion of neo-liberalism where the duty of a company was to make as much money as possible, with other objectives being looked after by someone else.  But as free trade progressed like a monopoly game multinational companies became more powerful than governments, so there was no one to stop the accumulation of wealth and power.  Power and wealth became the important items.  If you had these, clearly you would know what to do.

A number of small stories often give insights into changing priorities.  When I was at school and aged about 11 another boy, Geoff, went on a trip to the USA, a rare thing to do at that time.  We eagerly asked him what it was like over there.  He said, ‘Money just stands up and talks over there.  If you have money and you say something everybody listens’.  What he meant was that it was not because the rich person actually knew anything.

When I worked at Sydney Water, there were 17,000 employees and there was had a program to separate storm water and sewage in the pipes in the old part of Sydney, where they had all been the same.  There were employment programs for the long-term unemployed, disabled people and even ex-prisoners.  There were quality control units and a well-respected apprentice training school with about 220 people that produced plumbers, electricians and carpenters. The staff worked their way up the hierarchy so everyone knew their job and the tasks that they were supervising.  In the early 1980s these was a major change.  Sydney Water was reclassified as a State owned enterprise. It was to be ‘right sized’ which was the euphemism for downsized to about 3,000 people.  All functions not immediately necessary were stopped.  No pipe replacement programs, fix them when they burst. No apprentice training. No quality control- (has to be out-sourced). No printing. No computerised land mapping program (a world first, given to the Land Titles Office and later privatised) and the government was entitled to a ‘dividend’ from the enterprise which was about a billion dollars a year from all the salaries saved and work not done.  There was a game of musical chairs which went on for about a decade with new management structures, each with fewer places in it, where people repeatedly applied for jobs that had slightly different titles but which amounted to what they had done before.  But more than this there was incredible nepotism and people who knew about money or were politically favoured replaced those who knew about pipes and water.  Deskilling was on a massive scale. Then there was a project to look at salary relativities, which seemed to come to the conclusion that the salary should relate to how many people you managed.  Professionals were hard to fit into this framework, so it was opined that they should get less, but in order to get them at all, there had to be some consideration of what they were paid outside the organisation.  As a professional I was also high enough up the hierarchy to get ‘management training’.  It seemed that the key objective was to create a new culture in the organisation, and the main element in this was the destruction of the old culture, which was naturally assumed to be inferior to the new vision of the new management.   Workshops were held to define our objectives and visions. The silly old guard had thought that it was to provide water and take away the pooh.

This seems to be what has happened throughout the entire public service.  Lifetime employment has gone, and the gradual salary increments that made public servants content to work for less because they had lifetime security of employment and respect for the niche knowledge that they had developed. 

Now the two overwhelming values are power and money. They are assumed to go together.  Money buys political power, and political power gives control of large amounts of money.  So part of this new values hierarchy is the assumption that other values are lesser.  Public interest knowledge as stored in the public service, the Australian Bureau of Statistics or the research community are run down as the new breed of consultants rise. The consultants are chosen by their masters for their political or economic orientation and have to come up with solutions that fit with the views of their masters lest they not get their next job.  It is an incestuous and nepotistic system where ideology and opinion have displaced long-term experience and expertise.

Some years ago, as a NSW Democrat MP, I went to a YADS (Young Australian Democrats) conference in Canberra. The YADs were enthusiastic young people interested in politics, and some of them were lucky enough to work in Parliamentary offices.  On the Saturday they hospitably asked me to come to a party that they were attending.  I felt a bit old for the group, but they insisted.  It turned out that the Party was at a Liberal staffer’s house.  No one took much notice of the old guy in the corner sipping his beer, so I observed a group of very privileged young people telling stories of their exploits in the corridors of power. The striking part of the stories was the extent to which they were merely playing a chess game.  They were the goodies, Labor were the baddies and the whole discussion was about winning. There was no policy content at all. The issue was whether we won or not.  John Howard was Prime Minister and I was left with the overwhelming feeling that power was in the hands of those who had neither knowledge nor respect for the responsibility that they were carrying.

So I was interested to read this article by Jack Waterford, which traces the replacement of the public service by political staffers, ambitious non-experts with a lot of ideological baggage and little time for long-term expertise. 

The replacement of respect for knowledge with respect only for power and money may be the reason for the decline in decision-making in our political and management systems, and may yet be the cause of the decline of Anglo civilisation.

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Our Military

April 15 2021

If you ask soldiers to do totally unreasonable things, you should probably expect totally unreasonable things.

The Australian Commander, John Cantwell was of the opinion that the Afghan war could not be won, and every Australian life lost in Afghanistan was totally wasted. He was on the short list to be the supreme head of the Australian armed forces but he took himself off the list and retired in 2011 with PTSD and wrote ‘Exit Wounds- One Australian’s War on Terror’ in 2012. It is inconceivable that he did not tell the Australian hierarchy that the war was unwinnable prior to his resignation in 2011, which is 10 years ago.

To ask for ethical behaviour from the troops, when there is none at the top of the nation is hypocrisy writ large.

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Myanmar, What is likely?

14 April 2021

The Myanmar Generals are shooting their population, who at present continue protesting.  As I have written before on my visit to Myanmar in 2017-8 my observation was that the population have no time for the military, who were hanging onto power and had kept Aung San Suu Kyi as a figurehead without power or real democracy.  The military were socially isolated, but in a highly privileged world of their own.

The government has a capital 4 hours from Yangon and totally isolated  from the reality of the rest of Myanmar.

If the people are willing to be shot as they protest, we might ask where this will go.  Gandhi used passive resistance against the British, where the people just kept coming as the police beat them with batons. The strategy was to look for a changed response from those doing the beating.  I am unsure whether this will work in Myanmar.  Perhaps the military will just keep shooting. 

But if there is a national strike and the economy falters, what then? Will the Chinese step in and help?  For how long? Myanmar also has immense internal problems with ethnic armies fighting the central government. These are quite well armed, but have been confined to their own provinces.  Will they link with the people against the common enemy, the military junta?  Will the world take action?  Probably not militarily against a well-supplied army fighting for their own country- this might actually allow the government to get legitimacy against the foreign threat, and no country is likely to want to be in the front line.  The UN is unlikely to be able to act anyway with Russian and Chinese  arms sales and UN vetoes.

I fear that there will be immense bloodshed.  The question is whether change can be achieved. There is little doubt that the people want it and have waited a long time, so will be willing to sacrifice a lot. 

Here is Peter Hartcher’s opinion from the SMH of 13/4/21

Trump’s example playing out in Asia, the world has to intervene

The generals of Myanmar decided to follow Donald Trump’s example. Like Trump, they declared a free and fair election to be a fraud. Like Trump, they made an unconstitutional grab for power.

But where Trump was frustrated in his attempted coup, the generals of Myanmar were successful. Or so it seemed. There was a moment of quiet shock on February 1, when the army cancelled parliament and locked up the elected leaders including Aung San Suu Kyi.

Senior General Min Aung Hlaing announced a one-year state of emergency and installed himself as ruler. But resistance has built every day since. At first, it was demonstrations by students and young people, then the whole society seemed to join in. Truck drivers stopped delivering goods arriving at the ports. Workers went on strike, forcing banks to close. Civil servants stayed home, cutting government services. Doctors marched against the junta. The army restricted internet access to try to stop protesters organising.

The Myanmar military controls a multibillion-dollar business empire that funnels profits from jade, rubies, banking, oil and gas, construction and mining into the army’s pockets. These independent profits allow it to operate outside the structures of the state and to act with impunity.

So the resistance aims to shut down the economy as a way of curbing the army. It is starting to work. Myanmar’s economy thrived during its decade of democratic rule, growing at 6 per cent every year and doubling in size.

Now the World Bank expects it will shrink by 10 per cent this year. The financial information company Fitch Solutions says that “all areas of GDP by expenditure are set to collapse”, that a 20 per cent economic contraction this financial year is “conservative”.

And a second front against the army soon opened. The ethnic armies that once warred against the state had become largely inactive, but in the last few weeks the Karen and Kachin and the Shan and the Rakhine militias have joined forces with the civilian opposition. The ethnic armies are demanding that the military, known as the Tatmadaw, restore civilian government. And they are moving to take up arms.

“If the Kachin, Karen, Shan and maybe Rakhine insurgents were to engage in widespread military operations, however loosely co-ordinated, and at the same time there is an increase in violence in the heartlands, the Tatmadaw would face a huge problem,” according to Anthony Davis, a security analyst with Jane’s intelligence. He estimates the total strength of the ethnic armies at around 75,000 fighters.

Two fronts – the civilian opposition on one side and the ethnic armies on the other – is too many for the regime. Fearing exactly this, the Tatmadaw asked for negotiations with the ethnic armies. That was rejected. So the air force has started bombing them instead.

At the same time, the military has grown increasingly violent with the civilian protesters too. The army’s latest escalation came on Friday. It was bad enough that troops had been firing into crowds of peaceful protesters for weeks, worse that they’d started to order snipers to shoot unarmed civilians in the head.

But on Friday the army launched a dawn raid on a protest camp in the ancient capital of Bago, firing rocket-propelled grenades and machine guns at unarmed demonstrators. They killed at least 80 that morning, the biggest massacre in any one place since they launched their coup. The Tatmadaw has killed more than 600 civilians in total, according to a monitoring group.

The two resistance movements are in the process of formalising their alliance: “We are waiting on a daily basis for the announcement that a national unity government has been formed,” says Chris Sidoti, Australia’s former human rights commissioner and one of the three members of an international expert group calling itself the Special Advisory Council for Myanmar.

The “unity government” would include Aung San Suu Kyi’s National Democracy League and its elected members of parliament as well as civil society leaders and the ethnic armies.

“The military lacks legitimacy and it seems to be losing control,” observes the Australian federal Liberal MP and former diplomat Dave Sharma, who is convening a parliamentary sub-committee on foreign affairs and aid to discuss the crisis on Tuesday.

The UN’s special envoy to Myanmar, Christine Schraner Burgener, predicts a “bloodbath” unless there is some sort of intervention. The UN Security Council, however, is paralysed – vetoes by China and Russia prevent it from even condemning the coup, much less taking any action.

Sharma worries about a worst-case scenario: “If you have a protracted civil conflict it inevitably pulls in outside actors and you can have a situation where Myanmar becomes Syria in Asia,” as neighbouring countries take sides to protect their own interests. A failed state in the heart of Asia, in other words.

The conflict could spill across borders, driving big flows of refugees, as Sharma points out. “I think this problem is only going to get larger for Australia and the region. We will need to examine policy settings and co-ordinate with regional countries.”

There’s no evidence of any activity by the Minister for Foreign Affairs, Marise Payne – which is probably why it falls to Sharma, a mere backbencher, to try to stimulate debate, though he’s too polite to say so.

Sidoti has a list of policy ideas for Australia. One is to join the US and Britain in imposing sanctions on the Tatmadaw’s commercial empire. Another is to join the two-year-old genocide prosecution of the Tatmadaw in the International Court of Justice.

A third is to work with Thailand to make sure humanitarian help flows into Myanmar. Fourth is to work with ASEAN, which is having trouble bringing coordinated pressure to bear on the Tatmadaw, partly because ASEAN can only act with the agreement of all 10 of its members and Myanmar is one of them.

Who would represent the country at an ASEAN meeting? Australia could help break the impasse by convening a larger initiative to mediate with the regime, including some key ASEAN members plus the US, China, India, Timor-Leste and Japan, suggests Sidoti.

Finally, Canberra should stand ready to recognise a united national front as Myanmar’s legitimate government the moment it is announced. The coup attempt didn’t work for Trump, gratefully. The world has an opportunity to make sure it doesn’t work for Myanmar’s military either.

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A Look at the NDIS (National Disability Insurance System)

14 April 2021

The whole model of the NDIS is wrong. It is all about turning care into a commodity for private profit. The con was that the people with disabilities would have ‘choice’ and could buy services from a range of providers, who would compete to give great service. But there are big structural faults.

Firstly, big corporations want big profits, so this creates an overhead so there is less money available.

Secondly, people are assessed by ‘experts’ so how much money you get based on a single interview. They are not people who actually do the job and could allocate compare the needs of different people in an area. The assessors are an overhead- another layer of managers.

Thirdly, once the money is allocated, those who have it will be encouraged to spend it whether they need it or not. And of course, this will favour those who present well (usually the middle class) and totally disfavour those who did not get a ‘package’.

Fourthly, the ‘market’ model does not work. Those who need the services do not necessarily know who can give them what they need. They are vulnerable to sales pitches from a limited number of providers and they may not even know about other options. In some geographical areas there may be only one provider, so there is no competition anyway; the provider can set the price and the profit.

Finally, the government can just lessen the amount of money and packages available.

When I was in a Parliamentary Committee looking at disability, the first thing we tried to find out what how many people were disabled. No one had wanted to keep records.  People who had tried to get services from a provider and been knocked back because there were no places assumed that there would be a list there and if a place came up they would be offered it. Wrong. Usually there was no list, and a new person got the place if they happened to know someone or turn up at the right time. But at a broader level, experts we asked about how much disability there was either told us how many people were on various schemes and tallied these up, or looked at AIHW (Aust. Institute of Health and Welfare) figures, which said what percentage of the population had a disability and multiplied this by the population. The second method gave figures that were about 10x the people on benefits. So it was very obvious that if there was a supposedly universally available system the cost was going to blow out enormously because of the unrecognised demand.

The solution in my view was to have a universal support system that was community-based, like a district nurse model, and then ask the people actually doing the job, who needed more, and who could be helped to get their own home help from a number of people who would be registered in classes of carers. The government would then buy services in response to the needs identified and quantified by those doing the job. The essence of this was the empowerment of those actually doing the job. NDIS actually does the opposite. It is about the government shovelling money to the private sector with some middle ranking experts supposedly swooping in and saying how much money is needed. If they were embedded in the service delivery framework, they would be discussing needs and relative needs with those actually delivering services.  

But modern management and politics assumes it knows best and those at the bottom need to be ‘managed’, i.e. told what to do. My experience is that people doing a job usually know more about it than anyone else and the intelligent use of their expertise is the most solid base for management. My experience is also that putting people in charge who are there for the money rather than the job are unlikely to do a better job than those who are more concerned with the job than the money.

I put this in a paper to Kevin Rudd’s’ 2020 Vision’ in 2000, but never even got an acknowledgement. The NDIS, like the Aged Care Act of John Howard seems to have used ‘choice’ as a Trojan Horse for a market model and privatisation.  We need to start again.  This is just a suggestion of a better model, but given the power of money in politics I am not hopeful of change.

A new article in The Saturday Paper 10/4/21 looking at the cost blowout and blaming those who need the services has a depressingly familiar ring.  The blowout was eminently predictable and cost control by victim-blaming at the bottom is more likely than looking for corporate rip-offs at the top.  This is what I see every day in Workers Compensation and CTP insurance.

www.thesaturdaypaper.com.au/news/politics/2021/04/13/exclusive-documents-leaked-secretive-ndis-taskforce/161829180011445#mtr

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Politicisation of Vaccine Rollout has caused the Problems

13 April 2021

Scott Morrison’s objective was to have a low risk strategy. He got the States to handle the COVID19 crisis, while he merely took the credit for its success. Then he wanted to have a successful vaccination programme, and go quickly to an election. He announced a lot of vaccine deals, waving a chequebook with our money to put us high in the world’s vaccine queue. (Tough luck poorer countries with much more cases).

But the deals were soft, the Qld vaccine had problems with false positives for the HIV/Aids test, and it seems the Astra-Zeneca vaccine is not quite as effective as the others, and had a few side effects. So his loudly-touted intervention has just made him look ineffective.

The problems in the health system with the overlapping Federal/State responsibilities and cost-shifting, and the starving of Medicare with subsidies to the private system have all been swept under the carpet in the crisis. But the government’s new dynamic, which is to ignore good advice and treat everything as a political problem, with Morrison giving advice on every subject from weather forecasts, to fires to vaccines is part of the replacement of knowledge by politics, which is a problem in many areas.

Here is an analysis of this fiasco by Steven Duckett, one of Australia’s leading health economists.

https://theconversation.com/4-ways-australias-covid-vaccine-rollout-has-been-bungled-158225

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Vaccines and Probabilities

April 9 2021

Many years ago as I tried to tell sceptical people that smoking killed people, the research was all about the probability of smokers getting diseases more often than non-smokers.  People would often reply, ‘Lies, damn lies and statistics’ as if this was some sort of frightfully clever response that neutralised any sensible discussion.

Statistics have been used by researchers for years and are the basis of the experimental method to get towards scientific truth.  Things are rarely ‘proved’ in science, they are just rendered more and more likely, so that the probability of their not being true becomes infinitesimally small. 

Where there are number of variables the statistics become ever more complicated and the proofs more arguable.  Some of us get a bit lost as the complexity rises, and try to retreat to ‘common sense’, with is another way of saying what is most probable based on facts we are already sure of. 

The Astra-Zeneca vaccine has been pushed in Australia, and there is a world shortage of vaccines, despite Prime Minister Morrison running around with an open chequebook for a long time and boasting that we were at the front of the queue for was it 4 different ones ‘in development’?

The loss of the Uni of Qld. vaccine because it gave a false positive in the HIV/Aids test was a bad blow, given that it was ‘ours’ and the vaccine against cervical cancer had been so successful. 

As more and more countries expressed reservations about the A-Z vaccine, it was becoming harder and harder to stick to the line that they were panicking and there was nothing in the stories about blood clotting in dangerous body locations. 

Now A-Z  is not recommended for the under 50 age group, which is most of the country.  Presumably this means that because under-50s are less likely to die of COVID19 even if they get it, the risk of dying from a clot becomes more significant.  Obviously in Australia, if we can keep COVID isolated forever, we will not need a vaccine at all unless we want to venture overseas.  So we are looking at the probability of the virus escaping, and the probability of other vaccines being available as well as the chance of dying at whatever age we are with whatever existing medical problems we may have, versus the chance of having a bad reaction to the vaccine. 

I want to get vaccinated so I can go on an overseas holiday at last, but the A-Z vaccine may be less effective against new and dastardly strains, and if I take that risk will I be stuck in a hotel in Mongolia unable to fly home because the government has changed its policy on my vaccination status or the absolute numbers who can be quarantined?

It is very hard to answer all these questions for anyone, and when older patients who have clotting problems ask for advice, it is very hard to give them an answer.  Doctors will have to spend a lot of time on this.   Our practice is not vaccinating at all, the red tape scared us off, despite the fact that we had bought a new vaccine frig and have been vaccinating people for 40 years.  Call me a coward if you will.  But for myself, I do have an appointment to have the A-Z vaccine next week.

Here is the SMH article:

AstraZeneca blood clot cases force major vaccine shake-up; Pfizer now preferred for under-50s

By Rachel Clun

April 9, 2021

Pfizer is now the preferred vaccine for people aged under 50 and the timing of Australia’s rollout is in doubt after medical experts expressed concerns about rare blood clots potentially linked to the AstraZeneca vaccine – the mainstay of the country’s existing COVID-19 strategy.

Prime Minister Scott Morrison said on Thursday night the government will review Australia’s vaccine portfolio and accept medical advice that will preference the Pfizer vaccine over AstraZeneca’s in adults aged less than 50 years old who have not already received a first dose of AstraZeneca, putting plans to vaccinate the entire population by October in doubt.

Australia’s decision follows changes by European medical regulators after a review of data confirmed a rare blood clotting condition seen in a small number of patients was linked to the AstraZeneca vaccine.

Mr Morrison said the new advice from the Australian Technical Advisory Group on Immunisation was not a prohibition on the use of the AstraZeneca vaccine in people aged under 50.

“This is not a directive. This is not an instruction,” he said, noting they were taking “an abundance of caution” with the new advice. He said the impact of this decision on the timeline of the rollout was uncertain.

“Tomorrow, and over the weekend, there will be a recalibration of how the program will need to be adjusted to take into account decisions the government’s taken tonight to accept those recommendations from ATAGI,” he said on Thursday evening.

Chief Medical Officer Professor Paul Kelly said the rare but serious blood clot disorder was discussed in the meeting, taking into account what was decided overseas and looking at what that would look like in Australia.

“This is a rare event,” he said. “But it is serious and can cause an up to 25 per cent death rate when it occurs.”

For those over 50, Health Department secretary Professor Brendan Murphy said AstraZeneca was strongly recommended.

“It is a vaccine that is very, very effective,” he said.

ATAGI spent hours on Thursday considering the medical evidence. It then issued new advice on the AstraZeneca vaccine, which it provided to the government just after 7pm.

The medical experts made three recommendations, including that AstraZeneca was preferred in adults over 50, after a lengthy meeting. They also recommended adults under the age of 50 should only be given AstraZeneca where the benefits clearly outweighed the risks. Third, it recommended that adults under 50 who had already received their first doses without experiencing serious side effects could safely be given their second dose.

Professor Kelly stressed the data on the rare clotting side effect, venous thromboembolism, was still only preliminary.

Britain’s vaccine advisory committee says adults under 30 should be offered an alternative to AstraZeneca’s COVID-19 vaccine when possible, due to a very rare side effect of blood clots in the brain.

“There are very few cases of this extremely rare event that have happened anywhere in the world, but the ones we’ve seen, there’s definitely a tendency for the younger people [to develop it],” he said.

The UK regulator has decided to offer an alternative vaccine for those aged under 30.

Australia has purchased 20 million doses of the Pfizer vaccine and has been relying on the AstraZeneca vaccine as the workhorse of the rollout. The country is expecting its first deliveries of the Novavax vaccine, pending regulatory approval, some time in the fourth quarter of the year.

Late on Thursday, Australian pharma giant CSL said “it remains committed to meeting its contracted arrangements with the Australian government and AstraZeneca for locally produced AstraZeneca COVID-19 vaccines.”

AstraZeneca Australia added that it respected the decision outlined by the government.

“Regulatory agencies have reaffirmed the vaccine offers a high-level of protection against all severities of COVID-19 and that these benefits continue to far outweigh the risks.” a spokeswoman for the company said.

Earlier, the Prime Minister said the risk of severe side effects with the AstraZeneca vaccine is much lower than with common drugs including paracetamol and the oral contraceptive pill.

Mr Morrison said it was important to know the risk of developing venous thromboembolism was much lower following the AstraZeneca vaccine than the risk of death from COVID-19.

“Let’s note that in the UK, the advice is that some 6000 people’s lives have already been saved by this very vaccine. So we need to consider the positive benefits,” he said.

From UK data, the risk of venous thromboembolism following the vaccine was about one to five per million people.

“To put that in some sort of perspective, the combined oral contraceptive pill, that can include adverse side effects of venous thromboembolism – that’s seven to 10 per 10,000,” Mr Morrison said.

The advice has been shared with the expert medical panel, the Australian Health Protection Principal Committee, which comprises all state and territory chief health officers and led by federal Chief Medical Officer Professor Paul Kelly.

The matter will also be discussed in national cabinet on Friday and in meetings with state and territory health ministers, who were due to meet on Thursday night to discuss the revised advice and its implementation.

On Wednesday 75,880 doses of the Pfizer and AstraZeneca vaccines were administered across the country, Scott Morrison said, taking the national total to 996,214 doses administered so far during the rollout.

The states and territories have administered 509,802 doses. Through the federal government, 486,343 doses have been administered, including more than 125,260 through aged care.

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The IMF suggests taxing those who have benefited from the COVID pandemic.

4 April 2021

So I guess that would be the companies that had just a part of their organisation drop 30% in turnover for a short period, and then claimed for the whole company for a long time- the people mentioned in Michael West’s article yesterday. Here is the article below from the SMH today. And yes, it is the IMF, hardly a Leftie organisation suggesting this, though the Greens did also.

Tax those who prospered during pandemic to repair budget: IMF

Shane Wright, 4 April 2021

Sydney Morning Herald, Senior economics correspondent

The International Monetary Fund has urged nations to consider using the Abbott government’s temporary budget repair levy to overcome the huge deficits left by the coronavirus recession, warning deep cuts to spending could lead to political instability.

Amid predictions Australia’s budget deficit could be $50 billion less than feared, the IMF has also suggested taxes on “excess” profits such as the abandoned mining resource rent tax.

Governments around the world have all been forced to run huge deficits to deal with the COVID-19 outbreak, with collective deficits approaching 13 per cent of global GDP. Australia’s deficit, forecast to reach $197.9 billion this financial year, is close to 10 per cent of GDP.

The IMF, in its fiscal monitor report ahead of this week’s world economic outlook, said that while governments had been forced to run large deficits there had also been an increase in income and wealth inequality because of the pandemic.

It said governments faced difficult decisions on how to cover their large deficits while also not exacerbating inequality.

Among budget repair options, the IMF said those nations with “robust tax systems” could look to increase top personal income tax rates, similar to the budget repair levy put in place by the Abbott government in 2014.

“Temporary increases in personal income tax rates (often restricted to the highest income brackets) were previously introduced during exceptional circumstances in Germany, Australia and Japan,” it said.

The budget repair levy, which was a 2 per cent impost on people earning more than $180,000 a year, ran between 2014 and 2017, raising more than $3 billion to help reduce the budget deficit.

The IMF said another option was to tax so-called “economic rents” or super-profits, targeting those sectors that had done well during the pandemic.

“Taxes on ‘excess’ profits, either in addition to or instead of the regular corporate income tax, can assure a contribution from businesses that prosper during the crisis (such as some pharmaceutical and highly digitalised businesses) and not affect companies (and their workers) otherwise earning minimal profits or incurring losses,” it said.

The fund warned trying to repair budgets by cutting expenditure on services or support to those left behind by growing inequality could lead to substantial political problems.

The Morrison government has pledged not to increase taxes, as the Abbott government pledged ahead of the 2013 election.

Very high iron ore prices, strong GST returns and a better-thanexpected economy are already reducing the budget deficit.

Deutsche Bank economist Phil Odonaghoe said it was not inconceivable the deficit could be half of what had been predicted in the mid-year update.

He cautioned everything would have to go right for that to occur, which would result in a deficit of about $100 billion. Even that would still be a record budget shortfall.

Mr Odonaghoe said a deficit of about $150 billion was more likely, which would set up the budget for future years. “The better starting point in 2020-21 also means smaller deficits across the forward projection period. On our revised profile, the federal budget could conceivably return to balance by 2025-26,” he said.

ANZ economists Hayden Dimes and David Plank said the deficit would be as low as $155 billion because of the better expected economic conditions.

But they cautioned some of this improvement was due to GST receipts.

Due to the way the GST is refunded to the states and territories, the better revenue this financial year could end up a shortfall in 2021-22.

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