Doctor and activist


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Tag: Personal

Limits to the Market? A New Paradigm Needed!

15 May 2017

Since the last two world wars were over markets, it was assumed at the conference at Bretton Woods that if there were free markets everywhere there would be no wars and countries who did well would prosper. It worked.  Germany and Japan traded in markets that had been denied to them pre-war and ‘won the peace’. The dogma was that because there was efficiency in production we would all be better off as goods would be available all over the world quickly and cheaply. And, helped by the overwhelming dominance of Milton Friedman’s economic theories the market has spread into every aspect of life. The fact that when Friedman’s theories were actually implemented in South America that they failed miserably was merely a blip ignored. 

Now the market is assumed to be better than anything else as a way of allocating resources efficiently. It is better than government, better than planning, hey it is infallible, and probably inevitable as well!

Governments do not have to manage anything; they can sell it, even if they do not need the money. Inner city buses are the latest. 

If you read Chapter One of most economics books, it tells you about competition and how you cannot charge too much or a competitor will uncut you, so prices are kept down.

The rest of the economics book tells about monopolies or oligopolies, where there is poor competition and you can charge what you like, or there are high set up costs as barriers to competition, or regulatory hurdles, artificial training or registration requirements, geographical limitation, existing facilities, impractical duplication costs etc etc, which make monopoly or ‘supernormal’ profits a certainty.  Yet Governments plough on creating private monopolies and compliant political parties are rewarded by campaign funding to keep on winning elections.

What I am writing is not new or original and is known by anyone with even the most basic grasp of economic theory.  Do the politicians not read past Chapter One?  Do they never think that they are creating uncontrolled monopolies as they transfer assets from ownership by all the society to ownership by a moneyed elite?  Are they so ideologically committed to privatisation that they no longer think at all?  Do they not care, or will they do anything for their own short-term interest? It seems that the answer to all these questions is YES!

They have sold the airport, the sea port, the water supply (an endless subsidy to an unused desalination plant), the railways, the electricity, the road network and easements under it, the world standard database of land titles registration, the small councils power to control development, the list goes on and on.  The health system is being sold by stealth. Medicare is being starved to death, as private health insurance is just subsidised inefficiency, and NDIS disability services will go the same way, no government services, oligopolies for profit paid for by the ‘Medicare’ levy rise, which is not even committed to Medicare.  The education system no longer produces tradesmen to do the job and private education rip offs abound from dodgy day cares to non-Gonski funding to schools to post-TAFE colleges selling dubious certificates to phantom colleges ripping off visa-seeking migrant students.

The public service is being ‘hollowed out’. It no longer retains centres of expertise as it can always buy ‘consultants’ who carry briefcases and impressive CVs and have no interest except the public good.  It closes offices, hires short term workers, relies on PR driven websites and replaces people with knowledge by ‘Services NSW’ which has someone who might know which department might do what you might want.

Our existing political system seems unable to govern in our interest. The interest of the political parties no longer coincide with the public interest. Our governments’ decisions have been bought like everything else.  I do not think that money can be held at bay by electoral funding law reform. When we fought the tobacco industry, it sponsored sport and culture to get political allies. When that was banned, it sponsored ethnic groups, rescue boats and helicopters, any worthy cause that could lobby for it, and that was without gifts in kind, dodgy ‘foundations’ or other less visible influence-buying. 

The only answer that I can think of is Swiss-style democracy where major decisions are taken by referenda of the people, and Parliaments merely implement decisions that the people have made. Any other suggestions?

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My second Obeid story. 29/6/16

I was in NSW Parliament and an old school friend wanted to meet for old times, so we went down to the coffee shop at Sydney Hospital.  As we went in Grahame Richardson and Eddie Obeid were talking together. As we walked past Richo was facing me, Eddie had his back to us. I nodded at Richo and went past.  My friend and I had rather a long chat, but as we came back, Richo and Eddie were still there.  I nodded at Eddie.  Richo, (who is a very sociable guy whatever else he may be) said, ‘Hello Arthur’.  I was a bit surprised he even knew my name, but he is good at that sort of thing. I stopped, turned round and replied, ‘Hi Richo’.  Then a sense of devilment took me and I added, ‘What are you going to do about Beasley?’  Beasley was ALP leader at that time and was not doing very well in the polls, and some people wondered when he would be replaced.

‘We are going to replace him’ said Richo.

‘And who with? I asked.  (No harm in asking).

‘Rudd’, said Richo.

‘He’s not much chop is he? Bit of a Bible botherer?’ I replied.

‘Best we’ve got at the moment’, said Richo.

‘That may be,’ I said and toddled off.

Seven months later Rudd replaced Beasley, and the rest is history.

Richo is not a man to stab you in the back- he stabs in the front, presumably smiling and telling you it needs to be done.  Eddie was the NSW numbers man, which is why no one moved against him.  Carr and Egan kept him out of the ministry, but when Carr went, he came in. Things went bad, and eventually when things were very bad, compromise Premier Nathan Rees tried to clean up the NSW Labor party, and drop Tripodi, a mate of Eddie’s. He failed and was then thrown out.  Kristina Keneally became Premier, just before the election with a good new female image, but of course NSW Labor was not fixable or saleable by then, and Barry O’Farrell won in a landslide, only to lose office due to forgetting that he received a bottle of Penfold’s Grange Hermitage from the property developer today said to have called on Eddie.

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Eddie Obeid. My First Story. 28/6/16

When I first got into Parliament in 1998 Eddie offered me a lift to Parliament.  I accepted. It seemed harmless enough. He had a car with a driver and lived not far from me.  Then he offered to give me some advice about how to get on in Parliament. 

I said, ‘Fine, Go ahead’. There was no harm in listening.

He said, ‘Arthur you are in a very little party, but if you vote with the (then Labor) government, we will give you a little win just before the election and you will be re-elected’.

I said, ‘Well, Eddie, you might think we are a little party, but we have a lot of policies that are important and if you help those policies, I will vote for you and if you don’t I will vote against you. That is my job”. 

He said, ‘No Arthur, you do not understand, we are the government’. 

I said, ‘That does not really impress me, my job is to change the government’. 

He gave me a lift the next 2 times and we had virtually the same conversation. He would say, ‘Arthur, you are not really understanding,’ (meaning I was not voting the way he wanted).  ‘You are a very small party and we are the government and if you vote with us, just before the election we will give you a little win etc’..   So  on the 3rd recitation of this I wondered what a ‘little win’ might be. I had got into politics campaigning against tobacco and I knew that what was needed to save a lot of lives was smoke-free air everywhere, especially in the pubs and clubs that were the bastions of smoking, and a big health campaign against tobacco. ‘So I said, ‘Well, what I came onto parliament for was to fix the tobacco problem, you could fix that at no cost. It is just a ban, and the health campaign would pay for itself in hospital costs almost immediately.  That could be the ‘little win’ you talked about’. 

He said, ‘That is a very big thing. We could never do that’. I said, ‘Well I guess its no deal then’. He turned up the radio and we sat without talking as Ray Hadley rabbited on. 

I did not get a lift in the mornings, but I kept getting a lift with him for some time in the evenings when we finished late.  He was quite friendly and I used to meet him in his office. But one day he said to me, ‘Arthur I give you a lift home and you do not vote for us.’  There was no answer to this.  Could anyone think that a lift home should change a vote in Parliament?  Eddie obviously did.  I figured there were some people who did nothing for nothing.  After that I took a taxi voucher.  The taxpayer had to cop the extra price of an independent mind in Parliament.

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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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House of Welcome is a group that helps refugees.

19 June 2016

The House of Welcome had a fundraising dinner in North Sydney Community Centre tonight that I attended. Great food cooked by refugees in a variety of national recipes, with folk singing and dancing.

The House of Welcome started from people who were visiting detainees at Villawood Detention Centre and then became aware that they were being let out the gate with $10 and no benefits.  The continuing support evolved and they now have 26 properties and 96 people housed.  They feed a lot of people, trying to get food banks food with mainly ingredients so that the refugees can cook themselves.  They also help with CVs to get jobs and setting up small businesses selling crafts or food at fairs, or home careering for entertainment.

North Sydney Community Centre staff came in and helped free, and have done so for some years.  It is great and gutsy stuff, but I could not help thinking that in the 1950s, Australia took hundreds of thousands of post-war refugees and had programmes for them.  Now we have expensive deterrence programmes, and the arrivals have no welfare or Medicare.  The House of Welcome is doing a great job- I just wonder why the government is doing so little.  Australia should do better.

Donate at:

www.stfrancis.org.au/house-of-welcome/make-donation-house-welcome

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