Putting the charlie foxtrot that is Obamacare into perspective

Via Foxnews


This message came to us from Bill
in Kentucky. 


"Putting things in
perspective: March 21st 2010 to October 1 2013 is 3 years, 6 months, 10
days.  December 7, 1941 to May 8, 1945 is 3 years, 5 months, 1 day. 
What this means is that in the time we were attacked at Pearl Harbor to the day
Germany surrendered is not enough time for this progressive federal government
to build a working webpage.  Mobilization of millions, building tens of
thousands of tanks,  planes, jeeps, subs, cruisers, destroyers, torpedoes,
millions upon millions of guns, bombs, ammo, etc. Turning the tide in North
Africa,  Invading Italy, D-Day,  Battle of the Bulge, Race to Berlin
– all while we were also fighting the Japanese in the Pacific!!  And in
that amount of time – this administration can't build a working webpage."

In fact, Obamacare Exchange has
more lines of code than Apple’s OIS, Windows ZP, Facebook, Linus and Google
Chrome combined. 

Via Alex

Lines of code obamacare

Only one 6th of US GDP
is spent on Health Care, so what could
possibly go wrong with Obamacare



Follow Andy on Twitter

Andrew Bolt is right on drugs

TerpstraIn a follow-up to News Ltd columnist Andrew Bolt's recent article about drugs, Ben-Peter Terpstra presents his three-point plan to combat drug abuse. Many, if not most Australians will agree with both journalists, but not our authorities, it seems.

I don’t always agree with Andrew Bolt. But, when it comes to drugs, well, he does make a strong case for a get-tough approach. Or as the Herald Sun columnist clearly articulates, “The ‘war on drugs’ can’t be said to be lost just because some people still take them. It’s like saying laws against murder have failed because some people still kill.” 

I mean, what’s next? “Rape is a part of life, so legalise it”? 

Following the drugs-first libertarian argument, we’d end up with anarchy, including LSD for primary-school students.

Keep in mind too that celebrity twits openly talk about their personal drug use in Australia, meaning that our drug laws aren’t scary enough. 

So, here’s my novel plan:

First, enforce the laws we already have on the books. 

Second, introduce tougher sentences and enforce them, Singapore-style. 

Third, prepare to witness a big drop in crime. 

Of course, a real war on drugs has never been launched in my lifetime because our look-at-my-compassion elites feel it’s their duty to mother drug users, as opposed to their long-suffering victims. 

Notably, Bolt advances the argument that our self-styled experts on drugs aren’t being frank either: “When Hong Kong legalised opium, almost one-third of the Chinese on the colony were said to be users. When America gave up the much-rorted Prohibition, drinking rose, as did deaths by boozing, says the US National Bureau of Economic Research. Let the drug legalisers be frank. If we legalise drugs, more people are likely to use them.”

Moreover, it’s illogical to portray drug use as just a private liberty matter when so many drug users are sucking the life out of our social security. They, in my experience, often smell too.

And that’s the problem isn’t it? After all, many smelly drug-addicts are government-dependent citizens, with no real prospects because they have fried their brains.  

Perhaps, some junkies didn’t plan for this, but results speak louder than intentions. Indeed, when taxpayers are forced to pay for overcrowded public hospitals, it’s time to get tough. 

Remember: families have a right to safe roads, small businesses have a right to operate in safe streets and you have a right to be as safe as a Singaporean. 

Coming from a Dutch background, I suspect Bolt understands that appeasement has irreparably damaged Europe. I’ve witnessed it firsthand. Bolt isn’t anti-liberty. He’s just against drugs-first libertarianism.

Ben-Peter Terpstra contributes to many publications including MH and Quadrant.

His blog: B.P. Terpstra.


MUST READ: A Health Warning For Liberals

Medicine is pressured by a radical socialist transformation

Medicine is pressured by a radical socialist transformation. Some of this is top down. Much of it is bottom up, writes Dr Grant N Ross

2 years I was the Melbourne University Liberal Club’s token doctor.
Turning up late, or never, I would always be out of kilter with JSM,
political theories and fights of the day and somewhat under the
impression that Kroger was a kind of cheese. 
being a stereotype got me over the line.

would like to redeem my standing by attempting to write about the
direction of health under Labor and the alternative policy direction
the Liberal Party should choose when in Government.

feel that there is a need f
or a Liberal establishment to take note of
the direction of health under Roxon and Plibersek and to hear the
story I am about to tell about the pressures within medicine that
will come to change the way doctors do politics for the next 20
years. All is not well, and I want to tell you why.

we speak, Medicine is pressured by a radical socialist
of this is top down. Much of it is bottom up.

The Top Down 

the top down, there have been a series of reforms that:

  • Create
    a greater role for government in health

  • Are
    mostly anti-doctor

  • Occurred
    without significant consultation with the medical profession

  • Involved
    the creation of enormous layers of bureaucracy to centrally manage
    an existing private industry

  • Prioritised
    special interests and unions rather than the front line service

reforms include the creation of many different councils to
micromanage various health care aims instead of directly funding
practitioners; and by doing so orchestrate a transfer of power away
from practitioners and patients towards bureaucrats and their

quick list of the agencies and bureaucracies created by federal Labor
include the following:

  • Australian
    commission on safety and quality of healthcare

  • National
    Health performance authority

  • Independent
    Hospital Pricing Authority

  • The
    Administrator and funding body

  • Medicare

  • Australian
    Medical Locals Network

  • Australian
    national preventative health agency

  • Local
    Hospital Networks

  • Health
    Workforce Australia

  • Aged
    Care Reform Implementation Council

  • Mental
    Health Commission

  • Aged
    Care Financing Authority

are three cardinal reforms by Labor that have made things worse in
health; national registration, Prescribing and Medicare Locals.


2010 we have had the imposition of a massive tax on doctors by way of
a National Registration reform by Nicola Roxon.
Previously, doctors were registered to a state body but are now
registered to the Australian Health Practitioners Registration
Agency; a centralised national authority.

formed by Labor to ‘facilitate’ national registration, imposes a
$680 ‘Doctor Tax’ on doctors every year; much higher than
previously imposed. The agency’s role, it seems, is to run a police
check once a year, keep names on a register and then deal with a
doctor if they do something wrong by threatening or taking away the
legal right to practice Medicine.

most doctors agree on the need for professional regulation, nobody
accepted the AHPRA model being imposed in the face of a functioning
previous system.

is an overwhelming sentiment among the medical community that the
AHPRA reforms are decidedly anti-doctor. Firstly, they removed
semi-autonomy from the previous state based QUANGOs. Secondly, the
AHPRA came about against the wishes of the AMA and the medical
profession at large. Thirdly, doctors have to pay extraordinarily
higher registration fees. Fourthly, AHPRA lumps doctors together with
other health professionals in an overt breach of professional


Footnote I – The Health Practitioner Regulation National Law came into effect in 2010. Whilst it was a COAG agreement, AHPRA was a cornerstone commitment of Labor and driven largely by their political agenda and under mostly government influence.

is most worrying is that the registration reforms are a direct step
towards the complete Federal take over of health; via monopolising
the licensing of ALL health professionals in the country to one
federally controlled agency. This should be interpreted as a step
towards government socialisation of the entire health workforce. 

is quite sure what will happen in the future with AHPRA. I would look
at it as a dysfunctional way of registering doctors and a target for
reform under a Liberal government.

under Labor

Labor reforms have particularly offended the medical profession by
allowing nurses and other non-doctors to prescribe medications.
Prescribing has long been the privilege of the physician, a deeply
difficult and precise business and the Government have legislated for
non doctors to prescribe dangerous medications.

still do not agree with this. Below is an example of a lethal
medication that should not be given to people in a range of
circumstances ranging from addiction to intra cranial conditions that
is available from a nurse with no medical training. 


Footnote II – http://www.ahpra.gov.au accessed 6/11/2012
nobody would wish the loss of political capital by enabling more
practitioners to prescribe, a government should make a principled
stand on prescribing and give that right exclusivity to those who
lead the health system; doctors. Put simply, do not politicize
opiates; morphine is a drug, not an entitlement. We are all better
off without this gray zone.

Practice and the Medicare Locals

Locals are essentially the creation of large bureaucracies all across
Australia to control the delivery of General Practice services.
Marking the greatest shift of power away from the functioning private
sector to yet more bureaucrats, these organizations claim to
‘coordinate resources’, ‘identify gaps in access’ and other
nebulous imperatives.

are really about creating a centralized bureaucracy, more removed
from front line services, to control the allocation of General
Practice visits. Most of these agencies will be run by non-doctors
with political agendas. This
redirect front line funding.

most left leaning elitists and pundits would label a move against
Medicare Locals as ‘protectionism’ for doctors, it should be a
Liberal priority for several reasons.

for service, rather than centralized allocation, is the most
efficient form of funding for primary care. Doctors alone deliver the
vast majority of primary care via their minute to minute labor.
Direct funding is clearly superior.

reinforcing private practice builds trust within the medical
profession and empowers doctors to deliver good care for their

it builds on the only model that can safely deliver cost effective
health care in a flexible and dynamic way. There is pragmatism within
the medical profession that is unrivaled in history. Pragmatism
requires individual liberty. It is the antithesis of bureaucracy.

should be allowed to govern how they arrange their practice and the
market is the best way to ensure that each patient finds the doctor
they prefer. We all know that we would prefer to choose our doctor
when we need them; not when the government tells us.

have written about three big players in the health reform agenda of
the last 5 years. National Registration and the step towards
socialist health system, widening of prescribing rights and finally
the complete government takeover of General Practice. These are just
a few example of the top down socialist pressures on health that I
have noticed. 
they are not the most worrying change ahead of us.

for us, Peter Dutton, Shadow Minister for Health, has already
demonstrated his capacity for reform by pledging to scrap the
Medicare Locals and GP super clinics.

is an ex policemen, successful businessman, ex-Minister in the Howard
Government and assistant treasurer to the great Peter Costello. He is
clearly a man who understands health and has a distinct policy vision
to restore the health system to a position of strength, rather than
interference and bureaucratization. I believe he will be warmly
welcomed by the medical community and be one of the best advocates
for the restoration of a sensible health system.

The Bottom Up 


have spoken about some of the top down pressures in a socialist
direction on the health system. I would like to talk briefly about
some of the pressures from the bottom up, that only a doctor can see,
that are still pertinent to the Liberal agenda.

the fantasia reforms of the Roxon/Plibersek era are anything to lose
sleep over, they are nothing on the bottom up forces plaguing
medicine at a much more sinister level.

my entry into medicine as a first year student in 2006, the values
underpinning medicine have been rampantly veering towards the left.
The pressures mounting from the bottom, aka medical school
environments, are horrendously aligned with ALP and Greens stigmata.
For those who thought that foaming at the mouth socialism and
bureaucratic elitism were limited to the confines of the Arts
departments, you are wrong.

Medical schools themselves have pursued a long march style reform
into the medical degree; especially in the selection of candidates.
Traditionally, school leavers were selected based on ENTER/ATAR score
and the Undergraduate Medical Admissions Tests. No test is perfect,
but the principle was that admission was based on objective academic
capacity; with a view to selecting bright school leavers (whether
advantaged or otherwise).

principle cemented medicine as being about academic capacity,
something worth its salt in any market, rather than ‘social
equity’. This is the right way for things to be.

courses almost universally select via interview. You can dress up how
‘official’ and ‘standardized’ your interviews are, but they
remain the quintessence of subjective selection. That is the purpose
of interviews. They are effectively a mechanism to allow people to
form a personal opinion on a candidate. And exercise bias. 


a background of the inherent socialist tendencies of education at
both secondary and tertiary level, the reforms to selection have
outright enabled the medical schools to pursue a political agenda
that aims to expand the role of government in healthcare, involve
medicine into a nexus of government social equality agendas and
further the promotion of minority special interests to any particular
degree. This is the definition of long-marching.


results of these efforts are now coming to fruition. Medicine is
becoming overtaken by special interest group after special interest
group, all vying to dictate the rules of medical practice and
employment, values and principles in an ever growing mountain of
elitist control. The effects of this can be seen via organizations
such as the Australian Medical Students Association, the Post
Graduate Medical Council of Victoria and even the Medical Journal of
Australia and the Australian Medical Association; a nexus of
bureaucratic woe:


Footnote III – http://www.amsa.org.au

organizations are replete with bureaucratic choke holds and
indecisive post modern ‘collaboration tactics. The result,
obviously, is what we have seen under Kevin Rudd: Power from the
people to their overlords in an ever growing unholy alliance of
bureaucrats, red tape and pathetic backyard politicians who would
rather do anything to promote themselves rather than a good idea. It
promotes ‘sellout politics’ and betrays the individuals who
together make medicine what it is and what gives individuals the
right to be free in this country. 
long as this framework persists, doctors will be worse off and
patients will be worse off. 

the moment, the AMA can be proud of the leadership it has had.
Brendan Nelson went on to become Liberal Party Leader. Rosanna
Capolingua was clearly Liberal, Michael Wooldridge kept General
Practice sustainable and independent. Steve Hambleton, current AMA
leader, stands for sensible restraint and genuinely aims to protect
autonomy for doctors. We have been lucky. But I am not so sure about
our future. Just look at what the ever growing Australian Medical
Association calls for on Climate Change:


Footnote IV – http://www.amsa.org.au/press-release/20120703-amsa-calls-for-leadership-on-climate-change/
  • Australian
    Medical Student Association


    Footnote V – Australian Medical Students 2010 Policy Document Climate Change and Health see website http://www.amsa.org.au
  • The
    Australian Medical Association’s is little better than the student
    body in this regard:

Footnote VI – http://ama.com.au/node/4442

think I have made my case. 
anybody in the Coalition did have a silver bullet to stop the long
march, they’d immediately be preselected for a golden safe seat. I
am not that man.

if we were to theoretically look at reversing the political bias
pressuring medicine in Australia, I would start with reforms that
target medical selection, medical training, the de-bureaucratisation
of medical registration at the junior level and aim to move the
governance of medical training away from University bureaucrats and
elitist back to grassroots doctor groups.

would help. 
is an argument for such change on the basis that it restores
efficiency and principles of autonomy to the medical profession and
by extension of that, to patients. It would be one hell of an effort,
but I honestly do not believe it to be beyond an Abbott government to
achieve in some capacity.

other issues are perennial for Liberals; especially for those of us
who have campaigned on campus. The fight against bureaucrats, against
elitists and to genuinely reform education in this country in the way
that David Cameron is trying in England. Perhaps some of the above
changes could be caught up in a commission of audit. I would like to
see that. But I don’t know. I am not a politician.


a doctor, I naturally bring more of a background of social sciences
and welfare to the Liberal table than I do tax reform and economics.

However, there is a need for a Liberal establishment to take note of
the direction of health reform that the Roxon and Plibersek ministry
has imposed on health and a need to identify them as inefficient,
retrograde, centralist and to be removed as needed. Equally important
is the message I would like to impart about the need to think about
what is needed to prevent the medical establishment being long
marched into foot soldiers for the ALP.

remember, health accounts for 12-17% of spending and employs 11% of
all Australians. That is one hell of a voter base to lose to the

Dutton has a lot to contribute to health in the next Liberal
Government. Autonomy, efficiency and restraint will serve our country
well. Similarly, I encourage young Liberals in rising positions of
leadership to consider the principles of a sound health system as
they develop their policy directions.

The electorate expect a good
health system and we have no excuse for leaving ourselves weak on
this front from a simple lack of knowledge.

Grant N Ross MBBS B.Med Sci is a medical practitioner and graduate of
Melbourne University.



I – The Health Practitioner Regulation National Law came into effect
in 2010. Whilst it was a COAG agreement, AHPRA was a cornerstone
commitment of Labor and driven largely by their political agenda and
under mostly government influence.

II –

see About AMSA accessed 6/11/2012

IV –

V – Australian Medical Students 2010 Policy Document Climate Change
and Health see website

VI –

Teen Cannabis Use Lowers IQ, Despite Claims to Contrary

If ever you stumble upon a radio talkback discussion on the effects of pot smoking tune in, it's marvellous comedy. It's like honey to long-term potheads who go on air to extol the virtues of smoking dope.

The announcer: Welcome Fred and how long have you been smoking dope?

Fred: Hey man, like, er, how long was what man – what was the question?

Announcer: Do you think cannabis effects your brain?

Fred: Hey man, I've been toking daily, sometimes all day, for 40 years man, and to tell you the truth, my brain is sharper than ever it was before when it wasn't as sharp as now. I get good ideas now, but I forget most of 'em.

Announcer: Fred, do you have job, do you work?

Fred: Work, did you say, shit man, I grow me own and that's bloody work, a full time job man.

Announcer: I think we'll leave that one there listeners, I can hear the police knocking down Fred's door. GC.Ed.

A new study published in the scholarly journal PNAS questions the conclusion ofa paper from last year that was widely seen as greatly strengthening the evidence that regular cannabis use beginning in adolescence and continuing throughout young adulthood causes a decline in IQ by the late 30s.

In the original study, co-author of this article Madeline Meier and her colleagues assessed changes in IQ and specific cognitive abilities between adolescence and the age of 38 in 1,037 New Zealanders. All the subjects were born in Dunedin in 1972 or 1973.

Toke more: http://www.theepochtimes.com/n2/science/teen-cannabis-use-lowers-iq-despite-claims-to-contrary-336149.html

The Consequences Of The “Constitutionality” Of Obamacare

IMG_7667Dr. Michael Keane looks at the long-term effects of "Obamacare" on conceptions of personal identity and mental health:

This week the Supreme Court heard oral arguments related to the constitutionality of Patient Protection and Affordable Care Act (aka the PPACA or Obamacare). The pivotal issue is that of the mandate for individuals to purchase health insurance. If the mandate is found to be constitutional there will be consequences for the Federal Government’s ability to regulate private citizens’ lives far in excess of the power to compel the purchase of a private product.

The Essential Health Benefits package in the PPACA outlines the broad classes of conditions that must be covered in order to satisfy the mandate. It is the requirement for coverage of mental health and substance use disorder services (including behavioral health treatment) that has the potential, when taken to its logical conclusions, to open the whole scope of human behavior to regulation by the Federal Government.

The Government is arguing that the Commerce Clause of the Constitution gives it the power to enforce the individual mandate. The rationale is that health care has a significant effect on interstate commerce and that everyone will need health care at some stage. Therefore, the individual mandate is conceptualized as merely being a way to regulate WHEN payment should be made for the inevitable consumption of health care. This inevitability-of-health-care argument is thus used to justify the Government’s ability to compel individuals to buy an insurance product. The inevitability argument is untenable on a number of fronts when put in the context of accepted clinical, biological and ethical principles as is outlined in the accompanying article in the Mayo Clinic Proceedings http://www.mayoclinicproceedings.org/article/S0025-6196(12)00198-X/fulltext

Firstly, we have to be aware of what the term mental health and has become. Most are comfortable conceptualizing, for example, schizophrenia, major depression, bipolar disorder or incapacitating anxiety disorders as illnesses. However, the concept of “mental health” has morphed and expanded and now concerns itself withevery imaginable dysfunctional, odd, eccentric, antisocial and criminal behavior. Absolutely anything you can think of can be coded as a mental illness, especially with the catch all code of Not Otherwise Specified (NOS). It is furthermore likely that as we discover the neuropsychological basis of some behavioral problems it may well be appropriate to conceptualize them as mental illnesses. On this front, many people are already understandably frustrated when certain behaviors, especially the dysfunctional behavioural components of addictive disorders, are classified as brain disorders; thereby removing personal responsibility from the individual. “It’s not my fault, it’s my disease”.

For the sake of this discussion, we also have to be aware of the ideological underpinnings of mental health. I say this with no prejudice but merely attempt to indentify a reality in order to give readers some context. If you were to look at a distribution curve of the political and ideological leanings of academics and activists within mental health it would be centered on the left of the spectrum. The prevailing ideology has become one of the informed elite having a moral duty toregulate and control the lives of we, the people; the very opposite of rugged individualism. We just have to be realistic about the direction in which mental health is being driven, especially now that everyone will be forced to be covered for mental health services.

It has been uniformly accepted that the Government is not justifying its use of the Commerce Clause for the sake health INSURANCE per se. It is the underlying health care consumption that is being used to justify the mandate to buy health insurance. It is the underlying illnesses and diseases that force people to consume health care; or as one Appeals Court Judge summarized "No one can opt out of illness, disability, and death."  Thus, if the individual mandate is found to be constitutional, it will mean that all the diseases and illnesses for which coverage is mandated are in fact the elements that affect interstate commerce; because it is health care consumption, not insurance consumption which justifies the Governments mandate.

This will have a number of far reaching consequences. Firstly, it will bring almost the entire human condition under the reach of the Commerce Clause. Remember that virtually every dysfunctional behavior can be coded as a mental illness. Therefore every dysfunctional behavior can be said to affect interstate commerce.

Since the utter absurdity of the Twinkie defense, legislatures have attempted to reduce the opportunity for criminals to avoid punishment by the use of obscure and marginal mental illnesses. However, this current situation would represent a completely separate matter. Currently, to avoid prosecution for a crime you have to demonstrate that a mental disorder affected your capacity to know that what you were doing was wrong; the presence of a mental illness per se does not excuse criminal behavior. However, if the mandate is allowed to stand the mere presence of a diagnosis of a mental illness would categorize a person as being open to regulation by the Federal Government under the Commerce Clause.

This would represent a stark reversal of opinion by the Supreme Court. Previously, it ruled that criminal behavior per se could not be regulated under the Commerce Clause. The Court reasoned that in order to connect criminal conduct with interstate commerce, inference upon inference would be needed to make the connection. Not so if the individual mandate is found to be constitutional. With or without the need for the “Not Otherwise Specified” code, it is possible to code mostcriminal acts as components of mental illnesses. And as mental illness would now be considered to affect interstate commerce, the Federal Government could legitimately enact laws to regulate the manifestations of that mental illness.

Even aside from frank criminal behavior, any sort of subjectively anti-social, coercive or manipulative behavior would be fair game to regulate under the Commerce Clause. There are also many categories within mental illness classifications for behavior which is odd, unusual, eccentric or merely out of the mainstream. The unkempt hobo could certainly be controlled by the Federal Government for the effect s/he was having on interstate commerce. You can beconfident that creative politicians, lawyers and psychiatrists will use this to advocate for regulation of ever more parts our lives, especially now that any excess behavior can be labeled as an addiction (I have even heard of someone being clinically diagnosed with heavy metal addiction!) In this context, we have already seen the first generation of attempts to associate political leanings with brain function. In the future it is feasible, if not predictable that attempts at politicalregulation will be advocated for.

These are the consequences of accepting that mental illnesses affect interstate commerce; the inescapable logical consequence of accepting the Government’s rationale for the individual mandate. If the cost of treating mental illness is an INEVITABLE phenomenon that affects interstate commerce, then the Government has a legitimate stake in regulating those sufferers of mental illness as they directly affect interstate commerce.

There is another consequence of accepting the Government’s inevitability-of-health-care-argument. If the legal precedent is set that the manifestations of illnesses are inevitable, then what does that say for all the aberrant behavioral problems that can be coded as a mental illnesses? The abrogation of personal responsibility that might arise from such a legal precedent is mind boggling.

Aside from the immensely complex ramifications of mandating insurance for mental illnesses, the consequences of accepting the inevitability-of-healthcare-consumption argument are many. For example if the mandate is found to be constitutional, the Supreme Court, in one fell swoop, will be rejecting the very basis of lifestyle medicine, preventive medicine and much of public health.

Dr. Michael Keane is an anaesthetist and researcher with interests in illicit drug use and drug policy, bioethics and public health. He is also a lecturer in public health at Monash University, and a member of the Liberal Democratic Party. 

Medicare & The Loss Of Personal Freedom


The Hon. Dr. Peter Phelps MLC explains how socialised Medicine is responsible for destroying personal responsibility and creating the nanny state: 

What is the connection between a tax on alcopops, increasing the health insurance penalty, banning solar beds and restrictions on smoking? They are all a consequence of the socialist medical system in Australia. Most people say that they like Medicare, but do they really understand its consequences? Let me put it plainly. Medicare offers moral justification for the Government to interfere in your life. How does it work? Medicare allows for medical treatment at no direct cost to the patient. People might not like to admit it, but health is a market and, like all markets, where there is no cost there is no price signal to influence behaviour. What does that mean? It means that, in the absence of a price signal, there is no reason to behave in a healthy manner. People can be as dissolute as they like and pay no personal cost for their actions—this has consequences. 

The first consequence is the failure to provide any incentive to do the right thing. You might as well go out, get drunk, get into fights, smoke crack cocaine and have unprotected sex—after all the Government will pay your medical bills, not you. But this leads to the second consequence: governments do not have money of their own. They take it from people in what is generally called taxation, but it might just as appropriately be called legalised theft. To pay for the medical consequences of the indulgences of person A, governments must raise funds from person B. "Ah", I hear you say, "but they also raise funds from person A." That may be true, but the question is: Do they raise enough taxes from person A to entirely cover their medical costs? If the answer is yes, then why do we need socialised medicine in the first place? Why not just let everybody pay for their own expenses? However, if the answer is no—which is more likely—then we have the situation where those who live healthy lifestyles are compelled to pay for the cost of those who do not. 

As I said in my maiden speech, why do socialists believe that a rational market will pursue virtue, when virtue is punished and wickedness and indolence are rewarded? As medical costs rise, taxes must also rise and all governments hate the political consequences of raising taxes. So the Federal Government seeks to defray the health costs by forcing people on above average incomes to pay an additional amount of pseudo-taxation. People are compelled to either subsidise the private health sector through private health insurance or face a higher Medicare tax. Either way they are being forced to subsidise a system which, if they take care of themselves, they may never need to use. I do understand the plight of those who have chronic biological medical conditions and simply cannot fund their own medical costs. This is an instance where market failure legitimately calls for government intervention, and I am happy to contribute to such. But I am totally unsympathetic to those who have consciously adopted, and continue to maintain, destructive lifestyle choices that necessitate my subsidising their medical care at great expense. 

Aside from the purely fiscal considerations, there is a much more insidious and dangerous problem caused by socialised medicine. Governments now run what are euphemistically called lifestyle campaigns, purportedly to make us healthier and because they care about us, but really they are to reduce the net demand for health services. We are told to stop smoking, stop drinking, exercise more, not use drugs, not to eat fast food, put on sunscreen and make sure our kids do not get fat. When that fails, as it inevitably does because there are no price signals limiting demand for health services, out pops the authoritarian hoof and governments start banning stuff. Members will recall that I have spoken of the petit Fascism of the scientific community in relation to man-made global warming. But that same strain also emerges in some sections of the medical community: The mentality of not just "we know what's best for you" but "you must do what we say".  It is the idea that adults are children who cannot be left to their own devices. 

This desire to run our lives dovetails nicely with government's desire to reduce medical costs. So they play off each other, mutually supporting, mutually reinforcing. The net result of all this is a massive loss of liberty and a destruction of the right to freedom of action by individuals. The ability of people to make their own mistakes, to pay and learn from them, has disappeared. We are now little children who must be told what to do in our lives. Who is to blame for this lamentable state of affairs? We are. We, the Australian people, who thought we could get something for nothing and found that the laws of economics are just as immutable as the laws of gravity. My fellow Australians wanted a system of so-called free medical care and they got it. Are they now prepared, as a direct consequence, to let government run their lives, rather than as they see fit?

Peter Phelps is the Government Whip in the New South Wales Legislative Council, and is a former long-term staffer in the Howard Government. He has a PhD in Australian History.  

Medicare HECS?

Terje-PetersenTerje Petersen considers reforming Medicare through a HECS-style payment system:

The level of debate regarding health care reform in Australia is really rather pedestrian. We should be opening up the health sector to more private involvement and more personal responsibility. We need more price signals on both the supply and the demand side of the equation. However it seems the best we can manage in price signals is a modest tax rebate from the Liberals if you buy private insurance, and a higher medicare levy by the ALP if you don’t. Neither of these is the sort of market price signal we need. We need price signals that link consumers to suppliers.

Currently the medicare levy raises about 1/6 th of the amount that the government actually spends on health. If the Medicare levy was meant to raise the revenue needed to pay for Medicare it would need to be about 9%. So if we increased in from 1.5% (there abouts) to 9% and cut income taxes by 7.5% we would still pay the same in taxes (the levy is a tax) but we would have a lot more transparency informing the debate.

Each quarter we ought to get mailed a statement from the Medicare office outlining how much expenditure we incurred using our Medicare card. Again this would not change the benefit we receive but it would improve transparency and better inform the debate.

If the Medicare statement suggested above was actually an invoice and we were required to repay the expenses we incurred using our medicare card this would allow us to cut taxes by about 9% (inclusive of the current 1.5% Medicare levy or else just the 9% levy suggested above). Given the dead weight cost of taxation this would be real boost to the economy.

However there is a social policy concern with this approach that cuts to the heart of why Australians overwhelmingly like Medicare. The cost may deter poorer people from getting treatment. Fair enough. We can fix this concern by allowing people who can’t or don’t pay the invoice to automatically roll the debt from their Medicare invoice onto their HECS debt. In short Medicare would become an income contingent loan from the government. The Medicare card would become an alternate payment system much like VISA or Mastercard but issued by the government and with an income contingent repayment plan. Social concern fixed because nobody is denied essential health care on the basis of affordability. HECS could be renamed to the “Health and Education Contribution Scheme” and still abbreviated as HECS.

Okay some people don’t want to burden their future self with such a debt. That is up to them. They can take out private insurance instead or pay as they go using cash. People will vary in their preference but nobody will miss out on medical service due to an incapacity to pay. And insurance could be bought unencumbered by the current prescriptive government rules about inclusions and excess thresholds. Consumer demand and insurance company innovation coupled via the market would allow a process of discovery to determine what health services get paid for by insurance and what get’s paid for via cash. Whether insurance has a small excess or a large excess. Whether we mostly all have the same scheme or if we want a lot of variety.

Having reformed the demand side of the equation we should seek to reform the supply side by privatising hospitals. We already have private GPs, private specialists, private medical centres and private pathology services. In fact most routine encounters with the medical sector is already through a private provider. We even have numerous private hospitals. It isn’t a sector that benefits from either government ownership or government operation so we should extricate the government from it and allow hospitals to focus on treating patients and allow governments to instead focus on making better laws.

Others have suggested that health care should be provided by governments issueing vouchers which people then use to pay for private insurance. My view is that this approach will lead to governments being prescriptive about what insurance policies must include. About what excess they must provide. They will tend to exclude the option to self insure for some medical expenses. In short I don’t think a voucher scheme would drive the same dynamic process of innovation.

Terje Petersen is a libertarian blogger and stood as a political candidate for the Liberal Democratic Party in the last two federal elections. This article was initially published at Thoughts on Freedom


Private Health Insurance Back Flip Cements Labor’s Legacy


Joseph Del Duca Bio Pic


Joseph Del Duca discusses how cutting the private health is the lastest in a long line of broken promises and bad policy by the Gillard Government:

 The Labor Government is in tatters. They have shown time and time again that they have nothing to offer Australia besides broken promises and a long running soap opera over the nation’s leadership.

The Prime Minister places her own self interest over the good of the country and has proven that she would rather lie and avoid the truth than give up the top job.

We have a Foreign Minister whose loathing of the Prime Minister is clear for all to see. He will stop at nothing to get his old job back. The government’s entire focus is on who will win the fight for the leadership.

 Labor has tried in vain to pass the leadership tensions off as media spin and scare tactics from the opposition. Nobody bought it.  The talk has started, Labor needs to bring this to head as quickly as possible and not allow it to continue to destroy the government. The Prime Minister can deny the writing on the wall as much as she likes but as the saying goes ‘If it looks like a duck and it walks like a duck, then it’s a duck.’

Federal Labor promised us that 2012 would be different. This has not been the case.  It seems that nothing has changed from last year. We have a government whose time is more consumed with political infighting than it is in doing its job.

There have only been eight sitting day

s of the calendar year and already the government has been taken well off track. In between evading questions on the Australia Day debacle, stalling on the Craig Thomson – Fair Work Australia inquiry and showing an erroneous lack of judgement through Four Corners Appearances this Government has simply not had time to get on with the job of running the country. Their incompetence does not allow it.

Whilst Labor members continue to watch their backs they are not looking out for the welfare of our country. Every day we pick up the newspaper and read about another illegal boat arrival, we see another story about more Australian workers losing their jobs to places off shore.

All this Government has to show is a legacy of broken promises.

The Prime Minister told us, ‘There will be no Carbon Tax under the government I lead.’ They have implemented a Carbon Tax.

The Prime Minister told us that her government will be tough on border protection. The Government has no policy on this issue, they can’t even get a consensus in their own party on what to do, and as they do nothing more and more boats arrive.

The Prime Minister made a deal with Andrew Wilkie promising him mandatory pre-commitment on poker machines. As soon as she no longer needed him she dumped him and tore their written agreement to shreds.

A lot was made of Tony Abbott’s comment last year about written truth vs. non written truth. It seems as far as the current Prime Minister is concerned, it does not matter if the promise is spoken, written, tattooed or used as a member of parliaments sole deciding issue on whom to nominate as Prime Minister. A Promise is something that need not be kept.

Both the Prime Minister and the then Health Minister Nicola Roxon MP are on the record saying they were committed to retaining all existing private health insurance rebates.  In the last sitting week they broke this promise and will now cut the Private Health Insurance rebate.

This will have a significant effect on our NSW economy. This decision will force many out of private health insurance and back to our already overburdened public health system. This will greatly increase the cost of private health care as premiums are raised to reflect the reduced membership.

This decision will transfer a larger portion of the cost of health care from the Federal Government to the State Government. Cutting the rebate will damage the level of health care offered in Australia and heap NSW with even more debt. This was only done to help the Prime Minister deliver a budget surplus something she sees as being vital to her staying in the position of Prime Minister.

This is just another broken promise in an ever growing list.

The Prime Minister has once again put her own self interests over that of the nation. Is anyone even surprised anymore?

Joseph Del Duca is a Mortgage Broker based in Sydney’s Inner West. He has previously worked as a Media and Communications Advisor to Federal Members of Parliament. Joseph’s two major interests are finance and politics. He enjoys all sports along with any other realm of life where two humans are competing against each other. He has a particular love of rugby league but is not sure how many more seasons of pain he can endure as a Rabbitohs supporter. 

Liberal Market Values have a lot to offer patients.

IMG_3115Dr. Grant Ross discusses the benefits that free markets bring to patients: 

Janet Albrechtsen argued in Peter van Onselen’s 2008 book, Liberals and Power: The Road Ahead, that the Liberal party has surrendered the moral high ground to the left. This is particularly the case for education and health.  

Publicly funded Health is a good thing but there is a point where the health stops and the public institution largesse and inefficiency supersedes. We must be honest about this reality.

There is a sentiment among doctors lately that the government is bending towards special interest groups who want to usurp doctors’ autonomy, money and power. These include Federal, State and Hospital bureaucrats, allied health professions, Nurse Practitioners and drug companies. This is a misuse of government power to steal market ground from doctors and exercise the politics of envy. This mechanism has potential to hinder the ability of the individual to decide which practitioner they want to go to, as per market practice.

The Roxon reign has not introduced a single reform that worked towards health care efficiency.

The e-health records involved inadequate medical input such that they are a useless diversion that actually increases doctor workload for no appreciable gain.

‘Nurse on call’ proved to do nothing to ameliorate the doctor workload as the nurses generally had little more clout on whether a patient needed to see a doctor than the patients themselves.

The Nurse Practitioner scheme, designed to create a new breed of ‘health professional’ to take over in General Practice proved so financially ridiculous that the scheme was shelved. Not only did a patient now have to pay to see a nurse practitioner, but then had to pay twice once they realized that the Nurse Practitioner had little ability to treat any of their presenting complaints and they still had to present to their doctor.

Then there was the push for prescribing rights and Medicare billing rights for allied health. Pharmacists wanted to be able to prescribe drugs. Psychologists wanted to bill Medicare. Who was going to pay for all this?

Most doctors know that free health care is wasted health care from over-servicing. Medicare is not there to drum up business for allied health. I am all for providing state dollars to get services when and where needed; but this model has no believable provision for rationalization of those services. Fee for service and GP referral does.

Ideologically, the widening of prescribing rights is just plain dangerous. It makes a mockery of medicine as a craft and brings danger and higher costs to the health industry.

The political push by allied health and nursing to usurp doctors’ work is dangerous and misguided. The recipe is well known; take an easy part of medicine, take it out of the ‘unknown diagnosis’ context, prove that somebody else can do it better than doctors already are, then claim that this should be a future model.

Unfortunately, humans are not as simple as cars and nor are they identical; a production line does not work. ‘Substitution’ to allied health increases the infrastructure costs by multitudes and rarely reduces the need for a doctor as allied health and nurses cannot integrate the findings based on their limited knowledge. Simply put, a doctor is the corner you just cannot cut. 

My honest view on the assault on doctors is that no government can recreate what Aristotle left behind. Both in homage to the great philosopher’s role as a physician himself and to his dictum ‘the whole is more than the sum of the parts’ I want to impart the purity of the role of a doctor in both vocational and philosophical terms. In Liberal terms, doctors are a self-defined market product that the government is trying to usurp. In Liberal terms, this is market interference by government and it is wrong.  

Kevin Rudd’s federal takeover of health excites me as a doctor, but scares me as a Liberal. On one hand, I love the idea of the fragmented state funding being taken out of the equation. Less fighting and blame shifting between governments, less complexity, less delay in approvals and policy change and greater concordance of workforce planning.

On the other hand, one sprawling enormous bureaucracy with eyes to taking jurisdiction over every patient, health record, nurse, doctor and hospital in the country is a recipe for inefficiency and complexity. I have a concern that this would make it easier for special interests to capture policy making when they only have to do so with a single government, i.e. the federal government.

Medicare Locals were a bad idea from the outset. They take a reasonably well functioning private and independent industry group and more or less nationalise it in order to ‘make it better’; without any extant support or endorsement from the AMA.

This has failure written all over it.

First of all, none of these models worked overseas and we knew that well back when this sorry saga started. Secondly, the Medicare Locals aim to replace the doctor to patient care model by creating schemes and incentives to control chronic disease and use other peoples’ money to do so. This is not about ‘patient care’; it’s about arrogant governments holding the belief that they can get ‘better results than doctors’.

Once you open up this ground to any purpose, you open it to all purposes and I disagree with the replacement of the doctor patient primacy on every level.

Every single doctor I speak to is against the changes to healthcare. This is particularly the case in General Practice. Allowing vocal special interests to manipulate health policy is a perversion of the intention of publicly funded health and is amount to theft from patients.

If you want quality, effective and rationalised medical services in Australia; the General Practice fee for service primacy model is the only one worth supporting. And we won’t see that with Roxon.

Grant Ross is a graduate of Medicine and Surgery from The University of Melbourne, where he was also President of the Rural Health Society.