An interesting and challenging concept: that it is quite possible that the government is not best positioned to decide where our money should be spent.

Imagine that.

Reading between the lines, the research fund was probably a last-minute addition to the budget, to give it a slightly less punitive image. It is an entirely "safe" and cost-free commitment, because a) it is planned to happen sometime in the future and b) few would notice if it simply dropped off the radar, or morphed into something else entirely.

The other aspect, that Mr Leyonhjelm alludes to, is that such a large pot of money will require a similarly extensive bureaucracy to support it. Which might have the mandarins of Canberra salivating at the number of new "executive" posts that will be needed, but means diddly-squat to the rest of us.

I'm beginning to like this guy. His latest contribution to our political debate is also worth a read.

http://www.theaustralian.com.au/national-affairs/crossbencher-david-leyonhjelm-warns-on-terror-law-moral-panic/story-fn59niix-1227036977631

Sadly, independence of thought is vastly undervalued in our two-party hegemony.

<In an ideal world we would shop for health services based on quality and price, protected from unaffordable costs by insurance.>

This is a real furphy,

The main reason for privatising health care in Australia, is that it will make a small select group of people very very wealthy.

The insurance system has not worked in the USA except to make a small number of people wealthy.

If you compare a common indicator used 'Life expectancy', Americans have a lower life expectancy rate than Australians.

<Market Arguments and the Consumer:- The unchallenged assumption behind arguments for
<a market based health care system is that market principles can be successfully applied to
<health care. Basic to this is the idea that the patient, a word which implies disempowerment
<and dependency is renamed a consumer or customer.

http://www.bmartin.cc/dissent/documents/health/health_works.html

The only real effect of having a market driven health care system is that the poorest people will have their life expectancy rate fall.

This author is either delusional or totally devoid of thinking matter!

The author and Pericles needs to read Professor Mariana Mazzucato's book, The Entrepreneurial State, or watch her talk at the London School of Economics.

Most of the most important medical drugs of the recent era have been achieved by medical laboratories financed by the USA Government, not by private sources. Mazzucato's book covers that subject very comprehensively. One drug company was reported as charging $20,000 for a years supply of a cancer treating drug. The drug was developed by a government laboratory, costs $1,000 to manufacture a years supply, and the drug company pays a miserable royalty to the government.

Mazzucato's book has a chapter titled, The State Behind the iPhone. It describes how mainly what Apple did was put publicly funded ideas (miniaturisation recording devices and of phones and touch screen technology etc.) into fancy marketing packages and move all its financial operations offshore so that it avoids paying USA tax.

Even the Google search engine algorism is based on earlier publicly financed research.

I agree the doctors, particularly the specialists are the ones doing well from medical insurance as instituted in Australia first by that paragon of the right, Pig Iron Bob. At least he had enough gumption to regulate the banks after defeating Chifley over bank nationalisation and petrol rationing.

We can and should fund it and the research conducted inside our best universities.
Other nations do just that, and seriously beats us on Government funded R+D!
And we would have no problem funding either, if we were only just wise enough to embrace REAL tax reform!
Tax reform which simply prevented the most wealthy corporations in the world, escaping a fair share of a common liability.
The answer is not more private research and or the inevitable price gouging by big Pharma; that surely follows that as night follows day?
But rather, tax reform that also forces those very same entities, to cough up tax, relevant to the amount of business or enterprise done/profit earned here!
Learning how to commercialize our own discoveries, would more than create enough new enterprises, and with them, vastly increased tax receipts to pay for even more research!
Which is then commercialized right here!
[Economic, rolled downhill snowballing!} And, well you get the picture.
What we need to assist just that very outcome, is real tax reform, that really does lower the common burden, to as low as just 5%!
And very doable, if we but jettison what we have now, in favor of a completely unavoidable, stand alone expenditure tax; which by its very unavoidable nature, completely negates tax compliance costs!
Which then completely negated, hands back to the averaged bottom line, some 7% averaged.
Now you don't have to be Einstein, to work out that a 5% expenditure tax impost, is still lower than the 7% returned compliance costs!
Why is it so hard for politicians to grasp super simple concepts!
And real genius is solving super complex problems, with very simple, and therefore superbly fail-safe systems!
Rhrosty.

It is my understanding that health care costs are the leading cause of individual bankruptcy in the PRIVATE Health care Insurance system of the United States.

So in reality, Insurance does not protect against price rises, or gold platting medical bills.

Senator Leyonhjelm makes some sound observations about the lack of a “price signal” in the current Australian medical system. Making consumers of medical services assess whether they think a particular service is worth paying for out of their own pocket makes the decision about which tests and procedures to undergo a little more rigorous than when someone else is paying.

But in order for this to be effective, the consumer must have enough information to make an informed decision about the effectiveness of the particular treatment and particular provider (and doctors, like the rest of us, hate having their performance being measured and publically displayed).
Medical services are an area where the normal assumptions that underpin efficient market theory break down. A “consumer” of a medical service can be faced with a choice where the product may not have a reasonable chance of succeeding, but the alternative is death where the money is useless anyway, so they make the (economically) irrational decision.

Similar irrational behaviour can also be observed in medical research donations. Senator Leyonhjelm makes the observation that breast cancer research is well funded, but when the level of donations is compared to the level of donations for research into male prostate cancer, we can see how “more interesting” conditions receive disproportionate levels of attention.

Government’s role should be much more limited than the all-pervasive role that it fill today. But a governments role is to intervene where the market cannot succeed, and the medical field, research funding in particular, is probably one of those areas.

This article addresses two separate issues. Government funding of medical research and visits to the GP.

I was interested in what he had to say as he rightly alludes to the Trojan Horse of the medical research fund to disguise the actual operation of dismantling universal health care.

Medical research is arguably the one area of research in Australia that does not require any more funding from government. This in stark contrast to other areas of research.

Wobbly is correct that medical debt is an enormous contributing factor in bankruptcies in the USA. With so many other variations of health care on display in OECD countries I cannot fathom why the one failing model is the one this government is hellbent on copying.

It is a popular belief that a large number of people go to the doctor just for a little chat and not a medical reason. Even if this were so, a doctor's visit is still cheaper than an admission to hospital, even for one day. The fact of course is that preventative health care is the best kind of health care and the GP is at the front line of this.

On top of that, we must have the biggest rip-off private health insurance scheme anywhere in the world. It is outrageously expensive with very, very little in benefit when required, considering medicare still pays 60% of all medical costs. What private insurers pay is a joke.

I would consider that to be irrelevant to this discussion, Foyle.

>>Most of the most important medical drugs of the recent era have been achieved by medical laboratories financed by the USA Government, not by private sources.<<

USA is different. It is a country with a substantial tradition of "having a vision". The practical results spun out from their 1960s era determination to reach the moon, for example, is a classic example of how "form follows function" in their R&D process.

Australia so desperately lacks any similar visionary leanings, that we have no guiding principles upon which to invest taxpayers' money into the kinds of longitudinal research that generates scientific breakthroughs of any kind. To think we can trust our political classes to direct relatively puny amounts of our money (but significant in a per-taxpayer sense) in a productive manner is beyond credence.

If you have ever tried to approach the government for an R&D grant, as I have, you would know beyond doubt that we have a public service with the breadth of vision and imagination of a small hamster.

I am not against public funding of research per se. But giving our money to our purblind pollies for such purposes is just another source of riches for the armies of rentseekers who thrive on our government's overweening incompetence.

That's all of our governments in living memory, by the way, not just this one.

Another great article David. It is so nice to see a clear thinking politician, telling it as it is, & putting his reputation out there on what he really thinks.

I have a couple of "conditions", & am on a diabetes watch. I make it to the $1000 worth of prescriptions, [even with the subsidy] a year. I most definitely don't object to paying that bit towards my medications, particularly considering the actual cost of some of them. Thanks young tax payers.

I have at least 4 blood tests & doctors visits a year, often more, & would be happy to pay this small part of my medical costs. Lets face it, all I'd be doing is giving back a bit of the pension the kids pay for now. Surely that is not too much to ask of us oldies being looked after so well.

I really do get so sick of the hand out takers fighting tooth & nail for every bit of the younger generations money they can grab. So many forget how good we've had it. When we were young, on the average wage we paid 7.5% tax. Yep 7.5%, we did not have so many welfare recipients to pay for, or as many bludgers.

At the same time the interest on a home loan was only 4.25%. Our kids would think it was heaven, if they had it so good.

Our kids are paying over 30% on the equivalent income, just when they are buying houses, raising kids, & all those expensive things. Some times many of my generation make me feel sick & ashamed.

On the doctors visit front Yvonne, it is so bad around here it can take 3 days to get an appointment, even if you have a serious problem.

WE have xxxxx care around here. A government funded community support agency. They are one of three.

They visit oldies to help with showering cleaning & other chores on a regular basis. They also fit handrails, clean out gutters, fix leaking taps, cisterns & dangerous stairs etc. This is a great help for many oldies, & probably productive cost saving in the long run.

They also have a bus. It picks up from a different outlying district each day, taking people once a week to the community center for socializing, lunch, & to do some shopping. It is a great day out for people beyond driving. Every second week they take many to doctors for an appointment.

My mother visited the doctor for a nice chat every fortnight for 10 years. He is a nice bloke, & it was a highlight of her fortnight. This was great for her, but was a terrible waste of Medicare funds.

I also don't agree with very expensive high tech medicine on the public purse. By all means cut out a cancer, & fix the general stuff, but heart, lung & other million dollar transplant surgery should not be on the public purse.

Sticking organs in clapped out old farts, like so many of us on here is more a criminal waste of money than kindness. In the same way, with so many of these things, the recipient is merely an expensive trophy to medical science for a short time, rather than a useful member of society.

Much of this stuff serves no useful purpose than to make surgeons rich, & our younger generation poorer.

Hasbeen, contrary to what some politicians tell you, it's not the co-payment that is the issue. If it was truly meant to improve medical expenditure it would be an easy sell.

Emergency departments are full to overflowing, not because every person who goes to ED has an emergency that needs to be seen by a trauma specialist, but because there are not enough GP spots available to make a last minute appointment. I'm with you on that one. I've been known to tell the receptionist at my practice, that no I can't make an appointment in 3 days, 3 days ago I didn't know I was going to be next to death's door, otherwise I would have. Fit me in TODAY!

The real issue is that this co-payment has very little to do with balancing the books. If ALL the $7.00 went towards medical care I'd listen. To have 2/3 go into some sort of vague slush-fund set up by a political party who happens to be in government? My whole being screams Nooooooo! I might even pay some attention if there was some sort of bipartisanship.

You've mentioned your mother's fortnightly GP visits before. And this brings us to medical care in general.

Your conservative friends within the AMA are vehemently opposed to Registered nurses and midwives taking over more care. Your own visits, for instance, of ongoing monitoring and even prescribing some medications, do not require the expertise of a medico. Most chronic illnesses and some acute ones can be dealt with by a much cheaper person, the RN.

I've been in both public and private health care since 1977. Here and overseas. Believe me I can tell you stories of wastage and mismanagement. And if you believe for one moment it is Private good, public bad you've fallen hook-line-and-sinker for propaganda. Both have issues. In private it's double dipping in the public purse, and a horrible lack of transparency. it's bad for business... In public its layers of management.

Excellent exposition of neo-liberal ideology, after the privatisation of medical research, we could privatise the police and fire services, after all, the proletariat have practically no assets to protect anyway, so why waste resources on them. We should also privatise politicians, why waste taxpayers funds on salaries? Or perhaps they should negotiate their salaries with their constituents.

Bravo Senator! Also note that President Eisenhower.did not just warn against the military industrial complex but also " be alert to the equal and opposite danger that public policy could itself become the captive of a scientifictechnological elite.
Right on the money and he would get my vote if he was standing in Victoria.

The entire Medical profession needs to be brought into the 21st century, they still operate on 18th century practices.
THEY get to choose who does Medicine, AND who gets into which specialty, a recipe for nepotism or what?
When you go to Emergency the odds are you will eventually see a doctor who has been on his feet for 60 hours and more, in other words, when you need a doctor most you're being seen by someone who's fatigued beyond safety or who is high on stay-awake drugs.
We've outlawed such practices in every other area, yet put ourselves and our loved ones into the hands of such people. Why?
Because that's the way it's always been and the medico's have a vested interest in not allowing changes.
The single highest portion of Hospital costs is the packages that the doctors get, including the right to use Public operating theatres, staff and wards for their private patients.
The costs of procedures, tests and medicines are wildly inflated and totally unjustifiable but no Government will do anything about that, why not?
Then there's that alleged fund that the Canetoad wants, a bucketful of money that HE promises will EVENTUALLY be used for research, and we should all be aware now what HIS promises are worth. Ever known ANY Government to sit on so much money and NOT steal it? Don't hold your breath!

You are right Bruce. The 'shortage' of medical specialists in Australia is totally manufactured. It got really bad during the Howard years. We still haven't caught up with Australian trained Australian doctors. For some reason Australian born residents have to leap through a complex series of hoops. School education must be of a much higher standard elsewhere than here in Australia.

And we're being told that there are now long waiting lists and increasing in the public system to have anything done. Because of a shortage of specialists. Yet, if you are willing to pay you can pretty well get anything done in a Public hospital if not next week, then within the month. If you are game to go to a Private Hospital you can have anything done straight away.

This is what I do and have done for myself and my kids. Just pay the shortfall from the medicare rebate and go through the public system. You just need to get a referral to a doctor who works both in Public and Private hospitals.

Yet people are being threatened and scared into taking on expensive private health insurance.

Yvonne my medical center has a nurse practitioner, & it is she I see for my monitoring. I had assumed this was standard practice. She will also do minor procedures, like getting some insect out of a kids ear etc.

It would be nice if we had some way of making sure medicos kept up with current practice. My doctor, who I believe is one of the better ones, kept taking me of cholesterol medication, as I don't have high cholesterol.

After each heart attack a cardiologist would put me back on it, & after the next blood test, he would take me off it.

It was only after the third heart attack that a cardiologist, a lady from the subcontinent I think, dained to talk to me, that I discovered why I was on the medication.

Even after 3 heart attacks, the specialists had not told my doctor why they proscribed the stuff. Perhaps if such communication happened as a matter of course, I could have had 2 less heart attacks, & the community would have had somewhat less unnecessary expenditure on my hospitalisation & treatment.

One real problem with medical people is their assumption of superiority. Most people of average intelligence could understand that the medication was to consolidate the plack already in the veins, if told, rather than to reduce the cholesterol level. My doctor did, when I passed it on to him. Why do they want to make a mystery of everything. It is not as if we are likely to go into competition with them.

Completely agree with you both.
I was lucky enough not to need any major medical services for my kids growing up, or since, knock on wood, but I myself have need of regular servicing these days, that's just life and having been a very naughty boy, lol.
I've dated enough nurses (one for 12 years) to get the inside drum on doctors and the system, and it's not a pretty picture, even allowing for the rather jaundiced eye of the source. Rather than monitoring and regulating them their Associations are there to protect them unquestioningly, and they rarely act unless dragged into it by outside influences.
Greed would appear to be the single biggest motivator for a majority of them, money has a well-known addictive property and doctors have access to a very large honeypot indeed.

Those who have no shame may still steal our tax-money for their medical services.

If you want a service and you can afford paying for it, then it is a matter of honour to pay for it yourself. There is no need to wait for legislation: I already refuse to give doctors my Medicare number and if I do (rarely) need their services, then I pay them myself in cash - the lot, not just a meagre $7.

If there are enough consumers like me, then we can turn the tables and demand that we only see such doctors who agree never to accept money from the government, then we can insist that doctors will serve us instead of serving them, our enemies. This way we can also prevent the government from gathering information about our private health issues.

<Those who have no shame may still steal our tax-money for their medical services.

<.This way we can also prevent the government from gathering information about our private <health issues.
<Posted by Yuyutsu, Tuesday, 26 August 2014 11:31:25 PM

Firstly the exact same people who steal from the government will also steal from you and your insurer. Health Insurance fraud in the United states is estimated to be around $100 billion dollars.

Secondly, governments or other institutions will collect data about you regardless, other private institutions may on sell that data, without your knowledge or consent.

Dear Wolly,

It's not shameful to be the victims of theft, it's only shameful to steal yourself or be an accomplice to theft, which is what one does if they accept money from the government.

It is true that data from clinics can find its way to wrong hands, but the chances of that happening are smaller when I don't divulge my Medicare number and pay in cash instead - then the doctor/clinic has no legitimate reason to pass this information to others, including government. Some baddies still could, but chances are smaller.

Hasbeen, you've touched upon a major problem in our health care system. The fragmentization. It's an ongoing gripe of GP's that they're not automatically kept in the loop. I don't altogether understand why your GP didn't receive info, or requested it.

One of the reasons is that patients don't give this information, who their GP is, when they are in hospital. And it is astonishing how many people do not have one primary GP. Or even practice. And with that lab reports and X-ray reports that are easily retrievable by all health care providers dealing with the patient. Unfortunately the money to be made from this by private enterprise from the way things are does not encourage change. I know. I see double testing all the time. All paid for by the taxpayers to private companies, because, you know, private enterprise is So Efficient and ensures Competition (sarcastic tone).

In my mind, part of good preventative health care and ongoing monitoring is to educate people how important it is to have a particular GP and get ALL information to be copied/sent to that GP. It will save us millions in dollars and have better outcomes for most patients with chronic or major issues.

Bruce, re the honeypot of money. Having been married for some 12 years to a medico who during our marriage got his specialist qualification I can say that that is really not the driving motivator. The income is woeful for the responsibility and hours worked until a specialist qualification is obtained. After 6 years med school, then a minimum of 2 years residency, then another 5 years as a registrar. The yearly salary is on par with a scientist working in a lab after 4 years study. My ex didn't get to earn any real money until he was 36. If money was the motivator you're an idiot doing medicine. Become an electrician or do a 2 week course and become a financial advisor and work for CBA instead.

Yvonne you had better suggest to those medicos that they do plumbing.

In my experience very few GPs have enough math to handle a TAFE electricians course.