2020 Health Overview (Doc Holliday) 6:44 AM

Australians are living longer than ever before. In 2004-05, the average life expectancy (at birth) of Australian men and women were 79 and 83 years. This makes Australian among the longest lived people in the world. The cost of health care is, for the moment, quite modest by international standards.

Yet there is quite a clear agreement that Australia’s health care system is stuffed, that somehow it is failing to deliver the sort of results that we would like. We have too many fat kids, kids that don’t exercise enough, kids that eat too much, kids with bad teeth, kids that smoke too much, kids that drink too much, kids that pop too many pills. It was so much better in our days – when all we could eat were lard sandwiches, smoke cigarettes behind the shed, and play football barefoot on the street, while our mothers were in the kitchen quietly dealing with an unwanted pregnancy. But no, our kids are too soft and we know what’s best for them.

But don’t just pick on the littlies. Why not the oldies? They’re too demented to know what’s good for them. Why, if only they exercised more and ate properly, they wouldn’t fall over and hurt themselves or clog up our hospitals with renal dialysis.

Then you’ve got the old (ho-hum) rugby scrum between the stern-looking guys in white coats and the witch-doctors promoting alternative therapies: ‘You can’t trust them holistic types, there’s no science in them’. And finally, there’s always that big bogey-man everyone loves to hate: big fat rich corporations (health insurance, pharmaceutical and, wait for it, oil companies) and professional associations (greedy doctors and dentists) all seeking for ways to rip you off.

There is one personality type that permeates the baying crowd: the one who knows the Truth. In his view all Australians should hike before breakfast, ride a bike to work, eat sushi for lunch, and have a cup of green tea after work. This one wants to ‘educate’ you, regulate you, provide you with all the infrastructure and incentives you would need, and then tax you to finance it all.

There is no doubt that Australia’s health-care industry can be improved. The problems almost always arise from the strange horse-trading that masquerades as government policy. There is, for a start, a rather odd relationship between Medicare and private health insurance (PHI): why should anyone take out PHI if Medicare is available for free? But Medicare is a major of problems because taxpayers are shielded from the effects that their lifestyle behaviours have upon the cost of the system. Fixing health insurance should be our first priority.

2020 Health Submission 4313 (Doc Holliday) 6:37 AM

I believe the Private Health Fund system is inefficient as there are too many funds which leads to much duplication of services. At the least the government should reduce the number of funds offering private insurance. This could be done by only allowing them. a reduced premium increase and letting market factors take their course. Those collapsed fund's members should be able to move to another fund without losing their accumulated benefits.

Better to put the several billions spent on private health insurance annually into public hospitals.

One of the great myths of the health insurance debate is that there is merit in having a single health insurer — that competition somehow leads to duplication.

The obvious extension of this logic is that all the clothes shops in Chapel St should be closed down, except one, since there is duplication. And while we’re at it, let’s close down all the souvlaki shops because, you know, there is duplication.

Where duplication does exist in health insurance, say in the number of actuaries employed, competition makes up for it through the innovation of new insurance products. Moreover, it is competition, not government mandate, that will eventually lead to lower insurance premiums — although the extent that this will occur will depend on how health care costs are controlled.

So if we have a single health insurer, why not make it publicly owned? And if we have a single clothes shop why not make it publicly owned too? Hell, why not combine clothes shops and souvlaki shops into Fur and Meat Emporiums and have the waif-thin fashionistas (‘That looks great on you’) teeter on high heels slicing lamb off the gyro.

Real reform to private health insurance can only be achieved by getting the right balance between private and public health insurance, and then deregulating health insurance to permit real competition. But we don’t like competition in health insurance.

‘Would you like yoghurt or sauce on your insurance policy, sir?’

Back of the envelope

• Cost --- Many billions
• Expected impact on average earnings --- Soviet era style living standards
• Expected impact on economic growth --- Big cut in GDP from reduced competition
• Impact on incentives --- Crappy customer service, poor health outcomes
• Impact on government spending --- big increase
• Impact on taxation --- big increase
• Winners --- Party officials
• Losers --- Everyone

2020 Health Submission 2015 (Doc Holliday) 6:23 AM

Dear reader, I have discovered on my hard drive a couple more health submissions from the book that never was. I will post them and the health over view over the forthcoming week. For those that are confused I suggest you reference the very earliest posts on this blogsite. Doc

Major medical problems in Australia due to obesity, smoking and alcohol need greater preventive campaigns and free behaviour change assistance for all people at risk.

This statement single handedly captures the ridiculousness of Australia’s Medicare system. What does ‘free behavioural change assistance’ really mean?

Medicare is compulsory national insurance: everyone contributes to it and is covered by it. However, contribution is based upon not the risk one poses to the national insurance pool, but by how much one can contribute. Thus a person’s lifestyle choice (how much they exercise, how much they eat, drink and smoke) has no bearing upon his or her financial contributions. Instead, he or she is covered, no matter what they do.

So unable to influence behaviour through the insurance system, governments instead focus on other ways to change behaviour. Government tend to lecture you (say, a multi-million dollar television campaign telling you that a glass of vino after work is the work of the devil). Governments can even get tough: ‘if we catch you drinking, or not exercising or smoking, then you are in really big trouble …’. But incentives are still important, so of course, there are many examples of governments turning to their own citizens to enforce is dictates.

So if you, Tim, plan to head off to the race track tomorrow to place a few bets, tug on a few ciggies, you better watch out. Somewhere there is a little boy scout ready to dob you into the re-education camp Stasi. Instead, treat the problem at its source, by fixing health insurance.

Back of the envelope

• Cost --- Multi millions
• Expected impact on average earnings --- Unchanged average weekly earnings except for public servants enforcing the law
• Expected impact on economic growth --- Big decrease in GDP as everyone lives in fear of little boy scouts
• Impact on incentives --- Don't do anything remotely fun, in case your neighbour thinks you're behaving suspiciously
• Impact on government spending --- big increase
• Impact on taxation --- big increase
• Winners --- re education camp managers, stasi officials and scouts
• Losers --- TAB Tim at the races

2020 Health Submission 2523 (Doc Holliday) 8:08 PM

Another excerpt from Australia 2020 Nutjobs, Happy Clappers and Carpet Baggers

Submission

Is the solution to binge drinking in Australia to halt the development of any new liquor outlets and pubs? Or is the solution more individualistic: limiting the number of alcoholic beverages each person can purchase and consume from pubs and liquor outlets? Possibly by having a card system in place: similar to those used in public libraries, that monitor and possibly limit how much alcohol a person both purchase and consume from liquor outlets and pub venues?

Wrap Up

Binge drinking, it is argued, is an epidemic currently gripping Australia. If you haven’t succumbed to binge drinking, then your loved one has, or your neighbour hasn’t, then your neighbour’s loved one has …

It has not been established, to my mind, with any certainty that binge drinking today is any worse than it was yesteryear. Indeed, the evidence suggests that Australians, on average, are drinking less. The Australian Institute of Health and Welfare (Health Australia 2006), reported that in 2003 (the latest year for which cross-country data is available), Australians drank on average 9.8 litres of alcohol a year (the equivalent of 1.25 bottles of wine a week). This was the ninth lowest out of a sample of 22 countries. This is one-third less than what was consumed in 1973, and about the same as 1963. The long-term trend is a decline in alcohol consumption.

Yet some dear citizens have suggested that we need an alco-card to ration the alcohol we can purchase from the local bottleshop. Let us assume that such a project will cost $100 million to issue cards to all our dearest throughout Australia.

Clearly, under-age drinkers wouldn’t receive an alco-card, since they are automatically prohibited from purchasing alcohol. So clearly, the card applies to alcos older than 18 years. Should it apply to everyone? How do you tell if someone has a drinking problem — from the colour of their nose? What if you don’t have a drinking problem, are you still limited by a quota? Does the local priest need an alco-card if he is bulk purchasing wine for Holy Communion? Does the congregation have turn up with their cards? Did Jesus have an alco-card?

Certainly, a small community may get together to ban access to alcohol. But it is not clear that a member of the general public, fully sober and rational, should be penalised because they like a nice drop after work. And finally, who would enforce it? Prohibition didn’t work in the 1920s and I doubt it would today.

Back of the Envelope

• Cost: $200 million including enforcement costs
• Expected impact on average earnings: Unchanged
• Expected impact on economic growth: Unchanged
• Impact on incentives: Big incentive to set up illegal alcohol sales. Random alco-card checks
• Impact on governement spending: Big increase in enforcement
• Impact on taxation: $200 million
• Winners: Green teas salesmen
• Losers: Everyone else

2020 Helath Submission 1177 (Doc Holliday) 7:25 PM

Another exerpt from Australia 2020 Nutjobs, Happy Clappers and Carpet Bagers

Submission

Supertooth and Good Food Friends are online school community projects that recognise chewing … [displaces] food… left trapped between teeth and inside pits and fissures … after every meal or snack

Wrap up

Tooth decay, it is argued, is the next most expensive chronic disease, after heart disease and type 2 diabetes. It is well known that, apart from fluoridation of water, chewing certain substances after a meal can effectively reduce tooth decay.

When you eat starchy foods, leftovers get into the pits and fissures and between your teeth. Chewing ‘hard’ after a meal displaces the lodged material. Moreover, it also promotes the production of saliva, which can also get into those hard to get places. Examples of hard food include foam strips impregnated of barium sulphate, non-cariogenic foods (such as nuts), and celery string.

Say what? It’s hard enough to hand out nuts at any school for fear of poisoning some allergic kiddie. And strips of barium sulphate? If kids don’t start tripping, their parents certainly will.

And you can’t seriously contemplate doing it at home either. Can you imagine introducing a reward system for your children: ‘son, if you do your violin lessons, I’ll give you celery string’. Why stop at celery string, why not feed them really small pebbles? ‘Crunch on these, son.’

But the emphasis o on education not handing out food. Poor bloody teachers are bombarded every day with requests by interest groups to gain access to the young kiddies. Our kids are certainly being educated, but not how to read and write.

If tooth decay is serious enough a health issue, most people would eventually learn of its importance and learn to floss a bit more.

Back of the envelope

• Cost: $100 000 plus reduced literacy levels
• Expected impact on average earnings: Unchanged
• Expected impact on economic growth: Unchanged
• Impact on incentives: No incentives for kiddies to do extra curricular work
  
• Impact on government spending: Slight increase of $100,000
• Impact on taxation: Slight increase of $100,000
• Winners: Dentists and nut sellers
• Losers: Kiddies no longer being able to read and write.

2020 Health Submission 1267 (Doc Holliday) 3:18 AM

Scepticism was used to protect a seventeenth century English mindset influenced by puritanical deist, Calvinistic beliefs that saw nature as evil. Any science oriented towards herbalism and vibrational medicines was attacked as SPAGYRIST ALCHEMY while mineral alchemy (turning base metals into gold) was elevated as the nobler pursuit, and consequently became mineral-technology-money economy. The foundation of material chemistry RETARDED biological science significantly by deferring all living sciences to physics. Biochemical research which includes genetics, bioengineering, is only decades old and its success due to chaos theory and investigations into hyperincusive anticipatory systems or radical recursion.’

The scientific method remains, probably, the only way by which we can arrive at a truthful understanding of the universe around us. The principle that every idea is only as good as its ability to predict, is a cornerstone of the scientific method. And we must protect it.

So it is very serious matter when one part of the scientific community (biological sciences, especially those focusing on alternative therapies), should levy against another (non-biological chemistry). It is not clear how deal with a conspiracy: do we launch a multibillion dollar (and clearly, the world largest) class action with the ACCC? Who do you sue? Were prices set or just people excluded from doing business?

How can there be a conspiracy? How could one branch of science come to deny another opportunities to inquire and investigate the universe around us? Will anyone initiate new research knowing that there is a risk of class action hanging over their head?

A conspiracy is very difficult to maintain over several hundred years between members who don’t know each other. A simpler explanation is that the culprit is the very non-conspiratorial invisible hand. The economy, like any complex organism, comprises a large number of individuals making intimate, personal decisions. The failure of alternative therapies to succeed in the market is because they were unable to stand up to scientific scrutiny and to demonstrate their economic effectiveness.

The extent to which alternative therapies based on biological chemistry will become widespread will depend upon how they can stand up to scrutiny in the laboratory and in the marketplace.

Back of the envelope

• Cost: $20 Billion law suit
• Expected impact on average earnings: None
• Expected impact on economic growth: Negative
• Impact on incentives: reduced independent research
• Impact on government spending: $20 Billion defecit to fund
• Impact on taxation: $20 Billion to fund defence fund
• Winners: Lawyers
• Losers: Rest of Australia

2020 Health Submission 179 (Doc Holliday) 7:51 PM

An excerpt from the book that never was, “Carpet Baggers, Nutjobs and Happy Clappers.

‘We should change over to a public provided health care and only mandate private health care for those [earning] over [$]150,000 per annum.’

Health care policy is pretty screwed up as it is, and this proposal doesn’t make it any better. It’s not clear whether the suggestion is in relation to health insurance, general practice, hospitals, or all three.

The sole virtue of Medicare is that it provides care to those that could not afford private health insurance. But it does so very badly. By being free, it encourages a waste of health resources: some people over-use it, while others who need it get stuck on waiting lists. Moreover, it encourages bad lifestyles, as individuals do not face the financial consequences of their lifestyle choices. By reducing the scope for private health insurance, the public health system would resemble that of France’s, whose health system costs about 2.1 per cent of GDP more than Australia — or $20 billion per year

There is also a strange relationship between Medicare and private health insurance. If you want to purchase additional private health care services to those offered under Medicare, you have to pay for your entire health care cost again — not just the top up. There is no obvious reason why you should take out PHI. To make it attractive, governments must either subsidise private health care or deliver substandard quality of public health care.

It seems Australian governments are doing both.”Everyone is a loser, babe, and that’s the truth” goes a popular 70s song.

The only decent proposal for governments is to replace the current public–private health insurance paradigm with one in which everyone receives a Medicare grant to use towards purchasing insurance (supplied by a public or private provider) and medical services. Individuals can choose to purchase additional health insurance. Insurers and hospitals will compete for patient funds, thereby promoting competition and efficiency.

The back of the envelope

• Cost: ~$20 billion:
• Expected impact on average earnings: Reduced incomes in long term
• Expected impact on economic growth: Reduction in growth
• Impact on incentives: Major incetive for moral hazard
• Impact on government spending: Big increase
• Impact on taxation: Taxation increased by 2% of GDP
• Winners: Public Health Administrators
• Losers; Patients and taxpayers

2020 Health Submission 155 (Doc Holliday) 7:12 PM

An excerpt from the book that never was, “Carpet Baggers, Nutjobs and Happy Clappers.”

Adopt a National Recreation Strategy after discussions with states/territories; Commit to a 'Recreation Summit;' … Fund access and endorse recreation faculties for all ages, levels and abilities; Provide infrastructure which allows recreation on naturally occurring facilities; … Endorse a National Education Plan for getting people out to recreate; … Endorse monetary carbon exchanges advantages at a personal level for people who walk or cycle to work etc.’

Recreation is seen as a useful way of offsetting obesity and to improve health. The answer, for one pundit, is to educate kiddies on the virtues of recreation, invest large amounts of money to make facilities available (presumably free of charge), and if the personal benefits of improved health and fun alone are not enough, offer a carbon refund for every time you recreate.

Who funds the construction and operation of the recreation infrastructure and at what cost? Who manages and operates the recreation infrastructure? Who will be paid to stand outside handing out carbon credits to passers by? Will carbon credits be enough to promote recreation?

It is not clear that there will be a surge in recreaters. Australia is already well-endowed with a good climate and plenty of open space, so access to facilities is not the problem. Rather, the issue is whether people sufficiently value recreation over other activities. So even if you have a swag of outdoor walking trails, the odds are that most mugs would choose to stay indoors surfing the net and playing Nintendo Wii.

And, carbon credits are not likely to be worth much more than a cup of coffee. If you were offering a coffee to every commuter, how many will bring along their spare running shoes to con the government to pay for their morning coffee at work?

If we build enough stadiums to seat one half of Australia’s population, you’re looking at a total cost of $360 billion, or about one-half of Australia’s GDP.

The back of the envelope

• Cost: $360 billion
  
• Expected impact on average earnings: Major reduction in income
  
• Expected impact on economic growth: Big increase in GDP , big increase in government debt
  
• Impact on incentives: 1 carbon credit = 1 cup of coffee
  
• Impact on government spending: Up by two thirds
  
• Impact on taxation: Up by two thirds
  
• Winners: Stadium operators, public servants and coffee shop owners
  
• Losers : Everyone else
  

2020 Summary of Health Stream (Doc Holliday) 12:26 AM

2020 The health stream summary

An excerpt from the book that never was, “Carpet Baggers, Nutjobs and Happy Clappers.”

Australians are living longer than ever before. In 2004-05, the average life expectancy (at birth) of Australian men and women were 79 and 83 years. This makes Australian among the longest lived people in the world. The cost of health care is, for the moment, quite modest by international standards.

Yet there is quite a clear agreement that Australia’s health care system is stuffed, that somehow it is failing to deliver the sort of results that we would like. We have too many fat kids, kids that don’t exercise enough, kids that eat too much, kids with bad teeth, kids that smoke too much, kids that drink too much, kids that pop too many pills. It was so much better in our days – when all we could eat were lard sandwiches, smoke cigarettes behind the shed, and play football barefoot on the street, while our mothers were in the kitchen quietly dealing with an unwanted pregnancy. But no, our kids are too soft and we know what’s best for them.

But don’t just pick on the littlies. Why not the oldies? They’re too demented to know what’s good for them. Why, if only they exercised more and ate properly, they wouldn’t fall over and hurt themselves or clog up our hospitals with renal dialysis.

Then you’ve got the old (ho-hum) rugby scrum between the stern-looking guys in white coats and the witch-doctors promoting alternative therapies: ‘You can’t trust them holistic types, there’s no science in them’. And finally, there’s always that big bogey-man everyone loves to hate: big fat rich corporations (health insurance, pharmaceutical and, wait for it, oil companies) and professional associations (greedy doctors and dentists) all seeking for ways to rip you off.

There is one personality type that permeates the baying crowd: the one who knows the Truth. In his view all Australians should hike before breakfast, ride a bike to work, eat sushi for lunch, and have a cup of green tea after work. This one wants to ‘educate’ you, regulate you, provide you with all the infrastructure and incentives you would need, and then tax you to finance it all.

There is no doubt that Australia’s health-care industry can be improved. The problems almost always arise from the strange horse-trading that masquerades as government policy. There is, for a start, a rather odd relationship between Medicare and private health insurance (PHI): why should anyone take out PHI if Medicare is available for free? But Medicare is a major of problems because taxpayers are shielded from the effects that their lifestyle behaviours have upon the cost of the system. Fixing health insurance should be our first priority.

Analysis of individual submissions to follow