Friday, April 4, 2008

Oh McGoo, You’ve Done It Again!

Remember the old cartoon show Mr. McGoo? Voiced by the late comic actor Jim Backus, Mr. McGoo was a character depicting a senior citizen with appallingly bad eyesight. Whenever he lost or forgot his glasses, which was frequently, mayhem would follow, usually when he was behind the wheel. It was great entertainment and very funny. Today, it would be seen as politically incorrect and presenting a stereotypical image which discriminates against the elderly, excuse me, seniors.

Of course, it should be a matter of common sense that as we get older things like eyesight can begin to fail. When you are driving a motor car, such things have a direct bearing on the safety of both yourself, and other road users. That’s why it’s hard to understand why some people are still criticizing the new rules for senior drivers.

Older drivers will now be required to undertake a driving test, or an assessment every two years after they turn 85. But that is actually less onerous than the previous requirement to be tested every year. In addition, they will also be required to take a medical test every year from the age of 75. Now that’s not really an imposition when most people in that age group are getting regular check ups anyway.

In the end, surely the safety issues are more important than any ego driven concerns about age discrimination. In fact, if it makes the whingers happy, I would be quite willing to have increased testing for all drivers. That is both driving tests and medical tests. Why shouldn’t we have to demonstrate our competency every time we renew our licence? That way, I’d be a lot more confident about the abilities of all the “other idiots” on the road that we are always warned about.

Thursday, April 3, 2008

A Cure For Public Hospitals?

It has been revealed that the New South Wales Government is planning to announce a policy which makes significant changes to the way that patients access public health services through the Accident and emergency Department. It appears that the plan is for certain categories of patients will be diverted to other units to address there needs. For example, so called “frequent flyer” senior patients will be sent to a Medical Assessment Unit, while chronic patients are to be sent to Care Co-ordination Centres. These units are to be co-located alongside Ambulatory Care Units and the Emergency Departments.

While there is a great deal of merit in the idea of providing a range of more tailored streams of treatment apart from simply admitting patients to already overcrowded wards, concerns have been raised about the proposals.

Dr. Tony Joseph of the Australasian College of Emergency Medicine has suggested that the new arrangements will do no more than create another layer of bureaucracy. It is, he believes, just another obstacle between the patient and definitive medical care. He asks who is going to staff it and where will they get the doctors from? In his opinion, a better solution is to simply increase the staff in the Emergency Department so that patients are seen more promptly.

Another concern is that patients referred to the Care Co-ordination Centres will be separated into those with private insurance and those without. Now this is where the plan is really treading dangerous ground. The fundamental underlying principle of out Public Hospital system is that all patients are entitled to the best available care. If we start separating out the patients who arrive at a Public Hospital on the basis of their insurance status then we have put our front foot on the slippery slope leading to a two tier health system where patients are treated according to their insurance rather than according to their medical needs.

That’s just not the Australian way.

Wednesday, April 2, 2008

Let’s Get Hammered

Those are the words used by Kieran Perkins to describe the culture of binge drinking which he says exists within Australian Swimming. While the general public sees a squad of elite athletes who represent the pinnacle of health and fitness, the truth is that they are all human too. Kieran Perkins points out that the swimmers, like other athletes, train very hard and are very disciplined, but when the rare opportunity arises for the team to celebrate there is a tendency to binge.

Mr. Perkins has also confessed to his own foolish prank during the 1994 Commonwealth Games involving an air pistol. He says he is very lucky he was not sent home as a result of the incident, and that if the same thing happened now, he would not get away with it. His point is that the situation now confronting Australian Swimming involving criminal charges against Nick D’Arcy seems to have arisen from that culture of drinking.

Whether it is coincidence or synchronicity, this controversy has arisen against the backdrop of the Prime Minister’s heavily publicized plan to combat binge drinking, especially among teenagers. It serves as a clear lesson in the dangers of alcohol fuelled violence arising from circumstances that begin as innocent celebrations.

Kieran Perkins is adamant that what he calls “tomfoolery” in the past is poles apart from the criminal matters now being discussed, and he’s right. But ultimately it seems to be a question of the power of alcohol to undermine or even destroy the power of good judgement, especially when it seems to be the accepted culture to celebrate any good fortune by “getting hammered”.

Tuesday, April 1, 2008

Dental Plan No April Fool’s Joke

Last November, days before losing office, the Howard government made significant changes to a scheme which provided some Medicare funding for dental care. First introduced four years ago, the scheme originally provided $240 in rebates for some dental services. In November that figure was increased to $2125 per year, targeting people with life threatening chronic disorders where dental health is a contributing factor.

As of April Fool’s Day, applications for the funding are no longer being accepted. Those who are already in the system will continue to receive funding until the end of June.

It has been well known for quite some time now that diabetes, some heart conditions, some cancers, and other conditions have demonstrated links to dental health, so it makes sense that appropriate dental treatment should be funded through Medicare. In fact, I would argue that all dental care should be eligible for Medicare rebates for the simple reason that dental health is an essential component of good general health.

The new Federal Government campaigned heavily on dental care as part of its election platform. It promised to reinstate the Commonwealth Dental Scheme, which had been discontinued by the Howard Government when it was first elected in 1996. So, in place of the Medicare rebate, the new Commonwealth Dental Scheme, along with the new Teen Dental Scheme, will commence from the First of July. These programs operate by handing the money to the States to deliver the service.

While it is a good thing to honor an election commitment, and a good thing to boost the funds provided to the States to pay for public dental services, to do so at the cost of losing the Medicare rebate is actually a step backwards. Firstly, fewer than 10% of dentists work in the public system, so there just isn’t the capacity to treat everyone in a timely fashion. Secondly, far from the $2125 available to an individual patient through the Medicare scheme, the new funding equates to less than $50 if divided up among the chronic patients, or less than $5 if divided among all patients.

Yes, the Public Dental services need and deserve more funding, but the Medicare program addresses a specific area of need which is unlikely to be met any other way. And, as always, it’s the most vulnerable people, that is pensioners and low income families, who will suffer the most.

That doesn’t exactly sound like a Labor Party principle, does it?

Monday, March 31, 2008

Interest Rate Increase Would Be An April Fool’s Mistake

Well it’s the end of another month, and a new month is upon us. April begins with a Tuesday this year so not only is it April fool’s day, but the Reserve Bank of Australia board is meeting once again. So are we to expect another interest rate increase?

These are, in some ways, extraordinary times. Unemployment is at a record low. Economic growth, despite the global situation, has yet to slow significantly. Inflation is still being targeted as the number one priority of both the reserve Bank and the Federal Government. All of those factors point to a possible interest rate rise.

But, at the same time, there are clear signs that further interest rate increases are not needed. Retail sales have softened. Real Estate auction clearance rates have plummeted. Mortgage stress is pushing more and more families closer to the financial edge, and not just in low income families. Banks have taken it upon themselves to increase interest rates independently of the Reserve Bank. All of those factors suggest that there is no need for any further interest rate increase.

In fact, an increase could well prove to be the last straw, not only for mortgage holders, but for the economy too. The current international crisis has been triggered by unsustainable debt, and Australia also has high levels of debt. One of the best mechanisms for tackling high debt is to allow inflation to erode some of its value.

The economy is bit like a shark: it needs to always move forward to stay healthy. While increasing interest rates are intended to slow the economy, high debt levels act to magnify that effect, so that the slowdown could easily become more severe than intended.

For those reasons, I believe that an interest rate rise is not needed at this time. It remains to be seen if the Reserve Bank agrees with me.