What's this crap about the EU needing a 16 trillion bailout?

[PhoneLobster]

Until you address this issue, I am un-intrested in your remarks. You refuse to address the public services own opinion peices on the issue and instead resort to straw man arguement, when I have cited evidence produced and endorsed by the civil service itself.

What fucking issue? Some guy says he has an opinion on the matter, meanwhile Victoria goes without fucking electricity, new south wales goes without rail and the nation goes without health care.

You think I don't include your sacred idol (who's name you have difficulty with) as a proponent and hack in favour of PPPs. Being a public servant doesn't stop you from being a corrupt PPP supporting hack, among other things it's a great golden parachute.

I can point to real practical privatisation nightmares around Australia and around the world and you point to a mission statement and some speeches and demand I address them before we can continue?

Indeed you use this as an excuse to totally ignore the standard PPP condition of the government party shouldering all the risk when these projects are actually put into practice! That is government TOO ready to accept risk, and private firms in PPP arrangements that are remarkably shy of it!

So really, if you think the fact that there are people that agree with you and some of them some how infiltrated the oh so hard to infiltrate public service (yeah, you might need a sarcasm indicator on that comment) but feel free to brush aside you know, traffic chaos, 3rd world electricity supplies, and an ongoing degredation of an excellent health system that costs real lives... Well then fuck you too you moron!

Wrong.

Your statements on health in no way refute or even directly address my own. I HAVE done a lot of research on this and followed the issues over the years. I'm not pulling facts out of my ass, everything I mentioned is god damn history.

Of course, massive medication errors pervade all health systems, but you're not going to be able to demonstrate that the public sector is better overall on any set of metrics.

Go play on the health care thread and learn a few lessons there. They all apply.

But most notably, after all its been a few years since some of the stories I was referring to, what if public hospitals now were in some way worse than the private ones.

It is better for the rich to have a right to longer lives how exactly?

What the UK does

Private enterprise is hostile to competition. Any hybrid private enterprise situaition is by definition unstable, the outcomes in the UK are both not yet determined and not nearly as clear cut as you pretend.

Among other things there is what you present as the ultimate proof, some person saying stuff about it that agrees with me.

I especially like "One must question the fiscal integrity of a government that permits billions of pounds of taxation to be siphoned off by executives and shareholders of large, private, healthcare providers when similar resources could be provided by the NHS at a fraction of the costs, especially when the government has guaranteed an almost risk-free investment environment for these companies."

There are certainly any number of experts in the UK medical system itself who will tell you that the private component is needless costly in money and in actual outcomes.

Wrong. You know why we have a shortage of doctors and nurses? For the same reason we have a shortage of fucking plumbers and electricians. Skilled labour is hard to come by.

What? Skilled labour is hard to come by?

So when John Howard made it harder and more expensive to get a medical degree and all the experts told him that we needed more Doctors and he went on the radio and said that they were all wrong and there was shortage of medical students in Australia...

That had nothing to do with it. Subsidising medical education and encouraging it, that in no way would be a sensible way of creating more Doctors. All the experts in that field, since they disagreed with you, were clearly wrong despite the fact that they predicted a doctor and nurse shortage and it came about. Howard's prediction, that making it more expensive and allowing rich students to further bribe their way into becoming doctors despite sub standard test scores was the way to go, that was fine!

What we have is a shortage of doctors that want to get paid less than if they lived in sydney and instead live in Bendigo.

Hmm, so then the strategy would be to saddle graduates with larger and larger debts from their education, cut back on government funding and subsidising of medical practitioners close and wind back rural public hospitals and pump money into private hospitals in the cities that focus on high profit low risk procedures!

YES, what a genius plan that was from the "Choice" crowd when it comes to encouraging young doctors to go out into rural areas...

The whole thing where we arrested an innocent foreign doctor on trumped up charges in a decidedly illegal manner, that was just a cherry on top.

I honestly think that we have some of the best positioning on all metrics

We do well, we had a very successful purely public health care system, it has yet to be entirely dismantled despite being slowly starved of funds while money is pumped into a parasite that is harming it over the long term. You can't kill a successful public health system overnight, the public would come after you with pitch forks and burning torches. The cleptocrats like yourself know the way to go is "hybrid schemes", "Corporatisation" "Choice" and "PPPs".

The strategy is simple, introduce "choice" as a minor player, slowly push the system more and more towards the private side. Watch as folks like corporatised Telstra CEOs call for full privatisation as a cure for failures actually caused by corporatisation, Decry the massive failure of the hybrid system like Railcorp, demand more of the same and privatise the lot.

Your health care argument fits the same MO as the rest, propagandise, privatise loot, decry failure of government, privatise more, loot more, repeat for ever until the peasants turn up with pitchforks and torches and renationalise the trains.

[Username17]

Oh I agree, but due to the electorate not being entirely rational voters, this is unlikely to happen.

If you can empower a public employee to authorize a private contrctors to hire individuals with desired skill sets for X dollars, you can empower the same public employee to hire the same individuals for X dollars. The money, the work order, and the authorization for those workers all comes from the government anyway. The private contractor literally isn't providing a single thing in this equation. He's just taking extra money off the top in order to put the "private enterprise" stamp on the proceedings.

Yeah, this may require some out of the box thinking - but only because the box you guys are currently thinking in is apparently retarded.

-Username17

[name_here]

Actually, the pay scales are fixed due to unions, so the US government created MITRE. It's basically a government owned private contractor with a fancy name that doesn't get to have profits.

[PhoneLobster]

We get similar things from time to time.

Many private contractors for government agencies here are in fact public servants that were fired to save money and then rehired as various forms of casual worker with no job security.

Only they get employed constantly and often get paid more than they used to. So the cuts are originally justified as "efficiency" measures become a bloating of expense and administration of the more ridiculously complex work arrangements for no real gain.

This kind of insane "lose lose" employment scenario (more expenses for the business worse conditions for the worker) is especially prevalent with our privatised and corporatised bodies. So much for private sector innovation.

However it was sticking one in the eye of the unions, the public sector and those damn socialists so everything is cool!

Even if it saved money by undercutting unions (something these measures never seem to achieve despite the promises, at best they are used as accounting slight of hand to shift figures to different books) that would be bad policy because if you can't trust the government not to mistreat its workers how can you trust them to police work place rights elsewhere?

[cthulhu]

Oh I agree, but due to the electorate not being entirely rational voters, this is unlikely to happen.

If you can empower a public employee to authorize a private contrctors to hire individuals with desired skill sets for X dollars, you can empower the same public employee to hire the same individuals for X dollars. The money, the work order, and the authorization for those workers all comes from the government anyway. The private contractor literally isn't providing a single thing in this equation. He's just taking extra money off the top in order to put the "private enterprise" stamp on the proceedings.

Yeah, this may require some out of the box thinking - but only because the box you guys are currently thinking in is apparently retarded.

-Username17

Defiantely: But its not a line of thinking the public has historically been willing to accept. Helicopter flights are Not On. Neither are highly paid public service positions.

Incidently, I agree that hiring 'body shop' contractors is pretty poor: If the contracting organisation is offering no value, yeah, you're getting skimmed for no reason. If you're hiring the other brand of contractors, like lawyers from a big 6 firm, you are getting additional value from the contracting company.

The government just commissioned a review into long term hiring of contracts (Gershon for those that are intrested), recommending in the IT sector cutting contractors and getting more APS.

However, implementation is failing because the APS are, as has been established, full of idiots. The really highly paid contractors are just refusing to budge, but you cannot get rid of them, and the body shopped ones are being rehired as 'Non-ongoing' APS employees at total benefits packages equal to their contracting rate. So the government is back where it started.

@PL: Fed Gov Orgs have two separate funding buckets: Money, and Employees - the bloat of contractors is caused by the money bucket expanding, but business units not being allowed to increase head count as part of the efficiency dividend, so they hire contractors.

What fucking issue? Some guy says he has an opinion on the matter, meanwhile Victoria goes without fucking electricity, new south wales goes without rail and the nation goes without health care.

Wait so the treasury secretary is 'some guy' - he's either the most, or second most quoted public servant, with the head of the reserve bank probably taking first.

Sheesh.

I can point to real practical privatisation nightmares around Australia and around the world and you point to a mission statement and some speeches and demand I address them before we can continue?

I never pointed to a mission statement - I think you may have confused a report into attendance problems across all APS government agencies with a mission statement. I can see how you can get a hundred page report about deep seated cultural problems confused with a mission statement, so I apologise for your miss understanding, and would redirect you to the report. It may clarify the issues, with additional context coming from speeches by the most senior member of the Australian Public Service.

If of course you don't think Australia's most senior public servant is a source worth considering when speaking about the Australian public service, I'm not sure what to say to that.

So when John Howard made it harder and more expensive to get a medical degree and all the experts told him that we needed more Doctors and he went on the radio and said that they were all wrong and there was shortage of medical students in Australia...

Have you looked at the number of doctors per population in Australia in urban and rural environments? The AIHW has produced a number of excellent reports on the subject that you can peruse at your leasiure, and have also reported on the shortage of specialists, and the deep seated historical causes of it - mostly pay disparities between various sectors, so doctors gravitate in the main to the higher paid areas.

Hmm, so then the strategy would be to saddle graduates with larger and larger debts from their education, cut back on government funding and subsidising of medical practitioners close and wind back rural public hospitals and pump money into private hospitals in the cities that focus on high profit low risk procedures!

Mate, I agree - we're auging for the same things. The problem is achieving the outcomes. You think the government can just do it, but I think that it cannot in the current australian enviroment. Let us consider this scenario.

Clearly the answer to staffing up rural areas is to pay doctors in rural areas packages that start at 440-660k P.A. Average doctors incomes in Australia, depending on which private research report you choose to believe are in the order of 220k. You'll have no problems attracting students, because at a salary of 440k a year, they can easily pay down even a very significant hecs debt.

Currently the NT state government pays less than that for its practitioners: Almost half actually, despite a clearly stated preference by doctors to live and work in urban areas. Hence they cannot pay down costs etc. The government model has broken.

So the fix? Pay doctors 440k Per annum to work in rural areas.

Is that solution workable? No. The government won;t start paying people 660k. Its just not an option. Nurses salaries need to jump markedly as well. Why isn;t it an option? Lets do some benchmarking.

Assuming we adopt the french level of service, 100% scholarships for doctors, and a public and heavily subsidised insurance scheme that covers almost anything. This costs money, or we need to get our current dollars drastically further.

How do we achieve this?

A) Well, assume we adopt the french model - like you want. You'd have to double the GST - that produces very close to the required level of taxation revenue to do the things you just said you want.

I feel it is extremely unlikely that any government would survive an increase of the GST to 20%. This is just not currently acceptable to the voting public.

B) The state governments need to deploy a national E-Health framework like Denmark's publically held one, which increased primary care efficency by about 10%. This wouldn't get us close incidentally, you need to increase overall efficiency by a lot more to match france's levels of coverage, but hey, as an example.

NEHTA has responsibility for this in Australia. As a Government program, I have no doubt you can produce examples of the results it has achieved.

Actually wait, no you cannot, because you can read the BCG report that slams NEHTA for being ineffectual and accomplishing nothing for 4 years.

Really, which solution do you actually think will work?

A) Double the GST

B) The method that has proven to be beyond the capability of the Australian Public Sector to implement?

I suppose A hasn't failed yet, so maybe you should write to any politician and see what they think of doubling the GST. ha!

[name_here]

We get similar things from time to time.

Actually, the remainder of your post indicates that you either do not or you completely fail to understand the situation in both cases. MITRE and other such Federally Funded Research and Development Centers are ways to get technical workers who are actually any good and aren't willing to work at reduced rates simply out of patriotism. they're really not private corporations, and are in fact banned from A. making a profit, and B. doing things that aren't either RND or long-term tech support for things like the tax calculation computer, which has to be reprogrammed every time someone introduces a new tax break.

[PhoneLobster]

Actually, the remainder of your post indicates that you ...

So in other words you are prepared to go off on a foaming moron rant because I said governments employing expert contractors that are officially private but in practice actually government employees to avoid union/award/regulated conditions and rates.

And I dared to suggest that was similar to governments employing expert contractors through a specific agency that is officially private but in practice is actually a government employment agency to avoid union/award/regulated conditions and rates.

And you think those things are different.

Because in your world your right hand doesn't know what the thing on the end of your right arm is doing.

[Crissa]

Actually, there's no union requirement for things like tech workers. They'd need to have a union, first.

And the regulated conditions of government workers and regular employees of private firms is the same in the US... However the conditions of their managers are not the same; only the top level has to be reported publicly.

So the government contract for a service would be reported as an aggregate amount whereas government employees would have their pay scale reported directly.

That's really the way to hide the fleecing of taxpayers.

Anyhow, private-non-profit is different, and has little to do with the difference between a government entity doing research and a non-profit; both get a 'budget' or 'grants' and then do what they wish to based upon their charter.

Once again, it's a way to appease the no-big-government people and also to compartmentalize researchers so they can continue their work despite the fickle spigot of government funding.

My spouse worked as a NASA contractor. They got a grant to do a project. Without serious wanking, there was no way for the government to change their budget once it was set and paid for. However, the government under Bush still did manage to re-appropriate funds granted and paid to space and tech research.

So in the long run, it doesn't matter. Except that Bush can't appoint someone to hire for the contractor, because they're somewhat self-contained.

-Crissa

[PhoneLobster]

Once again, it's a way to appease the no-big-government people and also to compartmentalize researchers so they can continue their work despite the fickle spigot of government funding.

Which is pretty much in keeping with private contractors here. One of the primary reasons for their existence is an attempt to pretend there are less government employees and related expenses.

[cthulhu]

Actually, there's no union requirement for things like tech workers. They'd need to have a union, first.

Unions in Australia and America are different beasts: But all the Australian Government public service except the military is covered by the Australian Public Service Union, which negotiates pay and conditions for all workers including tech workers in the public service.

The Military has a seperate and completely ineffectual union.

[PhoneLobster]

You'd have to double the GST

I missed this before but caught it while scrolling down.

You really are a stupid fucking right wing fucking hack aren't you?

Double the GST? Private health services cost governments more. That is an incontrovertible fucking fact. So for that you would probably "have" to quadruple the GST.

But that's not what makes you a stupid hack who has swallowed the entire right wing party line hook line and sinker without question (though the sheer failure to deal with the reality of what kind of health service costs more is pretty bad).

No, the bit where you determine that the revenue for a progressive scheme MUST only come from YOUR right wing's own personal pet regressive taxation wank.

You fall back on the standard conservative bull shit "Services cost money, therefore they are never worth it, WAAAAH!", with a large spoonful of "Meanwhile I demand we further tax the poor! Because no other means of raising money exists! WAAAH!"

[Crissa]

It sure is funny how conservatives point to problems they made and say the problems are insurmountable because... Well, because they only accept their own way to not surmount them.

As if there weren't other ways of doing things.

I doubt that it'll be easy to get the same level of health service for much of Oz that France enjoys because of the largely rural areas. But one might think that, I dunno, having all the people covered and paid for in an area would make their jobs a bit easier and more profitable.

Or we could just pay doctors to be in all areas, and not just pay them when we see them. Then they'd be happier to be in BFE than they are now.

And in the long run, as France proves, cheaper.

-Crissa

[cthulhu]

Okay, while public vs private costs is an intresting debate, what I am using is the sum of private and public costs paid by two countries (AU and FR) as a percentage of GDP.

Armed with this combined total (I am not even drawing any difference between the two) the french model costs 12% of GDP combined public and private spending, while the Australian model costs 9% combined public and private spending according to the OECD statistics.

GST revenue is a bit under 3.8% of GDP currently, so factoring in some costs that aren't in that french 12% (education), it's not really much of a stretch to say that to fund the gap in costs between the french and Australian model would cost roughtly the equievelent of the GST costs.

If you actually do the maths, and just consider the raw costs, you'd have to raise the GST to 18%. But that isn't including the secondary costs, like the fact that every doctor and nurse in france gets a 100% fully paid scholarship, so maybe it would be a bit more than 18%.

Remember, the french model actually includes a more expensive range of services than Australia, so this isn't an apples to apples comparison, france does provide a number of extra medical services.

Anyway, if you want to dispute the OECD expenditure figures, I suggest you take it up with them. But the french do spend more on healthcare than Australians, and yes, more public money. To move to the french model would require extra health care expenditure by both the government and private individuals equivelent to raising the GSt roughly 8%.

You fall back on the standard conservative bull shit "Services cost money, therefore they are never worth it, WAAAAH!", with a large spoonful of "Meanwhile I demand we further tax the poor! Because no other means of raising money exists! WAAAH!"

Did I say services were never worth it? No, I never said that. I said it is politically unpalatable in the current environment to raise the GST by ~8% and move the Australian medical system to a french model.

If you disagree, start a fucking political party and stop debating it with me, because you know how to revolutionize healthcare in this country. Write a letter to to the MP of your choice. Seriously, no-one in any of the political parties (including the greens), or any independent is going to support that proposal.

[PhoneLobster]

Okay, while public vs private costs is an intresting debate

No it isn't.

Greater minds than the likes of you, or even I, have been over this.

The results are in.

Private costs more, the more private, the more it costs, and the margin is MASSIVE.

Edit: Also...

# Develop a National Health Care Strategy
# Redirect the $3 billion private health insurance rebate to public health and hospitals
# Protect and extend Medicare

... Yep, everyone must conform to your imaginary universe even the... well OK apparently not...

[cthulhu]

It sure is funny how conservatives point to problems they made and say the problems are insurmountable because... Well, because they only accept their own way to not surmount them.

I love how everyone assumes I am a conservative - if we go to where www.dosomefink.com you can see me getting flamed for suggesting that nationalised healthcare is vitally important.

Its fucking hilarious. Clearly of course they are right wing nut jobs, and PL is a left wing nut job, and I have committed the crime of not adhering to positions that are well outside of the overton window in Australian political debate.

As if there weren't other ways of doing things.

Sure, I've mentioned atleast 5 other ways of doing things

There is the Australian model, the NHS model, the US model, the french model and the Canadian model.

You get to pick one then tweak the sliders a bit. If you want denmark, its like us except with more public healthcare. If you want singapore, its like the NHS. Finland is like Canada.

But these are major decisions that may indeed require constitutional change, or one level of government seizing power from another. Also, all the models are flawed. Australia's is inequitable. The US is too expensive. The NHS delivers poor service. No-one has teh write answer here.

I doubt that it'll be easy to get the same level of health service for much of Oz that France enjoys because of the largely rural areas. But one might think that, I dunno, having all the people covered and paid for in an area would make their jobs a bit easier and more profitable.

Everyone in those areas does actually get covered on medicare, which is very important. The problem is getting these people to a specalist. Specalists don't want to live in hicksville. They want to live in cosmopolitian sydeny. It takes very large sums of money to move them from Sydney to Hicksville and this is a really big problem.

Or we could just pay doctors to be in all areas, and not just pay them when we see them. Then they'd be happier to be in BFE than they are now.

Sure, but this is highly expensive for someone. As I pointed out, positions in rural hospitals offering 300k + super + car + housing cannot get any qualified takers. Paying more will work eventually, but you can see the problem. That is a lot of money, more than the head of the department of health gets paid.

And in the long run, as France proves, cheaper.

-Crissa

As a percentage of GDP, summing private and public expenditure, france pays the most out of any OECD nation except america. Oh. And Switzerland.

So its not really cheaper per say. Is it it better? Very possibly.

[cthulhu]

Okay, while public vs private costs is an intresting debate

No it isn't.

Greater minds than the likes of you, or even I, have been over this.

The results are in.

Private costs more, the more private, the more it costs, and the margin is MASSIVE.

Dude, I don't care. France pays more than Australia. I don't care about the breakdown, I care about the total cost of healthcare in that country. France pays more. Whoopie! (for reference, 77% of total healthcare expenditure in france is public sector and 67% in Australia)

Edit: Also...

# Develop a National Health Care Strategy
# Redirect the $3 billion private health insurance rebate to public health and hospitals
# Protect and extend Medicare

... Yep, everyone must conform to your imaginary universe even the... well OK apparently not...

Umm, you'd have to increase those numbers by a factor of MORE THAN TEN to reach the level of funding to shift Australia to the french model, and thats including cutting private healthcare expenditure by 30% and shifting that money into the public system via more taxation

I think that pretty much proves my point actually. They are proposing no new money, but to get us to france we'd need to inject over 30 billion new dollars. Thats almost the entire stimulus package. Actually, its more than that - remember you need to suck out 22 billion dollars from the private healthcare sector and transfer that to the public healthcare sector.

So the greens are going.. 6% of the way to your 'Make Australia Like France Proposal' which I agree is very laudable, but not really within the realms of the possible.

[Crissa]

I think your math is off, cthu.

While yes, France does consume 2.4% more of their GDP on healthcare... That difference is actually $751 per capita, which is actually only 2% of Oz's GDP, and that's assuming you're buying EU or US trained and supplies, which I doubt you are. If you buy locally or even from cheaper countries, it's only 1.5% of AU GDP (nominal).

That point made, I really don't see how the government revenue can be only 3.8% of the GDP.

-Crissa

[Crissa]

Wow, cthu... I'm gonna stop there.

You're not even our reality if you think France pays more (public+private) than the US, in total or per capita.

In 2006, the US spent over $6K per capita, or over 15% of the GDP. France spend just under $4K, 11% of their GDP; and Australia spent just over $3K, 8.8% of their GDP.

-Crissa

[cthulhu]

I think your math is off, cthu.

While yes, France does consume 2.4% more of their GDP on healthcare... That difference is actually $751 per capita, which is actually only 2% of Oz's GDP, and that's assuming you're buying EU or US trained and supplies, which I doubt you are. If you buy locally or even from cheaper countries, it's only 1.5% of AU GDP (nominal).

That point made, I really don't see how the government revenue can be only 3.8% of the GDP.

-Crissa

I don't like to benchmark with the absolute dollar figures, and instead stick to the % of GDP metrics. Absolute dollars is risky business. For example, using that logic we could build two Korean health services for what we currently spend on ours. And Korean healthcare isn;t bad, so logically with two of them it would be awesome.

The reality is given the distance factors you point out healthcare is going to be more expensive to deliver in Australia. Heck, it is, the cost of traveling to hospital or a specialist for 1/3rd of the population (1k) is much greater than the average cost of said visits.

3.8% of GDP is derived as government from one specific tax - the GST - which is a VAT or sales tax applied to all goods and services except unprepared food, and a few other things. I use that because recently the idea was kicked around to raise it to 12% - and public opinion was not good - so 18% is going to be a bit vile.

[cthulhu]

Wow, cthu... I'm gonna stop there.

You're not even our reality if you think France pays more (public+private) than the US, in total or per capita.

In 2006, the US spent over $6K per capita, or over 15% of the GDP. France spend just under $4K, 11% of their GDP; and Australia spent just over $3K, 8.8% of their GDP.

-Crissa

I'm just going to assume you cannot read here.

What I said

As a percentage of GDP, summing private and public expenditure, france pays the most out of any OECD nation EXCEPT america. Oh. And Switzerland.

What you read:

Something completely different. Did you see the EXCEPT in that sentence? Maybe you need to re-read it. Once you have, you can stop telling me what I already said.

[Crissa]

...And if Australia spent 110% of what France does per capita, they still wouldn't spend more of their GDP than France.

Shut up.

-Crissa

[cthulhu]

Awesome. But under that logic, we could all adopt the Singaporean system (because they spend 2.8% of GDP and have a fairly comprehensive healthcare system), abolish the regressive GST and still save billions of dollars which we could spend on.. I dunno. Education? Hats?

[Koumei]

billions of dollars which we could spend on.. I dunno. Education? Hats?

I hear our sporting people are crying that, if they don't get billions of dollars, we'll be out of the Olympics and suck as a sporting nation. So clearly that deserves more attention and money than, say, health and education, or even hats.

[cthulhu]

This is Australia! Oi Oi Oi!

[Draco_Argentum]

The AIS is an impressive example of what Australia can do if it wants to. Pity its not an institute of something useful.