Medibank skips health insurance grilling

Medibank won’t join other health funds to explain soaring private health insurance premiums at a parliamentary inquiry despite being the biggest player in the market.

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The private health fund insists it can’t make it for Thursday’s public hearings although other major players Bupa, HCF and NIB are preparing to front the Senate inquiry in Canberra.

A Medibank spokeswoman told AAP senior executive Andrew Wilson was unable to attend because of a prior commitment but was able to make himself available “on another occasion if the committee chooses”.

It comes as the Federal Court this week hears allegations from the Australian Competition and Consumer Commission that Medibank misled and deceived its customers by secretly changing policies to boost its profits before becoming a public company in 2014, leaving patients with unexpected costs.

The Senate inquiry is looking into rules that make medical devices such as pacemakers more expensive in the private system then the public system – often blamed by private health insurers as a reason for higher premiums.

Medibank has made a submission arguing the disparity between prices for public and private patients is detrimental to consumers, health funds and the federal government.

“Removing prostheses’ price disparity would allow for real cost savings for consumers, savings Medibank is committed to delivering to our customers,” the spokeswoman told AAP.

The medical device industry argues prices are higher in private hospitals because public hospitals buy much larger volumes and don’t provide the same variety of devices to patients, meaning private hospitals can’t leverage the same economies of scale.

But the Medical Technology Association of Australia has pointed the finger at private hospitals, arguing a review of hospital costs would likely generate substantial savings given they represent 70 per cent of the total cost, while medical devices make up just 14 per cent.

It argues the benefit paid by private health insurers for medical devices has not changed since 2005.

One of Australia’s highest-paid health bosses, Ramsay Health’s Chris Rex, is being threatened with a summons to appear as private hospitals ignore requests to front the inquiry.

Senior Labor figure Sam Dastyari has urged Mr Rex to stop “hiding”.

Ramsay Health declined to comment.

Senator Dastyari says there needs to be more accountability from the private hospital operators, given the $6 billion of taxpayer funds handed to the industry.

“The (Ramsay) CEO gets paid $13 million a year and gave themselves a 20 per cent bonus last year and at the same time the cost of all their services keeps going up and up and up,” he told Sky News.

“There is some really serious questions about how this money is being spent.”

Workers stood down from $36b gas project

More than 800 staff have been stood down from the $36 billion Inpex gas project in Darwin over a contract dispute, a decision the CFMEU says was a “complete shock”.

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Construction group Laing O’Rourke has stood down around 245 local workers and around 395 fly-in fly-out workers over a dispute with consortium partner Kawasaki Heavy Industries.

A CMFEU spokesperson said 200 subcontractors had also been stood down.

Principal contractor JKC Australia says local workers have been told to go home, while fly-In fly-out workers will be placed on the next available flight out.

“They’ve all been shipped back to the camp and at the moment are packing their bags and heading to the airport,” CFMEU spokesman Josh Burling told ABC News 24.

Mr Burling said some people were told they were redundant when they arrived at work at 6am on Wednesday.

“I would imagine they’re not handling it too well at all,” he said.

“They’ve got to go home now and tell their wives, families there’s no more money coming in.

“Work is scarce at the moment, particularly in Darwin itself.

“It’s a complete shock.”

Laing O’Rourke and Kawasaki are part of a consortium tasked with constructing a network of four massive cryogenic tanks for the project.

JKC says that contract remained in place and it was confident Laing O’Rourke and Kawasaki would resolve the dispute.

“JKC’s expectation is that the parties will resolve the matters in dispute and the works will continue,” Executive Director John Bramley said in a statement.

It said the construction of the cryogenic tanks is approximately 91 per cent complete.

Labor leader Bill Shorten said workers have become cannon fodder in the legal battle between two employers.

“These people should be reinstated,” he told reporters in Melbourne.

He described it as a pretty, sad state of affairs when blue-collar tradies were sent home because of a contractual dispute.

“I think the government should try to facilitate talks to get these guys back to work because the work needs to be done and they are a good workforce,” he said.

Greens open debate on four-day week

Fancy a four-day working week? Have the Greens got an idea for you!

The party’s leader Richard Di Natale wants to trigger a national debate about shaking up the working week, with a proposal to shorten it to just four days.

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He is keen to question the long-held view that a good life can only come from work.

“We rightly talk about the 16 per cent of people who want to work more hours, but we never hear about the more than one-in-four Australians who want to work less,” he told the National Press Club in Canberra on Wednesday.

“A four-day work week or a six-hour day might actually make us happier and create more opportunities for others, not to mention reducing the costs of full-time child care.”

The Greens are not putting forward any specific model and Senator Di Natale would not be drawn on whether the party would favour greater government intervention or imposing conditions on employers.

“It’s a conversation that has to involve the business community, the unions, workers,” he said.

“We have to start it, we have to ask ourselves those questions and at the moment we’re just not doing that.”

The discussion should also include the idea of a guaranteed adequate income, he said.

Other countries have trialled models to ensure people are looked after through a social safety net.

“The very people who created the dog-eat-dog society – that so many of us now resent – will tell us these things are pipe dreams.

“Don’t believe them.”

There were worldwide examples of ways to encourage productivity and allow people to spend more time with their families without doing unpaid overtime.

Conservative Liberal backbencher Eric Abetz labelled the speech “delusional, out of touch and dangerous”.

“The Greens’ proposal to shorten the working week to four days would have a devastating impact on the Australian economy and its productive capacity,” he said.

“I’m not sure how Senator Di Natale intends on funding his socialist health, education and foreign aid proposals with a dramatically reduced revenue base.”

Outspoken crossbench senator David Leyenhjelm also dipped his toe into the debate.

“I fully support the idea of a four-day working week, particularly when applied to Senator Di Natale,” he said.

Westpac, ANZ to strengthen FX controls

Westpac and ANZ will overhaul aspects of their wholesale foreign exchange businesses under the eye of the corporate watchdog to address inadequacies in their systems.

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Both banks have entered into enforceable undertakings with the Australian Securities and Investments Commission after the watchdog highlighted concerns about their systems and controls between January 2008 and June 2013, including instances of employees disclosing confidential details of currency trades.

“The foreign exchange market is a systemically important market that depends on all participants acting with integrity and fairness,” ASIC commissioner Cathie Armour said in a statement.

“ASIC is committed to ensuring that major financial institutions have the systems in place to ensure that financial services are provided fairly, honestly and efficiently.”

ASIC will appoint independent experts to assess each bank’s progress, with both having already made changes since the period in question.

“ANZ has co-operated fully with ASIC’s investigation on this matter and we accept that during this period aspects of our supervision and monitoring of the Spot FX business were not good enough,” ANZ chief risk officer Nigel Williams said.

“We have taken responsibility and we apologise.”

Westpac also apologised and said it will continue to enhance its policies and controls.

Each lender has agreed to donate $3 million to charity.

In December, National Australia Bank and Commonwealth Bank agreed to similar enforceable undertakings and to each donate $2.5 million as part of the same industry-wide investigation.

Hope for patients with fatal brain disease

A drug used to treat diabetes has the potential to help sufferers of a rare and devastating Parkinson’s-like degenerative brain disease.

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A study published in medical journal Brain found neurons in the brains of patients with multiple system atrophy (MSA) showed insulin resistance, which is also marker of diabetes.

Scientists, led by Dr Fares Bassil from the University of Pennsylvania, then used the diabetes drug Exendin 4 on mice with MSA.

The drug improved insulin resistance in the brains of the mice and importantly preserved some of the neurons normally damaged by the disease.

This is an “incredibly encouraging” discovery, says Australian Professor Bryce Vissel, Director Neuroscience and Regenerative Medicine in the Faculty of Science at UTS.

“If proven to be effective for MSA, even if it slows it just a little bit, it wouldn’t have to go through enormous amounts of safety testing and development before it gets used for this disease,” Prof Vissel said.

MSA is a rare progressive brain disease that affects adults, usually in their 50s or 60s.

It is caused by degeneration, or atrophy, of nerve cells in specific areas of the brain.

The average survival time from diagnosis is six-to-nine years and there are no effective therapies to treat the symptoms which include fainting spells, loss of muscle co-ordination and speech difficulties.

“The suggestion that this diabetes drug could offer a therapeutic approach for MSA is therefore potentially of enormous importance and deserves close scrutiny,” said Prof Vissell.

While there is still a lot of work to do in the form of clinical human trials, Prof Vissell says, Exendin 4 may also offer “promise” for the treatment of Alzhiemer’s disease.

“Numerous studies have identified Type 2 diabetes as a risk factor for stroke, Alzheimer’s disease, vascular dementia, and Parkinson’s disease, among other disorders,” he said.

“We have previously suggested that brain insulin resistance, which is a characteristic of Type 2 diabetes, follows from the inflammation that is a hallmark of neurological diseases.”

Ponga to be tested in defence: Morgan

No one doubts Kalyn Ponga’s attacking prowess.

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But North Queensland’s Michael Morgan says the teenager will need a little help from his friends in defence in Saturday night’s NRL home clash with Manly.

Especially against his opposite number, Sea Eagles custodian Tom Trbojevic.

All eyes will be on Ponga – still just 18 – when he is unleashed at fullback, filling in for injured No.1 Lachlan Coote.

The big-stepping Ponga was an attacking threat from the outset as an injury replacement on the wing during the Cowboys’ 2016 finals run, almost scoring with his first touch.

Now the stage is set for Ponga to show his complete arsenal in his preferred position of fullback, with Coote (calf) out for at least a fortnight.

However, a big question mark looms over Ponga’s untested defence at the back – even more so with Trbojevic lurking.

The Sea Eagles custodian amassed a remarkable 305m, scored a try and set up another in their 38-18 last round loss to South Sydney.

“He had a really good game. Hopefully we can be a lot better defensively on the edges,” Morgan said of Trbojevic.

As a result, Morgan admitted Ponga faced a steep learning curve in defence but believed he had the necessary support around him.

“It is a big job defensively but we have enough experience on our edges to help him out,” Morgan said.

“It’s not one person’s job to come in and make a difference.

“It’s about us helping each other. That’s one way we can help Kalyn.”

Ponga also didn’t have to be reminded he would be tested under the high ball against Manly.

Morgan said they had done their best at training to simulate the air raid expected on Saturday night.

“We will do a few more (high balls) on Friday but he’s usually pretty safe,” Morgan said.

“He’s played a lot of fullback before. It is nothing new to him.

“Yes he’s in a different team to the Under 20s but he did a whole pre-season training at fullback with us.

“I have full confidence in him.”

So does Cowboys coach Paul Green.

Ponga’s selection ended talk the youngster had been out of favour with Green after signing a lucrative four year deal with Newcastle from 2018 in the off season.

“It was spoken about in the pre-season whether or not he should have been in the team and now the time is right,” Green said.

ATO ‘vulnerable’ to external cyber attacks

Two of Australia’s biggest government agencies remain vulnerable to cyber attacks from outside sources despite attempts to improve security.

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An audit of the Australian Taxation Office and immigration and border protection department found both had a “reasonable” level of protection from unauthorised leaks from within.

But neither were sufficiently protected against external attacks.

Each year the ATO collects more than $440 billion in tax revenue through its electronic lodgement system, while immigration electronically processes around seven million visas.

“Not operating in a cyber-resilient environment puts entities’ data and business processes at risk, with potentially significant consequences for Australian citizens and other clients and stakeholders,” the Australian National Audit Office said in its report, published on Wednesday.

The Department of Human Services, which is in charge of Centrelink, was the only one of the three audited agencies deemed to be “cyber resilient”.

That means it’s able to keep providing services while deterring and responding to cyber attacks, thus reducing the likelihood of a successful attack.

It was also the only one found to have fully complied with four mitigation strategies mandated by the federal government in 2013.

The audit found immigration allowed more than 1400 staff to bypass controls and install and use unauthorised applications on their computers – breaking its own rules and increasing its security risks.

It also found many immigration computers had outdated software, which could also increase security risks if it was no longer supported with regular updates.

Auditors said the ATO and immigration department needed to prioritise cyber security, which both accepted.

The tax office said it has committed additional resources and promised to focus fixing deficiencies.

“Immediate improvements have already been put in place with a commitment to reach cyber resilience status in 2017,” it said.

Immigration said it had continued to improve its cyber security since the last audit in 2014, but recognises it still faces risks and challenges.

By the end of June, the department has promised to deliver several programs it believes will improve compliance and capability as part of a broader five-year program to better resilience.

“These measures will enhance the department’s protection against cyber attacks from external sources and further improve the department’s robust cyber security controls against internal threats,” a spokeswoman told AAP.

NSW hospitals ‘pressure cookers to blow’

Doctors say NSW hospitals are “pressure cookers about to blow” with new figures showing more patients are flooding emergency departments.

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Almost 20,000 more patients attended emergency departments between October and December last year compared to the same quarter in 2015.

The number of sick people arriving at the state’s hospitals is at a five-year high, with 684,740 patients visiting an emergency department in those three months, the latest quarterly report from the Bureau of Health Information revealed on Wednesday.

Those transferred from ambulances to hospital staff within 30 minutes also hit its highest result ever this quarter – to 92 per cent.

But just 66 per cent of emergency patients were treated within the recommended 10-minute time frame, the report found.

The Australian Medical Association NSW has used the data to blame the federal government for being “asleep at the wheel” on policy, saying some were designed to shift people away from general practices and into hospitals.

It wants the government to lift the Medicare rebate freeze and commit to staffing the state’s growth areas in western Sydney.

Mistakes were bound to occur if staff had bigger workloads.

“Talk of crisis in healthcare happens all too often but these reports show us that’s exactly what’s happening right now,” president Brad Frankum said in a statement.

“The pressure cooker is set to blow.”

NSW Labor said families on tight budgets were turning to emergency departments in desperation.

“Emergency departments are meant for emergencies; not ear aches and minor sprains,” Labor’s health spokesman Walt Secord said.

NSW Health Minister Brad Hazzard paid tribute to hospital staff for delivering quality care while dealing with more arrivals.

He also jumped on figures showing wait times remaining stable over the period, with more people waiting less than four hours to see a doctor in emergency.

Elective surgeries also jumped by almost 1500 procedures the quarter.

“We’re playing catch up for the years of Labor neglect and we have a record building boom for health infrastructure across the state,” he told AAP.

NSW HOSPITAL VISITS: OCTOBER-DECEMBER 2016:

* Emergency department visits at the highest level of the past five years, with 684,740 patients

* 33 per cent of triage category 2 (emergency) patients did not have their treatment start within the recommended 10-minute time frame

* 92 per cent of ambulance patients moved to hospital staff within 30 minutes

* Elective surgery procedures jump by almost 1500 – the highest result ever

(SOURCE: HOSPITAL QUARTERLY, THE BUREAU OF HEALTH INFORMATION NSW)

Six years and counting: Syria’s civil war

There was a moment in August when the world found itself staring into the back of an ambulance.

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It was dark outside, a cluster of cameras in the ring of light cast from the vehicle on the road, all their lenses pointed at a little boy in an orange chair.

It was a moment of pause: for the boy, as he gazed silently into the glare, and for those watching him; a brief line of connection to his reality.

Omran Daqneesh, five years old, touched the wound he couldn’t see on his head, stared at the blood and dust on his hands, rubbed them onto the seat.

That brief moment – in a war already well into its sixth year – somehow transcended the daily churn of dust and fighting and airstrikes, and people across the globe stopped to look.

Perhaps it was Omran’s lack of tears, his raw bewilderment that caught their attention; or his cartoon Nicklodeon t-shirt, his feet that only just reach the end of the seat. Perhaps it was the look in his eyes – his simple acceptance of the horror around him, his palpable weariness. Some suggested he was channelling the mood of Syria.

This is a war older than Omran.

Omar Daqneesh, a five-year old Syrian boy, sitting in an ambulance after an alleged airstrike hit a house in Aleppo, Syria, 17 August 2016. (ALEPPO MEDIA CENTRE)ALEPPO MEDIA CENTER

A “torture chamber”, says the United Nations, washed by a “tidal wave of bloodshed”. The rhetoric of the Syrian conflict is sprawling, immense.

Zeid Ra’ad Al Hussein, the UN High Commissioner for Human Rights called it the “worst man-made disaster the world has seen since WWII.”

Still, it barely encompasses the enormity of this war.

The numbers are so huge, they become almost incomprehensible.

More than 11 million Syrians have fled their homes – nearly half the population of Australia.

Activists estimate more than 320,000 people have been killed – nearly the population of Canberra.

The UN says 2016 was the deadliest year yet for children. UNICEF says there are 5.8 million children in need – more than one and a half times all the school students in Australia. Of those, some 280,000 are living under siege.

This is a war sparked by the graffiti of a then-child.

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One Wednesday evening in the early Arab Spring – 14-year-old Naief Abazid and his friends scrawled a message on a school wall: “Your turn is coming, Dr [Assad].”

He was just doing what the bigger kids told him to, with a can of black spraypaint under the window of the principal’s office, trying to make them laugh, he said, years later. He didn’t mean to launch a revolution.

“It was something silly,” Abazid said, of what happened that day in Daraa, “I was a kid. I didn’t know what I was doing.”

Abazid’s graffiti and the subsequent detention and torture of he and his friends, gave rise to rebellion. The rebellion was met by automatic weapons. Then a popular uprising became a proxy war.

Accusations of war crimes directed at all actors – but most frequently at the Syrian government – have become a near-refrain.

A new UN commission of enquiry report says the Syrian air force deliberately bombed a spring outside Damascus in December, cutting off the water supply for 5.5 million people living in and around the city.

The Syrian government had blamed rebels, but UN investigators say the evidence showed the damage was caused by at least two air strikes.

The report also says the Syrian air force bombed a complex of five schools in Haas, a village in rebel-held Idlib province, on 26 October killing 36 civilians, among them 21 children.

Both acts labelled by the UN commission as war crimes.

INTERACTIVE: Move the slider to see how areas of control have changed over the last year.

Aid workers and medical staff have become targets. “Syria has become the most dangerous place on earth for healthcare providers,” say researchers in their first report for the Lancet Commission on Syria.

The study – of attacks on healthcare in Syria since 2011 – lists a deathtoll among medical workers of at least 814. Some of them were tortured and executed. There were nearly 200 attacks on healthcare facilities in 2016 alone, researchers say.

The “weaponisation” of healthcare: the killing of hundreds of healthcare workers, the targeted destruction of medical facilities has profound implications for medical neutrality in conflict zones

The battlefields are filled with a multitude of factions – guns turned on each other.

Syrian government forces loyal to President Bashar al-Assad, backed by Russian air power and Iranian militias are fighting opposition forces. Mr Assad refers to them all as “terrorists”.

Opposition groups include both Islamist militias and more moderate factions, supplemented by Kurdish fighters, backed by Saudi Arabia, Turkey, and until recently, the United States.

Despite fighting against Mr Assad’s troops, Turkish forces and Kurdish militias also clash – over long-running disagreements on control of the area on their shared border.

All sides are fighting IS, who rose to prominence in Iraq and Syria amid the fractious conflict.

They have provided a common enemy.

Syrian forces wrested the ancient city of Palmyra from their grasp in March 2016 – a symbolic win – over the course of the year to be lost, and won again.

United States Marines have joined boots on the ground, deployed to strengthen the fight against IS, by new US President Donald Trump.

Middle East analyst Rodger Shanahan, from Sydney’s Lowy Institute, says the new US administration is still grappling with their understanding of the protracted conflict.

“But I think they’re now coming to grips with the complexity of the Syrian situation as the Obama admininstration has had to do for the 6 years before,” he told SBS News, “so I think, while [Mr Trump] has said a number of things about how simple it would be to defeat Islamic State in Syria, that’s only been one side of the question.

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In the last year, some factions have won ground and some have lost. Military commanders say IS is on the defensive.

But this was the year the world watched a battle for a city.

Before the war began, Aleppo was Syria’s largest city. A year ago, it was in its 44th month of siege, bombs raining down from Russian and Syrian warplanes on more than 300,000 people in the rebel-held east.

Watch what happened in the 2016 Battle for Aleppo here:

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Mr Shanahan says the victory of Syrian troops in Aleppo has changed the narrative of the war

“We’ve probably seen the shift of the momentum go towards the Assad regime somewhat, but they’re still not in any position to reassert control over large parts of Syria,” he said.

That also doesn’t mean that Aleppo’s residents are receiving aid.

“The high insecurity inside Syria and the constantly shifting frontlines make it very difficult for us to access all these areas on a regular basis,” Evita Mouawad from medical NGO Medecins Sans Frontieres told SBS, from their regional headquarters in Amman.

“We are still unable to access government held areas. We have repeatedly asked the Syrian government to access these areas since 2012, but we have repeatedly been denied,” she said.

While emergency care has been prioritised over the last few years, other basic needs have been ignored, Ms Mouawad explained.

“This is why non-communicable diseases and mental health and vaccinations have maybe not been prioritised, but of course if you have heart disease or diabetes and it’s not treated for a long period of time, you could also die,” she said.

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Deep frustration has set in on all sides after numerous rounds of peace talks, numerous ceasefire violations.

Discussions over the last year have moved from those brokered by the UN in New York and Geneva to those led by Russia and Turkey in Moscow and elsewhere.

Syria’s opposition says they won’t be attending this week’s negotiations in Astana, because government forces are not respecting the cessation of hostilities in civilian areas.

Progress is likely to be slow, says Mr Shanahan.

“Those who are backing the Assad regime have more skin in the game than those who are backing the opposition,” he says, “and I think regional backers are going to be exhausted before Russia and Iran and the Syrian government is. How long that plays out and how long that takes, nobody really knows.”

But even in this war, so entrenched and complex – now entering its seventh year – Ms Mouawad says those living through it still have to believe an end will come.

“We see hope in the faces of the people we meet every day,” she said, “We see hope in women and children who have travelled such a long way in search of safety, in search of better lives.

“They are very resilient and they want to believe that one day they’ll be able to go back to their homes and live normal lives like everybody else.”

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Boult out, Southee in, Broom to debut in second test

Southee, who was omitted for the game at University Oval as New Zealand opted for two spinners, will replace Boult in the starting side.

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Batsman Neil Broom would also make his test debut in place of the injured Ross Taylor, Southee said, though they had still not finalised the remainder of their team for the match at the Basin Reserve starting on Thursday.

“There are still a couple of question marks around a couple of the players,” Southee told reporters on Wednesday.

Much of the debate in New Zealand centres around whether Jeetan Patel or Mitchell Santner would be the first-choice spinner if the hosts, as expected, revert to a three-pronged pace attack.

Matt Henry looms as the most likely third seaming option for the hosts along with Southee and Neil Wagner, with the wicket at the Basin Reserve offering a green tinge on Wednesday after several days of heavy rain and inclement weather in Wellington.

Wagner had a heavy workload in Dunedin, bowling 58 overs, with Boult only able to bowl 15 in South Africa’s second innings before he left the field.

Southee said the left-armer had dialed it down in training in the leadup to the test.

“Neil didn’t bowl a hell of a lot between Dunedin and now,” Southee said. “He had a bit of a bowl today just to freshen up and bowl a bit of the stiffness out of his legs.”

Southee added that losing Taylor would leave a large hole in the middle order, but they had faith the 33-year-old Broom would comfortably step into the number four spot.

“Neil has got the opportunity to perform now. He has been dreaming about this for a long time,” Southee added.

“He has shown glimpses this summer that he is capable of performing at the international level, so we’re looking forward to seeing what he does.”

(Reporting by Greg Stutchbury; Editing by Ian Ransom/Peter Rutherford)