Modest Expectations – John 1

Public health experts and academics — who have the luxury of not having to ever be elected, and who don’t need to care about the consequences of a prolonged economic crisis — have been demanding Italy-style quarantining from the get-go. The pressure to shut schools from media commentators and worried parents has been enormous.

A quote from Crikey, and yet … I have just added a footnote, which seems to fly in the face of the above. However, it is about time the highly paid individuals in the public health community takes responsibility and stand up to the politicians.

It’s late Saturday afternoon on 21st March and I am angry – very angry. Why was that cruise ship, Ruby Princess, owned by one of Trump’s mates, allowed to dock in Sydney and the passengers hurried off without being quarantined?

Ruby Princess

I would have asked that question at the Hazzard press conference if I had been there on Saturday, except for him coughing all over the place. Nobody asked that question. The media present did not. So Saturday’s spectacle was of NSW having at least 48 people off the boat infected with coronavirus roaming the community as the signature for the NSW health system. “Self-isolation” – what a joke if there is nobody to enforce it. Who at the media conference was the journalist who asked about that action of the Health Minister coughing and infecting NSW wantonly?

Kerry Chant, I remember you as a promising young public health physician. What were you thinking letting this occur? It flies in the face of all public health logic.

I know your Minister is well named, but Dr Sheppeard, who was at the press conference deputising for you, should have told the Minister to step away the requisite number of metres and “do unto himself as he would do unto others” what he had been spruiking. Did anyone do that? Did the Minister use hand sanitiser after he coughed into his hand? What measures were taken to shield those there from this hazardous coughing fit? Dr Sheppeard, Director of Communicable Diseases, was there to ensure that the Minister did conform…not!

Border measures in place whether by ship or plane were non-existent as the Minister blustered.

Watch the curve rise, Dr Chant, and weep for the contribution of the spread that the lack of border surveillance under your watch. You have been in the job for 12 years – too long – time for you to go, Dr Chant. After all, you have had a long time to develop a plan that would have avoided the current border chaos.

But before you go, Dr Chant, the reason for these ships dumping the passengers and repatriating most of the crew? It has been speculated President Trump wants to reveal that he has commissioned a number of these cruise ships to be used as hospital ships to lie off the US Coast – and guess what he will be using? But then, Dr Chant, you may have passed it off as only a rumour. If you read the American media, it is no longer a rumour.

And of course, there are the other four cruise ships allowed to berth. They should have been stopped from berthing. If a modicum of time had been spent in doing so, I presume that was your role.

The NSW Premier announced on Tuesday morning that 149 new cases turned up in NSW overnight, but failed to credit the decision on how many resulted from the failure of border control – and of course there are the other States to be unimpressed.

Overall as reported there are at least 133 cases from the Ruby Princess with three known deaths – the number of cases is still rising. Did I hear the Minister for Health asking whether someone would pass him the Sherry? Or was I just hearing things?

And, by the way, the collection of people on Bondi beach, which occurred at the same time as the cruise ships were berthing, and received condemnation. Is it about time that if COVID-19 was being spread through that congregation it should be manifesting itself? We know those testing positive in the cruise ship but what are the positive results from those who were on Bondi Beach that day?

As an important afterthought, could all States inform us daily not only of the number of positive cases and the number of deaths, but also the number who are in hospital and of those, the number who are in intensive care, together with the number of people who have already recovered. We need to stop the dazzling modelling and deal with reality on a daily basis.

I vicoli vuoti

The quote:

The neutron bomb is a nuclear weapon that maximizes damage to people but minimizes damage to buildings and equipment. It is also called an enhanced radiation warhead. The neutron bomb is a specialized thermonuclear weapon that produces a minimal blast but releases large amounts of lethal radiation, which can penetrate armour or several feet of earth.

Nothing like what the coronavirus has done to the streets of Italy. Barely a piece of paper floats along the lanes of the closely packed cities and towns, most unchanged since the Renaissance or before.

The neutron bomb, the development of which commenced in 1958 as a by-product of the atomic bomb, was eventually abandoned as too dangerous. Even though it protected the architecture, the radiation effects were lethal on the population. There were debates around cities being devoid of population – literally dead cities. It was a consequence that the then leaders could not tolerate. The image of beautiful sights where no-one walked was just too terrible to contemplate. The Duomi, their massive doors open, but nobody came.

But the Virus did.

Memories of Poliomyelitis

There was a polio epidemic each side of WW2 in Australia. I remember one; and my cousin who is 94 remembers the other, when she was in her first year of high school. My mother-in-law, who is the same age would today have been at high school but in those days my country cousin was the exception. Girls left at the end of primary school to work on the farm. It was the Depression, and to her family my mother-in-law was unpaid labour.

However, it was the 1937-1938 polio epidemic and in a way closure of schools in the country was somewhat academic. They both remembered the permit system. Everybody travelling from Victoria to NSW needed a permit because there were more cases of polio in Victoria than NSW. In fact, Victoria was seen to be the “villain” of the epidemic. Tasmania had restrictions on travel but that did not prevent the epidemic invading the island.

As one extensive thesis by Anne Killalea on this Tasmanian epidemic written some years ago concluded;

The greatest poliomyelitis epidemic of all time has left its mark on survivors, however well they have accepted their disabilities and built successful lives. Its mark also shows on those who themselves escaped the scourge, but lost beloved family members, or patients, or school pupils. Volunteers unceremoniously dismissed when no longer required also feel the hurt to this day. Many, if not most – patients, professionals and volunteers alike – expressed surprise to think that anyone after so long would be interested in their story.

As their story is so much part of what Tasmania is today, no one should forget.

They were prophetic words, and they did not only apply to Tasmania. A generation passes, and another polio epidemic was upon Australia.

My and my friend’s memory of the 1949-50 epidemic was of school closures. Our preparatory school was not closed; but there was a death of a young boy in our companion preparatory school. However, I did remember we didn’t play inter-school sport. Swimming pools were closed. My friend’s preparatory school was closed down for a period because one teacher’s son developed poliomyelitis, one of 760 reported in Victoria that first year. We were sent home straight after school, no chartered school buses in those days. The poliovirus is a gastrointestinal virus and for me, a boy living in an unsewered area where the nightman cometh, and where travel from school was on public transport entailing two trains and a tram, it was not exactly social quarantining.

However, I remember no panic; I remember children of my age with those unwieldy leg irons; thirdly I remember that we were told not to eat ice cream – and being an obedient child, I did not eat more than one ice cream a day – there were the penny and three penny cones. I always dismissed the penny cones.

Obviously, I was too young to follow the vaccine debates, but when the liberating vaccines came – first the injectable Salk and then Sabin in a spoon. In a few years polio became rarer and rarer. Even then there were the anti-vaxxers who refused their children the vaccine, often with calamitous consequences.

The epidemic provided the physiotherapy profession with a great boost, and I well remember the physiotherapy team at Fairfield Hospital in Melbourne concentrating on the rehabilitation of the chronic cases.   By the mid-1970s the number of chronic cases had declined to such extent that the physiotherapists were re-deployed into the early childhood development community health program.

However, remember, polio was a disease that disproportionately struck the young, and while there were closures, there was a different mindset in Australia then. When faced in Australia with an incurable disease caused by this virus, one epidemic in Australia during the Great Depression; the second just out from a horrendous wartime.

I am not sure now whether the stoical survival of that virus said something about resilience or resignation that it was just God’s Will.

However, schools were not closed, unlike during the 1918-1919 flu epidemic when the death rate among school age children was low compared to the older age groups – as far as I can estimate 3 per million – but then school attendance was far different from today.

I listened to one of the younger medical brigade expressed in public that “those of us had not experienced anything like that”. Not quite right, Dr Kidd.

Letter from Sweden

A Swedish medical friend sent me this data from Stockholm as of 24 March. Currently Swedish deaths from COVID-19 are 2 per million. It is calculated that Sweden is 15 days behind Italy, where there are 91 deaths per million. Nevertheless, it is a very big gap, and appeared similar to the situation in Australia. However, a subsequent communication indicates that the deaths there may have moved up to 4 per million – a little more than one per day.

The restrictions in place in Sweden include gatherings of 500 or more being forbidden, voluntary quarantine and an intense propaganda campaign to wash hands; and not to go to work if any – and they mean any – symptoms are present. Sounds familiar, and apparently as my friend described it, “a cosy après-ski party” had a significant role in spreading the virus.

Nevertheless, the Swedish government is pushing ahead with increasing the number of intensive beds, and using military hospital beds. The problem is that we are monitoring Italy with a ferocious thanatopsis; but from a more relevant public health point of view, maybe monitoring Sweden would make far better sense for Australia.

As directly reported in (and translated from) the local Swedish media:

A total of 2,016 people have been reported infected with covid-19 in Sweden (20 cases per 100,000 inhabitants), 54% of the reported cases being men. The cases are available at all ages (median 52). Half the cases notified so far has been infected abroad, but of the cases reported last week, the majority have been infected in Sweden

Some of the victims in Sweden have been infected by people, who have fallen ill after traveling abroad. Nationally, 25 of the cases have died.

In total, 80 intensive care patients with laboratory-confirmed Covid-19 have been listed in the Swedish Intensive Care Register’s special reporting module SIRI. The median age is 64 years (26-84 years).

Back to the Past

It is interesting to see how society copes with a catastrophe. My maternal great grandfather, a prudent and wealthy wood merchant, had his money in the Bank of NSW during the Depression of the 1890s, which was entwined with a major drought. He was cashed up, and survived.

On the other hand my paternal grandparents lost a substantial property when they were foreclosed in the 1920s. It was a financial disaster for the family as the property, “Oswego”, later became the Waverley Golf course, nearly 100 acres on the country fringe and long since subsumed by housing and light industry. These case histories were repeatedly drummed into me as a boy, so that I am a person who always wants to be debt free and I cannot stand having no cash.

We all have our foibles and for me, no less than any other. However, the world in which I grew up after WW2 was far different from today. Australia had managed to avoid being massively indebted because of the use of the taxation power, which the Federal Government assumed from the States and never gave back. Government bonds were sold locally and industrialisation, commenced seriously in the late 1930s including defence industries, occurred behind high tariff walls. The backbone for our prosperity was our primary industries – living off the sheep’s back, but not completely.

Barker Station Melbourne

However, there was a great deal of stress, there was rationing and with rationing comes profiteering. There are always good stories. During the war my Aunt Chattie, who lived in the country would send eggs, cream and butter to her daughters in Melbourne. She used to put the parcel on the train at Beaufort; the parcel was addressed to the stationmaster at Barker station, with instructions that my cousins would pick it up.

However those were frugal times – cash or cheque, which had to be signed in ink, only. The nearest one got to a credit card was to put it “on the tick”; but I was always bought up to pay.

Now we have a community loaded with debt, and the economy is shot to pieces. There have been multiple responses from government to COVID-19, each time increasing the pain – but it is confined to the ordinary people; there is no application to the elite.

All the over-paid need to do is to take a pay and perks cut –from the Prime Minister downwards, all those with inflated salaries and perks, including the inflated retirement packages – they should be reduced. All have been built up by sophistry to justify patronage, greed and corruption.

Superfluous political staff need to be pared back; lobbyists put on the same list as the beauticians. Given that the Parliament has voted the current Government a great deal of money, with its culture of handing it out to its mates, then it is all the more reason for Parliament and Government offices to cleanse themselves of rent-seeking vermin and put an end to rampant mercantilism which has been underpinned by our woeful taxation system.

It is thus a good time for levelling out the income scales – those who have been on the government mammae need to be forced to stop milking the system. Once the community went into debt to ape the lavish lifestyle of the seductive lifestyle magazines. Now this social tear in the societal framework with its long lines of inequality may change the attitude to one of disgust at the pampered life of an elite reinforced by these same lifestyle magazines. In the end the fuel is being accumulated for community uprising, especially when there are a large cohort in the community who face death, suicide being an obvious option, rather than from a virus, which seems to act like the common cold. That situation may change if the population is unable to maintain itself with a consequent weakening of the immune system.

However, this virus is wily and in each country is revealing the vulnerabilities of the health systems. America is reaching its moment of truth as already Italy and Spain have.

It is all very well for insulated politicians to tell us all to stay inside our houses, but as The Economist said this week “Suppression strategies may work for a while, but there needs to be an exit strategy…if the governments impose huge social and economic costs and the virus cuts a swathe through the population a little later…there will be hell to pay.”

Especially as there is a clown who perpetuates the distrust in politicians by lying about the reason the MyGov website fell over – a blatant lie. Does the Federal Government do anything about him? No, nothing. And his apology? An adolescent “My bad”.

Dangerous, even revolutionary times. Australia now has the population to sustain a popular uprising.

At present the Government’s solution appears to be to set up a “distinguished group” to advise, with the Messrs Gaetjens and Pezzullo as the bureaucratic conduits. Inspire anybody?

Hairdressers  

Janine Sargeant Highlights

Amid the rubble of businesses closed this week, hairdressing is still surviving as an essential service, but with strict adherence to “social distancing” and hygiene together with a curious debate about whether a haircut can be achieved in less than 30 minutes.

Some hairdressers, like mine in the Sydney suburb of Rozelle, had already instigated special hygiene measures, like handwashing on entry (here’s the basin, we’ll sing along for the 20 seconds), regular cleaning of all chairs and surfaces and the card reader, maintaining “social distance” and close attention to staff health with regular checks – they all have families. But what about this 30 minutes rule?

In 30 minutes I can still get a hair cut, but the foils are foiled for the foreseeable future and you can easily skip the blow dry and the colour for the present time. But tell me, Dr Murphy, what is the evidence for 30 minutes, or was it initially done with a roulette wheel.   And then, just a day or so later, all time restrictions off – not that you could have policed it anyway.

I did have my hair cut this week and I dreamed of that past time when one could find out easily how many people had tested positive and had subsequently recovered (that’s the problem of public health training, always thinking of the denominator). Increasingly it seems the community is now not allowed to have a complete overview. Just try to find out how many people have been hospitalised. There are some data – very little – on the number of patients in ICU, but difficult to find out. Dr Murphy, so why are you hiding this data? We are really not wanting to see any more of the horror photos from Italy. Are they really relevant to Australia?

But back to that 30 minutes, that became 90 minutes or whatever … and I’m still wondering what is going on in hairdressing.   Listening to the very loud calls for all hairdressing to be closed down immediately it becomes clear where the friction is – if Government closes down hairdressing then the salons don’t have to pay out the staff they stand down – Mr Just Cuts didn’t say this, but that was the underlying argument; it was made very clear on Sydney radio on Wednesday. Economics underpins everything, but it still doesn’t explain why hairdressing received special attention in the first place.

And one more brief lowlight before the mouse takes the stage … it was reported this week that a man in Italy contracted COVID-19; his wife and daughter caught the virus from him. But in two degrees of separation, 70 – yes that’s 70 – relatives caught the virus from those three at a family funeral. The normal disease pyramid pales into insignificance in the face of this sort of transmission.

Mouse whisper

From The Washington Post (murine edition)

It could only happen in America under that old Fox, Trump?

As of six days ago, my wife called up her former co-worker, one who dwells in Fox news so much that she has to rush home for certain Fox shows.  She was still intending to drive from San Jose to Seattle in order to visit her son and daughter-in-law.  They planned to stop and stay at gambling casinos along the way.  I betcha they had to change the plan.

The point here is that in the Fox news bubble, an awareness of the situation had not sunk in.

California Hotel Casino

Modest Expectations – The Two Noble Kinsmen

Leigh Sales, what planet are you on? Take your statement last week about those poor tradies who need to drive Uber at the weekend for extra cash. It was put into perspective a few nights later when – that “uber tradesman” Scott Cam was revealing as “chiselling” the Government out of a six-figure sum for his part time services. For his part-time activity he was not behind a steering wheel. He is the Wheel!

Ms Sales, “tradies” as you call them are doing very well, by and large. Probably given you are upwardly mobile, it is just conceivable that you employ a “tradie” or two. I like the word “tradie”; it fits into all forms of the alphabet a-gender

From personal experience, one of my “tradies” owns a hotel and the other has so much work, the last thing he requires is the wheel of car in the evening other than to go home. I suggest that Ms Sales profiles the Uber driver. I know anecdotally my Turkish-born taxi driver who has been driving me for years and who has had a network of drivers from the pre-Uber days, now drives for Uber in addition to his own clientele. However, I suspect that you will find a great many Uber drivers, who are first generation arrivals in this country.

One of the interesting aspects of taxi travel, of which I once did a great deal, always riding in the front seat, I learnt a lot about the outside world; it was the front seat to an ethnic collation.

However, the racial profile of taxi drivers has changed. I always remember a young Greek doctor who, when he first arrived in Melbourne in the mid 90s, could not believe the number of Greek taxi drivers here. Now there are less Greeks. Taxi driving is an indicator of a less established community. For instance, you may find that an increasing number of Sikhs, newly displaced from the Punjab, are a major taxi or Uber population. But freed from the bureaucratic entanglement of the old taxi cartel, Uber driving attracts the retrenched older person and the student out to make a quid – particularly overseas students. I do not deny that there is a poor postilion under-class, but it ain’t “tradies”.

Nevertheless, it made me think about the proposition of the under-utilised “tradie” workforce, if indeed there is such a thing.

Given that it is a local council responsibility to provide a home maintenance and modification service in addition to hospital adjustment to daily living (ADL) for patients returning home, I would have thought that if there were these Sales’ “tradies” out there looking for twilight cash, then they should be easily absorbed more usefully into an Australia-wide home maintenance and modification service co-ordinated as it is locally. It is difficult to gauge how prevalent these schemes are; I remember when I was running a community health program nearly 40 years ago, some of the more progressive local governments had begun to set them up, but in those days there was a bureaucratic separation between health and housing.

Michael Portillo has recently fronted a documentary on the UK public housing situation acting unfortunately as an apologist for (rather than he once was an acolyte of) Margaret Thatcher. She was guilty of poor decision making when she sold off the social housing stock for a pittance without any strategy for its replacement. Portillo himself tried to absolve her of the social vandalism.

The whole question remains of who pays for social housing but more importantly prevents the purchase for its speculative purchase to drive up prices and hence to conceal the underlying inflation in the economy. At the same time the tacit pact between big business and government suppresses the earning power of those who should be able to afford such housing, either by renting or purchase.

In any event, it is just another area for you to explore, Ms Sales, especially with all this talkfest going about us aged across Australia, rather than indulge in the mythology of the “poor tradie”.

Albanese and the Coal Scuttle

The Adani Coal Mine is a private mine. It’s been approved. It is going ahead. It’s not a Government mine… Finance has been the issue with the Adani mine, but it’s had its environmental approvals. I support the jobs that will be created by any project, any project in Queensland or anywhere else for that matter. What Government needs to do is to set in place strict environmental guidelines. When those guidelines are approved, then you have projects which go ahead if they receive private sector support. 

The first reaction to this Albanese mouthing is that the weasel should be removed as a protected species irrespective of the Albanese predilection to cuddle the animal.

Let us make an early prediction. Albo will have difficulty retaining his seat if he does not do a better job of explaining whether he will be emulating the Prime Minister and going into the House brandishing a lump of coal – Balmain coal – or not. After all, his electorate boasted a coalmine, and my late neighbour remembered as a boy running around the corner to pick up some lumps of coal for the family stove. The air was full of coal dust, pit ponies were still being lowered every day into the mine and there were several major accidents when men were killed. However, the coal was convenient to keep the stove going and the fire alight; ensuring the skies were grey.

It is written in the wind as far as you are concerned Mr Albanese. Go on a trip to Queensland, hug a replica of the Balcaldine tree, and desert a Sydney where the pall of brown smoke foreshadows summers of the future, where blue skies are an increasingly distant memory, as they were when coal was mined.

I have lived in the electorate long enough (although we were only recently redistributed to Albo) – long enough to have seen it desert its working class legacy to that of wall to wall cafés. I can remember the whistle signalling that work had commenced on Cockatoo Island across the Parramatta River. I can remember the odours from the soap factories, which had saponified the river for years. I had walked up the hill and been shown the entry to the Birthday and Jubilee mine shafts that had been sunk when Queen Victoria was in her venerable years. The area was a wasteland of weeds, but you could still see the access points to the mineshafts. The soil is thin and poor in Balmain and as you stir it you wonder how much of the contamination of the past is floating into the atmosphere. And the working class had to endure it, while the tycoons flourished.

Balmain coal mine

In Balmain, one of Paul Keating’s achievements in decontamination was the development of the old Ballast Point Caltex site into a magnificent public park; so much of the harbour waterfront was lined by industrial sites, now gradually renovated, although not necessarily reflected in the growth of liveable space. The working class has become educated, but the same tycoon-types still exist, now complicit with a rising rent seeker class, a.k.a. politicians.

Now, Albanese of Grayndler goes off to circulate in central Queensland, unfamiliar territory for a Sydneysider well versed in the rent seeker class who inhabit Sussex Street but will the Camperdown boy be seen at the end of the street in Moranbah? How much can a fleeting visit do for the Queenslander’s view of you, a Mexican arrayed in RM Williams clobber, your sombrero at a rakish angle to display your winning countenance.

Then that statement you made of: “if we don’t mine it, somebody else will.” A variant of “if we don’t kill our grandchildren than somebody else will”. How well you demonstrate the Hollow Man.

When you come back to your ex- coal mining electorate of Sydney, I’m sure you’ll get a rapturous welcome with us all waving soot laden miner’s lamps to welcome your return.

Oh, by the way, when you are hob-nobbing with the Adanis, tell them we exported coal from Sydney to India in 1799. It will inform how important your electorate has been in defining the genesis of Coal as an invaluable Export -and you as a reaper in the Carbon field, its representative.

Anti-Vaxxer – Prosecute for Genocide Part 2

According to a 2018 report by Complementary Medicines Australia, the country’s complementary medicines industry made $4.9b in revenue last year — including $2.77b in vitamin and dietary supplements — and is expected to grow by another $2b over the next five years.

Just a casual comment to indicate how much porcaria Australians are pouring into their bodies every year. What I find disgusting are the advertisements which show the happy family images loading up their shopping baskets with this stuff – as though a healthy young family needs it – and some of these naturopathic fanatics have the hide to fill their children up with these drugs while at the time perniciously undermining of the community’s health status, trying to claim that vaccination is harmful. Anti-vaxxers have been allowed to roam in this community.

We should take a leaf out of the Samoan legislative book, and prosecute and jail those who would willfully promote ant-vaccination messages and promote rubbish substitutes. To kick this matter along a letter will be sent to each politician in Australia, asking the simple question of whether they support vaccination or not. It will made very clear that a non-response will be taken as a “no”; and the results will then be published, so that at the next elections these enemies of the welfare of our children can be identified and dealt with at the ballot box – at least in the first instance. Legislation will follow.

Telling it how it is

Below is a note received from my private health fund. It is clear and needs to be read against the outpourings of the Grattan Institute.

I read the comment of one journalist the other day, who describes herself as “senior”. She reckons that she does not need all that private health insurance stuff – you know cataract, hip surgery and that unfamiliar set of lesions called “grab bag”. She boasts that she is fit and into marathon running. The association between long-distance running and knee and hip injury is still in dispute.

The problem is that the attitude being promoted by such comments constitutes an attack on community rating. Once community rating is destroyed, then life is a lottery as you enter the realms of catastrophic insurance and you being rated on your individual profile. You are laid bare – no community rating to protect you; warts and all, literally.

The other factor, which has had a disastrous effect on the health system, are all the cost shifting antics of the States, to which the health fund attests below. And even more outrageous, the diversion of money destined under the Commonwealth-State funding agreements being diverted to uses other than the health portfolio.

Anyway, in the meantime, read what is said by a health fund, which is not set up to make obscene profits to be repatriated offshore, but one where the membership is put first. Surprising, you say, but it does occur.

It can be a distressing time when you are admitted to a public hospital emergency department due to an accident or unexpected illness. 

Together with seeking medical care, you will be faced with another decision – do I use my private health insurance policy or Medicare to cover my admission?

What does it mean to be a private patient in a public hospital? 

To be privately covered in a public hospital means your private health insurance policy with us is covering your admission, rather than Medicare.  The admission costs can include your accommodation, theatre and medical fees. 

There are genuine and appropriate reasons to receive treatment as a private patient in a public hospital. However, its increasing prevalence in recent years has raised concern around the reliance of public hospital funding on private health insurance, and the impact this is having on premiums.

You may be approached by administrative hospital staff. Roles have developed within public hospitals and these staff, called patient or client liaisons, are responsible for signing up private patient’s health funds. There has been recent criticism made of the tactics used by these staff, so it is important you have the facts to make your own choice if you are approached: 

There is no obligation to use your private health insurance 

If you are eligible for Medicare benefits, you can choose to be covered as a public patient and all medically necessary inpatient costs will be covered by Medicare. You have a right to be a public patient, even if you have private health insurance, and this should not affect the level of clinical care you receive. 

The hospital may offer additional ‘perks’ if you choose to be a private patient.

Public hospitals are known to offer additional benefits to patients who choose to use their private health insurance, including free Wi-Fi, food vouchers or parking discounts. Information about being a private patient in a public hospital can be hard to find and varies between hospitals; particularly in regards to more important benefits such as guaranteeing choice of doctor, access to single rooms and specialised follow-up care. It is important to ensure you are receiving the right benefits by using your private health insurance. 

You could have out-of-pocket costs if you use your private health insurance. Your policy with us will apply to your admission if you choose to be a private patient in a public hospital. This means, you may be required to pay any excess, and the doctor who treats you may charge a gap for their services, above what Medicare and the health fund will cover. It is important to remember that if you are covered by our basic policy, no matter how it is promoted, any exclusions or restrictions of your policy will apply, so you may not be covered for the services you require.

Using your private health insurance can affect premiums. It has been reported that growth in private patient admissions in public hospitals has contributed to approximately 0.5% per annum increase to premiums over the past five years. This means, private health insurance premiums can be contributing to services that could be receiving public funding paid through taxes.

It is important to remember you have a choice when deciding how you will be covered for services in any private or public hospital.  

Be informed, be equipped with the right questions, and know your rights as a patient.

Amen.

Mouse Whisper

Some years ago, when Aleppo was still a beautiful place, an Australian senator was reported in The Weekend Australian as saying

“Syria is a country that has been a bastard state for nearly forty years.” However it should have read: “Syria has been a Baathist state for nearly forty years. The Australian regrets any embarrassment caused by the error.”

Sadly, no need to correct the statement these days.

Souk of Aleppo

Modest expectations – Temperature

There has been a great amount of strategic mucking around in the Northern Atlantic and the question of whether climate change had made the north-west passage navigable for most of the year has been troubling among others the Canadian security boffins. After all, there are many competing claims for the Arctic.

The Canadians … and the Danes claiming Hans Island

However, one of the most bizarre events was when the Canadians sent a helicopter to a speck called Hans Island, which lies in the stretch of water between Ellesmere Island and Greenland separating the Arctic Ocean from Baffin Bay. Canada disputes ownership of the rock with Denmark and after the Danes had raised their flag on the rock in 2002, the Canadians came back in 2005 and planted a windproof Canadian flag which promptly fell over. However the Danish flag was removed and returned to the Danish ambassador in Ottawa. There was Danish outrage, and immediate consideration was given to the dispatch of a destroyer, complete with not only the Danish flag but also a bottle or two of Danish schnapps.

The dispute is still raging with the Canadians retaliating with Canadian rye whiskey to complement the Canadian flag. The issue of course is definition of fishing and sea floor mining rights.

It is understood that the puffins, being very clever birds, have difficulty leaving the island now that they have learnt to open the bottles.

But as the Chinese have shown, you do not want to leave your rocks unattended and then complain about any unexpected consequence.

Confucius was a very wise man

It is somewhat ironic to see the SMH headlines screaming about Chinese infiltration when snugly lying within the paper was “China Watch”. It is like finding a copy of “Watchtower” in the Book of Common Prayer.

I glanced through the contents, and there was a piece about one of the many minorities. In this case it was about the sea gypsies or Tanka people who were resettled on the Fujian coast in Southern China. I always shudder at the word “resettlement” and who was the architect of the resettlement? It was none other that Xi Jinping, then the deputy secretary of the Communist Party in Fujian where he honed his political skills with minority groups over 17 years, as instanced by moving the Tanka people onshore. Much better for their life style onshore, rather than honour the centuries of tradition living on the sea. Sound familiar?

This was probably done for a strategic reason. Fujian is a sub-tropical province lying opposite Taiwan. Cleanse the water and give a clear line of sight to the rebellious “’province”. Yet Fujian itself is underdeveloped and quaint, the birthplace of oolong tea, soya sauce and a fermented fish sauce called kê-tsiap, which over the centuries with the addition of tomatoes became an Anglo-American national delicacy called ketchup with no residual relationship to its Chinese antecedent.

However, as I flicked through this insert, what attracted me as well was the announcement that the Sea Dragon 2, China’s new ice breaker was making its maiden voyage to the Antarctic base at Zhongsan, which is close to Australia Davis Station on the continental Antarctic mass; and also to Chang-cheng (“Great Wall”) located near the Chilean station on otherwise uninhabited King George Island in the South Shetlands. The crew complement was announced as containing scientists and support staff. Built in Shanghai, the vessel is 122.5 metres long and capable of sailing 37,000 kilometres in a single voyage. Moreover, China is already building a third.

Australia is building its new icebreaker in Romania named “Nyuna” (the Tasmanian aboriginal word for “Southern Lights”) due for delayed delivery next year. This icebreaker is longer, wider, and has twice the displacement of the Chinese vessel. It is supposed to have a life of 30 years. One wonders incidentally what ice sheets will be like in that time.

However, it was clear from incidents in 2013 when both the first generation Chinese and Australian icebreakers had difficulties in accessing a Russian ship stuck in the Antarctic ice that they needed vessels with improved capabilities.

Most of icebreaker activity has been confined to the Arctic region. After years of indecision, the U.S. government has issued a contract for the U.S. Coast Guard’s three new heavy icebreaker in decades, the first be delivered in 2024. As one source commented, “These ships are absolutely critical to the United States’ continued ability to conduct operations in ice-filled waters, especially in the increasingly strategic Arctic region.”

There was no mention of the Antarctic region because in the 60th year of the Antarctic treaty, the sacrosanctity of the Antarctic remains in place where everybody makes no territorial claims while agreeing to work together in spheres of scientific influence. This situation is in place until 2048 – neither mining nor militarization, even if contemplated, being allowed until that year.

However, like Japanese whaling for ostensibly research purposes and the self-regulated tourist pollution, the fact that the Chinese are already planning a third icebreaker, which will give them a distinct tactical advantage in navigating the Antarctic, the word “research” can be used to cover any number of deceptions.

Given the Chinese activities in the South Chinese Sea, there are many uninhabited places in the Southern Ocean, some of which come under the Antarctic treaty and some not. However, it will only take one nation to throw a rock into the Southern Ocean – and whether it will be noticed in the storms that rack that part of the world, who knows.

Not to put too fine a point on it, the Russians have 41 icebreakers and have just launched the first of three combination icebreaker warships complete with cruise missiles and of course a landing area for helicopters. The Arctic has no treaty to protect it and much jostling for sovereignty over the resources, especially now the waterways are more accessible because of climate change.

The Chinese I’m sure will be watching. They are always in for the long haul. The “China Watch” provides a useful insight into the thinking, even if we Australian readers may think it a bit of Sino-“puff”, remember “puff” is followed by the dragon – the magic dragon.

The new plague – the online anti-vax ‘influencer’

Guest blogger: Janine Sargeant#

A new plague is sweeping the world and we seem powerless to stop it. This is the epidemic of online anti-vaxxer ‘influencers’ whose commentary influences people to not protect their children from preventable disease; these ‘influencers’ should hang their heads in shame.

At a time when Samoa is struggling to deal with a shocking measles epidemic, this hasn’t stopped those who peddle nonsensical cures for measles from spruiking their wares. As of today, more than 60 have died, over 50 of these are children aged less than four. There have been more than 4,000 measles cases in Samoa’s population of around 200,000 since the outbreak began about seven weeks ago.

Measles is the most infectious disease and it has spread through much of the developed world this year. In developed countries there has been comparatively little loss of human life; New Zealand recently suffered its worst epidemic of measles in 20 years – 2,000 people were infected, but there were no deaths.

However, Samoa has been another story. Measles travelled from New Zealand to Samoa where the population had very low vaccination rates; WHO estimated Samoa’s total population immunity to be as low as 30-40%. Samoa’s health service was not equipped to deal with an epidemic.

In response to nursing error that resulted in two deaths in 2018, (the guilty nurses now serving five year prison terms) the immunisation program was shut down for months and was slow to recommence, and the anti-vaxxers leveraged off this medical error. Samoa’s vaccination rate plummeted.

A perfect storm – the Samoan population had no chance to resist and those who paid the price were the youngest and most vulnerable of the population who had no say in whether they should be vaccinated or not.

Anti-vaxxer advocates were proposing vitamins and alkaline water cures instead of the vaccine; but the prize goes to Samoan-Australian online influencer, Taylor Winterstein, who is reported as “liken(ing) the new mandatory vaccination regime (in Samoa to combat the outbreak) to Nazi Germany.” There’s been plenty of angry responders in the Australian media to that fatuous comment.

Winterstein’s husband is a Samoan-born rugby league player, who after stints with Manly and Penrith is now in France – not back to his native country to apologise for his wife’s behaviour. 

But back to Mrs Winterstein … let’s look a little further into this person’s medical and public health qualifications: well, she has none. However, as a self-described “Integrative Nutrition Health Coach” she is unqualified but adept in self-promotion and encouraging her “followers” to part with money to hear about the dangers of vaccinating children. 

Mrs Winterstein is quoted as saying: “The amount of NRL players and their partners who consciously choose NOT to vaccinate would seriously surprise you”. Well, she does mention the name of the pregnant wife of a Titans player – nobody else, but perhaps she should name names.

For my part I would strongly encourage all NRL players and their wives to publicly support vaccinating their and our community’s children from an entirely preventable disease that has caused so many deaths and continues to do so.

And let’s not forget those who suffer terrible long-term post-measles conditions such as subacute sclerosing panencephalitis (SSPE) – one for Mrs Winterstein and her ilk to look up. This causes a terrible, lingering death, brain gradually reduced to “porridge”.  

Mrs Winterstein, my anger is palpable. Perhaps if young parents see what happens to their children with this post-measles neurological complication, they may think again and defy your “influence” and head for the clinic. 

What are “influencers” in the online psyche? They are individuals with the power to affect purchase decisions because of their authority, knowledge, position or relationship with their audience. They drive traffic and sales to a product or service based on their recommendations. All very commercial; time to remind these “influencers” that this authority and power comes with very real responsibility and if you stray into public health and medicine, just remember that you should also do no harm. 

What is her solution? Black rice, which can be bought at the supermarket and which she sells at a substantial price premium.

Mrs Winterstein, you intended to go to Samoa with a pocketful of rice to give a workshop when there was one family in Samoa – their three very small children were all taken by this measles outbreak. Did they heed your advice? 

The Samoan Government has now arrested a “traditional healer” who has been telling people to not vaccinate their children.  His “traditional healing” that involved the use of somewhat non-traditional bottled vitamins, was facilitated by Mrs Winterstein’s “influencing”.  A recent post by Mrs Winterstein now says her family is coming under attack from media outlets around the world and she’s the target of a witch hunt – well that might just be the problem of being in the business of promoting eye of newt, toe of frog … and charms of powerful trouble*.

And Shannelle, the wife of the Titans player, you would have given birth by now – get your child vaccinated, please.

*with thanks to Mr Shakespeare from many ages ago.

#Among other things, Janine Sargeant is a Master of Public Health

How much are we paying these jokers?

In such circumstances, monetary policy needs to be accommodative. Low interest rates are acting to support borrowing and spending. While the recent changes to some lending rates for housing will reduce this support slightly, overall conditions are still quite accommodative. Credit growth has increased a little over recent months, with credit provided by intermediaries to businesses picking up. Growth in lending to investors in the housing market has eased. Supervisory measures are helping to contain risks that may arise from the housing market. 

There are further signs of a turnaround in established housing markets. This is especially so in Sydney and Melbourne, but prices in some other markets have also increased recently. In contrast, new dwelling activity is still declining and growth in housing credit remains low. Demand for credit by investors is subdued and credit conditions, especially for small and medium-sized businesses, remain tight. Mortgage rates are at record lows and there is strong competition for borrowers of high credit quality.

The easing of monetary policy this year is supporting employment and income growth in Australia and a return of inflation to the medium-term target range. The lower cash rate has put downward pressure on the exchange rate, which is supporting activity across a range of industries. It has also boosted asset prices, which in time should lead to increased spending, including on residential construction. Lower mortgage rates are also boosting aggregate household disposable income which, in time, will boost household spending.

The pace of growth in dwelling prices has moderated in Melbourne and Sydney over recent months and has remained mostly subdued in other cities. In other asset markets, prices for commercial property have been supported by lower long-term interest rates, while equity prices have moved in parallel with developments in global markets. The Australian dollar is adjusting to the significant declines in key commodity prices. 

Such are the public releases from the Reserve Bank Board. Two of the above paragraphs are from the latest report; and two from a report from 2015 when now Emeritus Sheriff Stevens was in the saddle. Then to give it extra emphasis I have mixed them up so each two-paragraph excerpt has one from Sheriff Lowe and the other the benefit of Emeritus Sheriff Stevens’ wisdom.

I asked someone wise in the world of finance what he thought of the following quote:

The genius of the recent administrations has been to transfer inflation to the stock market – that is to the prices of stocks and bonds instead of to the price of labour and production. Real wages are lower than they were in 1964 (written in 2005). 

He missed the bracketed attribution, and thought the quote referred to the current situation, whereas it was a prescient comment made in 2005 before the GFC. He agreed with the sentiment. Nothing has changed, he admitted.

As the excerpts from the RBA writing show, there is not much new thinking going on there, but what would one expect of a Board, with the Governor, the Deputy Governor, and Secretary of the Treasury being committed public servants that inhabit the Morrison self-described bubble; another who has lived in that curious chimera of public servant and multiple company directorships, three representatives of big business, a highly placed investment banker, and an academic with close links to the Anglican Church, which has been described as big business on its knees.

The problem with this economic and morally stagnant Australia is that the people making decisions enjoy the benefits of that stagnation. Neither political party dares to throw a stone into the fen where the water has stopped flowing and the fragrant algae of our political system, which thrives on stagnation, is hiding the poison that is killing Australia. Soon the beautiful fen with its wondrous fauna and flora will become an irreversible cesspool full of the tailings of illusionary productivity.

Which of the current Board would suggest that a wealth tax, a large increase in funding providing for education and health care systems and climate change proofing action, should get an airing rather than just allow this country to sink into an algae infested sink hole. From the sidelines one could imagine all the myriad rent seekers and mercantilists scrambling to get out of the hole while the ordinary Australian drowns in debt.

What is needed is to build the new political movement, which defines ‘the honest toiler” centre, which looks after the wellbeing of the nation rather just that of self-absorbed politicians. Development of this concept is just the shorthand for a series of future blogs, to assist in stirring the pool, clearing the algae and starting the water flowing.

After all, I do not want my grandchildren growing up in an increasingly uninhabitable planet.

Mouse Whisper

Talking of Danish schnapps or its other Scandinavian name aquavit, Finns are known for their taciturnity. So when a Swede and a Finn sat down to a glass of aquavit, the Swede said “Skol” the Finn said nothing, and they drank the philtre. This ritual was repeated five times the Swede said “Skol” on each occasion and the Finn said nothing. So they drank on, refilling their glasses on the way.

Aquavit for two

However, on the seventh occasion the Swede again said “Skol” and this time the Finn burst out, “The trouble with you Swedes you talk too much,” and drained his glass.

They say alcohol loosens the tongue.