Cutting the rave short to post!

Today some of my Twitter friends seemed to be getting very concerned about what has happened and what may be happening soon, to the Australian health system. I am a little worried about progress on mental health care, but not convinced that the government can force much privatisation on the populace.

First, several Tweeps were convinced that the article by Mark Metherell in The Age newspaper http://m.theage.com.au/national/health-group-lures-private-patients-from-public-system-20111104-1n04h.html
Health group lures private patients from public system, meant that the government was quietly divesting itself of publicly-funded healthcare and “forcing” people to buy into the private system. The article also implies that the private hospitals will “lure away” people who need particular types of care by demonstrating a better record on several health measures, eg. rates of hospital-acquired infections, higher recovery rates from some surgery etc. As I read it, there ARE some advantages to private hospital care for some conditions, but ONLY for younger, less complex cases. Public hospitals take the sickest people and are often willing to risk complications in the hope of saving a life that others might not see as worth the extra investment of time and effort.

On the other hand, hospitals already co-operate in the use of resources and specialists. For instance, when my partner needed an emergency operation to have his gall bladder removed, the health system did lots of juggling between different surgeons and hospitals so that he could be operated as soon as possible.The public hospital that gave him 24 hours of doctors, nurses, drugs & accommodation didn’t charge him a cent for this care! Meanwhile they rushed him by ambulance to a private hospital where the surgeon got theatre time, operated swiftly, and only had one extra day there.
If he had been able to stay in the public hospital and have the same surgeon operate under his “public hat”, then he wouldn’t have paid a cent for anything.

This sort of cooperation is the norm.

At a public training hospital...

NONE OF THIS WILL CHANGE for publicly funded patients under the health reform arrangements in Australia. If you need care, you will get it as quickly as possible and necessary. For people who HAVE PRIVATE EXTRA INSURANCE [only NECESSARY if your income is over $140 000 for a family, or you pay an extra 0.5% tax], the government will require them to USE it if hospitalised in the public system. Previously you only had to claim on it if you used extra private services while in the public hospital. Soon people will have to draw on it when it’s available. That’s all.

Netflix for lower carbon emissions!

On Four Corners (TV program) at the moment there is a big kerfuffle happening about the NBN (National Broadband Network, to the furriners and luddites out there).

Netflix for Australia!

Netflix for Australia!

The government representative is all for it as it will give everyone in the nation access to high speed internet. Since Australia has a small population scattered over a vast area, it is extremely expensive to lay optic fibre to every street and the capacity has to be sufficient to last well into the future. Alternate private companies are complaining they are being excluded from making a profit on their smaller investments in fibre which are only available in cities and some nearby towns. I can see the government logic- to justify their monster investment on the community’s behalf, they want exclusive access to carrying on it to the remote areas and are charging a flat rate everywhere. The flat rate will make city broadband more expensive than it would be if fibre was only in the cities and now the private telecoms want to have their own (cheaper) fibre used in the cities and outsell the NBN. I can see the government’s point as it wouldn’t be worth subsidising the country areas (with fewer users) and then lose money when all the city users switched to AAPT or Optus. So I think we have to proceed with the NBN as set out currently and tell the private companies to make their profits somewhere else, as a good flexible company ought to do!

You have the power. Save energy!

You have the power. Save energy!

 

Spotrick just made the point that a lot more country dwellers would connect to broadband (and pay their share of the costs) if Netflix would just pull its finger out and make internet movies available in Australia! wow- I could really go with that!

What really iced the cake was the thought of all the carbon emissions that would be saved by having everyone stay home watching Netflix movies rather than driving to the picture theatre or the rental place every time they wanted to watch the latest stuff!

So I propose pushing the NBN on the basis of lowering carbon emissions and saving the planet!! Julia will love me!

Blobs of CO2

Blobs of CO2

 

Day 15 NaBloPoMo: Seeking asylum in Oz

We just came back from a pub where we had the Wednesday $12 steaks, which were pretty good, although not the tastiest. Naturally, as we were eating, the topic of the latest asylum seekers came up. <img width=”200″ src=”http://api.ning.com/files/LMM2grJekVascwitLpc73mWCbu1aUQK4WhRiZv59cX*9WGAGJ8t*QBtMh2k-X-XYYj28OeobBEvNyoXw5*-28vji7FlBBUc0/ChrisIs.jpg?width=200″ style=”padding: 5px;” />

It was horrifying when they announced today that a boatload of women and children had smashed onto rocks on Christmas Island while trying to land during a storm. Spotrick had pointed out how thick and cyclonic the weather looked on the satellite map just this morning. These poor people had travelled thousands of kilometers, mainly over land, to have their hopes dashed and possibly half their lives taken, without quite reaching the land of their dreams.

You can see the flimsy boat and wild seas in this piece from an Australian report.

Inevitably, one of the people at the table asked why these asylum-seekers had not arrived by aeroplane, rather than via a smugglers boat from Indonesia. This is an ongoing topic here- if you arrive by air and have fake papers, you can immediately ask for asylum. You can then receive a temporary Visa and make your way into the Australian community- all according to international law. You don’t get any money to live on or anywhere to live- but you get the visa. Our friend always says this and I say the same in reply as well- these poor women and children couldn’t buy a ticket to Australia from Iran or Iraq; they come mainly from small towns, many unfamiliar with air travel, let alone to countries they have little knowledge of. All they know is that they want to get away from the constant threat they feel they are living under- they escape across a border, people hide them, feed them and send them on; maybe they are packed into a container or truck, or bundled onto a freight train to travel through unknown regions, meeting people they cannot understand. Eventually they arrive in India or Sri Lanka and discover there are men there who will get them to Australia if they can pay all the money they have. They may be lucky enough to get on the first boat they meet, but mostly they will be sent from pillar to post, living in primitive conditions and not knowing where their next meal is coming from. At last they all board a miserable looking fishing boat, captained by some down and out fisherman who needs the money, because his fishing grounds are not yielding any more, or he usually fishes illegally in Australian waters and the patrols are fierce that week.

It must be extremely anxiety provoking for the Iraqi and Iranian women, who don’t know how to swim, placing the lives of their precious children in the hands of some scruffy fisherman on his raggedy boat- but they do it with hopes for a secure future in that lovely empty land in the sun, Australia.

Unfortunately, distant conflicts bring desperate people to Australia. Some of them have heard about the country via relatives who have come here legally as part of an annual migrant quota or illegally at first, then granted asylum and gaining citizenship. Evidently Australia sounds rather attractive- there is no religious or regional conflict here, apparently most of the people are middle class and friendly and we have a democracy and an army that does not police the local community. What asylum seekers don’t know is that although Australia is huge, its 20 million people live in very small areas within the country where there is sufficient water (or there used to be) and where communities have been growing quite slowly over the years. They don’t know that Australia has its own poor people who are fully or partially dependent on the State for income and housing. They also don’t realize that our health and social services are linked to our taxation system, so that they can only provide enough largesse to cope with the numbers of people who are already reliant on them locally- we haven’t got the income or tax basis to cater for a lot more people at the same standards.

Some Australians are very hostile towards asylum seekers because they perceive them as Muslim hoards, representing the likes of Osama bin Laden, the Taliban and the Twin Towers atrocity. Obviously this is rather frightening for some people- you can hardly blame them when THEY don’t have the full picture either. However, most Australians are fairly willing to welcome newcomers, regardless of neither where they came from nor how they arrived. We find that as long as new migrants are friendly and curious, they are just as welcome as our friends and relatives who might visit from overseas. In my university classes this year, there were far more students from overseas (more than 50% Muslims) than there were Australians! Yet our lecturers said we were one of the best and most involved groups they had ever taught! So our section of the population seems to be able to live and co operate with non-Australians quite usefully.

Given that we probably welcome foreigners quite easily compared with many other countries, why am I still apprehensive about the continuous small stream of asylum seekers arriving offshore at Christmas Island and along our Northern coastline? I worry because I know that Australia is struggling to provide housing, appropriate utilities (like electricity and water supplies), health care and social welfare benefits to the Australians who are already living here. Migrants never seem to be told that public housing applicants might have to wait 10 to 15 years for a suitable dwelling to become available- hardly any new ones are built, compared with the numbers of needy people. Also, our rentals are starting to become quite expensive and are certainly out of the range of affordability for someone on the dole (unemployment or disability allowance, aged pension or supporting parents’ payment). My friends who arrived at my front door homeless last year had tried to obtain public housing or some assistance with paying the rent for private accommodation. One was on the dole and her daughter was waiting out a qualifying period after being sacked from her job as a miner. They were rejected completely from putting their names on the list for public housing because there were no children less than 18 years involved. When they sought out private rentals they discovered that they could only be subsidized to live in a dwelling that cost only $70 per person per week; over that price and they couldn’t get a cent!

The harsh reality is that people who arrive with nothing and no job don’t get a good deal in Australia at all. Sure- if you are genuinely ill, you can go to any doctor or hospital and you will be treated and you will NOT be given a bill. However, if everybody and his great grandmother goes expecting the same treatment, the system can’t cope and falls apart. Then everyone complains that the government they voted for isn’t doing what it promised, they throw it out, and then get a worse deal from the next lot who don’t know how to make good the promises once they see the state of the economy!

The situation with utilities has been getting quite serious over the last few years, especially water supplies in Southern Australia. There has been a drought for many years and several large cities have built desalination plants to extract fresh water from the sea, rather than relying on rain and reservoirs. South Australia is at the end of several thousand kilometers of slow-flowing rivers and gets very little rain. For many years the city of Adelaide (1 million people) has pumped water 80 km from the Murray River to fill reservoirs in the Hills just above the city. The reservoirs have reached very low levels at times, yet the river hasn’t been able to supply any more to top them up at the end of summer. We have been on severe water restrictions, causing the death of thousands of beautiful, big trees in public areas and uncounted numbers in private gardens. Most private gardens have withered and street trees became spindly and brown, houses have cracked because the ground has contracted and people have been putting as many water tanks onto their properties as they can afford- we haven’t got any!

So you can see that although we generally have a good reputation for taking in asylum seekers and integrating most of them into our society, there may come a time when that is no longer feasible. How long can Australian workers produce enough extra income to support both their own non-working family members, plus all the extra jobless living in the community and in migrant detention centres? I think it’s a crazy idea to try to deter asylum-seekers by “processing” them (ie. their claims for refugee status) off shore in Nauru, East Timor or Christmas Island. Asylum seekers don’t know anything about our local processes or ability to provide financially for additional people so it’s not going to “deter” them- they’re desperate and fear death or suffering in their own countries. They just want to live quiet lives, working hard in a decent job, providing for their families and taking their part in a community. They certainly don’t want to kill Australians or blow us up- they’re just people like us who have been placed in impossible life circumstances.

Can anyone find an acceptable solution for us all without cruelty to locals or migrants?

 

Day 12 NaBloPoMo: Wikileaks and life as we know it.

Today Spotrick and I missed out on our Social Media Adelaide Christmas Picnic to attend the local rally in support of Wikileaks on the steps of Parliament House, Adelaide. Spotrick took along is camera, so this is what it looked like:

There were around 300 people there in a very peaceful rally. Several Green politicians spoke, plus other representatives of various interests, such as the perennial Socialist Alliance. There were a few good slogans, eg. “Wikileaks and the Chamber of Secrets”, and the Quakers were there as usual with their wicker broom and placards promoting Peace and Free Speech.

Everyone agreed that Wikileaks is a good thing and Julian Assange, as a facilitator of open information, should not be hunted down and pilloried for any reason. The issue of sexual assault or other charges against him in Sweden seem an annoyance and nothing to do with Wikileaks the organisation. There is speculation about Swedish deals to allow the USA to extradite Assange to face charges of goodness knows what, but there are many possibilities about bringing charges of any sort against him- conspiracy? creating a diversion? trying to malign him in the eyes of the public? stopping him from speaking out because he’s locked up? He doesn’t generally speak much himself about anything, so it’s difficult to narrow down the motives that might exist.

We all agree that the accusations of Sarah Palin are the rantings of an underpowered intellect and that there ought to be a law preventing her from inciting intercultural conflict by calling for his capture or assassination like Osama bin Laden. Imagine if people said this about Bill Gates because he released a pile of information someone didn’t like? Sheesh!

Australia’s Labor Prime Minister [Labor is similar to Democrats in the USA], has made herself very unpopular with members of her own party by saying that Julian Assange has broken the law in leaking internationally sensitive information. However, it’s unclear whose laws and which particular laws may have been broken- none, we guess. Our new Attorney General has also put his foot in it by declaring that he IS NOT impartial about the correct administration of justice in our country after all! He wants the Federal Police to take 18 months out of their valuable public service time to hunt down crimes of which Julian Assange could be considered guilty- although he can’t think of any right this minute. I want a NEW NEW Attorney General- one who stays out of any particular dispute and only looks at the way in which justice is administered- not doling it out himself!

The business about Wikileaks releasing the list of sites in Australia that might be strategically important to the USA is a terrible Furphy- who doesn’t know where the trans-ocean cable comes ashore in Sydney? It’s pretty obvious to anyone except the blind and I’m sure someone would tell them if they asked nicely. But who cares if there is an open-cut bauxite mine in northern Australia? Is a terrorist going to blow it up the same way the miners blow it up every day? Huh?? Where’s the problem? Bauxite is the commonest substance mined from the earth’s crust and costs a small fortune to smelt, making rich profits for suppliers of electricity and virtually no one else! As for where Midazolam is manufactured, eg. a Fauldings laboratory in Victoria- it’s made all over the place- I’m sure the US could get plenty from other places to make Australians forget stuff they didn’t want them to remember if they really wanted to! We might be grateful to forget if it’s really that bad!

The business with Visa, PayPal, Mastercard etc is pretty smelly. We have let these monster private companies take over governance of the world’s monetary transactions. We should have kept a publicly operable back-up system so they didn’t grab the power inherent in the role. Silly humans- it actually worries me quite a bit now. We don’t want companies to hold onto OUR money instead of paying people they don’t like! Maybe it’s a good thing that these companies showed their hand, giving us a chance to get a reserve cash system in place for a real global emergency. How would it be if my bank decided it wouldn’t pay my phone company’s bill because that company was making a takeover bid for my bank?? Whose money is it then? Very dodgy state of affairs for the world.

When we had a scratch dinner with friends tonight it felt like the old student days- we sat there drinking wine (not me), eating and talking politics and ethics for hours!We are in a real quandary about how to get good government. We’ve just re-elected our Labor government by the slimmest of margins, against a Liberal Party [like Republicans, Conservatives] that appeared to have no policies of its own, except to reverse the policies changed during the old Labor regime. They have NOTHING new to offer and basically believe “user pays”. They want to cut down social services, cut taxes to the rich, make health as private as they can and make economic conditions favourable for big companies who give most of their profits to their CEOs. The Greens seem committed to doing something about Climate Change, but their other policies are non-existent or too simplistic to work in the current complex social environment- so we can’t have a parliament dominated by them. So who are we going to elect?

Anyone for yet another new political party in Australia? What will we call it- how about the Australian Democrats? Hmmm… now that sounds familiar, and NOT very promising.

Any ideas?

PS. What would our Aboriginal Australians say is our best national option? Anything new on that front?

Brain too full to post!

Trying to finish this Masters degree means I have to work hard on restricted topics for long periods of time. So why can’t I write a bit about one of those? Well- I feel guilty devoting any words to anything other than an essay or dissertation! My other blog has also died, even though I could write exactly the same thing in that blog as an essay (http://healthforhumans.blogspot.com).

My dissertation could have been finished by the end of first semester if I had been able to get ethical clearance and worked on the data then, but life ain’t like that in the Land of Research! I had written the background to the project, a “skeleton” article to pop the results into when I got them, plus an ethics committee submission for the university in the first 4 weeks of Semester 1. Now it is nearly Week 9 of Semester 2, with that plus weeks 10, 11 and 12 before uni breaks up for Christmas/summer! I still haven’t been granted access to the de-identified/anonymised data from the state health department- it takes forever until each little level of bureaucracy is satisfied I don’t want to publish the names of the patients and hospitals who have problems on Facebork or whatever! My supervisor and Head of Department have signed so many pieces of paper, they are getting RSI. And I have a wonderful task for them on Tuesday (Monday is a public holiday here)- ANOTHER bit of tree to sign! Must be patient…

I even had a little lecture on how to address an envelope suitably for the health department when I ended up trying to deliver a report to the exec officer for the ethics committee- the security guy said I should put my stuff in their internal mail to make sure it got to the top of her desk when she returned. So I got a security pass from him and toddled up to the first floor. There, an autistic person objected to the name I had put on the front of the reports with “To: X on 10th Floor” or whatever. I had to listen while she told me that my boss at the university should find out how the health department likes addresses to be formal, formatted in a certain way and on a WHITE label, ON an opaque envelope. I had a set of reports in a transparent plastic folder so they didn’t get separated! I could have clobbered her, but figured she really was autistic and had to go through her spiel no matter what anyone said. So I stood and took it.

Now I’m fiddling with the data I managed to get for free and without password from the Australian Medicare database containing info about how many prescriptions are dispensed for every medication in the system, in which state and whether paid for by Medicare itself (Public), Privately or by the Veteran’s Affairs Dept. I was able to download all my necessary numbers from here in January- now I have an extra 6 month’s worth to play with, thanks to everyone stringing me out!

I was so distracted when I was writing my first essay this semester for my last course-work subject, that I almost wrote a whole dissertation on it! The topic was in Indigenous Health (mainly pertaining to Australian Aboriginal and Torres Strait Islander peoples) and we had to choose a disease or illness that was a public health problem in this group. I chose Trachoma (an infectious eye disease, familiar in poor, developing countries like the Sudan and Afghanistan). There was masses of material to digest, especially from the World Health Organisation and UN. In addition, Australia has had decades of government policies about providing various health services which would have fixed the problem in no time flat, but they never implement them fully… You might have heard of a bloke named Fred Hollows- he set up a Foundation to care for vision problems, firstly in Australia and then internationally. His wife Gaby now administers the Fred Hollows Foundation and they mainly work in war-ravaged nations such as Democratic Republic (sic) of Congo, East Timor and Uzbekistan etc. Anyway, fred’s team charged out into the bush and fixed trachoma and other eye problems using surgery and antibiotics in the mid to late 1970s, ie. last century. However, the pussyfooting governments since haven’t followed up and the trachoma and blindness is coming back. Hopefully a new campaign, organised by a doctor who was just a young whippersnapper on Fred’s first expedition, Hugh Taylor, will get in there and hopefully eliminate the disgusting scourge over the next year or two.

The head lecturer even lent me a beautiful book by Hugh Taylor (and signed!) to help with the essay, but I’m afraid I just got even deeper into the subject and ended up having to cut what I’d written by two thirds at the last minute!! Oh dear- what a hash. Hopefully I’ll at least score a pass!

Anyway, I’ve learnt my lesson and I’m not consulting nearly as many references for the second (and last ever) essay which I have chosen to write on “Indigenous Mental Health, ‘Country’, and Land Rights”. It sounds like social studies rather than public health, eh?! ABC TV has some programs which help explain indigenous peoples’ attachment to ‘country’- which I certainly needed explaining to me 2 months ago, but now have a good understanding for a white person.

Now I guess I have made a bit of a post, so I can stop. I might be able to write something about analysing my data on possible connections between several drugs and adverse events in South Australia, once I get the de-identified information from the health department. It’s pretty weird stuff, but I think I could explain the essence of it simply!

SO, there you are- pretty boring, huh!