Healthcare that does more harm than good

Graeme Harris writes: Re. “The rise and rise of health spending — but don’t blame the old people” (yesterday). As a former GP who did an MBA I make the following comments on healthcare expense. You should read and publicise Michael Porter’s (of Porters five forces fame) HBR review of the US healthcare system. One of the basic important observations is that for all the money spent there is no measure of appropriateness or outcomes. 

A considerable proportion of the health budget is spent on the elderly and frail in the last few days of their life for heroic surgery and medical treatment to the patient’s considerable discomfort if not agony. Back operations that result in the recipients being in more pain, needing more medication and having more time of work than those who were judged to need the same operation but the operation was not administratively available (Cochrane review).

With the slip, slop, slap campaign we have swapped easily diagnosed, generally easily treated skin cancers for osteoporosis, an increase in hard-to-diagnose solid tumours and re-emergence of rickets. Cholesterol-lowering medications don’t appear to decrease the incidence of heart attacks, probably as they address an associated measurement, not a causative factor.

The list is very long of treatments at great expense that really miss an important medical maxim “first do no harm” and are incredibly expensive. You should have compared the longevity changes in Canada for your story — I wouldn’t be surprised if they showed increased longevity with decreased spending.

Less cynicism, please

Martin Gordon writes: Re. “Christopher Pyne’s strange and dated Anzac Day culture war” (yesterday). Bernard Keane writes in a style that is more typical of baby boomers, that endless cynicism which does him little justice with his silly ridicule. For Australia, a country that has a relatively short and positive history, there is excessive pessimistic focus on certain issues, which Keane seems to get tied up in knots over. There is scope to improve the lot of indigenous Australians and so on, but this repetitious drivel about our alleged imperial inferiority, etc, is tiresome. Australia participated in a war to defeat an aggressive Central Powers alliance of Germany, Austro-Hungary and Turkey. Australia enjoyed very good relations with modern Turkey, which arose from that war, via our PM of the post-war era (and veteran) Stanley Bruce, and through the Korean War and via our links to NATO alliance members. Turkey is an ally of Australia as is also Japan, in fact our most significant ally in Asia. Japan has been an ally for the vast amount of the period since 1901.

I am pleased that we commemorate our service personnel. I am pleased that our country has a solid record opposing totalitarianism and enabling people to determine their own destiny as we do. I am not one for jingoism, and the overdone aspects of Australia Day. I have worked with aborigines and appreciate the sensitivity about Australia Day, but this sensitivity is only a recent pursuit. Unlike Keane, I have a positive disposition about Australia’s future and our prospects for all of our people and our relations with friends and allies.

Ads or no ads, BOM a public service

Jeremy Apps writes: Re. “Tips and rumours” (yesterday). I’m not aware of any other government website that indulges in commercial advertising, and while some may have a philosophical aversion (to which I’m sympathetic), my primary concern with BOM advertising — as someone who works in the hosting industry — is not the commercial arrangement but its potential affect on site performance.

In the main, is a concise, informative, lightweight — as in payload, not quality — and responsive website, precisely what it needs to be. It’s important to get the application integration and operation right, particularly during high-demand periods — major large-scale weather events, et al — with critical content given priority over advertising, advertising that can be cast aside as so much jetsom when needed. It is, after all, a crucial public service. At least that’s what Captain Obvious once told me.

Hold onto your pension

John Falconer writes: Re. “Gillard’s ‘one crowded hour’ to win back Labor’s lost voters” (yesterday). So “George”, the self styled “socialist” retired school teacher, told his PM at the totally controlled town hall meeting with her that he would be OK to pay more tax on his pension? I’m guessing he must be receiving an unfunded Victorian government pension. (Good luck to him as he earned it by accepting low earnings during his working life). 

The money to fund George’s and other like pensions must be provided by future taxpayers as well as some support by prudent investing by his particular pension fund. The unfunded portion or shortfall in fund assets is massive and estimated to be over $200 billion for the federal government alone! The various state governments’ liabilities are also massive. Now THAT is a deficit to be proud of. 

George, as Margaret Thatcher once famously said, “Socialist governments traditionally do make a financial mess. They always run out of other people’s money”. I would not be in too much of a hurry to give any of your hard-earned pension back yet. George.