"If The Voice Loses It Will Be Albanese's…

"If The Voice Loses It Will Be Albanese's Fault!" Yep, I saw that…

Research shows young people want to contribute to…

Victoria University Media Release Victoria University research in partnership with the Youth Affairs…

Meta and Privacy: The Economy of Data Transgressions

Meta, to put it rather inelegantly, has a data non-compliance problem. That…

We need to change how we think and…

By Callen Sorensen Karklis Neoliberalism is an illness: unregulated capitalism, it is not…

HAK Birthdays: Henry Kissinger Turns 100

“Once you’ve been to Cambodia, you’ll never stop wanting to beat Henry…

Yes is inclusive, No is divisive

The words speak for themselves, but I shall return to them briefly…

Modi in Australia: Down Under Bliss for Hindutva

There is an interesting thread that links the Indian Prime Minister, Narendra…

Why the Conservatives cannot win the next election…

You are probably thinking, referring to the headline, that it is a…


Tag Archives: universal health

Is there a prescription drug shortage we don’t know about?

I’m on drugs. The legal kind. Earlier this year one of my specialists suggested to me I fill my prescription whether I needed a refill or not as there was a nationwide shortage of the drug. In Australia? Yes. So I dutifully filled my prescription. Doing so required a number of visits to local pharmacies, but one had a small supply left. The next time I needed a repeat, I was given a substitute drug. I didn’t think too much of all this at the time, but my experience then shows this is not now a new problem.

Last week I needed two drug prescriptions refilled. Pharmacy 1 – no supply of either. Pharmacy 2 – no supply of either but could order Drug A in for collection the next day from another pharmacy. Pharmacy 3 – no supply of either. Pharmacy 4 – had Drug A (so I kept that in mind in case Pharmacy 2’s order failed) and was able to substitute Drug B for me with another brand, something Pharmacy 3 had specifically told me they could not do without another prescription.

So I eventually got both drugs but it took two days, four pharmacies and a substitute drug. Not to mention the time and the travel costs involved. Yes, I could have called around, but I was already out of the house, so just kept going. Had no local pharmacy been able to supply, I’d have gone home and hit the phone.

Tell me again, I do live in a rich western country, don’t I?

When I returned to Pharmacy 2 the following day to collect Drug A, I asked why were these shortages occurring. The pharmacist told me it is because the government has lowered the prices they will pay the pharmaceutical companies to the point there is no profit in selling the drugs to Australia. Consequently they send their production to countries where sales are more profitable. If demand is higher elsewhere, Australia misses out.There is no profit in drugs for the pharmacy either, I was told. That explains why pharmacies are selling so much other “stuff” these days.

The pharmacist pointed to several heavily laden shelves. “Diabetes drugs”, I was told. Ordered in bulk to protect the health of their regular diabetes patients, because the pharmacy expects a drug shortage.

I don’t understand how the system works. Maybe I should, but I don’t – and I suggest the majority of the population don’t know the finer details. We get a prescription, we go get it filled, we take the drugs. We cringe if it is something not on the PBS. That’s about all of the process most of us delve into. I did read the following on the PBS website, titled “Setting an approved ex-manufacturer price for new or extended listings“. At that point I decided I wasn’t the woman for the job.

Price negotiations with the responsible person for new or changed listings are undertaken by the Pricing Section on behalf of the Minister, following a positive PBAC recommendation. A Cost Information (PB11b) form is required to be submitted by the responsible person as part of the initial application to the PBAC.


After a price has been negotiated, the responsible person is requested to submit a Request for Approved Ex-manufacturer Price (PB11a) form in order to formalise the price offer. The responsible person is then notified by email when the Minister has formally agreed to the negotiated price.

Who pays for the drugs? The government or the pharmacies? Do the pharmacies act as distribution centres? I thought the PBS provided subsidies: perhaps I am wrong. I’m not sure I want to understand. What I do know is that as a patient prescribed medication by my medical specialists, I expect to be able to get that medication without the risk of politically induced shortages – or pharmaceutical company avarice. I don’t begrudge the companies achieving a profit, businesses running at a loss don’t stay in business for very long. Greed is not good, despite Gordon Gekko‘s beliefs – or the current competition on Melbourne’s Gold 103.4 radio station.

The first time I experienced a shortage with Drug A, I asked the specialist was there an alternative. He said yes, there was, but the side effects were pretty undesirable (my words, not his) and he’d prefer to avoid prescribing it.

I think of all the chronic condition patients in this country and wonder what the future holds.

In 2007-08, around 15% of people in the 0-24 age group reported having either asthma, type 2 diabetes, coronary heart disease, cerebrovascular disease, arthritis, osteoporosis, chronic obstructive pulmonary disease, depression or high blood pressure.

We read about the horrific medical costs in the USA and watch the Australian government undermine universal health.

I only questioned one pharmacist but what I heard was enough to cause concern and I have no reason to doubt the sincerity of the speaker. Is there a mainstream investigative journalist who will take up the challenge to find out the truth? Do readers have similar experiences to share?


Scrap the Medicare Levy, increase GST

We have to think outside the square. I am not suggesting this concept is THE answer, by any means. I’m merely suggesting we need to look for alternative solutions and encourage ideas and discussion.

I recently suggested scrapping the Medicare Levy totally on the basis it leads politicians to focus on the wrong aspects of Medicare. “Medicare is not sustainable” they cry, yet primary care accounts for only 10.2% of the health budget. An admission to hospital costs, on average, $5,000 – even 20 GP visits a year times the rebate is a lot cheaper than $5,000. In 2012 the University of Melbourne completed a study which showed there were 7,000,000 bed days in hospital that could have been prevented (Source: Prof John Dwyer, Insight, at 27 min mark). What a saving that could be to the health budget (although there would be costs associated with the prevention).

I’m not suggesting the nation forgo the Medicare Levy revenue stream. I am suggesting we stop allowing it to divert attention from the real areas of potential cost savings. Aside from the 7,000,000 bed days, do you know that doctors have to get a new provider number when they relocate? Think of the administrative costs. What is the rationale? What is the benefit? Isn’t Dr J. Smith the same doctor irrespective of whether she or he is located in Euroa or Williamstown? Doesn’t this make reporting and auditing of a doctor’s performance or claiming patterns over his or her career more difficult and possibly expensive?

Subsequent to my admittedly rather off-the-cuff suggestion of scrapping the Medicare Levy, I was reminded that a number of our working population still have access to forms of salary sacrificing that have disappeared for many of us due to Fringe Benefits Tax (FBT). About twenty years ago we could salary sacrifice a car, private school fees, health insurance premiums and a number of other expenses. When FBT was introduced, the salary sacrificing of old virtually disappeared. Of course, CEOs still receive shares and other “indirect” remuneration, but the average management level employee suddenly had to pay their own health insurance premiums. For a while I was lucky and worked for an international company that had a global policy of paying health insurance premiums, irrespective of FBT in Australia, but it is no longer the norm for the majority of workers.

FBT doesn’t apply to all employees the same way. Not-for-profits have certain concessions, enabling them to provide salary sacrificing the commercial world no longer offers. Government department employees and politicians, for example, can take advantage. In June 2013, 16.4% of the working population in Australia were employed in the public sector. Not all of them would have access to salary sacrificing, but possibly enough to make a dint in the Medicare Levy revenue stream.

We know there are various ways of reducing taxable income and minimising income tax. Those who have higher earnings have more opportunities to do so than the average wage earner or salaried middle manager.

When income tax in minimised, so is the Medicare Levy. After all, it is assessed on taxable income. Get taxable income below the magic threshold and receive a higher rebate for private health insurance or avoid or reduce the Medicare Levy Surcharge.

Yet there is no reduction in rebate for those who may be shirking their fair contribution. Surely a better collection mechanism would be via the GST system, for the same reasons GST was implemented in the first place: those with a higher disposable income spend more and therefore pay more in GST.

There are, therefore two major problems with the Medicare Levy as it stands. First, it is distracting, as stated above. Secondly, it can be minimised by the very taxpayers who can most afford it. Increasing the Levy places the burden on those who can least afford it and does nothing to address the question of focus.

The challenge with the concept of moving the collection to the GST collection method is that we have a massive, expensive bureaucracy “managing” the collection and claiming back of GST by business. The businesses would not, I suspect, be overly thrilled with the idea of being expected to contribute to the universal health system when paying GST that is not claimable as a tax credit under the GST legislation. Edited to clarify – I am only referring to any GST that did not qualify as a tax credit under current policy. There is no suggestion the increase would be treated any differently. Yet why not? Is it not in the interests of business to have a healthy workforce? What is the impost on business of GST not able to be claimed as a tax credit? The costs of compliance could well be higher, although I’ve never set about analysing it. The end consumer is the one paying the bulk of the GST, as illustrated very nicely by the manufacture and sale of a table on the Australian Tax Office web site. An awful lot of toing and froing for $30, if you ask me. We have some very inefficient systems, we do. That is a debate for another day.


Like what we do at The AIMN?

You’ll like it even more knowing that your donation will help us to keep up the good fight.

Chuck in a few bucks and see just how far it goes!

Your contribution to help with the running costs of this site will be gratefully accepted.

You can donate through PayPal or credit card via the button below, or donate via bank transfer: BSB: 062500; A/c no: 10495969

Donate Button