Ideas@TheCentre – The Centre for Independent Studies

Ideas@TheCentre

Ideas@TheCentre brings you ammunition for conversations around the table.  3 short articles from CIS researchers emailed every Friday on the issues of the week.

Apocalypse now and then

Peter Kurti

09 October 2015 | Ideas@TheCentre

boom-ideasWhat is it with Christians and the end of the world? Many of my co-religionists are pre-occupied with an apocalyptic finale being nigh, and to latch on to any sign that our time on Planet Earth is almost up.

The latest prediction touted Wednesday 7 October 2015 as the Final Day. According to eBible, an online Christian organisation, that was the day the world would be permanently destroyed.

“It will be gone forever,” said eBible founder Chris McMann. “Annihilated.” McMann predicted it would be by fire rather than by pestilence, flood or famine.

Of course, McMann is not the first luminary to predict the apocalypse. Rasputin had pencilled in 23 August 2013 and former US presidential hopeful, Pat Robertson, took a punt on 29 April 2007 – and that wasn’t his first effort. None of them were right. But still the predictions and prophecies roll in.

Although ourindividual lives are all going to end someday, what’s the point of predicting the end of the world? Admittedly, knowing when we are all going to be hanged, as it were, might certainly concentrate our minds wonderfully.

But then again, if the game’s up, why not just kick back and relax?  Even Jesus didn’t think we needed to worry unduly about what comes next: “Be not therefore anxious for the morrow: for the morrow will be anxious for itself. Sufficient unto the day is the evil thereof,” he said.

I’m writing this just before midday on Wednesday 7 October, so if McMann was right and you don’t get to read this after all, was it really so bad that everything wrapped (or burned) up today?

For a start, just know that Prime Minister Malcolm Turnbull will now ride high in the polls for eternity. We’ll never know the outcome of Russia’s foray into Syria alongside its new regime buddy, Iran. But then again, we’ll also be spared the slings and arrows of a Trump presidency after 2016.

But again, some will think eBible’s prediction was adrift by a few days. Fans of England’s rugby team know the world ended last Saturday. Back home, NRL fans – at least, those outside North Queensland – are certain it happened on Sunday.

Best of all, if the planet was annihilated on Wednesday, it took that pile of ironing in my back room with it.

Uber gets green light in ACT

Patrick Carvalho

09 October 2015 | Ideas@TheCentre

11bbc8b5-153d-4604-999b-c1b9548f2747From 30 October 2015, the ACT will be Australia’s first jurisdiction — and the first capital in the world — to allow ridesharing business such as Uber to legally operate. The move could soon be followed by Victoria and other states.

This is good for competition and consumers. This process will drive more choice, better services and cheaper prices.

Although there are good arguments against the need for government regulation on the sharing economy in the first place, the ACT proposal does not impose disproportional compliance costs and adequately levels the playing field among varying competitors.

According to the proposed legislation, apart from third-party and property insurance, rideshare drivers will have to pay a $150 annual license fee and accreditation, plus a $65.40 annual vehicle inspection fee, a $45 national police check and a $23.80 driver history check. Further, a driver medical assessment (generally every five years) and an introductory minimum training will be required.

In response, Uber has already thrown its support behind the new regulatory framework. For the company – and rideshare drivers – despite the new regulatory costs, formal legal recognition and a transparent set of rules are better than undue prosecution and business uncertainty.

On the other side, the taxi industry has expressed anger. Anticipating the reaction, the ACT government tried to court them by reducing the taxi license fee from $20,000 to $5,000 and by giving exclusivity over picking up people off the street and at taxi ranks. Yet all in vain: apparently the taxi industry is more interested in clamping down external competitors rather than fighting for smart deregulation of its own industry.

For Australia, the ACT lead has the potential to kick-start a healthy round of competitive federalism with respect to disruptive technology regulation. If so, let the best win.

4 Corners on Medicare an economics-free zone

David Gadiel

09 October 2015 | Ideas@TheCentre

58f01929-1682-4382-9aa8-ab59e30f81d6On 28 September ABC Television screened an episode of its 4 Corners program, hosted by Dr Norman Swan, described as a special report “on the unnecessary testing and treatments choking the health system“. No doubt this was interpreted as a timely contribution to debate on the design of the Medicare Benefits Schedule in light of the Medicare Benefits Schedule Review Taskforce review announced by the Commonwealth Minister for Health in April 2015 to assess the effectiveness and value for money of services listed on the Schedule.

4 Corners interviewed a variety of clinicians, notably nominees of the Taskforce, including the co-author of a paper published in the Medical Journal of Australia in 2012 that identified a list of 156 ‘low value’ health care practices for which there are items on the MBS that are “potentially unsafe, ineffective or inappropriate in certain circumstances“.

By exposing patients to the risk of poor quality, unnecessary care or medical over servicing, 4 Corners argued that some services listed on the Schedule could represent a burden to Medicare and would be unlikely to contribute to health gain. This is neither a surprising or novel proposition. Over servicing has been a recurring theme in publicly-funded medicine in Australia since the early 1980s when the AMA and Royal Colleges accepted (on the basis of a rather dubious sampling model devised by the officers in the Commonwealth Department of Health) that doctors were costing the public purse some $100 million a year in fraud and over servicing-about 13% of all medical benefits then payable.

What was amazing about the recent 4 Corners program, however, was that it failed to interview a health economist or to acknowledge the interplay between medicine and economics. The existence of over servicing was evidently attributable simply to the existence of MBS item numbers that are available to doctors.

Of course, if one ignores the influence of price, supply exclusively or heavily dependent on public funding indeed creates its own demand. From this follows the policy prescription of regulating demand simply through the design of the Schedule-analogous to fruitlessly restricting hospital bed capacity in the 1980s, or to constraining doctor supply in the 1990s, in an attempt to control the cost of Medicare.

Without reference to effective pricing at the point of consumption that engenders rational decisions about service use in the doctor-patient relationship, the potential for efficiency gain in the supply of medical services through effective design of the Schedule will remain elusive and susceptible to being frittered away in over servicing-and so continue as a spur to costly and inferior work practices even if the care is otherwise unexceptionable. The way the argument about poor Schedule design and over servicing is being couched is one-sided, old-fashioned and misleading.