It appears that the Liberal government in Australia is leaking details of a plan to introduce a 'co-payment' for visits to a doctor that are bulk-billed, in order to find out exactly how much this would upset the electorate, and possibly to also soften voters up before anything concrete is announced in the May budget. The suggested amount is fairly small (about $5) compared to the minimum 'short consultation' fee bulk-billed for a GP visit, but would hopefully curb 'over-servicing' - whereby some elderly or unemployed patients sometimes visit their GP with great frequency in order to have a chat, rather than for any specific medical need.
While the AMA (the doctors 'union') always meets any suggestion of a co-payment with predictions of adverse patient outcomes ('the poorer patients won't see their GP when they need to') such dire predictions have to be taken with a grain of salt, given the conflict of interest between seeing patients as often as needed with the need to see patients as much as possible in order to boost bulk-billing income (one doctor was recently investigated for claiming to have seen hundreds of patients an hour, thereby billing medicare for thousands of dollars. When questioned about how he could treat a patient in less than a minute, he claimed he 'eyeballed' all these patients in his waiting room!). While the vast majority of doctors are presumably highly ethical and wouldn't think of trying to 'rip off' the public health system, it would be easy to tolerate over-servicing as actually providing a medical service - after all, the little old lady on high blood pressure medication that comes in for a chat every week might indeed benefit from such close medical supervision, and, like chicken soup for the 'flu, while it might not be doing any significant good, it can't hurt (except the federal budget).
The Labor party, having been trounced in the recent election, but bouncing back in the opinion polls (now that the new Liberal government has to actually work out which services to cut or taxes to raise in order to have any chance of reducing the multi-billion dollar deficits entrenched while Labor was in government) is obviously keen to portray this a terrible new tax, a hence a 'broken promise' (although if you promise not to raise taxes, not to cut services, AND to reduce the deficit, as both parties seemed to do during the campaign, how can ANY promises be considered 'core'?). The also like to portray a co-payment as the first step in dismantling medicare, claiming that that is part of the Liberals 'hidden agenda'... although since a similar co-payment was suggested by Bob Hawke it seems that both parties occasionally realise that the current rate of rise in health expenditure is unsustainable in the long term.
However, a co-payment probably would discourage some poor people from seeing a GP when they need to. But then again, some pensioners already choose to spend part of their government unemployment or aged pension on booze, cigarettes, and sometimes illicit drugs, rather than on medical care, or even the educational needs of their children (hence the well-intentioned but controversial 'intervention' and 'managed payments' schemes).
Overall, it seems a small co-payment for GP visits would be a good thing, so that the finite health budget can be spent where it is off greatest actual benefit to public health, but would probably also have to be matched by a similar amount of 'out-patient fee' at the public hospitals funded mostly by the states, otherwise there would be a large movement of bulk-billing patients from GPs to public hospitals in order to avoid the fee.
It will be interesting to see how much 'outrage' over this measure actually attracts - in some ways it seems very similar to the mock outrage that was whipped up when a small 'user pays' fee was introduced for all ambulance services - prior to which there were cases reported of elderly patients calling an ambulance to take them to public hospital for free, in order to fill the medical prescriptions, simply to save travelling to the nearest pharmacy by bus or taxi to fill their prescription! Any public service that appears to be entirely 'free' to the consumer will end up suffering from considerable over-servicing, often at huge expense to taxpayers for very little benefit.
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Monday, 30 December 2013
Tuesday, 3 December 2013
Net Worth: November 2013
A rather weak month for the Australian stock market reduced the value of my leveraged share portfolios, but the value of my SMSF account still managed a slight increase due to the unhedged exposure to international share markets. The fall of the Aussie dollar boosted the value of the Vanguard HighGrowth Fund units, which form a large part of our SMSF investment portfolio. The recent rise in the Sydney real estate market boosted the estimated market value of our house, which also added to my net worth total this month.
* the Stocks figure is portfolio value - margin loans. The LVR is around 80% overall.
^ doesn't include the ~$675,000 of investment loans
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| Assets | $ Amount | $ Diff | % Diff |
|---|---|---|---|
| Stocks * | $219,413 | -$5,109 | n/a |
| Retirement | $562,016 | $3,048 | 0.55% |
| Properties | $466,400 | $7,773 | 1.69% |
| Debts ^ | $ Amount | $ Diff | % Diff |
| Home Mortgage(s) | $102,383 | $10 | 0.01% |
| Net Worth | $1,145,446 | $5,702 | 0.50% |
^ doesn't include the ~$675,000 of investment loans
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Friday, 1 November 2013
Net Worth: October 2013
An even better month for the stock market boosted both my leveraged share portfolios and the value of our SMSF investments. This month also saw two months of employer contributions deposited, which also helped.
* the Stocks figure is portfolio value - margin loans. The LVR is around 80% overall.
^ doesn't include the ~$675,000 of investment loans
With a large exposure to the stock markets, a return of investor confidence and bullish stock market would provide a major boost to my NW progress. Hopefully 2014 sees a return to stronger global growth and reduced uncertainty and volatility. The trick will be to know when to start reducing my leverage in preparation for the next inevitable correction or bear market. Having seen out the GFC and EFC, I hope I don't have to go through a third 'once in a lifetime' market crisis. But there are still major storm clouds in the horizon in terms of the massive government debt levels present in many developed economies, an aging population increasing welfare costs and reducing productivity growth, and the costs of 'peak oil' and many other finite commodities and tackling global warming (or mitigating the effects thereof).
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| Assets | $ Amount | $ Diff | % Diff |
|---|---|---|---|
| Stocks * | $224,522 | $55,331 | n/a |
| Retirement | $558,968 | $22,685 | 4.23% |
| Properties | $458,627 | $0 | 0.00% |
| Debts ^ | $ Amount | $ Diff | % Diff |
| Home Mortgage(s) | $102,373 | $7 | 0.01% |
| Net Worth | $1,139,744 | $78,023 | 7.35% |
^ doesn't include the ~$675,000 of investment loans
With a large exposure to the stock markets, a return of investor confidence and bullish stock market would provide a major boost to my NW progress. Hopefully 2014 sees a return to stronger global growth and reduced uncertainty and volatility. The trick will be to know when to start reducing my leverage in preparation for the next inevitable correction or bear market. Having seen out the GFC and EFC, I hope I don't have to go through a third 'once in a lifetime' market crisis. But there are still major storm clouds in the horizon in terms of the massive government debt levels present in many developed economies, an aging population increasing welfare costs and reducing productivity growth, and the costs of 'peak oil' and many other finite commodities and tackling global warming (or mitigating the effects thereof).
Subscribe to Enough Wealth. Copyright 2006-2013
Saving Pennies - closing an inactive credit card account
One of those annoying little avoidable expenses that has been bugging me for ages is the annual fee on an ANZ credit card account I never even use. I can't remember how I ended up having this account in the first place (I think there must have originally been a $100 bonus for opening a new account and using it a few times), but for the past couple of years the only activity on the account has been the annual fee of $30. I would totally forget about the account (as they only send out a monthly statement if there have been any transactions or if there is a balance carried on the card), and then remember it again when the statement arrived showing the annual fee that had been charged. Every year I've been promising myself to close the account down just before the next annual fee falls due, and then forgetting all about it again. The problem was that, having just paid the annual fee, I thought I may as well keep the account open 'just in case' for the remainder of the year, and that having a extra $15,000 credit line available in case of emergency might come in handy at some time...
This year was even worse, as I didn't even notice when the annual fee statement arrived, as we now have a savings account with ANZ for our self-managed superannuation fund. The envelop for the ANZ savings account statements looks identical to that used for the credit card statement, so I didn't even open up the credit card statement when it arrived, and only noticed the following month when another statement arrived showing a late payment fee of $20 and interest charged on the unpaid $30 balance! That was enough to convince me to finally phone up ANZ and close the account. Fortunately when I explained my reason for closing the account I ended up getting the annual fee, late payment fee and interest charged all waived (having $30,000 or so sitting in our SMSF savings account probably makes me a 'valued customer'). Well worth making the phone call!
Subscribe to Enough Wealth. Copyright 2006-2013
This year was even worse, as I didn't even notice when the annual fee statement arrived, as we now have a savings account with ANZ for our self-managed superannuation fund. The envelop for the ANZ savings account statements looks identical to that used for the credit card statement, so I didn't even open up the credit card statement when it arrived, and only noticed the following month when another statement arrived showing a late payment fee of $20 and interest charged on the unpaid $30 balance! That was enough to convince me to finally phone up ANZ and close the account. Fortunately when I explained my reason for closing the account I ended up getting the annual fee, late payment fee and interest charged all waived (having $30,000 or so sitting in our SMSF savings account probably makes me a 'valued customer'). Well worth making the phone call!
Subscribe to Enough Wealth. Copyright 2006-2013
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