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Category: Health

24/11/2022

iCare- a letter to the Editor of the Sydney Morning Herald

24 November 2022

Dear Editor,
iCare was set up by private insurers on their model with the NSW government keen to minimise costs, take profits and distribute them (just before the last election). So iCare delays or refuses treatments to the needy, and was very careless about what their Pre-Accident Average Weekly Earnings (PIAWE) were. Many accident victims complained that they were underpaid, and that was before their compensation was stopped or cut because they were certified partially fit to do jobs that could not be found.

The overheads of Medicare are about 5%, iCare about 38%, so it is totally inefficient as well as incompetent with bloated salaries for the top executives who think it is a financial problem rather than a medical one and hence are unable to solve it. The real solution would be to fund Medicare as the only medical system and let the insurers have widespread income-guarantee insurance.
Sincerely
Dr Chesterfield-Evans- works as a GP specialising in Workers Comp and CTP injuries.

Here is an article from today’s SMH

EXCLUSIVE
Injured workers to lose benefits
Adele Ferguson

Greg Dayman is one of almost 400 workers who will get a Christmas ‘‘present’’ they will never forget.

The Sydney construction worker was badly injured on a building site in 2013, which left him unable to work with chronic pain in his neck, the side of his head, down his arm, torso and leg.

In 2017 he was among thousands of employees whose compensation payments to cover wages were cut as part of controversial reforms to the state’s scandal-ridden icare organisation. Changes to the legislation terminated injured workers receiving weekly wage benefits after five years unless they met a whole body impairment assessment of more than 20 per cent.
However, he still received medical or health benefits. Now he has found out even these will be cut from December 25.

‘‘It’s another upper-cut,’’ he said. ‘‘And to do it on Christmas Day, that’s just cruel.’’

Dayman is one of 395 workers facing a grim future as a crisis at icare deepens, with a document prepared by the State Insurance Regulatory Authority (SIRA) revealing the workers’ compensation scheme ‘‘has deteriorated to the point the longer-term sustainability of the scheme is under threat’’.

NSW Auditor-General Margaret Crawford will hold a performance audit into icare next year that will examine how effectively key risks are managed, including the rising cost of workers’ compensation claims and its payment processes. Dayman said he lost everything after his injury.

‘‘I lost my health, my career, and financially I’m in a position that if my specs break I can’t afford to buy them. The system dehumanises you, so you give up.’’

He does now qualify for a disability pension but will have to rely on Medicare for future medical treatment. ‘‘I have been suicidal at times because of the system and the way it treats you,’’ he said. ‘‘My time is spent trying to survive.’’

In the executive summary of SIRA’s review into icare’s Nominal Insurer Improvement Plan, dated September 26, the authority said it had a ‘‘low level’’ of confidence icare’s strategy would improve return to work rates and overall performance.

In 2015-16, 93 per cent of injured workers were back at work 26 weeks after their injury, compared with 84 per cent in August 2022.
SIRA said it believed icare’s strategy ‘‘encompasses an increase in work capacity decisions to cease worker benefits instead of focusing on improving health and recovery through return to work’’.
Richard Harding, icare’s managing director and CEO, said it was the insurer’s role to implement the law, and legislation ‘‘does not give icare any discretion to act outside that’’. ‘‘Tailored and individualised support is provided to workers transitioning from the workers’ compensation scheme,’’ he said. ‘‘This may include support from NDIS, Community Support Services and Medicare in conjunction with their GP.’’

This masthead this week revealed a third underpayment scandal of injured workers and concerns raised by NSW Treasury in August that a deterioration in icare’s finances would require insurance premiums to rise 33 per cent by 2025, or $1 billion a year, to cover the shortfall.

Against this backdrop, the icare board granted pay increases to 116 of its executives, including Harding, making him one of the state’s top-paid public servants, earning more than $1 million a year.
Shadow Treasurer Daniel Mookhey said icare’s finances were in a catastrophic condition.

‘‘They’ve lost billions. They are planning massive premium hikes. And their next step is to expel even more injured workers from the system,’’ he said.

‘‘It is a ruthless tactic stemming from their financial desperation.’’
In a statement, SIRA chief executive Adam Dent said its views on the Nominal Insurer Improvement Plan in September were made with limited detail on how the plan would be executed.

‘‘Over recent weeks, SIRA has continued to engage with icare to address information gaps, including detailed briefings on managing IT and transition risks associated with the onboarding of new claims services providers.’’

But SIRA said poor return to work performance continued to be an issue of concern.

‘‘Icare’s targets for 2023 are lower than current return to work rates, and they are projecting a further decline of 2.5 per cent on 26-week return to work rates through 2023 and 2024 as the scheme transitions to new claims providers,’’ Dent said.

Icare said its focus was building injured workers’ capacity for employment using rehabilitation providers and associated vocational placement interventions. ‘‘This includes assistance with job seeking and vocational retraining. Work capacity decision-making is applied when the worker has a demonstrated capacity for work and has been provided the right support.’’
Lifeline: 13 11 14

23/11/2022

British American Tobacco launches new Campaign to legitimise Vaping.

23 November 2022

Almost all the vaping products are owned by tobacco companies, and the marketing is almost a re-run of their tobacco campaigns. i.e:

1. Assume that it is here to stay, and hence legitimate and unstoppable.
2. Suggest that ‘courtesy and consideration’ is all that is needed.
3. Fight regulation as much as possible.

Naturally they are keen to say that any attempt to restrict nicotine is doomed to failure as it is already totally available on the Black Market.

It might be noted that when there were different regulations in Canada from the US for tobacco labelling, cigarettes were smuggled through the Indian reservations, and all labelling that used to allow the source of the cigarettes to be identified was removed from the packaging, which showed what contempt the tobacco industry had for regulations that lessened their sales.

We might expect that similar things are happening in sales of vaping products and liquids. Naturally as they talk about how hopeless it is to regulate vaping products they want to hark back to the failure of alcohol prohibition in the 1930s, which led to Al Capone and his gangsters.

Older folk will remember that as the tobacco control movement grew stronger in the late 1970s we were attacked as ‘wowsers’ and ‘killjoys’, with the implication that we were stopping people having a good time, which was what smoking was all about. It is the same tactic again. We want to stop all the happy vapers.

The tobacco industry used the fact that some doctors think that vaping can help people QUIT to allow them to sell their product without having to prove it was safe. They only had to prove it was less dangerous than tobacco- a very very low bar.

Now vaping is used more as a gateway to smoking than a path from it, and often if there is nicotine in the vape it can be used alternately as a substitute. So presumably will be a move to push vaping in smoke-free areas. Then vaping will be the ideal product for the tobacco industry, being used everywhere, helping consumption, and keeping some people smoking at other times. Just like the good old days.

Health interests have to keep the government onside, but also demand some serious anti-vaping campaigns.

Vaping uses solvents, which dissolve fats. If this is the case, it is like upmarket petrol sniffing, as it will dissolves cell membranes, especially in the brain, which has the highest blood supply of any fatty tissue in the body. This is likely to lead to gradually progressive dementia. Naturally this may take years to manifest, and even longer to be identified and scientifically proven, given that a highly sceptical Industry that will criticise the research; in short a re-run of the tobacco wars.

If we look at the history of tobacco, it was used in relatively small quantities until the invention of the cigarette rolling machine by Duke in 1898. It was massively marketed during and after WW1 from 1914. It was shown to cause lung cancer in 1950. Advertising bans started in the mid 1970s, but full sponsorship bans and smoke-free indoor air did not come until 2000. The tobacco epidemic lasted a full century; so watch out for a vaping re-run with a dementia epidemic in older folk. Unlikely? No;. quite possible. So will the tobacco industry prove it is is safe. They can’t, don’t want to; now don’t have to, and have put out this BS new organisation.

www.theaustralian.com.au/the-oz/news/big-tobacco-company-behind-vaping-overhaul/news-story/1078baf2358e5ba3d96c6235aac49610

19/11/2022

BUGA UP – the issues keep resurfacing

19 November 2022

BUGA UP originated in 1979, when its 3 founders were prevented from a regular evening out to re-face tobacco billboards by pouring rain. As it they sat and waited, they thought about how to publicise their work so that it did not appear as random anti-tobacco graffiti. They wanted a word that would be irreverent and would embody the concept of hitting back against the unhealthy promotions. After some discussion, the word BUGA UP was developed, an acronym for Billboard Utilising Graffitists Against Unhealthy Promotions. From that night they signed all the re-faced billboards with BUGA UP.

The major problem at that time was tobacco promotion, which accounted for over half outdoor advertising, with alcohol second. The concept was self-regulatory in that anyone taking up a spray can had to make their own decision about what they wanted to say, i.e. what they were willing to be arrested for.

A relatively large number of graffitists, especially from the medical fraternity, were inspired by what appeared to be a large campaign and were willing to be arrested for spraying on tobacco billboards. Other activists were concerned about alcohol promotion and some were concerned about sexism in advertising. A relatively small percentage were willing to be arrested for junk food or drink ads. (There were no ads for gambling at that time).

BUGA UP, however, looked at the whole issue of the regulation of advertising, asking that it not be one-way communication with no input from consumers or regulators as to the content or consequences of the promotions. The advertisers’ position was that it was their money, they could say what they liked, as this was ‘freedom of commercial speech’. Note the extra word in the cliche ‘freedom of speech’.

The advertisers set up a farcical ‘Advertising Standards Council’ which had very loose ‘codes of practice’ and an industry dominated judicial system, which took so long to work that the ad campaign was invariably over even if they banned an ad, which very rarely happened as they had the numbers in the kangaroo courts. One hapless paediatrician was recruited onto one of these committees, had his name used to champion the quality of its membership, and of course was outvoted in every deliberation. He eventually acknowledged sadly that he had been ‘used’ and he resigned.

But BUGA UP was active, producing a publication, ‘Billboard’, which was sent to all the major players in the advertising industry to emphasise to them that their regulatory systems were recognised as farcical. BUGA UP invented the ‘Advertising Double Standards Council’ to satirise the ‘Advertising Standards Council’. Its slogan was ‘If advertising standards are good, double standards are twice as good’.

One of BUGA UP’s members, Peter Vogel, wrote over 400 complaints about many ads. He was labelled a ‘serial complainer’ and they wanted not to respond to his complaints. He insisted that by their own charter they had to. They rejected all 400+!

Eventually there had been so much publicity about advertising regulation that the advertising industry wanted the Trade Practices Commission to re-legitimise its self-regulatory system, presumably as they thought government regulation was possible in the future. The Fairfax newspapers fronted this action, and it was opposed by ACA, The Australian Consumers’ Association. The advertisers said that their codes and practices were working well. At this stage Peter Vogel of BUGA UP came out of the woodwork, with his huge file of denied complaints. He had systematically made complaints using every item of the advertisers codes of practice and had a farcical response to every item, which the Commission could judge for itself.

Two academics, Shenagh Barnes and Michael Blakeney wrote a book called ‘Advertising Regulation’ (Law Book Co 1982) which concluded that the self regulatory system manifestly lacked credibility’. But despite the moral victory, the consequences of the trial were not good. The Trade Practices Tribunal concluded that it was not able to set up a regulatory structure, but could only either approve or reject what was put in front of it, so in the absence of any alternative it approved the self-regulatory system as it might have a bit of benefit over nothing at all. ACA, the Consumers’ organisation, was almost sent bankrupt by the legal fees involved, and overall the Industry had got what it wanted. A few years later when the issue had faded from the public eye, the Advertising Standards Council faded too.

The original BUGA UP guide, ‘Ad Expo- a self-defence course for children’ from 1983 is still available online, but of course its ads are now dated. (ww.bugaup.org/publications/Ad_Expo.pdf)

But now, as gambling wreaks havoc with families, and childhood obesity skyrockets, the issue of irresponsible advertising is back in the spotlight. Let us hope that there is more success this time, but a lot of work will be needed even to get up the momentum that BUGA UP had in 1983.

Here is an article on sugar and obesity:

Sugar shovellers are making us sick, fat and poor (and check out what they pay in tax!)

19/11/2022

The Myth of Liberal Competence-1

19 November 2022

One of the enduring myths of politics is that conservatives are better money managers. This is the case in the US, where the Republicans, who enthusiastically dismantle government programs that help poor people and the UK Conservatries who do the same. And it is the case here with the Liberals.

Perhaps the logic is that since they are rich, they must be better with money. But I wonder at the influence of Christianity. The key message is that you must suffer to be redeemed. Suffering is worthy and will later be rewarded. This seems to play into notions that the country will benefit if we all suffer now, ‘we’ in this case being those more dependent on welfare, or those at the bottom of the heap.

The other overarching fact in a market economy the more wealthy people can set the prices, which effectively means they set their incomes. At the bottom of the social pyramid, those at the bottom compete for the jobs and wages set by others. In short, the rich get richer and the poor get poorer. The game ‘Monopoly’ was designed to illustrate this. People play Monopoly, and when they win or lose, they stop the game and go on with life. But what is the game were real and never ended? The losers would get poorer and poorer until they had nothing else to give. That arguably is what a market economy will do without some intervention from an outside force, like a government, to intervene in the cause of those going backward.

Arguably the world’s leading economist is Thomas Piketty. He is a Frenchman who, as he rose, was offered a post in Harvard. He did not take it, opining that economics in the US was theoretical and not based on hard data, as a science should be. Records of national income and death duties going back for 400 years in 4 countries had been put together and he analysed it. His book, ‘Capitalism in the 21^st Century’ is a towering work. It is long, but it is very well-structured with concise conclusions at the beginning and the proof in the later chapters for those who want to read more. He observed that the wages of the population go up at the inflation rate, and the income of the rich who loaned money go up at the interest rate, but the interest rate was always higher than the inflation rate, otherwise there would be no profit in lending. So the income of the rich would always go up faster than the rest of the population, so social inequality would increase in the absence of other interference.

It has always been known that money goes round, and to stimulate the economy people have to spend more. But Piketty points out that poor people spend a greater percentage of their money than rich people. Very poor people spend all the money they have, rich people save about a third. So if you want to stimulate an economy, you should give money to poor people. This is of course not what conservative governments do. They give money to infrastructure, which these days means big private contractors or have industry assistance packages. But these initiatives are giving money to the rich, on the assumption that it will generate more jobs in the long term than the extra consumption would have generated.

(You might ask why Piketty has not got a Nobel Prize for being the first economist to use real data over centuries and come to such a profound conclusion. If you did ask that you might wonder if the Nobel prize economics committee are all neo-liberal economists and you might be right).

The point is without government intervention, the rich will get richer and the poor will get poorer. The best way to minimise this is to have as much shared wealth as possible in the form of park and public facilities, such as transport, health, education and essential services that blunt the significance of income disparities, as a base-line is set without it having the stigma of charity.

But conservative governments, like the Nobel committee want to ignore Piketty and the obvious facts as they do not suit their ideological agenda. A cynic would say that the ideological agenda from right wing ‘think tanks is merely an endless list of convenient reasons to keep the money flowing to the top end of town, to lessen government ‘interference’ which might act for fairness, and to commodify everything such as housing, transport and education so they can become profitable, increase inequality and profit those at the top. How can this agenda ever be considered the foundation of good financial management?

But as Treasurer, Morrison was not even clever in his management of his own revenue. Here is a tale of how his GST deal with Western Australia was out by a factor of almost 10 times over 3 years. Yet the legacy of this shambles is contracts and deal that other have to grapple with.

One of the modest contributions that I am seeking to make to political discourse is to sheet home the blame for failures to the people responsible for them. Here is a start, from the SMH:

Cost of Morrison’s WA GST deal blows out by $20 billion as debt hits record high

By Shane Wright SMH November 14, 2022 — 5.00am

A deal put in place to placate Western Australia when its share of GST revenue was tumbling is on track to cost the nation’s taxpayers 10 times more than originally forecast, helping drive up federal government debt and interest payments to record levels.

Pulled together by then-treasurer Scott Morrison in 2018 before being put through parliament by his successor, Josh Frydenberg, the deal that was originally expected to cost $2.3 billion is now on track to cost more than $24 billion.

WA, which delivered four seats to Labor at the May election on the back of a 10.6 per cent swing, is vowing to fight to keep the arrangement, due to expire in 2026-27.

Morrison struck the deal at a time WA’s share of the tax pool had fallen to an all-time low of 30 cents for every dollar of GST raised within the state. Its iron ore royalties were effectively being redistributed among the other states and territories based on a Commonwealth Grants Commission formula that takes into account each state’s revenue sources and expenses.

Under Morrison’s deal, from 2022-23 WA must receive a minimum of 70 cents in the dollar before increasing to 75 cents in 2024-25. When the policy was put in place, it was expected iron ore prices would fall and WA’s share of the GST pool would therefore rise. Instead, prices have soared.

The Morrison government ensured other states and territories wouldn’t be worse off, which requires the top-up funding for the deal to come from outside the $82.5 billion GST pool.

It was originally forecast to cost federal taxpayers $2.3 billion over three years, including just $293 million in 2021-22, but the surge in iron ore prices has meant more top-ups and for longer.

The October budget revealed that last year, the deal cost $2.1 billion and is forecast to jump to $4.2 billion this financial year. By 2025-26, the cost of the entire deal is on track to reach $22.5 billion, with another $2-3 billion likely the year after that.

Throughout the entire period, the budget is expected to be in deficit, forcing the extra cash to be borrowed. In percentage terms, the blowout in cost is larger than the NDIS, aged care, health or defence.

Independent economist Chris Richardson said the deal had been ill-conceived from the beginning with the cost to be borne by future taxpayers.

He said all significant spending programs needed to be properly assessed, including the GST deal.

“Yes, the politics of it are difficult. But we have a whole host of other issues, like the NDIS, and the economics of them have to be dealt with,” he said.

Any change to the GST deal would create enormous political problems in WA which is likely to gain more political power with an additional seat in a looming federal electorate redistribution.

WA Premier and Treasurer Mark McGowan, who reported a $5.6 billion budget surplus for the 2021-22 financial year, told this masthead he expected the GST deal to remain.

“I have made it very clear that West Australians will not accept any changes to the GST distribution,” he said.

“Those on the east coast who are demanding WA lose out still do not realise that under the reforms, WA will receive 70 per cent of its population share of the GST next financial year. In complete contrast, no other state has ever received a share of the GST lower than 83 per cent.

“WA will continue to subsidise all the other states into the future under this arrangement. No state has lost a dollar under these reforms.”

The extra borrowing for the GST deal has contributed to the lift in gross debt, which on Friday reached a record $909.4 billion.

Ahead of the COVID-pandemic, gross debt was expected to reach $576 billion this financial year. Instead, it is now forecast to reach $927 billion before reaching $1 trillion in 2023-24.

Treasurer Jim Chalmers said the cost of servicing the debt was getting more expensive and was now the budget’s fastest-growing expense.

“We’ve made good progress in a very short space of time. We’ve found $22 billion in savings and kept real spending growth flat across the forward estimates,” he said.

“[But] it will take more than one budget and more than one term of government to make up for a decade of missed opportunities and messed-up priorities.”

16/11/2022

BUGA UP Nostalgia

16 November 2022

BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions) was most active fro m 1979-1985, and had a big effect on tobacco and smoking. It was also a high point in the demand for advertising to be responsible for the consequences of its use of its products.

In the end, the advertisers accepted a ban on tobacco to keep the threat of stronger regulation at bay. They cut back on sexism a bit and the movement to regulate them died down. So alcohol, gambling annd junk food ads have survived.

Here is a link to some of the TV programs from that time and a little after.

www.youtube.com/user/BUGAUPTube

15/11/2022

Submission to Inquiry into Online Gambling

11 November 2022

Dr Arthur Chesterfield-Evans

The Internet Problem

The issue of online Gambling is similar to many problems in that online gambling involves an area of activity that is largely beyond the direct control of the Australian Parliaments, or indeed any single Parliament. The internet was designed to be anarchic, and so it is.

Programs to deal with gambling regulation are thus ineffective, but the limited terms of reference of this inquiry suggests that governments are not thinking in terms of what they can do at a systemic and global level and are turning instead to a focus on the individual.

Need for an Industry focus rather than an Individual Focus

It must be noted that where creating public health problems benefits an Industry, the response must be against that Industry. Concentrating on individuals while the Industry markets to the world is a very inefficient strategy. To use a historical example, the Tobacco Industry marketed with ubiquitous ads, sponsorships, product placements and many other techniques, yet wanted medical professionals and school education to be the only techniques used against them, framing the issue as personal choice (and responsibility) and ‘smokers v. non-smokers’ requiring courtesy (and no criticism and restrictions).

This is the situation that the Gambling Industry is in now. They demand to be able to market to the world, but want all harm minimisation programs directed at individuals. They know that this is a winning strategy for them.

What the Federal Government Can Do

While it is true that the Australian Federal government has no effective jurisdiction over the internet, and does not licence or control the Hotels, Clubs and Casinos with their poker machines, it has control over Australian media advertising laws and also allocates grants to States. The Federal government could ban all Gambling advertising on electronic media in Australia, and lessen grants to States in proportion to their revenue from Gambling. This would stop the States getting any benefit from gambling revenue, which they rely on quite highly. Western Australia, which is missing out on Gambling revenue would certainly support this.

The ban on tobacco advertising and sponsorship has set a precedent for action on public health issues, and there was censorship of certain opinions that were antithetical to a national COVID strategy, so the idea of a ban on Gambling advertising is not new or radical. VicHealth also replaced tobacco advertising with ads for healthy lifestyles and anti-Gambling advertising could replace ads for Gambling. The protest group, BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions) in the 1980s used satire of tobacco advertising to sharpen the focus on the Tobacco Industry’s absurd imagery and callous disregard for the lives of their customers. They won hearts for their Robin Hood approach to the entrenched power of the Tobacco Industry and set the world standard for action against tobacco, because compared to their actions, everything else became ‘moderate’. But less recognised than their billboard campaign was the re-framing of the debate from ‘smokers v non-smokers’ and ‘personal choice’, to a ‘Tobacco Industry campaign to make a profit even though it kills people’. This reframing in the public mind allowed governments to stand up to the Tobacco Industry and forced political parties to eschew their donations (at least publicly)..

Gambling Industry Strategy

The Gambling Industry’s ads are very clever, appearing to take the loser’s side to identify with (usually) him and dangle the prospect of a win, though of course this is statistically impossible in the medium term. They are perverting the idea of ‘mateship’ to a group Gambling session with a cheery comparison of who they are backing as they watch sport. This would be very vulnerable to a satiric response, based on a commiseration as to which mug lost the most and a final comment that ‘gamblers are losers’.

Laissez-faire v. Health

The Federal government is responsible for the health of Australians and with an increasing percentage of health problems being related to lifestyle choices, the government cannot simply ‘leave health to the market’. ‘The market’ will sell anything that makes money irrespective of whether it has good health outcomes or not, so leaving the national wellbeing to ‘the market’ is a highly flawed strategy as the government in the end picks up the tab for all problems. The Federal government should unashamedly promote sales and practices that are good for health and discourage things that are not.

Encouraging good personal decisions

Any reasonable management textbook will say that the best way to manage things is to have good decisions made at the lowest possible level within the organisation. Yet gambling advertising uses distractions and dreams of riches that are statistically extremely unlikely to encourage people to gamble, and thus not use their money wisely. If the ads said ‘Do not contribute to superannuation’, ‘Do not save’, Do not worry if you do not have enough money to feed your kids’, there would be a huge outcry. Yet this is the outcome with a large percentage of gambling money received being from people who cannot really afford it. The social problems created take an immense amount of effort from government and NGO charitable organisations to try to rectify them. Often they cannot. This problem is entirely created because of bad decisions on gambling made by people who the Gambling Industry has conned. It is exactly like people taking up smoking. It was portrayed as a bit of harmless pleasure, but when people were hooked, it did them immense harm. Gambling is the same.

Need for Gambling Research

One the other problems of Gambling is that the research is funded by the industry, so its scope and nature are controlled. The amount of harm that it does is poorly quantified, so that there is little evidence for those opposing Gambling to use in political debate. The lack of evidence and the lack of debate suits the Gambling Industry fine- they are more than happy to continue and extend the status quo. Given that the Federal government is a major player in cleaning up the social problems created by the Gambling, it should insist that there be well funded research on the social consequences of Gambling, and the nature of this research should not be determined by the Gambling Industry. The Gambling Industry in Australia is extremely large by world standards, perhaps the largest in the world apart from little enclaves like Monaco or Macau where the money is retained by the State and the social problems are either ignored or assumed to be manifest elsewhere. The social indices of distress are very high in Las Vegas. It might be said that the Gambling Industry in Australia is like the gun lobby in the US; it is almost unchallengeable. This must change, and the Federal government must initiate the change.

Off-line Gambling

It is interesting that the Clubs lobby is under challenge at a state level. The origin of this is uncertain. There has always been a lobby against Gambling, and this may have been helped by the rapid rise in the inflation rate which is straining the family budget, particularly of disadvantaged people, who are the ones most affected by Gambling losses. It is also no doubt helped by the revelations that the Casinos have happily laundered money for organised crime, by-passing their regulatory systems, and being perceived by organised crime as an easier target than foreign jurisdictions. The public also notice that the Casino boards were well stacked with ex-politicians, who were presumed to be there to smooth the political pathway of the Casinos in their dealing with regulation or (even) enforcement. It might be noted that despite the huge amounts of money being laundered and the findings that the Casinos were not fit to have licences, their share prices have only suffered modestly, showing that everyone knows that eventually their licence will be restored and it will be ‘business as usual’. The public is also well aware that the charade, ‘’I had no idea what was happening’ from the politically connected people at the top, merely leads to a resignation or two, but there is no penalty on the individuals. An aboriginal youth can go to gaol for petty theft, but laundering billions for organised crime merely leads a Casino director to a sojourn in the yacht club. While the major political parties have been very reluctant to upset the Hotel and Club industry, as evidenced by the 20 year delay in introducing smoke-free indoor air legislation, the rise of the Teal candidates threatening once safe seats, has pressured the major political parties to take a more ethical stance, and also blunted the financial advantage that support from the pubs and clubs lobby gives to their campaigns.

Online v. Off-line Gambling

But the final possibility for the pressure on the Clubs and Hotels may have come from the Online Gambling lobby. If it is assumed that people who want to gamble will use what is available, there is a real possibility that the lack of poker machines availability in pubs and clubs may lead to an increase in online Gambling. Supporters of the pubs and clubs are quick to point out that the clubs are non-profit and spend their monies enlarging their premises and providing facilities in Australia, as well as paying at least some tax to State governments. If there were a change towards online Gambling this money would go overseas. This overlooks the social context of gambling. Playing a poker machine is quite different from going online, so there is unlikely to be a direct transfer, even if the online experience is made more similar.

Need for Federal Government Action on all Gambling

The lesson for the Federal government, however, is that Gambling must be discouraged at both the pub and club level, and online at the same time. Both have similarly detrimental financial consequences for the players and punters, though the industries are distinct. From the public’s point of view, it is worrying that the terms of reference of this inquiry neglect that issue of Gambling in pubs, clubs and the TAB, as it suggests that these influences have restricted the terms of reference. The regulation of the internet is also a wider problem, which usually comes into focus with the issues of inflammatory hate speech, medical disinformation, defamation or an aspect of pornography. Gambling for money should be in a similar category to these and discussed in a similar context.

Recommendations:

The Federal Government should recognise that the Gambling Industry and its power is the reason that Australia has a worse Gambling problem than almost any other developed country and the the Gambling Industry has a hold on Australian politics as strong as the Gun lobby in the USA, and with a detrimental effect that could be of similar magnitude.
The Federal government should take an unequivocal stand that Gambling is harmful in that it encourages poor financial decision-making which puts a strain on the whole welfare system, Federal, State and NGO.
The Federal government should recognise that all forms of Gambling need to be discouraged, pubs, clubs, TAB, on-course and online and this needs to be an unequivocal campaign, similar to Quit or for the necessity for vaccination.
The campaign against Gambling needs to be in schools and have both a mathematical component as part of statistics, and a more practical part looking at online Gambling, and the social institutions which encourage Gambling.
The campaign against Gambling must involve electronic media advertising bans on TV and all advertising and sponsorship. It must involve active ads against Gambling as well as merely bans on pro-Gambling ads. It should use satire and be prolonged.
The control of online Gambling should be seen in the context of minimising the harm of the ubiquitous internet, and research on how to lessen Gambling should be pursued with endeavours to lessen other social harms such as child sexual exploitation, bullying, vaccine disinformation, tobacco and vaping advertising and disinformation, hate speech, video games that promote violence and defamation.
The Federal government should fund Gambling research so that the social consequences can be quantified and rational decisions made about the cost-benefit to society. Gambling research should not be neglected, limited, financed and controlled by the Gambling Industry as is currently the case.
There must be support for people who have a gambling problem. Such services need to be publicised, and destigmatised, as happened for those with mental illness. However, individual services must not be a substitute for a more systemic industry-focussed approach.
There needs to be a national register of addicted gamblers to allow better exclusion from gambling facilities. If this were comprehensive, it could be used to prevent addicts losing money online with a caveat emptor for those who took the bets from registered addicts. The credit card companies could be recruited not to allow Gambling to such addicts and not to honour Gambling debts incurred by registered addicts.
The Federal government should consider family support for addicted gamblers in the same way that child support is available for at risk families.

About the Author

Dr Arthur Chesterfield-Evans is medical doctor, who trained in surgery and became a tobacco-control advocate, then an Australian Democrat MLC in the NSW Upper House. He is currently working as a GP.

10/11/2022

Vaping- A WHO Guide

10 November 2022
The World Health Organisation is trying to lessen vaping, which is now reaching epidemic proportions in young people. The attached article clarifies the tobacco Industry’s gobbledygook, though it is fairly soft on their rapacious marketing.

Social media has allowed the tobacco industry to target children and young people without adults noticing, which is different from the tobacco marketing days, when everyone saw the same ads.

The Industry claims that since vaping is less harmful than smoking, it should be legal, and most importantly that they should not have to prove it is safe. They have achieved this latter, and now because this has allowed them to achieve high sales they have made it hard to ban. They also use a lot of kids marketing to kids, as happens with illicit drugs, to make it harder again.
Of course not very many people use vaping to quit, and it now seems that vaping is a gateway to smoking, and a way of not quitting. But do not expect the Industry to do anything except maximise their profits.
The health interests are ponderously getting their resources together, for a battle that will take a generation or two, if tobacco, asbestos, lead etc are any guide.
www.facebook.com/groups/GlobalTobacco/?multi_permalinks=5906974112658360&notif_id=1668001224984823&notif_t=group_activity&ref

16/10/2022

A Robodebt Re-Run? Labor bound by Pre-election contracts?

22 July 2022

It seems that the Liberals are ruling beyond the election, by letting long-term private Centrelink contracts that Labor must honour. With the public service effectively dismantled, all work is done by private contractors, and doing tasks defined in a highly ideological framework. Even if the contracts were rescinded, with whatever penalty clauses the Libs and their contractors had agreed on, the Labor party has insufficient public administration staff capable to do the job of paying people in the short term. So they default to the Liberal contract.

This is about managing Centrelink’s Jobseeker program and ‘debt recovery program’. We have seen how the Liberals used Tax Office records in the Robodebt scandal, with totally unsubstantiated financial demands, then enforced by garnisheeing payments leading to suicides. Behind this sort of activity is a philosophy that those on welfare have only themselves to blame and need to be forced back to work, even when it is obvious that there are fewer jobs than job seekers, so that all that will change is who gets what jobs there are. Labor has to change the philosophy to a more realistic one, then have a serious plan to help those who cannot get jobs. Everyone knows that technology is replacing people in many areas, and jobs are moved offshore in manufacturing or services such as call centres because it is cheaper.

The fact that Labor was dependent on contractors chosen by the Liberals is another feature of privatisation that must be reversed. The Public Service must be rebuilt, and staff given guarantees of long-term employment- like they used to have. They must do their job helping people without the cost constraints of false bonuses that reward them for doing the easy tasks and leaving the hard ones.

www.sydneycriminallawyers.com.au/blog/robodebt-2-0-labor-moves-to-hit-up-the-unemployed-for-debts-caused-by-mismanagement/?fbclid=IwAR1S4n-kMmQIO70ABi_kStmuTgnqw2zQOE6RgXRz_C31hFJfQ3_0vik_Pio

16/10/2022

Priorities for a Pro-Life US State Senator

3 July 2022
One of my US friends quipped that ‘Republicans are pro-life until it is actually born’. During the birth
process Republicans are against free health care and after the birth they are against welfare, child
support, living wages, equal opportunity in education etc.
The Pro-life senator in Oklahoma, Wendi Sherman, who was the proponent of the abortion ban
there, said, “The purpose [of government] is to protect life, not to provide for citizens.”
The practical corollary of this definition of the role of government is that women are forced to have
children that they did not want and then forced to care for them, when they knew before the birth
that this was too difficult to attempt. One might ask whether this is the same religious view that was
extant when I was young that having a baby was punishment for the sin of having sex. There is no
quote or evidence of a question on this subject, but these sort of fundamentalist views do seem
extant in the US.
I wonder if political hardheads in the Republican party just use abortion to shore up the significant
religious vote. Abortion is painted as a ‘life and death’ issue and so has great weight. Other policies
like foreign wars, tax cuts for the wealthy and cuts to Medicare and welfare programs can sail
through because of this preoccupation/obsession.
www.abc.net.au/news/2022-07-03/abortion-rights-oklahoma-roe-v-wade/101167280

20/05/2022

Government protects Bonuses of iCare Executives while workers are dudded.

20 May 2022

Some things make me unspeakably angry.

In the SMH online today the government giving bonuses to executives who presided over iCare cheating injured people out of their payments and treatments.

In my real job, I treat injured workers and motor vehicle accidents. Many wait more than a year for surgery- my longest was 9 years. They are subjected to Independent Medical Examinations that find any other reason than their accident for the cause of their pain. Age, previous injury and arthritis are the commonest ones. It is stated that they are fit for work, when they are obviously not, or that they can get another job when they obviously have no physical or mental capacity to do another job, let alone compete for one.

The ongoing inefficiency of the computer algorithms making decisions without even anyone being responsible was the brainchild of John Nagle, whose other bright idea was to change his KPI (Key Performance Indicator) from getting people back to work, to having them declared fit to be back to work. Nagle resigned after a bad day at a Parliamentary inquiry. All this happened while iCare was under Treasurer Dominic Perrottet.

A friend of mine injured his back lifting on a Friday. He called his GP and visited him on Saturday. He had an MRI scan on Monday which showed a bad disc injury, saw the neurosurgeon on Thursday, had a discectomy on Saturday and went home on Monday. All fixed in 8 days. That is what should happen. It never happens in the WC or CTP system.

The Workers Comp system takes 14 days to accept liability, then has to ‘decide’ if the treatment is appropriate, so weeks go by, and if they dispute it, years. People wait 3 months for the insurer’s medical examination, 6 weeks for the result of it, another couple of months for their specialist examination and a few months for the government medical to settle the dispute. And they blame the injured people for the worse results out of the system, and give bonuses to those who managed to reduce the costs. Given the huge administrative machinery, the clerk, investigators, extra medical examiners, lawyers, dispute resolvers and the rest, all the savings come from not treating people. And those responsible get bonuses, and the government, ever keen not to upset the private sector ring-ins makes sure that they are amply rewarded for this appalling situation. Perrottet, the most recent architect of iCare, had a 2^nd inquiry by McDougall to kick the can down the road, then rose to be premier before his report was out.

Here is the SMH article:

Government votes to protect bonuses for icare executives

By Lucy Cormack

May 20, 2022 — 5.00am

The Perrottet government has protected bonus payments for icare executives, rejecting a bid to ban the practice after revelations millions of dollars in bonuses were handed out while injured workers were underpaid.

The attempt to strip bonuses from executives at the state insurer was contained in Opposition amendments blocked in the lower house this week during a vote to amend the state insurance and care legislation.

Icare has been the subject of intense scrutiny since an investigation by the Herald and ABC TV’s Four Corners in 2020 revealed the underpayment of workers while senior executives claimed almost $4 million in salaries and bonuses.

The insurer, which provides workers’ compensation insurance to 3.6 million public and private sector employees in NSW, has since been forced to repay $38 million to 53,000 injured workers.

The scandal prompted the government to amend legislation governing icare, following a review by former judge Robert McDougall, QC.

More than 200 icare employees are entitled to bonuses, including chief executive officer Richard Harding, who is entitled to an incentive of $411,000.

Opposition treasury spokesman Daniel Mookhey said there was little justification for bonuses while the insurer continued to record billions of dollars in underwriting losses.

“Employers are staring down the barrel of a decade of rising premiums, yet the government is protecting bonuses for top executives at Australia’s most disaster-prone insurer,” Mookhey said.

“We intend to stand up for employers and injured workers. We will fight against lavish bonuses for icare’s top executives in the Legislative Council next week.”

During debate on Wednesday, Minister for the State Insurance Regulatory Authority Victor Dominello said the McDougall Review had not found executive bonuses at icare were excessive.

He said McDougall noted the benefit of allowing icare to set competitive salaries to “attract appropriate talent”

The Herald last year revealed icare hired 18 new executives with potential annual bonuses collectively worth more than $1.2 million, while employee operating costs have increased from $162 million to more than $200 million since 2020.

However, an icare spokesman previously told the Herald no executive bonuses have been paid in the past two years.

Unions NSW boss Mark Morey wrote to NSW MPs last week calling for reforms to address “repeated governance, financial and operational crises”, including ending executive bonuses.

Other proposed reforms included enforcing the same procurement laws that govern the NSW public sector, from which icare is exempt, and appointing an injured worker to the board.

Morey on Thursday said the government had missed an opportunity to “clean up” the state insurer.

“How can the premier justify continued bonuses for highly paid executives when sick and injured workers have been dudded and small businesses are paying increased premiums?” he said.

Other changes sought by the government included additional powers for the State Insurance Regulatory Authority and expanded access to commutation, which allows injured workers to negotiate lump sum payments and exit the system, rather than remain on weekly payments.

However, the government agreed to withdraw its proposal to allow changes to commutations via regulation and reconsider them in future legislation.

Opposition spokeswoman for industrial relations, work, health and safety Sophie Cotsis said she was pleased the government had agreed to consult further on lump sum payments, arguing that regulation should not be used to expand the system.

The State Insurance and Care Legislation Amendment Bill 2022 will now move to the upper house, where the opposition will make another attempt to ban bonuses.