More about the revised co-payment

GP co-payment 2.0: a triple whammy for patients

Good article here from Grattan Institute about the complexities of the changes to the co-payment scheme, and how it will hurt patients.

I tend to think that these problems need to be brought quickly to the publics attention by those opposed to it, because the headlines so far will not have given a correction impression of the consequences of the changes.

Ridley takedown

Matt Ridley, Anti-Science Writer, Climate Science Denialist – Greg Laden's Blog

Ridley is a favourite of the IPA style denialist set, and well and truly outed himself as having no credibility in his recent writings in which he endorsed Jonova's completely bogus complaints about BOM's work on temperature records in Australia.

Greg Laden does a good job at explaining how he is a denialist twit.   Hence, he will continue to be believed and quoted by Bolt and Catallaxy.  

Right wing torture

I said yesterday that it seemed to me that the American Right was not sure how strongly to respond to the Senate Report on CIA torture.  It now seems though that they have decided to push hard the CIA's line that it was all worth it and got heaps of benefit from it, and that this is all politic-ing by Democrats.

There are truly revolting Fox News clips  around, and I see that the Wall Street Journal is prominent in the "Go, CIA!" defence.

The Obama response - to sit in the middle at least on the issue of whether it was effective or not - seems measured and appropriate.

Despite the CIA's claimed justification, I just can't see the public accepting that the methods used, now that they are fully detailed, were acceptable in any context.  It also shines the strongest light ever on the genuinely Orwellian use of language in the phrase "Enhanced Interrogation Techniques."   The thing is, when you read a list of them described dispassionately, such as here, people might think "well, used judiciously, I can live with that."   (And who doubts that this is how the CIA sold it to politicians in briefings.)   But when you read the details of how they were actually applied - a prisoner freezing to death on the floor, being forced to stand with broken bones, rectal "feeding" that caused injury - well, that it puts the theory into ugly reality. It's no longer just the matter of "is waterboarding torture?", which was the main way the public perceived the issue 10 years ago (remember Hitchens writing about that?); it is much, much more.

Brains and religion

Finding God in a seizure: the link between temporal lobe epilepsy and mysticism - Encounter - ABC Radio National (Australian Broadcasting Corporation)

 I heard part of this on the radio while in the car yesterday, and it did indeed sound very fascinating.

There is more in the full episode than appears in this article.

Why would anyone ever believe them again?

Even allowing for the normal way that parties, once they achieve government, will let some promises drop and reverse some others, it really is extraordinary the number of broken promises or reversals of position this Abbott government is making.  Why would the public ever believe anything anyone in this government says about their future intentions again?

The latest example of bold faced, direct reversals (and one with really no attempted justification at all) comes via Julie Bishop:

The Abbott government has denied international pressure forced its decision to commit $200 million to a global climate fund it had previously said it could not support....

The foreign minister also responded to criticism that the funds should not be drawn from Australia's existing foreign aid budget.

"This is our neighbourhood, this is where we are already using our aid program to assist developing countries in the Pacific," she said.

"This is money from the aid budget that would have otherwise been allocated to the Pacific for climate mitigation and climate related action to work against the impact of climate change."

In an interview with the ABC in 2012 while in opposition, Ms Bishop said climate change funding should not be "disguised as foreign aid funding".

"We would certainly not spend our foreign aid budget on climate change programs," she said at the time.

All you never wanted to know about "rectal feeding"

Controversial 'rectal feeding' technique used to control detainees' behaviour | US news | The Guardian

 I'm sure I wouldn't be the only person greatly surprised that the CIA torture regime could include "rectal feeding".  Rectal re-hydration I thought possible, but feeding?   What's more - look at what was fed:

Officers also administered a “lunch tray” enema to Majid Khan that
consisted “of hummus, pasta with sauce, nuts and raisins [that were]
‘pureed and rectally infused’”.

Bloody hell...

The Guardian article at the link, though, does give a detailed background as to the idea of inserting real, minced food  there for medicinal purposes.  It includes this bit:

When President James Garfield was shot by an assassin in 1881, he was kept alive for several days with enema infusions of “fresh beef, finely minced, in 14 ounces of cold soft water”, along with egg yolk and a bit of whiskey.

Not surprisingly, the idea was abandoned by just about everyone not into torture about 60 years ago, apparently.

Now, this post may well sound as if it is making light of an odd aspect of the report.

It's not meant to - the activities detailed in the report are truly scandalous, and I find it hard to believe that the "pushback" by past CIA figures is going to wash with anyone other than the nuttiest figures on the Right.  I get the impression that parts of the Right don't really know how to play this -  Breitbart is not giving it much prominence, and is simply running with a "CIA defends itself" story. 

Update:   this Slate article gives a good summary of the report and how the CIA got into the torture game.

Just thought I would add a bit of information to a graph....

Hey, I thought removing the carbon tax and mining tax was going to make everyone feel fantastic and full of confidence and financial vigour?  [Sarc, of course]

We'll be hearing more from GPs soon, I expect

The GP co-payment trick that purports to save $3.5 billion

Peter Martin explains that a lot of the government's claimed "savings" from their new policy comes from some quite dramatic changes to the rebate to doctors:

Part of the trick is that it isn't the co-payment that saves the government money, it's the cut to the Medicare rebate. That cut was always going to be $5 per consultation. If doctors had had the ability to charge a $7 co-payment they would have got an extra $2 in their
pockets. Now they won't.

Another part of the trick is that the government will now cut some rebates by much more. Standard so-called Level B consultations of up to 10 minutes currently attract a $37.05 rebate. Under the changes they will classified as Level A and attract $16.95 for the young and
concession holders and $11.95 everyone else.

And the two-year freeze on Medicare rebates that was going to extend to June 2016 will
now become a four-year freeze, extending to June 2018.

That sounds a huge difference to me, and (I would have thought) both guarantees the end of practices that bulk bill everyone, and lead to significant extra payments to make up for lost revenue from the re-jigging of the rebates.   I mean, will a GP seeing 6 sick kids in a hour really take $102 for the pleasure?

A universe that runs forwards and backwards

Here's an interesting article on a new-ish idea about what causes the arrow of time.

Tentative new work from Julian Barbour of the University of Oxford, Tim Koslowski of the University of New Brunswick and Flavio Mercati of the Perimeter Institute for Theoretical Physics suggests that perhaps the arrow of time doesn’t really require a fine-tuned, low-entropy initial state at all but is instead the inevitable product of the fundamental laws of physics. Barbour and his colleagues argue that it is gravity, rather than thermodynamics, that draws the bowstring to let time’s arrow fly. Their findings were published in October in Physical Review Letters.....

Although the model is crude, and does not incorporate either quantum mechanics or general relativity, its potential implications are vast. If it holds true for our actual universe, then the big bang could no longer be considered a cosmic beginning but rather only a phase in an effectively timeless and eternal universe. More prosaically, a two-branched arrow of time would lead to curious incongruities for observers on opposite sides. “This two-futures situation would exhibit a single, chaotic past in both directions, meaning that there would be essentially two universes, one on either side of this central state,” Barbour says. “If they were complicated enough, both sides could sustain observers who would perceive time going in opposite directions. Any intelligent beings there would define their arrow of time as moving away from this central state. They would think we now live in their deepest past.”

What’s more, Barbour says, if gravitation does prove to be fundamental to the arrow of time, this could sooner or later generate testable predictions and potentially lead to a less “ad hoc” explanation than inflation for the history and structure of our observable universe.

 

Interesting, but...

The Australian is delighting in running a story about how a couple of  Fairfax editors were out to get Hockey after having to apologise for errors in a previous story.

Two questions:

a.  yeah, it's all fun reading, but I'd love to see emails that circulated within News Ltd papers during the Gillard era.  Wouldn't mind betting that they would be the most incendiary since the Whitlam era, especially she got on the phone to them about the Milne article.

b.  the defamation case (as far as I can tell) turns on the question of how literally readers take headlines, rather than headlines read with the article itself.   Surely there is allowance for the fact that headlines routinely need explanation or elaboration in the body of the article?  I wouldn't mind betting that if one took the literal approach that headlines alone convey the story, there would be hundreds of cases of defamation of Rudd/Gillard from the Daily Telegraph alone.

Hockey is a big, rich sook, and a failure as a Treasurer.

As a man who formerly had ambitions to be PM, he's probably the government's number one loser, and the defamation case indicates he's feeling it.

Pincer

Not quite understanding

This new Abbott attempt to get money out of universal medicine (to put it into a medical research piggy bank that is going to cure cancer or Alzheimer's , or something) has confused me.

I don't suppose the doctors' wives were ever going to vote for him, but they'll actually  be manning the polling booths next time.

And as someone said at The Guardian, where the report is already up to 575 angry comments:

Abbott has dropped the co-payment from $7 to $5, with pensioners, children under 16yrs, veterans, people in nursing homes and concession card holders being excluded from this payment.
So how exactly does he figure that it will still reap up to 3.2b in revenue and can still start up a medical reasearch fund ?? He must of got Hockey to do the figures.
At the end of the day it is still an attack on medicare, no matter how he dresses it up.
Worst government ever

I gotta say, I also don't understand the basics of how it's supposed to work, and a lot of comments at the Guardian indicate the same.

I can't see the policy winning hearts and minds.  But the prospects of GP's getting paid less gets Adam Creighton excited:

 
Nothing wrong with him that a fat injection couldn't improve.*

* insult designed for readers who have read a nearby post

An announcement...

I am only 21 posts off published post no. 8,000.

I should start working on the celebration now......

German prominence

A story in the (UK) Telegraph recently about the increasing popularity of male, um, member enhancement, brought to my attention something I had previously overlooked:  Germany appears to be the European centre for surgical penile enlargement.

Now that I Google the topic, I see that earlier this year, the same paper had asked the hard question (*snigger*):  why is this operation so popular in Germany?   It involves a ligament snip (which I had heard of before) but also this:

Next, fat harvested from elsewhere on the recipient’s body is injected into the penis shaft so it “grows” (by a modest 2-3 cm girth).

Gee.  I'm a little surprised that the injected fat stays in situ, so to speak.   I mean, to use German engineering speak for a moment, it's going to be subject to some mechanical compression of some vigour, no?   But I assume it doesn't all get relocated at the base, or other end, or we would have seen an example on Embarrassing Bodies by now.

As for the reasons why Germans are into it to such a degree, the Tele does mention an apparent national fondness for pornography (I had thought the Scandinavians might hold the European title for that, but this is based on impressions formed in the early 1970's and may require revision.)   They don't mention the national fondness for bratwurst, but I wouldn't be surprised if that has something to do with it, in some subliminal sort of way.

Those readers who want to know more about the matter can visit this site from the German Centre for Urology and Phalloplasty Surgery - a very fancy name, hey?   But it does some unusual plain talking, for a medical centre:

When we ask patients who have had a failed penis operation somewhere else before coming to us for corrective surgery why they underwent surgery somewhere else in the first place, the answers are always the same:

• '...because it was so cheap there...'
• '...a plastic surgeon even performed the surgery...'
• '...but they promised that it would work...'

We are astonished at all of these answers. Please excuse us for being direct, but is very unfortunate to hear these types of childish answers from grown adults when it is a matter of their health, particularly when it involves the primary male organ.

 I wonder if all German doctors have such a bedside manner...

And thus ends the post with possibly the biggest use of the "p" word in this blog's history.

Update:  it appears some cosmetic surgeons don't think much of the procedure:

Fat grafting is the most common, and the most notorious, of the penile augmentation procedures. It can result in disasters such as loss of the penis if fat is injected into blood vessels or if infection occurs. When the augmentation does work, the result is temporary. Complications such as nodules in the penis, skin deformity, and scarring and loss of normal contour are common. The injected fat is extremely fragile and needs to remain fairly motionless in order for blood vessels to grow into the tissue. If they don't grow in three days, the fat will die and be absorbed by the body. If the fat is disturbed during the first three weeks, it will lose its new blood supply and be resorbed. The penis cannot stay motionless when urinating and when erections develop. Virtually by definition, fat grafting into the penis is doomed to fail.

 Update 2:  on the Australian scene, here's the Australian Centre for Penile Surgery describing the recovery process for the procedure it uses:

You will need to spend two weeks lying flat in bed in order to minimise any swelling. Excessive swelling strains the blood supply of the penile skin and may cause it to die, resulting in loss of shaft skin. This is almost entirely avoided by lying flat.
During this time, you will also need to take a combination of three drugs to prevent you having erections. As a side effect of these drugs, you will feel very drowsy.

 Gee.  Men really put themselves through that for cosmetic purposes?

The technique for this are different from mere injection, too:

The Australian Centre for Penile Surgery does not recommend penile widening by fat injection because of the risk of fat necrosis. Dr Moore uses dermal fat grafting which is long-lasting in 98 percent of cases, and produces excellent results.

 So, sounds like there might be genuine dispute about technique that is apparently popular in Germany.

But here's another good bit from the Australian site:

What are the chances of retraction?

During follow-up, you'll be taught how to stretch your scar. If you fail to perform this exercise properly, some or all of the length gained through surgery might be lost.
Retraction may also result from the patient's own excessive production of adrenaline, which causes the penis to shrink. This is extremely rare.

A trilogy of wrong, illustrated

Laffer Curve: Napkin Doodle Launched Supply-Side Economics - Businessweek

What a remarkable idea - bringing together three Republican stars, all of whom have been shown to be involved in decisions that went badly wrong:

That's Laffer, in the middle.

(OK, Laffer may not be completely wrong; but his idea gave rise to tax cutting exercises that simply did not work, and tax cut worship that persists to this day on the Right.)

Real Climate is hot

While watching the Abbott government implode is getting a bit dull, Real Climate has couple of posts well worth reading about "the pause", and deceptive graphing by Anthony Watts.

Apparently, this graph is consistent with not taking any action on climate change, according to more than half of the Coalition, nearly all libertarians,  and Andrew Bolt:

 Scientists like Andrew Bolt and Monckton (and an aging chemist from Newcastle, who the incredibly easily self deluded at Catallaxy treat as having disproved global warming) all prefer to use graphs from the RSS satellite, because it has been the outlier on the cool side for some years now (not even agreeing with UAH's numbers.)

A hot and stormy start to summer, meantime, makes people think about climate change and how the Abbott government doesn't really believe in it.  That's good.

Update:  I see that Sinclair Davidson recently tweeted a link to Jo Nova (another reliable climate scientist) who plotted UAH figures to "disprove" BOM's claim that Australia has had its hottest Spring on record.

Rather than believe thermometers on the ground, they now rush to believe the rather more complicated methods used by satellites to measure the temperature of the atmosphere above the ground.  Because, of course, the BOM can't be trusted to do analysis of ground temperatures: they are corruptly out to prove global warming by hook or by crook.

Sinclair, haven't you got some more mathturbation to do on tobacco and plain packing, rather than reading Jonova?

I also see that Jonova and the IPA are both making end of year plea for donations.   A bigger bunch of  moochers I have never seen.  Can't you just write begging letters to Gina and Rupert and be done with, instead of begging on street corners?

Continuing

I cannot resist

Pretty disastrous interview with Sunrise for Abbott this morning, I reckon.   Called him "Chris"; denied any apology warranted for a string of broken promises; kept running the line decided by someone in his office last week that if he keeps repeating it was a year of great achievement, people will start to believe him. 

Of course he painted himself into this corner when Opposition Leader, with so many quotes floating around about how he would not break promises, be a government of no surprise, would even let the budget suffer a bit if it meant keeping a promise.

It's impossible for him to talk his way out of this, and as such, I would have thought his best strategy would be to disappear for a month. 

What?

Intellectual powerhouse

Anything But with Tim Wilson - The Drum (Australian Broadcasting Corporation)

I would have thought being a superhero called Selfie Man would have been more his style, but no, Tim Wilson goes with the classics:

If you were to be an action hero, which one would you like to be?

I think I'm going to have to go Batman, but not like Christian Bale,
über-cool Batman, much more 1960s, soul, Adam West Batman. You know, a
little bit camp, prepared to go out there and fight for a good cause,
and occasionally enjoy a good outfit from time to time. Though I don't
slip into the Batsuit. The equivalent I've got, you know, from looking
at today, is a grey suit with a green checked shirt and a blue and green
dot tie, but you have to take these things a little bit seriously if
you want to live your life and achieve things, so the outfit makes sense
as well. But you can't discount the campness factor behind Adam West's
Batman, because it's important to have almost a cartoonish approach
where every time you're achieving some objective it's sort of a "Pow" or
a "Gazump" as part of the process.

 Look, I already thought Timbo was an intellectual lightweight with a chronic interest in self promotion, but there are so many, many other passages in this ill considered interview that help confirm my assessment of him, I can't be bothered repeating them...