An Obesity Epidemic is horrible too

An Obesity ‘Epidemic‘ is every bit as horrible as the more obvious ones

The World Health Assembly passed a resolution in 1991 to eliminate leprosy by 2000. It was unsuccessful, although its prevalence has decreased by around 90 per cent over the years since.

Smallpox was officially declared eradicated in 1980. In Samoa, a measles outbreak last year (2019) saw almost 6000 people catch it and 82 of them died.

Sars – severe acute respiratory syndrome – killed more than 700 people around the world during an outbreak in 2002-03, after originating in China. In total, it infected more than 8,000 people in 26 countries. In early 2020, a similar outbreak is causing alarm in China and worldwide.

Although Obesity is not literally an epidemic, which occurs when an infectious disease spreads rapidly to many people, in 2017-18, the Australian Bureau of Statistics’ National Health Survey showed that two thirds (67.0%) of Australian Australian adults were overweight or obese (12.5 million people), an increase from 63.4% in 2014-15.

Epidemics such as smallpox, measles and leprosy cause immediately visible signs and symptoms. Rashes, spots lesions and the rapid onset of serious illness trigger rapid response from communities and governments. Obesity’s onset is gradual and rarely accompanied by immediate illness.

Obesity’s consequences are every bit as noxious as the more obvious epidemics. To quote the World Health Organisation See source

“Being overweight or obese can have a serious impact on health…. leads to serious health consequences such as cardiovascular disease (mainly heart disease and stroke), type 2 diabetes, …. osteoarthritis, and some cancers (endometrial, breast and colon)”

What Causes Obesity and overweight?

The British Medical Journal BMJ – See Source

“Fresh evidence links popular processed foods with a range of health risks….the volume of industrially processed products in global food supplies has increased. … transition towards diets linked to a rising prevalence of obesity and non-communicable diseases in many countries.

One such category is ultra-processed foods, defined as “formulations of food substances often modified by chemical processes and then assembled into ready-to-consume hyper-palatable food and drink products using flavours, colours, emulsifiers and other cosmetic additives….growing body of evidence associating consumption of such foods with poor diet quality, increased cardiovascular risk factors…. obesity and metabolic syndrome.”

Proper foodstuffs not readily available in remote areas and in disadvantaged neighbourhoods

“Indigenous Australians and those living outside Major cities or who are in lower socioeconomic groups are more likely to be overweight or obese”See Australian Institute of Health and Welfare

Health Care and obesity’s consequences

AMA President Tony Bartone:- The Australian 7th January 2020 –

“Massive increases in the numbers of people with obesity and diabetes is amplifying the pressures on public hospitals. But Dr Bartone said these were the kinds of diseases that should be able to be prevented and treated in the community.”

The economic burden of treating obesity-related diseases is estimated to rise from A$12 billion in 2014 to A$21 billion in 2025. We spend far, far less on measures to deal with obesity – the most obvious cause of the diseases to be treated.

Artificial sweeteners –

Harvard Health Publishing – See source

  • “… People who use artificial sweeteners may replace the lost calories through other sources…”
  • “….sweeteners are far more potent than table sugar and high-fructose corn syrup …. these products change the way we taste food….
  • frequent use of these hyper-intense sweeteners may limit tolerance for more complex tastes…means people who routinely use artificial sweeteners may start to find less intensely sweet foods unpalatable..”
  • “…they may prevent us from associating sweetness with caloric intake…., we may crave more sweets, tend to choose sweet food over nutritious food, and gain weight.”
  • “Participants …who drank more than 21 diet drinks per week were twice as likely to become overweight or obese as people who didn’t drink diet soda.”
  • “Animal studies suggest that artificial sweeteners may be addictive. .. don’t know what effect large amounts of these chemicals will have over many years…. “
  • ‘Daily consumption of diet drinks was associated with a 36% greater risk for metabolic syndrome and a 67% increased risk for type 2 diabetes. “

Conclusions

  1. Obesity and being overweight is incompatible with good health and adversely affects individuals, public health systems, aged care and disability care, the national economy, the natural environment and just about every other aspect of life and society.
  2. Obesity and overweight ‘sneaks-up’ on us: it lacks immediate and distressing visual symptoms – rashes, lesions. Death and disability wait until later.
  3. Sugary, refined foods, especially soda.Junk food companies are aggressively and  heavily marketing soft drinks and junk food, particularly to children
  4. Artificial sweeteners very probably trigger unfortunate responses in humans – crave more sugars – eat more sugary foods.
  5. We need to ensure that good tucker is available to everyone, not just the fortunate.
  6. We urgently need to up-grade our knowledge and appreciation of good healthy food. How to grow it, use it, cook it and enjoy – start at schools. even pre-school.

What do we do about it?

Bans can be placed on products and product-related services if there is a risk that they may cause serious injury, illness or death. – Commonwealth permanent and interim product safety bans, and state and territory interim bans include – See link

  • “Glucomannan in tablet form: Mini jelly cups containing konjac – Chocking hazard -see link :
  • Novelty cigarettes or ‘puff cigarettes’ are banned: Chewing tobacco and snuffs- banned .”

Banning junk food and dangerously unhealthy soft drinks is, at first sight, an attractive option. However, bans seem likely to be distracting and at odds with the compelling need  to focus on alerting and educating us about the links between what we eat and how wide-spread obesity seriously damages people, society, economies and the natural environment.

Banning the use of artificial sweeteners is another matter. There is already sufficient reason to believe that theses things distort our sense of taste and our metabolism.

They provide no useful food. They provide an advertising blurb –  ‘diet soda’  – ‘no added sugar’. There is no need for them – use sugar instead: far less additive and destructive of our senses. We did not ban building boards – we banned the use of asbestos in the boards.

Junk food and drinks warning labels

Image result for tobacco warning label

A 2018 study ….. warning labels — particularly graphic, negative warnings — encouraged people to exercise self-control when selecting meals.

The use of warning labels and plain packages has been a seriously useful means of reducing the number of smokers,

Menus and billboards should also include graphic warning about sugar and junk foods and how limiting their use is essential to good health.

Advertising

Advertising tobacco products is banned. Crap sodas and junk food is advertised endlessly and directed at children and those of us who are least well informed. Ban all advertising of junk food and ‘soda’.

Taxes and Licence Fees

An effective tax system that could see a higher tax added to junk foods and a zero rate or even a subsidy (negative tax) on real food would seem useful. Changing the quality and ingredients in the ‘burger’ – more fibre, less sugar and salt etc. ‘Fries’ replaced with another potato product – herbs instead of loads of salt – better frying oils – etc.

If a Licence is needed for a Pub, why not one for a food and drink shop? Fees linked to how good or noxious are the product sold?

Aboriginal and remote communities

There is rarely any regular access to fresh vegetables and fruit. Staples such as bread and cereals are industrial grade. Transport costs  low volume of sales and lack of completion see high prices.  Once upon a time, many of these communities had a market-garden, usually operated by Chinese migrants and often with Aboriginal people involved.

There is an urgent need for Aboriginal and Remote communities to have access to a Community Garden and a School Gardens with associated education in growing, preparing and cooking quality foods.

Governments should foster such initiatives, which would have enormous social and community benefits as well,

A Job Guarantee program, managed a Community level, would be an effective vehicle to deliver  these benefits –See this Blog Job Guarantee

Education about health and lifestyles: proper food, how to get it, cook it and enjoy it

The whole Australian Community urgently needs wise and effective Government  intervention with suitably designed and delivered programs, which might include-

  • Mandatory School Syllabus inclusion of  health and lifestyle, food gardens, preparation and cooking – just as important as reading, writing and ‘rithmetic.
  • Targeted education to the broad community on similar issues – Government advertising TV, Media. Bring back the home garden – even tubs on balconies provide greens and herbs in useful quantity.

Urgent Government Action needed – not endless enquires and Studies

The Sydney Morning Herald See Source

“..the Morrison government’s minister for sport Richard Colbeck, announced the move on Monday while releasing the final report of the five-year review of the Health Star Rating System.

Shoppers would see a confronting 16 teaspoons of sugar on the label of a 600-millilitre Coca-Cola bottle if the advice of health experts is followed by the Australia and New Zealand Ministerial Forum on Food Regulation.”

 

 

Indigenous Issues and a Fair Go

Did it all start with Governor Phillip’s Mob?

No. What we see today has much of its origins in the British Government’s  decision to settle in what is now Australia at Botany Bay. “…a colony there would be of great assistance to the British Navy in facilitating attacks on the Spanish possessions in Chile and Peru… https://en.wikipedia.org/wiki/Arthur_Phillip”

At the time, British and European Society, indeed the World’s Societies, were fragmented – upper/lower classes: brutal and inhumane.  Phillip was a product of his times and culture, more enlightened than most.

“The laws of this country [England] will of course, be introduced in [New] South Wales, and there is one that I would wish to take place from the moment his Majesty’s forces take possession of the country: That there can be no slavery in a free land, and consequently no slaves.”[

Phillip believed in severe discipline; floggings and hangings were a almost daily event, although Philip commuted many death sentences. Phillip ordered that Aboriginal people they must be well treated, and that anyone killing Aboriginal people would be hanged. Despite this and over many years Aboriginal people were driven-off, killed, mistreated. The European population of New South Wales in 1792 was 4,221, of whom 3,099 were convicts. Most of the rest were soldiers.

Not a great start, but almost inevitable because those ruling and administering (and plundering) were uneducated, often sick (scurvy, smallpox) but most significantly, accustomed to being brutalised and incapable of understanding “All things whatsoever ye would that men should do to you, do ye even so to them.” or “Whatever is hurtful to you, do not do to any other person.”

Despite Phillip’s ‘enlightened’ views, subsequent dealings with Indigenous people were seriously and brutally mismanaged. A good deal of the mismanagement continues to this day.

Some key relevant points (see)  https://www.creativespirits.info/aboriginalculture/history/australian-aboriginal-history-timeline

  1. Federation – The Commonwealth Constitution states “in reckoning the numbers of people… Aboriginal natives shall not be counted”.
  2. White Australia policy – ban all non-Caucasian people from entering the country.
  3. Commonwealth Franchise Act 1902 which grants men and women in all states the right to vote in federal elections, but denies it to every ‘aboriginal native’ of Australia, Asia, Africa, or the Islands of the Pacific.
  4. Charles Perkins becomes the first Aboriginal university graduate at University of Sydney with a Bachelor of Arts. First Aboriginal Australian to graduate from university.
  5.  Charles Perkins leads a freedom ride by Aboriginal people and students  …draw attention to segregation (places of leisure in country towns – swimming pools, picture theatres, hotels and RSL clubs), refusal of service in shops,  and the appalling conditions under which Aboriginal people live.
  6. Causes of a low life expectancy include: poverty poor health and nutrition – Research found that about 80% of the life expectancy difference is due to preventable chronic conditions, such as type 2 diabetes and cardiovascular disease, poor housing, dispossession of their traditional lands, low education level, high unemployment, hidden racism, and inability of politicians to address Aboriginal problems.

 Further observations and some tentative conclusions

  1. Since Australia was settled by the British, essentially as a place to dump the unwanted and to provide a naval base, progress towards a ‘fair go’ was severely and adversely affected by the prevailing cultural, social and political views and cultures of the era along with an under-resourced community – convicts, soldiers, uneducated and sickly.
  2. It took too long to wake up to some aspect of Indigenous disadvantage – it took until 1962 to see Commonwealth Electoral Act provide that all Indigenous Australians should have the right to enrol and vote at federal elections, 2008 to see a bi-partisan Parliament apologise for the Stolen Generations.
  3. Preventable chronic conditions, such as type 2 diabetes and cardiovascular disease, poor housing, low education level, high unemployment, poverty – all of these horrors are evident in both both Indigenous and other  under-privileged Australian Communities.
  4. An inability of politicians to address Aboriginal problems is little different to their failure to deal with unemployment and social problems generally – eg Newstart, Robo-debt Aged Care and NDIS.
  5. Noel Pearson  has said “I believe that there is similar dysfunction in white populations as we witness in my Indigenous communities. I’ve got no doubt the kind of dysfunction that we see is not the result of skin colour, it’s the result of long-term welfare dependency, tied up with the epidemics of substance abuse. So I’ve got no doubt that this is a universal problem”. https://theconversation.com/noel-pearsons-policies-embraced-by-white-australia-but-how-effective-are-they-2226

Recommended

The government should introduce a Job Guarantee that offers a job at a living (minimum) wage to anyone who wants to work but cannot find employment. See:-https://futuretofightfor.org.au/policies/01/ and Associate Professor Pavlina Tcherneva  https://www.pavlina-tcherneva.net/job-guarantee-faq

The Australian government can afford this program because it has has no financial constraint as the issuer of the currency. A currency-issuing government can always choose the unemployment level once the spending and saving decisions of the non-government sector are implemented.

In terms of the overall working of a national economy ( macroeconomics), a Job Guarantee would be an automatic stabiliser that ensures that the Government isp doing necessary amount of spending where it is needed in the right places and right time to achieve full employment with stable prices.

When the private sector is recovering, federal government spending would automatically fall as people leave the Job Guarantee for higher paid jobs elsewhere. When the private sector experienced a downturn, federal government spending would automatically increase as people lose their private sector jobs and enter the Job Guarantee.

Unemployment is a major loss of valuable productive resources, depressing the economic economic growth and lowering our standard of living of the whole community.

Offsetting the cost of a Job Guarantee would include lesser demand for Centrelink services, enhanced tax revenue and receipts, including those on superannuation and investments.
The costs associated with substance abuse, including health care costs and police interventions would lessen. Unemployment and its adverse social effects adds very substantially to on-going and escalating Government spending. Local economies, particularly those in Rural and Remote areas would see an enhanced economy and small businesses would have better prospects.

Training must be included, to ensure that the unemployed are equipped with skills that will be needed when the private economy starts again to employ more people.

Not a “work for the dole” proposal. This is voluntary, full time employment, guaranteed and managed by the government.  It is not intended to be compulsory: it’s there for people who want to work. How to deal sensibly and humanely with those who are able to work and refuse to do so should examined and addressed – it is beyond the ambit of this paper. Those who cannot work because of drug or alcohol dependencies should be offered health care, training counselling and more to equip them for meaningful work.

Job Guarantee Programs should be managed at local area or even neighbourhood levels. Each area’s Program must be managed and supervised  by appropriately qualified people – a well paid, sought-after job. (eg – maybe Centrelink staff, fewer of which would be now needed).

Some  relevant Job Guarantee examples

  • Noxious Weed eradication – pests: graffiti
  • Road Maintenance at low levels – small truck/4 or so workers- potholes, rubbish.
  • Climate change responses – tree planting and care
  • Enhanced care of National Parks, recreation areas, sporting facilities, school premises and streets and neighbourhoods generally
  • Indigenous health, nutrition, social and other problem areas  – Care for Country.
  • Gardens for fresh produce in remote areas, particularly Aboriginal and Islander Communities.

The points made above are only a very broad outline – see here  and  generally  online and elsewhere for much more information. See also another Post on this Blog

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Aged care – Royal Commission into Aged Care Quality and Safety

Aged Care in Australia: A Shocking Tale of Neglect

The Royal Commission into Aged Care Quality and Safety’s Interim Report

… the aged care system fails to meet the needs of its older, vulnerable, citizens. It does not deliver uniformly safe and quality care, is unkind and uncaring towards older people and, in too many instances, it neglects them.

The Commissioners’ investigation into Australia’s aged care system led them to describe the aged care system as ‘a shocking tale of neglect… far from the best that can be done…a sad and shocking system that diminishes Australia ..a fundamental overhaul of the design, objectives, regulation and funding of aged care in Australia is required.https://agedcare.royalcommission.gov.au/

The Interim Report makes this very important point clearly:-

“A number of people will seek out aged care services either independently or at the urging of family, friends, doctors and hospitals. Unfortunately, it is at this point, when the aged care system should be welcoming and easy to navigate, that the first problems emerge.People are met with a telephone and internet-based national aged care entry system called My Aged Care that many people in their eighties and nineties find frightening, confronting and confusing. They are then referred for a face-to-face discussion to assess how much care they can receive and whether that will be in their own home or a residential care provider. This is the first of many assessments. Too often they must tell their story over and over again.Left to fend for themselves at this point…”

I have had the good fortune to have had tertiary education, many years with computers and websites and no obvious disability despite being in my 85th year. I wanted to see what I should do about aged care for my wife and I and encountered this –

“Request activation code for Aged Care Client Portal – Please enter the email address that was provided in your user access request form. An activation code will be sent to this email address with instructions on how to complete the account activation process. A user account has not been created for this email address within the Department of Social Services application. Please try again or contact the My Aged Care Service Desk on 1800 200 422 or email macservice@myagedcare.gov.au for assistance”.!!!!

Rock Fishing for Seniors and Paragliding for  the Aged and Infirm may be better options than seeking access to an Aged Care described by a Royal Commission as “… .a sad and shocking system that diminishes Australia”

Some comments and examples offered to Royal Commission

  • Under-staffing  … providers are accused of running understaffed homes to keep surpluses up. More than half of Australia’s residential aged care facilities have unacceptably low numbers of staff.- https://agedcare.royalcommission.gov.au/publications/Documents/research-paper-1.pdf
  •  About 80 per cent of the workforce are personal care workers who can be paid as little as $18 an hour — the same rate paid for packing supermarket shelves.
  • There is no standardised training … courses dished out by dozens of organisations varying in duration and quality from as little as six weeks’ online to 12 months at TAFE
  • The number of registered nurses has dropped from 25 per cent to 19 per cent over the past 12 years, while personal care workers, who previously made up 50 per cent of staff, now represent over 70 per cent.

Other relevant observations

 A  Report Commissioned by the Australian Nursing & Midwifery Federation –

“.. By number of beds, not-for-profit providers are the largest aged care provider group in Australia (52% in 2013-2014), however there has been a rapid growth in the size and spread of for-profit companies.. 6 for-profit companies operate over 20% of residential aged care beds … were given over $2.17 billion AUD via government subsidies http://anmf.org.au/documents/reports/ANMF_Tax_Avoidance_Full_Report.pdf 

Rural Doctors Association of Australia Submission to the Royal Commission into Aged Care Quality and Safety –

Aged care providers will not continue to operate where their business model is unviable. Where this is the case Commonwealth and State/Territory governments have a responsibility to make other arrangements for aged care provision that allows people to live in the places of their choosing for as long as possible. However, where market-based models of service delivery are not working to improve access to health and other aged care professionals and services, non-market-based models must be implemented to ensure aged care services are available for those who need them.”

 

A Fair Go –  Suitable Aged Care Versus Profits for Investors and others

The provision of … uniformly safe and quality care and profits for investors and others highlights fundamentally incompatible practices and cultures. The following are some of them –

  • To make a $, a business will hire as few staff as possible; pay them as little as possible. Paying low wages will see a business hiring less qualified staff, often less caring and empathetic.
  • Management level staff come and go frequently, as do  most others – often in disgust with a $ Versus  care and need culture.
  • A business will locate its facility only in densely populated areas and often where land is cheaper – on the outskirts or near a road/railway or industrial area.
  • A business that sees it business model or location as no longer viable (in terms of $$$) will close or move or “Phoenix” its structure to set aside its assets or coffers.
  • There are undoubtedly many business operators who are ethical, caring and totally above board. Unfortunately, those who have an eye only for $$$$ have major advantage in a competitive environment.  

Conclusions and suggestions aimed at delivering  ‘uniformly safe and quality care’

  1. Safe and Quality Aged Care, available to all Australians, should be provided and available to all by an Australian Government Agency at facilities, places and institutions manged and controlled by the Australian Government Agency.
  2. The responsible Australian Government Agency should urgently develop ‘best practice‘ to include evidence-based management process, staffing levels, work practices and such other matters found to be necessary to deliver ‘uniformly safe and quality care’
  3. Aged Care provided at all places, facilities, and institutions by any party – the  Australian Government Agency  itself or any  other Aged Care provider, either non-profit or for-profit, must be required to adopt and meticulously follow ‘best practice‘.
  4. An  Aged Care provider, either non-profit or for-profit, that can demonstrate by all relevant means including where necessary an on-site Government Auditor, that it uses and meticulously follows ‘best practice‘ may be deemed to be manged and controlled by the Australian Government Agency.
  5. A non-profit Aged Care provider that may consider that its business model is nonviable if it must follow mandatory ‘best practice‘  should be encouraged so seek to work with the Australian Government Agency to for example, permit the Agency to conduct the health and care requirements of residents at the premises, leaving the non-profit provider to manage premises, catering , outings, cultural practices and such other things as it may value.
  6. If a for-profit Aged Care provider does not wish to be subject to these contractual conditions then they must leave  the Industry leaving the Australian Government Agency free to negotiate a market based price for relevant assets or to  instead simply go into liquidation if that is its choice.
  7. Small and medium-sized business and privately owned firms have advantages that enable them to operate profitably and more effectively in satisfying the needs of a major enterprise that must focus on its prime function – in this case to deliver ‘uniformly safe and quality care’. A local business can provide and deliver meals (subject to mandatory quality and nutrition). Cleaning, lawns and gardens, data management, communications – so much more. Involve the local community!

How do we Balance the Budget and pay for all this?

 Australia issues its own currency, $A. It can  run a pure deficit, without borrowings. A budget surplus  drains savings from the private sector and that leads to loss of jobs and less work done. The Government has to spend money into existence. Without that there can be no tax. 

A Sovereign Currency Nation’s government like Australia’s primary purpose is to improve the well-being of its population. Balancing budgets is an irrelevant and destructive blind alley. The real economy is what is relevant to well-being, care for the environment, defence, research education, aged-care and employment (and so much more).

A Sovereign Currency Government issues the currency and it must first spend it by crediting private bank accounts before it can tax – by debiting bank accounts. The claim that governments must tax or borrow to ‘finance’ its spending is false under a fiat-currency system. See – https://www.investopedia.com › Economy › Economics

The restrictions on government spending are the quantity of real goods and services available for sale in its own currency, including all the unemployed labour. The only constraint that a currency-issuing government, such as the Australian government faces, are how many real goods and services are available for sale in $A.

Our wide-spread quasi-superstition about balanced budgets is a blight on public policy discussion. However this Blog is about Safe and Quality Aged Care and there is ample material on the Web about monetary theory and practice – see for example- http://bilbo.economicoutlook.net/blog/?p=41133#more-41133

All about a Budget Surplus

. Both Labor and Liberal/National Coalition are still making Policy decisions based upon  outdated ideas about how a modern economy really works. Governments, much of the media, some economists, academics and others are just as uninformed.  Most of the rest of us believe what we have been told without looking too hard at the substance of what we are told: economics is boring and we have our lives to live.

Related image
The Australian Budget 2017/2018 intended to-

  return to balance in 2020-21 and continuing projected surpluses ….will enable a reduction in debt. This will place Australia in a better position to withstand any future economic downturns. It will reduce the need to increase taxes or cut back on essential services ….by living within its means the Government will not burden future generations with debt from today’s everyday spending. From 2018-19, debt will not be required to fund recurrent spending for the first time since the GFC.

See  Australian Budget.

These statements of intent are totally at odds with the reality for a Sovereign Currency Nation’s public purpose. Australia issues its own currency, $A. It can  run a pure deficit, without borrowings. A budget surplus  drains savings from the private sector and that leads to loss of jobs and less work done. The Government has to spend money into existence. Without that there can be no tax. 

A Sovereign Currency Nation’s government like Australia’s primary purpose is to improve the well-being of its population. Balancing budgets is an irrelevant and destructive blind alley.

The real economy is what is relevant to well-being, care for the environment, defence, research education, aged-care and employment (and so much more).

A Sovereign Currency Government issues the currency and it must first spend it by crediting private bank accounts before it can tax – by debiting bank accounts. The claim that governments must tax or borrow to ‘finance’ its spending is false under a fiat-currency system. See – https://www.investopedia.com › Economy › Economics

The restrictions on government spending are the quantity of real goods and services available for sale in its own currency, including all the unemployed labour. The only constraint that a currency-issuing government, such as the Australian government faces, are how many real goods and services are available for sale in $A.

A currency-issuing government can, for example, mitigate the economic and social disaster caused by mass unemployment by spending enough. Aboriginal and Islander Communities could see a Job Guarantee based around care-for-country and the public good rather than destructive handouts and associated misguided measures.

 

 

NDIS – Well intended: wrongly based: seriously flawed

The National Disability Insurance Scheme (NDIS) is required by law to provide “reasonable and necessary supports” to help eligible people with a disability live more independently.

The Agency administering  NDIS is governed by the NDIS Act, (191 pages!) the Rules and the Operational Guidelines.

Not supposed to have  predetermined criteria for ‘reasonable and necessary supports’. Different people with the same type and severity of disability may  require different kinds of help.  NDIS only funds a support if it is considered ‘reasonable and necessary’ and is directly related to a person’s disability. What’s covered varies from person to person.

Determining what supports are reasonable and necessary involves subjective assessments by the National Disability Insurance Agency (NDIA), which administers the scheme, or its contractors. 

Planners are employed or contracted by the agency to help each applicant identify their goals and draft a plan. The plan sets out the supports needed to achieve their goals. Participants are then allocated funds for these supports, which, the Agency suggests ‘must represent value for money’. Funds can only be used to achieve the goals in the NDIS plan.

NDIS offers ‘three main ways to manage your plan and its budgets (and you can change how you do this at any time, you just need to ask the NDIS) or you can choose a combination of options. Plan managed and Self managed and Agency managed  How to choose which one is challenging even for someone with tertiary education and no disability!

The NDIS uses tight definitions when  allocating individual support packages. It doesn’t duplicate other formal supports such as health and education. It does not pay  day-to-day living costs or the kind of help able to be given readily by family and friends.

Guidelines say the NDIA will fund daily living activities, social activities, aids and equipment and home modification that are necessary.  At a practical level the NDIA assessor decides what is reasonable and necessary and  if someone gets an individual support package or misses out.

NDIS delivery – more problems than you can poke a stick at, including:-

    • Baffling –  complex,  complicated, too bureaucratic and too hard to navigate
    • People are waiting too long – for entry, for support, for equipment, for reviews
    • Carers, particularly those caring for children, have often to be on hand and work 24/7 – no access to respite and help with a singularly challenging role
    • People need more help at every stage of the process – with applying, with planning, and with getting their plan into action
    • Staff lack basic skills, are not experienced in different kinds of disability and lack resources to call on when they need help.
    • Some employees and contractors stay briefly with  NDIS  – quit ASAP – too stressful and confused
    • Some people have to  go into significant debt paying for assessments to try and gain access to the scheme (if they can borrow at all)
    • People on Newstart, Disability Support Pension, the homeless and others who don’t present well to NDIS contractors and staff often see their applications rejected. Assessors have no life experience or professional understanding of these people and their needs.

In 2018, the Commonwealth Ombudsman investigated the NDIS’s handling of reviews on the basis that around one-third of all complaints it received about the scheme related to this issue. This system was judged “unapproachable” and “lacking in fairness and transparency” and leading to delays of up to nine months to receive an outcome.

The NDIA received significant criticism for spending over A$600 million in 2017-18 on consultants, contractors and outsourced staff.

NDIS is NOT an insurer or corporation – it is about people and society, not an economy

NDIS is set up as a ‘pretend’ insurer or corporation/business – it is not about $$$$ and taxes and budgets and bureaucratic crap designed to scare and belittle those in need. The disabled, aged, sick, and disadvantaged are people. We  live in a society, not an economy.

NDIS should be scrapped and what it is intended to do should be done by the Australian Government’s Department of Human Services, which includes Centrelink and Medicare and Child Support.

 Centrelink is, already,  ‘….responsible for the development of service delivery policy and provide access to social, health and other payments and service. This includes seniors, job seekers students and trainees, families, carers, parents, people with disability,Indigenous Australians , and people from culturally and linguistically diverse backgrounds.

Medicare funds access to health care. This covers some of a disabled person’s  needs. The  Medical Benefits Scheme, provides benefits including:-

    • out-of-hospital medical services, including general practitioner (GP) and specialist services
    • selected diagnostic imaging and pathology services
    • allied health services in limited circumstances
    • medical services for private patients in public and private hospitals (excluding accommodation, theatre fees and medicines).

Suggested  ways to effectively deliver “reasonable and necessary supports” to help eligible people with a disability live more independently.

    1. If someone is unable to hold a job because of disability or the needs of a disabled person for whom they are a carer, they  should get a pension, equal to the Australian Minimum Wage, presently about $741 per week. In addition, a supplementary payment aimed at mitigating the financial pressures inherent to disability and common to most disable persons  and carers – travel to health professionals, costs with maintaining houses and equipment and similar things.
    2. Those who work despite disability  should receive supplementary payments to mitigate the additional cost inherent in travel and being in a workplace whilst suffering from a disability.
    3. These supplementary payments should be ‘generic’: those relative few who need more should get more on application – the  bonus for the relative few who need less is offset against the admin. cost of case by case application.
    4. Medicare, which already funds access to health care, should be ‘tweaked’ to cover as many needs common to people with a disability as possible. The special needs of a relative few  should be case-managed promptly competently and with empathy.

Other necessary measures suggested

A Job Guarantee Program, which Australia and much of the World needs desperately, would be particularly useful, cost effective and inclusive resource for the disabled . See this Blog September 2019 Unemployment – A Job Guarantee Solution

A Job Guarantee Program would complement programs aiding people with disability.  A Community Garden is already acknowledged to be an outstanding resource.

Those with mobility issues and many other problems find enormous difficulty  in finding work. Employers don’t appreciate that a disability need  not preclude employment. It needs to be demonstrated by a Government Agency  that the disabled are a valuable resource  too.

There is substantial evidence to suggest that obesity and being overweight along with substance abuse are significant causes or contributing factors in  many disabilities – Type 2 Diabetes, Dementia, Fetal Alcohol Spectrum Disorder, Alzheimer’s – many more.

National action to drawn attention to the dire consequences for both health and disability and to deter or curtail the use of junk food and ‘soda’ and promote health eating and lifestyles would be both efficacious and cost effective.

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Unemployment – A Job Guarantee Solution

In Australia at the end of September 2019 there are around 700,000 persons unemployed. A further 1.1 million persons are underemployed. https://www.abs.gov.au/ausstats/abs@.nsf/mf/6226.0

Unemployment and the associated poverty and social ill effects include:-

  1. The longer people stay unemployed, the more they lose work-skills and non-government employers tend to prefer to hire from those already working or who have been unemployed short-term.
  2. Poverty reduces people’s capacity to buy nutritious food, housing and health care.
  3. Unemployment can indirectly affect health because of reduced participation in society or from the stress of financial strain.
  4. Prolonged unemployment can lead to an erosion of skills, basically robbing the economy of otherwise useful talents. 
  5. Unemployment can force families to deny educational opportunities to their children and deprive the economy of those future skills
  6. Particular parts of the community are more severely affected than others, exacerbating problems of inequality within metropolitan areas and between the cities and some regional areas. Outback Qld circa 13% Youth around 20%.
  7. Mature-age job seekers lose their skills tend to be lost over time, particularly as they are more likely to experience longer periods unemployed. These skills are also lost to the labour market and industry.
  8.  Prolonged unemployment can lead to greater skepticism and pessimism about the value of education and training – workers less willing to invest in the years of training some jobs require.
  9. Young people are particularly adversely affected – large numbers, particularly in rural and remote areas – a dreadful situation for them to be in to face a meaningful future in our society.
  10. Government’s providing derisive and inadequate income support eg Newstart to provide a Budget Surplus!!!!
  11. Drugs, alcohol abuse and crime flourish in a poor, unemployed community.

Distinguished British economist John Maynard Keynes, as long ago as the 1930’s wrote : ‘… outstanding faults of the economic society in which we live are its failure to provide for full employment and its arbitrary and inequitable distribution of wealth and incomes.’  https://www.investopedia.com/terms/k/keynesianeconomics.asp  

The government should introduce a Job Guarantee that offers a job at a living (minimum) wage to anyone who wants to work but cannot find employment. See:-https://futuretofightfor.org.au/policies/01/ and Associate Professor Pavlina Tcherneva  https://www.pavlina-tcherneva.net/job-guarantee-faq

The Australian government can afford this program because it has has no financial constraint as the issuer of the currency. A currency-issuing government can always choose the unemployment level once the spending and saving decisions of the non-government sector are implemented.

In terms of the overall working of a national economy ( macroeconomics), a Job Guarantee would be an automatic stabiliser that ensures that the Government is doing necessary amount of spending where it is needed in the right places and right time to achieve full employment with stable prices.

When the private sector is recovering, federal government spending would automatically fall as people leave the Job Guarantee for higher paid jobs elsewhere.

When the private sector experienced a downturn, federal government spending would automatically increase as people lose their private sector jobs and enter the Job Guarantee. 
Unemployment is a major loss of valuable productive resources, depressing the economic economic growth and lowering our standard of living of the whole community.

Offsetting the cost of a Job Guarantee would include lesser demand for Centrelink services, enhanced tax revenue and receipts, including those on superannuation and investments.
The costs associated with substance abuse, including health care costs and police interventions would lessen. Unemployment and its adverse social effects adds very substantially to on-going and escalating Government spending.

Local economies, particularly those in Rural and Remote areas would see an enhanced economy and small businesses would have better prospects.

Training must be included, to ensure that the unemployed are equipped with skills that will be needed when the private economy starts again to employ more people.

Not a “work for the dole” proposal. This is voluntary, full time employment, guaranteed and managed by the government.  It is not intended to be compulsory: it’s there for people who want to work. How to deal sensibly and humanely with those who are able to work and refuse to do so should examined and addressed – it is beyond the ambit of this paper.

Those who cannot work because of drug or alcohol dependencies should be offered health care, training counselling and more to equip them for meaningful work.

Job Guarantee Programs should be managed at local area or even neighbourhood levels. Each area’s Program must be managed and supervised  by appropriately qualified people – a well paid, sought-after job. (eg – maybe Centrelink staff, fewer of which would be now needed).

Some Job Guarantee examples

  • Noxious Weed eradication – pests: graffiti
  • Rubbish removal on beaches and in waterways
  • Road Maintenance at low levels – small truck/4 or so workers- potholes, rubbish.
  • Bike paths – many rural roads see cyclists at risk from traffic. Path enhancement is useful and ‘pick and shovel’
  • Climate change responses – tree planting and care 
  • Aged Care needs, care etc – working with the long term professionals.
  • Community gardens, particularly in remote areas – good tucker for kids, aged, deprived.
  • Enhanced care of National Parks, recreation areas, sporting facilities, school premises and streets and neighbourhoods generally
  • Maybe ‘Night Watch’ patrols – DON’T approach or  try to apprehend suspicious parties – just call the Police!
  • Indigenous health, nutrition, social and other problem areas  – Care for Country. 
  • Gardens for fresh produce in remote areas, particularly Aboriginal and Islander Communities.

 The points made above are only a very broad outline – see here  and  generally  online and elsewhere for much more information.

 

Deficits and Budget Surpluses

We must also balance the budget!

Both Labor and Liberal/National Coalition are still making Policy decisions based upon  outdated ideas about how a modern economy really works. Governments, much of the media, some economists, academics and others are just as uninformed.  Most of the rest of us believe what we have been told without looking too hard at the substance of what we are told: economics is boring and we have our lives to live.

The Australian Budget 2017/2018 intended to-

  return to balance in 2020-21 and continuing projected surpluses ….will enable a reduction in debt. This will place Australia in a better position to withstand any future economic downturns. It will reduce the need to increase taxes or cut back on essential services ….by living within its means the Government will not burden future generations with debt from today’s everyday spending. From 2018-19, debt will not be required to fund recurrent spending for the first time since the GFC. This will make Australia stronger and more resilient to the shocks that may come its way.

See  Australian Budget.

These statements of intent are totally at odds with the reality for a Sovereign Currency Nation’s public purpose. Australia issues its own currency, $A. It can  run a pure deficit, without borrowings. A budget surplus  drains savings from the private sector and that leads to loss of jobs and less work done. The Government has to spend money into existence. Without that there can be no tax. 

Nobel Prize winning economist William Vickrey wrote-

‘If a budget balancing program should actually be carried through …sooner or later a crash comparable to that of 1929 would almost certainly result. .. relinquish our unreasoned ideological obsession with reducing government deficits…the economy and not the government budget that needs balancing …-

Vickrey, William A Disquisition on Demand Side Economics William Vickrey October 5, 1996)

A Sovereign Currency Nation’s government like Australia’s primary purpose is to improve the well-being of its population. Balancing budgets is an irrelevant and destructive blind alley.
The real economy is what is relevant to well-being, care for the environment, defence, research education, aged-care and employment (and so much more).

A Sovereign Currency Government issues the currency and it must first spend it by crediting private bank accounts before it can tax – by debiting bank accounts. The claim that governments must tax or borrow to ‘finance’ its spending is false under a fiat-currency system. See – https://www.investopedia.com › Economy › Economics

The restrictions on government spending are the quantity of real goods and services available for sale in its own currency, including all the unemployed labour. The only constraint that a currency-issuing government, such as the Australian government faces, are how many real goods and services are available for sale in $A.

A currency-issuing government can, for example, mitigate the economic and social disaster caused by mass unemployment by spending enough. Aboriginal and Islander Communities could see a Job Guarantee based around care-for-country and the public good rather than destructive handouts and associated misguided measures.


 

Sovereign Currency

Australia’s Sovereign Currency

The Australian Government uses its own currency, issued by The Reserve Bank of Australia (RBA) USA, Japan, United Kingdom and New Zealand and many others do the same. Most European Countries do not have a common currency and use the Euro.

A Bank of England publication ( Quarterly Bulletin 2014):-

A central bank simply creates new money at the stroke of a computer key, in effect increasing the credit in its own bank account. It can then use this new money to buy whatever assets it likes’. http://www.bankofengland.co.uk/monetarypolicy/Pages/qe/default.aspx> .

Every time the Australian Government spends a dollar, it does so by crediting the reserves of a commercial bank which are held at the RBA (Australia’s central bank) by that dollar, and having the commercial bank credit the bank account of whoever has been the beneficiary of that spending. 

The Australian Government has an unlimited capacity to pay for things, to make contracted future payments and it has an unlimited ability to provide funds to the other sectors. The State and Local Governments cannot issue currency and rely on transfer payments from the Australian Federal Government, State and local taxes, stamp duties, rates, fines and fees, poker machine taxes etc.

A Sovereign Currency country – Doesn’t borrow in foreign currencies or peg its currency to any other: Spends and taxes only in its own currency, which floats against other currencies: and the central bank sets policy interest rate.

A Sovereign Currency country’s government can purchase anything that is available for sale in that currency including all idle labour. Productive resources need never be idle if they are looking to be used.

Growth in the money supply is critical for economic growth, and there are only two ways that the money supply can grow in a fiat currency system – Government spends more than it collects – runs a deficit or by private credit growth.\

Adding money to the economy is not inflationary until full economic capacity is achieved. Government spending is not constrained by inflation. It is constrained by the capacity of the real economy. Once spending (either by the private sector and/or the government sector) exceeds the capacity of the real economy inflation increases. 

The Australian Government does not fund its spending from taxes. Its capacity to spend is independent of taxation revenue. Taxation supports demand for the currency. The non government sector cannot pay taxes without the government first spending.  Sovereign Currency Governments spend first and tax afterwards

Taxpayers do not fund anything. Taxpayers simply lose or gain purchasing power as the national government manipulates the policy parameters in search of public purpose. Tax is all about the social consequences; that is the total impact of each tax on the real economy and on people’s well-being. In a modern economy, spending and taxing are economically separate activities.’

A Sovereign Currency Government can always buy or construct things or fund things if they can be paid for in its own currency. It must carefully consider the effect its spending on the economy, prices, unemployment levels, industrial and other output, foreign trade, etc but there is never a shortage of money unless it is self-imposed.