Doctors shun Defence’s new insurer

A DOCTORS revolt threatens to cripple military healthcare, with just one in 10 specialists so far signing on to a newly privatised medical scheme for the Defence Force.
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Under changes set to be finalised on Monday, all Defence personnel being treated in Australia, including soldiers wounded in Afghanistan, will be handled by Medibank Health Solutions, an offshoot of the government-owned health insurer Medibank Private.

But the $1.3 billion contract to outsource treatment has sparked a backlash from many doctors who say the fees being offered by Medibank are too low.

They also say the changes compromise the professional relationships between GPs and specialists. Under the changes, military doctors who presently refer patients to specialists through their own trusted networks will instead make referrals through a Medibank call centre to ”preferred providers” signed on with the health fund.

The Australian Medical Association and the federal opposition warn that military personnel might have difficulties accessing good-quality specialists because of the low take-up of the contracts.

The country’s largest operator of private hospitals, Ramsay Health Care, was yesterday still negotiating with Medibank. Industry sources told Fairfax that Ramsay had significant concerns with the terms being offered.

Many doctors say the fees being offered are up to 50 per cent less than what they now charge.

Early results from an online survey by the AMA indicate fewer than one in 10 specialists now treating defence personnel will continue to do so.

Stephen Milgate of the Australian Society of Orthopaedic Surgeons said experienced and well-established specialists ”are walking away from the contract”.

Orthopedic surgeon Stephen Doig on Friday operated on what he said would be his last Defence Force patient, having spent 21 years helping injured air force personnel in Victoria.

”I’ve always worked for the army because I enjoy it,” Dr Doig said. ”But the whole arrangement of this is totally wrong.”

Chris Scott, director of hand surgery at Liverpool Hospital, the nearest public hospital to Sydney’s Holsworthy Barracks, wrote in a blog postthat the fees were too low. Dr Scott, who also has a private practice, wrote that it was ”unlikely that I will attempt to retain Defence personnel in my practice”.

Medibank executive Andrew Wilson rejected suggestions there would be clinical interference under the new arrangements and stressed the call centre would relieve administrative burdens.

”I don’t think people have really understood what has been put in place,” Dr Wilson said. ”This is not a change that will lead to any interference in clinical care.

He said 2500 specialists had so far signed on with Medibank, as had 3000 allied health professionals and 112 hospitals. More were expected. Australia has about 25,000 specialists.

Some areas such as the ACT, where more than 5000 defence personnel are based, face serious shortfalls, doctors say.

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Slipper slams Abbott, Bishop

FORMER speaker Peter Slipper has launched a scathing attack on his one-time Coalition colleagues, Tony Abbott and deputy leader Julie Bishop, over their opposition to the government’s wheat deregulation bill.
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The Coalition was embarrassed in the vote on the bill in the House of Representatives on Wednesday when West Australian National Tony Crook voted with the government, and two WA Liberal MPs, Dennis Jensen and Mal Washer, abstained.

Mr Slipper said he found it abhorrent that Ms Bishop was prepared to say to the wheat industry of WA it was important to defeat the legislation not on any matter of principle or to help producers, but simply to assist the leadership of Tony Abbott. He said the party’s position on the bill ”has no political credibility at all”.

”It’s all about naked politics. This is all about preserving the flawed and fatal and terminal leadership of the Leader of the Opposition,” he said.

Mr Slipper voted with the government, which secured enough crossbench support to pass the bill following a deal with the Greens, who agreed to back the bill in return for amendments.

It is now assured of passing the Senate, but more Coalition MPs are expected to abstain or cross the floor.

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Gillard accused of ambushing senator over foreign worker report

LABOR Left faction convener Doug Cameron has accused Julia Gillard of ”ambushing” him in caucus over a report that urges a tougher attitude to the importation of foreign workers.
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The Prime Minister clashed with Senator Cameron over the leaking of the report, prepared by a committee of caucus. Ms Gillard said on Tuesday she would put the report to the bottom of her papers, because she had read it in the media before receiving it. She did not mention anyone specifically over the leaking, but Senator Cameron believed she was eyeballing him.

The report is from the committee on spreading the benefits of the mining boom, which Senator Cameron chairs. The group was set up because of caucus and union discontent after government approval for Gina Rinehart to bring in foreign workers for her Roy Hill project.

It recommends that discussions take place with the union movement to develop an agreed formula for access to enterprise migration agreements, 457 visas for foreign workers, and the operation of regional migration agreements.

A still-angry Senator Cameron said on Wednesday there had been opportunities for Ms Gillard to raise the matter with him before the caucus meeting. ”I was with her the day before and the issue wasn’t raised with me, so I was a bit surprised and I felt a bit ambushed in the caucus, that it was raised in the manner that it was,” he told reporters.

He said the minerals sector was ”not playing a proper role in this economy. They are not making a proper economic contribution. They are not making a proper social contribution and the report that’s been adopted by the committee goes to many of those issues, to give people a fair go.”

The government needed to be involved in ensuring people got a fair go, Senator Cameron said.

The report was ”the property of the caucus” and it was ”in the long history and tradition of the Labor party to look after those that can’t look after themselves, to make sure that those with power and privilege don’t get access to … excessive economic rents and get too much profit at the expense of others.”

He said the committee had adopted the report on Tuesday and he had asked for it to be on the caucus agenda for the last parliamentary sitting week in late November.

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Girls behaving badly so true to life

Isla Fisher, Kirsten Dunst and Lizzy Caplan head out on the town.’SINCE a movie called Bridesmaids came out,” comedienne Lizzy Caplan says, ”everyone has remembered that women can be funny in movies, instead of being the boring one who is always yelling at the funny boyfriend.”
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Yes, she’s talking about you, Todd ”The Hangover” Phillips. And you too, Farrelly brothers. Even about you, Judd Apatow, because even if you did end up producing Bridesmaids, all hail to you, you still gave Katherine Heigl all the duff lines in Knocked Up.

Caplan is at the Locarno Film Festival to talk about Bachelorette, in which she stars alongside the luminous Kirsten Dunst, Isla Fisher and Rebel Wilson – a high count of Australians there – as a quartet of old school friends reunited for the wedding of their least likely bride, the inescapably tubby Becky (Wilson).

People who haven’t seen it are calling it Bridesmaids 2. In fact, the director, Leslye Headland, wrote it five years ago as an adaptation of her hit play, also called Bachelorette, which was part of a series she is writing about the seven deadly sins.

Bachelorette’s central sin is gluttony. ”I think specifically my experience as an American woman is that we are encouraged to fall in the trap of being consumers in every sense – food and fashion and looking thin and having the right stuff, having a career, all of that – and a man can be part of that,” Headland says.

Not that the man is the focus of acquisitiveness in this story. The wedding is the thing. More particularly, the wedding dress, which gets ripped to pieces and covered in blood, vomit and semen in the course of a hen’s night that, you will have guessed, goes very wrong. Headland is loud, brash and outspoken. So, unsurprisingly, is Bachelorette.

Headland says that when she tried to interest producers in her script four years ago, ”They said women talk like this but women won’t pay to see this. That is literally what was said. And I just felt that wasn’t true.”

Women’s responses have shown her hunch was right. Everyone in Bachelorette, led by Dunst’s alpha control freak Regan, cats about each other. Wilson’s fat bride is the one character who seems happy in her skin.

Headland says she was questioned for casting Wilson, given she had already been in Bridesmaids, the film to which theirs was inevitably going to be compared. ”But she’s a genius, you know,” Headland says. ”And her character is so incredibly different. She’s beautiful in this film; we’re not laughing at her. To show that versatility was something I felt strongly about.”

Caplan had been in Mean Girls (2004), the high-school comedy scripted by Tina Fey. Again, the tiny number of comedies by women means comparisons are inevitable.

”There are some Mean Girls attitudes happening here,” Caplan agrees, ”but it’s far more pathetic because we are no longer in high school and we are still talking about each other as if we were.”

Her character Gena is an unreconstructed stoner. ”You go, ‘Oh, this one does a shitload of drugs’, so you know she’s damaged and her life isn’t so together,” Caplan says.

Bachelorette has drawn every kind of reaction from American audiences, from rapture at The New York Times to fury from critics who can’t get past the fact that they don’t like any of the characters.

Headland is happy people are arguing about it. She refers to Billy Wilder’s The Apartment, which was also criticised for switches between comedy and darkness. ”And he had this great quote, which was that The Apartment was about life not as it ought to be, but as life is,” she says. Writing Bachelorette, she felt the same. ”I just wanted it to be very honest.”

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