Merry Christmas from National

28 comments on “Merry Christmas from National ”

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1. the sprout 1

   17 December 2008 at 3:24 pm

   “demonise ACC and justify privatisation further down the track”

   Exactly Eddie. That’s the whole basis of the beat-up and faux-outrage over this non-issue.

   I mean, were National actually surprised that investment funds aren’t performing to thier optimal capacities at the moment?
2. George 2

   17 December 2008 at 3:26 pm

   And not a single apology from the labour side about dropping NZ’ers in the faecal matter in the first place. Interesting how marion and labour have all the answers after the fact. Macdoctor has it right on this one.
   • Steve Pierson 2.1

     17 December 2008 at 3:49 pm

     George. Labour didn’t drop NZ in it. There was no mismanagement of ACC. The costs have increased for a few simple, unavoidable reasons. One is increased rehabilitation costs because medicial technology means more people who once died from injuries are now surviving in need of a lot of expensive rehabilitation. The other big one is the financial crisis, which has hit the returns on the ACC’s assets.
3. infused 3

   17 December 2008 at 3:44 pm

   Some calculations under privatizing it actually makes it look good. It’s quite a bit cheaper.
4. Mr Magoo 4

   17 December 2008 at 4:00 pm

   And not a single apology from the labour side about dropping NZ’ers in the faecal matter in the first place.
   WHAT?! I know that the national party are doing everything BUT saying this outright in the full knowledge that their mindless flock will fall into this conclusion – but seriously. Not even THEY are saying labour caused this??

   Some calculations under privatizing it actually makes it look good. It’s quite a bit cheaper.
   
   Christ almighty…do I even bother??

   Power
   Phone

   People said the same thing when the same thing was done previously. I assume by “Some Calculations” you mean those by private industry and those commissioned by national? Perhaps the tory treasury has some figures on this??

   I really do lament at the sheer ignorance and stupidity that NZ is going through here. (These posters are just echoing a large portion of NZ’s sentiment) I am honestly starting to believe that this country seriously deserves a right tory gang bang. Maybe that will shake them out of it?
   The US went through 9 years of it, but a great short-doco I just watched would indicate that that gang-bang was one too many. (ref: http://www.youtube.com/watch?v=O_TjBNjc9Bo)
   That doco brings up many issues that NZ IS facing now, but could be facing in the future in the same magnitude if we keep burying our heads in the sand.

   I think I need to stop reading comments sections of blogs..it is depressing the hell out of me.
5. George 5

   17 December 2008 at 4:18 pm

   Mr Magoo, So ongoing slices being taking from your pay packet doesn’t depress you, depresses me no end.

   Steve, Labour has dropped the new zealand public in it through something called project creep. Under Labours watch it has accelerated so that ACC now covers things that don’t neccesarily need to be covered, ie absolute top of the line hearing devices, the latest and greatest, at $8k a pop, when last years go for around $3-4k. it happened under National too, but speed up under Labour. if someone had been watching the costs of ACC and what was being forked out for, rather than just expecting money to appear magically to meet these increased costs, then the position would not be as bad as it is now. it would be bad, but not this bad.

   i’ll repeat myself, Macdoctor has the reasoning behind this.
6. Kerry 6

   17 December 2008 at 4:20 pm

   Mr Magoo – exactly right!

   The more I read from right wingers the more I think this country is fucked….you simply cannot have a fair and just society with right wingers in charge…

   Where does the right wing mentality come from? surely not from a decent education….just look at John Banks and Paul Henry!!!! Just goes to show that you can be as rich as hell but it doesnt guarantee smarts or taste!
7. djp 7

   17 December 2008 at 4:23 pm

   Is Labours “laterally” thought out plan merely to dump the current costs on taxpayers in 2020?

   Surely the comman man is getting tired of ponzi schemes.
8. higherstandard 8

   17 December 2008 at 4:26 pm

   It is also of note that one can often access non subsidised pharmaceuticals via ACC that PHARMAC has (most often rightly) deemed to be too expensive as cheaper alternatives suffice.

   While I’m no huge fan of PHARMAC some of their fiscal management might come in very handy in relation to some of the excesses that are allowed under ACC.
9. Mr Magoo 9

   17 December 2008 at 4:42 pm

   Mr Magoo, So ongoing slices being taking from your pay packet doesn’t depress you, depresses me no end.
   George, what would depress me more is if a Kiwi’s life was completely and utterly ruined because of an faultless accident at work, especially due in part to poor safety standards. It would depress me more if the majority of people though a few bucks a week (e.g. a coffee or a beer or two) out of their pay packet was not worth this.
   I also believe in a public health system and a welfare state.

   If you do not, then we will just have to agree to disagree on that.

   The point I made still stands completely unmodified however. Your premise is completely and utterly false and your reasoning is the is the product of National’s cunning spin.

   Is Labours “laterally’ thought out plan merely to dump the current costs on taxpayers in 2020?

   Here here djp!
   If you have not already, watch that 1/2 hour doco. NZ is fast heading towards this situation if we do not act now.

   The US currently would have to invest around 170k per citizen TODAY to pay for their social security/medicare bill in the future.
   Our ACC and pension is very similar in this regard, although not as bad as theirs just yet.

   Both major parties are completely lacking in this area. Kiwisaver was a START, but it should have been ramping up to 8%, not 4%. (more like aussie)

   Higherstandard:

   I thought ACC DID do this already? You have not referred to the particular case in question, but I would be wary about assuming this logic off the bat.
   ACC is notoriously stingy but has different objectives to PHARMAC. PHARMAC does not care if you get back to work earlier or healthier. ACC does because it is likely paying you 70% of your wages during this time!
   PHARMAC calculations (and I have seen these personally) are based on outcomes per head per funding. ACC can take a more individualistic approach and offset the cost against the expense of not getting you back to work early.
10. infused 10

    17 December 2008 at 5:10 pm

    IrishBill: you were banned on the “gratitude” post.
11. Quoth the Raven 11

    17 December 2008 at 5:56 pm

    HS – … but the excesses of herpceptin are absolutley tolerable because National did it.
    On the side of that Sccop artilce they linked to this.
    The New Zealand Society of Physiotherapists appeals to the National Party to engage with physiotherapists and other treatment providers regarding their policy on choice and competition for workplace injury coverage. “There were terrible results when this policy was introduced last time,’ said Mr Warren. He said that physiotherapists saw many examples of patients who were so confused about how to claim coverage that they sometimes just gave up in frustration, or alternatively delayed seeking treatment and therefore hindered their recovery.
    Just thought I’d point it out.
    Privatising ACC seems to be the least pragmatic most ideologically driven thing National plans to do.
12. higherstandard 12

    17 December 2008 at 6:06 pm

    QTR

    Once and for all the decision regarding Herceptin is supported by all NZ oncologists (including those who provide advice to PHARMAC) as it reflects the best evidence to date in relation to this medicine.

    In relation to the physiotherapists – I’m not surprised they are worried about someone looking at the excesses of ACC the private physio providers are one of the worst abusers of this in the land.

    Magoo

    Have a look here as to why many of us in the medical profession are are bit jaded in relation to ACC

    http://www.macdoctor.co.nz/?p=900
13. Quoth the Raven 13

    17 December 2008 at 7:15 pm

    HS – Got any links or quotes or something to back up your claims. Do you not see any inconsistancy in your stance? I don’t really want to open up that topic again (your position has been debunked in other threads), but anyway how about this: Auckland Women’s Health Council report:
    The AWHC supports the proposal to decline to extend or replace the current publicly-funded nine-week course of Herceptin with a publicly-funded 12-month course of the drug. The reasons for our stance are as follows:

    • There has been no new evidence presented that would indicate that a 12- month course of Herceptin is a great deal more effective than a nine-week treatment period of Herceptin administered concurrently with taxane.

    • There is a reduced risk of cardiac toxicity with the shorter treatment period.

    • The evidence published thus far has revealed that administering Herceptin concurrently with taxane appears to be more effective than administering Herceptin sequentially after other chemotherapy.

    • As Roche has not published the data from a key clinical trial and continues to withhold the results of this trial, the AWHC believes that it is very likely that the data on the missing women are being withheld due to the fact that including them would reduce the claimed effectiveness of administering Herceptin sequentially Roche’s preferred treatment regime.

    • The results of a small trial recently presented at the 2008 annual meeting of the American Society of Clinical Oncology showed that the addition of Tykerb to Herceptin improves progression-free survival in pre-treated women (2). This provides further evidence to support the proposition that administering Herceptin for HER2 positive breast cancer concurrently is more effective than sequential therapy.
    • Despite the small size of the trial, the FinHer study revealed an appreciable effect, where disease-free survival was statistically significant. This result was achieved in spite of the small number of patients. The AWHC is therefore strongly supportive of the research currently being done which will hopefully provide answers to the questions about the optimum duration and the sequencing of Herceptin treatment.

    • The Council believes that in the context of the New Zealand health care system and the budget constraints faced by the District Health Boards (DHBs) a cautious approach to the funding of Herceptin is justified, particularly when PHARMAC is faced with the withholding of important data from clinical trials and the resulting publication bias. (3)
    
14. Tim Ellis 14

    17 December 2008 at 7:40 pm

    I posted this at the right-wing blog this morning but it still has currency here.

    I see Maryan Street has put out a statement saying that National should defer fully-funding ACC until 2019 to keep levies down. This is an outrageous statement. By 2014 the government will have had fifteen years to move to a fully-funded ACC system, paying the total future costs of claims in the year they were incurred. Labour’s solution to spread this out further would have passed enormous costs onto future levy-payers. The fiscal irresponsibility of this is quite staggering. Labour did some very good things in Government, like setting up the Cullen Fund to help fully-fund the future cost of national superannuation and not pass that burden onto future taxpayers. Labour was quite happy to do the opposite with ACC.

    In ACC Labour wanted to promise a gold-plated system delivering extremely generous entitlements by international standards, and pass the bill onto future generations. They went into this election promising lower ACC levies. They now say any moves to properly fund ACC, and potentially rationalise the entitlement system, is a pre-cursor to privatisation, even though they know fully well that there is no possibility of privatising the non-earners or motor vehicle accounts, and the chances of privatising the earners’ account is also next to zero.

    Their dishonesty over this issue really has cost them any moral authority on ACC.
15. higherstandard 15

    17 December 2008 at 8:36 pm

    QTR

    To the best of my knowledge there isn’t a single oncologist or qualified medical professional on the AWHC.

    For a view typical among oncologists I suggest you look here.

    http://www.nzma.org.nz/journal/120-1259/2676/

    You should note that Richard has one of the largest private practices in NZ as well as his public practice, so one could suggest that wishing to have Herceptin available and fully funded for 12 months was not in his best interest from a financial perspective.

    The AWHC also quote the results of a small trial with the addition of lapatinib in advanced breast cancer which is irrelevant as the issue in NZ is in relation to early breast cancer – there is no variance of the use of Herceptin from the norm in ABC in NZ.

    The PHARMAC decision regarding Herceptin was financial if it was not they would have supported the longer regimen (as has every other similar country).

    I don’t know of a single oncologist in NZ that thought PHARMAC’s decision was clinically justified.
16. Johnty Rhodes 16

    17 December 2008 at 8:47 pm

    Thank you Labour, my tax cut will be smaller now. Simple as that.
17. rave 17

    17 December 2008 at 9:12 pm

    Scrooge Key’s Xmas vs Tiny Timoti’s

    There is the Xmas at St Stephens Ave with tax kuts, Kiwisaver kuts, cheap labour, gutted unions, kuts in ACC to bosses (relative to workers) topped off with a lucky dip of state houses in SA to keep the proles quiet, bail for tagger killers, bang up the gangs, Herceptin to reward women voters (OK but the rich wont pay for it), gated housing at Hobsonville, national standards to keep the rich kids winning and fine the losers into the jails; roads, pollution and a Rooted MA to get the bottles through to the grog shop so that the yoof can binge out into the arms of the offender squad….

    Then there is the Xmas at McGehan Close…
18. Quoth the Raven 18

    17 December 2008 at 10:15 pm

    HS – I really don’t want to get into another drawn out argument over this. Anyway, whether or not AWHC has oncologists as members is immaterial they were citing a clinical study carried out by oncologists and the fact that Roche is witholding the results of a study. One would have to ask themselves why they would do that and a critcally minded person might come to the conclusion that a profit motive is behind it that the results would undermine the claimed effectiveness of administering Herceptin sequentially. Now I’m absolutely sure this has been pointed out to you before, but if you read the relevant information at pharmac’s website you’ll see that pharmac consulted oncologist and reviewed all the clinical evidence before making its decision. Herceptin Questions and Answers. Herceptin a summary of the evidence at August 2008. The Lancet aricle was quoted in the second link:‘Failing to publish inconclusive results can mean wide (and wasteful) use ofineffective treatments, or even unnecessary illness and death if the reported risksof harms are underestimated. Clearly adjuvant trastuzumab is effective but howbest to use it appears to have been hampered by some publication choices thatpresently are unclear. There is a duty of care to trial participants, sponsors, regulators, and the public good to promptly publish outcomes in all exposure groups.’
    And of course there is the rest of the argument, the matter of what is best for us to spend our limited amount of money on (whether or not it is the best publicised disease or not) and the issue of the government overruling the decision of an indepentdent body and making its own medical decisions and what that bodes for the future of this kind of funding in New Zealand. e.g. a National MP has a mate who owns lots of shares in this pharmaceutical company and they’re pushing this dodgy drug…
    I’m sure if Labour had made such a decision you’d screaming about their arrogance and know it all attitude.
19. NickC 19

    17 December 2008 at 10:29 pm

    “Labour didn’t drop NZ in it. There was no mismanagement of ACC. The costs have increased for a few simple, unavoidable reasons.”

    Steve thats nonsence and completely avoids the issue. Here we have a gold plated scheme which is willing to hand out vast amounts of money, run various ad campaigns and generally incurr high costs. Sure Labour could not control the financial crisis which hits ACC’s asset returns, or the fact that new medical technology has ment increased payouts. But they can very much control the nature of the system itself by limiting the amount of money ACC handed out and the situations in which it did so.

    Labours so called solution is also a completely useless. Their aproach is; Why pay back the debt when we can just legislate to pay it back later!? You once again fall back on the smokescreen arguement that this is all somehow ment to soften us up for privitisation, but i put it to you that given this inditement on the system that ACC privitisation is not only nessesary but inevidible.
20. DeeDub 20

    17 December 2008 at 10:56 pm

    Why do the righties who post on this site have such an appalling grasp of the subtleties of the English language, right down to spelling ‘inevitable’ with a D?

    That’s not a typo, that’s a dumbo. (Seems appropriate with the avatar anyway…) 😉

    The same kind of thinking that invents words like ‘picture-ress’….

    I bet most of them say ‘irregardless’ often and loudly, too??!!
21. Sarah 21

    18 December 2008 at 12:20 am

    I cannot actually stand reading this. This site cannot be taken credibly when it bases entire posts on nothing more than innuendo and what the party-line says. Flying the red-coloured flag high again i see.
22. Camryn 22

    18 December 2008 at 5:34 am

    Mr Magoo – This is going to be an aside to the discussion at hand, and I admit that. So, with that off my chest… can we all please stop making out that every little aspect of the social safety net in this country is just “a coffee or a beer or two (a week)”. They do all add up you know, and it doesn’t take long before all the beer and coffee money is gone and we start cutting into other aspects of households’ potential spending. Not to mention putting the beer and coffee industries out of business 😉 Obviously not quite, but my point is that not every $1 or 2 per week for every service is the ‘first dollar’. They add up!

    Also, Bush is socially right wing but on economics he’s right/left/incoherent… whatever. Don’t try to tar National with that brush!

    Captcha: Jamaica time!
23. higherstandard 23

    18 December 2008 at 8:16 am

    QTR –

    Final word to the NZ oncologists who being the experts in the field we should perhaps take credence of.

    “We remain perplexed as to why the Medical Advisory CaTSoP committee of PHARMAC was told that 12 months was not an option when considering their recommendations. We note that CaTSoP expressed a strong preference for 12 months of therapy, but were given the option of 9 weeks or nothing. Subsequent to the CaTSoP adjudications the evidence supporting 12 months treatment has further strengthened as studies continue to collect more follow-up data.

    Why, with CaTSoP’s stated preference for 12 months of therapy did PTAC, the PHARMAC Board, and the DHBs not actively pursue additional funding from the Health Minister, rather than try to restrain spending within their current budget?
    Health care is becoming inevitably more expensive with many other new drugs and technologies becoming available and offering potentially significant benefits. Beyond the issue of cost, if we do not adopt proven new therapies the quality of our care will inevitably fall further in comparison to other countries, at a time when our take up of new therapies is well behind most other OECD countries.

    In this setting, it is disappointing that PHARMAC appears unable to weigh up the narrow (drug costs), short-term fiscal imperative against available research evidence together with the wider and longer-term health care costs, in a logical, systematic, and transparent fashion.

    A major role for PHARMAC here, which has proven to be very effective in the past, should be to push for optimal pricing of Herceptin by negotiation with the pharmaceutical industry.

    It is clear that Herceptin improves the outcome of patients with early stage HER2-positive breast cancer, but the current international standard of care remains 12 months of therapy. PHARMAC have now introduced a regimen for funded treatment on the basis of very poor evidence, which is one small trial with serious statistical concerns, in preference to regimens supported by robust clinical trial data.

    While PHARMAC have a difficult job in balancing pharmaco-economic benefits of treatment, we believe in this instance they have placed too little weight on compelling scientific evidence. The risks they have taken with their decision to fund 9 weeks of Herceptin are not so much with their limited budget, but much more significantly with patients’ lives.”

    I also agree and can’t be bothered arguing with someone who hasn’t the slightest grasp of how to interpret clinical trial data and the body of clinical evidence, that aside have a good Xmas.
24. Mr Magoo 24

    18 December 2008 at 8:50 am

    Also, Bush is socially right wing but on economics he’s right/left/incoherent whatever. Don’t try to tar National with that brush!

    And the brush began with Regan, then Bush Senior. Of course we forget them because they have been completely overshadowed by Bush Jnr.

    Having said this, just because National has been irrelavent for the last 9 years and you and everyone else have forgotten their MO, does not mean I cannot tar them with whatever brush happens to be appropriate. They have been in 1 month and they are back to their fiscally irresponsible tricks.

    And they are NOT like Bush?? Slashing Kiwisaver, increasing debt with stupid spending, privatising ACC, reducing workers rights, gutting environment policy, climate change increasing???

    1 month. You just wait for the next 2 years, 11 months.
25. Mr Magoo 25

    18 December 2008 at 8:53 am

    Higherstandard:

    I have yet to hear a doctor say a good thing about any government department! 🙂

    I understand your point and I am not claiming ACC is perfect. However one cannot ignore the fact that our ACC system is one of, if not the, best in the world. The way I see it, it is the best that any beurocrats could do.
    Of course we could have more doctors and nurses running it! That would be great.

    Of course there are not enough as it is!
26. Ianmac 26

    18 December 2008 at 10:30 am

    The simple main issue is: should MP’s make decisions for Pharmac?
    If Yes then change Pharmac so that each medication supply decision goes through Parliament.
    If No then the Herceptin decision is a bad undermining ill informed decision with serious flow on implications.
    Argue as much as you like about the details but thos bottom lines remain.
27. higherstandard 27

    18 December 2008 at 10:38 am

    No Ian

    The issue is should PHARMAC hide behind the illusion that their decisions regarding new medicines are based on science rather than economics, this is why many of us would prefer to see the clinical decision completely separate from the economic decision, that is an assessment of medications on clinical grounds by the medical experts sitting outside of PHARMAC followed by a separate economic evaluation and decision on what to fund by PHARMAC.

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