Crispin Hull

A healthy debate is under way. On one side, several urologists and prostate cancer patients are arguing for routine screening for prostate cancer among men over, say, 55. They say that if caught early, the cancer is quite treatable and the spreading of the cancer to other vital organs can be prevented. On the other side, some public-health doctors are pointing to the downside of routine testing. They say the test is relatively unreliable. Depending on where the cut-off point is set, it gives too many false positives and too many false negatives, both with unfortunate effects. Some men might be put on unnecessarily debilitating treatments like surgery, radiotherapy and chemotherapy when if left alone they would most likely die from some cause other than the cancer. Conversely, some men might go away with the false knowledge that they are free from cancer.

This debate can be quite constructive. Viewed sensibly, it indicates that more research is needed. It will require greater investment (and nearly all medical research should be seen as investment rather than just funding).
Continue reading “1995_10_october_leader09oct”

Federalism is bad for our health. The drift from private health insurance is having a huge impact on the ACT health system, particularly Woden Valley Hospital. Public hospitals charge privately insured patients much more than Medicare patients. The trouble is people are dropping out of private insurance. It means that private patients comprise a lower percentage of patients at Woden. They were 41.3 per cent in 1989-90 and only 17.6 per cent in 1994-95, and will fall to 12.6 per cent this financial year. It has meant revenue for Woden Valley has fallen $20 million for providing the same service.

The reasons for people deserting private cover have been apparent for several years. Medicare, which everyone has to pay for anyway, provides virtually the same benefits for catastrophic or life-threatening illness as private cover. Indeed, some private patients end up financially worse off. Seriously ill patients virtually get choice of doctor or are in a situation where choice is irrelevant (their life is threatened and only one is available; or there is only one or two specialists in the town who can treat the patient).
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Parents will be somewhat comforted by this week’s report on computer games which says they are not addictive and children playing them will not become more aggressive. The report even suggested that some games could even improve family relations because encouraged joint family activities on a scale rarely seen since the advent of television.

For generations parents have been worried about the latest fad engaging their children. Computer games, like previous fads, were not part of the childhood experience of present parents, so parents are largely ignorant of their influence, perhaps exaggerating it while having an idealised view of their own childhood.

The research, by Kevin Durkin, an associate professor of psychology at the University of Western Australia, indicates that computer games are not all that different from the fads of previous generations … apparently capable of generating obsessions but in fact just one of many activities. Obviously, children might be better off spending less time on the games and more on homework, reading or sport. But computer games appear to be better than a lot of television watching. Television is more passive. Computer games, the report showed, are an entree to the use of computer technology for children and appear to help them learn to think better and improve their ability to solve problems, adding to cognitive, perceptual and social development.
Continue reading “1995_10_october_leader06oct”

The evidence is coming in that falls in the road toll and the number of traffic accidents in the past five years is not a call for self-congratulation on the part of Australian drivers. Rather it has been a incident of economic recession. This has meant people have cut down on the frequency and length of their car trips and have not replaced their cars as frequently. It has added up to fewer accidents costly less in terms of money, injuries and lives. Alas, it is not evidence that more drivers are voluntarily driving more carefully.

The latest evidence is from the insurance group AAMI which publishes an annual crash index. It shows that as Australia has been coming out of recession over the past three years, the accident rate has increased by 15 per cent. It shows that half the accidents are caused by rear-end collisions and not giving way … in short, driver negligence. Given total accident property costs of $2.6 billion, it is safe to assume that more than $1 billion a year is caused by this sort of driver negligence.

The AAMI index showed that in the past year the accident rate rose from 13.9 per cent to 14.4 per cent. That probably shows longer trips as we come out of the recession and/or more crashes per kilometre.
Continue reading “1995_10_october_leader04oct”

In the six months before an election is due, Australian politics shows lots of movement and no direction; all heat and no light. Important and difficult decisions are put on hold. In their place foolish promises are frequently made to special (and usually undeserving) minorities because they might deliver votes.

In this environment the Australian wine industry awaits the Government’s response to the Industry Commission report on wine. The chair of the commission, Bill Scales, recommended that wine tax go up from 26 per cent to 32 per cent. Admittedly it was a minority report. However, if it enough to send chilly winds through the investment climate in the industry.

The president of the Wine-makers Federation of Australia, Stephen Shelmerdine, says that the Government has had the report for three months. It is plenty of time to reply. To date the Government has only hinted that it will do nothing. That is not enough. Investors hate uncertainty.
Continue reading “1995_10_october_leader03oct”

The people of Canberra have shown a stubborn liking for glass milk bottles. It is hard to tell whether that is because of a belief that glass containers are more environmentally friendly or whether they think the milk tastes better from taste-neutral glass than from waxed cardboard cartons.

In any event, the Act Milk Authority should not be allowed to get away with eliminating the glass option by stealth or what it thinks is benign neglect. It would be all to easy for the authority to use the excuse of the current worn bottle-washing equipment to phase out glass bottles. The worn bottle-washing equipment is increasing the risk of glass particles falling in bottles. The authority says there is a health risk and in that circumstance distribution should cease till the problem is fixed.
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Last year the High Court ruled in favour of freedom of political communication. In effect, it means no more easy defamation politicians. It removed one of the greatest impediments to reform of defamation law … the self-interest of politicians who had most to gain from a restrictive law. Their conduct was less open to comment and they could pick up defamation damages.

Politicians are now more likely to think, that if it is good enough for us to be subject to a free-speech regime, it is good enough for everyone else.

So reform is now more likely, but it must be the right sort of reform. Last week, the NSW Law Reform Commission reported. It recommended that the onus of proof which presently falls on publishers to prove the truth of what they publish be reversed. It would mean plaintiffs would have to prove the falsity of the publication. This has problems.
Continue reading “1995_10_october_column31oct”

The wording of the Constitution and the war enabled the Feds to take away income tax from the states and we are now suffering the consequences. It means the states have to go cap in hand to Feds to get tax money they should have raised themselves and each can blame each other when voters whinge about high taxes or low services. Further the Federal Government has built up a large duplicate bureaucracy to ensure its money (which is really the states money being reimbursed) is properly spent.

Last week the federal Coalition said it was going to do something about it. Prime Minister Paul Keating immediately said it meant state income taxes and … shock, horror … a state GST. As if the state petrol, tobacco and booze taxes were not a GST anyway. Besides, broadening state consumption taxes would run into constitutional strife because Section 90 gives the Commonwealth the exclusive right to levy excise taxes (in layperson’s language this means sales taxes). The High Court has only tolerated booze, smokes and petrol taxes as historic accidents.
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One of the bad practices of Tudor monarchs in the 16th century is to be repeated in the Albert Hall next week. The Tudors used to replenish their coffers every now and then by selling monopoly rights to engage in certain trades. Sometimes they would just give the monopoly rights to mates. It caused great agitation among the good traders of England, but to defy it could result in fines, imprisonment or death.

It was only with the arrival of the Stuarts that the traders and Parliament were powerful enough to get the Crown’s rights restricted with the passing of the Statute of Monopolies in 1623, which restricted monopolies to inventions, and even then only for about 15 years.

Since then, Crown monopolies have re-emerged in a different form … the licence. Parliament has allowed the Executive to licence some activities to the exclusion of other practitioners for a hefty fee.
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