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5 ways to reduce everyday bills

<p>It’s not uncommon to get to the end of the month and be surprised by a figure in your bills. But this surprise needn’t be unpleasant. There is wide a range of simple measures you can employ to reduce your monthly bills without too much effort. Follow these five simple tips and save money.</p> <p><strong>1. Food and groceries</strong></p> <p>Food can be a problem area in the average Australian’s budget, either because we’re physically eating too much, eating out too much or spending too much money on groceries. But that doesn’t mean you have to transition to a Spartan diet. Here’s how you can save on your grocery bill:</p> <ul> <li>Reduce the amount of times you’re eating out or getting takeout a week</li> <li>Use a shopping list and coupons, pay for groceries (this means you’re less likely to splurge on items that you don’t need) and buy more non-perishable foods to store and save</li> <li>Consider starting a garden and grow your own fruit and veggies</li> </ul> <p><strong>2. Energy</strong></p> <p>Many people have found their energy bills have been increasingly steady over the past through years, but this doesn’t mean you have to be part of that trend. With a little bit of ingenuity and not a lot of fuss you can make your house energy efficient and enjoy huge power bill savings:</p> <ul> <li>Switch to energy-efficient light bulbs. In many cases these bulbs do cost more than traditional bulbs, but they use much less energy and can last up to 10 times longer</li> <li>Unplug unused electrical devices that are draining electricity</li> <li>Make sure you home is airtight to prevent cold drafts in winter and the loss of cool air in summer. This will also reduce your heating/cooling bills accordingly</li> </ul> <p><strong>3. Cars</strong></p> <p>As fuel, registration and maintenance costs start to pile up, a car can seem less like a convenience and more like a money pit rolling around on four wheels. That being said, there is a range of ways you can enjoy the access vehicle ownerships provides, without having to pay through your nose:</p> <ul> <li>Underinflated tyres reduces the value of your cars fuel economy significantly, so make sure you take a couple of minutes to check the air pressure and reinflate once a month</li> <li>Consider selling a vehicle if you’re not using it often. Without taking the cost of parking and toll roads into account driving vehicles costs thousands of dollars a year</li> <li>Use more public transport and consider setting up car pools with friends/colleagues</li> </ul> <p><strong>4. Grooming and beauty  </strong></p> <p>Looking and feeling great is important, but it doesn’t necessarily have to be a hugely expensive ordeal. With a little bit of ingenuity, creativity and willingness to not spend $10,000 on that jewel encrusted headdress you can still be the belle/male-belle of the ball without breaking the bank:</p> <ul> <li>Reduce the amount of money you spend on clothing by keeping your eye on sales</li> <li>Consider lower cost alternatives to your favourite beauty products</li> <li>Cut back on the amount of times you have your hair cut and styled</li> </ul> <p><strong>5. Additional entertainment expenses</strong></p> <p>Your deluxe gym membership might give you access to the power lifting body attack class, but are you really getting the full value for it and the other regular entertainment expenses you’ve signed up for? There are still ways to stay entertained without having to break the bank every week.</p> <ul> <li>Consider cancelling club memberships for places you don’t visit often</li> <li>Investigate free events and inexpensive entertainment ideas like cheap movies Tuesdays</li> <li>Magazine and newspaper subscriptions can also become expensive if you’re not actually reading the papers, as well as pay television services that can be easily eliminated</li> </ul> <p><em>Image credits: Shutterstock</em></p>

Money & Banking

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Readers response: What’s your best advice for managing medications while travelling?

<p>When taking a trip, many people often have to factor in how their changing schedule will affect their regular medication routines. </p> <p>We asked our readers for their best advice on managing medications while travelling, and the response was overwhelming. Here's what they said.</p> <p><strong>Kristeen Bon</strong> - I put each days tablet into small ziplock bags and staple them at one corner. All that goes into one larger ziplock bag and into my toilet bag. I store all the outer packs flat into another ziplock bag and that stays in the zip pack with my first aid kit in the main suitcase. I travel long haul up to six times a year and this is the most manageable way I have found.</p> <p><strong>Diane Green</strong> - Firstly, take sufficient  supply of all meds to last the time I'm away. I separate morning medications and evening medications. Then it depends on how long I'm away. I have one that needs to be refrigerated. Depending on where I travel, this can entail arranging overnight in the establishment fridge while taking a freezer pack for daytime travel.</p> <p><strong>Irene Varis</strong> - Always get a letter from my doctor, with all my prescriptions for when I get overseas. Saves you a lot of trouble!</p> <p><strong>Helen Lunn</strong> - Just get the chemist to pack into Medipacks. I usually take an extra week. I alway put some of the packs in my partners baggage incase my bag goes missing and a pack and a doctor’s letter in my hand luggage.</p> <p><strong>Jancye Winter</strong> - Always pack in your carry on with prescriptions.</p> <p><strong>Jenny Gordon</strong> - Carry a letter from doc with all medications, leave in original packaging. Double check that it isn’t illegal to carry your medication as some countries have strict regulations for things like Codeine. Always carry in carry on as you don’t want them to get lost.</p> <p><strong>Nina Thomas Rogers</strong> - Be organised with all your medicines before you leave.</p> <p><em>Image credits: Shutterstock </em></p>

Travel Tips

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Vandals wreck roadside CCTV leaving locals with $300k replacement bill

<p>Two mobile roadside cameras have been targeted and damaged by a group of young men, leaving a local Aussie council with a large replacement bill. </p> <p>Video of the incident was shared on social media over the weekend and shows about a dozen men, most of them covering their faces , pushing over a camera trailer before swinging on the boom and hitting the camera. </p> <p>The "night time shenanigans" drew a mixed reaction, with some praising their antics saying: "Not all heroes wear capes."</p> <p>Others described them as "legends" and said  "good job fellas."</p> <p>However many slammed their acts of vandalism, with one person saying: "Total of 49 braincells combined."</p> <p>According to <em>Yahoo News</em>, the cameras were not monitoring drivers and are not managed by Queensland's Department of Transport and Main Roads. The cameras belonged to local government area intended to tackle anti-social behaviour and crime.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/DAfgtmOPqxk/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/DAfgtmOPqxk/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Its Called Straya 🇦🇺 (@its_called_straya)</a></p> </div> </blockquote> <p>"Over the last week two of Council’s mobile CCTV camera trailers have been destroyed by vandals," a spokesperson for the council told the Townsville Bulletin.</p> <p>"The total replacement cost of both trailers is estimated to be more than $300,000 to ratepayers."</p> <p>According to council officials, the cameras were damaged in the suburbs of Woodstock and Bohle. </p> <p>"Townsville City Council has an extensive CCTV camera network of more than 600 fixed cameras and six mobile trailer cameras that can be deployed across the city to reinforce Council’s commitment to community safety," the spokesperson said.</p> <p>Police are investigating the incidents, urging anyone with information to come forward. </p> <p><em>Images: Instagram</em></p>

Legal

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More Australians are using their superannuation for medical procedures. But that might put their financial health at risk

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>A record number of Australians are accessing their superannuation early on compassionate grounds, mainly to fund their own medical procedures – or those of a family member.</p> <p>Some 150,000 Australians have used the scheme in the last five years. Nearly 40,000 people <a href="https://www.ato.gov.au/about-ato/research-and-statistics/in-detail/super-statistics/early-release/compassionate-release-of-super">had applications approved</a> in 2022-23, compared to just under 30,000 in 2018-19 – an increase of 47%.</p> <p>Some people think this flexible use of funds is a good way to ensure people can fund their own medical needs. But more transparency and better oversight is needed.</p> <h2>What are compassionate grounds?</h2> <p>Since July 2018, the Australian Tax Office has administered the early release of superannuation – meaning before <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/super-withdrawal-options#Preservationage">retirement</a> – under certain circumstances, including compassionate grounds.</p> <p><a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/early-access-to-super/access-on-compassionate-grounds/expenses-eligible-for-release-on-compassionate-grounds">Compassionate grounds</a> for you or your dependant (such as child or spouse) are:</p> <ul> <li>medical treatment or transport</li> <li>modifying your home or vehicle to accommodate special needs for a severe disability</li> <li>palliative care for a terminal illness</li> <li>death, funeral or burial expenses</li> <li>preventing foreclosure or forced sale of your home.</li> </ul> <p>The medical treatment must be for a life-threatening illness or injury, or to alleviate acute or chronic pain, or acute or chronic mental illness.</p> <p>The treatment cannot be “readily available” through the public system. Cosmetic procedures are excluded.</p> <p>You also have to prove you cannot afford to pay part or all of the expenses without accessing your super, for example, by spending your savings, selling assets or getting a loan.</p> <p>People who can access other funding for the expense, such as via the <a href="https://theconversation.com/lists-of-eligible-supports-could-be-a-backwards-step-for-the-ndis-and-people-with-disability-236578">National Disability Insurance Scheme</a>, are ineligible.</p> <h2>Why are people using this scheme more?</h2> <p>The ATO has not explained what is driving the surge. General cost-of-living pressures may play a role. People may have fewer savings to draw on for medical procedures.</p> <p>But the treatments most commonly being accessed using superannuation – fertility treatments, weight loss surgeries and dental care – point to other systemic issues.</p> <p>There have long been issues with IVF and <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086#:%7E:text=The%20real%20reason%20dental%20hasn,has%20a%20structural%20budget%20problem.">dental care</a> not being readily available or funded in the public health system.</p> <p>Weight loss surgeries (including <a href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258">bariatric surgery</a>) can help combat potentially life-threatening conditions such as heart disease. Recent <a href="https://www.monash.edu/news/articles/fewer-australians-having-bariatric-surgery-monash-university-led-report">research</a> suggests there has been an overall drop in the number of Australians having bariatric surgeries since 2016. But of those, 95% are performed through the private system.</p> <p>While early access to super can provide individuals access to critical treatment, there are issues with how compassionate grounds are defined and regulated.</p> <h2>Lack of clarity</h2> <p>As my co-author and I <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2021/06/Issue-442-PDF-3-Bhatia-and-Porceddu.pdf">have shown</a>, the vague wording of the <a href="https://www.legislation.gov.au/F1996B00580/2022-09-28/text">Superannuation Industry regulations</a> leaves them worryingly open to interpretation.</p> <p>For example, the meaning of “mental disturbance” is not defined.</p> <p>You may not meet the criteria of having an acute or life-threatening illness, or acute or chronic pain. But if you can show a certain condition causes you acute mental disturbance, you may qualify to release your superannuation early.</p> <p>People accessing their superannuation for IVF use this criterion, for example, by arguing they need to access funds to continue treatment and alleviate the acute mental distress caused by ongoing infertility issues.</p> <p>Two registered medical practitioners are each required to submit a report demonstrating the treatment is needed, and one must be a specialist in the field in which the treatment is required. However, the regulations do not specify clearly that the specialist should have relevant qualifications.</p> <p>In the IVF example, this means the specialist opinion can be provided by a fertility doctor rather than a mental health expert – and that person may stand to profit if they later also provide treatment.</p> <h2>A closed-loop system</h2> <p>Conflict of interest is another major issue.</p> <p>There is nothing in the regulations to stop a medical practitioner – such as a dentist – being involved in all steps and then financially benefiting. They could encourage a patient to access superannuation for a treatment, write the specialist report and then also receive payment for the treatment.</p> <p>Some clinics <a href="https://www.theguardian.com/australia-news/2024/apr/06/online-ads-promote-simple-access-to-super-to-pay-for-healthcare-despite-strict-rules">promote</a> accessing superannuation as an option to pay for expensive treatments.</p> <p>This raises important questions about the independence of the process, as well as professional ethics.</p> <p>Medical practitioners making recommendations for early release of superannuation should be doing so on genuinely compassionate grounds. But the potential for exploitation remains an ethical concern, when a practitioner can financially benefit from recommending early access to nest egg funds.</p> <p>Transparency around potential <a href="https://theconversation.com/people-are-using-their-super-to-pay-for-ivf-with-their-fertility-clinics-blessing-thats-a-conflict-of-interest-161278">conflicts of interest</a> are impossible to ensure without proper oversight.</p> <h2>What is needed?</h2> <p><strong>1. Mandatory financial counselling</strong></p> <p>The ATO <a href="https://www.theage.com.au/healthcare/worrying-trend-record-number-of-australians-raid-super-to-fund-medical-treatments-20240920-p5kc44.html">has warned</a> accessing super early is not “free money”, with a spokesperson urging people to get financial advice. But the law should go a step further and make this compulsory. That way people making decisions during an emotionally charged moment can understand any future implications.</p> <p><strong>2. Tightening of the criteria</strong></p> <p>Greater clarity in the legislation – such as defining “mental disturbance” – would help prevent loopholes being exploited.</p> <p><strong>3. Better oversight</strong></p> <p>Less health-care industry involvement would promote greater transparency and independence. An independent body of medical practitioners could assess applications rather than practitioners who could financially benefit if applications are approved. This would help alleviate perceived and actual conflicts of interest.</p> <p>Accessing superannuation early may be the only option for some people to start a family or access other life-changing medical care. But they should be able to make this decision in a fully informed way, safeguarded from exploitation and aware of the implications for their future.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239588/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/neera-bhatia-15189"><em>Neera Bhatia</em></a><em>, Associate Professor in Law, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/more-australians-are-using-their-superannuation-for-medical-procedures-but-that-might-put-their-financial-health-at-risk-239588">original article</a>.</em></p> </div>

Money & Banking

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Bill Shorten quits politics and reveals his next move in heartfelt speech

<p>Bill Shorten has announced his shock departure from politics after an almost two-decade-long career in parliament.</p> <p>The former Labor leader will remain in cabinet until his retirement from politics in February next year, when he will start a new career as vice chancellor of the University of Canberra.</p> <p>In a media conference in the Prime Minister’s courtyard on Thursday, Shorten made the shocking announcement alongside Anthony Albanese, reflecting on his career. </p> <p>“Over 30 years ago, when I joined the Australian Workers Union, I was driven by the belief that everyone, regardless of circumstance, deserves an equal opportunity,” Mr Shorten said.</p> <p>“The opportunity to fulfil their potential. Fair wages, safe workplaces, decent conditions, that is what they are all about. It’s about recognising the merit and worth of every individual. As the same principle that brought me here in 2007.”</p> <p>"Every day in this job, and I'm sure every member of parliament agrees, is a privileged day."</p> <p>He also shared his motivation behind moving into the education sector, highlighting his love of education. </p> <p>“Education is the modern means of taking someone from disadvantage to advantage in a way that no other method can,” Mr Shorten told a media conference in the Prime Minister’s court yard.</p> <div> <div id="sda-INARTICLE"></div> </div> <p>“Universities have a critical role to play. The hopes and dreams of Australians are lifted when they are able to fulfil their own potential and the hopes and dreams of our nation are lifted as well.”</p> <p>Albanese also praised his colleague and his extraordinary career, saying, "Through his years as leader, no-one worked harder than Bill."</p> <p>"No-one brought more energy, enthusiasm, ideas and ambition to advocating the need for a Labor government."</p> <p><em>Image credits: ABC</em></p>

News

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John Boland’s battle against prostate cancer and the urgent need for reform

<p>John Boland, a 74-year-old retired Navy Reserve Lieutenant Commander, found himself at a crossroads – a place where hope and despair often meet in the lives of those battling life-threatening illnesses like prostate cancer. </p> <p>Diagnosed five years ago, John’s journey has been a relentless fight against a disease that, despite medical advancements, still claims the lives of 10 men in Australia every day.</p> <p>After undergoing surgery and 37 rounds of radiation therapy, John’s battle was far from over. His PSA (Prostate-Specific Antigen) levels, an indicator of prostate cancer activity, were not dropping sufficiently, signalling that the fight was only getting tougher. It was then that John was introduced to a groundbreaking treatment: Lutetium-177 PSMA therapy (LuPSMA), a targeted radionuclide therapy with pinpoint accuracy to attack cancer cells.</p> <p>This innovative treatment offered a glimmer of hope, a chance to strike at the heart of the disease that had disrupted his life. But there was a catch – the cost. Each round of LuPSMA treatment costs $10,000, and while some patients may require up to eight rounds, John’s doctors recommended two based on his response. Even so, the financial burden was immense, forcing John to dip into his superannuation, ultimately spending $60,000 on the treatment that was not covered by insurance.</p> <p>Despite the financial strain, the results were nothing short of miraculous. After just the first round, John’s PSA levels dropped by a staggering 95%. After the second, they fell to nearly zero. The treatment had not only attacked the cancer but had also restored his quality of life, allowing him to once again enjoy the simple pleasures – time with family, daily activities and even golf. It was a victory that brought renewed hope and confidence for the future, a victory that made the $60,000 investment worth every cent.</p> <p>“My case was remarkably successful after the second treatment, which are eight weeks apart, after the scan had no cancer, and my PSA was effective to zero. So it was a reliable result for me and a huge boost, but unfortunately, they're $10,000 a time, and you can require up to eight treatments,” says John. “Fortunately we were able to fund it from our superannuation pension account, the $20,000, but I imagine that a lot of people, they can’t find that $20,000.”</p> <p>But John’s story, while inspiring, also highlights a grim reality: many Australians are not as fortunate. The LuPSMA treatment that worked so well for John remains out of reach for many others due to its prohibitive cost. And this isn’t just an isolated issue; it’s a systemic problem affecting thousands of men across the country.</p> <p>A new report, the <a href="https://www.pcfa.org.au/media/nbennwom/aus-np-1123-80001-amgen-access-gap-report_april-2024-data-final-approved.pdf" target="_blank" rel="noopener">Australian Patient Access Gap Report</a>, has shed light on the alarming delay in the public availability of new medicines in Australia. The report reveals that Australians with life-threatening illnesses are waiting an average of 591 days – more than 18 months – for access to new, potentially life-saving medicines. For some, the wait can be as long as three years. These delays are not just statistics; they represent real people, real lives hanging in the balance.</p> <p>The Prostate Cancer Foundation of Australia (PCFA), the country’s leading organisation in the fight against prostate cancer, is calling for urgent reform. They argue that the current system, which often requires multiple rounds of review before new treatments are approved for public use, is failing Australians. </p> <p>PCFA CEO Anne Savage points out that while 10 men die from prostate cancer every day, the approval process for new treatments drags on, leaving patients like John Boland to fend for themselves – often at great financial and emotional cost. “In almost every instance, Australians are being denied access to new medicines that can extend and save their lives, simply because our approval systems have not kept up with the pace of change,” she says. </p> <p>“In relation to prostate cancer, applications typically undergo two or three rounds of review before achieving a positive recommendation, while 10 men die a day from the disease. It’s simply not good enough.”</p> <p>John’s story serves as a strong call to action. His successful treatment with LuPSMA is a testament to the power of modern medicine, but it also underscores the urgent need for change. No one should have to choose between their life savings and their life; it’s time for Australia to modernise its pharmaceutical benefits scheme, ensuring that all Australians, regardless of their financial situation, have access to the treatments they need.</p> <p>As we move forward, the PCFA is urging Australians to take part in initiatives like <a href="https://www.thelongrun.org.au/" target="_blank" rel="noopener">The Long Run</a> during Prostate Cancer Awareness Month in September, raising awareness and funds to support the fight against this devastating disease. </p> <p>For John Boland, and for the thousands of others who share his struggle, we must work towards a future where no one is left behind in the fight against cancer.</p> <p><em>Image: Courtesy of John Boland.</em></p>

Caring

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What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Migraine is many things, but one thing it’s not is “just a headache”.</p> <p>“Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.</p> <p>Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.</p> <p>Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.</p> <h2>What’s happening in my brain?</h2> <p>The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:</p> <p>The earliest phase is called the <strong>prodrome</strong>. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=485&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=610&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">The hypothalamus is shown here in red.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></span></figcaption></figure> <p>Next is the <strong>aura phase</strong>, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.</p> <p>In the <strong>headache phase</strong>, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.</p> <p>Finally, the <strong>postdromal phase</strong> occurs after the headache resolves and commonly involves changes in mood and energy.</p> <h2>What can you do about the acute attack?</h2> <p>A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.</p> <p><iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <p><strong>Aspirin</strong></p> <p>For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.</p> <p><strong>Triptans</strong></p> <p>For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.</p> <p>Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.</p> <p>The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).</p> <p>As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.</p> <p><strong>Gepants</strong></p> <p>Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.</p> <p>Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.</p> <p>They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.</p> <p><strong>Ditans</strong></p> <p>Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.</p> <p>However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers.</p> <h2>What about preventing migraines?</h2> <p>The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.</p> <p>Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives.</p> <p>Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:</p> <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> <p>Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.</p> <p>For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.</p> <p>It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more.</p> <hr /> <p><iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <hr /> <h2>‘Nothing works for me!’</h2> <p>In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP.</p> <p>The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.</p> <p>These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist.</p> <p>Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.</p> <p>Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.</p> <p>Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>.</em></p> </div>

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"We should give back": Bill Gates' ex-wife on giving away her $16bn fortune

<p>Melinda French Gates has opened up on her decision to give away her fortune after leaving the Bill &amp; Melinda Gates Foundation in June. </p> <p>Melinda, who is reportedly worth $16.8 billion, said that she will stick with her decision to give away her fortune on <em>The Late Show with Stephen Colbert, </em> as it's "the right thing to do for society". </p> <p>"If we grew up in the United States, anybody who has grown up in this country has been really lucky and I don't care who you are," she explained.</p> <p>"To be able to go to a decent school, grow up and pursue your career, and if so you are a billionaire, my gosh, you have benefited from this country, right?</p> <p>"So we should give back."</p> <p>She also feels there is "a responsibility and to do it in a way that's incredibly thoughtful".</p> <p>Melinda, who divorced the Microsoft founder Bill Gates back in 2021, has announced her plans to focus on her organisation Pivotal Ventures, which she founded in 2015.</p> <p>The organisation's aim is to "advance social progress by removing barriers that hold people back."</p> <p>She said that she is  determined to ensure that "women's rights are not only on the agenda, but that women are setting the agenda" – especially after watching women's rights be rolled back internationally over the last few years."</p> <p>"What I saw, part of why our women's rights got rolled back in the United States is that those organisations were starved for funding, and they were playing defense," she explained. </p> <p>Melinda has pledged to donate $1 billion to this end over the next two years. </p> <p><em>Image: Julien De Rosa/EPA/ Shutterstock Editorial</em></p> <p> </p>

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Taking too many medications can pose health risks. Here’s how to avoid them

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a></em></p> <p>When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact?</p> <p>The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines).</p> <p>I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65.</p> <h2>Polypharmacy among older adults</h2> <p>Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics.</p> <p>Is it a good idea to take so many drugs?</p> <p>According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability.</p> <p>In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic.</p> <h2>The risks of polypharmacy: 5 points to consider</h2> <p>When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken.</p> <ol> <li> <p>Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments.</p> </li> <li> <p>A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses?</p> </li> <li> <p>The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences.</p> </li> <li> <p>The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death.</p> </li> <li> <p>Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks.</p> </li> </ol> <p>Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements.</p> <p>Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health.</p> <h2>3 tips to avoid the risks associated with polypharmacy</h2> <p>What can we do as a patient, or as a caregiver?</p> <ol> <li> <p>Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ?</p> </li> <li> <p>Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced?</p> </li> <li> <p>Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter.</p> </li> </ol> <h2>Benefits should outweigh the risks</h2> <p>Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion.</p> <p>Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>.</em></p> </div>

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How to sign up for energy bill relief

<p>In the face of rising living costs, thousands of Australians have turned to their energy providers for financial assistance, highlighting the community spirit and support available during these challenging times. Energy companies like AGL Australia and Energy Australia are stepping up to help their customers manage their bills and find relief.</p> <p>AGL Australia has seen a significant increase in its financial hardship program, with 10,000 customers joining in the past year. Energy Australia receives 1,000 calls every weekday from customers seeking bill relief. These numbers reflect the proactive measures Australians are taking to manage their expenses and the readiness of energy providers to offer support.</p> <p>Crystal Noronha, who has worked at the AGL call centre for 11 years, has witnessed firsthand the growing need for assistance. "There's a lot of distress in their voice, there's anxiety," Noronha <a href="https://www.9news.com.au/national/thousands-of-customers-signing-up-for-energy-bill-relief-with-millions-more-eligible/9dc9535b-f94b-42f4-aeaf-6534dc898df2" target="_blank" rel="noopener">shared with 9NEWS</a>. "Some hide away from sharing their difficulties, but we're here to help them."</p> <p>Customers need not face extreme financial hardship to seek help, as everyone is eligible for some form of assistance.</p> <p>Gavin Dufty, from the charity St Vincent De Paul, underscores the commitment of energy companies to support their customers. "Every energy company has a legal obligation to provide support for all households regardless," Dufty explains. The assistance offered varies based on the provider and individual circumstances, ranging from bill extensions and more manageable payment plans to, in some cases, complete debt waivers.</p> <p>Adding to this support, the federal government is taking significant steps to ease the burden on households. Starting July 1, every household will receive a $300 credit into their energy account, providing substantial relief. Additionally, a free government website is available for customers to compare energy plan prices and find the most cost-effective options.</p> <p>These measures reflect a collaborative effort between energy providers and the government to ensure Australians can navigate the financial challenges of today's world. By offering practical solutions and financial relief, they are making a positive impact on the lives of many, ensuring that no one is left to face these difficulties alone.</p> <p><em>Image: Getty</em></p>

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Australia can afford to bulk bill all GP visits. So why don’t we?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/yuting-zhang-1144393">Yuting Zhang</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/karinna-saxby-1045932">Karinna Saxby</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Being able to afford health care is a <a href="https://www.abs.gov.au/media-centre/media-releases/more-people-putting-seeing-health-professionals-due-cost">pressing issue</a> for many Australians. And encouraging GPs to bulk bill is <a href="https://theconversation.com/cheaper-medicines-and-a-new-approach-for-mental-health-care-will-the-budget-make-us-healthier-229612">one measure</a> the government is taking to ease the strain.</p> <p>So what would it take for GPs to bulk bill everyone? In our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-8462.12553">recent paper</a>, we calculated this is possible and affordable, given the current health budget.</p> <p>But we show recent incentives for GPs to bulk bill aren’t enough to get us there.</p> <p>Instead, we need to adjust health policies to increase bulk-billing rates and to make our health system more sustainable.</p> <h2>How do the incentives work?</h2> <p>In recent years, the government has introduced various incentives to try and encourage GPs to bulk bill (so patients pay nothing out-of-pocket).</p> <p>The most recent has been the “<a href="https://www.health.gov.au/our-work/increases-to-bulk-billing-incentive-payments#1-november-2023-changes">triple bulk-billing incentives</a>” or “triple bonus” for short. These have been in place since November 2023.</p> <p>Under these incentives, GPs in metropolitan areas are paid a A$20.65 bonus if they bulk bill concession card holders or children under 16 years. GPs in rural and remote areas are paid $31.35-$39.65 extra. These bonus payments are in addition to regular Medicare rebates GPs receive.</p> <p>But when we looked at whether these latest incentives are likely to work to boost bulk billing, we found a city-country divide.</p> <h2>City GPs may not be convinced</h2> <p>We worked out the triple bonus will not help most people in metropolitan areas.</p> <p>That’s because in these areas the bonus is much lower than what patients currently pay out-of-pocket. In other words, if GPs did bulk bill these groups, their income would be lower than what they could have charged. So the bonus wouldn’t be enough incentive for them to bulk bill.</p> <p>For example, we found in greater Melbourne, the average out-of-pocket costs for a non-bulk billed GP visit <a href="https://melbourneinstitute.unimelb.edu.au/research/HALE-Hub/data">is about</a> $30-$56 depending on the suburb. This is much higher than the $20.65 triple bonus amount in metropolitan regions. We see similar patterns across all metropolitan areas.</p> <h2>But country GPs may be swayed</h2> <p>The picture is different in rural and remote areas. Here, the average out-of-pocket cost for a non-bulk billed GP visit <a href="https://melbourneinstitute.unimelb.edu.au/research/HALE-Hub/data">varies substantially</a> – around $28-52 in rural regions and $32-123 in remote areas. The highest cost on the mainland was $79 but GP visits on Lord Howe Island were the most expensive overall, at $123.</p> <p>For patients living in areas where their actual payment is less than the bonus amount, the incentive does help. In other words, it would be financially advantageous for GPs to bulk bill these patients, but not where the out-of-pocket costs are higher than the bonus.</p> <p>Our <a href="https://melbourneinstitute.unimelb.edu.au/research/HALE-Hub/data">online map</a> shows where GPs are most likely to bulk bill. The map below shows how out-of-pocket costs vary around Australia.</p> <p><iframe id="SPzgj" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/SPzgj/" width="100%" height="400px" frameborder="0"></iframe></p> <h2>How about bulk billing for all?</h2> <p>The picture is a little more complex when we start talking about bulk billing all GP visits – regardless of location or patients’ concession card status.</p> <p>We worked out this would cost about $950 million a year for all GP services, or $700 million a year for face-to-face GP consultations.</p> <p>This is within reach under the current budget, especially for face-to-face GP consultations.</p> <p>The government has earmarked <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/budget-2023-24-building-a-stronger-medicare#:%7E:text=%243.5%20billion%20in%20bulk%20billing,40%2Dyear%20history%20of%20Medicare">$3.5 billion</a> over <a href="https://archive.budget.gov.au/2023-24/bp2/download/bp2_2023-24.pdf">five years</a> for the “triple bonus” incentives. That’s $700 million a year.</p> <h2>We can afford to, but should we?</h2> <p>Introducing free GP visits for all would require careful consideration, as it would encourage more GP visits.</p> <p>This might be a good thing, particularly if people had previously skipped beneficial care <a href="https://www.abs.gov.au/media-centre/media-releases/more-people-putting-seeing-health-professionals-due-cost">due to high costs</a>. However, it may encourage more people to see their <a href="https://www.sciencedirect.com/science/article/abs/pii/S1574006400801675">GP unnecessarily</a>, taking away limited resources from those who really need them. This could ultimately increase wait times for everyone.</p> <p>So providing free GP visits for all may not be efficient or sustainable, even if it’s within the budget.</p> <p>But paying more than $50 for a GP visit, as many do, seems too expensive and also makes the health-care system less efficient.</p> <p>That’s because primary care is <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/primary-health-care">often considered</a> high-value and preventive care. So if people can’t afford to go to the GP, it can lead to more expensive hospital and emergency room costs down the track.</p> <p>So we need to strike a balance to make primary care more affordable <em>and</em> sustainable.</p> <h2>How do we strike a balance?</h2> <p>One, concession card holders and children should get free primary care regardless of where they live. This would allow more equitable care to populations who need health care the most. Bulk bulling children is a <a href="https://www.sciencedirect.com/science/article/abs/pii/S016726812200292X#:%7E:text=Beside%20the%20benefits%20for%20the,and%20Kuh%2C%202002%3B%20Centers%20for">long-term investment</a>, which may delay onset of diseases, and prevent intergenerational poverty and poor health.</p> <p>Two, the government could also provide free primary care to all people in rural and remote areas. It can do this by lowering the triple bonus to match what GPs currently charge. Over time, GPs and the government can evaluate and <a href="https://www.auspublaw.org/blog/2023/4/the-civil-conscription-sub-clause-in-section-51xxiiia-of-the-australian-constitution-no-impediment-to-reform-of-medicare">negotiate</a> fair prices for GPs to charge. This can be adjusted in line with inflation and other measures.</p> <p>Three, the government can increase Medicare rebates (the amount Medicare pays a doctor for a GP visit) so patients not covered above only pay about $20-30 a visit. We consider this an affordable amount that will not result in more use of primary care than necessary.</p> <p>Four, the government can design a policy to reduce unnecessary GP visits that take away limited GP time from high-need patients. For example, patients currently need to see GPs to get <a href="https://theconversation.com/specialist-referral-rules-havent-changed-much-since-the-70s-but-australias-health-needs-sure-have-144506">referral letters</a> although they already have an established specialist for their ongoing chronic conditions.</p> <p>Five, the government can provide GPs funding needed to improve patient outcomes and reward GPs who provide <a href="https://bmjopenquality.bmj.com/content/10/1/e001127.abstract">high-quality preventive care</a>. The current fee-for-service funding model hurts good doctors who keep their patients healthy because doctors are not paid if their patients do not come back.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230204/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/yuting-zhang-1144393"><em>Yuting Zhang</em></a><em>, Professor of Health Economics, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/karinna-saxby-1045932">Karinna Saxby</a>, Research Fellow, Melbourne Institute of Applied Economic and Social Research, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australia-can-afford-to-bulk-bill-all-gp-visits-so-why-dont-we-230204">original article</a>.</em></p> </div>

Money & Banking

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Shannon Noll postpones show due to medical emergency

<p>Shannon Noll has been forced to postpone two of his upcoming shows in Victoria due to a medical emergency.</p> <p>The former <em>Australian Idol </em>winner, 48, took to Instagram to announce that he had to undergo an "emergency procedure" although the exact details of the procedure was kept under wraps.</p> <p>"Hi guys, due to unforeseen circumstances I'm afraid I have to postpone this weekend's shows at Thornbury Theatre and West Gippsland Arts Centre," he began on the post shared on Friday. </p> <p>"I'm so sorry to do this but I had to undergo an emergency procedure yesterday that now prevents me from travelling for the next few days.</p> <p>"Huge apologies again everyone but I look forward to seeing you all at the rescheduled shows soon!" he concluded. </p> <p>Fans took to the comments to wish the star a speedy recovery. </p> <p>"Health comes first, wishing you a speedy recovery," one wrote. </p> <p>"Hope you are back to good health quickly Shannon. All the very best," another added. </p> <p>"Health is the absolute priority - we hope that you’re back fit and fighting very soon!" a third commented. </p> <p>"Get well soon Shannon! Take the time you need to recover," added a fourth. </p> <p>It has been 20 years since the singer rose to fame after becoming a runner-up on the first season of <em>Australian Idol</em>. </p> <p>"To still be a professional musician travelling the country and playing music 20 years later after a singing competition, I'm so thankful and blessed," he told <em>9Honey</em>. </p> <p>"And it's all because of the support the Australian public has given me over the years, during the ups and downs as well."</p> <p>"It's all because of the public. I'm thankful to them and will be forever," he added. </p> <p><em>Image: Getty</em></p>

Caring

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Cancer survivor slapped with $15,000 water bill

<p>An Aussie man has been slapped with a $15,645.86 water bill after the <span style="font-family: Inter, sans-serif; font-size: 16px; letter-spacing: -0.16px; background-color: #ffffff;">Goulburn Mulwaree Council </span>claimed he had used more than 35,000 litres a day over 104 days. </p> <p>Anthony, who lives on his own in the Southern Tablelands, said that his bill is normally around $290 and that he uses about 130 litres of water a day, the average amount a person would use according to Sydney Water. </p> <p>"A 15-and-a-half thousand dollar water bill, they can go and get themselves nicked," he told <em>A Current Affair</em>. </p> <p>"I'm not paying it, no way in the world."</p> <p>The local mechanic is a cancer survivor, but the disease has made it difficult for him to communicate, so he went to a council meeting with his father, Neil, who talked on his behalf. </p> <p>"I couldn't believe it when he showed me the bill," Neil said. </p> <p>"Currently now, we're at this point in stage where we can't get any reasonable common sense from the council.</p> <p>"I said, 'It's got to be the crook meter', and she said, 'We've had a lot of meters tested and they've all come back positive. </p> <p>"And I said, 'What about this meter?' and she said, 'It'll cost you $50 to have it tested but there'll be nothing wrong with it'."</p> <p>Anthony is accused of using more than 3.6million litres of water,  which is equivalent to filling two Olympic sized swimming pools - or having five taps running all-day. </p> <p>He has received multiple emails from the local council asking him to prove his claim. </p> <p>The local mechanic also said that he received an overdue bill notice ordering him to pay it immediately. </p> <p>"I got an email saying I can have a payment plan and all the rest of it... like, get real," he said. </p> <p>"I'm not going to pay it."</p> <p>Anthony uses his own water tank to water his lawn, fill his fishpond and wash his car, and only uses town waters to wash up and shower. </p> <p>He has been asked to prepare a detailed letter of his water usage, which will be presented at a council meeting later this month.</p> <p><em>Image: Nine</em></p> <p> </p>

Money & Banking

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Kochie reveals the simple way to halve your grocery bill

<p>David Koch has revealed the simple trick to help you save big bucks at the supermarket as the cost of living crisis continues to hit hard. </p> <p>Kochie, who is the Compare the Market's economic director, calculated that Aussies can save up to $100 per trip to the grocery shop by making the switch to home brands. </p> <p>According to research of major Australian supermarkets, the average household can save big bucks by choosing not to buy well-known brands, which can lead to a saving of $5,000 per year. </p> <p>"So, when you're doing your supermarket shop, what's in a brand name? Well, let me tell you - plenty," Kochie said in a video posted to the Compare the Market Instagram account. </p> <p>"You are paying plenty more for that loyalty to a brand that you love."</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C57UwVrvSZ5/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C57UwVrvSZ5/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Compare the Market AU (@comparethemarket_aus)</a></p> </div> </blockquote> <p>Compare the Market took to a major supermarket and bought 25 items from big name brands, and another 25 similar items from a challenger supermarket selling cheaper home brands.</p> <p>Based on substituting big-brand products for lesser-known labels, grocery bills would fall from $201.19 a week to $103.51, taking the weekly saving up to $97.68.</p> <p>"Now, multiply that weekly shop over a whole year and that's a saving of over $5,000."</p> <p>"Almost three return economy airfares to London."</p> <p>Everyday Aussies are continuing to struggle with the rising cost of groceries, with the price of bread and cereal increasing by 7.3 per cent in the year to March, an official monthly measure of inflation showed. </p> <p><em>Image credits: Instagram </em></p>

Money & Banking

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"There's no way": Man receives $52 billion tax bill

<p>An American man has been left confused after receiving a letter from the government claiming he owed $52 billion in unpaid taxes. </p> <p>Barry Tangert got two letters in the mail from the state of Pennsylvania, opening the first to find a refund check from the federal government for over $900.</p> <p>His joy was short-lived though as he opened the second letter to find the income billing notice from the Pennsylvania Department of Revenue claiming that he owed a jaw-dropping $52,950,744,735.28 ($34,576,826,561.47 AUD).</p> <p>“I knew it was an obvious blunder. I don’t even make over $100,000 a year, so there’s no way I could owe anywhere near that,” Barry Tangert told local outlet <em>News 8</em>.</p> <p>The total sum was so large it didn’t even fit on a single line on the document.</p> <p>Tangert immediately knew it was a mistake, with the astonishing number being more than triple the $11 billion America’s richest man Elon Musk says he owed the government in 2022.</p> <p>How the error made it all the way to his doorstep is still a mystery to Tangert.</p> <p>“I don’t know if it was a computer glitch in the transmission or if it was an input error from my tax preparer,” Tangert said, noting that his tax preparer filed an amendment after noticing an error on his 2022 return.</p> <p>He reached out to the Pennsylvania Department of Revenue’s customer service line, which also provided little help to the baffled man.</p> <p>“The first thing he said was, ‘You had a good year.’ And I said, ‘I wish,’” Tangert said.</p> <p>Fortunately, the state department has since resolved the issue, which it chalked up to wrong numbers simply being put into the system.</p> <p><em>Image credits: WGAL News 8</em></p> <p> </p>

Money & Banking

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Tourist slapped with $225k bill after simple mistake

<p>An American tourist has revealed the moment he was charged with a $US143k (AU$225k) bill after a short holiday to Switzerland. </p> <p>Rene Remund and his wife Linda went on the trip last September.</p> <p>Prior to their travels, Remund made sure to inform his mobile phone provider, T-Mobile, that he was going overseas and as a customer of 30 years, he was told he was “covered”.</p> <p>So, with no worries at all, the tourist shared photos of his moments in the Swiss countryside with friends and family via photo messages. </p> <p>Imagine his surprise when he came home to a six-figure bill, after he racked up thousands and thousands of dollars in daily roaming costs. </p> <p>“I get this T-Mobile bill and it doesn’t bother me very much because I was reading $143,” he explained, adding it wasn’t until he went to pay the bill that he realised a few more zeros were involved.</p> <p>“I look at the bill and I say, ‘excuse me’,” he said.</p> <p>“$143,000 … are you guys crazy?”</p> <p>According to the bill, Remund had racked up 9.5 gigabytes of data while in Europe, which cost him thousands of dollars each day. While it wasn't a huge amount of data, not being covered by roaming fees will cause a user to run up a huge bill very quickly. </p> <p>“I called [T-Mobile] and the girl put me on hold for a while,” he explained.</p> <p>“She said let me check this out and I’ll get back to you. She gets back and says, yeah this is a good bill.</p> <p>“I said, ‘what do you mean it’s a good bill?’ And she says ‘well, this is what you owe’.</p> <p>“I said ‘you’re kidding me … you’re crazy’.”</p> <p>After confirming that his bill was in fact  AU$225,000, Remund hired a lawyer to argue the fact that he was covered for international roaming. </p> <p>His lawyer issued a letter to the president of T-Mobile, and they only received a reply a few days ago. </p> <p>The letter from T-Mobile allegedly said that the service provider was “sorry” for the charges, and that Remund would receive a “credit” to eliminate the entire bill. </p> <p>In an email shared to local media <em>Scripps News Tampa</em>, the mobile phone provider said that customers should always “check the travel features of their plan, such as international data roaming, before departing”.</p> <p>“If a customer is on an older plan that doesn’t include international roaming for data and calling, they’ll need to make sure they’re using aeroplane mode and wi-fi when using data to be certain the device doesn’t connect to an international network.”</p> <p><em style="box-sizing: inherit; margin: 0px; padding: 0px; border: 0px; font-size: 16px; vertical-align: baseline; color: #323338; font-family: Figtree, Roboto, 'Noto Sans Hebrew', 'Noto Kufi Arabic', 'Noto Sans JP', sans-serif; background-color: #ffffff; outline: none !important;">Images: ABC Action News</em></p> <p> </p>

Travel Trouble

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Asking ChatGPT a health-related question? Better keep it simple

<p>It’s tempting to <a href="https://cosmosmagazine.com/news/chatgpt-and-dr-google/">turn to search engines</a> to seek out health information, but with the rise of large language models, like ChatGPT, people are becoming more and more likely to depend on AI for answers too.</p> <div class="copy"> <p>Concerningly, an Australian study has now found that the more evidence given to <a href="https://cosmosmagazine.com/technology/chatgpt-an-intimate-companion/">ChatGPT</a> when asked a health-related question, the less reliable it becomes.</p> <p>Large language models (LLM) and artificial intelligence use in health care is still developing, creating a  a critical gap when providing incorrect answers can have serious consequences for people’s health.</p> <p>To address this, scientists from Australia’s national science agency, CSIRO, and the University of Queensland (UQ) explored a hypothetical scenario: an average person asking ChatGPT if ‘X’ treatment has a positive effect on condition ‘Y’.</p> <p>They presented ChatGPT with 100 questions sourced from the <a href="https://trec-health-misinfo.github.io/" target="_blank" rel="noopener">TREC Health Misinformation track</a> – ranging from ‘Can zinc help treat the common cold?’ to ‘Will drinking vinegar dissolve a stuck fish bone?’</p> <p>Because queries to search engines are typically shorter, while prompts to a LLM can be far longer, they posed the questions in 2 different formats: the first as a simple question and the second as a question biased with supporting or contrary evidence.</p> <p>By comparing ChatGPT’s response to the known correct response based on existing medical knowledge, they found that ChatGPT was 80% accurate at giving accurate answers in a question-only format. However, when given an evidence-biased prompt, this accuracy reduced to 63%, which was reduced again to 28% when an “unsure” answer was allowed. </p> <p>“We’re not sure why this happens,” says CSIRO Principal Research Scientist and Associate Professor at UQ, Dr Bevan Koopman, who is co-author of the paper.</p> <p>“But given this occurs whether the evidence given is correct or not, perhaps the evidence adds too much noise, thus lowering accuracy.”</p> <p>Study co-author Guido Zuccon, Director of AI for the Queensland Digital Health Centre at UQ says that major search engines are now integrating LLMs and search technologies in a process called Retrieval Augmented Generation.</p> <p>“We demonstrate that the interaction between the LLM and the search component is still poorly understood, resulting in the generation of inaccurate health information,” says Zuccon.</p> <p>Given the widespread popularity of using LLMs online for answers on people’s health, Koopman adds, we need continued research to inform the public about risks and to help them optimise the accuracy of their answers.</p> <p>“While LLMs have the potential to greatly improve the way people access information, we need more research to understand where they are effective and where they are not.”</p> <p><em>Image credits: Getty Images</em></p> <div> <p align="center"><noscript data-spai="1"><em><img decoding="async" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/12/MICROSCOPIC-TO-TELESCOPIC__Embed-graphic-720x360-1.jpg" data-spai-egr="1" width="600" alt="Buy cosmos print magazine" title="asking chatgpt a health-related question? better keep it simple 2"></em></noscript></p> </div> <p><em><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=301406&amp;title=Asking+ChatGPT+a+health-related+question%3F+Better+keep+it+simple" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em><em><a href="https://cosmosmagazine.com/technology/ai/asking-chatgpt-a-health-related-question-better-keep-it-simple/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto/">Imma Perfetto</a>. </em></div>

Caring

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Embracing healing: The rise of medical cannabis in Australia

<p>In recent years, Australia has made significant strides in healthcare, particularly in the realm of alternative medicine. One such breakthrough gaining widespread recognition is the availability and utilisation of medical cannabis. <a href="https://www.oversixty.com.au/health/body/how-nurses-are-changing-the-conversation-around-medicinal-cannabis" target="_blank" rel="noopener">As attitudes shift and research unfolds</a>, the once-stigmatised plant is emerging as a source of genuine hope and relief for patients across the country.</p> <p>Medical cannabis, derived from the cannabis plant, contains compounds known as cannabinoids, notably THC (tetrahydrocannabinol) and CBD (cannabidiol), which possess therapeutic properties. While recreational use remains a contentious issue, the medicinal potential of cannabis cannot be overlooked.</p> <p>In Australia, its legal status has evolved; in October 2016 the Australian Government changed the law to allow organisations to grow cannabis for research and to make pharmaceutical products, allowing patients to access cannabis-based products under specific conditions.</p> <p>One of the most significant benefits of medical cannabis is its ability to alleviate symptoms and improve the quality of life for patients suffering from various medical conditions. From chronic pain and epilepsy to nausea induced by chemotherapy, medical cannabis offers relief where traditional treatments can fall short or have significant long-term side effects. For people with debilitating illnesses, this alternative therapy can open doors to a life with reduced discomfort and enhanced well-being.</p> <p>Moreover, the availability of medical cannabis fosters a more patient-centric approach to healthcare. By recognising the diverse needs of individuals and offering alternative treatment options, healthcare professionals empower patients to take control of their health journey. This shift towards personalised medicine acknowledges that what works for one person may not work for another, and cannabis-based treatments provide another tool in the arsenal of healthcare interventions.</p> <p>Australia's embrace of medical cannabis also extends to research and innovation. With an increasing number of clinical trials and studies exploring its efficacy and safety, the medical community is uncovering new insights into the potential applications of cannabis-based therapies. This commitment to scientific inquiry ensures that medical cannabis is integrated into healthcare practices responsibly and ethically.</p> <p>Furthermore, the legalisation of medical cannabis opens doors for economic growth and innovation. Australia's burgeoning cannabis industry has the potential to create jobs, stimulate investment and drive technological advancements in cultivation, processing and distribution. By capitalising on this emerging market, Australia can position itself as a global leader in medical cannabis research and production.</p> <p>Take the example of <a href="https://www.montu.com.au/" target="_blank" rel="noopener">Montu</a>, a Melbourne-based medical cannabis company that in November was <a href="https://www.montu.com.au/_files/ugd/0ee6ca_f78badef1cf64ccba22263ed6b5ea5d0.pdf" target="_blank" rel="noopener">named the fastest-growing tech company</a> in the entire country for the second consecutive year. The groundswell of public and investor support for such a company – whose stated mission is to deploy technology to create a better medical cannabis ecosystem for suppliers, practitioners, pharmacies and the patients they serve – is testament to the rapidly growing popularity of medical cannabis as a viable everyday resource for health and wellbeing. </p> <p>Companies like Montu that are streamlining and regulating access to medical cannabis via a growing network of medical practitioners are playing a vital role in getting help for those who need it most. Even though Montu was only formed in 2019, with its first products entering the market in 2020, the evolution of its company ecosystem has been dramatic to say the least. Now with a diverse range of companies under its umbrella, Montu is using innovative solutions to enhance the patient experience – from their "Leafio" dispensing system bridging the gap between suppliers and pharmacies, to their growing variety of products and brands, to their "Alternaleaf" telehealth service that connects patients with expert clinicians, and their high-end "Saged" professional online learning portal for healthcare professionals, this integrated approach is shaping a future where medical cannabis is accessible, efficient and tailored to meet the diverse needs of patients and healthcare providers alike.</p> <p>Perhaps most importantly of all, the availability of medical cannabis promotes harm reduction by offering a safer alternative to potentially addictive pharmaceutical drugs. For patients struggling with opioid dependence or other addictive substances, cannabis-based treatments provide a non-addictive option for managing symptoms, reducing the risk of substance abuse and overdose.</p> <p>The legalisation of medical cannabis in Australia marked a pivotal moment in the nation's healthcare landscape. With growing recognition of the therapeutic potential of cannabis-derived treatments, Australia has taken decisive steps to ensure that patients in need have access to this alternative therapy.</p> <p>Through rigorous regulation and oversight, the legal framework surrounding medical cannabis balances patient safety with the need for compassionate care, allowing individuals suffering from debilitating conditions to explore new avenues of treatment.</p> <p>This landmark decision not only reflected a shift in societal attitudes towards cannabis but also underscored Australia's commitment to evidence-based medicine and the well-being of its citizens.</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">As attitudes towards cannabis evolve and its medicinal benefits become more widely recognised, Australia stands at the forefront of a healthcare revolution – one of </span>hope, healing and a future where patients can experience relief and improved quality of life.</p> <p><em>Image: Getty</em></p>

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Attempts to access Kate Middleton’s medical records are no surprise. Such breaches are all too common

<p><a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, <em><a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p>The <a href="https://www.abc.net.au/news/2024-03-20/claim-hospital-staff-tried-to-access-kate-middleton-health-info/103608066">alleged</a> data breach involving Catherine, Princess of Wales tells us something about health privacy. If hospital staff can apparently access a future queen’s medical records without authorisation, it can happen to you.</p> <p>Indeed it may have already happened to you, given many breaches of health data go under the radar.</p> <p>Here’s why breaches of health data keep on happening.</p> <h2>What did we learn this week?</h2> <p>Details of the alleged data breaches, by <a href="https://www.mirror.co.uk/news/royals/breaking-kate-middleton-three-london-32401247">up to three staff</a> at The London Clinic, emerged in the UK media this week. These breaches are alleged to have occurred after the princess had abdominal surgery at the private hospital earlier this year.</p> <p>The UK Information Commissioner’s Office <a href="https://ico.org.uk/about-the-ico/media-centre/news-and-blogs/2024/03/ico-statement-in-response-to-reports-of-data-breach-at-the-london-clinic/">is investigating</a>. Its report should provide some clarity about what medical data was improperly accessed, in what form and by whom. But it is unlikely to identify whether this data was given to a third party, such as a media organisation.</p> <h2>Health data isn’t always as secure as we’d hope</h2> <p>Medical records are inherently sensitive, providing insights about individuals and often about biological relatives.</p> <p>In an ideal world, only the “right people” would have access to these records. These are people who “need to know” that information and are aware of the responsibility of accessing it.</p> <p>Best practice digital health systems typically try to restrict overall access to databases through hack-resistant firewalls. They also try to limit access to specific types of data through grades of access.</p> <p>This means a hospital accountant, nurse or cleaner does not get to see everything. Such systems also incorporate blocks or alarms where there is potential abuse, such as unauthorised copying.</p> <p>But in practice each health records ecosystem – in GP and specialist suites, pathology labs, research labs, hospitals – is less robust, often with fewer safeguards and weaker supervision.</p> <h2>This has happened before</h2> <p>Large health-care providers and insurers, including major hospitals or chains of hospitals, have a <a href="https://www.theguardian.com/australia-news/2023/dec/22/st-vincents-health-australia-hack-cyberattack-data-stolen-hospital-aged-care-what-to-do">worrying</a> <a href="https://www.afr.com/technology/medical-information-leaked-in-nsw-health-hack-20210608-p57z7k">history</a> of <a href="https://www.innovationaus.com/oaic-takes-pathology-company-to-court-over-data-breach/">digital breaches</a>.</p> <p>Those breaches include hackers accessing the records of millions of people. The <a href="https://www.theguardian.com/world/2022/nov/11/medical-data-hacked-from-10m-australians-begins-to-appear-on-dark-web">Medibank</a> data breach involved more than ten million people. The <a href="https://www.hipaajournal.com/healthcare-data-breach-statistics/">Anthem</a> data breach in the United States involved more than 78 million people.</p> <p>Hospitals and clinics have also had breaches specific to a particular individual. Many of those breaches involved unauthorised sighting (and often copying) of hardcopy or digital files, for example by nurses, clinicians and administrative staff.</p> <p>For instance, this has happened to public figures such as <a href="https://www.latimes.com/archives/la-xpm-2008-mar-15-me-britney15-story.html">singer</a> <a href="https://journals.lww.com/healthcaremanagerjournal/abstract/2009/01000/health_information_privacy__why_trust_matters.11.aspx">Britney Spears</a>, actor <a href="https://www.nytimes.com/2007/10/10/nyregion/10clooney.html">George Clooney</a> and former United Kingdom prime minister <a href="https://www.theguardian.com/uk-news/2024/mar/20/when-fame-and-medical-privacy-clash-kate-and-other-crises-of-confidentiality">Gordon Brown</a>.</p> <p>Indeed, the Princess of Wales has had her medical privacy breached before, in 2012, while in hospital pregnant with her first child. This was no high-tech hacking of health data.</p> <p>Hoax callers from an Australian radio station <a href="https://theconversation.com/did-2day-fm-break-the-law-and-does-it-matter-11250">tricked</a> hospital staff into divulging details over the phone of the then Duchess of Cambridge’s health care.</p> <h2>Tip of the iceberg</h2> <p>Some unauthorised access to medical information goes undetected or is indeed undetectable unless there is an employment dispute or media involvement. Some is identified by colleagues.</p> <p>Records about your health <em>might</em> have been improperly sighted by someone in the health system. But you are rarely in a position to evaluate the data management of a clinic, hospital, health department or pathology lab.</p> <p>So we have to trust people do the right thing.</p> <h2>How could we improve things?</h2> <p>Health professions have long emphasised the need to protect these records. For instance, medical ethics bodies <a href="https://www.bmj.com/content/350/bmj.h2255">condemn</a> medical students who <a href="https://www.abc.net.au/news/2014-04-14/picture-sharing-app-for-doctors-raises-privacy-concerns/5389226">share</a> intimate or otherwise inappropriate images of patients.</p> <p>Different countries have various approaches to protecting who has access to medical records and under what circumstances.</p> <p>In Australia, for instance, we have a mix of complex and inconsistent laws that vary across jurisdictions, some covering privacy in general, others specific to health data. There isn’t one comprehensive law and set of standards <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">vigorously administered</a> by one well-resourced watchdog.</p> <p>In Australia, it’s mandatory to report <a href="https://www.oaic.gov.au/privacy/notifiable-data-breaches">data breaches</a>, including breaches of health data. This reporting system is currently <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">being updated</a>. But this won’t necessarily prevent data breaches.</p> <p>Instead, we need to incentivise Australian organisations to improve how they handle sensitive health data.</p> <p>The best policy <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1475-4932.12693">nudges</a> involve increasing penalties for breaches. This is so organisations act as responsible custodians rather than negligent owners of health data.</p> <p>We also need to step-up enforcement of data breaches and make it easier for victims to sue for breaches of privacy – princesses and tradies alike.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226303/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, Associate Professor, School of Law, <em><a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/attempts-to-access-kate-middletons-medical-records-are-no-surprise-such-breaches-are-all-too-common-226303">original article</a>.</em></p> <p><em>Images: Getty</em></p>

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Millions of Aussies set for power bill relief

<p>Millions of Aussies are set for some financial relief, with electricity costs set to drop by up to 7 per cent in the coming months. </p> <p>The Australian Energy Regulator (AER) and Victoria's Essential Services Commission (ESC) both released their draft default market offers - the maximum energy retailers are allowed to charge customers - for the 2024-25 financial year. </p> <p>Under the AER draft, residents in Sydney, Newcastle and the Hunter on the default offer will pay between 3 and 3.4 per cent less for electricity starting from July 1. </p> <p>The biggest drop is set for Victoria, with the ESC proposing a 6.4 per cent decrease. </p> <p>Those in Western Sydney, the Illawarra, and South Coast, will see their electricity bills decrease by 1.9 to 7.1 per cent. </p> <p>South Australians will receive a drop between 0.5 and 2.5 per cent. </p> <p>A number of small business customers will also benefit from lower power bill costs with 9.7 per cent for Sydney, Newcastle and the Hunter; 4.4 per cent for Western Sydney and the South Coast; 0.3 per cent for South-East Queensland; 8.2 per cent for South Australia; and 7 per cent for Victoria.</p> <p>Energy Minister Chris Bowen welcomed the news of lower power bill costs, but acknowledged that it will continue to play a part in the cost of living challenges faced by many Australians. </p> <p>"This is encouraging news," he said.</p> <p>"Encouraging for those small businesses and families who will receive lower energy bills as a result.</p> <p>"But nobody should suggest that there aren't real cost of living pressures around the world and in Australia, and energy prices are of course part of that and will continue to be."</p> <p>Not everyone will see a drop, with customers in the rest of regional NSW to get a small increase of 0.9 per cent, while the default offer for South East Queensland will increase by up to 2.7 per cent.</p> <p>While not all households are on the default offer, Bowen said that the AER's decision will also affect those not on the offer. </p> <p>"This either impacts directly or indirectly your energy bill," he said.</p> <p>"Directly for those on the default market offer. For those who aren't on the direct market offer, indirectly - the energy companies have to benchmark themselves against this, tell their consumers how they compare to this, and it provides very real pressure on them to match it.</p> <p>"If they don't, consumers will know about it and will make choices accordingly.</p> <p>"It's partly about those on the default market offer, but it actually impacts on all our bills indirectly."</p> <p>AER chair Clare Savage said that the cost of living crisis was the main contributor for their draft decision. </p> <p>"We know that economic conditions have put pressure on many Australians and the increases in electricity prices over the last two years has made energy less affordable for many households," she said. </p> <p>"In light of this, the AER has, in this decision, placed increased weight on protecting consumers." </p> <p>The draft decision is not final, with both the AER and ESC to receive consultation and feedback from stakeholders before confirming their default market offers in May.</p> <p><em>Image: Getty</em></p>

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