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

When taking a trip, many people often have to factor in how their changing schedule will affect their regular medication routines. We asked our readers for their best advice on managing medications while travelling, and the response was overwhelming. Here's what they said. Kristeen Bon - 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. Diane Green - 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. Irene Varis - Always get a letter from my doctor, with all my prescriptions for when I get overseas. Saves you a lot of trouble! Helen Lunn - 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. Jancye Winter - Always pack in your carry on with prescriptions. Jenny Gordon - 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. Nina Thomas Rogers - Be organised with all your medicines before you leave. Image credits: Shutterstock

Travel Tips

Medicare is covering less of specialist visits. But why are doctors’ fees so high in the first place?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/susan-j-mendez-2219444">Susan J. Méndez</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Fees for medical specialists are going up faster than <a href="https://www.abc.net.au/news/2024-09-25/medicare-rebates-only-covering-half-of-specialist-costs/104389360">Medicare rebates</a>, leading to a bigger gap for patients to pay. Recent data from the <a href="https://www.aihw.gov.au/reports/medicare/mbs-funded-services-data/contents/summary">Australian Institute of Health and Welfare</a> shows that in the first quarter of this year, Medicare rebates covered just over half (52%) of the total fees. This is <a href="https://www.abc.net.au/news/2024-09-25/medicare-rebates-only-covering-half-of-specialist-costs/104389360">down from 72%</a> two decades ago, and the lowest proportion on record. Doctors can charge what they like, while the government determines the Medicare rebate. The difference between the two, or the gap, is what impacts patients. For GPs, the government provides an incentive for doctors to <a href="https://www.health.gov.au/our-work/increases-to-bulk-billing-incentive-payments#1-november-2023-changes">bulk bill</a>, but there’s no such incentive for other specialists. Doctors blame large gap payments on rebates being too low, and they’re partly right. After adjusting for inflation and increasing demand, the average dollar amount one person receives in Medicare rebates annually dropped from <a href="https://www.aihw.gov.au/reports/medical-specialists/referred-medical-specialist-attendances">A$349 to $341</a> over the past decade. But this is only a part of the problem. When many people can’t afford hundreds (if not thousands) of dollars for essential specialist care, we need to look at why fees are so high. <h2>How do specialists set their fees?</h2> Although general practice is technically a speciality, when we talk about medical specialists in this article, we’re talking about non-GP specialists. These might include paediatricians, oncologists, psychiatrists and dermatologists, among many others. In determining fees, specialists consider a combination of patient-level, doctor-level and system-level factors. Patient characteristics, such as the complexity of the patient’s medical condition, may increase the price. This is because more complex patients may require more time and resources. Specialists, based on their experience, perceived skill level, or ethical considerations, may charge more or less. For example, <a href="https://www.sciencedirect.com/science/article/pii/S0277953623007104?via%3Dihub">some specialists report</a> they offer discounts to certain groups, such as children or pensioners. System-level factors including the cost of running a practice (such as employing staff) and practice location also play a role. Problems arise when prices vary considerably, as this often signals limited competition or excessive market power. This holds true for medical services, where patients have little control over prices and rely heavily on their doctors’ recommendations. In <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4909881">recent research</a>, my colleagues and I found fees varied significantly between specialists in the same field. In some cases the most expensive specialist charged more than double what the cheapest one did. <h2>Doctor characteristics influence fee-setting</h2> My colleagues and I <a href="https://doi.org/10.1016/j.healthpol.2024.105119">recently analysed</a> millions of private hospital claims from 2012 to 2019 in Australia. We found the wide variation in fees was largely due to differences between individual doctors, rather than factors such as patient complexity or the differences we’d expect to see between specialties. Up to 65% of the variance in total fees and 72% in out-of-pocket payments could be attributed to differences between doctors in the same field. To understand what doctor-level factors drive high fees, <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4909881">we looked at</a> data from a representative survey of specialists. We found older specialists have lower fees and higher rates of bulk billing. Practice owners tended to charge higher fees. We also found doctors’ personalities affect how much they charge and how often they bulk bill patients. Doctors who scored more highly on the personality trait of agreeableness were more likely to bulk bill patients, while those who scored more highly on neuroticism tended to charge higher fees. What we couldn’t show is any evidence fees were associated with competition. <h2>Effects on patients</h2> This is not a competitive market. On the contrary, it has high entry restrictions (long training requirements) and a limited supply of specialists, particularly in <a href="https://www.aihw.gov.au/reports/workforce/health-workforce">rural and remote areas</a>. Meanwhile, patients’ access is controlled by the need for referrals which expire, generally after a year. Patients are often unable to shop around or make informed decisions about their care due to a lack of information about the true cost and quality of services. For private hospital services, the fee structure is complicated by the fact that several providers (for example, surgeon, anaesthetist, assistant surgeon) bill separately, making it difficult for patients to know the total cost upfront. Despite efforts to introduce price transparency in recent years, such as through the government’s <a href="https://medicalcostsfinder.health.gov.au/">Medical Costs Finder</a> website, the system remains far from clear. Reporting is voluntary and the <a href="https://doi.org/10.1016/j.healthpol.2020.06.001">evidence is mixed</a> on whether these tools effectively reduce prices or increase competition. All of this contributes to high and unpredictable out-of-pocket costs, which can lead to financial strain for patients. About <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release#barriers-to-health-service-use">10.5% of Australians</a> reported cost was a reason for delaying or avoiding a specialist visit in 2022–23. This raises important questions about equity and the sustainability of Australia’s universal health-care system, which is built on the principle of equitable access to care for all citizens. <h2>What can be done?</h2> Patients can take steps to minimise their costs by proactively seeking information. This includes asking your GP for a range of options when you’re referred to a specialist. Note the referral from your GP can be used for any other doctor in the same specialty. Similarly, ask the specialist’s receptionist what the fee and rebate will be before making an appointment, or for a <a href="https://www.ama.com.au/articles/informed-financial-consent#Two">detailed quote</a> before going to hospital. Shop around if it’s too high. But responsibility doesn’t only lie with patients. For example, the government could seek to address this issue by increasing investment in public hospital outpatient care, which could boost competition for specialists. It could also publish the range of fees compared to the rebate for all Medicare-billed consultations, rather than relying on voluntary reporting by doctors. Price transparency alone is not enough. Patients also need quality information and better guidance to navigate the health-care system. So continued investment in improving health literacy and care coordination is important. If things don’t change, the financial burden on patients is likely to continue growing, undermining both individual health outcomes and the broader goals of equitable health-care access.<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/239827/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-j-mendez-2219444">Susan J. Méndez</a>, Senior 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> Image credits: Shutterstock 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/medicare-is-covering-less-of-specialist-visits-but-why-are-doctors-fees-so-high-in-the-first-place-239827">original article</a>. </div>

Money & Banking

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> 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. 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%. 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. <h2>What are compassionate grounds?</h2> 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. <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: <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> 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. The treatment cannot be “readily available” through the public system. Cosmetic procedures are excluded. 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. 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. <h2>Why are people using this scheme more?</h2> 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. But the treatments most commonly being accessed using superannuation – fertility treatments, weight loss surgeries and dental care – point to other systemic issues. 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. 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. While early access to super can provide individuals access to critical treatment, there are issues with how compassionate grounds are defined and regulated. <h2>Lack of clarity</h2> 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. For example, the meaning of “mental disturbance” is not defined. 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. 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. 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. 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. <h2>A closed-loop system</h2> Conflict of interest is another major issue. 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. 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. This raises important questions about the independence of the process, as well as professional ethics. 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. 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. <h2>What is needed?</h2> 1. Mandatory financial counselling 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. 2. Tightening of the criteria Greater clarity in the legislation – such as defining “mental disturbance” – would help prevent loopholes being exploited. 3. Better oversight 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. 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.<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" /> <a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, Associate Professor in Law, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock 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>. </div>

Money & Banking

Surcharges are added to most purchases, but what are the rules behind these extra fees?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/steve-worthington-138">Steve Worthington</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> You head to the register at the cafe to pay for your lunch, swipe your card and suddenly realise you’ve been hit with an extra small but unexpected charge. It might be listed on your receipt as a service or merchant fee, but either way it’s because you’ve used a credit or debit card. With the pandemic accelerating the use of cards instead of cash – <a href="https://www.rba.gov.au/publications/bulletin/2023/jun/cash-use-and-attitudes-in-australia.html#:%7E:text=Cash%20payments,-The%20CPS%20suggests&text=In%20value%20terms%2C%20the%20cash,cent%20by%20value%20in%202022.">only 13% of Australians use cash</a>, dropping from 27% in the last five years – these extra charges have become mainstream. However, as was highlighted by National Australia Bank chief executive Andrew Irvine during a <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Joint/Corporations_and_Financial_Services/FinancialAbuse">parliamentary inquiry</a> into bank charges last week, they are often applied, in varying amounts, by businesses for reasons not always in line with their original purpose. Irvine slammed as <a href="https://www.afr.com/companies/financial-services/credit-card-surcharges-should-be-banned-or-regulated-nab-boss-says-20240830-p5k6jm">“outrageous”</a> a 10% surcharge he was forced to pay when he recently bought a cup of coffee at a Sydney cafe. “I don’t like the lack of transparency and lack of consistency,” he said. But most Australians are making these extra payments every day, without question. So how did this end up happening – and what can you do about it? <h2>Card surcharges in Australia</h2> At the start of this century, payments for goods and services were mainly made by cash, paper cheques, credit and debit cards. The first two of these options would eventually be deposited into a bank account by the merchant who ran the business. The latter two would be processed by the bank or financial institution which would charge the business a merchant service fee. For debit cards this might be a fixed fee. But for credit cards it would be proportionate with the value of the goods or services. The Reserve Bank of Australia became concerned the use of credit cards was greater than that of debit cards and <a href="https://www.rba.gov.au/publications/consultations/201106-review-card-surcharging/background.html">introduced surcharging in January 2003</a>. The intention was to lower the cost to the merchant of accepting debit cards and change customer behaviour. This has been achieved, as both the volume and value of paying by debit cards now exceeds the volume and value of paying by credit cards. However, the reality in 2024 is that card surcharges have become commonplace, and in a wide variety of payment situations. <h2>It’s estimated to cost us billions</h2> It is difficult to calculate the total cost of surcharging to Australian consumers since they became legal more than 20 years ago, because the rates charged vary widely. But at last week’s inquiry, Labor MP Jerome Laxale suggested it added up to <a href="https://www.smh.com.au/money/banking/card-surcharges-are-costing-us-billions-but-can-they-be-avoided-20240830-p5k6o8.html">A$4 billion</a> in the last year. Surcharges can be imposed by small to medium enterprises such as your local cafe, doctor’s surgery, your energy supplier, or when you use a card to pay your council rates. As an example, my rates are payable by card, with a surcharge of 1.10% for Mastercard and Visa credit, and 0.55% for eftpos and Mastercard and Visa debit cards. <h2>When surcharges can be applied</h2> Many merchants charge the same rate for all their card payments and some fail to alert customers to the extra fee before accepting the payment at their terminal, which they are required to do. Indeed, even on a receipt for payment, the surcharge can be described by the merchant as a “handling” or “merchant” fee. The Australian Competition and Consumer Commission <a href="https://www.accc.gov.au/consumers/pricing/card-surcharges">(ACCC)</a> regulates surcharging and demands the merchant prove a surcharge is justified. Furthermore, the ACCC says if there is no way for a consumer to pay without paying a surcharge – that is, they can’t pay by cash or cheque – then the business must include the surcharge in <a href="https://www.accc.gov.au/business/pricing/price-displays#toc-display-of-surcharges">the displayed price</a>. <h2>Penalties for misuse</h2> The ACCC can take merchants to court to enforce these regulations and there have been some examples of this in recent history. In July 2021, <a href="https://www.accc.gov.au/media-release/nine-entertainment-pays-penalties-for-alleged-excessive-payment-surcharges#:%7E:text=The%20ACCC%20alleged%20that%20these,Deputy%20Chair%20Mick%20Keogh%20said.">Nine Entertainment paid penalties totalling $159,840</a>, plus $450,000 redressing customers, for charging subscribers and advertisers excessive surcharges. The ACCC specifies that the surcharge must not be more than it costs the merchant to use that payment type. As guidance to the merchants, it also offers <a href="https://www.accc.gov.au/consumers/pricing/card-surcharges">the average costs for different payment types</a>: eftpos less than 0.5%, Mastercard and Visa Debit 0.5%–1% and Mastercard and Visa credit 1%–1.5%. However, despite the ACCC setting guidelines for the amounts that can be charged, many surcharges are above this guidance and in some cases more than 2.0% for all cards. Some merchants do charge different surcharging rates, depending on the cards they accept, be it eftpos, Mastercard or Visa. In theory, the surcharge rate is meant to be determined by the merchant service fee, which is negotiated between the merchant and their bank. Larger merchants, such as the supermarkets, department stores and energy companies, can negotiate low rates (reportedly as low as one cent a transaction). But smaller merchants with less negotiating clout will have higher service fees. The arrival of new payment players, such as <a href="https://www.forbes.com/advisor/business/software/square-vs-stripe/">Square and Stripe</a>, has offered businesses an alternative banker of card payments, which can then use surcharging as part of their merchant service fees. <h2>Surcharging overseas</h2> The <a href="https://europa.eu/youreurope/business/finance-funding/making-receiving-payments/electronic-cash-payments/index_en.htm">European Union</a> already has a long-standing ban on surcharging, while in the United States, surcharging is illegal in some states. Other countries, including the United Kingdom, have tried surcharging on card payments, only to abandon them as it was rorted by some merchants and became an unnecessary expense for consumers. <a href="https://bluenotes.anz.com/posts/2023/07/anz-news-surcharge-steve-worthington-australia#:%7E:text=In%202018%20the%20UK%20Treasury,their%20hard%2Dearned%20money%E2%80%9D.">A statement</a> released by the UK Treasury when it banned the practice in 2018 described surcharges as <blockquote> Hidden charges for paying with a debit or credit card, which will help millions of UK consumers to avoid rip-off fees when spending their hard earned money. </blockquote> <h2>What can you do about it?</h2> Before surcharging was allowed by the Reserve Bank in January 2003, acceptance by merchants of payments was just another cost of doing business. And it seems many consumers have just accepted surcharges as part of their transactions. There are ways to avoid them, the most obvious being to use cash. Using eftpos involves charges, but they are less than those imposed on credit and debit cards. The Reserve Bank is working on implementing a so-called <a href="https://www.rba.gov.au/payments-and-infrastructure/debit-cards/least-cost-routing/#:%7E:text=What%20is%20least%2Dcost%20routing,'merchant%2Dchoice%20routing'.">“least-cost routing”</a> system that defaults to the lowest cost network when processing payments. Unfortunately, this is yet to be widely adopted by businesses.<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/237964/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/steve-worthington-138">Steve Worthington</a>, Adjunct Professor, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Shutterstock 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/surcharges-are-added-to-most-purchases-but-what-are-the-rules-behind-these-extra-fees-237964">original article</a>. </div>

Money & Banking

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

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. 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. 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. 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. 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. “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.” 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. 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. 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. 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. “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.” 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. 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. 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. Image: Courtesy of John Boland.

Caring

Aussie motorist's act of defiance against parking fees

Aussie drivers have been warned against replicating a cheeky way a motorist tried to pay for parking at a cashless parking meter. The motorist wasn't able to pay for his parking charges with a card, so instead they erected a sign in his car with gold coins attached, proving they are good for the parking fees. The driver said the cashless revolution doesn't "suit their lifestyle", but added they are "willing to pay for parking with these coins any day of the week". Despite displaying their method of payment, the North Sydney Council, who recently upgraded all their parking meters to cashless ones, explained to <a href="https://au.finance.yahoo.com/news/major-136-fine-warning-after-fed-up-aussies-3-cashless-act-of-defiance-023528239.html" target="_blank" rel="noopener">Yahoo</a> Finance this method could massively backfire. "The only way to avoid being fined is to comply with the signage restrictions for the space in which you have parked," a Council spokesperson said. "In metered spaces, you must pay using our parking meters. You are likely to receive a fine if you leave a note and do not pay," with parking fines in this council setting you back $136. After the driver's unique payment method garnered attention on social media, many agreed with their sentiment saying there should always be an option for people to pay with cash. "Should always have a cash option," wrote one user, while another said, "How can they expect everyone to be credit card online app savvy anyway and download it while standing in the street? I have so much trouble paying." A third added, "This is a great idea, but the inspectors do not have a sense of humour, they just issue you with a fine." Image credits: Facebook

Legal

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

<div class="theconversation-article-body"> <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> Migraine is many things, but one thing it’s not is “just a headache”. “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. 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. 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. <h2>What’s happening in my brain?</h2> The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply: The earliest phase is called the prodrome. 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. <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&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&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption>The hypothalamus is shown here in red. <a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></figcaption></figure> Next is the aura phase, 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. In the headache phase, 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. Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy. <h2>What can you do about the acute attack?</h2> 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. <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> Aspirin 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. Triptans 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. Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action. 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). As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke. Gepants 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”. 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. They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke. Ditans 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. 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. <h2>What about preventing migraines?</h2> 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. 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. 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: <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone. 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. 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. <hr /> <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> <hr /> <h2>‘Nothing works for me!’</h2> 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. 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. 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. 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. 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. 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.<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" /> <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> Image credits: Shutterstock 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>. </div>

Body

Major banks hand over millions in refunds over unfair fees

Four major Australian banks are set to cough up close to $30 million in refunds to low-income customers after the Federal corporate watchdog revealed a pattern in high fees. A new report from the Australian Securities and Investments Commission revealed ANZ, Commonwealth Bank, Westpac, as well as mid-tier Bendigo and Adelaide Bank kept at least two million low-income customers in high-fee accounts. Many of these low-income earners rely on Centrelink payments, and were unfairly slapped with unreasonably high fees. The report followed an ASIC review which focused on improving financial outcomes for First Nations customers by addressing avoidable bank fees. “We focused in this project on the banks who were most likely to have First Nations consumers on low incomes trapped in high-fee accounts,” ASIC commissioner Alan Kirkland said. ASIC said the four banks have committed to moving more than 200,000 customers into low-fee accounts, saving them about $10.7 million a year, with the financial institutions also committed to refunding over $28m in fees to these customers over the next 12 to 18 months. This includes $24.6 million to Aboriginal and Torres Strait Islander students and apprentices receiving ABSTUDY payments, and customers in areas with significant First Nations populations. “At any time ASIC, and the community, expects that the banks will treat their customers fairly,” Mr Kirkland said. “But that’s particularly important for people on low incomes and for people who are struggling to make ends meet, the last thing they need is to have the very little income that they have being eaten away in unnecessary bank fees.” Mr Kirkland added that the implications of ASIC’s latest review applied to all banks across the country. “We’re expecting all of them to read the report and make improvements to their practices to stop other people being trapped in high-fee accounts that they can’t afford,” Mr Kirkland said. Image credits: Shutterstock

Money & Banking

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a> 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? 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). 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. <h2>Polypharmacy among older adults</h2> 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. Is it a good idea to take so many drugs? 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. 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. <h2>The risks of polypharmacy: 5 points to consider</h2> When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken. <ol> <li> Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments. </li> <li> 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? </li> <li> 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. </li> <li> 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. </li> <li> 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. </li> </ol> 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. 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. <h2>3 tips to avoid the risks associated with polypharmacy</h2> What can we do as a patient, or as a caregiver? <ol> <li> 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 ? </li> <li> 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? </li> <li> 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. </li> </ol> <h2>Benefits should outweigh the risks</h2> 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. 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.<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" /> <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> Image credits: Shutterstock 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>. </div>

Body

Bruce Lehrmann ordered to pay millions to Network Ten

Bruce Lehrmann has been ordered to pay a whopping $2 million to Network Ten to cover the network's legal fees from his failed defamation lawsuit. Lehrmann's suit against the network, and in turn The Project and Lisa Wilkinson, came to a end when Justice Michael Lee found he had, on the balance of probabilities, raped Brittany Higgins at Parliament House in March 2019. The former Liberal staffer's case was dismissed after Justice Lee concluded he was not defamed by Lisa Wilkinson's tell-all interview with Brittany Higgins on The Project in 2021. Following the conclusion of the case, Lehrmann was ordered to pay Network Ten's astonishing legal fees, returning to court on Thursday to discuss the manner in which they will be paid. Ten’s barrister Zoe Graus on Thursday told the court that the broadcaster had sought a $2m lump-sum payment from Mr Lehrmann which Justice Lee ordered that Lehrmann pay, though he noted Mr Lehrmann was a man of “modest means”. As a result, Mr Lehrmann could be forced into bankruptcy if he fails to meet the hefty costs order. The court was told that Network 10 had offered to pay Ms Wilkinson $607,850 for the journalist’s legal costs, given the fact that she had independent representation during the trial. However, an independent referee will determine the final amount to be paid to Wilkinson. Image credits: MICK TSIKAS/EPA-EFE/Shutterstock Editorial

Legal

Aussies hit with "hidden fees" for using common payment method

Millions of Aussies have copped up to $1 billion in "hidden fees" for choosing to use one common payment method. Many are unaware about the secret extra charges that come with using the tap-and-go payment method, as millions of customers use it as the preferred way to pay and go. However, according to financial counsellor Scott Pape, also known as The Barefoot Investor, while tapping your card may be easier, it might not be great for your bank account. “What most people don’t know is that, when they tap, their bank generally defaults that payment through Visa or MasterCard, who pays them a fee — instead of defaulting that payment through the much cheaper bank-owned EFTPOS,” Pape said in his column for the <a href="https://www.dailytelegraph.com.au/business/barefoot-investor/the-common-smartphone-app-thats-ripping-you-off/news-story/0b71afa29c86faf2b938c44f93bbc8d6?amp" target="_blank" rel="noopener" data-link-type="article-inline">Daily Telegraph</a>. While some businesses choose to absorb the cost, others pass it on to the customer as a surcharge, as Pape says, “Talk about a rort.” According to the Royal Bank of Australia (RBA), Visa and Mastercard are generally more expensive for merchants than the EFTPOS network. Payments through EFTPOS are generally about 0.3 per cent of the transaction value, while Debit Mastercard and Visa Debit may cost many some people about 0.5 per cent. Mastercard and Visa credit could cost customers more than 0.75 per cent of the transaction, while American Express card payments are even more, charging merchants 1 to 1.5 per cent. Thankfully, according to Pape, there are ways to avoid paying the extra fees. If your bank card is attached to your smartphone, you can change the default payment setting. “On an iPhone, open ‘Settings’, go to ‘Wallet & Apple Pay’, then tap your debit card,” Pape said. “Then look for ‘Payment Option’. It will generally have ‘MasterCard’ or ‘Visa’ preselected, but instead you should select ‘EFTPOS SAV’.” This is not allowed on all cards, however, and those who use Android will need to check with their bank if a possible solution exists. <div> </div> The other way to avoid paying the surcharges is to just start inserting or swiping your card again. “I know it’s annoying, but if you swipe and insert your card you can choose ‘cheque’ or ‘savings’ and it’ll go through the EFTPOS system, which at the bigger retailers means you’ll be less likely to be charged,” Pape said. Image credits: Shutterstock

Money & Banking

Lisa Wilkinson's hefty legal fees revealed

The eye-watering costs of Lisa Wilkinson's legal battle against Bruce Lehrmann after he unsuccessfully sued her for defamation has been revealed. Lehrmann took Wilkinson and her former employer Network Ten to court following the airing of allegations by Brittany Higgins that she was raped in Parliament House in 2019. The defamation suit was lost by Lehrmann in April after Justice Michael Lee found that Lehrmann had, on the balance of probabilities, assaulted Ms Higgins, therefore cannot be defamed for the allegations. Ms Wilkinson has now returned to court in an attempt to recuperate approximately $1.8 million in legal fees from Network 10 after she decided to be represented separately to her former employer. Documents released by the Federal Court on Thursday reveal the eye-watering cost behind Ms Wilkinson’s defence by high-profile defamation lawyer Sue Chrysanthou SC. The documents detail numerous invoices issued to Ms Wilkinson throughout the years-long legal battle; the most recent being an invoice dated May 9th for $405,328. The fee is listed as being for Ms Sue Chrysanthou‘s counsel; similar fees dating back to mid-2023 ranged in size from $10,340 to $97,988 before GST was added. The largest single invoice issued to Ms Wilkinson was dated February 29th 2024 and amounted to a whopping $576,224.72 after GST, which included news subscriptions and lunches. Early costs agreements sent to Gillis Delaney Lawyers, who Ms Wilkinson had retained to represent her, and Ms Chrysanthou quoted fees of $8,000 per day. A range of other expenditures are included in the documents, including thousands of dollars for printing and folders, USB drives, and subscriptions to The Australian. A referee is expected to be appointed for certain items that the Network claims did not come under legal costs, with Justice Lee foreshadowing a similar process for costs being asked of Mr Lehrmann. In earlier written submissions, Network 10 said it did not have to pick up the bill for Ms Wilkinson’s legal costs which were “unnecessarily duplicative or wasteful”. The referee, called for by Network 10, will be tasked with combing through the legal bills incurred by the former The Project host to decide whether the costs were reasonable, and whether she would be compensated. Image credits: Steven Markham/Speed Media - MICK TSIKAS/EPA-EFE/Shutterstock Editorial

Legal

Cafe targeted online for charging customer a "heating fee"

A cafe in Melbourne has copped a wave of backlash online after allegedly charging a customer to heat up his muffin for breakfast. The disgruntled diner took to Facebook to complain about the extra fee on his $7 muffin at the cafe and claimed the first he knew of it was when he saw it on his receipt. His post went viral with hundreds of people slamming café etiquette and urging him to go to the ACCC. "A f***ing dollar to heat my muffin? It's cr*p like this that just makes you shake your head and question where it is all going," the customer wrote in his original post. The cafe has since hit back at the post, and the angry customer who wrote it, saying the extra charge had been an error despite Heat Standard $1.00 being written on the receipt. They also said the customer could have simply solved the issue in person rather than blasting them online. "We do not nor have we ever charged for any heating of our wonderful baked treats," the café spokesperson told <a href="https://www.dailymail.co.uk/femail/real-life/article-13465591/Melbourne-cafe-targeted-angry-mob-charging-1-heating-fee-muffin-Aussies-reveal-hidden-charges-theyve-hit-amid-cost-living-crisis.html" target="_blank" rel="noopener">Daily Mail Australia</a>. "Unfortunately this has become a mountain of an issue that could have easily been resolved without a lynch mob caused by negligence at the hands of an influential keyboard warrior who ironically sells the idea of spiritual life practices and being grounded yet flipped out over a muffin." The original post racked up more than 870 comments before it was deleted, and more than 1,000 reactions. Some of those who saw it went on to slam the cafe by sending them threatening messages, commenting on posts on Instagram and calling their business phone to hurl abuse. "It's a sad world when a local cafe that aims for nothing more then customer satisfaction and community values to be upheld gets threatening messages from rogue vigilantes about wanting to see us go out of business over a muffin being prepared and served to quality standards," the cafe owners said. The cafe responded to the growing backlash online by announcing their muffins would be free on Tuesday. Image credits: Facebook / Shutterstock

Travel Trouble

Shannon Noll postpones show due to medical emergency

Shannon Noll has been forced to postpone two of his upcoming shows in Victoria due to a medical emergency. The former Australian Idol 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. "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. "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. "Huge apologies again everyone but I look forward to seeing you all at the rescheduled shows soon!" he concluded. Fans took to the comments to wish the star a speedy recovery. "Health comes first, wishing you a speedy recovery," one wrote. "Hope you are back to good health quickly Shannon. All the very best," another added. "Health is the absolute priority - we hope that you’re back fit and fighting very soon!" a third commented. "Get well soon Shannon! Take the time you need to recover," added a fourth. It has been 20 years since the singer rose to fame after becoming a runner-up on the first season of Australian Idol. "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 9Honey. "And it's all because of the support the Australian public has given me over the years, during the ups and downs as well." "It's all because of the public. I'm thankful to them and will be forever," he added. Image: Getty

Caring

"A little bit steep": Jetstar passenger hit with "wild" excess baggage fee

A Jetstar passenger has been slapped with a "wild" excess baggage fee after her luggage was less than just one kilogram overweight. Monique McCreanor was flying from Melbourne to Sydney after competing in a fitness competition when she was hit with the unexpected fees. Travelling with only carry-on luggage, Ms. McCreanor said she made a mad dash to the airport to catch her flight, only to be stopped at the gate due to the weight of her bag. Because of the prizes she won at the competition, her bag was just 900g over the 7kg limit, and she was issued a $75 fine. Ms. McCreanor took to TikTok to share a warning with other travellers to triple check the weight of your bag, as even being over the limit by mere grams will set you back. “This isn’t a complaint, this is merely just warning you guys,” she said in the clip. “If you do fly with Jetstar on a domestic flight, and your bag is even 100g overweight, you’re going to get charged $75 at the gate for that excess luggage." “Now, this kind of sucks, because I’m like damn, I could have had 15kg in this bag to really make it worthwhile." “I got hit with $75, so just make sure are booking the extra checked baggage, it is better to be safe than sorry, because $75 is a little bit steep for just 900g overweight.” While her video quickly garnered thousands of views, many were left divided in the comments about her complaints. One person sided with the airline, saying, “No sorry, it clearly gives a weight allowance. You went over, you pay.” “Seriously it doesn’t matter who you are with, you will have to pay any way, they are the rules,” another added. Others were quick to empathise, sharing their own experience of encountering excess baggage fees. “They did this to me on my honeymoon... I was p****d,” one person said. Image credits: TikTok

Travel Trouble

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

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. <div class="copy"> 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. 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. 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’. 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?’ 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. 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. “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. “But given this occurs whether the evidence given is correct or not, perhaps the evidence adds too much noise, thus lowering accuracy.” 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. “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. 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. “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.” Image credits: Getty Images <div> <noscript data-spai="1"><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"></noscript> </div>  <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&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" /><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>. </div>

Caring

Embracing healing: The rise of medical cannabis in Australia

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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. As attitudes towards cannabis evolve and its medicinal benefits become more widely recognised, Australia stands at the forefront of a healthcare revolution – one of hope, healing and a future where patients can experience relief and improved quality of life. Image: Getty

Caring

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

<a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> 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. Indeed it may have already happened to you, given many breaches of health data go under the radar. Here’s why breaches of health data keep on happening. <h2>What did we learn this week?</h2> 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. 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. <h2>Health data isn’t always as secure as we’d hope</h2> Medical records are inherently sensitive, providing insights about individuals and often about biological relatives. 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. 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. 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. 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. <h2>This has happened before</h2> 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>. 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. 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. 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>. 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. 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. <h2>Tip of the iceberg</h2> 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. Records about your health might 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. So we have to trust people do the right thing. <h2>How could we improve things?</h2> 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. Different countries have various approaches to protecting who has access to medical records and under what circumstances. 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. 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. Instead, we need to incentivise Australian organisations to improve how they handle sensitive health data. 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. 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.<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" /> <a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, Associate Professor, School of Law, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> 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>. Images: Getty

Legal

Restaurant sparks outrage for "ridiculous" fee

As inflation rates continue to rise it is not surprising that restaurants are charging extra fees, but one disgruntled customer was particularly shocked to see this "ridiculous" fee on their bill. The customer, who dined at restaurant and cocktail bar in Georgia, USA shamed the restaurant for charging their customers a $20 fee for “live band entertainment”. They shared their complaints on Reddit with a copy of their receipt and an unexpected fee at the bottom which read: “Two Live Band Entertainment Fee — $20”. Most people in the comments were equally annoyed and called the fee "ridiculous". “This is one of those leave money on the table, hand the waiter a tip and leave, sorry but if I didn’t order it, I’m not paying for it,” one wrote. “Great way to not have repeat customers,” said another. “This will backfire for them, just be honest and upfront," a third added. Other commenters were less sympathetic and did not understand why the customer was complaining when it looked like they could afford it. “When you’re paying seven dollars for a bottle of water, you really don’t get to complain about ‘unexpected costs.’ You knew what you signed up for," one commenter wrote. “Imagine a live band getting paid, huh,” another added. “They’re buying $7 bottles of water, they can probably afford it,” added a third. Image: Getty/ Reddit

Money & Banking

Big W customer gobsmacked over $4000 shipping fee

A Big W customer was only trying to buy an outdoor play set for her kids but got the shock of her life when she saw the "ridiculous" shipping fee that was over three times the cost of the play set. The Singleton mum had added the $1,200 item to her cart while shopping online and was about to check out when she was greeted with a $4,466 shipping fee. "How in God's name can they charge $4,466 for delivery! Big W are slowly losing my vote!" the outraged mum wrote on Facebook, even swearing off the department store for the apparent money grab. According to the Big W website, the play set is sent via Plum Play, a "trusted partner", and not by Big W stores, and because the woman lives in a rural area, she initially believed that was the reason for the extortionate shipping costs. A few other shoppers criticised the high fee. "That is fricken ridiculous!!!! No one would pay that," one said. "Jesus, are you ordering a few pallets of bricks? No way normal merchandise would cost that much to send," another wrote. A few others questioned the weight of the item and where she lived, while others tried to buy the same item and got even higher shipping fees. "It jumped a few grand for a couple of ks for me," one wrote, with the cost of standard delivery for the play set at $7,858. Some reported fees of up to $50,000, but most were $7,000 to $10,000. The department store has addressed the issue and told Yahoo News Australia that an "error on the website" was to blame. They have since corrected the delivery charges which should have been about $100 for the woman's location. "We were made aware of a delivery calculation error on our website which has since been resolved. We apologise for any inconvenience this has caused," a spokesperson told the publication. Image: Getty

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"A little bit steep": Jetstar passenger hit with "wild" excess baggage fee

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

Embracing healing: The rise of medical cannabis in Australia

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

Restaurant sparks outrage for "ridiculous" fee

Big W customer gobsmacked over $4000 shipping fee

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