The 'Dispatched' Week in Review'- 27 February

In this episode, we examine funding uncertainty for genomic profiling through OMICO, structural tensions within the PBS and pharmaceutical supply chain, and broader concerns about how political and financial incentives shape health policy and budget decisions. The episode concludes with an uncomfortable discussion of recent public commentary on hostility against some communities (trigger warning).

Transcript

Paul 0:08

Hello, welcome to the Dispatched Podcast Week in Review. It's Friday the 27th of February. It's almost March. My name is Paul Cross, and I'm delighted to be joined by Mike Kuhus, Felicity McNeil, PSM, Chair of Bitter Access Australia. Hi Felicity. Hi, Paul. How's your week? Pretty good. Pretty good. A couple of AFL season starts next week.

SPEAKER_02 0:30

Next week, yeah. You going? No.

Felicity 0:33

Gonna go and watch Charlie.

Paul 0:34

No, no, because he plays for another team now.

Felicity 0:37

No, but you guys just can't help yourselves.

Paul 0:39

But I have, as you know, I have worked out that my love for Carlton just causes me abject misery.

Felicity 0:48

Yeah, you should try being your friend. You poor thing.

SPEAKER_02 0:53

It's terrible to watch.

Paul 0:55

It's there's just no happiness at all.

Felicity 0:59

I know.

Paul 1:00

I mean It's just abject misery for so many years.

Felicity 1:03

This is the thing. And but you see it in me too, which is you watch someone you care about just suffer. It's suffering. Yes.

Paul 1:12

It's suffering. My AFL seasons, 2023 was okay, but have for unfortunately most of the last 30 years been like watching a close friend die every year.

Felicity 1:27

Yeah, and getting angry about it.

Paul 1:29

And getting angry about it. So I'm actually not looking forward to it. We've had an alright preseason, only a small number of injuries. Looks like they've met. Because you know, my my complaint about my team is that they play or they have been playing like they've never met each other.

Felicity 1:45

You think they've moved from beyond Instagram to actually recognize the person?

Paul 1:49

Yeah, they've known each other's nose, so that's great. But but yeah, it's crazy. Anyway, let's let's get into the uh discussion. A few things to talk about today. I want to talk about uh change. And you know, we wrote this week about Omico and the prospect trial. And they have some budget challenges. Well a budget challenge in that their funding essentially runs out. They're currently profiling profiling around 180 patients a week. I think they said to me to extend that for a little bit longer, they could drop that to about 80. But they have put in a a request in the budget to get beyond September this year. And more broadly, it just strikes me as a project where a group of people have got together and just decided to do this off their own bat with a range of partners and invite government in to support it. And government has done that naturally. They don't the government act acts according to its own timeline. But it just was an interesting observation as to how change can occur within a status quo institutional framework, as our health system is. And the challenge for government in then incorporating this approach to care within its institutional care frameworks.

Felicity 3:31

Yeah, well let's be clear, they don't want to have that level of precision and diagnosis in the system because as MSAC always tells us, heaven forbid we might diagnose people and have to treat them. And as you've rightly pointed out in the past, this is a win-win at the moment for the government because they provide some funding towards it, and the pharmaceutical companies provide the medicines for free. So why would they want to move it into the mainstream health system when it actually opens it up to everyone, gives a quality of access to everybody, and therefore the access to those medicines would then be funded by the PBS? I mean, let's put that I know you want to talk about the budget, you know, tough budget coming. Well, why on earth would finance want anything to do with that?

Paul 4:18

I I can't see any way for the PBS to accommodate genomic profiling of tumors and a suite of products match to the profiling. I can't I it just it just doesn't work that way.

Felicity 4:35

I mean it can.

Paul 4:36

It can, but it won't.

Felicity 4:37

It it absolutely can. But again, I know you want to talk about it later too. We have a four and a half-year-old HTA review that has deliberately tried to skirt away from this, really.

Paul 4:50

Well it doesn't even talk about it.

Felicity 4:51

Yeah. So you can draw linkages and bows, but the system is very good at protecting itself against those things. I mean, you know that I've had to do that in newborn blood spot screening. I mean, government had funded a massive trial of newborn blood spot screening in certain amounts, certain children in certain diseases in Victoria, and that was going to be a five-year programme, and everyone was ecstatic about that because we'll we'll do some more research on it, as opposed to actually meanwhile, all these children are missing out on a diagnosis, the system doesn't want it. So the our our health system does not want diagnosis. It it actually really does not. So when we talk about the hoopler of during COVID, all these you know cancers were diagnosed later or these chronic diseases were diagnosed later, and you know, Mark Butler gets out there and says, Oh, look, you know, it's bowel screening month, everybody, do a poop scoop. And the reality is the system doesn't really want it. It doesn't want to know. We just like medicines are on a supply arrangement of just in time in this country, we pay for medicines on a just in time basis, uh, relying on the fact that they will be there so that we can get a low price. But our health system doesn't really want chronic disease management, it doesn't really want to know exactly what's going on because there is a cost. It'd be great if everyone then suddenly needed, you know, from doing this precision genomics, everything was dozy tax, or you know, exactly at a at$1.75 a vial. But what if it's one of the PD ons? You know? So I I like what you're saying that you know it's a group of people that got together and said, well, we want to do this work and we want to help people, so this is how we'll start to do it, and hopefully we'll create the space for a government initiative to then say, Well, we need to incorporate this. Let's look at lung screening, lung cancer screening. This is a government that never likes to give everything to everybody. This is a government that, and I don't mean big G government there. I mean this is small G, this is how the system operates. It doesn't like to do that. It likes to slice the salami incrementalism to control costs. And that is going to be their challenge. So, you know, it'd be really easy for the government to continue to to fund this, you know, a pilot, the expansion of, you know, getting more data. Uh, and that allows a certain number of people each month to continue to have access to that opportunity of a of a better diagnosis, um, or for some people to pay for it themselves, or you know, priv private.

Paul 7:35

Yeah.

Felicity 7:36

But yeah.

Paul 7:37

Our health system, certainly at the Commonwealth level, is a health financing system, but operates within an ideological framework. And no one should be naive about that. There are a lot of political constructs around things like health technology assessment. It is a political, ideological construct. And this is why people thinking that most favoured nation pricing, the US administration's more assertive stance on pharmaceutical pricing, you do realise that our HTA overlords will look at that in ideological geopolitical terms. They will say they'll resist any response that involves higher prices to ameliorate the impact for political reasons. Because they're ideologues. And so, yes, we also wrote this week about humanity, bringing humanity into decision making, something I I'm a great believer in because our system dehumanizes, but it it's designed to dehumanize because it is ideological. And so unless we're willing to challenge that and the fact that a lot of these outcomes are political considerations. I mean, they're making a political point, and that will certainly be the response of the institutional framework to MFN. No one should think for a second that the little G government in Australia and its little supporting Quangos are going to say, well, we're gonna have to be a bit more flexible, aren't we? No, they'll they'll they will prefer to see us die than concede. Now, a lot of them probably, I have no doubt, because look, let's face facts, you're sort of centre-left to be on these advisory committees, right? There aren't too many coalition voters on these advisory committees. I think I think it's fair for me to say that. So they they bring a political perspective to these outcomes and these processes. And so some of them probably suffer from the old Trump derangement syndrome, which which I actually think is a diagnosable thing. You can think what you like about Donald Trump, but some people are completely loopy about it.

SPEAKER_04 10:09

Yeah.

Paul 10:10

And so they will see they will see MFN in those terms. And so the response will be political. So we need to be realistic about that. Anyone expecting a rational response, you need to think again. It's not gonna happen. And so that all's it's all part of the same dehumanizing effect of these processes. We need to be we need to be realistic about that.

Felicity 10:40

Oh yeah, and with a little bit of feeding the chugs. So, you know, that the system's also very smart at actually giving you a little bit here of of, you know, giving you something. Feed the chugs so that yeah, okay, well, we're getting somewhere when you're actually not. Well, that's the HTO review. Yeah. But I think it's interesting you you talked about it's health financing, and it is. We don't see it as health care, it is health financing. And if you think about the iterations of that group, it has actually previously been called health financing, you know. But because it's like, oh well. So everywhere else we're writing policy and caring and sharing, it's all good, but this is about financing, it's not about health.

Paul 11:18

Well, they don't do policy. They used to. 10-15 years ago, they're doing policy in that area. Now they're just administering a portal and evaluating submissions based on contested economic models. But yeah, I I I think people need to be realistic about it. I w I want to talk about the really interesting presentation by Eboss, the full-line pharmaceutical wholesaler, did their half-yearly update. It was so interesting. I think I thought it was a very good presentation, but I was very thoughtful. They had they had a good first half, driven by rising prices, rising volumes, including GLP ones, and the emergence, the increasing emergence of high cost therapies. It was interesting because of and I I I described it as like the bi bifurcation of the PBS where for some people the program is going through strategic expansion, but for others it's never been worse. And that's that's a really interesting divide now. There's effectively two programs. And that's partly maybe it's an unintended consequence of the governments insisting on paying the lowest benchmark prices in the world or amongst the lowest in the world, and the willingness to hide that. The deal they they've done is hey, if we just do these confidential pricing arrangements, we can get super low prices. But of course, the supply chain gets remunerated on the published price.

Felicity 13:08

Yeah, and with 1 July coming and Section 100 drugs will now come under the CSO arrangements if they're available in the community setting. And there's an extra, I think,$75,$85 million going into the CSO for that. Uh the WMU uh wholesale markup will actually be available for those medicines as well, too. And one of the the selling points on that is oh, good news, previously pharmaceutical companies had to pay the negotiator wholesale markup for supply of their medicine if it was S100 into the community setting. But hey, now fantastic. Um, government will be meeting that cost. But the point you bring up is very real. So when EBOS gets the markup for the expensive medicine, let's say you know it's$150, but the reality of the pricing means it should only be, you know,$52. The pharmaceutical company is paying for that. They they are paying the gap. They're not just paying the gap in the medicine price, they're paying the gap in the wholesale markup price. And that's that's a serious question about is is that appropriate? We know why in 2018 the department, in a most appalling way, tried to address this issue of the the money going through the system and back through the system, including ignoring the uh tax office and uh what the rules are about issuing fake invoices.

SPEAKER_04 14:37

That was wild.

Felicity 14:38

Still still just but go goes to how that area of health thinks about itself as just being a rule unto itself and didn't even think about tax law. So we do have to look at those things. There's a really good reason that there's going to be a$10 million funded review of uh wholesaling in Australia in 2027-2028. And one of the things that the industry, as in pharmaceutical industry, needs to get ready for is how are you going to address that? Because it's one thing for you to have a hidden price and be paying back, you know, 60% of the published price. But when are you actually going to attack that construct that says, well, we want that money back? That's that's your responsibility, government, not ours. Like you, you, you shortchange and you know you've got all these administrators for price disclosure and administrators for the CSO, get them to calculate it, get them to give us our money back. We shouldn't be paying for that. And that's where some of the really sophisticated uh policy research and analysis needs to be happening. Because, like you said, we are bringing more expensive medicines uh to Australia at times, and it has become because so many things move off the the funded component of the PBS. Where is that all going and where is the work being done on that? And you know, I'm not begrudging wholesalers for earning a good living and having access to the CSO and and making sure medicines are available in in remote communities when needed. But there is a really big issue coming, and like you said, I don't think the argument is being articulated clearly, and people do not understand the haves and the have-nots and where there is money in the system to actually be proportioned.

Paul 16:27

A leave behind linking the issue to MFN is not going to do it. This is this is a this is a time for high quality work, particularly knowing that that ten million dollar review is coming. No doubt now's group will do it because they are the consultant du jour.

Felicity 16:42

Yeah, that's what happens when you put all the former deputy secretaries of health in the one group. Oh, you couldn't possibly ask anyone else.

Paul 16:48

You need to create an evidentiary basis for why this is a problem and get broad acceptance that it's not fair and that it is a problem, and then think about the solution. And a two-page leave behind is not going to do it.

Felicity 17:04

No.

Paul 17:05

Because it's also You need to do some high quality work.

Felicity 17:08

You do, and you're also failing to understand like you've talked about MFN how the system sees it and how it sees it can actually respond to it. And when you put a leaf behind that actually validates what the system wants to do, no problem. But the system there is so many more points of tension and points of access need at the moment, and that higher level conversation that taking the the parliament on a journey with you, taking the community on a journey with you, it's not happening.

Paul 17:47

Well, and the wholesalers have a quite reasonable position on this, which is well, hang on, but we're paying we're paying the list price. We're not we're not paying the confidential price. We pay that that if that we pay in our cash flow shows that we're paying the the list price.

SPEAKER_02 18:06

Exactly.

Paul 18:07

So that's agreement between the manufacturer and the government is an agreement between the manufacturer and the government, but the supply chain is funding the full cost.

SPEAKER_02 18:15

Correct.

Paul 18:16

So it's not an unreasonable position. And I I I just thought I th I I mean I I clipped the relevant slide from the investor deck, but it is definitely worth people going to have a look at that entire deck because it's a wholesale now that has not been a great business, not eBoss, but wholesaling has been a tough business for a long time. And this was a wholesaler talking about strategic expansion and partly driven by the growth in PBS volumes and prices, and other people are experiencing the system a little differently, but it is definitely worth informing your advocacy by understanding how it might impact other parts of the supply chain.

Felicity 18:57

Absolutely. I mean, you think about the fact that under the 2022 agreement there are no medicines under$4 now with an AMP because the government said, well, that should be our new starting base, irrespective of what they actually cost, and irrespective of how many brands we have, and irrespective of whether there are shortages or not. They did a a really crude policy to get one area of the sector up to just play ball on other things that want wanted and needed to be done, which had some more deleterious impacts for more expensive medicines. And I think the system and the sector hasn't realized you need to understand what your interlocutors and what your fellow stakeholders may prioritize over what you want to prioritize, and you need to look at each other and go, well, do you have money to give, do we have money to give, or do we all need more money, or does some money need to be better spent in existing policies and programs? And I don't think that analysis is being done.

Paul 20:01

Yeah, so I wonder if if certain industry association boards are away for a few days to do a strategic discussion or strategic planning session over a few days, let's say that's happening right now, this week, then I think it's worth understanding how other players might be thinking about the system. Because the government's not going to pull one lever without understanding how it impacts others. And that to me is a stakeholder group respecting the framework, which I think is very important. Part of respecting the framework is doing a lot of work to understand how it works. Now, the supply chain, the failed supply chain reform was a classic example where a government didn't do that. They announced it, budgeted the change because one stakeholder group said, Yeah, we can do that without thinking, based on unlawful fake invoice, fraudulent invoicing system. The government then went away and said, actually, this is basically impossible because there's going to be all sorts of unintended consequences. So we're just going to get people to pay their invoices fast. Uh and that has not been that has been an imperfect outcome.

Felicity 21:12

It has, and I think the sector needs to understand how deleterious that stuff up was. Because it wasn't just a stuff up that made the Department of Health and the industry group that supported it look like fools. It humiliated the Departments of Treasury and the Departments of Finance. Treasury, who actually has the Australian Tax Office as part of its broader agency remit, they published all of that in the budget papers. They showed the changes to published versus effective pricing. Remember all the beautiful graphs about this, you know, we'll see a temporary dip in the PBS, but then you know, once we've all ameliorated that, it will flow through. The entire government costing in both revenue. And expenditure all stuffed up because they said, Yep, we've got this, we've got this, and no one asked the really sensible question, which is, are fake invoices real? Like, are is that legal? And like I said, particularly the Department of the Treasury who let all that go through and didn't consult with their own agency. So when you start to put more ideas forward, when we start to unravel the complexity of whether it's MFN and hidden pricing or um rebates, etc., anything that you're pushing forward from here on end, the keepers of this of the government money, they were embarrassed by how everybody fell for that very flawed policy and then having to reverse it out.

Paul 22:46

It's and it's a long time ago now, so the corporate memory of that two-year period is probably not great, but it was a complete the whole process was a complete and utter joke. And I think it was Brett Barrens from EBOS, Symbion, spoke at my conference and said, This cannot happen. It's just simply can't it can't happen. Yeah, and and I think David Slade said the same thing. This is just absolutely ridiculous. But the people who didn't actually operate in the supply chain you know, the medicines just go to a distribution center and then someone else has responsibility for it, decided that yes, they could agree to this. And it was unserious. And this is where I wanted to have a conversation about respect, manipulation, contempt. You know, unfortunately, the industry tends to be very malleable and it can be manipulated. Greg Hunt did it a lot. And to me, the willingness to manipulate to manipulate reflects a sort of a lack of respect, almost a contempt.

Felicity 23:58

They confused being liked with being r respected.

Paul 24:01

Yes, you saw it with the with his astroturfing allegation. And no one challenged him on it publicly. Except me, I think. No one no one actually said, I'm sorry, you are not saying this. Chris Bowen did when he was shadow health minister. Because it was an outrageous allegation against a patient group who had no industry funding.

Felicity 24:19

Yeah, neither the pharmaceutical company nor the pharmaceutical industry stood in to say that's outrageous.

Paul 24:25

And so there's a consequence for not standing up for yourself.

Felicity 24:28

Or standing up for patients.

Paul 24:29

Yes, pre-2020, when they were manipulated into a green upfront to savings. That that that that was it was not just a very underhanded thing to do, but it was a sign of contempt.

SPEAKER_04 24:43

Yeah.

Paul 24:44

Because it's almost we don't think you're competent, so we can almost get away with anything.

SPEAKER_02 24:50

Yeah.

Paul 24:51

The irony is that the the and you might disagree with me on this, I don't know, but the 60 day, the way government did 60 days dispensing on pharmacy was on the one hand incredibly disrespectful, but on the other hand, a sign of great respect. I suspect the government said we can negotiate it with them, and they said there's just no way. We are not going to be able to convince these guys to accept this. So we're just going to have to announce it and then have a fight and get on with it. It it's it's it in a way it was a it was a show of a acknowledgement of strength.

Felicity 25:27

Yeah, I I do see it differently as as we talked about on the podcast at the time. I I see it as that part of the department mistakenly thinking that the way that they could engage with the pharmaceutical sector was the way that they could engage with pharmacy, thinking that it's just a matter of if we're just tough, you know, they just need to be they just need to be sh taught a lesson. Um we c we can do this. And look I I know running the sister, it it's a lot harder work, but that to me was completely misjudging what will happen. And if I if you think about some of the most horrific things that Mark Butler would say on morning breakfast shows about the guild, I I I actually don't think it was about respect and then like let's just go in and and and have a have a stoush and see where we can get to. I really think it was completely misjudging. He was a new minister. They said, Don't worry, this will be fine, we do this, we'll get it all sorted. You know, we've had this thing before. No, I I think they tried to treat the pharmaceutic pharmacy sector like the pharmaceutical sector, and then learnt a lesson. And when it's a good but for 20 years now we might do it because the system will say you Well you might you might be right, you know.

Paul 26:46

I I at the time I used the analogy that they just kick their ministry out of a plane and if the parachute opens good and well, and if it doesn't someone else would replace him. But that was kind of there was an element of that. Was he poorly advised? Possibly, yeah. I don't know what happened behind the scenes, and at some point we'll find out. But you compare you know, pharmacy is happy to cross the road into the world of politics. So when when the minister was saying they're just the pharmacy lobby and the pharmacy union and all this kind of stuff, they're very militant. Like I I think the guild would have just gone, yeah, fine, okay. If it we'll just cross the road and we'll have that fight. I think another urgent care clinic opened yesterday. This one in the inner suburbs of Brisbane.

unknown 27:30

Right.

Paul 27:30

And you sort of go, where are the doctor groups on this? That is the the the fact that the government is just going charging on nationalizing journal practice, one clinic at a time, and the GPs, the great solution from the GP group was an independent pricing authority to set Medicare rebounds, which has to be it's a podium finish for the dumbest ideas of all time.

Felicity 27:50

Oh, it's it's horrific.

Paul 27:52

But I mean I bro I just burst out laughing when I saw it. I said that is just an act of ritual suicide.

Felicity 27:59

But you know, last week you recalled that as we were recording the podcast, you talked about the fact that the second report on urgent care clinics had come out and you said, Yeah, you know, we'll have to take a look at that. Did you take a look at it?

Paul 28:10

No, I didn't take a look at it.

Felicity 28:12

Well, you probably didn't get a chance to, because this is what happened. The second interim report on urgent care clinics finds that while staff and patients are pleased with the clinics, there is no clear evidence that the wait times for urgent care equivalent cases in emergency departments has improved. Released on Friday, the report looks at nine measures of success using data collected between June 23 and August 25. It builds on the first interim report, which was released in March 2025. Editors note Shortly after this article was posted, the review was unpublished from the Department of Health, Disability and Aging website. It is no longer accessible.

Paul 28:48

Unless you saved a copy. Which I did.

Felicity 28:51

Yeah.

Paul 28:51

Uh yeah, that's inter that's interesting. Now, no surprises there. Everyone knows that if the government involves itself in something, it's going to get more expensive. Yeah. Like when there's a skills department, there's going to be fewer skills, and when there's a housing department, there's going to be less housing. And when there's an e-safety commissioner, there's going to be less e-safety. Everyone knows that. That's just the way the world works. When government involve themselves in something, it never it never gets better. It gets expensive. Of course, what the e-safety commissioner is doing is just redefining what it means to be e-safe as she travels the world. But her travel diary is insane.

SPEAKER_02 29:24

It's very important.

Paul 29:25

Making it commitment. It's like the genomics commissioner. We're going to have less genomics. It's because that's that's what happens. And the fact that that report was released, where are the GP groups? No, no, they want to further nationalise medical practice by having an independent pricing authority, and we all know how that's going to go. There is no government-run pricing authority that ends up with high prices. It doesn't happen.

Felicity 29:48

No, and we see the joy of the Internet Hospital Pricing Authority that also does aged care now. And you know, does it go now into the NDIS? Does it just become this mega you know price setter, which I think is incredibly dangerous?

Paul 30:03

Um it's just it is that because they said, well, when it's getting too political. Well, it was the politics of it that managed to restore indexation, which had been frozen for such a long time. Because what'll happen within the independent pricing authority, the first couple of years will be fine. We're ever going to have inflation adjustment. Then it will be, well, with AI, it's getting a lot more efficient now. So we want inflation minus. That's what that's what's going to happen. The price is going to fall because the government independent, yeah, with the parameters set by the government, it becomes like the PVAC. And they stack these things with all the all the all the people who think like they do. It'll be full of health economists.

Felicity 30:42

But a lot of people I don't think understand how the independent hospital pricing authority works. It's based on three years past data. So, you know, one of the things that we used to see a bit in organ and tissue uh donation, etc., is that if something changes in the system, it takes three years for the pricing to adjust to that. So if we've got like a new um device that helps keep our um a heart transplant patient alive for longer but costs$200,000 to do until the for those few weeks until a heart becomes available, that$200,000 cost is not actually being factored into the cost of caring for that patient under the funding models until three years after that it's actually been used. So when you want to set prices, they're not prospective. They're retrospective and saying, well, this is what the average was over the past three years. And the only time, you know, in the hospital system, if something's gone through uh MSAC or PBAC, then that's already in it's counted in and that's taken as given. But those those modules are a nightmare, but they are retrospective, not prospective.

Paul 31:51

And government, I don't I I was just I was just flabbergasted by this. Because I'm trying to think of an example where government doesn't set the rules to suit itself. The PBS is a great example, but even MSAC, which is now reviewing uh devices for inclusion in the prostheses list. So private uh government committee deciding what private health insurers can fund via medical device reimbursement.

Felicity 32:19

Yeah, and a really long, complex we'll get to it when we can get to it. Oh, this could take nine months.

Paul 32:24

So there's not even an direct benefit for government in this. The only indirect benefit is maybe to take one decimal one tenth of a percentage point of premium increases. We see it in the PBS where it gets very extreme. Where it's Medicare,$35 billion program, they are going to be so conflicted that this this will become a source of great angst. The politicization of rebate levels is your strength. The Department of Finance would have looked at that release and said, This is absolutely fantastic. This is how we can control this thing. We just stack this thing with a bunch of health economists, friendly academics, and former finance officials, like they've done to the NDAA board, and and we'll and we'll sort it and we'll sort it out. I just thought I can I I I anyway, the broader point I've been trying to make is that the government manipulates and when they're doing it overtly, it's a sign of respect and often contempt. Because if you are easily manipulated, it's a sign of weakness and they take it as a sign of weakness. And you've got to think about that. You really gotta think about that in your engagement. Speaking of talking tough, the government's talking tough over the budget. Capital gains tax, obviously.

Felicity 33:51

Yeah, that's yeah, I think in capital gains tax is the reason we have a housing shortage.

Paul 33:56

Yeah, yeah. The if there's unequal treatment of assets, it's just gonna have a massive disording effect. But it made me ponder. Governments talk tough on budgets every year at this time of year. But how often do we actually get something that you would look a budget that you'd look at and you go, whew? And I'm thinking there's maybe one a decade. Maybe.

SPEAKER_02 34:21

Yeah, maybe.

Paul 34:22

So there was the first one of the former coalition government in 20, sort of after the National Commission of Audit?

SPEAKER_02 34:26

Oh yeah, 2013-14, yeah.

Paul 34:28

Yeah.

SPEAKER_02 34:28

I don't think one medicine on, one medicine.

Paul 34:31

I don't think the Rudd Gillard Rudd government had a tough budget in all their time. I don't know. They were tough in programmes, but they weren't.

Felicity 34:38

But no, but they didn't, because on the GFC hit, they just actually released all the funds in all the nation building funds that we had and dispensed like pink bats. Um the bath water and then the bath at soil.

Paul 34:49

That was that was and we're still paying for that and we will be forever. The Howard government had sort of won a tough, really tough one.

Felicity 34:57

Oh yeah.

Paul 34:59

Went, shut the departments, sold off all those assets, increased prescription copies, really had an unstated intention to get rid of bulk billing. That was certainly the behind the scenes conversation. Uh the Hawke government, when Peter Walsh was finance minister, I think there's and and Keating was treasurer, those first few years of the Hawke government, I think they were pretty tough. They were very reforming. But there hasn't been a tough budget in Australia for well over a decade.

Felicity 35:31

Yeah, but I think particularly this government, their idea of a tough budget is we're going to tax you more so we can spend your money that you earn.

SPEAKER_01 35:40

Because no one spends money better than the government.

Felicity 35:43

There's a there's a lovely um reel on Instagram at the moment about uh how one dollar earned in Australia gets taxed six times by the time you know you die, and how it actually goes through the system, whether it's you know your your personal income tax and then the GST, and then if you actually invest the money at all, then you pay you know uh tax on the the interest that you raised from actually saving your own money versus then if you put it into something like CDT uh attractable areas and you get taxed on that, and then if you put it into your superannuation or into your your your trust for your family, then it gets taxed again when you know you die and you give it to your family. So the six times you get taxed. So I think you know, like you, it's um and I really wish Ken Henry would go somewhere else. I'm really tired of listening to him and um he's hyperbole, but it's to me is about we want to tax more so that we can spend more. I mean, let's be clear, the Prime Minister has said that he wants to be the man remembered for starting the the fast rail project from Sydney to Newcastle, and apparently we've got to spare 600 mil to just do that, no dramas. But that's the business plan. Yeah. But six hundred million, how many medicines would that provide access to? Well Isn't that the GLP one or something?

Paul 36:53

I mean, I know he's obsessed with infrastructure, but a fast rail between Newcastle and Sydney, what's the strategic merit? I suppose building Newcastle as a commuter city, which it already is? It's already a train line. 90 billion, where's this money going to come from?

Felicity 37:10

That's what uh CGT.

Paul 37:14

Well, that's not gonna raise that much. How much is the CGT?

Felicity 37:18

Oh, it depends which day of the week they're talking about.

Paul 37:20

Going going to raise. But I I completely agree with you. I I I don't think it would be a particularly tough budget. There's an offset requirement. Well, there's an offset always an offset requirement. Yeah, that's standard budget operational rules. Yeah, when is it when has it not been, except in COVID?

Felicity 37:33

Yeah, and offset rule.

Paul 37:35

Speaking of speaking of the industry being manipulated.

Felicity 37:38

Yeah, but I I guess also, you know, the only time offset rules really, really move beyond is when it's offset plus. So you've got to come forward plus an extra, you know, five percent of savings. And occasionally you get those um budgets where you're asked to put forward, you know, yeah.

Paul 37:53

I can remember in the one of the Hawk budgets because we get the 20-year cabinet release now, but it used to be 30. And maybe about six or seven years ago, we got some from a Hawk budget where it was cost offset plus. You cannot even make a new policy proposal with spending unless it's cost offset plus. Yeah. That that was a tough budget.

Felicity 38:13

That was a tough budget.

Paul 38:14

That's that's a tough budget. I can't see this government doing that. And and I think some of the actual talk that's framing it as a tough budget.

SPEAKER_02 38:22

And so then people go, oh, that's awesome.

Paul 38:24

Yeah, and this is so everyone goes, Oh, it's not really that tough.

Felicity 38:26

But and well, they've done it all better on CGT, so we went from we were gonna remove the twent the cut from 25% and restore it back to 50 to now suddenly maybe it's 33?

SPEAKER_04 38:36

Yeah.

Felicity 38:37

Like, oh, it's not so bad after all. I mean, we all do understand Comms 101. Well, most of us understand Comms 101. We can understand when we're being led down a path.

Paul 38:45

Yeah, so I don't I don't think it'll be particularly tough. They're not I mean it's very hard because I think because of COVID, all the years up to COVID, we were told there's no way we can handle another financial crisis after the GFC. And what why there you go. We could just go on international debt markets and completely bankrupt the country, become like France, and I don't think the electorate buys it anymore. All those definite debt remember what was the um when Howard was elected in ninety six, what was it? Was the ten billion dollar ten billion dollar black hole? Like they chased Kim Beasley as opposition leader down the hole over a ten billion dollar gap. That's a rounding area for this government. 10 billion. We're about to pass a trillion dollars in debt. Twenty years ago we had no national debt as a country. It's pretty outrageous. And now we've got one trillion dollars. Okay, and it's not okay, I'm not sure. Have we got value for that?

Felicity 39:41

Exactly. And you know, people always talk about all these different things that we can be doing, and you know, it's great to fund childcare, and it's great to fund this, and it's great to fund batteries, and it's great to fund windmills. I'm saddling my children and my grandchildren and my great-grandchildren with the most extraordinary amount of debt. And one of the things that then I find is then used against me as an older person is that therefore if I've actually made any savings or I have superannuation or I've set aside nested for both myself to self-fund my retirement and to give to my children, then well, we need you to give that back. We need to tax that back because we've now saddled these kids with this debt, so now you have to pay that again. I'm like, how many times do I have to pay for your incompetence of financial.

Paul 40:26

We have no way of repaying this debt.

unknown 40:28

No.

Paul 40:29

It's the biggest line item of budget. A debt servicing is bigger than the NDIF.

unknown 40:32

Yeah.

Paul 40:33

It's like the level of defence spending.

Felicity 40:34

Yeah, and that actually means that you have to stop, you know. I I wish that every politician could remember what it's like to run their own household budget, which is there's a certain amount you can spend, you've got your mortgage, you have to set that aside, and you make difficult choices about your spending rather than getting the 17th credit card.

Paul 40:55

Well you know, I think there isn't the speculation that it will be on two homes. The CGT discount. And no one I the discount applies to assets held for longer than 12 months. And and and it applies to all assets shares and precious minerals and metals and it applies to all of those things. So how they're going to do this without distorting investment markets, I don't know. Uh it'll apply to more than two homes, I think. So all those politicians who have their taxpayer-funded homes in Canberra using their travel allowance, which is I think is possibly the most revolting thing I've I've heard. That just absolutely infuriates me.

Felicity 41:41

Because it's untaxed money.

Paul 41:42

Yeah, I I'm so furious by it because the travel allowance does not apply equally. Is that they get the travel allowance in Canberra in very different terms, so they get it in Sydney or Melbourne, another capital city. So if you go to uh Sydney and you stay in a private home, you don't get the same level of travel allowance as a politician as you do if you stay in a hotel. But in Canberra, it's all the same. So it's a complete fixed job so they can build asset portfolios.

Felicity 42:06

Yeah, and here's the thing. So anyone else who is uh living in in Canberra or travelling to Canberra and then decides to actually purchase a home because they've got two residents. A lot of people do. Some people live in Tassie for some time of the year and um, you know, or Sydney or Melbourne. If you go and purchase a property to live in because you are working in two different places, you're purchasing that post-tax. So you have to earn the money, pay as you go tax, and then you know you start to go through through the processes of of your um mortgage for it, etc. And yes, I know you can claim CGT at the end. But the flip side for a politician is that their travel allowance is tax-free. And so if they're getting$100 or$200 or$300 a night, that's$300 gross, no tax involved. So if you got$300 in in that in your income and you use that, that would be taxed at 47 cents. But meanwhile, they get it for free, tax-free, and then they get to use their their job to actually make a nice little asset earner. And so they make money on that. So my question is given the first buy home home buyer's subsidy where the government will put in 5% for your um property, and then thereafter you owe them back that money when you sell the place, why isn't the taxpayer going after every politician who bought a house here in Canberra and sold it when they retired and saying, you owe us all this money, we want our money back, please, with the interest on it, like you're going to do to first-time buyers?

Paul 43:34

It creates an appalling incentive too. So rather than flying into Canberra for on the on the Monday morning of a sitting week, they're flying on Sunday. Flying out Thursday night, no, I'll get an extra night of TA. I'll f I'll stay until Friday. And and these are the politicians who sit in judgment of everyone else.

Felicity 43:51

Oh yeah.

Paul 43:53

You know, they have all sorts of committees of inquiry about how everyone else behaves, based on commercial incentives. But they never look at themselves. All they'll ever say is well it was within the rules.

Felicity 44:04

Oh yeah, thanks, Anika Wells. Thank you, sir.

Paul 44:06

Yeah, Sarah Hansen Young with their 50 trips from her husband, lobbyist. I just think it's absolutely appalling. It's it's you know, and they will fly in on Sunday and I'll see them at my local supermarkets because they all live around where we are. And park in the park in the disabled car park. The comp car, certain Tasmanian Senator. Park it the comp car parks in the disabled car spot in the supermarket while she wanders around the the aisles getting her biscuits and her cereal and a her her tea. Yeah. And I I'm just appalled by it. And it has to stop.

Felicity 44:40

It does.

Paul 44:41

And because I it it it is undermining the legitimacy of the institution.

Felicity 44:46

One hundred percent he tees that turn because we are getting back into the the footy season. But it is, and I think you know, there are many things that are horrific about what happened in Bondi, and it's great to see that the Royal Commission has has kicked off this week, and and I like that the um the Commissioner has been quite clear on what she's doing and what she can and can't cut cover and why to to give the community confidence. And I also like she's already said, Hey, I'm having trouble getting stuff out of these people, um, which is putting her first report in jeopardy, the interim report versus the final.

Paul 45:19

But what a surprise.

Felicity 45:22

That moment, up until that moment, the conversation that was going on in Australia was about the snot. Sorry, not the snot, the pig in the trough.

Paul 45:35

Snout in the trough yes, the snout in the trough. Which might lead to some snot in the trough. It's like when my dogs drink water, there's a lot of residue.

Felicity 45:45

That that's what I was thinking. W The country was absolutely infuriated about the the abuse and misuse of entitlements and the whole argument of oh, it's within the rules. As I said, it actually wasn't within the rules. Sarah Hansen-Young did not comply with the rules because she didn't comply with the fact that you're supposed to publicly answer for things that may or may not be seen as appropriate. But even then, if those are within the rules, then the rules are completely inappropriate. If you're willing to take away uh, you know, a lot of people who own uh properties, investment properties, are, as they say, mums and dad workers. They are policemen, they are nurses, they are everyday people in the community who use that to save up for a nest egg and to provide some some additional income once they've got some equity. They're people who are trying to make a life for themselves, and you're really happy to rip about the rules for them because you think they're ripping off, you know, someone who might want to buy a home, yet you sit there with these rules and go, good news, it was in the rules, so we'll just keep doing this. It's disgraceful. Very disingenuous.

Paul 46:49

It does stink, yeah.

Felicity 46:50

And they have taken advantage of the fact that we rightfully as a community have had to focus on what happened in Bondi, and that is a serious problem that all of the community wants to get to the bottom of and and protect the Jewish community and uh end anti-Semitism in this country. But I hate the fact that the politicians are hiding behind that and go, well, if we focus on all of this, hopefully none of you will remember what really poorly behaved people we have been, many of us, over the past couple of years and not hold us to account.

Paul 47:21

Well, can I just say on that I was very disappointed with the Prime Minister's back down on his description of that former Australian of the year whose name I'm not going to mention. I thought it was actually far too polite. I mean, let's think about what they said about the Jewish population in Australia effectively that they should be subjected to the sort of treatment that Israelis got during the first and second interfada. So in the second interfada, there were suicide bombers going into cafes in Tel Aviv and Haifa in Jerusalem and killing women and women and children. Is that what she wants? She wants people like me dead? That's effectively what she was calling for.

Felicity 48:08

Yes, I don't know where she gets her definition of um interfada.

Paul 48:13

Well, she's obviously a moron. You know, and I I thought he was far too polite for her. And the people then then conflate this into some sort of misogynistic thing. Well, what is being a murderous, hate-field bigot? Which is clearly what she is. I mean, to call for that treatment of Jews in Australia and globally.

SPEAKER_02 48:34

Yes.

Paul 48:35

Which is what she did. So that's okay. We're meant we're meant to just accept that. I'm sorry I don't accept that. You know, I don't like the victim mindset of my community. Zionism is a response to that, to the sort of anti-Semitism that we've seen over the last couple of years. Zionism is not symptomatic of anything, it's evidence of anti-Semitism and the destruction of Jewish communities around the world. And we've had we've had attempts to destroy the Jewish community in Australia since 2023. But they certainly predate that. There is not one synagogue in Australia. In fact, there's probably not one synagogue in the world that doesn't have 24-hour armed security. That's the reality. There is not one Jewish school in Australia that does not have security guards at it.

unknown 49:18

No.

Paul 49:19

Now, if we don't see that as a problem. And if we think it's fine for someone who's been venerated in this country, for her terrible experience as a young person, no one's denying that. But that doesn't give her the right to call for the murder of an entire group of Australians.

Felicity 49:35

I agree. And I think there's a really good article in the Australian last weekend about the lack of guidance and support when someone in that circumstance who is brave and changes laws in respect to her lived experience sees that they are perhaps only rewarded if they are advocating and angry. And it's a bit like when that experience at uh the lodge and wouldn't shake the Prime Minister's hand, everyone said, That's great, that's wonderful. And I know we talked about, and I said, to me, it read of someone that says you don't have wise heads around you saying there are certain ways we do things and don't do things, and there are times you can make a statement, but you know, to to further your cause and to to further things and how things should be, sometimes the community behaves as a community, and if you want the community to support you and to understand your lived experience, then you need to be a bit more respectful of the community and its leaders too. And what I watched happen on uh that um rant was was extraordinarily terrifying because take it three steps back and the lived experience of that former Australian of the year is failing to acknowledge about what happened to the women and children in 2023. And it's like when a lot of the Jewish women in Australia said, Jewish women are women, rape is rape, murder is murder, sexual assault is sexual assault, but apparently not if you're Jewish. And that was so distressing in the community to have to fight so hard to say that you know, anti-Semitism is racism, but rape of a woman is rape of a woman, rape of a child is rape of a child, and this country in many instances went silent on that. And to then have someone who has asked for the community support and who the community has stood up and said, absolutely, to set aside the trauma and the experience that Jewish women have experienced in Israel and the threat that they live with here in Australia. I I was appalled. Well and I agree with you, the Prime Minister. I think in trying to be sometimes you can be too diplomatic, you know, and his whole, you know, let's turn the heat down. Like, no, actually, you turn the heat down by saying we do not accept that behaviour. And once again, Premier Chris Mins, I continually turn to for leadership in this country on taking a strong stance and um the South Australian Premier. They'll call it when they see it.

Paul 52:16

Well, yes. The South Australian Premier, I'm convinced that guy signed the wrong wrong form when he joined the Labour Party. He sounds like a He's so entrepreneurial. So entrepreneurial, it's unbelievable. But but I hate to labour the point because it's just like October 7th. We were given a few hours before there were people calling for our death in Sydney at that iconic opera house site. We were given a couple of weeks after the pogrom in Bondi. The murderous rampage targeting Jewish to see, and you know how upset I was to see Jews cowering, it brought back a lot of memories for a lot of Jewish people and a lot of people in the community. I mean, and we were given a couple of weeks to grieve, and then it all started. I started seeing it on LinkedIn.

unknown 53:10

Yeah.

Paul 53:10

Some of the some of the comments I got because I said that cartoon in the age was the worst trope. And I said, I'm not gonna pay for anti-Semitism, I can get it get it free walking down the street because I've I'm a recognizable Jew. And I'm not gonna pay for it. And the response I got to that Yeah, which is interesting. Yeah, and you know me, I tend not to back down because I'm I'm not gonna be that person. I'm not going to allow this to happen anymore. I'm gonna stand up. And so I fight back, and they generally go quiet because it's not very hard to point out the ridiculousness. And so within a couple of weeks are the pogrom of Bondi. And these goblins are gathering again in Sydney to call for which is what the interfighter was. One and two. It was the intentional murder of Jews simply for being Jews in Israel. And I think the Prime Minister was very polite about that particular individual. Because I probably would have used terms like stupid, idiot, murderous, threatening. Surely it's a hate crime.

SPEAKER_02 54:38

Yeah, well, I know Chris Mins and their legislation, they want to try and make it that, yeah.

Paul 54:42

Yeah, but anyway, it's yeah, I don't really want to on on that note, but I I was very disappointed by him on it, because he has been a lot better recently. He made a lot of missteps in the last couple of years. And my community made that clear to him when he turned up at Bondi. Yeah that we weren't very happy about him, and I think he's maybe got a better understanding of it. I mean, you know, he did recognise the Palestinian state. I think we were meant to have an election in uh December, wasn't it? What a surprise that hasn't happened. But uh anyway, uh I think when there's drive to survive, let's end on a happy night. Does that start today?

Felicity 55:24

Yeah, yeah, it does.

Paul 55:25

But um It's on American time wise, I said it won't be till tonight though, will it?

Felicity 55:29

Oh yeah, that's all right. But I mean the F1's the actual first race of the season, Melbourne next weekend now. So I'm looking forward to that as well, too. You gotta, you gotta, you know, um I didn't think I was gonna be in Australia to be able to watch it, so it's um I've got that now as well. So you've got to pace yourself on Netflix because they do that horrible thing to you too, which is they'll give you four episodes.

SPEAKER_04 55:50

Oh right.

Felicity 55:51

And then they'll give you the next four, and what you've got to wait. But you've also there are only eight episodes, and so you've got to you know, it's like a like a thing of Tim Tans. You want to eat the whole packet through.

SPEAKER_01 56:03

Oh, you want to binge, yeah.

Felicity 56:05

But so I'm just how do you how do you make sure you only have one? And I always I always start out with the best intentions. I'm just gonna watch one, and then everyone else will try and get off the couch. I'm like, no, no, no, I just think I need to see what happens in the next one.

Paul 56:15

Yes, I'll just watch the first five minutes.

Felicity 56:17

Yes, I just need to see how it ends.

Paul 56:19

Well, Melbourne will be fantastic next phone because you've got that and you've got the AFL season starting, so it's just gonna be fantastic.

Felicity 56:26

Yeah, it's gonna be madness.

Paul 56:27

It is gonna be madness. I don't know how many games are in Melbourne. Um Carlton have only in Sydney.

Felicity 56:32

I know because they I know there's a little controversy last year because they actually put football games on at the same time as the Grand Prix, and everyone went, really?

SPEAKER_01 56:39

I think it was a Melbourne game, but to be fair It's a very AFL thing to do.

Felicity 56:43

And and look, it's Melbourne, which of course, you know, they're used to Melbourne supporters not showing up for the ski season, so of course they're not going to show up when the the Grand Prix is on as well, too.

SPEAKER_01 56:51

So uh that's all still the funniest the funniest thing of all time was that was that a photo taken of someone from the Melbourne fan that was eating the cheese board?

Felicity 57:01

Yes. Well, I mean, haven't you seen the new ad they've done for our membership recruitment with um uh Max and various people and about you know and Hamish Blake about sorry I can't be there right now, I'm I'm up at Perisherew. And you know, Melbourne fans are like my cootery board. They wouldn't let me in with my knife.

Paul 57:21

These fans were more buller than Perishow.

Felicity 57:24

Yeah, well that's where Hamish.

Paul 57:25

Because Bulla's a bit closer to Melbourne than Perisher, so it's quicker than that.

Felicity 57:28

I think I think Hamish was trying to move away from the Buller moment because I think that would actually be a bit too close for most of the people that were participating in the commercial.

Paul 57:36

And you get to stop at those nice restaurants on the way, you know.

Felicity 57:39

Well that sounds like you. I don't know.

Paul 57:43

It's a nice drive up to Buller. No, it's a uh that I haven't been I used to go five, six times a year.

Felicity 57:50

I know.

Paul 57:52

Used to be a Yeah, I'm sort of, you know, got physical issues now, it's getting makes it a bit hard, but uh I do miss it.

Felicity 58:00

You can just be an Apri ski bunning, but always upri.

Paul 58:04

Last time I did that was when I had some broken ribs up there. And the doctor said I sort of felt like I can't, so I could barely walk. And the doctor said, I'm gonna give you some pain relief?

SPEAKER_01 58:16

Some pain relief. And it was the strong good stuff, and he said, Take this for a couple of days. I said, Oh, okay. He said, but under no circumstances, drink. What's the first thing you do when someone says that to you? Let me see what happened. Let's go straight to come on. It's like when they they serve you a meal at a restaurant, they say the plate's really hot.

Felicity 58:39

You have to touch the plate. Well, it's a bit like uni when you know when with when you were really broke, and so you'd you'd go and donate blood first before you went out on your Thursday night, so then you needed less alcohol.

SPEAKER_01 58:50

Okay, yeah, so your experience. Your experience in university is very different to mine.

Felicity 58:55

I want to say choose wise, responsible service of alcohol, but if you could only afford two glasses, well, you know, you might as well do something for the community while you're at it. Yes. And you've got a cookie.

Paul 59:04

So thanks, Felicity, thanks everyone. Uh we have hopefully a big week for our publication next week. We're launching the new functionality.

Felicity 59:16

Ooh.

Paul 59:18

It is an IT project.

Felicity 59:20

On time, on budget. I've got some specified objections.

Paul 59:22

I've got to test in it at the moment, and it's 90% there, but there's still still a bit of work to do. But I am really genuinely excited about it, and hopefully people will take to it. Uh, and if they don't, that's cool too. We're just we'll just keep doing what we're doing, but we're just adding some a new feature to the site, which I think is going to be really cool.

Felicity 59:40

Well, someone who's been allowed to have a bit of a play in it, it's been in the sandpit, it's been awesome.

Paul 59:45

Yeah. Yeah, yeah. I think it's amazing. They're doing a really good job building it. But thank you everyone. Keep the feedback coming. We do we do enjoy it, and uh, we hope everyone has a nice weekend.

Felicity 59:59

And being on March, sitting week.

Paul 1:00:03

Oh, yeah, it's a sitting week. Two of them. Oh, really? Okay. All right. Thanks everyone. Thanks for listening. Bye.