Minutes/Policy Development Committee Meeting/2014-10-08

Meeting Minutes This document is a record of a meeting. Do not edit this document without contacting the relevant group first.

Attendees

• Andrew Downing (Chair)
• Mozart Olbrycht-Palmer (Inquiries Officer)
• Sunny Kalsi
• David Crafti
• Bill McLean
• Mark Gibbons
• Ben Fairless
• Fletcher Boyd (late due to DST transition confusion)

Absent

• Brendan Molloy (PPAU President)
• Fletcher Boyd
• Mark Gibbons

Apologies

• Brendan Molloy (PPAU President) - Brendan resigns as formal PDC member. Will attend as appropriate.
• Daniel Judge

Agenda

Early other business

   Based on Discourse discussion, it is suggested that we have a Censorship(anti) Policy
   MarkG rant on the topic at https://discuss.pirateparty.org.au/t/free-speech-section-18c-policy/330/13 plus several follow-up discussion points may serve as a good starting point.
  

Planned items

Mozart status report on submissions

  Responded to Foreign Fighters proposed bill.  Brief response. 400 pages and only 1 week to review.
  Next: Need to respond to proposed Data Retention bill.

Progress reports from WG's

Distributed Digital Currencies and Economies Policy (Chair=AndrewD)

     Had a couple of WG meetings now. 
     New WG member jscinoz is a solid contributor
     It would be nice if others turned up.  Meetings are every second Monday evening at 8:30
     Action: AndrewD to ensure meetings are in the PPAU Calendar.

     Current focus is on whether there should be a country specific digital currency and if so, what would it look like?
     Loosely speaking, it looks like this:
     1. Central admin + distributed processing and auth
     2. Wallet types, allowing transactor types 
     3. Transactional tax, dependent on transactor type
     4. Pseudo anonymous. Not everyone can know who you are, but central admin can
        The non-centralAdmin aspect could be as tight as per Monero, so it's very hard for non-centralAdmin to hack.
        Issuing by central admin could be paired one-time-key type deal
     5. Would have to be turing-complete ala Ethereum, to support complex distributed financial instruments
     Will be making a nicer writeup soon, suitable for Discourse 

   Discussion:
      dcrafti: It shouldn't be possible for a central authority to be able to track everything you spend and earn. That part sounds bad.
      AndrewD: The problem being solved, is how to have TAX so we can have roads and stuff
      dcrafti: I think the first questions have to be what sort of currency we want from a philosophical perspective.
      MarkG:   We should also be clear about what purpose the digital currency is accomplishing
      MarkG:   I think we talked about it as an engine for a basic income
      brendan: Why it's a priority over other policy development issues :P
      AndrewD: brendan: Moderate priority in my mind, as it's a proactive policy in a core area of PPAU interest and a space where the major parties have zero insight.
      Brendan: Absolutely, but we should be looking more to regulatory issues. They are the pressing areas of difficulty 
      Brendan: Is crowdfunding attracting GST ?
      Brendan: The core concept of how it's taxed is not working so well I'd say. Double GST for one.  It's just inconsistently regulated and also, it's before a committee of parliament right now.

Library and Cultural Development Policy (Chair=Sunny Kalsi)

   We had a few meetings, and they were very productive
   We should have a cultural policy as that is core business for the Pirate Party. If we are talking about how Copyright *shouldn't* be, we should also be talking about how things *should* be.
   We wrote up a pre-amble for discussion on discuss but it hasn't gotten too much attention.
   Someone named Peri volunteered to help but she isn't here now, hopefully she'll be at the next meeting
   We have a fair bit of text that could form the pre-amble of the policy, and a bunch of links and ideas for the core of how it would work.
   Action: thesunnyk: Make a point of emailing Peri a couple of days before next meeting

Focus session on Universal Health WG - led by BillM

   See discussion points prepared for by by BillM at:  http://pad.pirateparty.org.au/p/healthWG
   We had one WG meeting, attended only by Andrew, Brendan and myself.  On the weekend I circulated minutes.
   At this stage, the policy is wide open for comment.  I want to get a sense of what people feel are the main issues we should address.
   On the pad I give a link to the Doctors Reform Society, in particular an article on the long term agenda of the LNP to kill universal health care.
   The following is a summary of discussions, adjusted to group by topics covered, without the overlapping discussions that occur in IRC.

   AndrewD:       I think there's a cross-link to our Pharmaceutical Patents policy, in that government as single-payer should be in a powerful position to drive the incentives for development of cures, preventions and regenerative processes that reduce its costs
   BillM:         My view is that a core element of our health policy should be universal public provision, not a two-tier system with just a low-quality safety net for those who can afford private insurance.

   AndrewD:       What does "Gonski-style minimum resource standard " in point 10 mean?
   BillM/MarkG:   The main idea of point 10 is taken from the Doctors Reform Society (originally formed to support introduction of Medicare). 
                  I think it would encourage innovation by giving hospitals the chance to experiment with different methods.
                  It would cut the bureaucratic centralism and needless report-filling.
                  A problem with the current health system is that it is divided into silos.  Each silo has a budget that it defends, and getting the different bits to cooperate is difficult.

   Mozart:              Is point 4 (Ban use of antibiotics in animal feed.) for the benefit of humans or the benefit of the animals?
   AndrewD/MarkG/BillM: Both. Factory farming would be impossible without abusing antibiotics, but it also avoids the antibiotic resistance problem for human benefit.
   BillM:               I will try to find suitable references for 4.

   MarkG:        Re point 8 (Either scrap medicare levy or else raise it to cover full cost of Federal health spending.), I think the answer is "scrap".
   AndrewD:      As full-Levy, corporate tax would not contribute. Also, the people maying the most Levy would be the people most able to afford private, so they would constantly push back against it
   BillM:        From a strictly rational economic point of view, it would be more efficient to scrap the medicare levy.
   MarkG:        Linking bits of government to individual levies is inflexible and complex and not really worthwhile
   BillM:        You could change the name from 'levy' to 'health insurance premium', as a way of undermine private health insurance.

   AndrewD:      re: Point 7, I think Mental Health already got included recently, but Dental would be a great addition. Dental health issues are the underlying cause of many other progressive degenerative health issues
   MarkG:        http://www.health.gov.au/internet/main/publishing.nsf/content/mental-ba-fact-pat
   
   BillM:        The current version of medicare pays your doctor when you get sick. Instead I want to pay your doctor to keep you healthy.
                 The problem with fee-for-service medicine is that it encourages over-servicing.
   AndrewD:      Yes - on the proactive thing. Core rationale for the policy. Put in Preamble.

   benfairless:  Would you prefer a system where GPs are paid a salary instead of paid per paitent?
   BillM:        The key change is that the individual patient is not a purchaser of medical services.  
                 The regional health council is, on behalf of the patient.  
                 That gets around the market failure problems in health care.
   AndrewD:      I like the adaptability that provides for different regions with different problems.

   BillM:        Any thoughts about the how the directors of a regional health council should be chosen?
   benfairless:  Non-Compulsory voting?  Residents of each council area vote for (at least) some of them?
   MarkG:        Does the regional health council appoint local hospital boards, or is it possibly made up of representatives from hospital boards?
   AndrewD:      I expect that a regional board that makes decisions about local expenditure on healthcare, would need a strong input from the doctors that actually do the work, but the local people would need a say also
                 Probably need something in their constitutions about that, and about public consultation
   BillM:        I think the federal and state governments would want to appoint some of the directors.
                 It might be possible to design a transparent process for selecting directors, that was not an election but still ensured public input.
   AndrewD:      I expect so. The deal would be to not let them dominate
   MarkG:        Appointees from hospital boards, elected persons, medical experts and appointees from the different levels of government
   benfairless:  Nomination process? Like you do for police officer of the year or something

   MarkG:        I can look into some ways of making health dollars go further. There's bound to be ideas out there and we'll have to do that if we want to upgrade the safety net as was mentioned by Bill before
   AndrewD:      Generally, making people healthier will reduce costs
                 Much of this comes down to campaigning/Marketing at people to change their habits
                 The regional centers probably need to be able to direct money into such activities also
                 Like, how amazingly successful has the anti-smoking campaign been over the years, and, given our drug policy ... we're saying it's a health department issue right?
   BillM:        The figures I quoted on the pad show that non-govt spending on health is now 31% of the total. Replacing all of that with public money will cost around 3% of GDP.
                 Even things like urban planning (or the lack thereof) have a big impact on health outcomes.
   MarkG:        I've heard offering specialised training for nurses is one of the more subtle ways of improving efficiency and flexibility
   BillM:        Another advantage of moving away from fee-for-service is that it gives doctors an incentive to use nurses more, hence reducing costs.
   AndrewD:      Yes - and community nursing can take out a lot of the hospital/ER/Doctor visits when it's just something needs bandaging or some dressings
                 and they're more likely to do that if they have a fixed budget per person and they have to make things stretch out and be efficient
   MarkG:        Hospitals can utilise/fund specialised nurse training for whatever their specific needs are. It feeds into the trying different ideas concept of point 10
                 There really is an issue with people going to doctors without a good reason. Community nurses might be a better answer to that than copayments

   BillM:        Does everyone share my hostility to private health insurance?  even with private insurance you still have large gap payments.
   MarkG:        I'm not hostile, but don't see why it should be subsidised. I wouldn't want to give up private insurance, but there's no particular reason i should get tax rebates for having it
   benfairless:  I love my Private Health, but feel bad for those who can't afford it for one reason or another
                 I hate these side agreements that PHI's have with some services  "Oh, you can get Physio for $8 instead of $80, but only if you go to the guy we have an agreement with"... something seems wrong with that
   MarkG:        It's anti-competitive
   AndrewD:      benfairless - That is a really interesting point. The connection between Health Insurance and Health Services has MANY bad side effects
                 BillM       - refer to my discussion trail above about elective procedures. There are degrees and the case for each person is different.
   MarkG:        If private insurers offer something people want to buy good luck to them

   AndrewD:      There are marginal cases, degrees of electiveness in procedures.
                 Consider something that it kind-of elective. 
                 Cosmetic things often fall into this category, but there's cosmetic in the "I want to look like a movie star" case, 
                 and then there's cosmetic in the "I want to have a face" kind of scenario
                 What I worry about, is that there is not a sharp line between stuff that we all agree should be publically paid for and stuff that you should have to pay for yourself
                 They tend to list "Procedures" as being included or not, rather than considering people and their situations
   benfairless:  As you said for cosmetic surgery, getting a breast enlargement (or the equivalent for men) because you feel depressed I don't think should be covered.
   AndrewD:      What then of the woman who just had a breast removed due to cancer and now needs the implant just to look "normal" ?
   benfairless:  Was going to mention that. I think a doctor needs to say it's "medically nessecary"
   BillM:        That approach seems OK to me.
   MarkG:        Seems fair. There's stuff like body dismorphia that's cheaper in the long run if you just grant cosmetic surgery and thus avoid years of mental health treatments
   AndrewD:      What I'd like to see, is a reasonable scheme that allows a fair amount of disgression for doctors, plus some avenue of review. Both ways

   benfairless   What about incentives or requirements for business to contribute to healthcare?
                 My employer provides a rebate on glasses that are needed for work. Others offer "wellness" packages which include certian health benefits...

   BillM:        So, are we OK with scrapping medicare levy surcharge and lifetime cover penalty?
   AndrewD:      Yes from me.
   MarkG:        The tax policy has a not-quite scrapping of the medicare levy

   BillM:        I would like to call it quits soon.  Can I suggest a WG meeting towards the end of the month? Say Tuesday 28th?
   AndrewD:      I vote we wrap it up for the evening.   Meeting -> calendar via  [email protected]
   benfairless:  Agreed