Copayment Realities

Medicare Dismantling

By Mike Fitzsimon

 Tuesday, December 23rd, 2014 at 23:42

It’s not just Medicare that is being dismantled; the very existence of General Practice is also at risk.  It’s not just asking patients to pay $5; it’s THE CHAOS on the other side of the reception desk.

There is no way a GP can bulk bill, and accept the Medicare rebate for, a consultation up to 10 minutes after January 19.  To do so would mean they are operating below cost price.

It’s bad enough that the Rebate paid to GPs was frozen for another 4 years at the 2014 budget.  There is certainly no corresponding freeze on practice costs; receptionist and nurse wages, surgical dressings, rent, electricity, phone calls, IT services, laundry, etc.  These all increase relentlessly.

And sure, the reduction is not as severe for longer consultations.  But with costs increasing, any reduction is not sustainable.

And before anyone says, “Yeah, but doctors make a lot of money”, let me tell you: GPs who own their own practice DO NOT.  You might be thinking of employee doctors who are contracted and paid a fixed fee per consultation, hospital doctors on a salary, or specialists.

URGENT Action Now

As far as anyone in General Practice knows, this horror will be visited upon our nation’s primary care system on January 19.  It will be introduced “by regulation”.  This means it will not go before the Senate.  There are no Senators to be lobbied, this time.

It can only be stopped by a massive flood of complaints to sitting LNP members.

Phone, email, write to your local member of parliament.  Point out how their attempt to crush Medicare will also kill General Practice.

Email to our Local Member

My wife, Maureen, is a hard-working family medical practitioner with 35 years experience.  The last 33 years have been in our local area.  She is now treating the grandchildren of the people who were her first patients.  She does home visits and continues treating patients in nursing homes.  Proper family care.

She is extremely busy and rarely takes time out to address politics, but now it is serious.

This is the email she sent tonight to our local LNP member for Forde, Bert Van Manen.

From: Maureen FitzsimonDate: 23 December 2014 20:56:52 AESTTo: Bert van Manen <bert.vanmanen.mp@aph.gov.au>Subject: Medicare dismantling

Dear Bert,

Are you aware that your government has slashed the Medicare Rebate for consultations up to 10 minutes with GPs from $36.50 (frozen for the last 3 years), to $11.95, for the patients of all GPs who have undertaken 3 extra years of study, and thousands of dollars in course fees to gain post graduate qualifications?

 Meanwhile, a nurse practitioner, who studies for 1/3 of this time, attracts a $16.95 rebate, and a GP who has not bothered to gain these qualifications, attracts a rebate of $21 for the same time spent.

I’m furious, and the patients are going to be contacting you in droves when this slug hits them on 19th January.

Government expenditure on General Practice has risen just $60 per person per year, over a period of 10 years. If the government wants to save Medicare dollars, I have a myriad of suggestions.

For instance, other specialists training for around the same time as postgraduate GPs are often seeing patients for only a couple of minutes, and attracting Medicare rebates of $120 and more.Most specialists also demand a new referral every year, (usually unpaid work for us), so that they can charge patients as a “new patient”, when clearly they are not. If we refuse, and insist on a 5 year referral, we are seen as unreasonable, instead of them being fraudulent.Many specialists hang on to patients and see them for minor complaints, easily managed cheaply by GPs.

Child psychiatrists demand a referral for the mother, father, and child, and most of them charge for each one. When GPs see a child, we do not charge Medicare for seeing the parents as well as the child.

Many of the areas in which GPs hold skills are not rewarded at all. For instance, I prevent numerous referrals to rheumatologists, costing Medicare considerably, by performing joint injections. The Medicare rebate was reduced to zero a few years ago for this GP service. I continue to do this procedure, as I am skilled in this, and patients cannot afford $450 for a visit to a rheumatologist.

Ditto diabetes. I have done several advanced courses in diabetes management, as have my nurses. Endocrinologists in Brisbane charge $450 for a consultation. With my colleagues, we save the Federal and State Governments countless thousands of dollars by managing chronic conditions, such as diabetes, for a pittance.

Similarly, I have postgraduate qualifications in Psychiatry, and rarely refer, saving more dollars to the patient and taxpayer.

I could go on and on. Demolishing general practice will result in massive blow outs in the health budget. No young doctor is going to study for 12 years, and incur a massive HECS debt, to be valued at less than a nurse, trained for a third of the time.

Australia spends 9 per cent of GDP on Health (and not much of this is on general practice). The USA, which does not have a universal health scheme, spends over 17 per cent of GDP on health. The USA is moving towards a family doctor model of practice, while your government is kicking GPs into oblivion.

Your Government talks about a “price signal”. Then, after announcing this latest version of health policy “on the run”, Mr Dutton announced that GPs would now be able “to bulk bill 8 million Australians”. He was referring to freezing the rebate for card holder rebates for another 3 years. Where is the “price signal” in that? I know this chap was a public servant formerly (and still is!). As such, he does not seem to have a clue about small business. How does he think GPs are going to do this promised non price-signalling bulkbilling with rebates frozen for 6.5 years? Wages, insurances, rents, accreditation, drugs and dressing etc., are rising all the time.

I could go on and on. I have 35 years’ experience of this topic. The politicians making these policies, which are disastrous, short-sighted, and very, costly - not cost saving- , have not had time to even look at these issues for more than hours. Ignorance reigns!

Currently, I do a MINIMUM of 2-3 hours of unpaid work every day. That’s enough.So, in summary, the career politicians, inexperienced in the real world, who make up the leaders in your government, are going to cost this country dearly.

Any questions and complaints will be referred to you, as their local member, and the new health minister, Sussan Ley. GPs are not prepared to cop the flack from these cutbacks. If your government wants to cut rebates by up to 67% - as detailed above- for common GP consultations, you will need to defend it. 

Dr Maureen Fitzsimon

Sadly, the only response was from Bert’s “Out of Office” message advising that his office would be unattended until January 5.  This goes “LIVE” 14 days later!

This post originally appeared on Mike Fitzsimon's blog "MikeFitz with overflow bit set..." under the title Medicare Dismantling. It has been reproduced here with Mike's permission. 

The Other Side of the Fence

As several media veterans have noted, ABC Political Editor Mark Simkin’s decision to jump the fence from journalism to political spin is a courageous one indeed. Never mind for the moment the product he has to work with; the two fields are not as similar as many assume them to be, and as technology, media and audiences become more sophisticated, the differences become greater. 

Mr Simkin has accepted a role in the Prime Minister’s Office (the PMO), heading up Tony Abbott’s Communications Team. Included in his position description will be such fabulously new and interesting concepts as crafting the message, media strategy, scheduling, social media engagement, stakeholder management, risk management, damage control, feedback and assessment – and if these aren’t all in the position description of Communications Director, they’re doing it wrong.

My lecturer in Communication 101 started our first lecture by telling us that the quality of our communication would be effected by our perception of the product. In other words – don’t try to sell a product you don’t believe in. We’ll have to assume that Mr Simkin is a Liberal supporter. Like Abbott and Joe Hockey, Mark Simkin is a product of a Catholic North Shore education, courtesy of St Aloysuis’ College. 

This move should mean a change in profile too, as Simkin moves from in front of the cameras and behind the microphone, to behind the scenes and out of sight. Tony Abbott must be front and centre as both the product itself, and the spokesman for the government. While redeveloping Tony Abbott’s public persona with one hand, he’ll also need to work on minimising the visibility of Chief of Staff Peta Credlin. 

The first challenge Mr Simkin will have to deal with is Tony Abbott’s skill-set. Personal charisma may be an asset, yet Public Speaking is not in the Prime Minister’s strengths column.  Even his scripted speeches and press conferences are peppered with ums, ers and uhs, resulting in a faltering rhythm that lacks the air of confidence and robs his words of credibility. A speech therapist, or a stint with Toastmasters might work wonders.

And lets stop calling it a “gummint”!

Don’t expect miracles though, as the Prime Minister has admitted that he doesn’t trust himself to stick to the gospel truth. Coupled with his awkward speech pattern, we can almost see his mind ticking over, searching for the next phrase or repeating the one he’s just said. At its worst, it’s uncomfortable to watch.

The logical approach is better preparation - rehearse the Prime Minister to the nth degree. The downside: you risk a Pavlovian response similar to the one we saw this week with Lisa Wilkinson on the Today Show. Ask a question about the government’s achievements? Talk about repealing the Carbon Tax. Repeat the rehearsed talking points and annoying slogans. 

And then there’s the messaging. Tony Abbott’s pressconference yesterday about the threat of terrorism in the aftermath of the Sydney siege was simply one of the worst press conferences I’ve ever seen. From anyone. Are we supposed to be afraid of the terrorists, or reassured that the government, along with police, ASIO and Defence, have the increased threat under their control? Even experts in terrorism were puzzled, suggesting that the press conference was unofficially raising the threat level from three to three and a half. 

Since the G20 in Brisbane last month, the government has been in panic mode, with the Prime Minister talking openly and vaguely about barnacles and resets. Frankly, these terms, these conversations are the ones that should be kept within the PMO. Weeks of mocking speculation about who or what might constitute a government barnacle have provided a new setting for Canberra’s brilliant crop of political cartoonists. 

The Reset itself, announced in a Monday morning press conference that should’ve set the agenda and tone for the week, has been such a spectacular failure that had it not been for the announcement, we might not have noticed it at all. The standout message from that press conference was that the need for a reset was equivalent to an admission of failure. And now, we’re scraping barnacles off the reset, or resetting the barnacles. It's unclear. It’s been an awful few weeks of strategic communication that should find its natural home in a first year textbook about what not to do.

Then, of course, came this week’s reshuffle, less than a week before Christmas. Aside from former Assistant Treasurer Arthur Sinodinos, only one Cabinet level barnacle was punted – former Defence Minister David Johnson. To the amazement of many on the left, as well as some on the government back benches, serial underperformers George Brandis, Christopher Pyne and Joe Hockey were left unscathed. 

The deeply unpopular Scott Morrison has been moved to Social Security, unleashing a torrent of hostility and disbelief that the Minister who has dealt so callously with asylum seekers will be handling our unemployed, our homeless, our disabled and disadvantaged. Former Health Minister Peter Dutton, a man so loyal to his constituents that he tried to hop electorates to a “nicer” one and failed preselection there, gets to wrestle with on-water matters in the Immigration portfolio, while Kevin Andrews, known for his pre-nuptial counselling vouchers that no-one wants, gets to play with the big boys’ – and girls’ - toys at Defence during a period of significant upheaval.

It doesn’t matter how many times the Prime Minister expressed his confidence in his senior ministers, or how many times he refers to a year of achievement. If the public is not convinced, repeating it won’t help.

Obviously, Mark Simkin’s new role will be about managing perceptions, and right now, the Abbott Government has an enormous problem with how it is perceived. How do you spin a positive message when the figurehead is a poor communicator, the message is confused, and the product is unpopular?

My old Communication lecturer would have told me to walk away. Unless Mark Simkin believes heart and soul that the Abbott Government is on the right track, he – and the government – will continue the struggle.

Ginger,get the popcorn!   

The Ironing is Delicious

Whenever Prime Minister Tony Abbott opens his mouth, he jams at least one foot into it. Don’t laugh – it’s fact worthy of the Guinness Book of Records. No-one can be that verbally accident-prone, surely. There must be an explanation: magnets, or a super-secret homing device that mean his toes are fatally attracted to his molars.

The only other explanation is that he’s just stupid, and we wouldn’t elect an inarticulate chump to lead our country, would we?

Don’t answer that.

Instead, let’s explore this morning’s display of involuntary foot insertion, televised for all to see on Nine’s Today Show.  When host Lisa Wilkinson asked the Prime Minister – who has appointed himself as the Minister for Women – what was his most worthy achievement as the Minister for Women, he answered repealing the carbon tax. 

"Well, you know, it is very important to do the right thing by families and households. As many of us, er, know, women are particularly focused on the household budget and the repeal of the carbon tax means a $550 a year benefit for the average family."

And there goes his foot, all the way down to his tonsils. Apparently the carbon tax is a women’s issue, because when we’re balancing the grocery budget, we’ll have an extra $550 per year to spend at Aldi. Or we could save it all up to spend on doctors' visits and pharmaceuticals.

Two things spring to mind: Firstly, I know of no-one who is saving anywhere near $550 a year on their electricity, and secondly the absolute certainty that Tony Abbott has been instructed that the answer to any question about his government’s biggest achievement is “repealing the carbon tax”. If Ms Wilkinson had asked what his biggest achievement for multiculturalism was, the answer would have been the same. If she’d asked about his biggest contribution to arresting climate change, the answer wouldn’t have changed then either.

It’s nothing new for the Minister for Women, though. As Opposition Leader, one of his early foot in mouth displays involved having no carbon tax, thereby benefiting women by making the electricity cheaper so that women could do the ironing at home. After Mr Abbott’s gaffe today, countless vintage ironing memes appeared on social media. 

"What the housewives of Australia need to understand as they do the ironing is that if they get it done commercially it's going to go up in price, and their own power bills when they switch the iron on, are going to go up," Mr Abbott said in 2010.

Yet again, it falls to someone else to extract the foot. Today, it was Julie Bishop’s turn, and she did a reasonable job of trying to make his remarks as vague as possible. 

"Women's policy is everyone's policy," the deputy Liberal leader said. "What's good for women is good for the community generally.

"I think the Prime Minister was focusing on the policy change that would have the largest impact on families and households and getting rid of the carbon tax is certainly that."

Meanwhile, we still don’t know why, when he had the opportunity to add more women to his front bench, he chose to keep such stellar betesticled performers as Attorney General and Minster for Bookcases, Senator George Brandis, former Minister for Heterosexual Marriage, Kevin Andrews, who is now in charge of Defence, and the former Minister for Copayments, Peter Dutton.

Apparently we should be thrilled that he doubled female participation by promoting Sussan Ley to Minister for Health. It’s hard not to be insulted when he promises promotion to Cabinet is strictly merit-based, but can only find two women who merit a position up front.

When Lisa Wilkinson asked the question about the Minister for Women’s biggest achievement, she wasn’t looking for a stock one-size-fits-all response. She was looking for action on more conventional ‘women’s’ issues’ – a focus on domestic violence, pay equity, affordable child care, sexism and gender discrimination – and we all know that. The fact that Mr Abbott was unable to address any of those issues by pointing to an achievement is a measure of how effective he has been as Minister for Women.

Strangest of all, polling by Roy Morgan shows that women are generally more committed to action on climate change, and were more accepting of the carbon tax. Perhaps if he was to spend more time listening and less time gnawing on his own shoe leather, he might not have such a problem understanding women.

I'll be over here, not doing the ironing.

Anti-Social Media

In case you’re not a Twitter user, or have been distracted, a bizarre political topic has been generating a lot of interest in Australia: #blockedbybishop has been trending for most of the last 24 hours.

The phenomenon started yesterday, when a few political engaged tweeters discovered that they had been blocked by Foreign Minister Julie Bishop. (For the non-tweeters, if you’ve been blocked by someone, you can’t follow them. In practice, if you’ve been blocked, you can’t see that person’s tweets in your twitter feed, or search what they’ve tweeted, although there are ways around that for determined tweeters.) According to Twitter:

Twitter gives users a variety of tools to control their experience, including blocking. When your account is blocked by another user on Twitter, we limit your account’s ability to interact with that user.

If you visit the profile of a user that has blocked your account, you will not be able to see that user’s Tweets or other account information.

But why would a federal Minister block hundreds – possibly thousands – of twitter accounts? Obviously many of them are from the opposite end of the political spectrum, and some of them may even be abusive - and twitter abuse should always be met with a firm block. Having said that, I know that many twitter users on Ms Bishop’s Block list are polite, interested and engaged Twitter users because they’re people I tweet with on a daily basis. But some of the blocked tweeters don’t follow Ms Bishop, have never even tried to follow Ms Bishop, and have no interest in following her. The only pattern seems to be that she has blocked twitter users who don’t agree with her, who support Labor and the Greens, who question the policies of her government.

I’m one of those Twitter users that she’s blocked.

As communication strategies go, it’s absurd, particularly when almost three million Australians are Twitter users. These users defy the stereotype; rather than teenaged girls swooning over the latest tweet from Justin Beiber or Harry Styles, QUT researcher Axel Bruns described Australian Twitter users as being more mature. 

He said while many users remained anonymous or gave limited biographical detail on their handles, some common traits about #aussietweeters emerged.

“They seem to be in the 25 to 55 age range, fairly affluent, well-educated, urban users, what advertisers would call the AB demographic,” Professor Bruns said.

“[So] it might only be 2.8 million accounts, but those accounts probably represent a particularly influential slice of the Australian population.”

Social media is an important part of the communication mix for this government, even though many MPs still refuse to use it. In February this year, the Sydney Morning Herald reported that the Department of Immigration and Border Security had paid $4.3m to consultancies to monitor social media with the aim of monitoring sentiment towards the department’s policies. Unhelpfully, this multi-million dollar investment was about “market research”, not about engaging. 

Excerpt from Julie Bishop's Twitter feed (@JulieBishop)

Social media is not like traditional broadcast media in that it allows the users to engage with each other in discussion. In fact, savvy users of Twitter expect to engage and be engaged, and political Twitter users expect to find people who share their perspective as well as people who oppose it vehemently. What Ms Bishop has done is to mute one side of the conversation, ensuring that she only engages with those with whom she shares some common ideology. She’s preaching to the converted. Needless to say, that’s not the way to win votes.

This wholesale blocking of political opponents is not government policy. In addition to being blocked by Ms Bishop, many of the left-leaning tweeters have also been blocked by Joe Hockey, but not by Tony Abbott, Scott Morrison or Mathias Cormann. Therefore, the mass blocking by Ms Bishop and Mr Hockey must reflect their personal preferences, or those of the respective communications teams.

Pierre Omidyar, founder of eBay, summed it up this way: 

I've seen firsthand the power of human connections online forming communities of interest. They are self-monitoring, with their own norms and expectations. From the printing press to the telephone to the Internet, each of these tools has been a way to organize and activate -- to give people the voice they want and deserve. Forward-thinking governments will listen to those voices and empower them. Others will be fearful of the voice of the people and remain on the losing side of history.

The reality is that Ms Bishop and Mr Hockey are losing far more than the twitter users they’re blocking. They have consciously chosen to silence the dissenting voices and reject the chance to engage with half of the electorate.

In contrast, those of us who have been blocked have lost nothing; anything of importance will be retweeted into our twitter streams anyway...and that's just one way of accessing the tweets of someone who has blocked you. Wouldn’t it be wiser Ms Bishop and Mr Hockey to break out of the petty, Coalition-friendly echo chamber they’re sustaining, and listen to all of the Twitter users who might want to communicate with them.

Source: http://3rdsense.com/blog/09012014-1121/australian-digital-statistics-2014

Inside Canberra's Beltway

Australian voters should be forgiven for asking who the hell is in charge of our federal Government. Is it the Prime Minister and Cabinet, is it the Senate cross-benchers, or is it the Prime Minister’s Chief of Staff, Peta Credlin? Whoever it is, the Australian people aren’t happy, and a government “reset” isn’t going to change that.

Rumours are circulating through the back benches and the media that we can expect a Cabinet reshuffle, and possibly a Liberal leadership challenge during this holiday period. The problem for the battered government is that no amount of reshuffling or spin can undo the damage of the past 15 months quickly.

Many fingers, including some from within the government itself, have pointed to Ms Credlin as the root of all evil. This week, we’ve been inundated with reports – and subsequent denials – that Ms Credlin and Foreign Minister Julie Bishop are not on good terms.

On behalf of those of us who are not on the inside, I say who bloody cares? In a comparison with The West Wing – something conservative commentator Chris Kenny will hate – nobody elected Peta Credlin.

It’s an unenviable position; the chief of staff to any government head is undoubtedly a powerful position, and yet it needs to be silent and virtually invisible to the outside world, and should hold no sway at all over policy. The role of the Chief of Staff is to facilitate to workings of the leader’s office, and act as a wise counsel to the leader…and to stay in the background. 

So why is Peta Credlin all over our media?

Back to the West Wing we go: In America, there’s an idiom to describe those who are in the know, who are connected to the federal Government. If you’re described as “inside the Beltway” you’re a Washington DC insider. Beltway Bandits, as they’re sometimes known, work in or with the government; they mix with other Beltway Bandits and include the politicians themselves, their senior staff, experienced media, lobbyists and some senior public servants.

Peta Credlin is at the centre of Canberra’s version of the Beltway. Married to Brian Loughnane, Federal Director of the Liberal Party, she is incredibly well connected – as if her title wasn’t enough to open any door she needed to open.

Beltway Bandits like Mr Loughnane and Ms Credlin share one colossal problem. They don’t get out much, resulting in a vicious circle of whispered rumours and half-truths, bouncing around Canberra like so many silvery balls in a psychotic pinball machine. Hit a journalist willing to run with a story and Ding-Ding-Ding! A little nugget of inside information stands a chance of crossing the Beltway into the real world.

Peta Credlin should never have become a household name outside of Canberra’s Beltway. That she has developed such a high profile suggests that there’s a problem: she’s wielding too much power with stakeholders inside the Canberra Beltway, or she’s too visible, or too controversial, or she’s incompetent…or she’s having an affair with her boss – an unsubstantiated rumour that’s been bumping around for years.  

There’s definitely something that is newsworthy about Peta Credlin, and she’s been happy to put herself in the public eye when it could benefit Mr Abbott.

Peter Van Onselen says much the same thing in his editorial for the Australian this weekend:

Many of the attacks on Credlin are unfair; others are entirely fair. Some reporting is conjecture, and much of it would be unwanted. But there is no escaping that across newspapers and other media platforms she is getting a level of attention out of all perspective with what’s tolerable for a backroom operator.

If it were a simple case of a media pack peddling untruths, that would be one thing. But the criticisms are coming from cabinet ministers, junior ministers, parliamentary secretaries, backbenchers and even sections of the leadership team. Abbott’s loyalty prevents him from removing Credlin, and that is to be admired. But a chief of staff loyal to “the boss” shouldn’t put a PM in a position where his loyalty is tested. Not in a Westminster system.

News Corp’s Samantha Maiden reported today that Liberal MPWarren Entsch has lodged a formal complaint against the Prime Minister with the government whip Phillip Ruddock. The issue is Tony Abbott’s defence of Peta Credlin, which emerged as an accusation of sexism towards those backbenchers who’ve quietly complained about the Prime Minister’s Office to anyone who’d listen. 

“It’s not about her bloody gender for God’s sake,’’ Entsch says.

“Is Julie Bishop sexist? He needs to be very careful ­because there are a lot of cabinet ministers who have a problem with how the Prime Minister’s Office is operating.

“One cabinet minister doesn’t know what the other is doing. They are briefing against ministers out of the PMO. It’s coming from the PMO. The buck stops with him or it stops with the chief of staff.”

Warren Entsch is not the first person to complain about Ms Credlin, although he may be the first to make that complaint through official channels, and go on the record with the media. Back in late 2011, when the Liberal Party was in Opposition, Crikey’s Power Index rated the Loughnane-Credlin duo alongside Kevin Rudd and Therese Rein. Of Ms Credlin, they said: http://www.thepowerindex.com.au/power-couples/

Credlin travels everywhere with Abbott, organises his diary, hires and fires staffers, and oversees his media appearances. She's the one who's kept Abbott, once regarded as something of a loose cannon, so ruthlessly on message throughout the year. The Queen of No, as she calls herself, has also cracked down on non-media staffers fraternising with the press gallery.

She's got a lot of admirers – but also a heap of enemies. Backbenchers who have been on the receiving end of one of Credlin's savage text messages find her overly abrasive. Party elders, meanwhile, worry she's obsessed with short-term political gains at the expense of strong policies.

Without the existence of a Beltway-style echo chamber in Canberra, Ms Credlin’s profile may well have remained in the shadow of her Prime Minister, where it should be. While Peta Credlin should take much of the credit for elevating Tony Abbott to the Prime Ministership, her profile and her reputation are now a liability to the entire Abbott government.

Whether Tony Abbott can survive the demands of the Prime Ministership without Ms Credlin running his office, his diary and his media appearances is yet to be seen. The left would undoubtedly like nothing more than to see the current level chaos continue until the government implodes and an election becomes inevitable. 

The quickest way to “reset” this dysfunctional government is to reset the Prime Minister’s Office – and that means that Tony Abbott will have to get past his loyalty and replace Ms Credlin – whom nobody elected.

Don't Call Me Stupid

Conservative commentator Rowan Dean has scaled the heights and reached peak absurdity. In an opinion published by News Limited yesterday, Mr Dean proposes that recent opinion polls do nothing more than prove that the majority of Australians are largely morons for preferring Bill Shorten as Prime Minister over Tony Abbott. 

In surprising contrast to recent media coverage, interviews with Prime Minister Abbott by everyone from Karl Stefanovic and "Chris" Koch to Alan Jones and Andrew Bolt have been critical of the government, but Dean's commentary lacks even a single note of negativity about the government. All of his criticism is aimed at "us", telling us - the x% of the population that prefers Bill Shorten to Tony Abbott - that we're wrong.

Wrong, and terminally stupid.

Of course, Rowan Dean - advertising and marketing legend, conservative writer/commentator and talking head for hire - and the Liberal Party are right in every way. The rest of us should remove our flawed, inferior DNA from the Team Australia gene pool.

It's a calculated opinion, deliberately placed in News Corp's daily tabloids. His words are for the readers of Murdoch's dailies who may have been carried away in the unexpected wave of end of year anti-Abbott hysteria. Regardless of how bad you might think Abbott is, Shorten will always be worse, wafts from the spaces between the lines.

Bill Shorten, when he wasn’t busy knifing one leader to replace him with another, then knifing that one and replacing her with the first one (clearly a man of strong convictions and sound decision-making skills), sat at the big table and happily splurged our cash. And we want to put him in charge of cleaning up our finances? Darwin Award for Category A Stupidity – tick!

While criticism of the Abbott Government is entirely absent from Mr Dean's rant, so too is praise. Nowhere, not even once does Dean have anything complimentary to say about the Abbott Government. There's not a word of approval, no hint of respect for the first fifteen months of the Abbottocracy.

Condescension is in plentiful supply though. Mr Dean takes aim at conservative-leaning swinging voters who are fleeing the barnacle-ridden Good Ship Abbott in search of calmer, saner waters, and proceeds to mock them for not agreeing with him.

But Mr Dean has sailed off into the Sea of Snark, taking with him a vague argument loaded with assumption. He's hoping to convince a segment of voters that sways on the breezes of practicality to stick with Tony Abbott because Bill Shorten was a member of the Rudd-Gillard governments. 

Really? That's an argument you could make about anyone leading the federal Labor Party. Equally, you could refer to Tony Abbott as the 'former Opposition Leader', as @ABCNewsIntern did on Twitter last night.

The Coalition won the 2013 election with simple slogans that reminded us to be afraid of something, underpinned by a sustained attack characterised by a single concept: We're better than they are. After more than a year in government, many undecided voters have decided that's no longer true.

Don't try to lecture these people on vague principles; they aren't interested. The question they want answered is "what's in it for me?" and Mr Dean has not acknowledged the question, much less answered it.

By the way, it’s neither necessary nor wise to treat your audience as though they’re dumb:

Let me run that past you again – slowly this time, really slowly, because it’s obvious there are some pretty slow people out there: a … majority … (in other words, enough voters to win an election) … think … (i.e. have apparently used what passes for their brains and come to this conclusion) … that Bill Shorten … (a bloke who is so empty-headed he once said: “I don’t know what Julia Gillard said, but I agree with every word of it”) … would be a better prime minister … (in other words, be making every single decision every single day for three years that will determine the prosperity and financial success of every one of us and all our children) … than Tony Abbott (a bloke who, regardless of whether you like him or not, has as his sole focus a single-minded determination to fix the economic mess that this country is in).

Those who respond to ideological argument have already chosen sides. Suggesting, with all the subtlety of a McDonalds birthday party, that those with a solid ideological preference will shift when reminded that "we're better than them" is at least as dumb as Mr Dean believes Australians to be, and those who are open to change are moving left.

We were just dumb enough to allow Tony Abbott to be Prime Minister once. Don’t expect us to be that stupid twice.

A Matter of Trust

Today’s edition of The Australian suggests that Aussies are pessimistic and have stopped listening to the federal government. Economics writers Adam Creighton and David Uren propose that continuing uncertainty about job security has us all in a bit of a funk. What’s even worse? We’ve stopped listening. We’re not paying attention to the Abbott government’s attempts to regain control of the agenda via Operation Reset this week.  

“Pessimism is becoming a standard part of the current ethos,” said sociologist Hugh Mackay, who blames the insidious impact of the spread of business marketing techniques into political campaigns.

“If the sloganeering and branding persist, people will feel politics is being trivialised more and more, resulting in ever lower esteem for the process and the players,” Mr Mackay said.

The saddest face in Australian politics: Malcolm Turnbull

Business marketing techniques in the political sphere might have a role to play in our national mood, but so too does the chasm between what was promised by the Coalition prior to the election, and what has been delivered since. This climate of political ennui is a direct result of what the Coalition set out to develop when they were in Opposition: they wanted voters who were afraid of the status quo and distrustful of the government. They got their wish...and it got them elected.

Fifteen months later, the electorate still distrustful of their government, but this time it’s a different government. The approach goes far beyond economics: just look at the impact of the top three Coalition campaign slogans:

Stop the Boats

Regardless of intention, years of hearing ‘stop the boats’ and ‘off shore detention’ and ‘illegal refugees’ has made far too many Australians fearful of the people who are actually in those ragged little boats. Myth upon myth has been allowed to stand: myths about the amount of government allowance paid to refugees, the amount of crime committed by refugees, the standard of accommodation provided to refugees, about the religion and culture of these refugees and the dangers of allowing too many of “them” into “our” country.

The militaristic branding of Operation Sovereign Borders suggests that Team Australia is at war with the asylum seekers, rather than with those who operate the boats. Conservative politicians like Cory Bernardi, Jacqui Lambie and George Christensen support the myths, virtually unchallenged by the mainstream media and the obvious result? Fear. Fear of the brown Muslims in the boats. We can’t let them onto our precious land, lest we’re overrun with Sharia Law and gun-wielding criminals hiding under burqas.

The government’s decision to remain secretive about OSB hasn’t helped, particularly in light of the revelations about ‘on water matters’ on the ABC’s 7:30 last night. Keeping secrets is not a virtue in a society that values transparency and truth. 

Axe the Tax

A key plank of the Abbott campaign for government was their promise to repeal the dreaded Carbon Tax. The Coalition, clumsily aided by shock jocks and tabloid media, made their conservative audiences loathe the tax – and the doubt the reason for it – years before they ascended to government. The Coalition warned that Whyalla was going to be wiped off the map, and a leg of lamb was going to cost $100.

The tax was introduced and Whyalla remains as a functioning township where you can buy a decent leg of lamb for about $30. Australia survived the Carbon Tax, but the fear remains: fear of what might be introduced to replace it. In a unkind twist, those voters who aren’t afraid of the ‘cost’ of the Carbon Tax, or who believe that the benefits outweigh the risks, are terrified of the consequences of not having a national response to climate change.

Get the Budget Back Under Control

In order to accept the need to get the budget under control, we need to first accept that it was out of control. Despite Australia’s safe economic passage around the perimeter of the Global Financial Crisis, a rare Triple A Credit rating from all three ratings agencies, and Wayne Swan’s gong as Treasurer of the Year, the Coalition managed to convince a large slab of the population that Australia was sinking under the burden of massive debt and deficit we could never sustain. 

It was a relief to conservative voters when the Coalition won the election in September 2013, and the delicate Australian economy could be passed into the safe hands of Treasurer Joe Hockey. That relief has turned to pessimism, even for the Coalition’s most ardent supporters, when this year’s budget was unveiled, shattering pre-election promises, delivering less of something to almost everyone, and hitting the most vulnerable the hardest.

Pessimism is turning to incredulity now, as the Treasurer struggles to pass key measures of his much hated budget, seven months after it was brought down. In doubt are not only the Coalition’s commitment to policy promises, but also their ability to deliver them. Today’s growth figures just underlined the problem and confirmed that the government is somehow not delivering the results it promised.

“Listening” to the government is the probably not the best terminology the Creighton and Uren could have chosen to describe what’s not happening in the electorate. It’s more about not trusting or not believing than it is about not listening. 

Hugh Mackay in the Australian today:

“People are bewildered by what’s going on in politics — there’s a lot of eye-rolling stemming from a lack of trust in politicians,” he said, suggesting that Tony Abbott “personified” this for now, given the contrast between statements before and after the election.

This week’s attempt to "reset" the Coalition’s message hasn’t worked, and won’t. A 45 minute media conference by a distrusted politician can’t undo fear and suspicion built on years of focused campaigning. The pessimism, disengagement and cynicism are unlikely to reverse any time soon.

Strong Language

*** Warning: This post contains strong language. ***

"There's more than enough money in the goddamn budget for a three percent increase" declared Senator Jacqui Lambie yesterday, referring to her call for higher wages for Australia's Defence personnel. 

It's probably unusual for a politician to use such strong language in front of the media, although Senator Lambie is playing the parliament game using her own set of rules, most of which she makes up as she goes along.

Her use of "goddamn" to describe her feelings about the federal budget found me considering my own use of fruity language. Would I have described it as "goddamn"? I wouldn't, but "goddamn" is not a word I use. It's not that I don't swear; I've worked with truckies, wharfies and roadies. I just don't swear all the time.

But I love a good swear. Letting fly with an inventive string of expletives can be liberating and creative and expressive and cathartic and fun. Swearing is for special occasions; it can even be event or person specific. Employing four letter words as general descriptors is lazy and ultimately self-defeating. If you say fuck all the time, what do you say when you hit your thumb with the fuckin' hammer? Ow?

Profanity has been around forever. You'll find it in the Bible and in the works of Shakespeare. Our own Prime Minister Tony Abbott uttered a well-publicised "shit happens" while talking to defence personnel about the deaths of their colleagues. The tidal wave of criticism that followed was far more about context and attitude than it was about the language he used. Former PM Kevin Rudd was well known for his willingness to share his feelings without censoring his choice of words, and comedian Billy Connolly owes much of his stage act to his sweary-Scotsman persona.

It's possible that the Brits are the best at swearing, and the posher they sound, the better they swear. Just imagine the Queen, Nigella Lawson or Sir Patrick Stewart swearing a blue streak - and I'll bet that at least two of them do! Consider the Oscar-winning brilliance of Colin Firth in The King's Speech. 

Acclaimed British actor Dame Judi Dench admits to a bizarre hobby. On set she does elegant needlework featuring really rude words, and presents them as gifts to her co-stars. 

Corinne Grant has a rage index, which she describes in her recent must-read opinion for The Hoopla. Her prolonged aaaaarghs, and associated levels of rage are as joyous as a really good swearing session, and much more refined.

My late Grandma Queenie, a devout Presbyterian from a more genteel era, had three - and precisely three - levels of profanity. Bloody was the word for minor annoyances, like when her Canasta game was cancelled at the last minute and she already had her step-ins and stockings on. Mid level incidents, like breaking her favourite Royal Albert tea cup and saucer in the sink, would earn a heartfelt bloody bugger. The big kahuna of Grandma Queenie's delicate blue-tinged vocabulary was shit. I imagine she said it a few times when I wrote off the car at age 20, or when her young grandsons dug up her 'onions' and proudly presented them to her as ready to cook. (They were the tulip bulbs she'd planted just days earlier.)

But I've had a shocker of a year. The combination of testing personal challenges and the political antics of the Abbott and Newman governments has forced me to re-calibrate my personal list sweary-meter. No longer will a slightly hysterical Hugh Grant-esque fuck-fuck-fuckity-fuck do. With the assistance of Twitter and the Hipsternet, I've even outsworn Bill Nighy's magnificent turn in Love Actually: Fuck Wank Bugger Shitting Arse Head and Hole. I have an entirely new and improved lexicon of vulgarity, ready for any occasion.

Here, with apologies to Grandma Queenie, is my Top Ten:

10. Bollocks/Balls - useful in many mildly annoying situations, like when you spill coffee on your white linen shirt on the way to work.

9. Pants - for when your favourite television show is cancelled.

8. Shit - for when you realise that the fairies who unload the dishwasher are on strike.

7. Arse - usually related to cars and flat things: flat battery, flat tyre, flat petrol gauge.

6. Fucking Hell - for when the cat vomits on Mum's carpet

5. For Fucks Sake (abbreviated to FFS) - usually used on Twitter when a politician or troll has said or done something incredibly stupid.

4. Arsehat - used to describe Eddie McGuire, most real estate salesmen, and some annoying but harmless celebrities.

3. Douche-canoe - the noun to describe the politician or troll who has prompted the FFS; someone of the magnitude of Malcolm Turnbull explaining cuts to the ABC.

2. Fucktrumpet – Used exclusively to describe Joe Hockey.

1. Solid Gold, Fur-lined, Ocean-going... - used to preface any of the nouns above to multiply their intensity.

I'm yet to find a swear word or pithy phrase appropriate for life's genuine disasters. Redundancies, car crashes, most of the nightly news are just too horrific for the same old words we use every day. The current hipsterish comment "I can't even" suggests I'm not alone with that dilemma, although it too is becoming trivialised through overuse.

Sometimes silence is the most eloquent response.