Pyrmonter: Don’t let the data get in the way of your predisposition

The coronavirus pandemic has led to many judgements based on very limited data, often inescapable uncertainty, among which have been judgements of the comparative performance of different institutions, both political and market.

One that has emerged recently from the Victorian experience, and which has been championed by the ABC’s Norman Swan, is the comparative performance of private and public aged care homes.  Private homes (among which he counts ‘for profit’ and ‘non-government’ institutions)  appear to have much higher rates of Covid infection, something which surely is a Bad Thing.

While Swan’s Coronacast has been admirable for its clarity and near-complete disregard of the excesses of political tribalism, the Health Report, which he has presented for decades, has toyed with selective data-interpretation that flatters Swan’s avowedly social-democratic and anti-market prejudices, previously manifested in opposition to private pharmaceutical business, support for the centralised Pharmaceutical Benefits Scheme and scepticism toward private practice by the medical profession.   Swan it will be recalled first came to justified attention by revealing the poor scientific practices of William McBride, so it is regrettable when he uses his platform to jump to convenient conclusions.

Yesterday’s Health Report covered the apparently poorer performance of (mostly urban) private aged care homes compared to the (often rural) public homes.

In Swan’s hands, this is a matter of the absence of continual supervision by people holding occupational licenses – Registered Nurses – echoing a long-standing campaign by the nurses union to require the (expensive) employment of its members; as well as disparagement of the training and care delivered by casually employed lay staff, all sacrificed either to ‘lack of funding’ or the ever-evil profit motive.  (Swan appears to have forgotten the damning findings of the Royal Commission into South Australia’s government-run Oakden Older Persons Mental Health Service).  A link is here.

While the differences between institutions may be a contributor to their performance – there are reasons to be sceptical about the performance of both for-profit and ‘not for profit’ operators in the Australian aged care ‘market’, which features numerous policies designed to prevent entry, competition and choice by patients and their families – it is folly to jump to conclusions about comparative performance without considering context.

Here, a paper linked on Marginal Revolution provides some insight: a chief mode for transmission is the employment of staff in multiple homes.

Presumably this occurs more readily in private homes in urban rather than rural labour markets, where opportunities will be fewer; and among the less unionised carer groups.  If so, that’s a useful, and perhaps foreseeable, insight – but not something that flows inherently from the profit motive or the governance of the operator.  It is something one would expect could be managed by the personnel offices of each organisation.  It’s a problem that might well arise in the public sector, if staff were allowed to move between state operated homes.

By focusing on whether homes are state or independent, Swan likely misses the cause of the problem, and champions an illusory solution.

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15 Responses to Pyrmonter: Don’t let the data get in the way of your predisposition

  1. Petros

    How does Norman maintain his continuing professional development to call himself a doctor? Does he still see patients?

  2. Bruce

    Yet another example of the statists having a long-entrenched solution for which they have now found a “problem”.

    SOP

  3. Squirrel

    “…. the apparently poorer performance of (mostly urban) private aged care homes compared to the (often rural) public homes…”

    Fascinating insight – and yes, it’s very hard to believe that workforce issues (and not just stability) would go quite some way towards explaining the difference in outcomes between public and private care homes.

  4. egg_

    The coronavirus pandemic has led to many judgements based on very limited data, often inescapable uncertainty

    Welcome to the world of risk management, after-the-fact numpty!

  5. entropy

    The public homes are mostly rural, and the opportunity to have workers working in multiple homes extremely limited by distance. And that is even before you get into whether or not a lot of the services provided across urban private sector homes are even available in the public ones (the answer is not).

    That said, I would have thought that in the current covid response, movement between aged care facilities would be the second activity curtailed (after entry to the country) but no, we were too busy persecuting people going to such virus unfriendly locations such as the beach or the golf course.

  6. egg_

    What’s this Winter’s Seasonal Flu death rate to date?

  7. NoFixedAddress

    Isn’t it great to see that Australia has shed the notion of “Democracy”.

  8. NoFixedAddress

    Dear President Chávez,

    We, the undersigned citizens of Australia, would like to extend a warm invitation for you to visit our country. We have watched developments in Venezuela with great interest. We have been impressed by the great effort that your government has taken to improve the living standards of the majority of Venezuelans. We have also noted with keen attention the moves that your government has begun to make to create a society based on popular participation in all spheres of society—from the workplace up to the national government.
    Although we are on the opposite side of the globe we feel that our shared ideals of social justice and democracy bring us close together. Every country has its own traditions and culture and has to find its own solutions, but what Venezuela has been able to achieve in so little time will be a source of inspiration and ideas for many in Australia.

    In this light we believe that a visit to our country by yourself would not only help to improve the awareness of the Australian people of developments in Venezuela, but also be an unparalleled opportunity to strengthen the ties of friendship and solidarity between our two peoples.

  9. Beachcomber

    I don’t get it. People who are very elderly, frail and reaching the end of their lives will inevitably pass away. They often die in nursing homes. Why is this a major health crisis and scandal?

    Just looked at the the Australian Data. A total of 11 deaths yesterday in all Australia. OK. So in all of Australia the authorities could link only 11 deaths in some way to “Covid-19”. And that is with all the increased meaningless testing and “positive” results that are labelled as “cases”; despite the fact that almost all of these “cases” have no symptoms and are not cases of illness. And again, we know that all the deaths will be of people who were elderly, frail, reaching the end of their lives, or suffering other diseases.

    This is a mass delusion and vicious charade the like of which has never occurred before. We are being played for fools and abused by the Establishment and their Ministry of Truth media.

  10. Beachcomber

    Watching the Ministry of Truth Media tonight it is starting to look like Australia is the most stupid nation on the planet. Maybe too stupid to survive.

    The justifications for the manufactured crisis are breathtakingly idiotic and lacking in Reason. Nowhere is the Ministry of Truth able to show any evidence of illness and death caused by a super-infectious, super-deadly new virus.

    All they can show is new “cases” which are nothing more than positive results from scientifically meaningless testing. The number of new “cases” has nothing to do with the spread of a disease. It is entirely determined by the amount of RNA PCR “testing” and how those tests are conducted.

    It bears repeating over and over again.

    The world is suffering from a massive delusion based on the belief that a test for RNA is a test for a deadly new virus, …..

  11. Eyrie

    Around 400 people a day die in Australia on average. I wonder how many of the 11 died of or with the virus?

  12. Gerry

    I tend to agree that the prevalence of Wuflu outbreaks in Private Nursing Homes IS linked to staff mobility often between several Private Nursing Homes. But why does this not apply to Public or not for profit (NFP) institutions. I suspect a look at FBT rules might shed some light on finding an answer.
    Charity and NFP can package staff salary. From the ATO: ‘A public benevolent institution (PBI) is a charity whose main purpose is to relieve poverty, sickness, suffering or disability.
    Examples of PBIs include:
    disability support services
    some not-for-profit homes for the aged ….

    My admittedly superficial understanding of this salary sacrifice arrangement as is stands is that a private, for profit organisation wanting to employ an existing Charity and NFP staff member, may have to offer between $17,000 and $30,000 just to match that person’s current take home, more to attract them. Calculating the actual after tax difference is beyond my pay grade. I think this makes it clear why Public institution jobs are tightly held, and privates are left to employ who they can afford.

  13. John A

    Presumably this occurs more readily in private homes in urban rather than rural labour markets, where opportunities will be fewer; and among the less unionised carer groups. If so, that’s a useful, and perhaps foreseeable, insight – but not something that flows inherently from the profit motive or the governance of the operator. It is something one would expect could be managed by the personnel offices of each organisation. It’s a problem that might well arise in the public sector if staff were allowed to move between state-operated homes.

    Allowing for Gerry’s insightful analysis above, one asks, Are we being told anything about state-operated homes?

  14. Ubique

    Absolute cracker of an article in The Oz by Greg Sheridan regarding the collapse of democracy in Victoria.

  15. steve

    yet another Swan screws Australia….

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