Paul: 0:09

Hello and welcome to the Dispatched Podcast, our first of 2026. My name is Paul Cross, and I'm delighted to be joined by Felicity McNeil, PSM, Chair of Better Access Australia, amongst other things. Hi, Felicity.

SPEAKER_00: 0:25

Hi, Paul. Um, noticing the sunglasses, forgot to wear mine. Um, inspired by Trump, um, had an injury, uh, an eye infection.

Paul: 0:35

Emmanuel Macron Emmanuel Macron.

SPEAKER_00: 0:39

Did you see the room? Did you see the sunglasses? Yeah, they're pretty cool, man.

Paul: 0:43

He thought he was Maverick.

SPEAKER_00: 0:45

He looked good.

Paul: 0:45

He thought it was an eye infection, but I love Trump. I mean, the whole Davos speech by Trump was just people are far too emotional about that guy. If if you didn't laugh during that speech of all the Europeans just having to sit there and take as he well, what's the he was just shit shit? He was shit talking to them all. Just telling him how hopeless they were. I thought it was funny. And when it the the comment he made about the sunglasses, yeah, where he said they have a beautiful pair of sunglasses. What happened there? I think after the little incident on the plane with Macron's wife, that erased some suspicions. But uh oh the Trump's virtual. If you haven't watched it, you've got you people have to watch it. Because if if you you can if you cannot see the humour amongst all the serious talk, then you need to get alive, basically.

SPEAKER_00: 1:49

I I think it's really interesting. We have you know everyone sort of ranting to the media that you know when that bully walks in the room, I'm gonna tell him, I'm gonna tell him, and then they just sit there. No, just sit there and take it. It's that classic thing when you sit there, go, okay, we're all gonna go and do something. We've all been in a meeting where we go, we're definitely gonna tell the boss this thing, and we all walk in and you turn around and your entire cohort is no longer behind you.

Paul: 2:10

That that in corporate life used to absolutely infuriate me when people would do that. But but I I the they were just trash talking him the day before, saying how they were gonna do this and they were gonna do that, and they all just sat there and talked about And and then agreed to the outcome that we'd known he was looking for in the first place.

SPEAKER_00: 2:30

Agreed to the outcome.

Paul: 2:32

And it's just people just have not worked him out, or they are just so emotional they cut they can't work him out.

SPEAKER_00: 2:42

Yeah, and look, I find it interesting, and you and I have been talking about uh President Trump for quite a while, and um good to know that if we ever go to the US we've spoken relatively positively, so we should still get a visa. But um I find that in some respects the extreme reactions from people allow people to then actually come to agreements on things. So I don't object to one sovereign nation seeking to do the right thing by their own people and their own community, and we can sometimes lose sight of sight of that, and when we think about all the trade agreements that Australia enters into to defend our sheep and our beef and our sugar at all costs, and to defend our right to do certain things and our own immigration laws, etc. So I do find that it is creating extreme discussion, which can actually be a good thing. Can we actually stop for a moment and reflect that whether you agree with uh Donald Trump's policies or approach? And and I do understand he is has got a really wicked sense of humor. He is that guy at Christmas that sits down the end of the table, the uncle that deliberately ribs everybody who's at university right now and just says, yeah, well, you know. But I at least appreciate it for the fact that we are having much more sophisticated conversations about politics, about geopolitics, about our relationships with other countries, about what is important in our own country. And for that, while everyone keeps getting hysterical about him, things are getting done both within our own country and with others.

Paul: 4:23

Well, yes. And I mean, he was in the the belly of the beast at Davos, which just attracts sort of the let's let's politely describe them as the gl the global elite.

SPEAKER_00: 4:37

Hi, I'm really wealthy and doing really well. Let me tell you about how good I am and how nice I am to other people.

Paul: 4:43

David Beckham was there. Katy Perry was there with that Justin Trudeau's just just because let's face it, people talk about this global world order as if it's been working for people.

SPEAKER_00: 5:00

Yeah.

Paul: 5:01

And it's been happening for decades and decades and decades. Where they go to these multilateral forums, sign these agreements, and then just ignore and completely ignore them. They never have any intention of following through and what the what they sign up to. In fact, I think countries like Australia are some of the few in the world that actually take those agreements seriously.

SPEAKER_00: 5:20

Yeah, classic middle power. We go, we're the middle child. We go, look, Mom, I've really done such a good job, which in Australia is usually South Australia's.

Paul: 5:27

And and the classic example is Net Zero, where you know, and I'm I'm not interested in a discussion about the rights and wrongs of Net Zero. What we know is that Australia is pretty much the only country in the world who's taking it seriously. You know, the Europe, even the I saw the German chancellor Mertz, and I I have a theory that Mertz, Kirschdarm, Anthony Albanese, and Mark Carney, the Canadian Prime Minister, are pretty much all the same person. But because they all say that they're just one of those AI morphs. I know, I know, they're just dilettants, but but but they uh and they all say that say the same thing. But Mertz came out and said, maybe we did turn the nuclear power stations off a little bit too early. Because if you've been to Germany, it is just completely covered in windmills. If you drive between Munich and Berlin, I'll take your word for it. It's and that's a straight road, basically. And it's got it's an autobus, there's no speed limits, absolutely amazing. But it's just windmills, as far as the eye can see. And of course, they've completely deindustrialised Germany. It's just such a tragic story, but and now they're trying to reverse it. And so Trump, I just I thought it was really and I look, I'm not I'm not gonna reveal my true views of Donald Trump because it's no one's business what I think. But I do think he's right to go and tell those people that a lot of the stuff that you're doing is absolute rubbish, and if you understand the strategic imperative on Greenland, you can argue the rights and the wrongs of how he's gone about it. There is a very strong case for America to have a military presence in Greenland. So, and they're going to get one. So, anyway, welcome to 2026.

SPEAKER_00: 7:13

Yes.

Paul: 7:15

Uh I think it's going to be an interesting year. And during the break, as I always do, I took some time reading the cabinet documents.

SPEAKER_00: 7:24

Uh, to your listeners.

Paul: 7:26

From 2005.

SPEAKER_00: 7:27

I get the text at some random, I go, oh, I've just opened this, blah, blah, blah.

Paul: 7:31

Look, they're they're at they're at they're always an annual interest of mine, but they really should be of higher interest to anyone with any with any sort of level of interest, professional or otherwise, in policy and government decision making. Uh the releases have generally been quite difficult to navigate over the years. Primarily because they don't release all of the cabinet documents. They release a s a small number that have been scrutinized. And based on some input from historians, they're very they tend to be quite they focus on pol political highlights from the period.

SPEAKER_00: 8:10

And you've talked about that in the past, and I want to talk about the fact that this year you were a little bit excited because the ones that you normally have to request and pay for to be released actually showed up on the first of January. And again, if we think about politics, then given what had happened in the preceding four months, six months with respect to MFN, President Trump, what was being discussed here in Australia with pricing and tariffs, it actually showed that perhaps the um the historians had listened to actually what was happening in contemporary Australia, or maybe ministers in charge of those areas said, hey, this is important stuff to have released, because it might help frame what we might need to do and what we might need to be defending, as the minister had said to the whole community, which is his job is not to list medicines, his job is and to help patients, his job is to get the best price.

Paul: 9:02

Well, kudos to the National Archive, because the website they I think they did have a funding boost last year. They put it to good use. So the website has improved out of sight. These documents used to be very hard to locate and access. It's much easier now. Uh they categorised them by department, which sounds like a very obvious thing to do, but it's the first time that's ever happened. But 2005 was interesting because there was a lot going on. Yeah, it was. It was the precursor year to one of the biggest structural changes in the history of the PBS, which was the split into F1 and F2, which were medicines were categorized based primarily on patent status. So this was the period leading up to that. And what you had was uh you had the negotiation of the fourth community pharmacy agreement, a very angry finance department.

SPEAKER_00: 9:57

We're always angry, Paul.

Paul: 9:58

Because when we win, we're angry. Their cohort comments on the fourth CPA was three pages long, which and it was just this and another thing. Like if I, you know, my local council calls me and they they just absolutely cop it. It was just one thing after another because the this the strategy in that agreement was to break the link between pricing and pharmacy remuneration, and they were not successful, and it took another ten years for you basically to come along and do it. So that that was that was really interesting. Now, what had happened the year before, I I will say that Chris Bilke, who was the formerly head of pharmacia in Australia, pharmacia was acquired by Pfizer and set up a generic company called Bellweather, and a mutual friend of ours who is a lobbyist, a very high-profile lobbyist at the time. He took Chris around Parliament House with the pricing list of what generic companies were selling their medicines to pharmacy for. Everyone in the industry knew it was happening, but I don't think there was high awareness in the government that the discounts were as high as they were, and so the strategy in that negotiation was to claw those back. So the government was the beneficiary, but it took a long time to make that happen. But what it revealed was there was an IDC, interdepartmental committee on the CPA. There had been a completed IDC on the PBS effectiveness, quote unquote. And they re-established they re-established that IDC to take another look at the PBS, and it was all about generics aren't being used. Because at the time, for people who don't know, when a generic was launched, basically there was no price reduction to government.

SPEAKER_00: 11:57

Yeah, it was voluntary in 2005, mandatory from 2007, if there's any judges listening to my testimony.

Paul: 12:04

Well well, all of that mandating came out of these pro these processes in 2005. And I think I think it was a really, really interesting time. And ultimately it led to the the split. The government worked out that the gut the government worked out that the price of generics was being held up by HTA. So they had to br crate all those ref old reference pricing links. And if people hate reference pricing now, you should have seen it 20 years ago. But I think what's really, really important is how to consider this, and I'm gonna bring it forward now, is all of those issues in 2005 were in separate submissions. There were submissions about generics, there were submissions about fourth CPA, there were submissions about pricing for medicines, but they all discussed each other. They were all mentioned in each of the submissions. The point being that I don't think the government is looking at these issues in isolation. They think about them holistically. So it so so when you be when it when you bring it forward to to 2026 and you think about HTA review, you think about statutory pricing framework, which was mentioned in the incoming government brief last year, which is probably the last time we're gonna get those that that document in that form, and there's a whole bunch of redactions, you really need to think about them holistically. So, in such a critical 18-month period coming up between now and mid-2027, don't think about HTA review and its implementation in isolation of everything else. So when you when you look at the implementation groom, that's the bit that you see. What the cabinet documents reveal from 20 years ago is that that's not how the government thinks. There's a lot of intraagency involvement. We don't know. Maybe there is an interdepartmental committee on the HTR review. Maybe there was, I presume there was a an IDC on the eight CPA coming out of the 60-day issue. All of these things have to be considered together. We know the Health Department, based on its in incoming government brief, have been in discussions with the Department of Finance about financing new listings and the role of statutory prices, price reductions in that. So the environment that you can't see is highly complex but massively influential.

SPEAKER_00: 14:33

Yeah, no, it is. Um well we do talk. I like the stakeholders who knowingly go to, you know, there are some really smart stakeholders who will not only talk to the department and you know, both junior officers and senior officers, but they will seek to talk to Treasury and to finance to just say, look, we just want to give you context. This is what we're doing, knowing that it's very unlikely that Treasury Department's going, excellent, have you got some more money you'd like us to spend? We would love to do that. But education, because as we've often talked about in the past, and as I used to talk about when I was in the department, once a medicine or something was recommended by the PBAC or some other body, I effectively became the champion and the lobbyist for that to then go through government processes. The department goes from being gatekeeper to lobbyist to get it in. And the importance of actually including information or relevant information that approaches the skeptic skepticism of those other agencies, and and they all have a different perspective and they all have a different view on stakeholders and maintaining political relationships versus physical versus financial. Um, and you know, and you can guess which one does what, uh, as well as the broader areas, but government does always take a more strategic look, and half the time the line agencies hate the fact that finance will be the one that insists that there is a more holistic strategic view, because finance has in some respects the luxury of having to always sit above everything and see where things interact. I think as you know, as I've told you from working in finance, sitting looking at a proposal from one agency that directly impacted another agency and going across to another area of budget and saying, uh, have you got something on this? They're like, No, but this other agency's come up with this great idea too, you know, because communication doesn't happen. So there is always a longer term plan. There is always, if you've got those signals in the IGBs as we've discussed, that is that's still liberate. Like the fact that that was actually released, the fact that it was included in that. If I didn't want, you know, you can go back to RGBs when we all realised that everything was going to be made FIYable, and so governments gave directives on what kind of things to put in the IGB because they would have to be a good idea.

Paul: 17:36

We have 26 bathrooms and three meeting rooms. I mean, that's what they turned into for a while.

SPEAKER_00: 17:41

EBS is established under the National Health Act 1953. The Pharmaceutical Bananas Advisory Committee is And so you'd give a two-through page and say, Oh, and these are things they're you know, we list medicines approximately three times a year based on the meetings of the committee. So that would be there, and then you'd say, This is the kind of things you'd need to look at in your first two weeks, and then the real briefings would go because you could separate them. That IGB, I mean, it was awesome, and as we said at the time, well done to Secretary Blair Comley, it was a really good informative brief, but also it was a really good informative brief. It was a way to not only communicate to a minister who already knew this portfolio backwards and forwards, he knew everything that was in there already. That was a brief that communicated to the community and to the stakeholders. This is what we're going to be up to, guys.

Paul: 18:31

Yeah, I I think you've described the relationships really, really well. Health are the gatekeeper, but at a point they turn into your advocate and often your only friend in a government decision-making process. So for everyone in the pharmaceutical industry and really any healthcare provider, whilst you might be having difficult meetings with the health bureaucracy, understand that that that reflects the challenges facing the health bureaucracy itself. They're having very difficult meetings with central agencies, for example. And that's what that's why it's it's really important to understand those things. So even on something like the HTA review, which is very important to a lot of people, the the the health bureaucracy might appear very difficult on that. And and that's fair enough. They might bring their own opposition to that, they mightn't and that's important to understand. They also might be facing very significant opposition from other agencies, particularly finance, who'll be thinking about it in terms of this is going to make it far more difficult for us to manage this in five or ten years' time. One of the great documents that came out from 20 2005 was the decision to defenestrate Otagi on vaccines and to hand that over to the PBAC and their cost obsessed framework. And the submission, it's look. I'm encouraging people, please go and read it. Because the just the horror from the health bureaucracy that these people were making clinical recommendations and then behaving like they were advocates for clinical decision making on funding vaccines. This was absolutely just it was just dripping with this horror. So we need to make it far more difficult. And that's that's the that's the mindset you've you've got to face.

SPEAKER_00: 20:29

Yeah, and so that's why also m my counter-argument to to yours is that it's equally that the likelihood that the Department of Health is making it sound like it's a really tough thing for them to do so that you go, oh yeah, well, we really want this, so what do you want? Because it may not some of that stuff may not be that tough at all.

unknown: 20:52

Yeah.

SPEAKER_00: 20:52

Some of it really may not, but one of the things, you know, in negotiations we all know is how much our interlocutor wants something or doesn't want something. And the industry does have a tendency to I'd say where it's hard on its sleeve, but that's too hidden. Um it's like we know what you want all the time. And sometimes that is confused with being clear in messaging and knowing how desperate you are to trade off something over something else. So you you've got to be really careful about that, and you've got to work out, you know, as we've talked about since this um HTA review was included in that strategic agreement. It was a str it was a review that was designed for the industry by the department to get what the department wanted under the scope that the department wanted because it wanted to get certain things out of it, which is changes to the way the HTA is going, including, as we all know, the the introduction of the word disinvestment into the national medicines policy copious times, and to actually bring in the cost of actually the system and being able to charge more. Charge more.

Paul: 22:00

It's a cost recovery thing.

SPEAKER_00: 22:01

And then, of course, we've got a HDA review uh report which says, look, all this is great, but geez, it's gonna cost us. And so everything is leading to that moment where you want this, so what are you gonna pay for it? And like you said, this is nothing new. You read the IGB, you read the history of things, this is something that has been worked on and is not new to anybody in central agencies or any other line of industry.

Paul: 22:27

Well, any experience, anyway.

SPEAKER_00: 22:30

So the fact that you're all focused on it as an industry, the HTA review, it's not a surprise to the agencies who've been equally focused on it for the last five years.

Paul: 22:41

But I I can I completely agree that and this is why we have both been surprised at the enthusiasm for this process, because it was never about giving stakeholders what they want, it was about the government getting stakeholders to agree to what they want, and you can see it in the IGB that cost recovery they are completely obsessed with cost recovery and expanding cost recovery, not just in terms of the direct cost of the PBS process, but extending it to MSAC and even Stomer appliances, which is like a tender. But so it's pretty clear what that they want to get out of it, and this is why these documents from 20 years ago, and I have people say to me all the time, oh history, you've got to look forward, you've got to, yeah, but if you don't remember what's coming to the thing about government is that it is incredibly predictable. When I hear people say we just don't want any surprises, which has been the mantra for such a long time, there's nothing surprising in this system.

SPEAKER_00: 23:39

No, everything that's been put forward has been put forward in the past.

Paul: 23:43

Yeah, this it's it's so when you managed to break the relationship between pharmacy remuneration and and medicine pricing in 2015, it had been discussed for over a decade.

SPEAKER_00: 23:53

Yeah.

Paul: 23:54

So nothing that happens in 2026 should be surprising to anyone. The fact that the health department revealed last year that it was working with finance on a new statutory pricing framework, which is effectively what that document said, like that's not surprising. The current one expires in 18 months. They wouldn't be doing their job if they weren't actually talking about it. Now, is anyone preparing for that? No. And my frustration, and I've I've done a series this week on history around medicine's affordability, that for the past 36 months we've had people talking about affordability. Well, it's not doing very much on it, to be honest, but but we've had a lot of discussion about affordability being an issue. But since the 1980s, the the explicit purpose or in policy intent has been to make medicines less affordable.

SPEAKER_00: 24:40

Yeah, because as as we know, the the documents you've been summarising and uh commenting on are based on the 2001-2002 work that led to the intergenerational report where we said the PBS is going to grow by you know astronomical amounts. It was a SpaceX rock rocket. And that was couched in a time of like you've also reported on during the the progress of the the cost-effective analysis in the the legislation, this perception that people took medicines willy-nilly, that doctors couldn't be trusted to uh prescribe appropriately. Hey doctors, do you know how you're doing that to accusing pharmacy of that now? Ha ha ha, the irony. Um so it all comes from some particular place and where we go, and that it was just too easy to get a medicine and it was too cheap and all that kind of stuff. Whereas now we have, you know, I've been watching the the ads come in during the the tennis and the cricket and various, you know, and the the UK traders from the government, which is hey, let's all sit at a picnic knowing that your medicine now costs$25. Well they've been advertising that during the tennis.

Paul: 25:48

Yeah. What are the advertising rates for ten? Why are we advertising a free-to-wear TV?

SPEAKER_00: 25:52

Because I don't know if it was on free-to-wear or if it was on one of the apps. It wasn't general.

Paul: 25:56

It's a gener it's a general copay reduction.

SPEAKER_00: 25:58

And it's definitely on the SPS.

Paul: 25:59

So it's working families. It's working families basically.

SPEAKER_00: 26:02

It's working families who go on picnics. I just want to.

Paul: 26:05

But I said I've said this week, what one in six, it affects one in six prescriptions.

SPEAKER_00: 26:10

Yeah. And and as we know, you know, the the average individual, general patient, is only using a couple of scripts a year, so it's fine for them and it seems really great value. But as we've written for you know, lobbied for years in in our budget submissions and everything, if you're a working family and you're above the the the safety net, that the concession threshold, these medicines are not affordable. And that's before you even start about the number of medicines that aren't even on the PBS. Let's talk about the migraine medications.

Paul: 26:41

Well, as a starting point. What I've done this week is there's 350 million prescriptions dispensed in Australia every year. Uh one-third of those are transacted without any government subsidy. The private market is growing exponentially, and it's not just the GLP ones for weight loss, there's medicinal cannabis. A lot of women's health products. Now, some of those have been brought within subsidy now, but a lot aren't.

SPEAKER_00: 27:06

Yeah, and in particular, sorry to interrupt you, that's a very important area where we've allowed pharmacy prescribing to actually allow women to get access to you know UTI treatments, contraception when they need it. They are still paying out of they are paying out of pocket for that medicine. It is a non-subsidized medicine. They get access to the pharmacist for free, but they have to pay for the medicine, which is something that's supposed to be considered uh as part of this current CPA.

Paul: 27:30

Yeah. So 350 million scripts, of those, uh less than 10% are impacted by the general copay reduction on 1 January.

SPEAKER_00: 27:43

Yeah.

Paul: 27:43

In fact, the m market for non-PBS private scripts, so not under not under copay of PBS listed medicines where people don't get a subsidy, which is over 100 million, uh, will not shrink significantly as a result of the copayment reduction. The private market of non-PBS medicines is bigger in units than the general category for PBS medicines. So let's just put it in context. I'm not saying the government should not have reduced the copay, but let's not pretend it's going to make a huge difference for people. Because the vast majority of prescriptions dispensed to the majority of Australians attract no government subsidy. For most Australians, the PBS is a high-cost medicine subsidy program. If you're on a cardiovascular statin, for example, uh antihypertensive, if you're on metformin for diabetes, if you are on uh a basic pain medication, uh you are paying the total cost of that. And you have virtually zero chance of hitting the safety net. Now, does that affect people like me? Not really. I don't have a lot of scripts, I can afford it, I should pay. The issue that you've identified consistently in recent years and spoken about is working families on median income who don't have a healthcare card, have a couple of kids. The example I used was a family with one child who's got a chronic condition, they're getting 36 scripts a year, don't even get halfway to hitting the safety net. If you're a self-funded retiree, so if you if you're on the median income of$100,000 a year, two adults, two children, you don't get a you don't get a healthcare card for concessional scripts, and you have virtually no chance of hitting the safety net. Or, or frankly, even getting close. A self-funded retiree couple can earn over a hundred and sixty thousand dollars a year and get a healthcare card. And by the way, the$160,000 is tax-free.

SPEAKER_00: 29:52

Yeah.

Paul: 29:53

So that to me is very regressive and and not very fair. I'm not saying that self-funded retiree couple should lose the healthcare card. What I'm saying is the family should get access to cheaper scripts. And if that means people like me pay more, then we should pay more. The fact is that that as I know from my own experience in government, when we put up the tried to put up the copay by almost 40% in the 02-03 budget, which Labour did support in the end, the saving was not from people paying more, the saving was people filling fewer scripts.

SPEAKER_00: 30:30

Yeah.

Paul: 30:30

And the government argued at the time, well, it's all trivial. And we actually had this thing called lifestyle scripts, which has to be the dumbest policy. I see that CHF has been trying to revive this stupid idea where the doctor would prescribe not a medicine, like go for a walk.

SPEAKER_00: 30:46

Go for an art class.

Paul: 30:48

Eat an apple, eat a banana. And that lasted like a couple of months before everyone realised that it was a dumb idea. So yeah, I I I I think we we we've been on this affordabil affordability debate for a few years, driven by people like you, and driven by organizations like the Pharmacy Guild and Patients Australia have been part of that. But I I've I've said if we rely on muscle memory, this is a moment in time. Indexation re-kit restarts. The general copay is going to be back to$30 in a few years. And I think we've is this a long-term structural shift to recognise affordability is an issue? Or is it a moment in time? I suspect it's a moment in time.

SPEAKER_00: 31:37

I suspect it's a moment in time, and I suspect but this is why th there is a complex conversation to be had, like I said, other than 34 scripts for all, which is, you know, if that's what it is for concessionals, even just doing that for generals would be a little bit of a helping hand. But again, if it's not on the PBS, 25 doesn't matter. And you know, I think that's something that the industry really needs to to be focusing and highlighting on, which is how many medicines are not on the PBS, how many medicines are not coming to Australia anymore because of the system. So like I said,$25 only matters if it's on the PBS.

Paul: 32:16

The the The privatization of the PBS is making that more and more challenging. And this is goes back to the point why people have to look at this program holistically. Yes. If if you are shifting cost, which is what's happened, people talk, oh, the government's not investing in the PBS, but script volumes are rising and spending is going up. It's just that it's shifted massively in recent years to actual patients. So government spending is being constrained because it's shifting off the PBS.

SPEAKER_00: 32:46

Yep.

Paul: 32:47

So the reduction of the general copay is not really gonna change that. No, it'll slow it down for 12 months. So when they reduced the copay last year, the general copay to$30, the category flatlined. Okay, so it's gonna start growing again as indexation returns in terms of under copayments. So what happens is the government's ability to fund new medicines is naturally contracting over time because its share of PBS spending is shrinking. Its share of pharmaceutical spending is shrinking. Sorry. So it's it's harder and harder and harder. And PBSC responds perfectly rationally to that. There's less money, so we have we are going to make tougher recommendations. Uh industry responds to the tougher recommendations, particularly in the context of MFN and globe pricing in in CMS in the US. They say, well, we're not going to accept the price. And the critical thing is, from the industry perspective, and from a stakeholder perspective, this is important for patient groups to understand all these relationships because government will understand it.

SPEAKER_00: 33:58

Yep.

Paul: 33:59

And speak accordingly and provide the evidence, it is it is so critical at this juncture that if MFN if the new the US approach to pricing, which is mimics our own for the past 40 years, so we can't really complain about it, if if companies are delaying the listing of drugs or not progressing the listing of drugs in Australia because of what's happening there, combined with the pricing in Australia, then please say it. You've got to say it. Don't just go away and hide, hoping that they're nicer to you the next submission process. If you don't say it, nothing's gonna change.

SPEAKER_00: 34:40

Correct. And and if you don't if you don't get it in um before you know it, the legislation will be sitting there in front of the parliament again like this week, that it'll be rushed through without it with any hesitation.

Paul: 34:52

Let's talk about this for yeah. Zony week in camp. Parliament wasn't even meant to see it.

SPEAKER_00: 34:59

No, it wasn't. Surprise!

Paul: 35:01

Surprise. And then and then can I just I just want to say you know, LinkedIn has always been a a death roll for me. I can't stand it. But after Bondi and after The Age in Sydney Morning Herald decided to publish a cartoon that Goebbels would have been proud of. I I I cancelled my age subscription. Not not you know, and the I grew up with the age. My first job was delivering the age when I was young. It's it's it's important to me. Personally. And then I published that, and I just my view was well, I'm just not I'm not gonna pay for it. I I can just walk along the street and get anti-Semitism.

SPEAKER_00: 35:53

For free.

Paul: 35:54

For free. Some idiot wearing a kafir they got off Timu. I can get that for free. I'm not gonna pay for it. That that that was just the most horrible anti-Semitic trope by that cartoonist who I'm not even gonna name. I said that on LinkedIn politely, or wasn't Rangerous? Got this stream of invective back, which I showed you, and then I my my response to was well here's what this is why we need a royal commission, Prime Minister. This is you just look at the comments. And if you don't think anti-Semitism is not a problem in Australia, then I mean I know I I I don't think the Prime Minister is is anti-Semitic, but it's not in his heart. I use the analogy of uh me engaging in a debate about whether Carl McCollin would be better. And if I I like to argue for Collingwood, it's not in my heart. Okay, so so people would see it. But the fact is that members of his government marched across Sydney Harbour Bridge last year with people holding photos of Hania and Nasrala and the Ayatollah who's now got the blood of thousands of people on his hands.

SPEAKER_00: 37:07

Yeah, it's been a um an interesting week in Camber and obviously we yesterday had the National Day of Mourning, which confused me a little bit because it just seemed to be all over the shop.

Paul: 37:19

Yeah, thanks, David Little Pro.

SPEAKER_00: 37:20

To be perfectly honest, um it it really was it real or was it not? And yet, you know, had some feedback from people who were working at Parliament House this week and the incredible trauma in the gallery of people watching and reliving. And I think we all need to remember at times that making people relive an experience is very, very difficult. And um, you know, kudos to many of the senators and members who said some quite heartfelt and uh c courageous is probably the word these days for when you stand up against uh anti-Semitism and what happened in Bondi and and everyone's focused on it. But it was also an awkward week because you know I I listened to Senator Pocock who didn't support the passage of the bills, not because he didn't support that this work needed to be done, but why? Why were we doing this mad rush? Why were we cutting out the community from consultation so quickly? Why couldn't we have just okay, give it to us now? And we're gonna be here in two weeks' time, let's let's do it then and there, let's let's do it properly. And that to me again highlighted the absolute cods wallop that has been the handling of this by the government, which is it's all been about politics. And you know, to accuse the opposition of playing politics when they're constantly calling them and and referencing the politics. The reality is the Prime Minister didn't do anything about this, he didn't listen to the community. It took an extraordinary number of people to publicly come out, and then it wasn't even about us as a community, it took community leaders, people that you know, whose names meant something on a piece of paper uh or in an article for the government to realise that they they had to do something. They were dragged, kicking and screaming to it. Everything was like, what do we have to do to try and and hose this down or to make it go away, as opposed to this as a community that's really focused on this, really worried about this, and what is wrong with having a really robust debate, even if it means I have to hear some things I don't like to hear, and I know you don't like to hear, and I you know, I I used to cop a lot online when I started posting on October after October 7th and what was happening in Australia uh when that that first incident at the Sydney Opera House. And I used to cop a bit, and you still occasionally do, but nothing. It's always interesting. I find that I get to get a I can be allowed to say more because I am I'm not of the Jewish community, so therefore people don't attack me as readily as they will attack you. And that conversation needs to be had because we needed to actually air this all out. So it's why the Royal Commission is so important because we need to we need to hear it all, all the ugly truth, and we need to take it on head on and we need to do it properly. And I just think that, you know, in between, you know, now unfortunately, whether deliberately or otherwise, this really important, serious issue has been in some respects hijacked by an issue going on within a political party, which kind of gives the government a free kick in two weeks' time. We're going to be talking about um you know liberal and nationals and what's going on with them as opposed to staying focused and holding the government to account not only on its um uh allowing anti-Semitism to rise in this country but perhaps also their their travel entitlements but so many things they need to be held account for and we risk d distracting from that and it really, really frustrates me yeah it frustrates me I'm completely with you on that I don't think there was any need to rush I don't anti-Semitism hasn't been around since October 7.

Paul: 41:15

I know Jewish schools and synagogues have had security guards for as long as I can remember me too you know a police presence at Ben Gurion here in Canberra at the Holocaust Memorial which is is also a synagogue in a Habad that that that's not new had private security guards for as long as I can remember and the AFP have always had to be there. So this isn't this is nothing new. Everything's been a political calculation on this since it happened you know that the the Prime Minister's decision to visit Bondi the morning after when there was no one there didn't meet the community didn't only only attended a Gentiles funeral and I I don't mean that in an insulting way I the Jewish fam families would not have wanted him to be there. I think they made that very clear when he turned up I mean good on him for turning up to the memorial he got the the treatment he deserved and unf unfortunately this government has made my community part of a political calculation since October 7th when our foreign minister went to Israel after and didn't go to the site of the massacres the kibbutz in in southern Israel and so everything's a political calculation he invites President Herzog here and of course people want that cancelled it's just the whole thing is a complete f farce to me that that you had the Greens turning up to Bondi Yeah that was I that was difficult to watch. That was the i I found it incredibly difficult to watch and my frustration is that my community is far too polite about this far too polite. And and the fact that they st I mean maybe they didn't recognise that Senate particular Senator and that and now and now and now that Senator is now talking about the Jewish you know the global conspiracy this is this was during a motion in Parliament paying tribute to the victims. And you've got the self-loathing Jews Adelaide Arts Festival the Adelaide the writers festival talking about the the the dark hand of the Jewish lobbyists are you kidding me as Michael Gwenda pointed out in the Australian when he was editor of The Age there's nothing secret about these people they're very open these organizations have names and the leaders are interviewed every other day there's nothing secret about it they they try you know you cannot be a Jewish person an anti-Zionist I'm sorry you can't for whatever the Prime Minister says what does he argue for? He argues for a two state solution that makes him a Zionist I am a Zionist I'm I am a very proud Zionist I'm an old fashioned Zionist and I I do not recoil or deny that term in any way it is deeply deeply personal for me and in ways that very few people understand but I hate the way this has just been a political calculus all along 100% really and and this week has been the exemplar of that these hate speech laws are they going to stop people waving photos of Hania and Nasrella and Sinhua and the Ayatollah while they while they're in protest marches which which are attended by government MPs before you get the Greens and the former Australian foreign minister who's lost his mind on this stuff that is that is my none of no no no changes in hate speech laws are going to stop that. And the the fact is we are allowed to grieve in this case we were allowed to grieve for a couple of and I said this on social media I said we're allowed to grieve you give us two weeks like you you gave us 48 hours after October 7th whilst those murderous goblins were running around in southern parts of Israel killing people at a music festival people were demonstrat preparing to demonstrate here in Australia I'm sorry I'm sorry these relics of the Barter Meinhaf group from the 1970s in Germany in the Red Brigades who who make all the same arguments you give us a very short time to grieve and then it it all restarts you you I'm gonna say something this will get me in trouble now you wanted this war you celebrated it when it happened on October 7 you got what you wanted I don't want to hear any complaints. I don't want to hear any complaints so you know I get very angry about so I said I'm gonna I get very angry about it. And you know you know the nicest thing that happened to me after Bondi was the support of my friends because I don't I I've said I've lost friends in the last couple of years. And they're not real friends so it's like it's okay. But the people who have supported me my community have continued to support it including my neighbours because you know I flew my colours very publicly and and people said very nice things. My neighbors were very nice about it and I'm I'm appreciative of that because I'm I I am uh a Jewish Australian who's also very proud of Israel and I make no apologies.

SPEAKER_00: 46:57

You wanted this war we gave it to you and yeah people have died who shouldn't have died you know we shouldn't have attacked us on October 7th and yeah I'll get some emails send 'em by all means give us a bad review go right ahead I couldn't care less the idiot idiotic things that were said to me on social on LinkedIn I'm like oh okay right I you know it's it's it's a mental illness this hatred people have I have certainly I think we've talked about it in the past when um October 7th first eventuated and because it's sadly we've been talking about all this now for over two years which is I was naive in my understanding of the racism which is anti-Semitism is racism. Just people need to be very clear on that that you experience on a regular basis that it was unfathomable to me that no no we've all moved on this isn't really how it is um you know it's perhaps just that you know the odd the odd thing happens a bit like you know in in my religion you usually get teased here and there and it's been such a harsh and humbling and saddening learning to see it consistently increase since October 7th it was like a a gate was opened and people should feel free and the enabling of that within Australia by our leaders by our parliaments by our communities by the way that we you know we we we talk about influences all the time we worried about our children on social media you know we've we've had a laugh on that last year but you talk about how things are put out there and perpetuated well could we talk about how that happened this is one of the things that will be really important in the Royal Commission which is how did that all happen? How how did you know statements made by the head of ASIO who talked about what the greatest threats were at you know to Australia's safety which was anti-Semitism and that not be actioned I mean we can all see why the Prime Minister didn't want a Royal Commission because there are things that are going to have to be asked and you know what that's where it should be you know Scott Morrison didn't want to be asked about RoboDt but here we are the department didn't want to be asked about age care but here we are you know everybody didn't you know no department wanted to be asked about you know what was going on with disability. Veteran suicides no one wants to talk about it. So you know I'm so so grateful to you that there's so many people you know with public stature who use their public stature to influence for change for that Royal Commission to be called I was disappointed this week because the politicization that has continued and from you know both sides of the of the aisle now because of of what's happened and part of that is because it was rushed uh and it's created this this further wedge that we don't need. We need to actually debate and sort these things out but you know it's it's going to be a long year.

Paul: 50:01

It's going to be we've got a long you know we've got a long budget process ahead of us we've got you know unemployment down which you know interest rates up interest rates will be going up so cost of living is going to be there again um we've got you know more Tesla and Chinese batteries to install that oh my god cheaper rate oh that that was a classic wasn't is that that's the the saving that wasn't actually a saving yeah can you can you explain this to you this is real this is really critical the program that was meant to cost two billion was going to cost 14 but they've revised it down to eight and so it's a five billion dollar saving.

SPEAKER_00: 50:35

Yeah so that's that's actually not a real saving normally but you'd go to jail if you did that as a company.

Paul: 50:39

As it could be charm charging you with fraud.

SPEAKER_00: 50:42

Under the budget rules we wouldn't we would we consider that an estimates variation. However obviously the department that did it was very smart and said well this is now what it's going to cost and they put in a new policy proposal which can ch can trigger the budget operational rules so then you can try and claim the save. I guess that's what they did. But yes it's got to be an ironic thing when you completely miscalculate and misjudge how when you have put incentives into a market and in particular the incentives for the supplier how things will will operate and then to try and count that all as a savings measure was was most amusing. But I guess there's there's a big year ahead of us you know this sector is going to have a lot going on there's so many things coming to fruition either publicly or not publicly known and a lot of things are going on in the background we've got a broad broader economic challenge this is the last budget when any government will try and actually do something that's fiscally responsible because then they're facing an election so do a bit of hard love now go into my EFO before we then get ready for the next election. So this is this is going to be a big big year but a big six months and in the middle of an economy that you know we like to pretend it's going really well but it is actually struggling and the community people are struggling with the the um the economy and it's in what it's doing to their cost of living we're also going to be tackling these really serious issues and and we have to make space for all and we have to give time for it. So it's great that Dennis Richardson's going to expedite his stuff which is you know all fair and good if there's a way that you know ASIO and ASUS can communicate better with home affairs and you know various other eight and state agencies. Good good to know that sooner rather than later but we also need to be very honest as a country and get to the bottom of who knew what and who kept saying no to things if they did and what what were we trying to do as a country to to protect everybody.

Paul: 52:37

Yeah I I agree and and the role of social media obviously I'm I'm not I don't think I'm a supporter of this under 16 banks. I don't think it's going to work in the long term but and I I think human history shows that doing that is probably probably not going to be effective but I I stand to be proven wrong on it because I'm not a big user of social media it's and my sporadic uses of LinkedIn end up with me being very annoyed and my Instagram feed is pretty much all bass and hound puppies and things that I've searched for to buy on Google. Yeah like barbecue cleaners so it's not it's not it's not but but look the I don't know whether you saw the report that in the last uh 24 hours this guy who was gonna s throw Molotov cocktails in an Australian day event on Monday and I do want to talk briefly about Australian Day before we finish but and he he posted on Facebook which is how ASIO found out I mean it's like what how stupid are you like I'm gonna do this on Australian Day.

SPEAKER_00: 53:39

Thanks for sharing thanks for sharing I mean obviously ASIO aren't more sad but yeah I'm they've probably got an algorithm an AI algorithm that says oh okay if a go if someone is threatening Molotov cocktails at a should check that one we might we might that should come in on my fingers I think people it's been like someone said to me I think it was Jim Zenos actually uh from Nostradata said to me AI is going to make some people smarter and some people dumber yeah and and I thought that's Jim's a great guy I thought yeah that's it's very prescient I suspect but it's a very accurate representation of social media the impact of social media too it is and and before you go on to Australia Dave one of the things that really really frustrates me with this government and uh and in particular Minister Wells who is you know promulgating how fantastic it is that she's made these changes to protect children I'd like to remind most of those ministers in that government that you regularly post photos of your children. From babies to any age without that is if we want to talk about protecting our children doing that without consent doing that without considering what that does to the risk to your children for their identification for the future use of that information. I mean you only have to look at the campaigns the highly public campaigns in Ireland and Denmark and others that show the dangers to parents of actually constantly posting information about your children or photos of your children as part of your own thing.

Paul: 55:19

You showed me those videos those ads are horrible those ads are terrifying yeah they are they are absolutely terrifying people should search search for them.

SPEAKER_00: 55:26

Yeah well we should I'll I'll give you the links but you know it talks about the fact that you know that the guy walking around going oh you know happy birthday Jenna oh oh good luck you know is your mum going to pick you up from soccer or is it dad? Dad tends to run late and this child just watching going what's going on it's like you post so much about your child's life people know way more about them and then there's a second one that talks about the fact you have been putting so much information about your child online without their consent from such a young age that a they they can actually generate a sense of your child so by the time your child's 18 they can actually duplicate who they are.

Paul: 56:03

It just doesn't mean that people have to be told not to do that. And particularly about ministers and people in senior decision making roles on behalf of taxpayers. I just think it's a bit like those ads, you know those safety ads that they don't leave the gas on on your butt you know at home.

SPEAKER_00: 56:20

People need to be told that or when you remove the plastic bag from your cover don't leave it near a child. Yes don't suffocate your child but perhaps we can add to the bottle of that and while you're at it don't post your kid on Instagram unless you're sure that that's appropriate to do how stupid do you think we are it's like obviously people are stupid and as it turns out given the guy posting it on Facebook then he's going to be throwing Molotov cocktails in an Australia Day event apparently we are quite stupid as it turns out but I do want to talk about Australia Day and I have to say I am very happy to see the surge in support for the 26th of January as Australia Day.

Paul: 56:57

Yes I am so fed up with the Debbie Downers in our society who've decided that we've got to feel bad about everything. The fact is that this country yeah of course was colonization great for the indigenous people in Australia probably not I'm happy to have that debate with someone but does that mean we've got to be completely downbeat about the achievements what this country has achieved since I mean James Cook now they're talking about changing the name of James Cook University. James Cook was not a colonist no he originally came here Venus the the the transverse of Venus across the sun and to assess if you go to Greenwich they talk about the the trip because he was testing the longitude instruments and they were so desperate to colonize Australia they came back 18 years later that's how desperate they were if you want to get a real lesson of colonization read about the Congo and the Belgians and read about the conquistadors in the Americas so I'm not saying that we shouldn't have a discussion about it. I just think we need to be holistic about it. We can we can walk and chew gum at the same time and we can celebrate the great achievements of this country and they have been great and we should do that on Monday and I'm looking forward to celebrating and these absolute peanuts and these companies say if you don't you know if you don't want to celebrate on that day you can work from home no doubt and you can take a holiday another day no that's you're either all in or all out like if it's a matter of principle for you then don't do it. Then don't do it. Go to the office but of course oh I'm gonna work I'm not I'm not gonna celebrate Australia Day but I'm gonna work from home that day it's like yeah right you're gonna afford a couple of emails it's an absolute joke to me and you know the people who do have to work it's people in the service industries yep hospitals hospitals healthcare workers you know so let's you know there's a group of people who benefit from those sorts of policies and the vast majority of of us don't and so I'm really delighted to see the surgeon support particularly from younger people.

SPEAKER_00: 59:12

Yeah well I think there's people want to have pride and like as you say people can recognize most people are intelligent obviously not quite the ones that post on Facebook their intentions but people can say I appreciate that this happened and this is where we are but there's also a lot of good people like you said they can do both and we can have the sophisticated conversator going around talking about James Cook you know the first flute can we if we're gonna have a conversation about the first flute and we've discussed this before can we please understand what they went through none of them wanted to be here.

Paul: 59:51

Half of them died half of them died before the second flute came out two years later it was horrible horrible existence for And we can have both conversations. We can have both conversations. But pretending that this country the whole world's colonized at some point. The biggest victims of empire and colonialism. We're probably the English, yeah. I mean how far do we want to go back and talk about how many times was that country invaded?

SPEAKER_00: 1:00:25

The French, the Danes.

Paul: 1:00:26

Yeah, read about read about the Norman conquest in 1066 and the salting of the fields that destroyed agriculture in that country for 100 years. So let's have a mature, informed conversation about it. We can do both. And I sometimes feel that the ridiculousness, this r ridiculous tokenism is it helps people avoid a serious conversation about the plight of indigenous people in this country. Correct. Because it is of great shame what goes on in some of these communities and we don't talk about it. The prevalence of sexually transmitted diseases in children. Like if you want to blame colonization for it, blame it. But don't do it to avoid a conversation about the issue and how it needs to be resolved.

SPEAKER_00: 1:01:25

Yeah. This is an example of, you know, we've been talking earlier about you need to understand history to to keep in in putting up the PBS. This is an example where we need to moderate how much we input history into actually solving the problems of today.

Paul: 1:01:41

Yeah, your reconciliation action plan is not going to do it. It's not going to do it. Because they all say exactly the same thing. These companies pay tens of thousands of dollars for these things. And they all say we're definitely, definitely going to give some can give some consideration this year to engage in an Indigenous-owned business. I mean, it's come on. That's if you want to do something about it, do something about it. But let's not let's not pretend. And this is why I don't do country acknowledgements at my events anymore, because I'm not going to make you all feel good.

SPEAKER_00: 1:02:17

That that solves the problem.

Paul: 1:02:18

That that solves the problem. It does not solve the problem. It doesn't even go close to solving the problem. So last time, you remember the event last year where I said, I'm not going to do it, but I'm making a donation to a domestic violence shelter. And I encourage you all to do the same. And that that covered the cost, I'm still doing it, covered the cost of a bed for a victim of domestic violence in Hell Springs. So I thought I'm very proud to be celebrating Australia Day on Monday. And I hope other people feel the same way. And based on the recent polling, it appears that they do. And I hope for those people who want to work as a matter of principle, get off your ass and go to the office. No work from home nonsense. Go to the office.

SPEAKER_00: 1:03:07

Be truly defined. Go on. Show it.

Paul: 1:03:09

And if you're doing it as a matter of principle, don't take Tuesday off or next Friday off.

SPEAKER_00: 1:03:14

Correct.

Paul: 1:03:16

Do it as a matter of principle. But I'm I'm I'm looking forward to it. I think it's going to be a fun day.

SPEAKER_00: 1:03:21

And a hot day.

unknown: 1:03:22

Yeah, right.

Paul: 1:03:24

Hey, I do you reckon Annika Wells is going to appear at the Australian Open? I think it's pretty unlikely, don't you?

SPEAKER_00: 1:03:31

Oh, I don't know. It's kind of one of those. I know she's the sports minister. She's the sports minister. Usually the the Department of Health sports representatives go there in their droves.

Paul: 1:03:43

I know. Well she might send like the local MP as her representative. Minister does that. Yeah. But uh I feel sorry for her now because she can't do a job.

SPEAKER_00: 1:03:53

Well, she can. She just can't take the family with her.

Paul: 1:03:56

No, she can.

SPEAKER_00: 1:03:57

No, I mean, as in, I know she can take her family with her still, but she won't now because everyone knows how much it's costing her.

Paul: 1:04:03

I love the change where the family can still go, if like the spouse can still go if they've been invited. Okay, so Tennis Australia issues an invite to her and her husband. And the and the partner has to the spouse has to fly economy. So everyone's just missed the fact, okay, so the politician still gets to sit at the back of the plane, or their spouse sits down, sits down the back. That's gonna go down a treat.

SPEAKER_00: 1:04:26

It's like, yeah, just save me something. Save me the chip. Quick manager determines that I need to eat first.

Paul: 1:04:33

So they're getting the bottled water and the cookie or whatever they give them now.

SPEAKER_00: 1:04:37

Yeah, it's all good.

Paul: 1:04:38

Anyway, Felicity, welcome back.

SPEAKER_00: 1:04:42

Likewise.

Paul: 1:04:42

Thank you for that. That's a good chat. I've really missed doing it. And we're making some changes to this year, and we're in discussions with some people about that. I haven't advanced those discussions because it's been a bit of a break time, but we will. But we do enjoy doing it. We appreciate the feedback. Uh, if anyone wants to send me a bit nasty email about my comments about anti-Semitism, go right ahead. I don't care. Uh I'm I'm more than happy.

SPEAKER_00: 1:05:08

He frames them.

Paul: 1:05:09

Yes, I treat it as a as a as a badge of a badge of honour. Uh but uh yeah, I hope everyone had a good break and is looking forward to uh I think what what is going to be a really, really interesting year.

SPEAKER_00: 1:05:23

Yeah, look, thanks for the extra few weeks off because it's gonna be a long one.

Paul: 1:05:27

It is, it is, it is gonna be a long one. Thanks for listening.

SPEAKER_00: 1:05:30

Thanks, Paul.