Friday, January 16, 2015

Solar suppliers: get serious

I am a believer in solar power. I'm also an owner of solar power, and I run a business on it.

When I say “the supply side of the solar power industry in Australia is a sad joke”, I say it from a position of intimacy and dependency.

I'm not some right-wing nut-job trying to undermine the industry. I want it to work, and I'm not happy with carpet-baggers, snake-oilers, and passing profiteers stuffing it up.

I have spent a week trying to source critical equipment for fast delivery, on the Internet and on the phone, and I have failed utterly.

Last Friday, a lightning strike destroyed two 48V inverter-chargers at Bunjaree Cottages, which runs on solar power. Since then, apart from discussions with the insurer (Elders Insurance, which is handling things very well), I have been trying to find emergency replacements for the inverters.

The solar equipment supply-side in Australia is a joke.

My options are to buy cheap stuff from overseas with an uncertain delivery date; the same stuff from Australia marked up by multiples of its overseas price with a five-day delivery time; or high-quality like-for-like replacements from America with a two-week delivery time.

Not to mention the suppliers who promise call-backs and don't.

Not to mention that some of those companies won't provide prices online: they force you to phone them for prices, then they don't call back with the prices.

Not to mention the other companies that advertise products on Google, but won't actually provide the products unless you buy a whole system.

And so on.

Electricity is mission-critical for everybody, and for the solar industry to ignore this is plain stupid.

The utter lack of industry discipline means that everybody is left to do their own thing, and the suppliers do it badly with a casual disinterest in their customers' requirements.

When the requirement is “electricity”, that casual disinterest is going to bite the industry's arse, big-time.

I am not going to name individual companies, because frankly I have not found any solar supplier in Australia that gave a cube-root of stuff-all about the mission-critical nature of what it sells.

I would have happily paid a premium for next-day delivery of what I needed, and I could not even manage a same-day – oh, by now, same-week – quote. Which makes it impossible to finalise my insurance claim and actually get my solar power back online.

Don't bother recommending names to me: I've called or surfed them all, devoting about 20 hours in the last week to the task. I don't want your recommendations, because I've already seen them on Google, asked if they can deliver to my requirements, and been told “no”. 

There is a plaudit to be given. My Honda Eu6500 backup generator has run like a dream, 24x7. Thank heavens. 

Thursday, January 15, 2015

The abandoned copayment idea was stupid anyway

The assumption that distorted the government's frankly stupid and now abandoned position on copayment is that GP visits are (a) discretionary and (b) about poor people.

So I'll present a standing, constant and continuing inefficiency in the health system that demands “six minute medicine” and could be solved quite easily.

I won't reiterate Ms T's entire medical history: it's a chronic immune-system disorder that demands lots of specialists, lots of drugs (some nasty), and – pertinent to the GP copayment debate – lots of repetitive prescriptions.

It's the prescriptions that are relevant, because if your only reason to visit the GP is to knock off this week's list of new prescriptions, the visit will fall under the “six minute medicine” heading.

A typical exchange might be:

GP: “Hi, what do you need?”

Ms T: “Prednisone 5 mg and 1 mg. Ursofalc. Atenolol.”

GP: “I've read the letters from the specialists. Everything seems to be going well.” (While he's typing the prescription details and, if necessary, calling the PBS people for authority prescriptions like Ursofalc.)

And she's out the door.

Some of her medications can't be prescribed for more than a month, which means a minimum of 12 “six minute” appointments each year.

There's no point in him turning it into a long appointment to do “preventative medicine” things. She has seven specialists looking after her, three of them professors, and the GP is just a prescription-machine.

Oh, yes. With seven specialists, there's the other six-minute medicine thing that happens.

GP: “Hi, what do you need?”

Ms T: “My referral to X expired.”

GP: (writes new referral)

None of this actually needs the GP: all of these “six minute medicine” appointments are systematic. The rules demand a GP appointment, regardless of whether the GP has any agency in the outcome of the appointment.

Also: there are certain drugs whose rules limit their prescription duration to one month. For example, the pain patches that are replacing Ms T's former addiction to Endone.

There's a necessary 12 appointments per month. I don't disagree with the rules, but those 12 appointments aren't created by the patient, they're created by regulation.

If the regulations don't change, chronic patients and GPs live in a Venn diagram of routine drug prescription, controlled drug prescription, and specialist referrals.

Over to the government proposal: the idea of reducing GPs' rebate for all of these routine visits was plainly stupid or worse, deliberately malicious.

In either case it was inefficient, because it would encourage turning a routine brief “sign this” visit into something longer that would get a better rebate.

PS. A grand a year on GP copayments would pinch us, but not cripple us. But an awful lot of chronic patients are seriously poor, and I don't see why they should be punished for needing a new prescription.