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7 September, 2009
Britain: Question a doctor and lose your child
PARENTS are being threatened with having their children taken into care after questioning doctors diagnoses or ing to their medical care. John Hemming, a Liberal Democrat MP, who campaigns to stop injustices in the family court, said: Very often care proceedings are used as retaliation by local authorities against uppity people who question the system. Cases are emerging across the UK:
* The mother of a 13-year-old girl who became partly paralysed after being given a cervical cancer vaccination says social workers have told her the child may be removed if she (the mother) continues to link her condition with the vaccination.
* A couple had all six of their children removed from their care after they disputed the necessity of an invasive medical test on their eldest daughter. Doctors, who suspected she might have had a blood disease, called for social services to obtain an emergency protection order, although it was subsequently confirmed that she was not suffering from the condition. The parents were still considered unstable, and all their children were taken from them.
* A single mother whose teenage son is terminally ill and confined to a wheelchair has been told he is to become the subject of a care order after she complained that her local authoritys failure to provide bathroom facilities for him has left her struggling to maintain sanitary standards.
In the first of those cases, Ashleigh Cave, 13, from Liverpool, began experiencing severe headaches and dizziness half an hour after being inoculated last October with Cervarix, which guards against girls contracting the human papilloma virus. The schoolgirl was soon collapsing repeatedly; she lost the use of her legs and was admitted to Alder Hey childrens hospital. Nearly 11 months later she is still in hospital and is unable to stand or walk unaided. Her mother, Cheryl, has now been told that doctors believe her condition must be psychosomatic.
The hospital brought in social workers from the local authority who have told me they are considering putting Ashleigh on an at-risk register, Cheryl Cave said. She is convinced her daughters paralysis was caused by the vaccination. Cave said that a social worker from Sefton council said she suspected her of having Munchausens syndrome by proxy or factitious illness syndrome controversial conditions in which mothers are said to attribute illnesses falsely to their children in order to gain attention.
Cave said: The social worker said I should stop believing the injection has anything to do with Ashleighs condition because I am putting my thoughts on to her and stopping her getting well. Since Ashleigh was in hospital she has become incontinent and had double kidney infections and chest infections. Have I made all these up?
In the third of these cases, Melvilina Gavin-Langleys 16-year-old son Omar is terminally ill with Duchenne muscular dystrophy and restricted to a wheelchair. His mother is embroiled in a legal dispute with Birmingham city council over a partly completed extension intended to provide Omar with easy access to a bathroom.
Gavin-Langley, 49, who wants the extension rebuilt because she says it was designed in a way that was dangerous and obstructed access to sewers, said: I have had to carry Omar upstairs to bathe him but it was risking dislocating his shoulders and also I got a hernia from all the lifting. I told the council I could no longer lift Omar across my back.
They then turned that around and said I had said I could no longer care for my son. They say they have to put him into care because his hair has not been washed and hes not getting a bath. They have just threatened me with this because they dont like me taking legal action against them. A spokesman for Birmingham city council confirmed the council was seeking an interim care order but said social workers wanted Omar to remain with his mother.
Sefton council did not comment on the Ashleigh Cave case.
SOURCE
Do-It-Yourself Dentistry in Britain
I was lying awake at night being driven mad by this constant throbbing ache; it was horrible, recalls George Daulat of Scarborough, England. Over the course of several weeks, Daulat had developed a nasty toothache. When the pain became unbearable, Daulats girlfriend helped him look for treatment. She made calls to 20 public National Health Service dentists as well as private practices, though Daulat was unemployed.
However, because of a shortage of dentists, there was no dentist available. In fact, Scarborough residents needed to travel over 50 miles to other towns just to receive a check up or filling. The British The Sun newspaper reported in 2004 that Scarborough: "is so hard-hit with the lack of NHS dentists that queues stretched hundreds of yards earlier this year [February 2004] when one finally opened... Around 3,000 people tried to join [register for care] but they were left stranded when Dutch dentist Aria Van Drie fled after it was revealed she had criminal convictions".
In desperation, Daulat decided to do the work the old fashioned way by himself, using old rusty pliers: I knew it would hurt but I thought just suffer it rather than go through extended pain, Daulat said. In the end I simply could not take any more. He added: I had a pair of pliers in a tool box. They were old and a bit rusty but I knew they would do the job.
Daulat bought a bottle of vodka as anesthetic and, to dull the pain, drank a pint of it before pulling the first ailing tooth. Daulat describes the gruesome process in detail: "I gripped the first tooth, squeezed and pulled. I felt this blinding pain, followed by a snap as the tooth cracked... I pulled again and managed to get the whole thing out... However, the pain was still there and I went back for two more. I managed to get them out but the fourth wouldnt come... I tugged and tugged but I couldnt get it out and I have had to leave it halfway out".
In agony, Daulat called the local NHS emergency dentist center, Northway Clinic, for immediate care. But Northway refused to see Daulat the day he pulled the teeth because his call was not made early enough in the day. At last, the next day Daulat was treated at a local NHS dentistry after the practice read about Daulats handling in the newspaper. "He was obviously in agony and we wanted to help him, said Kasandra Dowling of Medimatch dental practice in Scarborough". Though relieved, Daulat said: Im so happy Ive got a dentist and Im not in pain anymore but did it really have to go this far before somebody did something?
He added, People will think I am crazy to have pulled my own teeth out but they werent living with the pain. It was the hardest and most horrible thing I have ever done, but I was desperate.
SOURCE
Whose Business in Health Care?
Our ongoing debate about government's role in health care is proving worthwhile because it forces people to focus on the real tradeoffs in a system mandated - if not directly operated - by government, rather than one selected by individuals or their employers. Today, our system is a dysfunctional hybrid.
To the extent that we cannot choose the health care coverage we want today, those restrictions are almost always the result of previous government interventions - tax incentives that make it easier for employers to buy insurance than for employees to purchase their own or laws requiring us to purchase coverage we may not need or cannot afford.
President Obama says all insurance policies will be required to cover preventive care and early screening for various maladies, as if he can force insurance companies - or doctors - to give us something for nothing.
He can't do that anymore than he can require restaurants to serve a free lunch every Thursday. Even under Barack Obama, Americans cannot be compelled to do business at a loss; they always have the right to lock the doors and close up shop.
That's why there's no free lunch - or free health care. Politicians aren't "giving" us these services; they are forcing us to buy them - and to pay more than the actual cost.
It never ceases to amaze when politicians who demagogue against "greedy" insurance companies will, in their next breath, require us to buy things through an insurance company that we could purchase less expensively if we simply paid out of pocket.
If both you and your doctor know that you need a colonoscopy, how can it possibly be cheaper for you to send your payment to an insurance company, while the doctor files a claim with that insurance company, and the insurance company processes the claim and issues payment - rather than for you to simply pay the doctor?
Yet ObamaCare would establish a mandatory list of insurable procedures as well as maximum deductibles. For those with money-saving high-deductible plans and health savings accounts - like the one I've had for 12 years - the President's promise that we can keep the plan we have just doesn't wash.
Americans who are understandably frustrated by health care costs are recognizing that the more control you give to government the more control you give to government.
Today, if you, your doctor and your insurer agree on a procedure, you make an appointment and "get 'er done." And if you can't agree, you are free to pursue other procedures that you can pay for yourself. (After all, what good is an extra $50,000 in your retirement account if you're dead?)
But if no one practices those alternative procedures because omnipotent health care bureaucrats won't pay for them, you are out of luck.
The larger point is this: Why is it government's business how much you pay, what doctor you see, or what treatment you receive, so long as you are paying the bill?
Health care, like any commodity or service, will always be limited by economic reality. Government health care programs are responsible for more cost-shifting than all of the "uninsured." Yet despite paying below-market prices, Medicare will be insolvent in just seven years and has amassed all by itself a deficit of $37.8 trillion.
If the government is empowered to supervise everyone's health care, then only two outcomes are possible: either everyone's health care is rationed to control costs or no one's health care is rationed and the cost of government health care finally breaks the camel's back, ushering in a worthless dollar, runaway inflation and skyrocketing interest rates. In either case, our impoverished children and grandchildren will forever curse our self-centered, shortsighted generation.
There can be no health care utopia any more than everyone can enjoy all they want to eat or live in the home of their dreams. Sooner or later, someone must choose between what we want and what we can afford. Who do you want to make those tough choices < yourself or someone in government?
SOURCE
Liberals push Obama towards setting up a government insurer
House liberals pleaded with President Barack Obama on Friday to push for creation of a government-run health care program as the Senate's chief negotiator said he won't wait much longer for Republicans to compromise amid dwindling chances for a bipartisan bill.
Finance Committee Chairman Max Baucus, D-Mont., held a nearly two-hour teleconference with his small group of negotiators, who call themselves the "Bipartisan Six." Afterward, Baucus was careful to leave the door open to a long-sought deal, but he clearly signaled the time has come for him to move ahead. "I am committed to getting health care reform done , done soon and done right," Baucus said in a statement. He is considering making a formal proposal to the group of negotiators.
Obama, meanwhile, tried to placate disgruntled House liberals who fear he is too eager to compromise with Republicans and conservative Democrats to get a bill. In a phone call from the Camp David, Md., presidential retreat, Obama spoke to leaders of the Congressional Progressive Caucus and other liberal-leaning House groups.
Caucus leader Lynn Woolsey, D-Calif., said the lawmakers expressed their commitment to creation of a government-run plan to compete with private health insurers. On Thursday, they sent Obama a letter saying they could not support a health bill that lacked such a public option.
Woolsey said Obama listened, asked questions and said the dialogue should continue. She said a follow-up meeting will occur next week at the White House. Another participant said the president was noncommittal about the government-run plan.
Senate Finance is the only one of five congressional committees with jurisdiction over health care that has yet to produce a bill. Baucus had held back from convening a bill-drafting session, hoping that his group of three Democrats and three Republicans would reach a compromise behind closed doors that could win broad support. But he faces a Sept. 15 deadline from the Democratic leadership , and the prospect of losing control of the legislation if he doesn't act.
On Friday, Baucus said the members of his group agree on several big-picture items, including the need to control costs, provide access to affordable coverage for all Americans and ensure that health care fixes don't add to the deficit. The negotiators have been working on a pared-back bill that would cost under $1 trillion over 10 years and drop contentious components, such as the government-sponsored insurance plan that liberals insist must be in the legislation. "Health reform is certainly a significant challenge, and each time we talk, we are reminded just how many areas of agreement exist," Baucus said.
The bipartisan group has scheduled a face-to-face meeting when the Senate returns on Tuesday, on the eve of a major speech by Obama to Congress. The president is trying to rescue his health care overhaul after a summer in which angry critics filled the Internet and airwaves with attacks, some clearly based on misinformation.
Senate aides say the six Finance Committee negotiators realize they have an historic opportunity to influence the direction of the health care debate , and its ultimate result.
But with Republican leaders solidly opposed to Obama's approach, the GOP negotiators are under tremendous pressure not to cooperate. In the last few weeks, two GOP negotiators , Chuck Grassley of Iowa and Mike Enzi of Wyoming , have made harsh public statements about the Democrats' approach. However, both insist they are serious about their negotiations with Baucus. The third Republican, Olympia Snowe of Maine, has been circumspect. "When Congress returns to session next week, we will be working with the same intensity ... to achieve a consensus bill," Snowe said in a statement. "I believe we must reduce the costs of health care and make coverage more affordable for all Americans." The other two members of the group are Democrats Kent Conrad of North Dakota and Jeff Bingaman of New Mexico.
Separately, the Democratic National Committee on Friday released a new television ad that counters Republican claims that lawmakers plan to raid Medicare's budget to finance coverage for the uninsured. Obama says wasteful Medicare spending will be reined in but won't affect benefits.
The Democratic ad, called "No Friend to Seniors," depicts Republicans as longtime opponents of Medicare. It will run on national and Washington, D.C., cable stations. A similar ad will also run in 10 Republican-held congressional districts.
SOURCE
Why Organized Labor Supports Government Health Care
Unions strongly support President Obama's health care reform, which includes a plan for a government-run "public option" that would crowd out private health insurance. Labor publicly argues that the current health care system serves Americans poorly. However, unions also have self-interested motives for promoting government-run health care:
* The legislation includes a $10 billion bailout of union retiree health plans;
* Nationalized health care would lead to millions of new dues-paying union members as government employees unionize more frequently than private sector workers; and
* National health care would also reduce unionized companies' competitive disadvantage.
However, unions do not support all health care reform plans. When Senators proposed taxing health benefits to pay for health care reform--a tax that would disproportionately fall on union members--the labor movement threatened to derail the legislation. Union support for health care reform is highly self-interested.
Unions strongly support health care reform and have made supporting a "public plan" that would lead to a government-run single-payer system their top priority. In fact, after opponents protested at town hall meetings this summer, the AFL-CIO spent $15 million to stage counter-demonstrations with union members.[1]
Why has organized labor made government-dominated health care such a priority? The AFL-CIO publicly argues that the "real-world toll of soaring health care costs, lack of insurance and systemic flaws in our health care system must come to an end."[2] They further state that their goal "is to win secure, high-quality health care for all."[3] Many union leaders and activists do genuinely believe this. However, the labor movement has not spent such large sums of money campaigning for health care reform out of disinterested concern for the common good: Unions will benefit immensely if the government takes over the health care system.
Taxpayer Bailout
The most obvious benefit President Obama's health care plan provides to organized labor is a $10 billion taxpayer bailout for underfunded retiree health benefit plans. Many unions negotiate benefit packages that allow workers to retire early and collect health benefits until they qualify for Medicare. Many of these plans they are underfunded because unions mismanaged them.[4]
The healthcare legislation transfers $10 billion to these accounts, in the form of a reinsurance program that pays most of the cost of claims for workers in these plans.[5] Like the GM and Chrysler bailouts, the health care legislation requires all taxpayers--including low income workers without retirement plans--to pay for benefits for already well-compensated union workers.
Government Health Care Facilitates Unionization
Government-dominated health care would transform union organizing. Whether or not the government explicitly nationalizes the health care industry, government funding and government-dictated standards eliminate competition. Under health care reform, unionized hospitals would not face a competitive disadvantage because no competition would exist. All health care workers would become quasi-public employees. Whatever costs unions increased would be passed on to the taxpayer and not threaten union members' jobs. For instance, taxpayers would cover the costs of reduced productivity due to inflexible union work rules. Prospective union members would know this and, as a result, become more likely to unionize. Every step toward government-run health insurance vastly simplifies the process of organizing new union members and keeping existing union members employed.
This is precisely what happened in Canada, a nation culturally and economically similar to the United States, but with government-run single payer health care. While only 18 percent of nurses belong to unions in the United States, 78 percent do in Canada.[6] A full 61 percent of all Canadian health care workers belong to unions, well above the 11 percent in the United States.[7]
Given these figures, it is no wonder that the Service Employees International Union supports government-dominated health care so strongly. The SEIU represents health care workers. Under a government-run health care system, the SEIU could easily organize millions of new members who would then pay billions of dollars in mandatory dues. For example, if unions organized nurses at the same rate in America as they do under Canada's national health care system, they would bring in two million new members paying roughly $1.8 billion a year in dues.[8] Whatever its effects on the overall quality of health care, government health care would bring a financial windfall to the labor movement.
Reduce Unions Competitive Disadvantages
Unions who do not represent health care workers will also benefit from this law because it reduces competition. Unions negotiate gold-plated health benefits for their members that raise their employer's costs. Such expensive benefits, however, put unionized firms at a competitive disadvantage.
However, if the government provided health care coverage through insurance exchanges, then taxpayers--not consumers--would foot the bill for health costs. This would reduce unionized companies competitive disadvantage.
Unions Oppose Legislation They Must Pay For
Union support for health care reform does, however, have its limits. In particular, organized labor does not support health care reform for which it might have to help pay. For example, Senate Democrats considered paying for the health care reform through taxing employer-provided health benefits. Such taxes would have fallen heavily on union members, since both private and public sector unions have negotiated expensive health benefit plans.
When news reports leaked that the Senate was considering such taxes the labor movement moved to quickly derail that idea. A coalition of 30 major unions sent letters to the Senate expressing their "strong opposition to any proposal that would pay for this reform by altering the tax treatment of employer provided health care."[9] Behind the scenes Organized Labor made it clear they opposed and would defeat any health reform that taxed employer health benefits.[10]
Organized labor supports health care reform only insofar as it benefits unions and their members. Despite their public arguments that the "real-world toll of soaring health care costs, lack of insurance and systemic flaws in our health care system must come to an end," the union movement will not sacrifice its own interests "to win secure, high-quality health care for all."[11]
A Financial Windfall for Unions
Unions claim that they support health care reform out of concern for workers' well-being. Many union leaders genuinely do, but the labor movement as a whole fights for government-run health care out of self interest. The health care reform legislation includes a $10 billion bailout of underfunded union health plans. More significantly, a government takeover of the health care sector would ease union organizing by eliminating competition and turning health care workers into quasi-public employees, as has happened in Canada. Unions would collect billions of dollars of new dues from millions of new workers. Government health care also reduces the competitive disadvantage unionized companies face in the marketplace.
Health care reform means a financial windfall for unions. However, unions oppose health care reform for which they must pay. Congress should not pass any "public plan" that would lead to the government directly or indirectly controlling health insurance at the behest of self-interested union lobbying.
SOURCE
The Devil Is in the Details of the Healthcare Bills, or Not
President Obama and congressional Democrats have been playing defense on healthcare reform throughout the month of August as congressional town hall meetings across the country have erupted in anger and frustration. A favorite theme in the Presidents and his allies speeches is that Americans have been manipulated and exploited by opponents of his healthcare initiatives, jack-booted obstructionists who are peddling falsehoods about what is actually in the bills.
Simultaneously, and somewhat incoherently, members of Congress who support the inclusion of a government-run option in healthcare reform legislation (as well as some of the other controversial items) have also been trying to peddle the line that taxpayers are overreacting, that there really is no bill yet. Sen. Arlen Specter (D-Pa.) arrogantly dismissed opposition to the bill, telling FOX News Sunday host Chris Wallace on August 23, 2009 that, There's no bill in the Senate. There's no bill on the House floor. A couple of House committees have considered it.
Not yet, anyway. Nevertheless, that kind of desperate spin rankles taxpayers who have actually leafed through the impenetrable, 1,000-page draft document that passed out of the House Energy and Commerce Committee (H.R. 3200) along party lines prior to the August recess. In fact, at town hall meetings, furious constituents are taking to the microphones armed with specific section numbers, quoting sections verbatim from both H.R. 3200 and the Senates Affordable Health Choices Act (commonly known as the Kennedy-Dodd bill), and asking very tough questions. Contrary to Sen. Specters technically-correct but rather delirious assertion, there are concrete proposals being debated and voted on. Taxpayers understand that and they do not like what they see.
Almost as important as what is contained in the various versions of healthcare reform currently under consideration in the House and Senate is what is not included. In the House, H.R. 3200 was parceled out to multiple committees for markup; amendments were crafted, debated, accepted, or rejected. It is instructive to review which amendments committee members chose to include and which they rejected.
During the House Energy and Commerce Committee markup, Rep. Cliff Stearns (R-Fla.) offered an amendment that would have codified that nothing in the final bill would prevent people from keeping their current healthcare plans, a principle President Obama has repeatedly committed himself to. Several committee members simply did not believe that such a guarantee was warranted so they voted the Stearns amendment down.
Reps. Mike Rogers (R-Mich.), Jim Matheson (D-Utah), and Phil Gingrey (R-Ga.) offered an amendment that would have ensured that health insurance plans which currently include the option of a Health Savings Account (HSA) would fit the statutory definition of a qualified health benefits plan. HSAs feature low premiums, have high deductibles and are owned and controlled by patients. The committee defeated that amendment.
Much has been made of the inclusion of a provision establishing a Comparative Effectiveness Research (CER) tool, a new bureaucracy within the Centers for Medicare and Medicaid Services (CMS) that would track which medical procedures are most effective at treating specific cases, collecting information on both their cost and clinical results. The idea of collecting and making public data on healthcare outcomes is an excellent one, but not if it will one day be used by federal bureaucrats as a tool to force doctors into making specific treatment decisions, determine health insurance coverage, or deny care to patients. Reps. Rogers and Gingrey (who is a physician), offered amendments that would have barred CMS from using the research gathered by CER to make coverage decisions on the basis of cost or to ration care. The good news is that those amendments passed (by voice vote). The bad news is that similar amendments under consideration in the House Ways and Means and Education and Labor Committees were defeated, which leaves the Speaker of the House and the House Rules Committee as the final arbiters to resolve that conflict.
During 13 days of debate over the Kennedy-Dodd bill, which was voted out of the Senate Health, Education, Labor and Pension Committee on July 27, 2009, hundreds of amendments were offered. Sen. Tom Coburn (R-Okla.), also a physician, offered many, one of which would have required all members of Congress and their staffs to enroll in the government-run health insurance option, the most contentious provision under consideration among the current reform proposals. Today, members of Congress, their staffs, and all federal employees and their families, 6.6 million people, are covered under the highly successful Federal Employees Health Benefits Plan, in which 283 private health insurers from around the country compete for their healthcare dollars, offering a wide range of options from which to choose. The Coburn amendment passed by one vote, but it will be anyones guess if that provision survives final passage of any healthcare reform bill.
Taxpayers visceral expressions of opposition to these so-called reforms over the August recess have put Congress on notice that the plans under consideration in Washington will not fly. However, when Congress reconvenes this fall, taxpayers must not assume the job is done and Congress will go back to the drawing board. They will need to continue to exercise sharp vigilance over the process if they intend to force the Democratic leadership and the Obama administration to fully abandon the ill-conceived government-run health insurance option, as well as the multitude of other toxic provisions being bandied about in the nations capital. It wont be enough to simply watch what lawmakers do; it will be just as crucial to watch what they dont do.
SOURCE
6 September, 2009
The NHS gets a bad bill of health
The British government could make the NHS more efficient by contracting out the management of its care, says Simon Heffer
Since McKinsey and Co, the consultancy company, is not a registered charity, I presume it cost the taxpayer a substantial amount for the firm to conduct an efficiency review into the National Health Service. Having commissioned the report, the Department of Health took one look at its main finding that 10 per cent of NHS staff should go in order to achieve efficiency savings and rejected it. If you seek an example of how superbly the Government spends money, this is a magnificent one.
Any fool knows that the NHS is overmanned: perhaps not with doctors and nurses, but certainly with bureaucrats and support staff. Even the fools who run the Department of Health must have realised that if they asked McKinsey to do this job, it would find there were too many people on the payroll. To order this review and then to reject it immediately is completely obtuse.
Having read some of the findings of the report, even I would not agree with all of them. I doubt it is sensible, with our ageing population, to pursue a goal of fewer doctors and nurses. But it has long been apparent that the NHS is an organisation that exists as much for the benefit of many of those who work in it, as for those it purports to treat. It is also apparent that, despite numerous reforms since it began in 1948, it is shaped by an immediate post-war ideology that has about as much relevance today as Bile Beans and Craven "A"s. No private-sector health concern would begin to think of running itself as the NHS does: it would be bankrupt within weeks. But then no private-sector health concern has as its mission in life the provision of jobs for Mr Brown's client state.
Labour rejected McKinsey's plans because it deemed them politically unworkable. It is not prepared to have a mature conversation with the British people about how their right to a health service free at point of use would not be affected by a desire to secure better value, in an economy that is cruising towards bankruptcy. Sadly, the Tory party doesn't want to have this conversation, either. Feeling morally blackmailed by a climate in which public spending, irrespective of the value obtained from it, is a good thing, it too has dismissed McKinsey, though with the caveat of saying (quite rightly) that there are bureaucratic jobs that can be lost.
Given the expense of the NHS more than 100 billion a year, or about a seventh of total public spending cowardice about how to reform it is not an option. It is derelict of anyone who seriously wishes to govern this country to say that we can go on in the same bloated, welfarist way that we have pursued since 1948. For a failure to get costs under control will, sooner rather than later, ensure that those same vulnerable people the NHS is supposed to help are at risk of having very little decent care at all.
The bold move for a government to take would be to contract out the management of the NHS. Hospitals, then possibly even whole health authorities, should be franchised out to the private sector, to break the culture of jobbery and self-serving trade unionism that has handicapped the development of the NHS. The service would still be free at point of use: but it would be delivered more efficiently. As McKinsey found, some hospitals are abominably wasteful. The rescue of the whole NHS should start with them.
Of course, all our politicians can carry on claiming that value doesn't matter, and believing that there is a bottomless pit of money to run our health-care service. In the suffering this will inflict on patients in the long term, it reveals an utter unfitness to govern.
SOURCE
Distortions -- or Truths?
by Pat Buchanan
We should have "an honest debate" on health care, said Barack Obama in his Aug. 22 radio address, "not one dominated by willful misrepresentations and outright distortions." Among the "phony claims" made against the House bill, says the president, are that it provides funding for abortions, guarantees coverage for illegal aliens, contains "death panels" and represents a federal takeover of the health care system. Is Obama right? Are critics misleading and frightening folks with falsehoods about Obamacare?
Well, let us inspect each of those "phony claims." Does the House bill fund abortions? No. However, while the House Energy and Commerce Committee at first voted to exclude abortions from "essential" services, to the howls of NOW, Chairman Henry Waxman conducted a second vote, to drop the anti-abortion amendment. That vote carried. In short, funding for abortions remains an open question. And whether Obama agrees to drop it to assure passage, he supports the Freedom of Choice Act that would, opponents insist, overturn every state and federal restriction, including the Hyde Amendment, which forbids federal funding. Obama has already used his authority to lift the Reagan administration prohibition against using foreign aid funds to procure abortions abroad.
Obama is a pro-abortion absolutist. And if abortion-funding is not in the final health care bill, does anyone doubt that Democrats will move swiftly to incorporate it in future legislation?
As for illegal aliens, Obama is right again. They are not covered in any of the five bills. All their children are automatic citizens and are covered, however. And no illegal alien who comes to an emergency room can be denied care. And there is no eligibility verification screening provided for in any of the bills to sort out and exclude illegal aliens. Obama said in Mexico City he is determined to put our 12 million to 20 million illegal aliens on a "path to citizenship." That would make them legal immigrants. And legal immigrants are covered.
Moreover, a high percentage of all immigrants, legal and illegal, are poor, uneducated, unskilled and unable to find the kind of jobs that carry health insurance. We have some 40 million immigrants today, with another 100 million expected by 2050. Any national health insurance system put in place today is going to be swamped if we do not close the borders and halt immigration. Obama and the Democrats, who are almost all pro-abortion and pro-amnesty, are assuring us their health care bill will not advance these goals to which they are committed by ideology. This is disingenuous at best.
What about the "death panels." No, they are not in the bill. Nor is there any doctor's right to perform euthanasia or mercy-killing. Obama's resolve to cut health care costs, at the same time he repeatedly reminds us that half of all such costs are incurred in the last six months of life, however, points straight to rationed care for the elderly ill, where drugs, procedures and operations necessary to life are going to be curtailed or cut off. There is no other way to get there.
And if government bureaucrats are making those decisions, can they not fairly be called death panels, especially if the folks for whom they are deciding are suffering from such diseases as senility and Alzheimer's? How do you curtail or cut care for the elderly sick and terminally ill without advancing the date of their deaths? Sarah Palin may have been factually incorrect, but her instincts about what is coming were dead-on.
What of Obama's dismissal as "phony" the claim that the "public option" for health insurance must lead to a government takeover? But did not Barney Frank say the government option is the best way to a single-payer system -- that is, a government monopoly? Barack says he wants competition. But in the past, he, too, has spoken of favoring a single-payer system and he, too, has said a public option is the first step on a 10- or 20-year march to single-payer.
Because Obama has ceased talking of a single-payer system and it is not in the bill does not mean that a public option will not put us on the road to government control. Indeed, does anyone believe Barack has any ions to government-run universal health care? Does anyone think that a government-run insurance program, with access to tax revenues and the ability to undercut all competition, will not crowd out private insurance and take us to where Barney and Barack want to go?
Both Barney and Barack are pro-abortion and pro-amnesty. Both have spoken favorably of a single-payer system where Uncle Sam shoulders aside the insurance companies that Nancy Pelosi calls the "villains" in the health care system.
As a Fabian socialist, however, Obama will accept a small victory, if the road leads toward ultimate triumph and the alternative is a big defeat. Thus, what the center-right needs to do is administer to this Fabian socialist a decisive defeat in a big battle -- like this one we are in.
SOURCE
How Obama Blew Health Care Reform On A Bet The Republicans Were Hollow Men
The Obama administration may have blown its chance to reform health care in the United States by cynically cutting deals with special interests and ignoring public sentiment, according to an explosive Wall Street Journal story today.
It's a profound piece of myth busting by the Journal. According to the story Obama likes to tell, he is engaged in a struggle against special interests to remake the health care system in a way that will benefit the American people. But there aren't really any special interests opposing him. The drug companies, the health care providers, the health insurers all signed on to Obama's plan long ago. They are actively lobbying for it.
The Obama administration "expended great effort to line up the support of health-care insurers, pharmaceutical makers and care providers, believing that by keeping them around the table, they could win over Republicans and stop the kind of industry-led attacks that helped sink the Clinton plan," writes the Journal team.
It was supposed to be a simple formula. Win over the health care industry shepherd, and the Republican will follow like sheep. But it didn't work.
What seems to have gone wrong can be described as a failure of the imagination: Obama's administration just never believed Republicans would stand up for their limited government principles if that meant opposing business interests. They were apparently assuming that Republicans and conservatives could be won over by winning over "business interests," as if free market and anti-government positions were just rhetorical cover for policy making at the behest of business.
There was plenty of evidence for this during the Bush administration, when the Republicans seemed to throw every principal overboard to serve special interests. (Well, every principal except "Do Not Speak Ill Of George Bush.") But, at least as long as they are in opposition, the Republicans now seem willing to buck the siren call of business interests supporting Obama's plan in favor of resistance to big government. Time may tell whether this is pure partisanship or a post-Bush return to principled conservatism.
But, in any case, the Obama administration's assumption that brining business to the table would win over the GOP opposition seems to have played a key role is putting the plan to reform health care in jeopardy.
SOURCE
Pulling the Trigger on ObamaCare
As bipartisan negotiations in the Senate have failed to trick Republicans into supporting a vigorous government-run takeover of the entire health care system, Barack Obama and congressional Democrats are making a last ditch effort to sway at least one Republican member: Olympia Snowe of Maine.
Reports CNN Politics, "For the past months, Snowe has been pushing the idea of a safety net plan, or 'trigger,' for a public health care option as part of a key compromise. A source familiar with her negotiations with Obama said that's one of the things they're talking aboutThe idea would give insurance companies a defined period to make changes in order to help cover more people and drive down long-term costs. But if those changes failed to occur within the defined period, a trigger would provide for creating a public option to force change on the insurance companies."
Concern over a government-run medical system has galvanized citizens nationwide in opposition to let their voices be heard in town halls. And they've left the members of Congress ducking for cover. The political damage has been so extensive that Barack Obama is preparing an address to a joint session of Congress on Wednesday to in yet another attempt to sell his latest scheme for ObamaCare.
According to FOX News, White House aides have said that Obama "will deliver the message that Democrats are willing to go it alone if it cannot get Republicans behind it." The joke is that he does not actually need a single Republican vote to pass what he wants if his own party would just rally behind him.
The true trouble that ObamaCare faces is that Democrats believe that they are on a political Titanic and vulnerable members in both chambers are stampeding to get to the lifeboats.
The reason Democrats want Snowe or somebody like her is so they can parade her around as the token Republican brokering a grand compromise, thus providing what they believe is political cover. And so, now they are ready to give Snowe what she has been asking for: a delayed implementation of the government takeover of the health care system in exchange for selling out her own party.
And if Olympia falls for the Snowe-job, she will do so knowing full well that her sell-out is a charade. After all, House Speaker Nancy Pelosi has already played the socialist hand. "If they want no public option, but a trigger, you can be sure that the trigger will bring on a very robust public option," said Pelosi, knowing full well that she gets to define and control the mechanism, tied to the escalating costs of providing life-saving treatments.
And of course, government controls that, too. It currently mandates minimal levels of coverage to be provided at the state level. It prohibits insurance to be purchased across state lines. It thus allows regional, corporatist monopolies to operate with impunity that in turn pay handsomely via political protection money to elected officials keep the status quo.
In the legislation now before Congress, even if the so-called public "option" were put on a trigger tied to costs, the bill would still force employers to provide coverage and individuals to buy coverage or else pay a tax. It would establish a whole new body of regulations that would force insurance companies that would eventually, inevitably bankrupt private insurance.
As reported by the Heritage Foundation, the legislation establishes "a single minimum coverage standard that will eventually apply to nearly all health plans and establishes a new 'Health Benefits Advisory Committee' within HHS to make detailed recommendations, which the secretary of HHS would then impose through regulation." Thus, by simply upping what must be minimally covered under private health plans, costs would skyrocket, and the deadly trigger on ObamaCare would be pulled.
They can call it whatever they want. A delayed public "option." A compromise. A trigger. But, Barack Obama, Nancy Pelosi, and Harry Reid are determined to get what they want. And whether now, sooner, or later, they are determined to force through a bill that inevitably results in socialized medicine.
Olympia Snowe can go along with it, too, if she wants. But she must realize that, really, she'll only be pulling the trigger on the American people. On freedom of choice. And on quality health care that provides for the young and protects the old.
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Health care reform means more power for the IRS
There's been a lot of discussion about the new and powerful federal agencies that would be created by the passage of a national health care bill. The Health Choices Administration, the Health Benefits Advisory Committee, the Health Insurance Exchange there are dozens in all.
But if the plan envisioned by President Barack Obama and Congressional Democrats is enacted, the primary federal bureaucracy responsible for implementing and enforcing national health care will be an old and familiar one: the Internal Revenue Service. Under the Democrats' health care proposals, the already powerful and already feared IRS would wield even more power and extend its reach even farther into the lives of ordinary Americans, and the presidentially-appointed head of the new health care bureaucracy would have access to confidential IRS information about millions of individual taxpayers.
In short, health care reform, as currently envisioned by Democratic leaders, would be built on the foundation of an expanded and more intrusive IRS.
Under the various proposals now on the table, the IRS would become the main agency for determining who has an "acceptable" health insurance plan; for finding and punishing those who don't have such a plan; for subsidizing individual health insurance costs through the issuance of a tax credits; and for enforcing the rules on those who attempt to opt out, abuse, or game the system. A substantial portion of H.R. 3200, the House health care bill, is devoted to amending the Internal Revenue Code of 1986 in order to give the IRS the authority to perform these new duties.
The Democrats' plan would require all Americans to have "acceptable" insurance coverage (the legislation includes long and complex definitions of "acceptable") and would designate the IRS as the agency charged with enforcing that requirement. On your yearly 1040 tax return, you would be required to attest that you have "acceptable" coverage. Of course, you might be lying, or simply confused about whether or not you are covered, so the IRS would need a way to check your claim for accuracy. Under current plans, insurers would be required to submit to the IRS something like the 1099 form in which taxpayers report outside income. The IRS would then check the information it receives from the insurers against what you have submitted on your tax form.
If it all matches up, you're fine. If it doesn't, you will hear from the IRS. And if you don't have "acceptable" coverage, you will be subject to substantial fines fines that will be administered by the IRS.
Under some versions of health reform now circulating on Capitol Hill, the IRS would also be intimately involved in how you pay for insurance. Everyone would be required to buy coverage. The millions of Americans who can't afford it would receive a subsidy to pay for it. Under the version of the plan currently under negotiation in the Senate Finance Committee, that subsidy would come through the IRS in the form of a refundable tax credit. Under the House plan, the subsidy would come directly from the Health Choices Administration.
In either scenario, the IRS would be the key to making the system work. Before you could receive any subsidy, whether through the IRS or not, the Health Choices Administration would have to determine whether you are eligible for it. To do so, the bills under consideration would give the Health Choices Commissioner the authority to demand sensitive, confidential information from the IRS about individual taxpayers. The IRS would have to provide it.
Under current law, it is a felony for a government official to release taxpayer information in all but the most limited of circumstances. One such exception is for law enforcement; the IRS is allowed to give taxpayer information to prosecutors in criminal cases. The information can also, in some instances, be released to the Social Security Administration and the Veterans' Administration for the determination of benefits. The health care bills would change the Internal Revenue Code to permit the IRS to give similar information to the vast, new health care bureaucracy.
That means the personal tax information of millions of Americans would enter the system whether they want it to or not. "There's a mandate to buy insurance," says one Republican House aide. "You have to buy it. You have millions of people who can't buy it without a subsidy, so they will have no choice but to accept the subsidy in order to buy insurance, and then the Health Choices Commissioner will have access to their tax records."
"How many hands would this information go through?" asks a GOP source in the Senate. "What are the quality controls? This increases the risk of misusing this information."
Some versions of the bill even permit the release of confidential taxpayer information for decidedly less pressing reasons. In H.R. 3200, the IRS would be required to provide taxpayer information to the Social Security Administration for the purpose of helping Social Security officials find qualifying seniors who can then be encouraged to enroll in the pre ion drug program. "There is no precedent for using taxpayer information for the purpose of identifying people to go out and advertise to them," says the House expert.
So far, there has been little substantive public debate about the integral role of the IRS in nearly every aspect of the various national health care proposals. But people who are closely involved with the process are deeply concerned about what they view as a massive, and in some senses unprecedented, expansion of the Internal Revenue Service.
First, they wonder whether the IRS can handle the new demands. "There is a sense at the IRS that their purpose is to collect revenue and not to implement all sorts of other programs," says a second Senate GOP aide. "Also, the IRS isn't necessarily great at doing what it does already. How is it going to determine whether 300 million people have health insurance?"
Second, they are concerned about anticipated abuse of the system. "You're going to have lots of fraud," says the House source. "People claiming lots of affordability credits or refundable tax credits. The IRS is not going to have the resources and expertise to police this stuff."
Finally, there is a third concern, more fundamental than questions of whether the IRS can handle the job: Should the IRS be involved in health care enforcement in the first place? As seen in the town halls across the country in August, many Americans are concerned about the coercive nature of the proposed national health care system. Handing the IRS the power to monitor every American's place in the system worries them even more.
Backers of the Democratic bills are betting that the handouts involved giving people money to buy health insurance will outweigh concerns about privacy and coercive government. Perhaps. But before Congress makes any decision on national health care, voters should know just what it will involve.
SOURCE
5 September, 2009
Fat with bureaucrats, the NHS is enormous and expensive
Note the math: 1.5 million employees but only 525,000 doctors and nurses. And even the doctors and nurses are constantly doing paperwork
It was always going to be expensive to create a healthcare system for all that was free at the point of service, but not even the NHS founding fathers could have realised what an economic colossus it would eventually become.
In 1948 the service had a budget of 437million, about 9billion today. Each year since, this figure has climbed by more than the rate of inflation, last year the budget topping 100billion more than 1,500 for every man, woman and child in the country. Sixty per cent of this goes on staff and 20 per cent on drugs.
The NHS, with its 1.5million employees, has become the largest employer in the world after Wal-Mart, Indian Railways and the Chinese Peoples Liberation Army
There are 90,000 hospital doctors as well as 35,000 GPs who operate in 10,000 practices seeing about 140 patients each a week. There are 400,000 nurses and 16,000 ambulance paramedics.
A million patients are seen every 36 hours. Accounting for, roughly, 18 per cent of all government spending.
SOURCE
Fatal or serious NHS medication errors double in two years
At least 100 patients are dying or suffering serious harm each year after healthcare workers give them the wrong medication. The number of alerts relating to errors or near-misses in the supply or pre ion of medicines has more than doubled in two years, the National Patient Safety Agency said.
More than 86,000 incidents regarding medication were reported in 2007, compared with 64,678 in 2006 and 36,335 in 2005. The figures, for England and Wales, show that in 96 per cent of cases the incidents caused no or low harm, but at least 100 were known to have resulted in serious harm or death.
Workload pressures, long hours, fatigue and reduced staff levels have contributed to errors, but the serious consequences of failing to administer, prescribe or dispense medicines correctly are still not well recognised in the NHS though they can be fatal, the report said.
The figures based on voluntary reporting by hospitals, clinics and GPs are thought to be a vast underestimate of the number of errors. Professor David Cousins, a senior pharmacist at the agency, said it was well known that only about 10 per cent of incidents were reported in most voluntary systems. This suggests that there were as many as 860,000 errors or near-misses involving medicines in 2007.
Of the 72,482 incidents known to have occurred that year, 82 per cent were made in the administration or dispensing of medicines by nurses or pharmacists, rather than in the pre ion of drugs by doctors.
Among the fatal cases and those that caused severe harm, 41 were caused by errors in the administration of drugs to patients by nurses and 32 were due to prescribing.
Use of incorrect medicines was involved in seven deaths and thirteen incidents where severe harm was caused. Life-saving treatment not being given or delayed was a factor in six deaths and twelve patients were severely harmed. Examples included an anticoagulant drug given in error to someone with a similar name to the intended patient, a strong sedative given to a patient instead of insulin, and heart medicine given instead of an anti-inflammatory drug. One patient was reported to have received 100mg of morphine instead of 10mg.
The report comes after The Times disclosed new guidance from medical regulators to ensure that undergraduate medical students receive more hands-on experience of working in hospitals and clinics before they graduate.
The Tomorrows Doctors guidance, published this week by the General Medical Council, is designed in part to help to reduce the number of pre ion errors made by junior doctors when they first start work.
SOURCE
Sentenced to death on the NHS
Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors warn today.
In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death. Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away. But this approach can also mask the signs that their condition is improving, the experts warn.
As a result the scheme is causing a national crisis in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Lukes cancer centre in Guildford, and four others.
Forecasting death is an inexact science,they say. Patients are being diagnosed as being close to death without regard to the fact that the diagnosis could be wrong. As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients."
The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.
The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours. Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions. It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Governments health scrutiny body, in 2004. It has been gradually adopted nationwide and more than 300 hospitals, 130 hospices and 560 care homes in England currently use the system.
Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor. They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication.
However, doctors warn that these signs can point to other medical problems. Patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated, for instance.
When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit. If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.
Dr Hargreaves said that this depended, however, on constant assessment of a patients condition. He added that some patients were being wrongly put on the pathway, which created a self-fulfilling prophecy that they would die. He said: I have been practising palliative medicine for more than 20 years and I am getting more concerned about this death pathway that is coming in. It is supposed to let people die with dignity but it can become a self-fulfilling prophecy. Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.
He added: What they are trying to do is stop people being overtreated as they are dying. It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking. He said that he had personally taken patients off the pathway who went on to live for significant amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.
Prof Millard said that it was worrying that patients were being terminally sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours. In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands. If they are sedated it is much harder to see that a patient is getting better, Prof Millard said.
Katherine Murphy, director of the Patients Association, said: Even the tiniest things that happen towards the end of a patients life can have a huge and lasting affect on patients and their families feelings about their care. Guidelines like the LCP can be very helpful but healthcare professionals always need to keep in mind the individual needs of patients. There is no one size fits all approach.
A spokesman for Marie Curie said: The letter highlights some complex issues related to care of the dying. The Liverpool Care Pathway for the Dying Patient was developed in response to a societal need to transfer best practice of care of the dying from the hospice to other care settings. The LCP is not the answer to all the complex elements of this area of health care but we believe it is a step in the right direction.
The pathway also includes advice on the spiritual care of the patient and their family both before and after the death. It has also been used in 800 instances outside care homes, hospices and hospitals, including for people who have died in their own homes.
The letter has also been signed by Dr Anthony Cole, the chairman of the Medical Ethics Alliance, Dr David Hill, an anaesthetist, Dowager Lady Salisbury, chairman of the Choose Life campaign and Dr Elizabeth Negus a lecturer in English at Barking University.
A spokesman for the Department of Health said: People coming to the end of their lives should have a right to high quality, compassionate and dignified care. "The Liverpool Care Pathway (LCP) is an established and recommended tool that provides clinicians with an evidence-based framework to help delivery of high quality care for people at the end of their lives. "Many people receive excellent care at the end of their lives. We are investing 286 million over the two years to 2011 to support implementation of the End of Life Care Strategy to help improve end of life care for all adults, regardless of where they live. [Blah, blah, blah!]
SOURCE
Double murderer wins right to cosmetic surgery on the NHS
While many of the sick elderly are left to rot
A double murderer serving a life sentence has won a High Court victory in his long-running legal campaign for the right to undergo cosmetic surgery to remove a large facial birthmark. The publicly funded legal challenge by Dennis Harland Roberts, 59, could prompt other prisoners to seek treatments they might otherwise have been denied because of an undisclosed policy operated by Jack Straw, the Justice Secretary. The policy restricts prisoners access to cosmetic and certain other treatments regarded as non-urgent even though the Government has said that they are entitled to the same NHS care as the rest of the population.
Roberts won a declaration at the High Court in London that Mr Straw had acted unlawfully and contrary to good administrationin failing to disclose his full policy. Coincidentally, Roberts, a Category A prisoner, was represented in court by Adam Straw, a barrister who is a nephew of the Justice Secretary.
The court case led to the full policy being publicly revealed last week. After its disclosure, the Ministry of Justice agreed to reconsider Robertss application to be escorted to hospital for laser treatment, if he could show that the birthmark was having a negative impact on his health. But Roberts and his lawyers continued their legal action to obtain a formal High Court declaration, making the position clear for other prisoners.
Roberts said that the large, congenital port-wine stain on the left side of his face, neck and shoulder had led to his being bullied at school and was linked to a violent temper. He had previously had hospital treatment to remove it on three occasions, the last one in July 2007. But his appointments last year were cancelled.
Roberts, from Newhaven, Sussex, was convicted at Lewes Crown Court in March 1991 of stabbing to death Stephen and Iris Hadler, both in their 70s, after breaking into their home in the summer of 1989. He is now at Frankland Prison, Durham.
A consultant dermatologist recommended him for treatment for the birthmark in 2006. The consultant stated: This has always been an embarrassment to him, but he is now developing small vascular nodules within it and I think that laser treatment on the NHS is entirely justified.
Roberts said in a written statement to the court that the treatment he had already received appeared to have had some success, lightening and removing some 30 per cent of the birthmark. He said he was extremely pleased and was expecting an estimated further four sessions of treatment but delays over further treatment caused by the failure to provide him with hospital escorts had sent him into depression.
Adam Straw told the court that, as a result of being bullied at school, he has a low tolerance for people commenting on his face. He feels self-conscious and fearful of his own reaction when he becomes aware of others looking at the mark. When the treatment was halted in July 2007, Roberts slid into depression and his violent temper re-emerged.
The Governments full policy, which had now come to light, allowed elective treatment only if there was a negative impact on the prisoners mental or physical health. The policy required the need for treatment to be balanced against public acceptability issues, and the fact that Category A escorts were resource intensive, both for staffing and expenditure. This differed from the published policy relied on by the Government in a case last year, which gave inmates access to the same range and quality of services as the general public receives from the NHS.
Had Roberts known about the unpublished policy, his lawyer said, he would have sought a medical report to show the impact that the birthmark was having on his health, and legal proceedings would have been avoided.
Mr Straw said that it had been necessary to seek a High Court declaration to prevent prejudice to many other prisoners with similar claims. Prisoners were entitled to know the correct policy so that they had a proper and fair chance to make their case. Agreeing with Mr Straw, Michael Suppertone, QC, a deputy High Court judge, declared in a judgment revealed yesterday: In my judgment it is contrary to good administration, and unlawful, for the defendants full policy on medical appointments not to be published.
SOURCE
Australian medical training: What a cock-up!
More badly-needed medical schools graduates are coming out and finding that there are no training places in hospitals for them. A medical degree MUST be supplemented by "hands on" training but places for such training have not been provided for all graduates. Instead we import poorly trained doctors from India and other third-world countries! Yet again, Australia is catching the British disease
PUBLIC hospitals across the country will be forced to close their internships to hundreds of overseas-born, locally trained medical graduates in three years, despite the nation's desperate need for doctors. As Australia prepares to spend $18million trying to recruit health workers from overseas, it has already begun turning away willing interns from the ranks of international students from Australian medical schools because of a lack of training funding and resources.
The Australian Medical Students' Association expects no state will be able to offer internships to international students with Australian medical degrees by 2012, when domestic medical graduate numbers peak. AMSA president Tiffany Fulde said the number of internships available after graduation had not kept pace with the explosive growth in the number of domestic medical students, let alone those from overseas.
About 2920 domestic and 517 international students are expected to graduate from Australian medical schools in 2012, up 60 per cent and 22 per cent respectively on last year's levels. "We're just in front of this wave of students coming through and all the predictions show it's going to be really tough to find enough (intern) spots in 2012," Ms Fulde said.
Overseas students who had trained for up to six years in Australian universities and paid $200,000 in tuition fees would not be the only casualties, she said. The health system would also forgo a cohort of committed graduates trained to Australian standards at a time of chronic health workforce shortages. "Having invested in them and trained them, we send them away and then we spend more money recruiting people from overseas," Ms Fulde said.
Federal and state governments have promised a new national body, Health Workforce Australia, to better co-ordinate the workforce, starting with a $18m international recruitment campaign. But The Australian revealed this week that the agency is one of several new health workforce initiatives, ranging from under-subscribed nursing undergraduate places to return-to-work schemes, that are struggling to get off the ground.
Fourth-year University of Western Australia medical student Nishant Hemanth from Singapore said emotions were running high among overseas students over the poor planning that had led to the internship crisis. "Many were extremely disappointed and shocked. They thought this was a severe case of discrimination," she said.
Most sixth-year international medical students in Western Australia this year will go without an internship offer from their state health department for the first time, and NSW and Queensland have also struggled to meet demand.
SOURCE
More Australian public hospital negligence
Man 'stuck' to bed pan after being left on it for a long period
A SYDNEY hospital is searching for answers after an elderly patient was allegedly left on a bed pan for five days and required surgery to remove rotting skin from his buttocks. However, Dr Matthew Peters, who heads the respiratory ward at Concord Hospital in Sydney's west, is doubtful about some aspects of the story.
The man remains there as a patient. It is understood the 80-year-old man has limited English skills and is a large person.
"It is true that he was on a bed pan for a period ... and he does have a bedsore and that bedsore has complicated his stay," Dr Peters told Fairfax Radio Network. "But it's not even in the ball park of five days. "He was sick before all this started. He remains sick now but he is improving."
Dr Peters challenged a Fairfax newspaper report that said the patient's skin was decayed so much that the bedpan was stuck to him. "I believe that's erroneous," he said. "He certainly has a nasty bed sore on his buttock. "I've never seen an incident of this nature in a very long time in hospital medicine." The man did require surgery "to cut away some of the tissue that had begun to die off", he said.
Dr Peters also said hospital staff were working to determine how the injury occurred. "It is a little bit unclear - the most plausible explanation is a simple error of communication or handover," he said.
NSW Premier Nathan Rees told reporters in Sydney that the incident had been referred to the Health Care Complaints Commission for investigation.
SOURCE
The real health-care problem in America isnt moral, as the president claims, but structural
Changing its tactics in the health-care debate, the White House has begun stressing the moral imperative to provide health insurance to all Americans. I am my brothers keeper, I am my sisters keeper, President Obama now argues. And in the wealthiest nation on earth right now, we are neglecting to live up to that call. But Obama is just plain wrong that America is neglecting its obligations to the most vulnerable. The real health-care problem is not moral but structural and systemic.
We already spend hundreds of billions of dollars every year providing health care to the elderly, through Medicare, and to the poor, through Medicaid. The first of these programswhich, experts estimate, may squander up to $60 billion every year in waste, fraud, and abuseis running a staggering, and unsustainable, long-term deficit of $38 trillion. The second is in even worse shape, with a 2006 survey finding that as many as half of all physicians have either stopped accepting new Medicaid patients or limited the number theyll see because reimbursements are so low. On paper, poor patients have great government insurance; their only problem is that they cant find a doctor.
Further, the bureaucrats who manage both the Medicare and Medicaid programs issue thousands of price controls every year, telling hospitals and doctors what services they must cover and what payments they must acceptregardless of whether the payments actually cover costs. In 2008, the consulting firm Milliman estimated that low reimbursements for doctors and hospital services shifted nearly $90 billion in costs annually from public to commercial payers. This cost-shifting represents a hidden tax that effectively robs Peter to pay Paul, while allowing the public programs defenders to claim that they are more efficient because they have lower costs than private insurers.
The White House is correct when it says that millions of Americans cant afford private health insurance. But what it doesnt mention is that government regulations reduce access to affordable private insurance, strangle competition, and make insurance more expensive. State insurance regulators frequently require insurers to offer certain servicesfertility drugs, alcohol-abuse treatment, and chiropractor services, for examplethat consumers might not choose if they had a say in the matter. The Council for Affordable Health Insurance notes that these mandates may push up the cost of basic health insurance by 20 to 50 percent, depending on the state.
Such mandates are part of a long history in which bureaucrats and policymakers have, with the best of intentions, distorted markets. In fact, what health-law scholar David Hyman calls the original sin of American health care was the World War IIera decision to offer employers, rather than individuals, a tax deduction for health insurance. Theres no good reason why insurance should be tied to employment, especially since losing your job often means losing insurance coverage, along with access to your regular doctor. The way the deduction works is also unfair: it isnt capped, giving higher-wage workers more of a benefit than lower-income workers. Further, employees at small firms that dont offer health insurance have to purchase it out of their own pockets. And adding insult to injury, the tax preference for health insurance over wagesa dollars worth of wages is taxed, but employees get to keep a whole dollar in health benefitsdrives health-care inflation, because employees opt for insurance policies with high (pretax) premiums and low (taxed) out-of-pocket payments. Over the long run, this health-care inflation saps middle-class incomes as insurance premiums rise much faster than take-home pay.
The American system of health insurance is unquestionably in need of serious reform. Mounting costs threaten to suffocate future prosperity as taxes skyrocket to pay for entitlements. But President Obama has let Congress craft legislation that does nothing to make the system any more sustainable and, moreover, would cost $1 trillion or more over the next decade. The presidents moral calls ignore the nuts-and-bolts economic causes of the systems problems, promising to make reform nothing but a fiscal shell game with a few biblical allusions thrown in.
SOURCE
4 September, 2009
Britain's NHS may need to lose 137,000 staff to meet 20 billion savings target
Despite already being grossly understaffed with doctors and nurses
The NHS may need to cut its workforce by about 10 per cent the equivalent of 137,000 staff to help to meet planned savings of 20 billion, according to a leaked Department of Health report. A study commissioned from the consultancy firm McKinsey and Company recommends cutting clinical staff posts as well as administrators to meet efficiency savings by 2014, suggesting a knock-on effect to patient care.
The report, seen by the Health Service Journal (HSJ), recommends a range of possible actions, such as a recruitment freeze starting in the next two years, a reduction in medical school places from October and an early retirement programme to encourage older GPs and community nurses to make way for new blood/talent.
The report was presented to the Department of Health in March, the HSJ says today. It carries the departments logo and has been distributed among senior NHS managers. The study said 2.4 billion could be saved if hospitals with the lowest levels of staff productivity improved to become nearer the average levels. It added that almost 40 per cent of patients in a typical hospital did not need to be there.
Productivity is notoriously difficult to measure in an organisation as large as the NHS, which employs 1.5 million staff, but the biggest causes for patients staying unnecessarily long in hospital were delays in receiving tests or therapies, or a lack of suitable carers or facilities that meant patients could not go home.
The report also said that if four million of the 29 million outpatient appointments each year could be cut, it would save 600 million. A further 700 million could be saved if procedures with limited clinical benefits such as tonsillectomies, varicose vein removal and some hysterectomies were no longer performed.
The analysis also suggests that up to 8.3 billion of hospital estates could be freed up or sold to generate income.
Andrew Lansley, the Shadow Health Secretary, said: Yet again Labour ministers are failing to be straight with the British people. Andy Burnham [the Health Secretary] promised to protect the NHS, but now we find out that his department has been drawing up secret plans for swingeing cuts. Clearly, we need to get better value for money from the NHS, so we applaud any drive for greater efficiency, but it is extraordinary that Labour plan to take an axe to the hospital budget rather than to the bloated health bureaucracy. Only a fifth of job cuts would be within the bureaucracy, meaning the vast majority to go would be frontline NHS staff.
After years of declining productivity, this report shows that Labour still doesnt get it. Instead of relying on plans drawn up by management consultants for top-down cuts, they should be looking to create incentives through the way hospitals are paid, which would drive up standards and drive down costs.
SOURCE
More "Don't give a damn" attitudes towards the elderly from the NHS
The NHS has apologised after writing to a man to address concerns over his treatment - three-and-half years after he died. Tom Milner's daughter emailed the National Patient Safety Agency (NPSA) after her 76-year-old father died at Sheffield's Northern General Hospital. Janet Brooks said when she received a response, it was entitled "Dear Tom". The agency said it had reviewed its systems to ensure the error did not happen again.
Mr Milner, who had terminal leukaemia, was not given his prescribed pain-relieving morphine in the last two days of his life, his family say. They claim he was left in agony and lay in his own urine and blood at the NHS palliative care ward at the hospital. The health trust responsible for his care said staff had "acted appropriately".
Mrs Brooks, 54, of Emsworth, Hampshire, said she had outlined her concerns about her father's treatment in an email to the NPSA. "They responded with 'Dear Tom'. "It's an example of the careless and shambolic attitude by the NHS towards my father and our family."
A spokesman for the National Patient Safety Agency said: "The NPSA is aware that an error was made when responding to an email enquiry from the relative of a deceased patient. "As soon as this was identified, we contacted the person involved and apologised for any distress caused. "The NPSA has also since reviewed its systems to look at how it can ensure this does not happen again."
Dr David Throssell, deputy medical director at Sheffield Teaching Hospitals NHS Foundation Trust, said: "The Healthcare Commission found that staff acted appropriately. "Mr Milner indicated he was not in pain and therefore the doctor agreed with the nurse that further medication was not required." [Typical British coverup. How likely is it that the man suddenly became pain-free as his illness worsened?]
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Media-Care and the NHS
Mark Colvin, a journalist with the ABC, Australia's state-owned broadcaster, has a disdainful essay about the ObamaCare debate. He dismisses skeptics as a bunch of liars and tells this story, which is supposed to illustrate the glories of socialized medicine in the form of Britain's National Health Service:I became ill in Britain in 1994, not long after an assignment for the ABC in Rwanda and Zaire.Norman Swan is a physician turned medical journalist, an Australian Bob Arnot or Sanjay Gupta. So the NHS is great, provided that (1) you have insurance provided by a foreign employer, and (2) you're friends with a media-star doctor, who can help you jump the line.
The disease I had contracted proved exceptionally difficult to diagnose--it's rare, and presents a varying range of symptoms. After several visits, my National Health Service doctor had the sense and humility to confess himself beaten, and sent me to London's Hospital for Tropical Diseases. There, also on the NHS, I was tested exhaustively for every known tropical disease.
If I'd been in America, I'd have already have spent thousands--in Britain I'd spent nothing.
But this was also where one of the failings of the NHS kicked in: waiting-lists. The Tropical Disease doctors discharged me with instructions to see another specialist, but when I rang him I discovered he couldn't see me for six weeks. My condition was deteriorating fast, so when the ABC's Dr Norman Swan got on the phone from Sydney to offer help, I jumped at it. He got to work and within a day had made an appointment for me with the doctor who would go on to save my life.
Insured by the ABC, I ended up spending almost six months in hospital. I was in a private ward, but treated in a National Health Hospital. The food was better in the private ward, and I had privacy, but I am certain that the treatment was the same. My doctors were sparing time for me out of their public rounds.
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Australia: Yet another Queensland ambulance failure
Long delay forces heart victim to take a taxi. A taxi arrived in 5 minutes: The contrast between a government service and a private one. And the government service was the urgent one!
A PETRIE man with a serious heart condition took a taxi to the hospital after he gave up waiting more than an hour for a Queensland ambulance. John Chatfield said his blood pressure soared, his heart was racing and he was shaking with fever when his wife Gaye rang 000 at about midnight on August 9. She called twice more, without being given a projected response time. After waiting an hour and a quarter, they called a taxi. It arrived in five minutes.
"If you have a heart condition, you probably shouldn't drive to a hospital as anything could happen," said Mr Chatfield, who had seven-hour heart surgery three years ago and minor surgery earlier this year. "Speed is important. They need to get their act together."
Wrapped in a blanket, Mr Chatfield rode 45 minutes in the taxi to a private Brisbane hospital, where he was admitted straight away. "I was ill. It wasn't a great ride," he said. He was in hospital for three days battling a bad virus.
The Queensland Ambulance Service said it categorised Mr Chatfield "Code 2 B" meaning a response time of up to an hour. Gaye Chatfield said that if she had been told about the response time, she would have driven him or called the taxi sooner. "Even after the last phone call they couldn't tell me how long it could be. I had in my mind that I could have been another hour," she said. "It wasn't very well handled."
She told dispatchers about her husband's cardiac history, but not about his surgery because she wasn't asked. Instead she was told to turn on lights and put pets away, which led her to believe the ambulance was coming soon.
QAS said more important calls were being handled, and the dispatch category was "appropriate." It said it "regretted" the delay and said it would apologise. [big deal!]
Mr Chatfield does not blame the paramedics or line staff at QAS, but thinks QAS management needs to lift its game. He didn't see his case as a non-emergency, considering his heart problems. "I was getting worried I can tell you," he said.
QAS said dispatchers didn't give callers response times. "QAS works in a dynamic environment and it would not be realistic to provide time frames," a spokeswoman said.
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Leftist Australian government forces IVF couples to have police checks
Infertility is a medical problem. Why are people being harassed because of their medical condition? Will people having treatment for (say) high blood-pressure be singled out next? It would make as much sense. There is Leftist misanthropy behind this
WOULD-BE parents are outraged at new laws forcing them to prove they are not pedophiles or child abusers before they undergo fertility treatment. Victorian IVF clinics have started asking patients to submit to police checks ensuring they are fit to be parents. The new law will affect about 5000 couples each year.
Briony and Lew Sanelle, who completed police checks three weeks ago so they could start trying to have their second child through IVF, said they were insulted by the discrimination. "My friends trying to have babies don't have to have a police check and go and talk to their doctor before they are given the go-ahead to have a baby, so why should I?" Ms Sanelle said. "People who have a shady past who they are trying to direct this at do not have to go through this to conceive naturally . . . this is discrimination."
Tam and Brenton Ward were asked by Melbourne IVF to undertake checks this week. They cannot understand why couples having fertility treatment were singled out. Having already experienced the wonders of IVF with a daughter born 17 months ago, Mr Ward said the emotional and financial hardship meant IVF parents would be least likely to harm or neglect children. "If it applied to the whole community I would not mind, but why single out people like us in particular, especially when we have been through such a rigorous process already - through numerous counsellors, doctors and everyone else."
The requirements were included in the Reproductive Treatment Bill passed by State Parliament last December, which paved the way for single women and lesbians to access IVF. Although the regulations were proclaimed on June 1 they have not yet been enacted because the Government does not have the resources to deal with hundreds of child protection record checks it demands. But clinics are asking patients to volunteer for checks to avoid hold-ups when the laws are adopted, which industry experts expect to happen between November and January 1.
IFV pioneer Prof Gab Kovacs, from Monash IVF, said his patients were stunned when told they would have to undergo police checks. "It is a stupid regulation, a stupid law and it is not evidence-based," Prof Kovacs said. Melbourne IVF chairman Dr Lyndon Hale said the checks were discriminatory and unfair.
A report from the Victorian Law Reform Commission recommends people should be barred from IVF if they have convictions for serious sexual or violent offences, have had children taken from their care, or are assessed as a potential risk to children. [On what basis did they recommend that? How many cases of abused IVF children have there been? None, I suspect. They might as logically bar ALL people from hospitals until they have police checks]
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Pfizer to pay $US2.3bn, agrees to criminal plea
This is a total absurdity motivated by a Leftist hatred of drug companies. If a drug has been found safe and effective and approved by the FDA, why cannot it be used for conditions related to the original condition for which it was approved? Is there any proof of harm done? It is a bureaucratic offence only and should not be attacked without evidence of harm done
PFIZER agreed to plead guilty to a US criminal charge overnight and has been ordered to pay a record $US2.3 billion ($2.7 billion) to settle allegations it improperly marketed 13 medicines. The world's biggest drugmaker was slapped with the huge fines after being deemed a repeat offender in pitching drugs to patients and doctors for unapproved uses.
Pfizer pleaded guilty in 2004 to an earlier criminal charge of improper sales tactics and its practices have been under US supervision since then. "If another one of these charges crops up, it would raise questions whether Jeff Kindler is keeping everyone at Pfizer on a tight enough leash," said Miller Tabak analyst Les Funtleyder, referring to Pfizer's chief executive officer. Mr Kindler had been Pfizer's general counsel from 2002 until taking the helm in 2006.
The company in January said it took a $US2.3 billion charge late last year to resolve allegations involving Bextra and other drugs, but did not provide details at the time. "The size and seriousness of this resolution, including the huge criminal fine of $US1.3 billion, reflect the seriousness and scope of Pfizer's crimes," said Mike Loucks, acting US attorney for the District of Massachusetts.
The settlement includes a $US1.3 billion criminal fine related to methods of selling Bextra, which was withdrawn from the market in 2005 on safety concerns. Pfizer acquired Bextra in its 2003 purchase of Pharmacia. Pfizer's marketing team promoted Bextra for acute pain, surgical pain and other unapproved uses, while its salesforce promoted the drug directly to doctors for those unapproved uses and dosages, according to the Justice Department. The company and Pharmacia also used advisory boards, consultant meetings and provided travel to lavish resorts to improperly promote Bextra to doctors and made misleading claims about the drug's safety and efficacy, the Government said.
The settlement also includes $US1 billion in civil payments related to so-called "off-label" sales of drugs - meaning for uses not authorised by the US Food and Drug Administration - and payments to healthcare professionals. Pfizer denied all of the civil allegations, except for acknowledging improper promotions of the antibiotic Zyvox. "We regret certain actions taken in the past, but are proud of the action we've taken to strengthen our internal controls," said Amy Schulman, Pfizer's general counsel.
Justice Department officials said cracking down on fraud in the healthcare industry was a key priority and comes as President Barack Obama is trying to push through reforms of the $US2.5 trillion healthcare system to clip soaring costs.
The settlement and guilty plea are not expected to significantly hurt Pfizer's ability to sell drugs, Morningstar analyst Damien Conover said. "However, it could send the wrong message at a time when you're making some pretty critical negotiations with the US Government on healthcare reform."
The settlement is the largest to date for improper marketing of pre ion drugs, topping the $US1.42 billion Eli Lilly and Co agreed to pay earlier this year for off-label sales of its Zyprexa schizophrenia drug. Pfizer said it will pay $US503 million to resolve practices involving Bextra, $US301 million related to its schizophrenia drug Geodon, $US98 million for Zyvox and about $US50 million for its blockbuster Lyrica used to treat nerve pain and seizures.
On top of the $US2.3 billion fine, Pfizer said it would take new charges of up to $US33 million to resolve state civil consumer fraud allegations related to promotions of Geodon. Pfizer did not specify whether it had disciplined any executives in connection with the latest infractions.
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3 September, 2009
Britain desperate for doctors
Rather than spend money on training enough of their own doctors, the NHS has long relied on importing poorly-trained Indian doctors -- but recent changes to the immigration laws have largely cut off that supply. EU doctors, however, are not subject to immigration restrictions
Doctors are being 'poached' from east European countries by the NHS. Health officials in Latvia have accused the NHS of 'buying up our doctors in bulk' to plug gaps in the British health system. They say the exodus of staff is 'ripping the heart' out of health care in the small Baltic state. Recruitment companies supplying the NHS, who are given large commissions, are offering Latvian doctors and nurses salaries of up to five times what they earn at home, officials claim. Some of the staff, who are being recruited for both full and part-time work, speak little or no English.
Professor Andreis Erglis, head of the Latvian Cardiology Centre, said: 'They are buying doctors and nurses literally in bulk. They are ripping the heart out of our health service. 'We are having our best specialists, along with residents who have just graduated, taken away. Old and young, with years of experience and with no experience at all. 'I don't know the exact number of UK recruiting companies operating in Latvia now, but we might lose between 200 and 300 doctors. 'Latvia spent millions on giving them very high quality training, and now they're being hunted away from us.'
Professor Erglis added: 'I have received offers to work in Britain, but I will never desert my centre. I can't blame my colleagues, though. 'Here cardio-surgeons earn around 700 or 800 a month. In Britain, they can get five times as much.'
Peteris Apinis, president of the Latvian Medical Society, said another 70 doctors and senior nurses served notice they were leaving in July by applying for the relevant documents to show future employers. 'The British are the most aggressive in recruiting our medical talent,' he said. 'They are virtually unstoppable. 'When one of our hospitals or clinics faces budget cuts, or staff are laid off, British recruiting agencies are there next day with big posters inviting them to move to the NHS.'
Dr Apinis said that the British companies have obtained the home addresses of Latvian doctors and bombard them with offers to work in the NHS. They are offered assistance with re , and help for spouses to get jobs, he said. He called for action by the European Union to stop so many leaving Latvia to join the NHS.
Latvia is in the midst of one of the deepest economic crisis in Europe and its government is trying to prevent the nation going bankrupt.
Up to a third of Britain's primary care trusts fly medical staff from Europe into the UK regularly because of a shortage of British doctors willing to work evenings and weekends. They can earn up to 100 an hour. But amid concerns about standards, the Royal College of GPs and the General Medical Council has demanded a ' radical review' of out-of-hours care so that the NHS no longer has to rely on help from abroad. The medics come from a wide range of European countries, including Poland, Germany, Hungary and the Baltic states.
One British company, ID-Medical, admitted that it currently has 80 Latvian doctors undergoing training with a view to switching to hospitals in England, many of them run by the NHS. ID-Medical, which also recruits doctors in Bulgaria, Romania and Poland, is planning a drive this month in the other Baltic states, Estonia and Lithuania. It boasts that it can provide cut price options to the NHS because Eastern European doctors can be paid less than UK medics.
James Coffill, who is leading a team recruiting medics in Latvia, said: 'With the NHS being in financial crisis, we are able to offer them the doctors at a reduced rate.' Medical staff replying to the company's advertisements are told they 'don't need to speak good English' since training courses would provide them with 'sufficient medical English to get by' and teach them 'the procedures and principles of the NHS'. Mr Coffill refused to discuss how his company's commission was paid, or who funded the intensive recruitment drive. But he said that Surreybased ID-Medical provides training for the doctors, enabling them to obtain posts in the NHS, at no initial cost to the staff they are recruiting. A spokesman for the company denied it was doing anything wrong, but said that he did not want to discuss details as it could be useful to competitors.
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Britain to invest in proton therapy after boy's Jacksonville treatment
We'll believe it when we see it. The NHS can't even afford enough nurses, midwives and cleaners. How are they going to afford $116 million for one machine?
Convinced that it was his best shot at survival, Alex Barnes parents rushed the 4-year-old last fall from their home in England to Jacksonville for six weeks of proton therapy. The results were two-fold: Alexs aggressive brain cancer all but vanished, and impressed British health officials have begun taking steps to establish the countrys first proton therapy center.
Englands National Health Service last week announced that it is accepting bids from hospitals to host proton therapy services. In a statement to the media, the head of the agency credited the initiative to the lobbying efforts of Alexs mother, Rosalie. Her campaign to bring proton therapy services to England so that other children and adults can benefit from having the treatment here impressed me greatly, said Health Minister Ann Keen, who had a one-on-one meeting with Rosalie last April.
Britain has a proton beam, but it is only strong enough to treat eye cancer. Health officials say the new device likely wont receive funding until 2011 at the earliest. They arent cheap the University of Floridas Proton Therapy Institute, which debuted next door to Shands Jacksonville in 2006, cost $116 million. The hefty price tag has limited the number of devices in the United States to six and worldwide to about two dozen.
Supporters say the key difference between proton therapy and conventional radiation, which uses X-rays, is the amount of healthy tissue it preserves around its target. Protons only destroy tissue at the tumor site whereas traditional radiation destroys everything in its path and beyond, leading to potential complications, they say.
For Alex, precision was crucial. Doctors worried that X-ray radiation would damage the boys hippocampus, the brains learning center, and his hypothalamus, which controls body function. That would have put him at risk for developing diabetes, cardiovascular problems and other complications.
Although the British government offers to pay for overseas proton treatments, the Barnes family skipped that process, fearing that Alex would die before his claim could be processed. As it stood, doctors only gave him a 25-40 percent chance of survival. Local news coverage of the boys plight helped the family raise thousands of pounds for Alexs treatment in America. Last September, the boy and his mother flew from their hometown of Fleckney to Jacksonville, where, as it happened, Rosalie went to high school and her parents still lived.
The boy, now 5, underwent surgery at Wolfson Childrens Hospital to remove a quarter-inch-long tumor in his brain. After a few weeks of healing, he crossed the St. Johns River for 33 proton therapy treatments. In the e-mailed words of his mother, Alex went straight back to school as soon as we returned home and he hasnt missed a day since. His eyesight is perfect ... and his hearing is sharp, too.
Coverage of Alexs story in the British press, coupled with Rosalies lobbying campaign, persuaded a contingent of British officials to visit the UF institute earlier this summer. The group spent most of their time quizzing the administrators about how they overcame the logistical hurdles to build the center, said Stuart Klein, the institutes executive director.
The visit also led to a new partnership. Recently, British officials said they have selected Jacksonville as one of three sites worldwide where they will send proton therapy patients until their device is ready.
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An Unclean Bill of Health
With the current proposed health care bill, it is hard to believe how much politicians think they can dupe Americans. After having looked over the proposed bill HR 3200 it is a wonder that these people can look straight into a camera and tell such bold faced lies about what is and is not in this bill without regard to the real affect it will have on every American.
And just for the record, the government has no money but that which it receives from taxes. It doesnt matter if you call it a fee or a separate fund or a fine, the bottom line is: its a tax. A tax, by the pertinent definition in the Oxford American Dictionary, is: a sum of money to be paid by people or business firms to a government, to be used for public purposes.
So, those in support of this plan can play with semantics all they like, but the American people know where the money is coming from and they dont want their money used to pay for abortions-period. This bill will result in taxpayer funded abortions.
There are lies about keeping your current doctors and insurance. This Congress must think the population is deficient in math skills and common sense. The fines (taxes) on people and employers for not participating in the governments plan are prohibitive. Most businesses will simply run the numbers, discover the fee (tax) is cheaper and viola those private plans, the ones people can keep if they like them, will be no more.
There are lies about health care rationing. Has anyone besides whoever wrote them actually read those sections of the bill? The part that outlines how it will be determined whether or not someone is eligible for healthcare and if so, what kind, how much, by what doctor and at what facility? Their solution will be the cost effective means health care rationing. Theres no nicer way to say it. For this program to be affordable, there must be rationing.
There are lies by omission. Those things that are not being mentioned, such as the fact that all Americans will be required to have their medical histories in a government database whether they want to or not. There is a disturbing lack of comment on the proposed national healthcare card which all Americans will be required to have. A card which will give the government access to our bank accounts as well as our medical histories.
There is also a lack of comment on the fact that there will be no way to dispute the withdrawal of whatever fees the government decides we owe for those services. Does anyone think that, having given the government free access to their finances, such access will not be abused? Please note, this card will be required for everyone, not just those in the government plan.
Then there is the biggest lie of all; that Congress has the authority to take over the nations healthcare industry in this manner. This proposal goes far beyond the enumerated powers of Congress in the U.S. Constitution. The states could implement this type of program on their own, as Mass. and Maine have already done, but Congress has no authority to impose this type of legislation on the country as a whole.
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Another Dirty Secret in Obamacare
Flying under the radar this past week was a new government report that forecasts that the national debt will double over the next decade. The White House has projected a cumulative $9 trillion deficit between 2010 and 2019, while the Congressional Budget Office estimates a more optimistic $7.1 trillion, based upon the expiration of Bush tax cuts. What this means is that Washington's out-of-control spending likely will turn the nation's already-staggering $11 trillion in debt into an astronomical $20 trillion.
But there are at least two ginormous expenses that are excluded in these projections. First, the projections from both the White House and CBO incorporate their belief that the deficit will decline quickly over the next three years, as they assume fewer bailouts are needed and the economy will grow rapidly. But isn't there also the real possibility that the economy will not recover as quickly as they hope? Every additional bailout or stimulus (large or small) and every margin of error in their three-year prospective climb out of the economic pit will inflate our nation's debt balloon even more.
The second expense is far less speculative -- and it has to do with about a fourth of America. The 72 million baby boomers (people born in America from 1946 to 1964), members of the largest generation America has produced, are going into retirement over the next two decades and will face the golden years of declining health and rising medical costs. Under current law, if the government were to add the projected baby boomer costs of Medicare and Social Security to its debt tab, it would send deficit projections into the abyss.
Here's the primary problem. Medicare is bankrupt. Medicaid is bankrupt. And Social Security is bankrupt. Though boomers have paid into these programs via their taxes for decades, there are not enough benefits to offer them now -- and even less in the future. The problem is compounded when one understands that the number of people in the United States who are 65 or older is expected to double by 2030, and so is the amount expected to fund their retirement and health care in their twilight years, which relatively few are prepared to handle themselves.
So what is the U.S. government to do, especially when it already is projected to have $20 trillion worth of debt in 2019? (Let alone what it will be in 2030!)
That reform is needed in health care is not a question, mostly because Americans are being raped by the insurance companies. But Obamacare in its present form is not the answer, because it progressively would cut (yes, cut) the care for baby boomers in the future, if not through the reductions and costs of private options then through the mandatory benefit cuts the government would have to make in Social Security and Obamacare (formerly Medicare). Think about it. If government can't handle the costs of the elderly now in retirement via its Medicare and Social Security programs, do we really expect they will offer the baby boomers better (and more costly) benefits in the future?
According to a CBO report called "Baby Boomers' Retirement Prospects": "Present trends are unlikely to persist indefinitely, however, because total payments to retirees are expected to grow much faster under current law than either the total incomes of workers who pay Social Security and Medicare taxes or the revenues earmarked for those programs. That widening gap will place increasing stress on both programs. Narrowing the gap could involve slowing the future growth of benefits."
Notice the words "under current law" and "slowing the future growth of benefits"? That is key. The only way around this future financial dilemma (according to this administration, at least) is to change "current law" and to "slow" or lower the benefits for baby boomers. That new law (or basic legislation upon which such changes can be amended) is Obamacare.
Look closely at the political pre ion from the CBO's same boomer report: "The extent to which baby boomers are providing for their own retirement -- and have time to react to policy changes (emphasis added) -- is thus an important consideration in evaluating proposals to reform the Social Security and Medicare programs." The only way the boomers will "have time to react to policy changes" is if they are enacted before they go into retirement! (Are you catching another reason for the White House's rush to pass this legislation?!)
This is dirty secret No. 4 in Obamacare that our government isn't telling you: Obamacare ultimately is designed to force retiring baby boomers into a much cheaper version of socialized medicine than Medicare, which already is being positioned to be cut to the tune of $500 billion. Obamacare is not merely about reforming health care to aid 47 million Americans who are uninsured. It is about reforming "current law" to ax 72 million retiring Americans, whom the government can't afford to support over the next two decades.
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Good Thing We Don't Mix Religion and Politics Anymore
Well, thank Heaven George W. Bush is no longer president! Gosh, all of that mixing of religion and politics darn near subverted our Constitution -- which, as all good liberals know -- enshrines the "wall of separation" between church and state.
What? That phrase doesn't appear in the Constitution? No matter. Democrats know that conservative Republicans, particularly Christians, are dangerous religious fanatics.
When Democrats invoke the Almighty, though, it's altogether different. Religion in a Democrat is evidence of deep moral commitment, even greatness. Many of the eulogies to Teddy Kennedy mentioned his "quiet Catholic faith." His favorite parts of ure, we were told, were "Matthew 25 through 35: 'I was hungry and you gave me to eat, and thirsty and you gave me to drink.'"
The Democrats, perhaps as a political Hail Mary pass in light of the resistance health care reform has encountered, are now hitting the religion angle pretty hard. At a Tennessee fundraiser over the weekend (at which Bill Clinton arrived early -- a modern miracle if you're looking for one), the reunited team of Clinton and Gore pushed health care reform as a "moral imperative." Playing off the Kennedy eulogies, Gore invoked the Christian obligation to care for "the least of these" as the force behind H.R. 3200.
President Obama, too, has donned the preacher's mantle. Speaking to a coalition of 30 faith-based groups, he thundered that opponents of health care reform were "frankly, bearing false witness." He then offered a religious justification for his policy preference that somehow failed to make liberal Democrats uncomfortable about church/state entanglement. "These are all fabrications that have been put out there in order to discourage people from meeting what I consider to be a core ethical and moral obligation: that is, that we look out for one another; that is, I am my brother's keeper, I am my sister's keeper. And in the wealthiest nation in the world right now, we are neglecting to live up to that call."
But the president really hit his stride when he spoke by conference call to about a thousand mostly Reform rabbis, asking for their support of health care reform when they address their congregations at the upcoming High Holiday services. As Tevi Troy blogged on National Review Online, the Jewish New Year observance features a prayer called U'netana tokef which reads in part: "On Rosh Hashanah will be inscribed and on Yom Kippur will be sealed how many will pass from the earth and how many will be created; who will live and who will die ... but repentance, prayer, and charity can remove the evil of the decree."
According to Rabbi Jack Moline of Alexandria, Va., who live-blogged the event but later removed his Tweets from the Internet, President Obama referenced this prayer and then told the rabbis that "I am going to need your help" in getting health care reform passed. "We are God's partners in matters of life and death," the president added.
One cannot even fathom the sort of media firestorm that would have erupted if someone like Sarah Palin had said that. But beyond the blazing double standard, does President Obama really want to venture this deep into moralizing? This is treacherous ground for him. For one thing, a man who is already known for his messiah complex ought to choose his words more carefully. Religious people may think of themselves as striving to do God's will, but declaring yourself God's partner is a just a tad presumptuous. Besides, there are very good reasons to believe that Obama's health reform would lead to worse outcomes, not improved care. More particularly, the administration has recently been drawn into controversy (rightly or wrongly) over "death panels" and also over the Veterans Affairs department's endorsement of a pamphlet that seemed to encourage the elderly and frail to consider whether their lives were really worth extending and/or whether they were "a burden" to their families. In light of that, some may hear a degree of menace in the phrase "God's partners."
But above all, President Obama has previously told us that questions about life were "above his pay grade." He has now pivoted to claim that his health care reform is a matter of life and death. If he is now going to invoke religious authority, his opponents are entitled to recall not only that Barack Obama has a perfect pro-abortion voting record, but also that just a few years ago he spearheaded opposition to legislation that would have simply required that an infant who accidentally survived an abortion be given medical attention.
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2 September, 2009
British Heart attack patients denied lifesaving drugs
Thousands of women and older people are dying unnecessarily because they are denied proper treatment after a heart attack, claim British researchers. Doctors are failing to prescribe a full range of medication to one in five heart attack survivors which raises their risk of death within a year by 50 per cent. Data shows women and those over 60 are least likely to be given aspirin, statin and two blood pressure drugs that improve the chances of long-term survival.
The data was collated by the UK Myocardial Infarction National Audit Project which recorded the progress of 60,328 patients discharged from hospital after a heart attack between 2004 and 2005 In England and Wales. It is estimated that 2,000 deaths over a two-year period could have been avoided.
Experts suspect outdated ideas about heart problems being a ' man's disease' are partly responsible. But NHS guidelines insist there should be no discrimination.
The data was presented yesterday at the European Society of Cardiology meeting in Barcelona. Professor Iain Squire, professor of cardiovascular medicine at Leicester University, said: ' Irrespective of age and gender physicians should be trying to get all four drugs into these patients.'
In the UK in 2007 100,000 women and 93,000 men died of heart disease.
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Seriously ill child dies after repeated NHS fob-offs and negligence
Even when he got to the stage above, NHS doctors just prescribed antibiotics
Ricardo Alves-Nunes spotted the tell-tale signs of chickenpox on his five-year-old son Fabio's face as he got him ready for school. 'Fabio was full of beans, just like he was on any other day, so I wasn't too worried about the three red spots on his cheeks,' says Ricardo, 37. 'Like most parents, we thought it was a good idea for him to have chickenpox young and get it over with. We both knew it could be a lot more serious for an adult. We kept him off school and waited for more spots to appear.
'My wife, Anna, phoned the GP to check if she needed to bring him in, but the receptionist told her it wasn't necessary. I'm from Madeira originally and Anna is Polish, and we've always had high regard for the NHS and trusted their advice.'
Little did the family know that Fabio would be among the one-in-100 chickenpox patients who suffer complications from the virus - and that three weeks later he would be dead. Around 95 per cent of children catch chickenpox before the age of 16, and for most it's a mild illness leading to itching, blisters and sometimes a high temperature. It's caused by the varicella-zoster virus and is highly contagious, usually lasting a week to ten days.
In an estimated one per cent of cases, though, serious complications can develop such as pneumonia, meningitis, encephalitis ( inflammation of the brain), inflammation of the heart and toxic shock, a type of blood poisoning - all usually down to impaired immunity.
Experts have calculated that complications may result in 6,700 children's hospital admissions a year in the UK. Indeed, there were 28 deaths from chickenpox in England and Wales in 2007, the latest figure available, including nine children.
Fabio's spots first appeared on February 7, 2008, but over the next few days Ricardo, a chef at a boarding school, and Anna, 36, from Redhill, Surrey, began to feel increasingly uneasy, despite being told a visit to the GP was unnecessary. 'Fabio had suffered from severe eczema outbreaks since he was a baby - he'd even seen the GP two weeks earlier because his skin had become so sore. The chickenpox spots just made it worse,' says Anna. 'As he scratched the blisters, they turned into sores and began to weep pus. He was extremely distressed, which was heartbreaking to see.'
By February 13, nearly a week after the first spots had appeared, Fabio was getting worse. Usually by this stage, the spots have begun to scab over and the worst is past. 'The doctor simply prescribed antibiotics and said I should carry on giving him Nurofen. I blame myself now that I didn't challenge the doctor'
Anna was so worried she phoned her GP surgery for a home visit. 'He had a high temperature and could barely open his eyes because they were so swollen,' recalls Anna tearfully. 'But the receptionist told me a home visit wasn't necessary and that I should give him a cool bath and some Calpol. At no point did she consult a doctor. 'I was upset, but didn't argue. All three of our children - Patrick, 12, Fabio and Olivia, who is now three - had been treated for severe eczema by the NHS and received good care. We had no reason to doubt them.'
But over the next 24 hours Fabio's condition worsened. Anna called the surgery again late in the afternoon. When she was referred to an outofhours service, she begged her brother, Jacek, to drive her to A&E at East Surrey Hospital a few minutes away. 'By this stage both Ricardo, who was home from work, and I knew Fabio needed urgent attention. The only time he stirred was when we touched him and that was because the pain woke him. 'I took a photograph of him before we left for hospital and thought I would be showing it to him when he'd got better to give him some idea of how ill he'd been. At the hospital, Fabio was so weak he had to be taken upstairs in a wheelchair.
'When I showed the doctor his open wounds I felt sure he would be admitted - if nothing else, I thought there must be a danger they could become badly infected. But the doctor simply prescribed antibiotics and said I should carry on giving him Nurofen. I blame myself now that I didn't challenge the doctor.
'The next three days were a nightmare. Fabio barely ate or drank and his skin was so raw and weeping that I had to change his pyjamas four times a day,' says Anna. 'Every morning his sheets were stained with blood.' 'But we trusted what the doctors had told us, so I never thought to take him back to hospital - of course, I see that was a mistake now.'
On February 17, Fabio began to lose consciousness. Ricardo says: 'I carried him downstairs and his head rolled back - I thought he was dying. I called 999, but they sent just one paramedic.' Although back-up was called, the crew were happy to leave Fabio at home and it was only on Ricardo's insistence that he was eventually taken to East Surrey Hospital.
'We spent three-and-a-half hours in A&E. When a doctor eventually came, I could see the shock and panic in his eyes. They couldn't even take any blood samples, as Fabio was so dehydrated,' says Ricardo. 'He was eventually admitted and I stayed with him while Anna looked after the other children at home. Fabio woke me several times that night asking for sips of water.
'When the nurses put bandages on, they used the type used on burns victims. No one gave us any indication that his life was in danger; we just thought: "Thank God he's finally getting treatment; he'll be OK now." ' But on February 18, Fabio's condition deteriorated and he was transferred by ambulance to the Evelina Children's Hospital in London. 'When we arrived, doctors warned us that he was very sick and might not survive,' Ricardo says. 'We were totally shocked. How could a skin infection have made him so ill that he was fighting for his life? Still, no one really explained what was wrong or what treatment they were going to give.'
It was only after Fabio's death that a post-mortem revealed he had developed toxic shock, a type of blood poisoning caused by the bacteria Staphylococcus aureus. A rare complication of chickenpox, the bacteria produces a poison which enters the bloodstream through a wound and can cause organ failure.
Fabio was given fluids and antibiotics and spent the next ten days on a respirator, which took over his breathing function and supported his organ function. He appeared to stabilise.
Anna's brother was now looking after the other children, who also had chickenpox (although less severely) so both Ricardo and Anna were able to stay with Fabio at the hospital. We talked to him and played CDs of his favourite songs and stories. He loved the Crazy Frog song and Winnie the Pooh; when we played them, he would squeeze our hands and move his head - he really wanted to live.' Sadly, it was too late; Fabio died on March 1 of multiple organ failure.
Seventeen months on and the couple remain devastated. Anna and Ricardo blame themselves - but feel staff at the GP surgery and East Surrey Hospital failed them. The family complained to the hospital after Fabio's death and had a meeting with officials, but it took until June this year to get a formal apology or explanation of the events that led to Fabio's death.
'A coroner's inquest found that Fabio died of natural causes, but how can it be "natural" for a child to die like Fabio did?' says Ricardo. 'For some reason, I wasn't allowed to give evidence at the inquest. I had a letter prepared about his eczema - but this wasn't discussed. It was as if they were saying it wasn't relevant.'
Now an independent investigation team, led by paediatric doctors and nurses from nearby Darent Valley Hospital, has published a damning 26-page report on what went wrong with Fabio's care at East Surrey Hospital. The report reveals a catalogue of 'missed opportunities' to treat the boy's condition earlier and more aggressively, poor communication between doctors and a culture where nurses said they felt unable to challenge medical opinion.
Names of staff are blacked out, but the report clearly states the care provided by three doctors at the hospital 'fell below the standard expected from a paediatric unit in a District General Hospital'.
Dr Gareth Tudor-Williams, reader in paediatric infectious diseases at Imperial College, London, says: 'It is easy to be wise after the event, but if a five-year-old child with chickenpox, a history of severe eczema and a heart rate of 164 presented to hospital, I would say unequivocally that he should be admitted and given acyclovir (an anti-viral treatment for chickenpox) intravenously.
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Stupid, heartless and useless British paramedic
Mother-of-three died in pub as solo woman paramedic 'stood outside and refused to help'. But no doubt she was following "the rules"
A pub manager has demanded disciplinary action against a paramedic she claims would not help save a customer's life. Melissa Procter-Blain, 32, died after suffering a heart attack at The Crown in Spondon, Derbyshire. Her friends and family have told how the lone paramedic who responded to a 999 call first parked outside the wrong premises and then refused to enter the pub. They also claim the female paramedic refused to try to resuscitate the mother-of-three on her own and that one of the pub's customers had to step in instead until back-up arrived.
Landlady Michelle Doherty, 34, is now calling for the paramedic to be suspended while an investigation into the incident is conducted. She said: 'We were waiting outside for the ambulance and we saw the paramedic had parked outside a garage down the road. 'A young lad ran from the pub down to tell her she was in the wrong place but came back and said she wouldn't come in. 'My partner Kevin then ran down to talk to her and she said she wasn't authorised to go into a pub alone and would only come in if he could guarantee her safety, which he did.'
East Midlands Ambulance Service had logged the incident as a category A - potentially immediately life-threatening - and sent a fast-response vehicle, which arrived within six minutes, and an ambulance, which arrived within ten minutes.
A spokesman said the solo responder paramedic took the life-saving kit from her vehicle into the pub but had described the atmosphere as tense and intimidating. But witnesses in the pub dispute this claim. Ms Doherty said that while her partner spoke to the paramedic, one of her customers, Leanne Dono, was on the phone to a 999 operator. She claimed the controller told her the sole responder would begin trying to resuscitate Miss Procter-Blain.
Miss Dono said she then spoke to the paramedic, who said she was not authorised to carry out cardiopulmonary resuscitation (CPR) on her own.
Miss Dono said: 'I was talking to the 999 lady and she said I had to count Melissa's breaths. I counted one, then there was a long gap, then I counted another. By the time I got to the fifth breath, her face had turned grey and there was foam coming out of her mouth. I told the lady on the phone I thought she was dead. 'That was when the paramedic came. I told her that the 999 lady was saying she should try to resuscitate Melissa but she said she couldn't on her own, so my boyfriend Scott started doing CPR instead.
'It was horrible. Everyone was standing around and crying, but it wasn't threatening. Everyone was just really upset.' Pub manager Kevin Pearson, 35, said everyone had been disgusted by the actions of the paramedic. He said: 'We were begging her to come in and help but she just said she couldn't do anything on her own. What was the point in sending someone on ahead if they can't do anything once they get there? 'She wasted so much time, parking outside the wrong place, refusing to come in then not doing CPR. We don't know if Melissa's life could have been saved, but the paramedic could have at least tried.' Miss Procter-Blain was dead on arrival at Derby Royal Infirmary following the incident on July 12.
She had arrived at the pub with her family. She was in a wheelchair after an accident eight weeks before, when she fell over a doorstep, and was drinking soft drinks. She was in the pub's toilet with pal Hailey Bell when she suddenly lost consciousness. Miss Bell, 27, said: 'I was just opening the door when I heard this really horrible noise and when I looked at Melissa, her head had rolled back and she was looking up at the ceiling. 'Scott took her out into the pub and she seemed to be coming round, but then her head fell back again, which is when Leanne called the ambulance.'
Miss Procter-Blain's father John Page has met representatives of East Midland Ambulance Service (EMAS) to discuss his concerns. He said: 'I think paramedics do a great job but this woman just stood there are refused to treat my daughter. I think she should be struck off for what she did.'
An EMAS spokesman said it had launched an investigation immediately after receiving Mr Page's complaint letter. He said: 'Once we have completed our investigations, we will notify Mr and Mrs Page of the outcome. 'Until then, it would not be appropriate for us to make further comment about the case.'
Miss Procter-Blain's three children, aged 14, nine and four, are now being cared for by her father John and mother Diane.
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Australian public health insurance system in a mess
Quick summary for non-Australian readers: Australia's Medicare is a government-run health insurance program that covers ALL Australians out of tax revenues. About 40% of Australians, however, want higher quality care than what Medicare will fund so take out private insurance and go to private hospitals. People with private insurance get a tax rebate in recognition of their reduced use of the public system
MEDICARE has been stretched to the point where it risks putting more into doctors' pockets than into care of the chronically ill. A major government-backed report has singled out poorly targeted payments for patient "care plans" as symptomatic of a primary health system fraying at the edges and in need of funding reform.
The long-awaited report into frontline healthcare, including GP services, was launched by Kevin Rudd and Health Minister Nicola Roxon yesterday with a promise to retain the Medicare Benefits Scheme at its core.
But the Primary Health Care Reform in Australia report warns that Canberra is expecting too much of Medicare by extending it beyond simple fee-for-service reimbursements to fund GP care plans for patients with complex, long-term health problems such as diabetes, heart disease and mental illness.
The costly expansion raised concerns that "the quality of care provided is unknown and that the ives of co-ordination and continuity of care may not be being achieved", it said. Ten per cent of GPs, for example, claim 54 per cent of all Medicare items for chronic disease management care plans, leaving the program's impact across the population "open to question", the report noted. Payments to doctors for CDM care plans cost taxpayers $204million in 2007-08 alone.
A Medicare Australia audit found that more than one-third of care plan items claimed did not comply with MBS requirements.
The Professional Services Review, which investigates potential Medicare abuses, has also written to the federal Health Department about the risk the claims could be driven more by business than clinical imperatives, the report revealed. "In particular, the PSR is concerned that plans are being opportunistically generated, based on system-driven templates that do not reflect patients' actual needs and that are not necessarily shared with or even provided to the patient," it said.
In the May budget, the Rudd government used excessive doctors' fees as justification for cuts to reimbursements for IVF, obstetrics and cataract operations, claiming the most prolific 10 per cent of eye specialists earned $1m through Medicare last year.
The latest report opens the door to further payment reforms, breaking away from fee-for-service arrangements towards salaries, pay-for-performance or other incentives.
The centrality of GPs' role in patient care could also be eroded in favour of giving people more direct, affordable access to allied health workers, using pharmacies to assess risk factors, and workplaces to deliver healthy lifestyle programs. "There is widespread agreement that the Australian healthcare system, in common with many other countries, does not provide the highest quality care for the money spent," the report noted.
But AMA president Andrew Pesce warned that patients' health would suffer if they lacked a doctor to co-ordinate overall treatment. "Unfortunately, there are some danger signs in this draft strategy and in the National Health and Hospitals Reform Commission Report that the government is planning a lesser role for GPs under the guise of 'health workforce reform'," he said. "The AMA must oppose any diminution of the role of the GP in primary care, and so should the whole community."
The government will not, however, finalise the draft primary healthcare strategy released with the report until late this year at the earliest. Despite receiving the report a month ago, the government will defer decisions on which proposals it will pursue until it strikes agreement with state and territory governments on how Australia's future healthcare system will be funded.
Relations between the government and the AMA have been strained by sharp policy differences on issues ranging from GP super-clinics to budget cuts to private health insurance and the Medicare safety net.
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Health care through central planning: A helpful analogy
Some wonderful analogies have been offered that sweetly damn the "Cash for Clunkers" idiocy. We can look at how this logic would extend to lousy houses that dont "work" anymore, and the mainstream news is reporting a possible "Kitchen Clunkers" program to "stimulate" department and home supply stores, presumable complete with public spectacles of smashing refrigerators. For farmers, the latest buzz is a "Cash for Clunker Cow" program. "[T]here are vast differences in cow efficiencySo, how about providing, say a $200/cow subsidy to allow producers the opportunity to trade in our older, less-efficient models for more efficient, newer models?" writes Cow-Calf Weekly editor Troy Marshall. Of course, he is writing tongue in cheek, picking up on a joke that has been on the cattle circuit since the onset of the "Clunker" program.
Having the federal government buy or subsidize worthless assets (with borrowed or confiscated money) is not new. I remember the stories of the $500 hammers and $2000 toilets back in the day when it was popular to question military waste. And thats parlor room stuff. In my lifetime, the wars pursued by the federal government, whether against drugs or countries or cultures have been classic case studies in obscene levels of federal spending, concomitant with physical destruction of people and property, for absolutely nothing. Afghanistan? Simply a "Cash for Clunkers" program on an international scale this one targeted at sustaining US military contractors, subcontractors, and extended family members, as well as bumping up the military budget (think Government Motors, Rockets, Planes and Torpedoes, Inc). Iraq, on the other hand, could be viewed as government spending at extreme levels for non-operating and insecurable oil fields and perhaps most significantly, on property that does not and will never belong to us! How Lehman Brothers! It all makes perfect and beautiful sense, in a "Cash for Clunkers" world.
The Bush buyouts were no surprise, nor should it be surprising that the insanity continues at home and abroad under Obama. After all, when you join a club, you do so because you like the way it does things and how it makes you feel, not because you want to make radical changes. Obamas pledge of "Change!" was certainly a cruel joke on the masses of nave believers in government who live, like picket-fenced housewives, in a world made substantial through dreams.
Lets consider how all this will work in government-provided health care, whether you call it single payer, or just Article 99 writ large, or something in between. We already have several examples of government health care and apparently the only one that people want to talk about is the Congressional insurance program, whereby millions of people subsidize the unlimited health care for an unaccountable few. Well, if you are the few, its a great program. But to hold this up as an example in town hall meetings is proof that a century of public schooling in this country has succeeded in producing a nation of parrots who can repeat words but have no idea, or apparently interest, in what those words mean.
The health care that the government already runs has also been mentioned. The real performance versus cost of the military hospital system, the abject hinterland of VA hospitals, and the contracted HMO memberships offered to the military families could be discussed. Less well known is the Indian Health Service, and its track record, described succinctly here in an article written by the executive director of the Property and Environment Research Center in Montana. Its not rocket science federal management of anything, even its bare-bones constitutionally chartered duties, is flawed at best.
But there is some good news about increased government ownership and direction of the health care system, presuming thats the path we're on. It comes in small ways, and some might think, mysterious ways. For example, I have a government subsidized medical insurance. Im not clear on what it provides or doesnt provide, exactly, as in the six years since I retired, I have used it one time, in getting a school physical for my then high-school aged son. We found out, after we paid our part of the bill at the physicians office, that they maintained one price for insurance, along with a cash price. Turned out .. drum roll the cash price was actually cheaper than the deductible! So henceforth, we paid cash.
Of course, my family has in recent years, been healthy, and in the case of accidents, costs have been shared by responsible parties. My daughter crashed into something on the soccer field and had to have some MRI work done our share for that ran close to $1000. One imagines how wonderful truly free market medicine would be, with real choice, and real competition in the industry.
We have examples ophthalmology and veterinarian services come to mind first. You can get an eye exam for $50, and then order glasses online for another $20. Overall, thats less than a pair of running shoes, or a meal out with the family at Applebees. The wide variety of eye surgeries available and the competitive and safe nature of these surgeries speak to the working of a freer market than what we see for the rest of our health care. The argument by the statist left and statist right is falsely premised by the idea that the current health care "system" is a free market system, and based on the ideas that free market systems cant work for health care because people are not all equal in either health, desires for health or finances.
But the market works precisely and wonderfully because we are differently abled, financed, with unique wants and desires! It works well in animal health care (you can buy cheap medicines and health aids across state and international lines for your pets competitively and privately, and a whole new array of private insurance products have emerged to help you meet the unexpected health needs of Fido or Kitty). Compare this to our government controlled and manipulated system where buying your meds in Canada or Mexico, or self-medicating with THC will land you in jail.
But what happens in this private system when animals, for example, dont get the heath care they need, due to poverty or ignorance? Private organizations unfortunately often working with the state, as in the case of the SPCA, or working in extreme ways, as with PETA) do step in. More often than not, they are beaten to the punch by neighbors and concerned citizens who work far more quietly and lovingly. In the case of human poverty, innumerable private organizations run hospitals, providing clinics and eyeglasses, and even surgeries for the needy. Again, unseen, is the quiet and sustained help given by family members and friends when people are in dire straits. We dont see this undercurrent on television or read about it in the news but it is real.
The marketplace would do a wonderful job in providing organs and blood products, if unleashed from government control. Everything has value, including above all the health of human beings and the most destitute among us can make a wish and have it granted by a free society and the innumerable charities a free society can support. For the rest of us, a little personal responsibility goes a very long way. Its also the American way, if you ever watched an old Western, or one of Clint Eastwoods more recent ones!
If we get more governmentized and centrally managed health care, one thing we can look forward to is even more waste and misal in the industry and both of these eventually find a home in black and grey markets, which in turn foster increased distrust and delegitimization of government.
What Americans need is a helpful analogy, like "Cash for Clunkers," to help them think about the health care proposals being put forth by government and interested corporate beneficiaries. How about collective agriculture in the old Soviet Union and Eastern Europe? During the Cold War, we often heard about the incredibly productive backyard gardens of the downtrodden peasants, and the poor yields of the massive state fields. The uninformed among us credited this as an excellent example of incentive over command economies. But what we forgot then, briefly, is that, absent a true pricing system and real freedom, productivity and availability of goods will always be severely constrained overall.
In the 1980s assessment of backyard garden superproductivity of the old Soviet Union, agriculturalists, economists and pro-freedom advocates all missed a simple fundamental reality. This mythical small-garden "productivity" was wholly dependent on a concentration of work time, equipment, fertilizer, good seed, and actual meat, grain, fruits and vegetable products "stolen" from the "state" and subsequently sold on the "free market."
That this theft was justified to feed the people is beside the point. Collective and command driven health care will produce similar results and ultimately we will begin to hate the healthy.
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Comparative effectiveness research and junk science
By: Michael Barone
Employing comparative effectiveness researchdetermining which medical treatments are most effectiveis one of the means the Obama administration says government can reduce health care spending. If government pays only for treatments that are most effective, the theory goes, then it will save money.
Ive been skeptical about comparative effectiveness research. In my July 12 Examiner column, I wrote, But comparative effectiveness research is, if not junk science, not a fully developed intellectual exercise. Medicine is an art as well as a science, and comparative effectiveness research may too often compare apples and oranges. In response, an email correspondent wrote, More generally, the entire concept of comparative effectiveness goes against the cutting edge of biomedical research. Evidence mounts daily that humans are far more individualized biologically than previously believed. . . different ethnic groups, age cohorts respond to drugs in ways almost as marked as disparate genders. Comparative effectiveness testing given just those variables quickly becomes more expensive than any possible realized savings. In short, comparative effectiveness is sloppy, shortcut thinking that ignores reality in an attempt to end debate, rather than struggle with the difficult question of how far we individuate treatment.
Today in the Wall Street Journal we have testimony to the same effect from two individuals far more expert than me or my email correspondentDr. Jerome Groopman and Dr. Pamela Hartzband of the faculty of Harvard Medical School. Dr. Groopman is also a staff writer for the New Yorker. They write:But once we leave safety measures and emergency therapies where patients have scant say, what is the right thing? Data from clinical studies provide averages from populations and may not apply to individual patients. Clinical studies routinely exclude patients with more than one medical condition and often the elderly or people on multiple medications. Conclusions about what works and what doesn't work change much too quickly for policy makers to dictate clinical practice.The idea that we can standardize medical treatments, so that health care operates with the mass efficiency of an assembly line at one of the old Big Three auto company plants, seems to be a delusion. Theres a reason that most of us are not only not physicians, but not capable of becoming physicians. Theres a reason it takes four years for physicians to get their medical degrees and that they typically need four or more years of post-degree training after that. Comparative effectiveness research may very well be useful. But to standardize medical treatment on the basis of comparative effectiveness research seems like the height of folly.
An analysis from the Ottawa Health Research Institute published in the Annals of Internal Medicine in 2007 reveals how long it takes for conclusions derived from clinical studies about drugs, devices and procedures to become outdated. Within one year, 15 of 100 recommendations based on the "best evidence" had to be significantly reversed; within two years, 23 were reversed, and at 5 1/2 years, half were contradicted. Americans have witnessed these reversals firsthand as firm expert recommendations about the benefits of estrogen replacement therapy for postmenopausal women, low fat diets for obesity, and tight control of blood sugar were overturned.
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1 September, 2009
Prisoners have a better diet than British public hospital patients
Patients in Health Service hospitals are far more likely to go hungry than criminals in jail, scientists warned yesterday. They say frail and elderly patients do not get the help they need with meals, and nobody checks whether they get enough to eat. Despite years of Government promises to tackle poor hospital nutrition, food still arrives cold, and patients often miss out because meal times clash with tests and operations.
Meanwhile, prisoners are enjoying carbohydrate-rich, low-fat foods which in many cases are better than they would have been eating on the outside.
The Daily Mail has been highlighting the scandal of old people not being fed properly in hospital as part of its Dignity for the Elderly campaign. Hospital meals are often taken away untouched, because they are either unappetising or are placed out of patients' reach. The latest figures show 242 patients died of malnutrition in NHS hospitals in 2007 - the highest toll in a decade. More than 8,000 left hospital under-nourished - double the figure when Labour came to power. The NHS throws away 11million meals every year, and many nurses say they are too busy to help the frail eat.
Earlier this year the Mail revealed that some hospitals spend less on meals than the average prison. Ten hospitals spent less on breakfast, lunch and an evening meal than the 2.12 a day allocated for food by the prison service. One spent just 1. Although most hospitals do spend more than 2.12, prisoners end up better nourished than patients, say experts from Bournemouth University. After studying the food offered to inmates and across the NHS, they found patients face more barriers in getting good nutrition.
Professor John Edwards said around 40 per cent of patients were already malnourished when they were admitted to hospital, but their condition did not tend to improve while they were there. 'If you are in prison then the diet you get is extremely good in terms of nutritional content,' he said. 'The food that is provided is actually better than most civilians have. 'There's a focus on carbohydrates, then there's the way they prepare the food, it's very healthy. They don't add salt and there's relatively little frying of food - if you have a burger then it goes in the oven. Hospital patients don't consume enough. 'And from the work we've done we know that people who sit round a table eat a lot more, but this doesn't happen in hospitals.'
His colleague, Dr Heather Hartwell, said fruit and vegetables were given out in hospitals 'but this doesn't mean it's eaten'.
While patients suffer due to a loss of appetite as a result of their illness, they often go hungry because there is no one to help them eat. Dr Hartwell said once food was prepared, it generally hangs around waiting for porters to transport it to patients. Then it may be left on wards until it goes cold. 'Ward staff also don't actually know how much patients are eating because it is domestics who clear the trays away,' she said. 'This is an example of fragmentation in hospitals that does not necessarily happen in prisons.'
The research found temperature and texture are among the most important factors in patients' satisfaction with food. It concluded lack of appetite due to a medical problem is probably the main reason for under-nutrition, but said hospitals can make improvements.
Liberal Democrat health spokesman Norman Lamb said: 'It's incredible that so many hospitals are failing to serve healthy meals. If prisons can serve good food then so can hospitals.'
The Department of Health said: 'The majority of patients are satisfied with the food they receive in hospitals, and we are working to improve services further. 'The Nutrition Action Plan, Improving Nutritional Care, outlines how nutritional care and hydration can be improved and highlights five key priority areas for NHS and social care staff to work with. 'We have also introduced the concept of "protected mealtimes" where all non-urgent activity on the ward stops, so that patients can enjoy their meals.'
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Australia: The moronic Queensland government ambulance service again
Young mother angry at 'stupid' grilling during emergency call -- but the QAS are not backing down or apologizing -- even though they cannot provide details to refute her claims. Sounds like she got a Pakistani callcentre operator. I am pretty sure the QAS record all calls so they must know exactly what happened and are just "hanging tough" -- in the light of the big spray of complaints that have recently been made against them. They think a policy of "no admissions" is going to help them ride out the storm caused by their own bureaucratic incompetence
A REDBANK Plains mother said she had to answer a list of "stupid" questions before she could get an ambulance for her newborn baby who was vomiting and shaking uncontrollably. Suzanne Lang said her son, Zavier, only 30 hours old, had his eyes rolling up as she struggled with a 000 dispatcher she could barely understand.
One question was whether her baby was talking or not, she said. After the ambulance arrived, she said she had a harrowing unsecured ride to Ipswich Hospital on a stretcher. Lacking a seat belt, "I literally fell across the ambulance with my baby in my arms", she said.
The emergency occurred about 10pm on August 19, the night after her baby's birth. Mrs Lang said she feared her child's convulsions were a seizure because one of her other children suffers from seizures. Doctors actually determined the cause was an allergic reaction to sterilisation chemicals.
The Queensland Ambulance Service said the ambulance arrived at the home in 10 minutes and dispatchers spent only two minutes on the phone before it was sent. "The QAS will investigate claims relating to restraints used in this case," a spokeswoman said.
The family said it was the second negative experience with the Queensland Ambulance Service in a year. Mrs Lang said she had to drive her partner, Marcus, to the hospital after he injured his back and she gave up waiting on an ambulance after 40 minutes. The hospital reprimanded the couple for driving him because of the potential for greater damage to his vertebrae.
Mrs Lang said some of the dispatcher's questions about her baby's condition were appropriate but others seemed a waste of critical time. She said the dispatcher seemed to become irritated when she couldn't answer whether the baby had a heart condition. "I said, not that I know of. I mean, he's only 30 hours old," she said.
Queensland Ambulance Service defended the way its dispatchers answered 000 calls. It could not provide a list of specific questions asked because more than 30 s were used depending on the emergency. However, it said of the 400-600 calls received a day from 000, audits showed 95 per cent were well handled. [And the 5%? Anybody disciplined?]
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Vive Le French Care?
Health care in France is often held up as a model the U.S. might follow. Yet the French have their own problems that show there's no such thing as a free lunch or a free doctor's visit
Call it the grass-is-greener syndrome. Advocates of national health care, acknowledging the flaws in ObamaCare yet despising the current U.S. system that has the best medicines, the best medical equipment and the shortest waiting lists, have turned their eyes lovingly to places like France. As City Journal contributing editor Guy Sorman notes, the French would also love to have the low-cost, high-service system some Americans gush about. Unfortunately, they don't. France's system isn't that cheap and is financed by high taxes on labor that have heavy economic consequences.
Sorman notes that a Frenchman making a monthly salary of 3,000 euros has 350 of them deducted for health insurance. Then the employer throws in an additional 1,200 euros. This raises the cost of labor to prohibitive levels and puts a brake on economic growth. This helps explain why French unemployment hovers around 10%.
France imposes an additional tax levy to cover the constant deficits that national health insurance runs. The French Parliament raises this levy, which applies to all forms of income, every year. Altogether, Sorman writes, "25% of French national income goes toward what's called Social Security, which includes health care and basic retirement pensions for all."
Drugs developed in America at enormous expense do cost less in France, which decides what drugs are to be used and at what prices. American patients in effect subsidize the French, who take the same pills at half the price because American pharmaceutical companies don't want to lose the French market.
French taxpayers fund a state health insurer, Assurance Maladie. Assurance Maladie has run in the red since 1989, and this year's shortfall is expected to be 9.4 billion euros ($13.5 billion) and 15 billion euros in 2010, about 10% of its budget.
Regardless of the cost, does the French system produce better outcomes? Not always. Infant mortality rates are often cited as a reason socialized medicine and single-payer systems are better than what we have here. But according to Dr. Linda Halderman, a policy adviser in the California State Senate, these comparisons are bogus.
Official World Health Organization statistics show the U.S. lagging behind France in infant mortality rates 6.7 per 1,000 live births vs. 3.8 for France. Halderman notes that in the U.S., any infant born that shows any sign of life for any length of time is considered a live birth. In France in fact, in most of the European Union any baby born before 26 weeks' gestation is not considered alive and therefore doesn't "count" in reported infant mortality rates.
France reimburses its doctors at a far lower rate than U.S. physicians would accept. As David Gratzer, a physician and senior fellow at the Manhattan Institute, wrote in the summer 2007 issue of City Journal: "In France, the supply of doctors is so limited that during an August 2003 heat wave when many doctors were on vacation and hospitals were stretched beyond capacity 15,000 elderly citizens died."
After the tragedy, the French parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly. It's hard to imagine that happening here, where hospitals have enough air-conditioned beds and doctors that aren't on vacation.
Fact is, most Americans like their health care. There are ways to provide expanded coverage at lower cost, such as pushing individually owned health savings accounts, malpractice reform and allowing insurance to be bought across state lines. We needn't be forced to sacrifice quality for cost. Nor do we need to look to the French for a better solution. They don't have one.
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Another Attack On Big Drugmakers
Powerful California Rep. Henry Waxman wants to save Medicare billions by going after drug industry "windfalls." As usual, his "savings" will very quickly turn into higher costs for you-know-who. So many industries, so little time that might be the Democrats' motto. By demonizing the drugmakers, Waxman and his allies in Congress hope to convince you they're doing something about rampant cost increases in Medicare.
They're right that Medicare costs have risen rapidly. Indeed, since 1970 Medicare's costs have risen 34% faster per patient than overall medical costs. To us, that's just another reason for not trusting our medical system to the government in the first place. But that hasn't stopped Waxman, who heads the House Energy and Commerce Committee and is widely seen as the most influential player in health care overhaul in the House.
Waxman's proposal to go after drugmakers to trim Medicare costs is wrong on many levels. For one, it'll shift costs onto those with private insurance. For another, it'll make all of us less healthy by forcing drugmakers to abandon or delay development of new drugs.
Recall that just a few months ago, drugmakers were forced to swallow a "deal" with the White House to cut $80 billion from the cost of drugs over 10 years. They did so reluctantly, knowing full well they'd be politically demonized and attacked if they didn't. Despite that good-faith effort, Waxman says it's not enough. He claims the industry is the recipient of a $3.7 billion "windfall" or $30 billion over 10 years due to new drug benefits that were added to Medicare in 2006. Those changes added 6.4 million people to Medicare's rolls who were previously on Medicaid. And since the Medicare Part D program the drug program doesn't let the government negotiate lower prices with drugmakers, while Medicaid does, these new enrollees cost the government more. Waxman thinks America's drugmakers should make up the difference.
This is par for the course for members of Congress. They think they can impose whatever costs they want on an industry, with no real-world impact.
For the record, drugmakers are largely responsible for the lengthening of lives worldwide. From 1986 to 2000, according to a recent study of 56 countries, life spans grew by nearly two years. That study by a Columbia University researcher found that 40% of the gain was due to new drugs. In the U.S., average life spans for women jumped from 74.7 years in 1970 to 80.4 in 2005. For men, it leapt from 67.1 years to 75.2. Drug company research creates blockbuster medicines for dreaded diseases such as cancer, stroke, HIV, heart disease, Alzheimer's and lupus. In other words, the drugs help us live longer and better lives.
Yet few Americans realize what goes into making a successful drug. Of every 5,000 to 10,000 new compounds investigated, only about five make it through the lengthy process and will be sold to the public. This process takes 10 to 15 years on average, data from the Pharmaceutical Manufacturers' Association show. The cost, according to research from Tufts University, is $1.3 billion per drug. And only two of every 10 drugs that make it to the market recoup even their R&D costs.
The point is, it's very costly to make people well. In 2007, spending on drugs reached $286.5 billion. As Sally Pipes, president of the Pacific Research Institute, notes in her book "The Top Ten Myths of American Health Care," that's bigger than Ireland's entire GDP.
To keep up the innovation and research, drugmakers need big profits. That's how they attract more investment, and how you benefit. Those who applaud as Congress goes after a successful industry that improves all our lives should be ashamed of themselves.
Every dollar Waxman takes from a drug company today will cost lives tomorrow. As for those who blame drug costs for soaring Medicare costs, it just isn't true. Pre ion drugs account for just 10% of U.S. medical spending. Yet, dollar for dollar, they arguably have the greatest impact on our health.
Waxman and the other health care control freaks in Congress would like nothing more than to dictate the prices you pay for drugs. Ultimately, that will lead to rationing and higher drug costs not to mention fewer life-saving drugs on the market. Waxman claims he'll "save" you money. But can he save your life? America's drug companies, the best in the world, can. Quit going after them.
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An ounce of prevention is no cost-saving cure
In the debate over health care reform, preventive medicine has become almost everyone's panacea. During recent campaign-style town hall meetings in New Hampshire, Colorado and Montana, President Barack Obama never missed an opportunity to claim that preventive care and wellness programs would save money and lives.
Yet there are some inconvenient truths facing would-be reformers who tout prevention as if it were a bottle of "Dr. Feel-Good's Incredible Health-Promoting, Cost-Saving Elixir." The facts suggest that Americans have plenty of reason to be reluctant to swallow what politicians are trying to sell.
The most recent warning came from the Congressional Budget Office. The nonpartisan agency has issued a study that debunks the claim that preventive care for all Americans would translate into substantial savings for the federal government.
To the contrary, the CBO noted, "Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness."
How could this be true? Can't just about everyone recite Benjamin Franklin's adage that "an ounce of prevention is worth a pound of cure?" Wouldn't it make sense to increase cancer and cholesterol screenings, vaccinations, anti-smoking programs, food content labeling and the like so that we focus on health care instead of disease care?
Obama made this case during his recent town hall meeting in Montana: "Are we better off waiting until somebody gets diabetes and then paying a surgeon for a foot amputation, or are we better off having somebody explain to a person who's obese and at risk of diabetes to change their diet, and if they contract diabetes to stay on their medications?"
Democratic congressional leaders echo the same refrain. "Reform will mean higher-quality care by promoting preventive care so health problems can be addressed before they become crises. This, too, will save money," argued House Speaker Nancy Pelosi, D-Calif., and Majority Leader Steny Hoyer, D-Md., in USA Today. "We'll be a much healthier country if all patients can receive regular checkups and tests, such as mammograms and diabetes exams, without paying a dime out-of-pocket," they said.
Republicans have also been eager to embrace preventive medicine. Sen. John McCain, R-Ariz., regularly insists that "the best care is preventive care." Former Republican presidential contender Mike Huckabee of Arkansas has claimed that wellness campaigns to reduce smoking and encourage diet and exercise could save "billions of dollars."
The number crunchers at the CBO aren't buying it. As the agency explained in an August letter, "for most preventive services, expanded utilization leads to higher, not lower, medical spending overall."
The CBO isn't alone in its assessment. According to Alan Garber, the director of the Center for Health Policy at Stanford University, "the few studies that have compared preventive care to treatment have shown that either form of care can be cost-effective -- or not -- depending on how it's used. There's no magic to the idea of prevention, except that it sounds good."
In a report published last year in the New England Journal of Medicine, researchers analyzed some 600 studies done since 2000 assessing the value of preventive care. They concluded that although about 20 percent of preventive measures -- including flu shots and colorectal cancer screenings -- did save money, "the vast majority reviewed in the health economics literature do not."
One reason why? Prevention programs spend a lot of money targeting people who are perfectly healthy. Say, for example, that in screening 500,000 people, health workers find one person whose ailment can be pre-empted before it develops into a costly, life-threatening condition.
They might save, say, $50,000 on late-stage treatment for that patient. But they will have spent much more than that to test the other 499,999 people who were just fine.
Here's another example from a study published last year in the journal Circulation. Suppose we enact several highly recommended measures to control cardiovascular disease and diabetes. Among other ends, the programs would improve blood pressure monitoring, increase access to medication and reduce cholesterol levels in high-risk patients.
Suppose that these prevention measures were 100 percent successful. The estimated cost of treating at-risk patients over the next 30 years would drop by about a trillion dollars. The preventive measures themselves, though, would cost $8.5 trillion -- offsetting the savings by a factor of almost 10.
As for the net value of wellness programs, the CBO has determined that there's not enough evidence to demonstrate that government efforts to discourage certain bad health habits would actually result in cost savings.
Fifteen years ago, the federal government began requiring food manufacturers to post nutrition and calorie information on food labels. Since then, Americans have had access to a barrage of data on every Snickers bar and bag of Cheez Doodles. But the labeling hasn't made us healthier. In fact, we're actually fatter -- since the advent of nutrition labels, the percentage of obese Americans has increased by two-thirds. With smoking cessation programs, the story is similar.
The reason is simple. Extending longevity tends to increase overall health spending. Illnesses like Alzheimer's, osteoarthritis, osteoporosis and prostate cancer make the final years of life incredibly expensive. The average nonsmoker who lives to age 84 will require about $100,000 more in medical expenses than the average smoker who dies seven years sooner because of his bad habit.
A few preventive measures do indeed save money. Others may impose a net cost but nonetheless are worth it because they improve our well-being. Preventive and wellness efforts may reduce pain and suffering and increase quality of life -- which may be justification enough.
But that's not the justification Washington is offering. Instead, lawmakers are trying to sell us on the seductive -- but ultimately false -- idea that taxpayer dollars spent on prevention can yield long-term savings.
We face a staggering federal deficit and increased taxes for all Americans if Obama's health care reform ideas are enacted. We need honest information about what proposed reforms will cost. And so it's time for politicians to swear off "Dr. Feel-Good's Incredible Health-Promoting, Cost-Saving Elixir."
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Leading Republican blasts health care plan
A leading Republican negotiator on health care struck a further blow to fading chances of a bipartisan compromise Saturday by saying Democratic proposals would restrict medical choices and make the country's "finances sicker without saving you money." The criticism from Sen. Michael B. Enzi, Wyoming Republican, echoed that of many opponents of the Democratic plans under consideration in Congress. But Mr. Enzi's judgment was especially noteworthy because he is one of three Republicans trying to negotiate a bipartisan bill in the Senate's so-called "Gang of Six."
In the Republicans' weekly radio and Internet address on Saturday, Mr. Enzi said any health care legislation must lower medical costs for Americans without increasing deficits and the national debt. "The bills introduced by congressional Democrats fail to meet these standards," he said.
Mr. Enzi, together with Republican Sens. Charles E. Grassley of Iowa and Olympia J. Snowe of Maine, has held talks with Senate Finance Committee Chairman Max Baucus, Montana Democrat. But the chance of a bipartisan breakthrough has diminished in the face of an effective public mobilization by opponents of Democratic proposals. "I heard a lot of frustration and anger as I traveled across my home state this last few weeks," said Mr. Enzi, who has been targeted by critics for seeking to negotiate on legislation. "People in Wyoming and across the country are anxious about what Washington has in mind. This is big. This is personal."
Hours after the address aired, about 1,000 people rallied in New York City in support of an overhaul. Rep. Carolyn B. Maloney, New York Democrat, told the crowd near Times Square about legislation that she said would lower costs for almost everyone.
The debate over health care will resume in Washington after Labor Day, just two weeks after White House budget officials projected that deficits would total $9 trillion over the next 10 years. Though President Obama has said he wants the total health care bill paid for without adding to the deficit, congressional budget specialists have estimated that House health care proposals would cost the government more. "The Democrats are trying to rush a bill through the process that will actually make our nation's finances sicker without saving you money," Mr. Enzi said.
Democrats also are calling for cuts in Medicare spending, using some of the savings to help uninsured workers. A House bill would result in a net reduction in Medicare of about $200 billion, though Mr. Obama has insisted the reductions would not cut benefits in the health program for the elderly.
But Mr. Enzi said, "This will result in cutting hundreds of billions of dollars from the elderly to create new government programs."
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