Saturday, July 11, 2009
When public health becomes a public nuisance
The bizarre advice given to British doctors on how to deal with swine flu confirms that top-down scaremongering is destroying medical practice
The combination of speculative scaremongering by Britain’s health authorities and increasingly absurd directives to general practitioner (GP) surgeries in response to the current flu outbreak confirms that public health has become a public nuisance.
On 3 July, the UK health minister Andy Burnham (the fourth since the last General Election) announced that the swine flu pandemic could no longer be contained and that there could be 100,000 cases a day by the end of August. In response to the suggestion from a TV interviewer that this could mean 40 deaths a day, the chief medical officer Liam Donaldson agreed that this was possible, and that it could be higher.
Burnham conceded that his figure was ‘a projection’, not a fact - he meant that it was a speculation based largely on ignorance, similar to previous (unfulfilled) predictions of catastrophic mortality from AIDS, mad cow disease and bird flu. Though leading public health authorities cling to the belief that proclaiming nightmare scenarios is useful in raising public awareness of disease, in reality this provokes anxiety out of all proportion to benefit.
On the same day we received in our GP surgery, by fax and email (and no doubt shortly also by post), the latest of the almost daily pandemic flu briefings from the local primary care trust (PCT). The headline barks: ‘PPE procedures to be used for every patient.’ The bulletin continues in the now familiar tone of an exasperated infant school teacher spelling things out for children who suffer from a combination of learning difficulties and attention deficit hyperactivity disorder (though it never goes so far as to explain that PPE stands for ‘personal protective equipment’):
‘GPs are reminded that on seeing a patient with flu-like symptoms they need to follow all guidance on PPE, including wearing a surgical mask, gloves and apron.’
This is the sort of advice that could only be given by somebody who has never set foot in a GP surgery, certainly not since the onset of the great swine flu scare. The simple fact is that many patients who have been alarmed by the pandemic propaganda take no notice of the advice to stay at home and come to the surgery (and bring their children) and - quite understandably - expect to be seen. So, after they have sat in the waiting room for hours, coughing and spluttering, we are then expected to scrub and gown up as though we were performing open-heart surgery - and then repeat this procedure for the 20 other patients in the queue? Dream on.
I am torn over what has been the most useful guidance we have received from on high. Is it the diagram showing a cross-section of the nasopharynx illustrating how to take a throat swab? Or is it the picture of the container showing how to package the swab for transport to the laboratory? It was also very helpful to receive ‘real examples’ of ‘what not to do’ detailing just how stupid some local GPs have been in misinterpreting simple guidelines. It is shocking to hear that some GPs have even confused World Health Organisation (WHO) pandemic alert algorithm S5a (for dealing with suspected cases) with algorithm S5b (for sporadic cases). Is it any wonder that the pandemic is out of control? Can revalidation come a moment too soon?
GPs who were instructed - as I was - by the Health Protection Agency (HPA) to visit a suspected case of swine flu solely to do a throat swab may be alarmed by the proposals for home visiting in the grand pandemic flu contingency plan. This anticipates that 28.5 per cent (note the decimal place precision) of a predicted 30million cases in the UK (based on a 50 per cent ‘clinical attack rate’) will require visiting at home. By my humble calculations, assuming a four-week period (and assuming, improbably, no GP absenteeism), this would mean about 10 visits a day for every GP working seven days a week. Whether or not this would be of any benefit to these patients, it would certainly bring primary care services to a halt. But, if the epidemiologists want swabs, why not ask patients to do their own? (They could be sent pictures to help them locate their noses and throats.) We do this already with suspected cases of measles and mumps, so why not for flu? Patients are quite capable of doing their own genital swabs for chlamydia. Indeed this suggests another role for the ‘flu friend’: why not ask them to do your chlamydia swabs as well and get even friendlier?
The unfolding swine flu fiasco raises some hypothetical questions. What if the WHO, the HPA, the Department of Health and the rest had declared an embargo on press conferences and public statements? What if they had encouraged the virologists to concentrate their energies in the laboratories (where their achievements have been impressive) and stay away from the TV studios (where their pronouncements have often been ill-judged and alarmist)?
What if the PCTs had simply let GPs respond in the familiar way to cases of flu apparently occurring in an unfamiliar season? Given the evident mildness of the vast majority of swine flu cases (often milder than seasonal flu), it is difficult to believe that this approach would have resulted in any higher morbidity or mortality. It would certainly have led to less anxiety, to a much lower number of confirmed cases and to a vastly lower consumption of marginally effective anti-viral drugs. It would also have prevented much distress to patients, and much disruption to schools and workplaces (not to mention to surgeries, out-of-hours services, and hospitals).
Ah yes, but it could have been worse, comes the doomsday chorus from WHO, HPA, and all the rest. No doubt, the H1N1 virus could mutate to become the most virulent strain since the 1918 flu pandemic that killed 20million people. It could even be worse than the Black Death of 1348 that reduced the population of Europe by a third. Or maybe not. The public health authorities appear to have become incapable of distinguishing between sensible contingency planning and scaremongering propaganda. But instead of quietly admitting at the outset that very little was known about H1N1 and discreetly getting on with the job of preparing a vaccine and testing drugs, they reached for the megaphone. Better, according to the official mantra of twenty-first century risk aversion, ‘to prepare for the worst and hope for the best’. But even if swine flu had turned out to be a more serious illness, it is difficult to see how scaremongering, swabbing, PPE and Tamiflu would have made much difference.
The ascendancy of public health over primary care revealed in the swine flu scare is an ominous trend. The statements of both national and local public health practitioners confirm attitudes of condescension, even contempt, for the individuals traditionally regarded as being at the centre of primary care - patients and GPs. For public health specialists, our patients are merely people committed to unhealthy lifestyles. Their risk factor epidemiology repackages old prejudices: people get ill because they are idle, promiscuous, gluttonous, drunken, and as the spread of swine flu confirms, dirty. They regard GPs as sadly lacking in the moral fervour required to transform the deviant behaviour of our patients.
The outlook of public health would not be of much consequence were it not for the fact that it has, over the past 20 years, acquired a growing influence over primary health care. This is confirmed by the prominent role of public health specialists, who often have little knowledge or experience of General Practice, in primary care trusts. It is also reflected in the shift in the focus of primary care away from the diagnosis and treatment of the illnesses presented by patients towards the attempt to manage the health-related behaviour of the practice population. The burgeoning activities of check-ups and screening are resulting in what might be called an epidemic (perhaps not yet a pandemic) of overdiagnosis and overtreatment particularly in relation to cancer, heart disease and diabetes.
The moralising propaganda of public health has a generally demoralising effect on society, encouraging fear and anxiety - and attendant sentiments of stigma and blame. It has a degrading effect on medical practice and is corrosive of good relations between doctors and their patients. As the swine flu scare confirms, it is also disruptive of day-to-day medical practice.
SOURCE
Insuring you won’t cut costs
Health care "reformers" keep talking about getting us more health insurance. Then they talk about cutting costs. This is contradictory nonsense. Insurance, whether private or a government Ponzi scheme like Medicare, means third parties pay the bills. When someone else pays, costs always go up.
Imagine if you had grocery insurance. You wouldn't care how much food cost. Why shop around? If someone else were paying 80 percent, you'd buy the most expensive cuts of meat. Prices would skyrocket. That's what health insurance does to medical care. Patients rarely even ask what anything costs. Doctors often don't know. Often nobody even gives a damn. Patients rarely ask, "Is that MRI really necessary? Is there a cheaper place?" We consume without thinking.
By contrast, in areas of medicine where most patients pay their own way, service gets better, while prices fall. Take plastic surgery and Lasik eye surgery: Because patients shop around and compare prices, doctors work hard to win their business. They often give customers their cell-phone numbers. Service keeps increasing, but prices don't. "In every other field of medicine, the price is going up faster than consumer prices in general," says John Goodman of the National Center for Policy Analysis. "But the price of Lasik surgery, on average, has gone down by 30 percent."
This shouldn't be a surprise. What holds costs down is patients acting like consumers, looking out for themselves in a competitive market. Providers fight to win business by keeping costs down and quality up. Yet politicians keep telling us the solution is more insurance. And they mean insurance not just for catastrophic diseases that could bankrupt us but also for routine treatments.
The politicians are so oblivious to reality that they are on course to make things worse. Obama would force every business to either give workers health insurance or pay a fine into the public system. Why is that something we should want employers to do? Premiums come out of our salaries, but insurers are accountable to our bosses, not to us. Why not just have a free market where people can buy whatever kind of health insurance they want? Competition would then bring prices down.
Obama and his Senate allies would limit competition by requiring insurers to cover everyone for the same "fair" price. No "cherry picking," the president says. No charging healthy people less.
They call this "community rating," and it sounds fair. No more cruel "discrimination" against people who have a preexisting condition, obese people or smokers. But such simple-minded one-size-fits-all rules take from insurance companies their best price-dampening tool: Risk-based pricing encourages people to take better care of themselves, just as car-insurance companies reward good drivers. With one-size pricing your car-insurance company must give the town drunk the same deal it gives you. Insane, but the health-insurance industry is playing along. Insurers say that if government forces everyone to have insurance, they will accept all customers regardless of preexisting illnesses.
They also offered to stop charging higher premiums to sick people. They're even giving up on gender differences. Sen. John Kerry huffed, "The disparity between women and men in the individual insurance market is just plain wrong, and it has to change." The president of the industry trade group, Karen M. Ignagni, agreed that disparities "should be eliminated."
Give me a break. Women pay more than men for health insurance for good reason. Despite being healthier than men, they incur higher costs because they go to doctors more often, and they take more medicine. Kerry is pandering. I don't recall him demanding that men be protected from higher life-insurance and auto-insurance premiums.
"Community rating" hides the cost of health care. It's as destructive as ordering fire insurance companies to charge identical premiums for wood frame and stone houses. Universal health insurance with "no discrimination" pricing will make health care costs rise even faster. When politicians interfere with free markets, unintended consequences harm everyone, except the companies that lobby hard enough to protect themselves. Is it too much to expect our rulers to understand this?
SOURCE
Health care is not a right
Amidst all the health care debate, there is one underlying assumption that hardly anyone challenges: the notion that people have a right to health care. The truth is that it’s a nonsensical notion. People no more have a right to health care than they have a right to education, food, or clothing.
After all, what does a right to health care mean? If I have a right to something, then doesn’t that mean that you have a correlative duty to provide it? If you’re a doctor, then it means that you are required to serve my needs, like it or not. If I need an operation, then you cannot say “no” because that would be denying me my right to health care.
Thus, isn’t the right to health care actually a power to force doctors to provide people with medical services?
Now, the proponent of health care as a right might say, “That’s not what I mean. Why, to force doctors to provide health care services to others would be akin to slavery, especially if it’s for free. I think that doctors deserve to be paid for their services.”
Fair enough. But then doesn’t the right to health care entail the power to force someone else to pay for it? Let’s assume, for example, that I need hip-replacement surgery that will cost $25,000 and that I don’t have the money to pay for it. Since I have a right to health care, that means that I have a right to get the money from you to pay for my operation. It also means that you can’t say no because that would be interfering with my right to health care.
Thus, the right to health care entails the power of everyone to get into the pocketbooks of everyone else. That’s not only a ridiculous notion of rights but also a highly destructive one. Since obviously people can’t go and take the money from others directly, it inevitably entails converting government into an engine of seizure and redistribution. Or to paraphrase Bastiat, such a concept of rights converts government into a fiction by which everyone is doing his best to live at the expense of everyone else.
Meanwhile, while everyone is using government to get into everyone else’s pocketbook to pay for his health care expenses, he is simultaneously doing his best to protect his own income and assets from being plundered by the government to fund everyone else’s health care bills.
Over time, it is easy to see how such a system devolves in everyone’s warring against everyone else. It is also easy to see that such a system obviously does not nurture friendly and harmonious relations between people. This is especially true when these types of “rights” expand to such areas as education, food, clothing, and housing.
The true nature of rights — the type of rights the Founding Fathers believed in — involved the right of people to pursue such things as health care, education, clothing, and food and that government cannot legitimately interfere with their ability to do so.
Thus, the right to life, liberty, and the pursuit of happiness, as described in the Declaration of Independence, doesn’t mean that someone else is forced to provide you with the means to sustain or improve your life. It means that government cannot enact laws, rules, or regulations that interfere with or infringe upon your right to pursue such things.
When Americans began looking upon rights as some sort of positive duty on others to provide them with certain things, that was when the quality of health care in America began plummeting. That was what Medicare and Medicaid were all about — the so-called right of poor people and the elderly to health care. It is not a coincidence that what began has the finest health care system in the world has turned into a system that is now in perpetual crisis.
There is one — and only one — solution to America’s health care woes — and it lies not in a government takeover of health care. In fact, the solution is the exact opposite: It is the end of all government involvement in health care — a total separation of health care and the state. That would entail not a reform or improvement of Medicare and Medicaid but rather their total repeal.
At its core, the solution to America’s health care crisis lies in the abandonment of the notion that health care is a right. Once people reach this fundamental realization, as our American ancestors did, the nation can get back on the road toward to a healthy, prosperous, and harmonious society.
SOURCE
The bizarre advice given to British doctors on how to deal with swine flu confirms that top-down scaremongering is destroying medical practice
The combination of speculative scaremongering by Britain’s health authorities and increasingly absurd directives to general practitioner (GP) surgeries in response to the current flu outbreak confirms that public health has become a public nuisance.
On 3 July, the UK health minister Andy Burnham (the fourth since the last General Election) announced that the swine flu pandemic could no longer be contained and that there could be 100,000 cases a day by the end of August. In response to the suggestion from a TV interviewer that this could mean 40 deaths a day, the chief medical officer Liam Donaldson agreed that this was possible, and that it could be higher.
Burnham conceded that his figure was ‘a projection’, not a fact - he meant that it was a speculation based largely on ignorance, similar to previous (unfulfilled) predictions of catastrophic mortality from AIDS, mad cow disease and bird flu. Though leading public health authorities cling to the belief that proclaiming nightmare scenarios is useful in raising public awareness of disease, in reality this provokes anxiety out of all proportion to benefit.
On the same day we received in our GP surgery, by fax and email (and no doubt shortly also by post), the latest of the almost daily pandemic flu briefings from the local primary care trust (PCT). The headline barks: ‘PPE procedures to be used for every patient.’ The bulletin continues in the now familiar tone of an exasperated infant school teacher spelling things out for children who suffer from a combination of learning difficulties and attention deficit hyperactivity disorder (though it never goes so far as to explain that PPE stands for ‘personal protective equipment’):
‘GPs are reminded that on seeing a patient with flu-like symptoms they need to follow all guidance on PPE, including wearing a surgical mask, gloves and apron.’
This is the sort of advice that could only be given by somebody who has never set foot in a GP surgery, certainly not since the onset of the great swine flu scare. The simple fact is that many patients who have been alarmed by the pandemic propaganda take no notice of the advice to stay at home and come to the surgery (and bring their children) and - quite understandably - expect to be seen. So, after they have sat in the waiting room for hours, coughing and spluttering, we are then expected to scrub and gown up as though we were performing open-heart surgery - and then repeat this procedure for the 20 other patients in the queue? Dream on.
I am torn over what has been the most useful guidance we have received from on high. Is it the diagram showing a cross-section of the nasopharynx illustrating how to take a throat swab? Or is it the picture of the container showing how to package the swab for transport to the laboratory? It was also very helpful to receive ‘real examples’ of ‘what not to do’ detailing just how stupid some local GPs have been in misinterpreting simple guidelines. It is shocking to hear that some GPs have even confused World Health Organisation (WHO) pandemic alert algorithm S5a (for dealing with suspected cases) with algorithm S5b (for sporadic cases). Is it any wonder that the pandemic is out of control? Can revalidation come a moment too soon?
GPs who were instructed - as I was - by the Health Protection Agency (HPA) to visit a suspected case of swine flu solely to do a throat swab may be alarmed by the proposals for home visiting in the grand pandemic flu contingency plan. This anticipates that 28.5 per cent (note the decimal place precision) of a predicted 30million cases in the UK (based on a 50 per cent ‘clinical attack rate’) will require visiting at home. By my humble calculations, assuming a four-week period (and assuming, improbably, no GP absenteeism), this would mean about 10 visits a day for every GP working seven days a week. Whether or not this would be of any benefit to these patients, it would certainly bring primary care services to a halt. But, if the epidemiologists want swabs, why not ask patients to do their own? (They could be sent pictures to help them locate their noses and throats.) We do this already with suspected cases of measles and mumps, so why not for flu? Patients are quite capable of doing their own genital swabs for chlamydia. Indeed this suggests another role for the ‘flu friend’: why not ask them to do your chlamydia swabs as well and get even friendlier?
The unfolding swine flu fiasco raises some hypothetical questions. What if the WHO, the HPA, the Department of Health and the rest had declared an embargo on press conferences and public statements? What if they had encouraged the virologists to concentrate their energies in the laboratories (where their achievements have been impressive) and stay away from the TV studios (where their pronouncements have often been ill-judged and alarmist)?
What if the PCTs had simply let GPs respond in the familiar way to cases of flu apparently occurring in an unfamiliar season? Given the evident mildness of the vast majority of swine flu cases (often milder than seasonal flu), it is difficult to believe that this approach would have resulted in any higher morbidity or mortality. It would certainly have led to less anxiety, to a much lower number of confirmed cases and to a vastly lower consumption of marginally effective anti-viral drugs. It would also have prevented much distress to patients, and much disruption to schools and workplaces (not to mention to surgeries, out-of-hours services, and hospitals).
Ah yes, but it could have been worse, comes the doomsday chorus from WHO, HPA, and all the rest. No doubt, the H1N1 virus could mutate to become the most virulent strain since the 1918 flu pandemic that killed 20million people. It could even be worse than the Black Death of 1348 that reduced the population of Europe by a third. Or maybe not. The public health authorities appear to have become incapable of distinguishing between sensible contingency planning and scaremongering propaganda. But instead of quietly admitting at the outset that very little was known about H1N1 and discreetly getting on with the job of preparing a vaccine and testing drugs, they reached for the megaphone. Better, according to the official mantra of twenty-first century risk aversion, ‘to prepare for the worst and hope for the best’. But even if swine flu had turned out to be a more serious illness, it is difficult to see how scaremongering, swabbing, PPE and Tamiflu would have made much difference.
The ascendancy of public health over primary care revealed in the swine flu scare is an ominous trend. The statements of both national and local public health practitioners confirm attitudes of condescension, even contempt, for the individuals traditionally regarded as being at the centre of primary care - patients and GPs. For public health specialists, our patients are merely people committed to unhealthy lifestyles. Their risk factor epidemiology repackages old prejudices: people get ill because they are idle, promiscuous, gluttonous, drunken, and as the spread of swine flu confirms, dirty. They regard GPs as sadly lacking in the moral fervour required to transform the deviant behaviour of our patients.
The outlook of public health would not be of much consequence were it not for the fact that it has, over the past 20 years, acquired a growing influence over primary health care. This is confirmed by the prominent role of public health specialists, who often have little knowledge or experience of General Practice, in primary care trusts. It is also reflected in the shift in the focus of primary care away from the diagnosis and treatment of the illnesses presented by patients towards the attempt to manage the health-related behaviour of the practice population. The burgeoning activities of check-ups and screening are resulting in what might be called an epidemic (perhaps not yet a pandemic) of overdiagnosis and overtreatment particularly in relation to cancer, heart disease and diabetes.
The moralising propaganda of public health has a generally demoralising effect on society, encouraging fear and anxiety - and attendant sentiments of stigma and blame. It has a degrading effect on medical practice and is corrosive of good relations between doctors and their patients. As the swine flu scare confirms, it is also disruptive of day-to-day medical practice.
SOURCE
Insuring you won’t cut costs
Health care "reformers" keep talking about getting us more health insurance. Then they talk about cutting costs. This is contradictory nonsense. Insurance, whether private or a government Ponzi scheme like Medicare, means third parties pay the bills. When someone else pays, costs always go up.
Imagine if you had grocery insurance. You wouldn't care how much food cost. Why shop around? If someone else were paying 80 percent, you'd buy the most expensive cuts of meat. Prices would skyrocket. That's what health insurance does to medical care. Patients rarely even ask what anything costs. Doctors often don't know. Often nobody even gives a damn. Patients rarely ask, "Is that MRI really necessary? Is there a cheaper place?" We consume without thinking.
By contrast, in areas of medicine where most patients pay their own way, service gets better, while prices fall. Take plastic surgery and Lasik eye surgery: Because patients shop around and compare prices, doctors work hard to win their business. They often give customers their cell-phone numbers. Service keeps increasing, but prices don't. "In every other field of medicine, the price is going up faster than consumer prices in general," says John Goodman of the National Center for Policy Analysis. "But the price of Lasik surgery, on average, has gone down by 30 percent."
This shouldn't be a surprise. What holds costs down is patients acting like consumers, looking out for themselves in a competitive market. Providers fight to win business by keeping costs down and quality up. Yet politicians keep telling us the solution is more insurance. And they mean insurance not just for catastrophic diseases that could bankrupt us but also for routine treatments.
The politicians are so oblivious to reality that they are on course to make things worse. Obama would force every business to either give workers health insurance or pay a fine into the public system. Why is that something we should want employers to do? Premiums come out of our salaries, but insurers are accountable to our bosses, not to us. Why not just have a free market where people can buy whatever kind of health insurance they want? Competition would then bring prices down.
Obama and his Senate allies would limit competition by requiring insurers to cover everyone for the same "fair" price. No "cherry picking," the president says. No charging healthy people less.
They call this "community rating," and it sounds fair. No more cruel "discrimination" against people who have a preexisting condition, obese people or smokers. But such simple-minded one-size-fits-all rules take from insurance companies their best price-dampening tool: Risk-based pricing encourages people to take better care of themselves, just as car-insurance companies reward good drivers. With one-size pricing your car-insurance company must give the town drunk the same deal it gives you. Insane, but the health-insurance industry is playing along. Insurers say that if government forces everyone to have insurance, they will accept all customers regardless of preexisting illnesses.
They also offered to stop charging higher premiums to sick people. They're even giving up on gender differences. Sen. John Kerry huffed, "The disparity between women and men in the individual insurance market is just plain wrong, and it has to change." The president of the industry trade group, Karen M. Ignagni, agreed that disparities "should be eliminated."
Give me a break. Women pay more than men for health insurance for good reason. Despite being healthier than men, they incur higher costs because they go to doctors more often, and they take more medicine. Kerry is pandering. I don't recall him demanding that men be protected from higher life-insurance and auto-insurance premiums.
"Community rating" hides the cost of health care. It's as destructive as ordering fire insurance companies to charge identical premiums for wood frame and stone houses. Universal health insurance with "no discrimination" pricing will make health care costs rise even faster. When politicians interfere with free markets, unintended consequences harm everyone, except the companies that lobby hard enough to protect themselves. Is it too much to expect our rulers to understand this?
SOURCE
Health care is not a right
Amidst all the health care debate, there is one underlying assumption that hardly anyone challenges: the notion that people have a right to health care. The truth is that it’s a nonsensical notion. People no more have a right to health care than they have a right to education, food, or clothing.
After all, what does a right to health care mean? If I have a right to something, then doesn’t that mean that you have a correlative duty to provide it? If you’re a doctor, then it means that you are required to serve my needs, like it or not. If I need an operation, then you cannot say “no” because that would be denying me my right to health care.
Thus, isn’t the right to health care actually a power to force doctors to provide people with medical services?
Now, the proponent of health care as a right might say, “That’s not what I mean. Why, to force doctors to provide health care services to others would be akin to slavery, especially if it’s for free. I think that doctors deserve to be paid for their services.”
Fair enough. But then doesn’t the right to health care entail the power to force someone else to pay for it? Let’s assume, for example, that I need hip-replacement surgery that will cost $25,000 and that I don’t have the money to pay for it. Since I have a right to health care, that means that I have a right to get the money from you to pay for my operation. It also means that you can’t say no because that would be interfering with my right to health care.
Thus, the right to health care entails the power of everyone to get into the pocketbooks of everyone else. That’s not only a ridiculous notion of rights but also a highly destructive one. Since obviously people can’t go and take the money from others directly, it inevitably entails converting government into an engine of seizure and redistribution. Or to paraphrase Bastiat, such a concept of rights converts government into a fiction by which everyone is doing his best to live at the expense of everyone else.
Meanwhile, while everyone is using government to get into everyone else’s pocketbook to pay for his health care expenses, he is simultaneously doing his best to protect his own income and assets from being plundered by the government to fund everyone else’s health care bills.
Over time, it is easy to see how such a system devolves in everyone’s warring against everyone else. It is also easy to see that such a system obviously does not nurture friendly and harmonious relations between people. This is especially true when these types of “rights” expand to such areas as education, food, clothing, and housing.
The true nature of rights — the type of rights the Founding Fathers believed in — involved the right of people to pursue such things as health care, education, clothing, and food and that government cannot legitimately interfere with their ability to do so.
Thus, the right to life, liberty, and the pursuit of happiness, as described in the Declaration of Independence, doesn’t mean that someone else is forced to provide you with the means to sustain or improve your life. It means that government cannot enact laws, rules, or regulations that interfere with or infringe upon your right to pursue such things.
When Americans began looking upon rights as some sort of positive duty on others to provide them with certain things, that was when the quality of health care in America began plummeting. That was what Medicare and Medicaid were all about — the so-called right of poor people and the elderly to health care. It is not a coincidence that what began has the finest health care system in the world has turned into a system that is now in perpetual crisis.
There is one — and only one — solution to America’s health care woes — and it lies not in a government takeover of health care. In fact, the solution is the exact opposite: It is the end of all government involvement in health care — a total separation of health care and the state. That would entail not a reform or improvement of Medicare and Medicaid but rather their total repeal.
At its core, the solution to America’s health care crisis lies in the abandonment of the notion that health care is a right. Once people reach this fundamental realization, as our American ancestors did, the nation can get back on the road toward to a healthy, prosperous, and harmonious society.
SOURCE
Friday, July 10, 2009
NHS nurse mocked frail old lady as 'drama queen'
By the time Ann McNeill was admitted to Edgware Hospital, in North London, her legs were raw and covered in bandages. The 71-year old grandmother had been diagnosed with the superbug MRSA, and the infection Clostridium difficile at nearby Barnet General Hospital following a succession of major operations.
Having spent decades working as a nurse, Mrs McNeill hated to bother the staff during the 10 months she spent in both hospitals before she died. When the stench of dried urine from a neighbouring bed in her ward in Barnet became overpowering, it was her husband Richard, who asked if it could be cleaned.
When a nurse told the frail pensioner that she "would never be going home" Mrs McNeill said nothing, only weeping later, when her husband visited. In October 2007 she was transferred to Edgware Hospital. The skin on her legs was raw, and partly covered with bandages, both to protect her wounds, and the fragile skin surrounding them.
As a night nurse roughly hoisted her into bed, knocking her legs, Mrs McNeill gasped in pain. "Oh, we've got a drama queen here," laughed the nurse, leaving the pensioner in agony, as blood slowly soaked the sheets. On many occasions, she was left in her own faeces.
Her widower recalls: "She hated disturbing the nursing staff, but she was totally compos mentis and she hated the indignity of it. She would plead with them to change her, but the answer was always firm: 'We will get to you when we have time". Mr McNeill was not convinced that time pressures were the problem. "Often I would wait at the nursing station, for perhaps five minutes, to ask for help for Ann. "They would keep chatting about this and that and I didn't want to interrupt them, I wanted to be polite. "But then when they got to the end of their conversation, they would go off, as though I wasn't there at all. I remember once I felt so desperate, I said to them, 'Are we invisible?'"
On another occasion, he arrived at Edgware hospital to find his wife sitting in a chair, her clothes covered in vomit. He was unable to find a nurse. In the next bed, the heavy breaths of an old woman, whose oxygen mask had fallen off, appeared to go undetected by staff.
On Monday 15 October 2007, less than a week after her surgeon said Mrs McNeill was recovering well, she died of bronchopneumonia, a condition which is closely linked to MRSA.
Her widower, now 75, says: "I know there is nothing I can do to bring Ann back, but it destroys me to think of what she went through, even with me trying my best for her every step of the way."
A spokesman for Barnet and Chase Farm Hospitals trust, which runs Barnet General Hospital, extended their apologies to Mrs McNeill's family for additional distress caused by the circumstances surrounding her death. He said the patient was in the hospital's care for an extended period of time, and that the trust would be happy to meet with her widower to hear his concerns. He added: "We are anxious to take the opportunity to make any improvements in the quality of care we provide."
Barnet primary care trust, which runs Edgware Community Hospital, said it worked to maintain high standards of health care and had not received any complaints about Mrs McNeill's care.
SOURCE
This is the sort of nut that the NHS can unleash on you
NHS nutritionist gave 'dangerous' food advice to diabetic patients
An NHS nutritionist told diabetic patients to eat a range of bizarre and trendy foods, including some that were 'dangerous', a disciplinary panel heard yesterday. Katie Peck, 32, recommended dandelion tea, kelp granules, milk thistle, flax seed oil and chromium supplements - all apparently without any clinical reason. She also allegedly recommended expensive vitamin supplements, including co-enzyme Q10, for which there is no evidence of any benefit.
A colleague at the Coxheath Centre Diabetes Clinic, near Maidstone in Kent, told a hearing most of the advice was baffling but harmless - but in the cases of two diabetic patients it was 'dangerous'. One, known as ES, who was on insulin and was also being treated for a thyroid condition, was told to take granules of kelp seaweed - a rich source of iodine. Sally Norris, a specialist diabetes dietician, told the Health Professions Council that extra iodine could dangerously interfere with both conditions. 'There would be a safety issue,' she said.
Another diabetic patient, KA, who was awaiting kidney dialysis and had high potassium levels, was told to eat half a large green banana - even though the fruit is known to be rich in potassium. Mrs Norris told the panel: 'What does that mean? Why does the banana have to be green? 'And I would certainly not expect somebody with high potassium levels to be recommended to eat bananas because it would be dangerous.'
Miss Peck also allegedly forbade some patients from eating grapes or drink coffee, and said one should eat cottage cheese - but never with pineapple. She banned mashed potato and alcohol and said red meat should not be eaten more than once a fortnight. Her other directions included that water must be filtered, eggs must be free-range and the dried fruit on one patient's daily porridge had to be organic, the panel heard.
Mrs Norris said there was no reason for that and it would cost the patients more.
She also said to have inappropriately recommended specific brands of products, including Rachel's probiotic yoghurt, Tilda brown basmati rice and Alpro soya milk.
Miss Peck was hired by West Kent NHS Primary Care Trust to cover for Mrs Norris when she went on maternity leave in 2005. When she returned to work in 2007 she sat in on one of Miss Pecks' consultations and was immediately concerned when Miss Peck tried to measure a patient's waist 'in the wrong place completely'. Mrs Norris then went through files and found dozens of examples of peculiar advice, which she reported to managers. She said: 'I was very concerned that things had been written down that didn't seem to have any explanation behind them and I could not see any clinical reasoning. 'There was no evidence that I could see that was behind what was being recommended.'
Miss Peck faces disciplinary charges in relation to 27 patients. John Harding, for the HPC, said: 'The allegation is that Katie Peck's fitness to practise is impaired by reason of lack of competence. 'It will be seen that in relation to each patient there is a common theme that develops - that the note-keeping was in a poor state and that recommendations made by Katie Peck were without any obvious reasons.'
Miss Peck denies any wrongdoing. The hearing in South London continues.
SOURCE
In Obama's America you are going to have to be rich to get good health care
The Obama administration might like to "spread the wealth around," but its proposed "health care reform" wouldn't spread consumer choice around. Rather, it would constrict consumer choice substantially — except for the very rich. That's the great irony of President Obama's ambitious health care agenda: His administration, which seems to feel little empathy for the rich, is paving the way to a two-tiered system in which only the very rich would have a choice.
Under ObamaCare, the rich would continue to get the care they want — whether here or abroad — by paying for it out of their own pockets. The rest of us would stand in line and wait for rationed care.
Most Americans want consumer freedom. They want to be able to shop for health care value — for the best care, at the best prices. They'd like to have a lot more freedom to shop for such value than they currently have. That's why Democrats are couching their proposed expansion of government-run health care in the language of competition and choice.
Listen to the president as he pitches the centerpiece of that agenda — a "public option," a form of Medicare for all. He says it's merely a way to give Americans another choice: People can buy private health insurance, just like now, or they can instead choose the government option. But millions of middle-class Americans who are happy with their employer-provided insurance would soon find the choice isn't theirs to make. The government would make it cheaper for employers to contribute to the government-run option than to keep providing private insurance. Millions of employers would do the math and pick the government option. The "public option" would provide a choice — for millions of employers, against the wishes of millions of employees.
The Lewin Group, a prominent consulting firm, estimates that a widespread "public option" with Medicare-like reimbursement rates would result in 118 million Americans losing their private insurance and being forced into government-run care. Meanwhile, private insurance wouldn't be able to compete on the uneven playing field that Congress would establish.
In its competition with FedEx and UPS, the Post Office at least has to provide a service. But the "public option" would merely use government's coercive powers to dictate prices and availability of services provided by others — by doctors, nurses, hospitals, etc. Private insurance can't similarly fix prices and would be run out of business.
Lower reimbursement rates, coupled with a dwindling pool of private insurers to whom to pass on costs, would mean lower incomes for medical professionals. The eventual result would be fewer people entering the medical profession.
A two-tiered system would then emerge: The very rich would take their spots like first-class passengers on the Titanic, paying for fine care and not asking the price. The rest of us would take our spots in steerage class, awaiting the inevitable collision between government-run health care and the iceberg of budgetary disaster.
White House budget director Peter Orszag recently opined that "the deficit impact of every other fiscal policy variable" is "swamped" by the deficit-threat posed by Medicare and Medicaid. Obama's solution? A massive new Medicare-like program! Medicare may not pay much to doctors, but taxpayers pay plenty to Medicare. As my recent Pacific Research Institute study shows, since 1970, Medicare's costs have risen 34% more, per patient, than the costs of all health care in America apart from Medicare and Medicaid. Medicare's costs have risen $2,511 more per patient.
Across nearly four decades, government-run health care has been far more expensive than privately run care. It comes down to a simple comparison and an obvious verdict: Privately run care offers choice and is cheaper. Government-run care denies choice and is more expensive.
But the particular losers under Obama-Care would be the middle class. The uninsured poor would largely benefit, although they might benefit even more — while hurting others far less — from fixing the unfairness in the tax code and giving them the health care tax-break that millions of insured Americans already enjoy.
The truly rich would be largely unaffected, as they never really needed private insurance anyway. They would continue to pay for the care they want, because they can.
Middle-class Americans wouldn't enjoy that freedom. They would lose their employer-provided insurance and be left with only the government-run "option." And, under a government monopoly, they would get rationed care. And every April 15, they would get a higher tax bill for their troubles, which just might make them feel sick enough to get back in line.
SOURCE
Medicare’s mythical administrative cost savings
by Megan McArdle
The title of this post is going to make some of my readers very angry. Medicare has lots of administrative cost savings, they will say. This may be so. But I mean mythical in another sense: there's ultimately no way to prove or disprove these amazing savings. The problem is indeterminate.
Jon Cohn, who I respect greatly, spends a lot of time on the money and time that insurance companies put into denying claims. This is undoubtedly true. But I have two caveats. First, some of that effort is a good thing: without it, there would be fraud. No, not the automatic denials so many insurers are fond of, and I'm not defending. But Medicare should probably spend a lot more effort rooting out excessive billing. And I don't know what percentage of claims denial consists of refusing to line the pockets of doctors and labs.
But the more important point is that I doubt this is the majority of their administrative costs, or even the difference between their administrative costs and Medicare's. I'm not trying to justify the bullshit automatic claims denial, but that's not actually a very costly process: a hospital submits a bill, they deny it, you yell at them. Nor is refusing to cover people with pre-existing conditions, or any of the other multifarious complaints of single-payer advocates.
Rather, private insurers have costs that Medicare doesn't have within the agency. Private insurers bill. Medicare does too, but the IRS has its own budget--hell, its own courts--which don't show up on Medicare's balance sheet. Private insurers negotiate with suppliers. Medicare does too, but most of the negotiation takes place between lobbyists and Congressmen who again, do not show up on Medicare's balance sheet. The Federal government has all sorts of these little items which relieve government agencies of reporting certain costs. But the costs remain.
My guess would be that these explicit costs are still lower than Medicare's. But then there are implicit costs to government fiat that markets don't have. As Tyler Cowen points out, taxation has deadweight losses, and Medicare is a tax on employment, which is something we are particularly anxious not to suppress right now.
The final point is that while people commonly think of administrative costs as "wasted", in fact, they are an important part of the market system. As Alex Tabarrok points out, and I have myself from time to time, many of the arguments in favor of national health care are literally socialist. And no, I am not using that term to apply to "anyone who is in favor of redistribution" or "government programs". But consider the following common arguments:
* National health care will be cheaper because we will reduce administrative overhead
* National health care will reduce wasteful competition in the form of me-too drugs
* National health care will reduce wasteful competition in the form of advertising and other marketing expenses
* National health care will allow us to rationally distribute care to where it does the most good rather than the current messy, wasteful hodge-podge
* National health care will use resources for production instead of profits
* National health care will achieve economies of scale in purchasing and record-keeping
* People will not overuse free goods because there are hard limits to desired consumption
These were all arguments advanced in favor of socialism. Contrary to popular conservative belief, socialists were not unfamilier with either the incentive problems of communism (people will not work hard if there's no benefit to doing so) or the Hayekian argument about the value of prices, aka the Socialist Calculation Problem. Rather, smart socialists thought that they could overcome these problems with a combination of status competitions (Hero of the Soviet Union, Second Class) and massive efficiencies gained by wringing all that fragmented, wasteful competition out of the system. Economists who would be ashamed to make these sorts of arguments about Proctor and Gamble or the used car market suddenly start parroting these things as if they hadn't been thoroughly discredited by the last seventy years.
But why were they discredited? That list looks really, really good on paper, even to my jaded libertarian eyes. A lot of the answer lies in the reason that we don't like monopolies--even though that list is just as true of monopolies as it is of the government. Monopolies, government or private, are risk averse, slow to innovate, and generally run things for the benefit of themselves rather than their customers. Hamstringing them with regulations can limit measurable outcomes, like excess profit-taking, but not unmeasurable ones, like the people who might have been cured by a drug the system didn't invent. And the political system introduces its own problems. As Robert Heinlein pointed out years ago, systems that have only positive feedback loops tend to fail catastrophically.
My critics will want me to explain why, then, Europe can do it cheaper. The answer is threefold. First, most European nations have better governance than we do--the American political system is a Public Choice disaster. Second, they pay people less money in a way that's hard to replicate here (and even if it wasn't, would be a one time savings that wouldn't check the rate of growth). Third, we're still driving quite a bit of product innovation. Our messy, organic, wasteful, unfair, irrational system allows experimentation, and they cherry pick the best results. If we stopped doing this, their system would stop looking so good.
SOURCE
By the time Ann McNeill was admitted to Edgware Hospital, in North London, her legs were raw and covered in bandages. The 71-year old grandmother had been diagnosed with the superbug MRSA, and the infection Clostridium difficile at nearby Barnet General Hospital following a succession of major operations.
Having spent decades working as a nurse, Mrs McNeill hated to bother the staff during the 10 months she spent in both hospitals before she died. When the stench of dried urine from a neighbouring bed in her ward in Barnet became overpowering, it was her husband Richard, who asked if it could be cleaned.
When a nurse told the frail pensioner that she "would never be going home" Mrs McNeill said nothing, only weeping later, when her husband visited. In October 2007 she was transferred to Edgware Hospital. The skin on her legs was raw, and partly covered with bandages, both to protect her wounds, and the fragile skin surrounding them.
As a night nurse roughly hoisted her into bed, knocking her legs, Mrs McNeill gasped in pain. "Oh, we've got a drama queen here," laughed the nurse, leaving the pensioner in agony, as blood slowly soaked the sheets. On many occasions, she was left in her own faeces.
Her widower recalls: "She hated disturbing the nursing staff, but she was totally compos mentis and she hated the indignity of it. She would plead with them to change her, but the answer was always firm: 'We will get to you when we have time". Mr McNeill was not convinced that time pressures were the problem. "Often I would wait at the nursing station, for perhaps five minutes, to ask for help for Ann. "They would keep chatting about this and that and I didn't want to interrupt them, I wanted to be polite. "But then when they got to the end of their conversation, they would go off, as though I wasn't there at all. I remember once I felt so desperate, I said to them, 'Are we invisible?'"
On another occasion, he arrived at Edgware hospital to find his wife sitting in a chair, her clothes covered in vomit. He was unable to find a nurse. In the next bed, the heavy breaths of an old woman, whose oxygen mask had fallen off, appeared to go undetected by staff.
On Monday 15 October 2007, less than a week after her surgeon said Mrs McNeill was recovering well, she died of bronchopneumonia, a condition which is closely linked to MRSA.
Her widower, now 75, says: "I know there is nothing I can do to bring Ann back, but it destroys me to think of what she went through, even with me trying my best for her every step of the way."
A spokesman for Barnet and Chase Farm Hospitals trust, which runs Barnet General Hospital, extended their apologies to Mrs McNeill's family for additional distress caused by the circumstances surrounding her death. He said the patient was in the hospital's care for an extended period of time, and that the trust would be happy to meet with her widower to hear his concerns. He added: "We are anxious to take the opportunity to make any improvements in the quality of care we provide."
Barnet primary care trust, which runs Edgware Community Hospital, said it worked to maintain high standards of health care and had not received any complaints about Mrs McNeill's care.
SOURCE
This is the sort of nut that the NHS can unleash on you
NHS nutritionist gave 'dangerous' food advice to diabetic patients
An NHS nutritionist told diabetic patients to eat a range of bizarre and trendy foods, including some that were 'dangerous', a disciplinary panel heard yesterday. Katie Peck, 32, recommended dandelion tea, kelp granules, milk thistle, flax seed oil and chromium supplements - all apparently without any clinical reason. She also allegedly recommended expensive vitamin supplements, including co-enzyme Q10, for which there is no evidence of any benefit.
A colleague at the Coxheath Centre Diabetes Clinic, near Maidstone in Kent, told a hearing most of the advice was baffling but harmless - but in the cases of two diabetic patients it was 'dangerous'. One, known as ES, who was on insulin and was also being treated for a thyroid condition, was told to take granules of kelp seaweed - a rich source of iodine. Sally Norris, a specialist diabetes dietician, told the Health Professions Council that extra iodine could dangerously interfere with both conditions. 'There would be a safety issue,' she said.
Another diabetic patient, KA, who was awaiting kidney dialysis and had high potassium levels, was told to eat half a large green banana - even though the fruit is known to be rich in potassium. Mrs Norris told the panel: 'What does that mean? Why does the banana have to be green? 'And I would certainly not expect somebody with high potassium levels to be recommended to eat bananas because it would be dangerous.'
Miss Peck also allegedly forbade some patients from eating grapes or drink coffee, and said one should eat cottage cheese - but never with pineapple. She banned mashed potato and alcohol and said red meat should not be eaten more than once a fortnight. Her other directions included that water must be filtered, eggs must be free-range and the dried fruit on one patient's daily porridge had to be organic, the panel heard.
Mrs Norris said there was no reason for that and it would cost the patients more.
She also said to have inappropriately recommended specific brands of products, including Rachel's probiotic yoghurt, Tilda brown basmati rice and Alpro soya milk.
Miss Peck was hired by West Kent NHS Primary Care Trust to cover for Mrs Norris when she went on maternity leave in 2005. When she returned to work in 2007 she sat in on one of Miss Pecks' consultations and was immediately concerned when Miss Peck tried to measure a patient's waist 'in the wrong place completely'. Mrs Norris then went through files and found dozens of examples of peculiar advice, which she reported to managers. She said: 'I was very concerned that things had been written down that didn't seem to have any explanation behind them and I could not see any clinical reasoning. 'There was no evidence that I could see that was behind what was being recommended.'
Miss Peck faces disciplinary charges in relation to 27 patients. John Harding, for the HPC, said: 'The allegation is that Katie Peck's fitness to practise is impaired by reason of lack of competence. 'It will be seen that in relation to each patient there is a common theme that develops - that the note-keeping was in a poor state and that recommendations made by Katie Peck were without any obvious reasons.'
Miss Peck denies any wrongdoing. The hearing in South London continues.
SOURCE
In Obama's America you are going to have to be rich to get good health care
The Obama administration might like to "spread the wealth around," but its proposed "health care reform" wouldn't spread consumer choice around. Rather, it would constrict consumer choice substantially — except for the very rich. That's the great irony of President Obama's ambitious health care agenda: His administration, which seems to feel little empathy for the rich, is paving the way to a two-tiered system in which only the very rich would have a choice.
Under ObamaCare, the rich would continue to get the care they want — whether here or abroad — by paying for it out of their own pockets. The rest of us would stand in line and wait for rationed care.
Most Americans want consumer freedom. They want to be able to shop for health care value — for the best care, at the best prices. They'd like to have a lot more freedom to shop for such value than they currently have. That's why Democrats are couching their proposed expansion of government-run health care in the language of competition and choice.
Listen to the president as he pitches the centerpiece of that agenda — a "public option," a form of Medicare for all. He says it's merely a way to give Americans another choice: People can buy private health insurance, just like now, or they can instead choose the government option. But millions of middle-class Americans who are happy with their employer-provided insurance would soon find the choice isn't theirs to make. The government would make it cheaper for employers to contribute to the government-run option than to keep providing private insurance. Millions of employers would do the math and pick the government option. The "public option" would provide a choice — for millions of employers, against the wishes of millions of employees.
The Lewin Group, a prominent consulting firm, estimates that a widespread "public option" with Medicare-like reimbursement rates would result in 118 million Americans losing their private insurance and being forced into government-run care. Meanwhile, private insurance wouldn't be able to compete on the uneven playing field that Congress would establish.
In its competition with FedEx and UPS, the Post Office at least has to provide a service. But the "public option" would merely use government's coercive powers to dictate prices and availability of services provided by others — by doctors, nurses, hospitals, etc. Private insurance can't similarly fix prices and would be run out of business.
Lower reimbursement rates, coupled with a dwindling pool of private insurers to whom to pass on costs, would mean lower incomes for medical professionals. The eventual result would be fewer people entering the medical profession.
A two-tiered system would then emerge: The very rich would take their spots like first-class passengers on the Titanic, paying for fine care and not asking the price. The rest of us would take our spots in steerage class, awaiting the inevitable collision between government-run health care and the iceberg of budgetary disaster.
White House budget director Peter Orszag recently opined that "the deficit impact of every other fiscal policy variable" is "swamped" by the deficit-threat posed by Medicare and Medicaid. Obama's solution? A massive new Medicare-like program! Medicare may not pay much to doctors, but taxpayers pay plenty to Medicare. As my recent Pacific Research Institute study shows, since 1970, Medicare's costs have risen 34% more, per patient, than the costs of all health care in America apart from Medicare and Medicaid. Medicare's costs have risen $2,511 more per patient.
Across nearly four decades, government-run health care has been far more expensive than privately run care. It comes down to a simple comparison and an obvious verdict: Privately run care offers choice and is cheaper. Government-run care denies choice and is more expensive.
But the particular losers under Obama-Care would be the middle class. The uninsured poor would largely benefit, although they might benefit even more — while hurting others far less — from fixing the unfairness in the tax code and giving them the health care tax-break that millions of insured Americans already enjoy.
The truly rich would be largely unaffected, as they never really needed private insurance anyway. They would continue to pay for the care they want, because they can.
Middle-class Americans wouldn't enjoy that freedom. They would lose their employer-provided insurance and be left with only the government-run "option." And, under a government monopoly, they would get rationed care. And every April 15, they would get a higher tax bill for their troubles, which just might make them feel sick enough to get back in line.
SOURCE
Medicare’s mythical administrative cost savings
by Megan McArdle
The title of this post is going to make some of my readers very angry. Medicare has lots of administrative cost savings, they will say. This may be so. But I mean mythical in another sense: there's ultimately no way to prove or disprove these amazing savings. The problem is indeterminate.
Jon Cohn, who I respect greatly, spends a lot of time on the money and time that insurance companies put into denying claims. This is undoubtedly true. But I have two caveats. First, some of that effort is a good thing: without it, there would be fraud. No, not the automatic denials so many insurers are fond of, and I'm not defending. But Medicare should probably spend a lot more effort rooting out excessive billing. And I don't know what percentage of claims denial consists of refusing to line the pockets of doctors and labs.
But the more important point is that I doubt this is the majority of their administrative costs, or even the difference between their administrative costs and Medicare's. I'm not trying to justify the bullshit automatic claims denial, but that's not actually a very costly process: a hospital submits a bill, they deny it, you yell at them. Nor is refusing to cover people with pre-existing conditions, or any of the other multifarious complaints of single-payer advocates.
Rather, private insurers have costs that Medicare doesn't have within the agency. Private insurers bill. Medicare does too, but the IRS has its own budget--hell, its own courts--which don't show up on Medicare's balance sheet. Private insurers negotiate with suppliers. Medicare does too, but most of the negotiation takes place between lobbyists and Congressmen who again, do not show up on Medicare's balance sheet. The Federal government has all sorts of these little items which relieve government agencies of reporting certain costs. But the costs remain.
My guess would be that these explicit costs are still lower than Medicare's. But then there are implicit costs to government fiat that markets don't have. As Tyler Cowen points out, taxation has deadweight losses, and Medicare is a tax on employment, which is something we are particularly anxious not to suppress right now.
The final point is that while people commonly think of administrative costs as "wasted", in fact, they are an important part of the market system. As Alex Tabarrok points out, and I have myself from time to time, many of the arguments in favor of national health care are literally socialist. And no, I am not using that term to apply to "anyone who is in favor of redistribution" or "government programs". But consider the following common arguments:
* National health care will be cheaper because we will reduce administrative overhead
* National health care will reduce wasteful competition in the form of me-too drugs
* National health care will reduce wasteful competition in the form of advertising and other marketing expenses
* National health care will allow us to rationally distribute care to where it does the most good rather than the current messy, wasteful hodge-podge
* National health care will use resources for production instead of profits
* National health care will achieve economies of scale in purchasing and record-keeping
* People will not overuse free goods because there are hard limits to desired consumption
These were all arguments advanced in favor of socialism. Contrary to popular conservative belief, socialists were not unfamilier with either the incentive problems of communism (people will not work hard if there's no benefit to doing so) or the Hayekian argument about the value of prices, aka the Socialist Calculation Problem. Rather, smart socialists thought that they could overcome these problems with a combination of status competitions (Hero of the Soviet Union, Second Class) and massive efficiencies gained by wringing all that fragmented, wasteful competition out of the system. Economists who would be ashamed to make these sorts of arguments about Proctor and Gamble or the used car market suddenly start parroting these things as if they hadn't been thoroughly discredited by the last seventy years.
But why were they discredited? That list looks really, really good on paper, even to my jaded libertarian eyes. A lot of the answer lies in the reason that we don't like monopolies--even though that list is just as true of monopolies as it is of the government. Monopolies, government or private, are risk averse, slow to innovate, and generally run things for the benefit of themselves rather than their customers. Hamstringing them with regulations can limit measurable outcomes, like excess profit-taking, but not unmeasurable ones, like the people who might have been cured by a drug the system didn't invent. And the political system introduces its own problems. As Robert Heinlein pointed out years ago, systems that have only positive feedback loops tend to fail catastrophically.
My critics will want me to explain why, then, Europe can do it cheaper. The answer is threefold. First, most European nations have better governance than we do--the American political system is a Public Choice disaster. Second, they pay people less money in a way that's hard to replicate here (and even if it wasn't, would be a one time savings that wouldn't check the rate of growth). Third, we're still driving quite a bit of product innovation. Our messy, organic, wasteful, unfair, irrational system allows experimentation, and they cherry pick the best results. If we stopped doing this, their system would stop looking so good.
SOURCE
Thursday, July 09, 2009
British tumour patient was treated in corridor
As Barbara McVernon was wheeled to the operation for brain surgery, she broke into song: "Wish me luck, as you wave me goodbye..." It was a typical gesture from an exuberant, sociable woman, who at the age of 76 was showing no signs of slowing down. If the keen artist and charity fund-raiser from Wokingham was fearful about the surgery to remove a tumour from her eye socket and temple, she was determined not to show it, recalls her daughter Lynne.
After the surgery, at the John Radcliffe Hospital, Oxford, in April 2006, Mrs McVernon remained in good spirits, laughing and joking with family and friends. However, further tests revealed that the growth – as well as pains in Mrs McVernon's hips, which her local hospital, the Royal Berkshire in Reading, had mistaken for arthritis – was in fact caused by multiple myeloma, cancer of the bone marrow. Nonetheless her specialist was optimistic: if the will was there, the pensioner could survive five years.
Soon after Mrs McVernon was transferred back to the Royal Berkshire, one of her hips broke. She was sent to a specialist NHS hospital, The Nuffield Orthopaedic Centre, in Oxford, for surgery the following month. It went well. Yet in the days following the operation, the outgoing, lively woman became increasingly confused and depressed.
Amid repeated concerns raised by her family, staff insisted her behaviour was normal – until 11 days after the operation, when a doctor diagnosed diabetes. An investigation found staff had made a "critical error" when the elderly woman was admitted to the hospital, by keeping her on a high dose of steroids which should have lasted for just four days. The findings, which included an admission that the mistake could have caused the onset of diabetes, reached Lynne on the day her mother died.
In her last few weeks, the increasingly weak pensioner had been transferred back to the Royal Berkshire Hospital, soon after her family found out that she was suffering from MRSA, which she had already been carrying before treatment at the Nuffield.
Hours after the transfer, her daughter found her being treated in a corridor, before a bed could be found. As the quality of her life deteriorated, and amid chaotic care, Mrs McVernon lost the will to continue, says her daughter. "She was having hourly blood tests because of the diabetes, her hands were caked with blood, she had bed sores, she was upset, confused and disorientated because her blood sugar levels were see-sawing. "It was hard to believe Mum was the same woman who had been singing on her way to surgery."
On June 22, Mrs McVernon died of pneumonia, multiple myeloma and MRSA.
A spokesman for Nuffield Orthopaedic Centre Trust said patient safety was its top priority, and that it regretted that the McVernons' experiences did not fulfil its usual standards. It said the trust had been open about the findings of its investigation, and learned lessons from the case. The Royal Berkshire trust said it was "deeply disappointed" that the family had not raised any concerns since Mrs McVernon's death, so that any failings could be investigated.
SOURCE
NHS units exposed over unacceptable conditions
This is a total whitewash. What they say about the food tells you that. British hospitals are notorious for inedible food
At least a dozen NHS units in England are treating patients in poor or unacceptable conditions, an official report says today. A national survey of 1,265 medical sites found that the vast majority of facilities scored either “excellent” (24 per cent) or “good” (60 per cent) for standards of cleanliness, decoration, linen, furniture and general state of repair. But of the rest, more than one in six sites (15 per cent) had only “acceptable” working conditions, while nine sites were rated “poor” by the local Patient Environment Action Team (PEAT) assessments.
Three sites — all rehabilitation units for mental health patients — were rated “unacceptable” for their environment: Windmill House in Bushey, West Hertfordshire; Norfolk Lodge, in Colliers Wood, South London; and Lodge Causeway, in Bristol.
The National Patient Safety Agency, which publishes the scores, said that poorly-performing sites would be followed up by the regional health authorities or the Care Quality Commission, the NHS regulator, to make sure standards were improved.
The PEAT programme was established in 2000 to assess all NHS hospitals with more than ten beds every year on a range of standards including food and whether patients were treated with dignity and privacy. The assessment teams consist of NHS staff, including nurses, matrons, doctors, catering and domestic service managers, executive and non-executive directors, dietitians and estates directors. Most also include patients and members of the public.
A total of 94 per cent of sites scored ‘excellent’ or ‘good’ ratings for levels of privacy and dignity, which examined the quality of their sleeping accommodation as well as toilet and bathroom facilities.
But Thorneywood Unit, a child mental health clinic run by Nottinghamshire Healthcare NHS Trust, and Norfolk Lodge, part of South West London and St George’s Mental Health NHS Trust were rated unacceptable.
On food, 95 per cent of sites achieved an "excellent" or "good" ratings for quality, choice and availability of their menus [By British hospital standards, maybe]. Just one unit, Ogden House in Ramsgate, a mental health inpatient unit, was rated unacceptable for its food.
Ann Keen, the Health Minister, said that the increase in trusts achieving good results was “great news for NHS staff and patients”. “Cleanliness is a top patient priority and these results show that the measures we have in place are working. We are also delighted to see such high scores in the area of privacy and dignity.” Ms Keen said that she expected to see further improvements in next year’s results after a drive to eliminate mixed-sex accommodation in the NHS.
SOURCE
More poison, not an antidote: Mandating employer health insurance
President Obama is either misinformed or lying about health care. He said the “free market has not worked perfectly.” There’s a market, but it’s not free. It’s infested with harmful political meddling. One example is government’s favoring employer-provided insurance, a poison to affordable medical care and insurance.
But unions and Congressional Democrats want to intensify the dose with a “pay or play” employer mandate. This would penalize employers for not buying medical insurance for their employees. This is not “reform;” it just entrenches flawed policies. It would violate rights, lower wages, and threaten jobs of minority single moms
Government’s favoring employer-sponsored insurance is the problem, not the solution. When your employer buys your insurance, it’s a non-taxable corporate expense. Employers save by “paying” you with insurance instead of higher wages.
This tax policy coddles insurance companies. They need only please your employer, not you. Most employers offer just one or two plans. Want more choices? If you prefer one of the many plans available at eHealthInsurance.com, you face a stiff tax penalty. Or try changing jobs. Insurers know you’re essentially stuck with your employer’s plan, so why should they please you?
Tax-discounted insurance has turned insurance into prepaid health care. If car insurance worked this way, it would cover predictable expenses like oil changes and replacement tires. You wouldn’t price compare or consider whether services were really necessary. Rather, you’d ask if “it’s covered.” Costs would soar. This has happened with medical care.
The tax bias for employer-sponsored insurance punishes those who incur medical conditions and then lose their job. A pre-existing condition can make them uninsurable.
This can create “job lock,” which stifles entrepreneurship. As Business Week describes: “fear of losing coverage keeps people at jobs … so many workers will keep hanging on to jobs they hate. … One single mom in New York, for example, is sticking with her graphic design job solely to retain the health coverage for herself and her son. … Her wish? To start a business doing bath and body products. ‘I feel stuck,’ she says.”
An employer mandate would further stifle entrepreneurs and destroy jobs. It would require a growing business to provide insurance when hiring its 10th or 20th employee. Since the additional employee would impose a huge cost, it might not hire anyone.
In response to an employer mandate, employers would shift this cost to employees by lowering wages. It’s worse for those with near-minimum wage jobs. These workers are “at substantial risk of unemployment if their employers were required to offer insurance,” write economists Katherine Baicker and Helen Levy. Employees “most harmed by mandated employer-paid healthcare are…more likely to be a minority, a single parent, and unmarried.” The employer mandate surely wouldn’t threaten union jobs, as unions support it.
An employer mandate would also violate our rights. Employers create jobs, and hence have the right to hire on terms mutually acceptable to both employer and employee. Politicians should not interfere with this private matter between consenting adults.
Tax-favored employer-sponsored insurance has created enough problems. Mandating it makes them worse. Politicians should not dictate whether you buy insurance directly from an insurer, through a membership group (like AAA), or through your employer. Legislators should both eliminate the tax exemption and decrease tax rates commensurately.
Second-best would be to make all medical insurance and expenses tax-exempt. This would remove tax bias toward excessive insurance coverage. Health Savings Accounts are a step in this direction, but they should be eligible to everyone, regardless of their insurance plan. Such “Large HSAs” would allow consumers to buy medical care and insurance with tax-free earnings.
Removing the tax code’s bias for employer-sponsored insurance can alleviate problems with job lock and pre-existing conditions. While some employers would offer insurance to attract employees, more people would buy policies directly from insurers when still healthy. Customers could choose — as many already do — a guaranteed-renewable policy, so the insurer cannot terminate coverage or raise premiums because you get sick.
The rigorous competition of a free insurance market could yield innovative products that protect against pre-existing conditions. For example, “health-status insurance” would pay for increases in your insurance premiums should your health status change, and you’d retain the freedom to buy a policy from insurers competing for your business. To learn more, look up “‘Health Status Insurance’ Provides Real Alternative to Universal Care.”
Mandating employer-sponsored insurance is wrong. It’s not a cure, but more of the disease: government’s bias for employer-provided insurance. This just benefits unions and politicians at our expense.
SOURCE
Obama’s job-killing health care tax
On June 15th, the Congressional Budget Office issued a crushing blow to President Barack Obama’s health care plan, placing a $1 trillion price tag on the Senate Health, Education, Labor and Pensions (HELP) committee’s draft legislation. And what did Americans get for their $1 trillion in new debt? A measly16 million net decrease in the number of people uninsured. Liberals in Washington decried the CBO’s findings, complaining that they had scored an incomplete version of the bill.
So this past Friday the CBO released a fuller scoring of HELP’s legislation, and indeed, the overall impact on our nation’s debt is lower: a mere $597 billion would be added to federal budget deficits over the 2010-2019 period.
How did HELP lower the bill’s budget busting total? Did they “bend the curve” on health care costs? Did they weed out administrative costs? Eliminate waste? Nope. The Washington Post reports:
In other words, the HELP committee wants to pay for their health care plan in classic “tax-and-spend” liberal fashion: by instituting a crippling new tax on our nation’s businesses. And not just any new tax. A tax directed like a heat seeking missile at job creation: an employer mandate. But don’t take our word for it. President Obama’s White House National Economic Council Director Larry Summers wrote in 1989:
And the HELP committee bill is still incomplete. Even its most current incarnation still would cover just 39% of uninsured Americans. So the Obama administration is also pushing for a further expansion of Medicaid. Add those costs into the mix and the final price tag shoots back up to $1.3 trillion. Wonder who the administration plans to tax to make up for that final trillion?
Defending his administration’s economic performance on ABC’s This Week, Vice President Joe Biden told George Stephanopolos: “There was a misreading of just how bad an economy we inherited.” The Obama administration can not blame President Bush forever. They can’t run around threatening to enact a $400 billion tax on employment and then blame others for double-digit unemployment rates. There is an alternative to government run budget busting health care. Some of which the Obama Administration even supports like removing the tax benefit of employer-sponsored health care coverage which will untie Americans health care coverage from their employers and help move the country towards a truly market based consumer driven health care model. Health care coverage can be expanded in a cost-efficient manner, but only by empowering Americans to make health care decisions with their doctors.
SOURCE
As Barbara McVernon was wheeled to the operation for brain surgery, she broke into song: "Wish me luck, as you wave me goodbye..." It was a typical gesture from an exuberant, sociable woman, who at the age of 76 was showing no signs of slowing down. If the keen artist and charity fund-raiser from Wokingham was fearful about the surgery to remove a tumour from her eye socket and temple, she was determined not to show it, recalls her daughter Lynne.
After the surgery, at the John Radcliffe Hospital, Oxford, in April 2006, Mrs McVernon remained in good spirits, laughing and joking with family and friends. However, further tests revealed that the growth – as well as pains in Mrs McVernon's hips, which her local hospital, the Royal Berkshire in Reading, had mistaken for arthritis – was in fact caused by multiple myeloma, cancer of the bone marrow. Nonetheless her specialist was optimistic: if the will was there, the pensioner could survive five years.
Soon after Mrs McVernon was transferred back to the Royal Berkshire, one of her hips broke. She was sent to a specialist NHS hospital, The Nuffield Orthopaedic Centre, in Oxford, for surgery the following month. It went well. Yet in the days following the operation, the outgoing, lively woman became increasingly confused and depressed.
Amid repeated concerns raised by her family, staff insisted her behaviour was normal – until 11 days after the operation, when a doctor diagnosed diabetes. An investigation found staff had made a "critical error" when the elderly woman was admitted to the hospital, by keeping her on a high dose of steroids which should have lasted for just four days. The findings, which included an admission that the mistake could have caused the onset of diabetes, reached Lynne on the day her mother died.
In her last few weeks, the increasingly weak pensioner had been transferred back to the Royal Berkshire Hospital, soon after her family found out that she was suffering from MRSA, which she had already been carrying before treatment at the Nuffield.
Hours after the transfer, her daughter found her being treated in a corridor, before a bed could be found. As the quality of her life deteriorated, and amid chaotic care, Mrs McVernon lost the will to continue, says her daughter. "She was having hourly blood tests because of the diabetes, her hands were caked with blood, she had bed sores, she was upset, confused and disorientated because her blood sugar levels were see-sawing. "It was hard to believe Mum was the same woman who had been singing on her way to surgery."
On June 22, Mrs McVernon died of pneumonia, multiple myeloma and MRSA.
A spokesman for Nuffield Orthopaedic Centre Trust said patient safety was its top priority, and that it regretted that the McVernons' experiences did not fulfil its usual standards. It said the trust had been open about the findings of its investigation, and learned lessons from the case. The Royal Berkshire trust said it was "deeply disappointed" that the family had not raised any concerns since Mrs McVernon's death, so that any failings could be investigated.
SOURCE
NHS units exposed over unacceptable conditions
This is a total whitewash. What they say about the food tells you that. British hospitals are notorious for inedible food
At least a dozen NHS units in England are treating patients in poor or unacceptable conditions, an official report says today. A national survey of 1,265 medical sites found that the vast majority of facilities scored either “excellent” (24 per cent) or “good” (60 per cent) for standards of cleanliness, decoration, linen, furniture and general state of repair. But of the rest, more than one in six sites (15 per cent) had only “acceptable” working conditions, while nine sites were rated “poor” by the local Patient Environment Action Team (PEAT) assessments.
Three sites — all rehabilitation units for mental health patients — were rated “unacceptable” for their environment: Windmill House in Bushey, West Hertfordshire; Norfolk Lodge, in Colliers Wood, South London; and Lodge Causeway, in Bristol.
The National Patient Safety Agency, which publishes the scores, said that poorly-performing sites would be followed up by the regional health authorities or the Care Quality Commission, the NHS regulator, to make sure standards were improved.
The PEAT programme was established in 2000 to assess all NHS hospitals with more than ten beds every year on a range of standards including food and whether patients were treated with dignity and privacy. The assessment teams consist of NHS staff, including nurses, matrons, doctors, catering and domestic service managers, executive and non-executive directors, dietitians and estates directors. Most also include patients and members of the public.
A total of 94 per cent of sites scored ‘excellent’ or ‘good’ ratings for levels of privacy and dignity, which examined the quality of their sleeping accommodation as well as toilet and bathroom facilities.
But Thorneywood Unit, a child mental health clinic run by Nottinghamshire Healthcare NHS Trust, and Norfolk Lodge, part of South West London and St George’s Mental Health NHS Trust were rated unacceptable.
On food, 95 per cent of sites achieved an "excellent" or "good" ratings for quality, choice and availability of their menus [By British hospital standards, maybe]. Just one unit, Ogden House in Ramsgate, a mental health inpatient unit, was rated unacceptable for its food.
Ann Keen, the Health Minister, said that the increase in trusts achieving good results was “great news for NHS staff and patients”. “Cleanliness is a top patient priority and these results show that the measures we have in place are working. We are also delighted to see such high scores in the area of privacy and dignity.” Ms Keen said that she expected to see further improvements in next year’s results after a drive to eliminate mixed-sex accommodation in the NHS.
SOURCE
More poison, not an antidote: Mandating employer health insurance
President Obama is either misinformed or lying about health care. He said the “free market has not worked perfectly.” There’s a market, but it’s not free. It’s infested with harmful political meddling. One example is government’s favoring employer-provided insurance, a poison to affordable medical care and insurance.
But unions and Congressional Democrats want to intensify the dose with a “pay or play” employer mandate. This would penalize employers for not buying medical insurance for their employees. This is not “reform;” it just entrenches flawed policies. It would violate rights, lower wages, and threaten jobs of minority single moms
Government’s favoring employer-sponsored insurance is the problem, not the solution. When your employer buys your insurance, it’s a non-taxable corporate expense. Employers save by “paying” you with insurance instead of higher wages.
This tax policy coddles insurance companies. They need only please your employer, not you. Most employers offer just one or two plans. Want more choices? If you prefer one of the many plans available at eHealthInsurance.com, you face a stiff tax penalty. Or try changing jobs. Insurers know you’re essentially stuck with your employer’s plan, so why should they please you?
Tax-discounted insurance has turned insurance into prepaid health care. If car insurance worked this way, it would cover predictable expenses like oil changes and replacement tires. You wouldn’t price compare or consider whether services were really necessary. Rather, you’d ask if “it’s covered.” Costs would soar. This has happened with medical care.
The tax bias for employer-sponsored insurance punishes those who incur medical conditions and then lose their job. A pre-existing condition can make them uninsurable.
This can create “job lock,” which stifles entrepreneurship. As Business Week describes: “fear of losing coverage keeps people at jobs … so many workers will keep hanging on to jobs they hate. … One single mom in New York, for example, is sticking with her graphic design job solely to retain the health coverage for herself and her son. … Her wish? To start a business doing bath and body products. ‘I feel stuck,’ she says.”
An employer mandate would further stifle entrepreneurs and destroy jobs. It would require a growing business to provide insurance when hiring its 10th or 20th employee. Since the additional employee would impose a huge cost, it might not hire anyone.
In response to an employer mandate, employers would shift this cost to employees by lowering wages. It’s worse for those with near-minimum wage jobs. These workers are “at substantial risk of unemployment if their employers were required to offer insurance,” write economists Katherine Baicker and Helen Levy. Employees “most harmed by mandated employer-paid healthcare are…more likely to be a minority, a single parent, and unmarried.” The employer mandate surely wouldn’t threaten union jobs, as unions support it.
An employer mandate would also violate our rights. Employers create jobs, and hence have the right to hire on terms mutually acceptable to both employer and employee. Politicians should not interfere with this private matter between consenting adults.
Tax-favored employer-sponsored insurance has created enough problems. Mandating it makes them worse. Politicians should not dictate whether you buy insurance directly from an insurer, through a membership group (like AAA), or through your employer. Legislators should both eliminate the tax exemption and decrease tax rates commensurately.
Second-best would be to make all medical insurance and expenses tax-exempt. This would remove tax bias toward excessive insurance coverage. Health Savings Accounts are a step in this direction, but they should be eligible to everyone, regardless of their insurance plan. Such “Large HSAs” would allow consumers to buy medical care and insurance with tax-free earnings.
Removing the tax code’s bias for employer-sponsored insurance can alleviate problems with job lock and pre-existing conditions. While some employers would offer insurance to attract employees, more people would buy policies directly from insurers when still healthy. Customers could choose — as many already do — a guaranteed-renewable policy, so the insurer cannot terminate coverage or raise premiums because you get sick.
The rigorous competition of a free insurance market could yield innovative products that protect against pre-existing conditions. For example, “health-status insurance” would pay for increases in your insurance premiums should your health status change, and you’d retain the freedom to buy a policy from insurers competing for your business. To learn more, look up “‘Health Status Insurance’ Provides Real Alternative to Universal Care.”
Mandating employer-sponsored insurance is wrong. It’s not a cure, but more of the disease: government’s bias for employer-provided insurance. This just benefits unions and politicians at our expense.
SOURCE
Obama’s job-killing health care tax
On June 15th, the Congressional Budget Office issued a crushing blow to President Barack Obama’s health care plan, placing a $1 trillion price tag on the Senate Health, Education, Labor and Pensions (HELP) committee’s draft legislation. And what did Americans get for their $1 trillion in new debt? A measly16 million net decrease in the number of people uninsured. Liberals in Washington decried the CBO’s findings, complaining that they had scored an incomplete version of the bill.
So this past Friday the CBO released a fuller scoring of HELP’s legislation, and indeed, the overall impact on our nation’s debt is lower: a mere $597 billion would be added to federal budget deficits over the 2010-2019 period.
How did HELP lower the bill’s budget busting total? Did they “bend the curve” on health care costs? Did they weed out administrative costs? Eliminate waste? Nope. The Washington Post reports:
Committee staffers reworked the bill — and added a new provision requiring most employers to contribute to the cost of health insurance — to arrive at the lower estimate. Under the new proposal, any business with more than 25 workers would be required to offer coverage or pay a $750 penalty per employee.
In other words, the HELP committee wants to pay for their health care plan in classic “tax-and-spend” liberal fashion: by instituting a crippling new tax on our nation’s businesses. And not just any new tax. A tax directed like a heat seeking missile at job creation: an employer mandate. But don’t take our word for it. President Obama’s White House National Economic Council Director Larry Summers wrote in 1989:
Mandated benefits are like public programs financed by benefit taxes… There is no sense in which benefits become ‘free’ just because the government mandates that employers offer them to workers. … [Minimum] wages cannot fall to offset employers’ cost of providing a mandated benefit, so it is likely to create unemployment.
And the HELP committee bill is still incomplete. Even its most current incarnation still would cover just 39% of uninsured Americans. So the Obama administration is also pushing for a further expansion of Medicaid. Add those costs into the mix and the final price tag shoots back up to $1.3 trillion. Wonder who the administration plans to tax to make up for that final trillion?
Defending his administration’s economic performance on ABC’s This Week, Vice President Joe Biden told George Stephanopolos: “There was a misreading of just how bad an economy we inherited.” The Obama administration can not blame President Bush forever. They can’t run around threatening to enact a $400 billion tax on employment and then blame others for double-digit unemployment rates. There is an alternative to government run budget busting health care. Some of which the Obama Administration even supports like removing the tax benefit of employer-sponsored health care coverage which will untie Americans health care coverage from their employers and help move the country towards a truly market based consumer driven health care model. Health care coverage can be expanded in a cost-efficient manner, but only by empowering Americans to make health care decisions with their doctors.
SOURCE
Wednesday, July 08, 2009
Diary of despair of old lady who died in 'zoo' NHS hospital after 'catalogue of blunders by staff'
A horrifying journal of the neglect a great-grandmother suffered in hospital has been published by her family. Betty Dunn, 79, was admitted with a routine stomach problem but died six weeks later after a string of medical errors. During this time her relatives compiled the diary detailing her ordeal in a ward they grimly nicknamed the 'zoo'. The dossier tells how Mrs Dunn was:
* Given medication containing penicillin - despite warnings that she was allergic to it;
* Forced to sleep on a bare mattress;
* Made to wait 40 minutes for a bedpan;
* Treated by staff who could barely speak English;
* Made to eat a food substitute against medical advice.
At one stage, the mother- of-four's children became so desperate that they called the police for help but were told nothing could be done. In a final insult, the news that Mrs Dunn was dying was broken to her daughters in a busy corridor in front of other visitors.
The wartime Land Girl was being treated on a mixed-sex ward divided into bays at Tameside Hospital, in Ashton-under-Lyne, near Manchester. Labour had pledged to scrap this type of patient accommodation.
'The ward where mum was treated was like a zoo, and we called it that afterwards,' said her daughter, Liz Degnen, 49, today. "It was manic and chaotic with people running around like headless chickens. 'It doesn't matter if you're 79, 29, or 109, the way the hospital treated her was disgraceful. Every aspect of her care was just terrible. The staff did their best but there were not enough of them to cope. It's a scandal that hospitals can operate like this in this day and age.'
Mrs Dunn, a former dinner lady from Gamesley, near Glossop in Derbyshire, was admitted to Tameside on January 4 with complications from a stomach bug. 'On the night she was admitted for treatment mum was waving and blowing kisses and saying "See you, love",' said Mrs Degnen, a teaching assistant. 'Yet when we left for a few hours we came back to find her slumped across a bedside trolley. Her eyes were at the back of her head, rolling about.'
Her children responded by keeping a round-the- clock vigil and documenting the care she was given. They noted that one nurse even refused to change a faulty drip because she was about to go off duty. A few days later came the mix-up over the penicillin. 'At this point we were in tears,' one of the sisters wrote in the diary.
'Mum had yet again missed another dose, this was the final straw.' Mrs Degnen said yesterday: 'We didn't feel like they were listening to us. They were making blunder after blunder in our face. 'We could see there were other patients not being cared for. We tried to communicate with the staff but some of them couldn't even speak English'
Mrs Dunn's condition appeared to stabilise but on January 21 her family were told she had contracted C. diff. They had nursed her themselves without being offered protective gloves or aprons to guard against such infections. She recovered sufficiently however to be transferred to a local hospital only to deteriorate again and be moved back to Tameside. Five days later she died from complications caused by the hospital bug.
The hospital insists doctors were right to prescribe antibiotics containing penicillin as it was felt that the benefits would outweigh any minor side-effects. A spokesman said: 'We acknowledged and apologised for the shortcomings in Mrs Dunn's care. We would reiterate the apology here.' Staff have been sent for retraining or are having their performance monitored.
In 2006, a coroner condemned the hospital after four elderly patients died in agony following what he called 'despicable and absolutely chaotic' treatment.
SOURCE
British man died of heart attack while cowardly paramedic stood outside and conducted a "risk assessment"
An open door frightened him!
A grandfather died of a heart attack while an emergency paramedic stood outside his home for 16 minutes, making a risk assessment. The family of Roy Adams, 60, claimed yesterday that he might have survived if the paramedic had entered immediately. London Ambulance Service said that it had begun an investigation into the circumstances of the delay.
Mr Adams, a chauffeur for the Metropolitan Police, dialled 999 complaining of breathing problems and chest pains just after midnight on June 29. He was told by the operator to leave his front door open so an ambulance crew could get to him quickly.
However, a paramedic who arrived six minutes later and saw the door open feared that the property was being burgled. He stayed on the doorstep carrying out a “risk assessment exercise” before calling police for support. When he entered the property, 16 minutes after arriving, he found Mr Adams in the front room of his home in Morden, South London. Mr Adams was not breathing and was dead when he reached hospital.
His daughter, Sarah Adams, 23, said: “It makes me feel sick to think that the paramedic waited outside for 16 minutes. They thought he was having a heart attack but didn’t go in. He was told to leave the door open, so I can’t understand how it was a surprise for the medic. The delay might have made all the difference. “I don’t understand what health and safety worries meant this man couldn’t help my dad. He was dying.”
Ms Adams said that the family was planning to sue the ambulance service. “No one has apologised to us for what has happened,” she said. “I would at least expect a letter or something like that — but I still want to take them to court.”
A spokesman for London Ambulance Service said that two “single responders” had been sent to the address in cars, an ambulance crew and a duty officer. “The first member of our staff to arrive carried out a full on-scene risk assessment and requested police assistance due to safety concerns,” the spokesman said. “He then took the decision to enter the property alone, while maintaining telephone contact with our control room. “We are looking into the incident and are in the process of contacting Mr Adams’s family to discuss things further.”
Concerns have been raised about the increasing use of solo paramedics as two-person crews were split up before the introduction of new government targets in April last year. Under the new targets, three quarters of the most serious emergencies have to be met within eight minutes of a 999 call being answered.
Ben Bradshaw, then a junior health minister, denied in December 2007 that “single responders” would put patients at risk. He said they could help to free resources and that emergency calls would be responded to more quickly.
Miss Adams added: “Why would you stand outside carrying out this risk assessment when you know an old man is inside with a serious medical emergency? My dad had been instructed to put the doors on the latch by the operator. Vital minutes were wasted. He might well have survived if the medic had gone in and treated him as soon as he arrived.”
The ambulance service spokesman described the risk assessment as a “mental checklist” which included considering the safety of the scene, types of risk and whether extra help or equipment was required. “We have a duty of care to treat patients but we also have to look after our staff,” he said. “In this case the medic conducted the assessment, had safety concerns and decided to call for back-up.”
SOURCE
Australian Feds trying to reduce government support for IVF
As the father of an IVF son, I wholeheartedy endorse the views below. I took no notice of the money cost of my heroic wife going through 10 IVF treatment cycles in a private clinic and have no clue what that cost was, but not everyone can afford to take that attitude
WHY are we paying the $5000 baby bonus to anyone who can get themselves knocked up, but taking money away from those who really want a baby, but can't conceive naturally? That's right. The Federal Government is planning to restrict Medicare funding for IVF, which could put the fertility treatment out of the reach of ordinary Aussies.
Most IVF users are devoted couples who deserve what the rest of us take for granted - a baby. I have watched many of my friends struggle - sometimes for years - to become parents. I have shared with them the highs, the lows, the pain, and the joy of IVF and other fertility treatments. Most have got there eventually - sometimes naturally after years of invasive medical treatments.
Others have had cycle after cycle of IVF and conceived only when they were on the verge of giving up - a miracle of medicine that has turned a couple into a family, and made them feel whole. Just one kid is enough to allow them to enter the magical world of parenthood - the trips to the park, the school days, the Friday night family dinners, cheering at sports matches, the school soccials, the children and the grandchildren.
It's a reminder that although my kids get me down at times, I know I am very lucky to have them. With three kids in 5 1/2 years, our fertility is a family joke. But our kids are a blessing for which I am grateful every day, and I want others to have the same chance. Surely having a baby is a basic right worth fighting for?
Why, then, would we ever think of restricting access to IVF just to those who can afford it? I hope this message gets across loud and clear in this week's Senate hearings on the issue. Let's not forget what the Federal Government change is estimated to do - triple the price of IVF, and thus put it out of reach of most middle-income Aussies. According to IVF rights campaigner Sandra Dill, from Access Australia, out-of-pocket expenses per cycle could be $3000 - up from $1000 at the moment. When you consider most people need two or three cycles to become pregnant, it's just not affordable.
I don't think fertility treatment is something that should just be the preserve of the rich, and not the rest. We'd end up like the US where the rich pay hundreds of thousands to buy a baby, rent a womb or choose the sex of their offspring, and the rest can barely afford to see a GP, let alone a fertility expert.
Federal Health Minister Nicola Roxon - herself a mother - says the Government is trying to crack down on doctors overcharging patients. But why not focus on the doctors rather than penalise the patients? We mustn't forget that IVF isn't just another medical procedure curing ingrown toenails or broken arms. And so we must fight for the right of 11,000 babies to be born every year to parents who desperately want to have kids, but can't for medical reasons.
After all, IVF is now mainstream - 3 per cent of all births are by assisted reproduction these days. Forget the Wacko Jackos and rent-a-womb Hollywood superstars. The "right to IVF" debate should instead be about the couple next door, and their right to have the baby they've always wanted.
SOURCE
The forbidding arithmetic of healthcare reform
THE FUZZY math behind the Massachusetts universal healthcare law is starting to add up - just as Washington studies the law as a possible model for the nation.
Because of a recession-related drop in state revenues and a surge in enrollment by the recently unemployed, the truth is emerging at an inconvenient time. Massachusetts doesn’t have enough money to pay for the coverage envisioned by the law. In June, state officials announced they are cutting $100 million from Commonwealth Care, which subsidizes premiums for needy residents. The poorest residents, along with the newest - legal immigrants - will take the hit.
This outcome is not surprising, but it is instructive as President Obama pushes for a national healthcare plan. On the day that Republican Governor Mitt Romney, for once, made Bay State Democrats happy, by signing the sweeping new healthcare bill into law, the Globe headline said it all: “Joy, worries on healthcare. As Romney signs bill, doubts arise about revenues.’’
In Massachusetts, the numbers never added up, as everyone involved in crafting the new law understood. But for a variety of reasons, ranging from Romney’s presidential aspirations to Senator Edward M. Kennedy’s longstanding commitment to healthcare reform, everyone smiled for the cameras and hoped for the best out of this noble experiment.
Today, the current governor, Deval Patrick, a Democrat, is skeptical about the end product. Asked during a televised town hall meeting in March if he believes national healthcare legislation should be patterned after the Massachusetts plan, he said, “I don’t know. I had real misgivings about it as a candidate. . . . I’m proud of it, but I don’t know if it’s a model for the nation.’’
The foundation of the Massachusetts law is the so-called individual mandate. That means everyone must have health insurance. From that perspective, the Massachusetts experiment is a success. The percentage of residents without insurance was down to 2.6 after two years. But, the law never provided an absolute way to pay for the expanded coverage, and it never addressed how to reduce costs. “They decoupled the access issue from the cost issue,’’ said Philip Johnston, chairman of the Blue Cross Blue Shield of Massachusetts Foundation, which played a key role in expanding healthcare coverage here. “The lesson is, there needs to be a dedicated revenue source to support health reform.’’
An even bigger lesson is that to make health reform happen, all the players must be invested from the start - and must stay invested. “Getting it done is politics. That means dealing with all the elements that are necessary for near-universal access and cost management, but not overreaching in any one area, so that major stakeholders turn from supporting the effort to opposing it,’’ said John Sasso, who represented Partners Healthcare, the largest healthcare provider in Massachusetts, and Blue Cross Blue Shield, the state’s largest insurer, during the reform process. The stakeholders are still at the table, trying to make the numbers work better, he points out.
It’s true that Massachusetts built a dream house of a healthcare plan, without knowing the exact cost or how to pay for it. But that doesn’t mean it should be dramatically downsized, as state Treasurer Timothy P. Cahill proposes as he positions himself for a gubernatorial run.
A recent report by the Massachusetts Taxpayers Foundation, a business-funded group that advocated for the healthcare law, found that state spending increased by about $88 million annually since it was implemented. Is that too much to absorb, within the context of a $28 billion state budget?
As Patrick also said about the state’s healthcare law at that town hall meeting, “The great story about Massachusetts is instead of waiting for the perfect solution . . . or doing nothing . . . we tried something.’’
Washington can’t be as adventurous. Costing out a national healthcare plan, and figuring out how to fund it, is the current fault line for Obama. The president insists he can overhaul the healthcare system without adding to the deficit. He should take this final lesson out of Massachusetts: Be honest about cost in the good times and make sure you can cover it in the bad.
SOURCE
A horrifying journal of the neglect a great-grandmother suffered in hospital has been published by her family. Betty Dunn, 79, was admitted with a routine stomach problem but died six weeks later after a string of medical errors. During this time her relatives compiled the diary detailing her ordeal in a ward they grimly nicknamed the 'zoo'. The dossier tells how Mrs Dunn was:
* Given medication containing penicillin - despite warnings that she was allergic to it;
* Forced to sleep on a bare mattress;
* Made to wait 40 minutes for a bedpan;
* Treated by staff who could barely speak English;
* Made to eat a food substitute against medical advice.
At one stage, the mother- of-four's children became so desperate that they called the police for help but were told nothing could be done. In a final insult, the news that Mrs Dunn was dying was broken to her daughters in a busy corridor in front of other visitors.
The wartime Land Girl was being treated on a mixed-sex ward divided into bays at Tameside Hospital, in Ashton-under-Lyne, near Manchester. Labour had pledged to scrap this type of patient accommodation.
'The ward where mum was treated was like a zoo, and we called it that afterwards,' said her daughter, Liz Degnen, 49, today. "It was manic and chaotic with people running around like headless chickens. 'It doesn't matter if you're 79, 29, or 109, the way the hospital treated her was disgraceful. Every aspect of her care was just terrible. The staff did their best but there were not enough of them to cope. It's a scandal that hospitals can operate like this in this day and age.'
Mrs Dunn, a former dinner lady from Gamesley, near Glossop in Derbyshire, was admitted to Tameside on January 4 with complications from a stomach bug. 'On the night she was admitted for treatment mum was waving and blowing kisses and saying "See you, love",' said Mrs Degnen, a teaching assistant. 'Yet when we left for a few hours we came back to find her slumped across a bedside trolley. Her eyes were at the back of her head, rolling about.'
Her children responded by keeping a round-the- clock vigil and documenting the care she was given. They noted that one nurse even refused to change a faulty drip because she was about to go off duty. A few days later came the mix-up over the penicillin. 'At this point we were in tears,' one of the sisters wrote in the diary.
'Mum had yet again missed another dose, this was the final straw.' Mrs Degnen said yesterday: 'We didn't feel like they were listening to us. They were making blunder after blunder in our face. 'We could see there were other patients not being cared for. We tried to communicate with the staff but some of them couldn't even speak English'
Mrs Dunn's condition appeared to stabilise but on January 21 her family were told she had contracted C. diff. They had nursed her themselves without being offered protective gloves or aprons to guard against such infections. She recovered sufficiently however to be transferred to a local hospital only to deteriorate again and be moved back to Tameside. Five days later she died from complications caused by the hospital bug.
The hospital insists doctors were right to prescribe antibiotics containing penicillin as it was felt that the benefits would outweigh any minor side-effects. A spokesman said: 'We acknowledged and apologised for the shortcomings in Mrs Dunn's care. We would reiterate the apology here.' Staff have been sent for retraining or are having their performance monitored.
In 2006, a coroner condemned the hospital after four elderly patients died in agony following what he called 'despicable and absolutely chaotic' treatment.
SOURCE
British man died of heart attack while cowardly paramedic stood outside and conducted a "risk assessment"
An open door frightened him!
A grandfather died of a heart attack while an emergency paramedic stood outside his home for 16 minutes, making a risk assessment. The family of Roy Adams, 60, claimed yesterday that he might have survived if the paramedic had entered immediately. London Ambulance Service said that it had begun an investigation into the circumstances of the delay.
Mr Adams, a chauffeur for the Metropolitan Police, dialled 999 complaining of breathing problems and chest pains just after midnight on June 29. He was told by the operator to leave his front door open so an ambulance crew could get to him quickly.
However, a paramedic who arrived six minutes later and saw the door open feared that the property was being burgled. He stayed on the doorstep carrying out a “risk assessment exercise” before calling police for support. When he entered the property, 16 minutes after arriving, he found Mr Adams in the front room of his home in Morden, South London. Mr Adams was not breathing and was dead when he reached hospital.
His daughter, Sarah Adams, 23, said: “It makes me feel sick to think that the paramedic waited outside for 16 minutes. They thought he was having a heart attack but didn’t go in. He was told to leave the door open, so I can’t understand how it was a surprise for the medic. The delay might have made all the difference. “I don’t understand what health and safety worries meant this man couldn’t help my dad. He was dying.”
Ms Adams said that the family was planning to sue the ambulance service. “No one has apologised to us for what has happened,” she said. “I would at least expect a letter or something like that — but I still want to take them to court.”
A spokesman for London Ambulance Service said that two “single responders” had been sent to the address in cars, an ambulance crew and a duty officer. “The first member of our staff to arrive carried out a full on-scene risk assessment and requested police assistance due to safety concerns,” the spokesman said. “He then took the decision to enter the property alone, while maintaining telephone contact with our control room. “We are looking into the incident and are in the process of contacting Mr Adams’s family to discuss things further.”
Concerns have been raised about the increasing use of solo paramedics as two-person crews were split up before the introduction of new government targets in April last year. Under the new targets, three quarters of the most serious emergencies have to be met within eight minutes of a 999 call being answered.
Ben Bradshaw, then a junior health minister, denied in December 2007 that “single responders” would put patients at risk. He said they could help to free resources and that emergency calls would be responded to more quickly.
Miss Adams added: “Why would you stand outside carrying out this risk assessment when you know an old man is inside with a serious medical emergency? My dad had been instructed to put the doors on the latch by the operator. Vital minutes were wasted. He might well have survived if the medic had gone in and treated him as soon as he arrived.”
The ambulance service spokesman described the risk assessment as a “mental checklist” which included considering the safety of the scene, types of risk and whether extra help or equipment was required. “We have a duty of care to treat patients but we also have to look after our staff,” he said. “In this case the medic conducted the assessment, had safety concerns and decided to call for back-up.”
SOURCE
Australian Feds trying to reduce government support for IVF
As the father of an IVF son, I wholeheartedy endorse the views below. I took no notice of the money cost of my heroic wife going through 10 IVF treatment cycles in a private clinic and have no clue what that cost was, but not everyone can afford to take that attitude
WHY are we paying the $5000 baby bonus to anyone who can get themselves knocked up, but taking money away from those who really want a baby, but can't conceive naturally? That's right. The Federal Government is planning to restrict Medicare funding for IVF, which could put the fertility treatment out of the reach of ordinary Aussies.
Most IVF users are devoted couples who deserve what the rest of us take for granted - a baby. I have watched many of my friends struggle - sometimes for years - to become parents. I have shared with them the highs, the lows, the pain, and the joy of IVF and other fertility treatments. Most have got there eventually - sometimes naturally after years of invasive medical treatments.
Others have had cycle after cycle of IVF and conceived only when they were on the verge of giving up - a miracle of medicine that has turned a couple into a family, and made them feel whole. Just one kid is enough to allow them to enter the magical world of parenthood - the trips to the park, the school days, the Friday night family dinners, cheering at sports matches, the school soccials, the children and the grandchildren.
It's a reminder that although my kids get me down at times, I know I am very lucky to have them. With three kids in 5 1/2 years, our fertility is a family joke. But our kids are a blessing for which I am grateful every day, and I want others to have the same chance. Surely having a baby is a basic right worth fighting for?
Why, then, would we ever think of restricting access to IVF just to those who can afford it? I hope this message gets across loud and clear in this week's Senate hearings on the issue. Let's not forget what the Federal Government change is estimated to do - triple the price of IVF, and thus put it out of reach of most middle-income Aussies. According to IVF rights campaigner Sandra Dill, from Access Australia, out-of-pocket expenses per cycle could be $3000 - up from $1000 at the moment. When you consider most people need two or three cycles to become pregnant, it's just not affordable.
I don't think fertility treatment is something that should just be the preserve of the rich, and not the rest. We'd end up like the US where the rich pay hundreds of thousands to buy a baby, rent a womb or choose the sex of their offspring, and the rest can barely afford to see a GP, let alone a fertility expert.
Federal Health Minister Nicola Roxon - herself a mother - says the Government is trying to crack down on doctors overcharging patients. But why not focus on the doctors rather than penalise the patients? We mustn't forget that IVF isn't just another medical procedure curing ingrown toenails or broken arms. And so we must fight for the right of 11,000 babies to be born every year to parents who desperately want to have kids, but can't for medical reasons.
After all, IVF is now mainstream - 3 per cent of all births are by assisted reproduction these days. Forget the Wacko Jackos and rent-a-womb Hollywood superstars. The "right to IVF" debate should instead be about the couple next door, and their right to have the baby they've always wanted.
SOURCE
The forbidding arithmetic of healthcare reform
THE FUZZY math behind the Massachusetts universal healthcare law is starting to add up - just as Washington studies the law as a possible model for the nation.
Because of a recession-related drop in state revenues and a surge in enrollment by the recently unemployed, the truth is emerging at an inconvenient time. Massachusetts doesn’t have enough money to pay for the coverage envisioned by the law. In June, state officials announced they are cutting $100 million from Commonwealth Care, which subsidizes premiums for needy residents. The poorest residents, along with the newest - legal immigrants - will take the hit.
This outcome is not surprising, but it is instructive as President Obama pushes for a national healthcare plan. On the day that Republican Governor Mitt Romney, for once, made Bay State Democrats happy, by signing the sweeping new healthcare bill into law, the Globe headline said it all: “Joy, worries on healthcare. As Romney signs bill, doubts arise about revenues.’’
In Massachusetts, the numbers never added up, as everyone involved in crafting the new law understood. But for a variety of reasons, ranging from Romney’s presidential aspirations to Senator Edward M. Kennedy’s longstanding commitment to healthcare reform, everyone smiled for the cameras and hoped for the best out of this noble experiment.
Today, the current governor, Deval Patrick, a Democrat, is skeptical about the end product. Asked during a televised town hall meeting in March if he believes national healthcare legislation should be patterned after the Massachusetts plan, he said, “I don’t know. I had real misgivings about it as a candidate. . . . I’m proud of it, but I don’t know if it’s a model for the nation.’’
The foundation of the Massachusetts law is the so-called individual mandate. That means everyone must have health insurance. From that perspective, the Massachusetts experiment is a success. The percentage of residents without insurance was down to 2.6 after two years. But, the law never provided an absolute way to pay for the expanded coverage, and it never addressed how to reduce costs. “They decoupled the access issue from the cost issue,’’ said Philip Johnston, chairman of the Blue Cross Blue Shield of Massachusetts Foundation, which played a key role in expanding healthcare coverage here. “The lesson is, there needs to be a dedicated revenue source to support health reform.’’
An even bigger lesson is that to make health reform happen, all the players must be invested from the start - and must stay invested. “Getting it done is politics. That means dealing with all the elements that are necessary for near-universal access and cost management, but not overreaching in any one area, so that major stakeholders turn from supporting the effort to opposing it,’’ said John Sasso, who represented Partners Healthcare, the largest healthcare provider in Massachusetts, and Blue Cross Blue Shield, the state’s largest insurer, during the reform process. The stakeholders are still at the table, trying to make the numbers work better, he points out.
It’s true that Massachusetts built a dream house of a healthcare plan, without knowing the exact cost or how to pay for it. But that doesn’t mean it should be dramatically downsized, as state Treasurer Timothy P. Cahill proposes as he positions himself for a gubernatorial run.
A recent report by the Massachusetts Taxpayers Foundation, a business-funded group that advocated for the healthcare law, found that state spending increased by about $88 million annually since it was implemented. Is that too much to absorb, within the context of a $28 billion state budget?
As Patrick also said about the state’s healthcare law at that town hall meeting, “The great story about Massachusetts is instead of waiting for the perfect solution . . . or doing nothing . . . we tried something.’’
Washington can’t be as adventurous. Costing out a national healthcare plan, and figuring out how to fund it, is the current fault line for Obama. The president insists he can overhaul the healthcare system without adding to the deficit. He should take this final lesson out of Massachusetts: Be honest about cost in the good times and make sure you can cover it in the bad.
SOURCE
Tuesday, July 07, 2009
British patient lived with cancer for 50 years before dying of bedsore in an NHS hospital
Cancer patient Pamela Goddard battled against cancer for 50 years before she died of an infected bedsore during a stay in hospital. The treatment for the cancer appeared to be working, but the bedsore continued to get worse.
Pamela Goddard had great faith in the NHS. It had, after all, kept her alive for more than half her 82 years. The piano teacher first contracted breast cancer in the 1960s and had survived a series of recurrences of the disease over the years. So when it returned last year, this "completely vital" woman, who was still working up to 30 hours a week, was fully expected survive. The cancer did not kill her, but a bedsore did.
What appeared to be the start of one was noted on her back as she was admitted for radiation treatment in September and it was allowed to gradually develop into a "raging sore" which left Mrs Goddard moaning in pain. During four weeks of what her family describe as "torture" in a bed in East Surrey Hospital, the sore resulted in a fatal blood infection and she died on October 27.
Her son Adrian Goddard, who lives in the US, said: "She survived cancer for 40 years, then died from a bedsore. "It is just beyond belief that they could let a bedsore develop to the point where it actually kills someone from septicaemia." He said the nurses seemed largely unconcerned by the growing size of the sore and his mother's increasing pain. "The bedsore was painful. There were various procedures that should have been done. You are supposed to debride the thing, clean it, treat it. "She was supposed to be lifted and moved so there's not constant pressure on it," Mr Goddard said.
"There were explanations like 'there was only one nurse and it wasn't possible to do it or the equipment was broken'... just a series of excuses. "Most of the time there were [enough nurses]. None of them struck me as being frantically busy to put it mildly. "There were lots of conversations about last night's activities in the pub, a lot of strolling around, looking at charts without doing anything. "The level of crisis that attracts their attention has to be very high for them to put down their biscuits. I guess they get inured to it, the moaning, the fact my mother was in great pain."
The first sign Mrs Goddard was unwell came early in 2008 when she suffered from back pain. She went to Barts Hospital in London but the recurrence of cancer which was the cause of the pain was not diagnosed until she broke her leg in June. The treatment for the cancer appeared to be working, but the bedsore continued to get worse despite attempts to treat it with "maggot therapy" in which maggots are used to clean out the wound.
On October 11, Mr Goddard said a doctor told him that "she was recovering well, except there was something in the blood work, which suggested an infection". "If it didn't go away, he said he would give her penicillin or something," Mr Goddard said. "It never occurred to him this by now raging bedsore was the source of the infection."
Mr Goddard said he and other members of the family had tried to persuade nurses and doctors to take more action, but said the "inertia was extraordinary, the worst sort of institutional dysfunction".
Mr Goddard said anyone in a similar situation should "do what you need to do to find some sort of private care for them". "She certainly wasn't ready to die. To the extent she realised it was happening, she must have been horrified," he said. "The thing that makes me most angry was she had such faith in the system and it let her down so badly. "She was basically in torture over a four-week period. Then she was drugged up and left to die. "It's unconscionable, very sad."
Surrey and Sussex Healthcare NHS Trust Director of Nursing, Mary Sexton, said: "We offer our sincere condolences to the family of Pamela Goddard on the loss of their mother. "We are committed to providing high quality patient care and are sorry that on this occasion the family feel that that standard has not been met. "We have received a formal complaint, which we have responded to, but are carrying out further investigations at the request of the family.
"The presence of pressure sores is associated with a twofold to fourfold increased risk of death, but this is because pressure sores are a marker for underlying disease severity and other co-morbidities. "Mrs Goddard was receiving complex treatment for a number of medical conditions from a number of health care organisations at the time of her death."
SOURCE
11 serious errors a day in NHS surgery
Eleven people are seriously harmed during NHS surgery every day, it emerged yesterday. The number of major errors has risen by 28 per cent in five years, with more than 4,000 patients hurt in 2007/08. Mistakes include objects such as scalpels and coils being left inside patients, organs being punctured, and the wrong dosage of drugs being given.
A total of 722 objects were left inside patients during surgery last year – one every two and a half days. That number has soared by 13 per cent in the five years to 2007/08.
The figures were revealed just days after a damning MPs' report found that many hospitals are routinely covering up such mistakes. The Commons health select committee warned that another hospital disaster like the one at Stafford, where up to 400 people died, could not be ruled out – because managers were putting Whitehall targets and cost-cutting above patient safety. Government policy 'too often' gave the impression that hitting waiting list targets, achieving financial balance and attaining elite foundation trust status were more important than patient safety. 'This has undoubtedly, in a number of well documented cases, been a contributory factor in making services unsafe,' the report said.
The MPs added that many mistakes were not reported by the NHS – raising the possibility that the recorded number of medical mishaps is just the tip of the iceberg.
The latest figures were uncovered by the Liberal Democrats in a parliamentary answer. Health spokesman Norman Lamb said: 'These figures raise serious concerns and call into question the Government's claim to be making patient safety a priority. 'There really is no excuse for leaving objects inside people. Far too many avoidable mistakes are still being made. 'Many doctors and nurses are under enormous amounts of pressure to meet Government targets. We have to ensure that patient safety isn't being compromised to satisfy the whims of Whitehall. 'If we really want to raise standards in the NHS then we need to give local people the power to hold their health services to account.'
The figures show that there have been a total of 17,921 errors during surgery over the past five years. The number of cases every year has shot up by 28 per cent to 4,161 in 2007/08 – 11 a day.
Most of the cases involve people having organs mistakenly punctured, which can lead to haemorrhaging. Over the last five years, the organs of 12,125 patients were punctured, with the annual figures soaring 33 per cent to 2,817 in 2007/08.
Hundreds of other surgical mistakes were reported, including not removing or inserting tubes properly, using wrongly-matched blood, forgetting to give drugs on time, and not sterilising equipment properly. Failure to sterilise is a key method by which superbugs such as C. Diff and MRSA can spread.
There were also dozens of reports of the catch-all 'performance of inappropriate operations'. The total uncovered by the LibDems represents only a fraction of the mistakes made in the NHS every year, as it only covers errors during operations. Overall, there are around 250,000 mistakes causing harm to patients reported across the Health Service every year. More than 3,600 of those affected die as a result.
SOURCE
Medical arrogance
During his ABC infomercial last week, President Obama continued to insist that the type of reform he has in mind would reduce the cost of health care, improve its quality, and enable people to keep their current insurance policies and doctors. He is wrong on all counts.
Very little in the Democratic bills making their way through Congress would do anything to reduce costs, while the new subsidies their authors envision would increase costs. That is why the Democrats are talking about both explicit and disguised tax increases. During the ABC special, the president hinted that reform would give doctors and hospitals new incentives to avoid unnecessary care. But since government cannot reliably distinguish between the necessary and the unnecessary, all it can do is encourage less care — and leave it to doctors and other health-care workers to administer the rationing. Obama would be well-advised, for his political health, to do no more than hint at this prospect.
Obama wants to establish a government-run insurer. Because it could pass along its costs to its private-sector competitors, that insurer would quickly come to dominate the market, regardless of its quality. (All estimates agree that many millions of people would lose their existing coverage.) It would thus strengthen the government’s ability to reshape health care to its specifications. Obama seems entirely too confident that it could do so intelligently.
The better course would be to make it easier for people to buy insurance policies for themselves and their families, so that they would not have to rely on either the government or their employers. Under such a system people would run less of a risk of being denied care that they want, and would also have an incentive to keep an eye on costs. And in a market less fragmented on the basis of employment status, individuals would be better able to buy renewable insurance policies that they could keep even after getting sick.
President Obama could easily get such a plan through Congress if he wanted it and were willing to face the wrath of the Left. By pursuing his political and ideological ambitions, he is risking getting no bill at all — or, worse, one that takes America in the wrong direction.
SOURCE
Obamacare: Do or die for America
With so much coverage of the current debate on Barack Obama’s attempt to impose nationalized healthcare on America, it may seem that little else can be said on the subject. Yet it needs to be discussed, and its manifold dangers explained to the American people. It is impossible to overstate the significance of this battle. If successful in establishing this pinnacle of his socialist agenda, Obama will unleash a “change” on the country from which it may never recover.
Clearly, he is aware of the governmental power he has the potential to accrue with the passage of this single atrocious new entitlement. His lust for that power is evident in the ferocity with which he is striving to ramrod his plan through the congress and onto America. The stakes are far too great for him to do any less. Ultimately, the zeal with which he is pressing forward should be the greatest indication to Americans of the long-term perils that await them if he succeeds.
While it may seem odd to draw comparisons between the healthcare “debate” and the recent uprisings in Iran, certain disturbing parallels indeed exist. America and the world witness the tragedy of an oppressed people yearning to be free, and the manner in which the Iranian government is scrambling to regain its iron-fisted control of the situation. Central to this effort is their disinformation campaign. And while nobody in our country is being slaughtered over health care controversies, the situation is rife with ominous signs of a government/media propaganda blitz that rivals anything ever concocted by Tass or Pravda.
Furthermore, though the violence in Iran is not likely to be recounted in our communities, particularly with respect to medical care, ominous patterns of governmental coercion, and suppression of all opposition are already beginning to unfold here. And if the poisoned seeds of impending tyranny are any indication, it is chilling to ponder the bitter fruit that they may bear if not immediately checked.
It is not necessary to delve into ideological parallels between Obama and the ruthless Iranian leadership. Clearly, his Cairo speech revealed an appalling willingness to laud the Islamic world in a manner that he never proffers on behalf of America and the rest of Western Civilization. Anyone who doubts this need only to contrast that speech against the venom and anti-American hatred of the “Reverend” Jeremiah Wright, under whose spiritual leadership Obama willingly sat for more than two decades.
Still, with respect to healthcare, the underlying ideology is a secondary issue. It makes no difference why Obama and his kind are so intent on lowering the quality of American healthcare to levels reflective of nightmarish and dysfunctional Euro-socialist states. Their willingness to employ fraud and overreaches of power speaks volumes in itself. The results of this approach are entirely predictable. Any program that is implemented through such thuggish tactics cannot possibly redound to the benefit of America’s greatness or the former freedoms enjoyed by its people.
Pivotal to the onset of unrest among Iranian citizens was the obvious tampering of election results, ensuring the reelection of Islamist puppet Mahmoud Ahmadinejad. On the Iranian street, it was a given that Ahmadinejad’s rival, Mir Hossein Mousavi, was far more popular. Yet the “election” results painted a completely different picture, and predictably, one that the “religious” autocracy had intended from the beginning.
Of course nothing like that could happen here in America, or could it? On June 20, just in time for Obama’s big healthcare propaganda blitz, an “independent” CBS News/New York Times poll was released which claims that an amazing 72% of Americans are in support of putting their medical care under the complete control of the government. Apparently, the monstrosity of a socialist bureaucracy enjoys even more popularity on mainstreet than Ahmadinejad does in Tehran.
However, on closer examination, it turns out that, by a two to one margin, participants chosen for the poll were Obama supporters. By resorting to such absurdly skewed “sampling” pollsters can easily manufacture “overwhelming” public support or opposition on any topic they choose. Thus has CBS/New York Times revealed its willingness to sway public opinion by generating the illusion of political momentum.
Equally significant is that, in this role, CBS/New York Times is clearly disseminating misinformation in concert with the agenda of Obama and the Democrats. These formerly respectable establishments of the press have abdicated their time-honored role of protecting liberty and national integrity by keeping the public informed. Instead, they have assumed the dark mantle of demagogues and propagandists for the state. Joseph Goebbels would be proud.
Much worse is yet to come. At least CBS/New York Times still felt compelled to do their dirty deed under the guise of an objective poll. In comparison, the actions of ABC “News” vastly eclipse any previous sellout of the public trust by the press. Not content to merely parrot the Obama/Democrat party line, on Wednesday June 24, ABC News conducted a government “healthcare” infomercial from inside the White House. Comically denying any partiality, this broadcast was clearly crafted to advance Obama’s socialist cause, denying any opposing viewpoint from being presented, even during paid commercials.
In a sad post-mortem on the demise of the American Republic, CBS News/New York Times, along with ABC News, would not be memorialized as principled martyrs who lost a valiant fight to keep spreading truth among the people of the country. Rather, descending to the point of becoming ideological brothels from which any “informational” service can be purchased for the right price, these once great institutions willingly abandoned their rightful purpose, and now publicly strut their wares for the right bidder.
Despite all of this, the path to a takeover of the medical system is far from certain. Obama’s own desperation, revealed in such antics as the ABC News publicity stunt, stand as evidence that huge obstacles remain before Americans will consign their physical well being to the insipient madness of liberal bureaucracies. In response, Obama has been driven to mimic the tactics of those Iranian Ayatollahs who feel their grip on power slipping away. While insisting that the plan is a “done deal,” he demeans any who oppose it as “not logical.” In doing so, he demeans himself and the office he holds.
Next week, this country will be celebrating the two hundred and thirty third anniversary of its founding. Those courageous individuals who crafted and signed the Declaration of Independence birthed a nation on principles so wise and noble that it has since risen to the pinnacle of civilization. But if such ideals are abandoned, it cannot exist forever on the mere momentum of its glorious founding.
It seems wholly unlikely that Americans may ever face the prospect of blood running in the streets of their cities. But the specter of a government run healthcare system, and the sinister manner in which it is being advanced, represent a dangerous departure from the nation’s former greatness.
SOURCE
Cancer patient Pamela Goddard battled against cancer for 50 years before she died of an infected bedsore during a stay in hospital. The treatment for the cancer appeared to be working, but the bedsore continued to get worse.
Pamela Goddard had great faith in the NHS. It had, after all, kept her alive for more than half her 82 years. The piano teacher first contracted breast cancer in the 1960s and had survived a series of recurrences of the disease over the years. So when it returned last year, this "completely vital" woman, who was still working up to 30 hours a week, was fully expected survive. The cancer did not kill her, but a bedsore did.
What appeared to be the start of one was noted on her back as she was admitted for radiation treatment in September and it was allowed to gradually develop into a "raging sore" which left Mrs Goddard moaning in pain. During four weeks of what her family describe as "torture" in a bed in East Surrey Hospital, the sore resulted in a fatal blood infection and she died on October 27.
Her son Adrian Goddard, who lives in the US, said: "She survived cancer for 40 years, then died from a bedsore. "It is just beyond belief that they could let a bedsore develop to the point where it actually kills someone from septicaemia." He said the nurses seemed largely unconcerned by the growing size of the sore and his mother's increasing pain. "The bedsore was painful. There were various procedures that should have been done. You are supposed to debride the thing, clean it, treat it. "She was supposed to be lifted and moved so there's not constant pressure on it," Mr Goddard said.
"There were explanations like 'there was only one nurse and it wasn't possible to do it or the equipment was broken'... just a series of excuses. "Most of the time there were [enough nurses]. None of them struck me as being frantically busy to put it mildly. "There were lots of conversations about last night's activities in the pub, a lot of strolling around, looking at charts without doing anything. "The level of crisis that attracts their attention has to be very high for them to put down their biscuits. I guess they get inured to it, the moaning, the fact my mother was in great pain."
The first sign Mrs Goddard was unwell came early in 2008 when she suffered from back pain. She went to Barts Hospital in London but the recurrence of cancer which was the cause of the pain was not diagnosed until she broke her leg in June. The treatment for the cancer appeared to be working, but the bedsore continued to get worse despite attempts to treat it with "maggot therapy" in which maggots are used to clean out the wound.
On October 11, Mr Goddard said a doctor told him that "she was recovering well, except there was something in the blood work, which suggested an infection". "If it didn't go away, he said he would give her penicillin or something," Mr Goddard said. "It never occurred to him this by now raging bedsore was the source of the infection."
Mr Goddard said he and other members of the family had tried to persuade nurses and doctors to take more action, but said the "inertia was extraordinary, the worst sort of institutional dysfunction".
Mr Goddard said anyone in a similar situation should "do what you need to do to find some sort of private care for them". "She certainly wasn't ready to die. To the extent she realised it was happening, she must have been horrified," he said. "The thing that makes me most angry was she had such faith in the system and it let her down so badly. "She was basically in torture over a four-week period. Then she was drugged up and left to die. "It's unconscionable, very sad."
Surrey and Sussex Healthcare NHS Trust Director of Nursing, Mary Sexton, said: "We offer our sincere condolences to the family of Pamela Goddard on the loss of their mother. "We are committed to providing high quality patient care and are sorry that on this occasion the family feel that that standard has not been met. "We have received a formal complaint, which we have responded to, but are carrying out further investigations at the request of the family.
"The presence of pressure sores is associated with a twofold to fourfold increased risk of death, but this is because pressure sores are a marker for underlying disease severity and other co-morbidities. "Mrs Goddard was receiving complex treatment for a number of medical conditions from a number of health care organisations at the time of her death."
SOURCE
11 serious errors a day in NHS surgery
Eleven people are seriously harmed during NHS surgery every day, it emerged yesterday. The number of major errors has risen by 28 per cent in five years, with more than 4,000 patients hurt in 2007/08. Mistakes include objects such as scalpels and coils being left inside patients, organs being punctured, and the wrong dosage of drugs being given.
A total of 722 objects were left inside patients during surgery last year – one every two and a half days. That number has soared by 13 per cent in the five years to 2007/08.
The figures were revealed just days after a damning MPs' report found that many hospitals are routinely covering up such mistakes. The Commons health select committee warned that another hospital disaster like the one at Stafford, where up to 400 people died, could not be ruled out – because managers were putting Whitehall targets and cost-cutting above patient safety. Government policy 'too often' gave the impression that hitting waiting list targets, achieving financial balance and attaining elite foundation trust status were more important than patient safety. 'This has undoubtedly, in a number of well documented cases, been a contributory factor in making services unsafe,' the report said.
The MPs added that many mistakes were not reported by the NHS – raising the possibility that the recorded number of medical mishaps is just the tip of the iceberg.
The latest figures were uncovered by the Liberal Democrats in a parliamentary answer. Health spokesman Norman Lamb said: 'These figures raise serious concerns and call into question the Government's claim to be making patient safety a priority. 'There really is no excuse for leaving objects inside people. Far too many avoidable mistakes are still being made. 'Many doctors and nurses are under enormous amounts of pressure to meet Government targets. We have to ensure that patient safety isn't being compromised to satisfy the whims of Whitehall. 'If we really want to raise standards in the NHS then we need to give local people the power to hold their health services to account.'
The figures show that there have been a total of 17,921 errors during surgery over the past five years. The number of cases every year has shot up by 28 per cent to 4,161 in 2007/08 – 11 a day.
Most of the cases involve people having organs mistakenly punctured, which can lead to haemorrhaging. Over the last five years, the organs of 12,125 patients were punctured, with the annual figures soaring 33 per cent to 2,817 in 2007/08.
Hundreds of other surgical mistakes were reported, including not removing or inserting tubes properly, using wrongly-matched blood, forgetting to give drugs on time, and not sterilising equipment properly. Failure to sterilise is a key method by which superbugs such as C. Diff and MRSA can spread.
There were also dozens of reports of the catch-all 'performance of inappropriate operations'. The total uncovered by the LibDems represents only a fraction of the mistakes made in the NHS every year, as it only covers errors during operations. Overall, there are around 250,000 mistakes causing harm to patients reported across the Health Service every year. More than 3,600 of those affected die as a result.
SOURCE
Medical arrogance
During his ABC infomercial last week, President Obama continued to insist that the type of reform he has in mind would reduce the cost of health care, improve its quality, and enable people to keep their current insurance policies and doctors. He is wrong on all counts.
Very little in the Democratic bills making their way through Congress would do anything to reduce costs, while the new subsidies their authors envision would increase costs. That is why the Democrats are talking about both explicit and disguised tax increases. During the ABC special, the president hinted that reform would give doctors and hospitals new incentives to avoid unnecessary care. But since government cannot reliably distinguish between the necessary and the unnecessary, all it can do is encourage less care — and leave it to doctors and other health-care workers to administer the rationing. Obama would be well-advised, for his political health, to do no more than hint at this prospect.
Obama wants to establish a government-run insurer. Because it could pass along its costs to its private-sector competitors, that insurer would quickly come to dominate the market, regardless of its quality. (All estimates agree that many millions of people would lose their existing coverage.) It would thus strengthen the government’s ability to reshape health care to its specifications. Obama seems entirely too confident that it could do so intelligently.
The better course would be to make it easier for people to buy insurance policies for themselves and their families, so that they would not have to rely on either the government or their employers. Under such a system people would run less of a risk of being denied care that they want, and would also have an incentive to keep an eye on costs. And in a market less fragmented on the basis of employment status, individuals would be better able to buy renewable insurance policies that they could keep even after getting sick.
President Obama could easily get such a plan through Congress if he wanted it and were willing to face the wrath of the Left. By pursuing his political and ideological ambitions, he is risking getting no bill at all — or, worse, one that takes America in the wrong direction.
SOURCE
Obamacare: Do or die for America
With so much coverage of the current debate on Barack Obama’s attempt to impose nationalized healthcare on America, it may seem that little else can be said on the subject. Yet it needs to be discussed, and its manifold dangers explained to the American people. It is impossible to overstate the significance of this battle. If successful in establishing this pinnacle of his socialist agenda, Obama will unleash a “change” on the country from which it may never recover.
Clearly, he is aware of the governmental power he has the potential to accrue with the passage of this single atrocious new entitlement. His lust for that power is evident in the ferocity with which he is striving to ramrod his plan through the congress and onto America. The stakes are far too great for him to do any less. Ultimately, the zeal with which he is pressing forward should be the greatest indication to Americans of the long-term perils that await them if he succeeds.
While it may seem odd to draw comparisons between the healthcare “debate” and the recent uprisings in Iran, certain disturbing parallels indeed exist. America and the world witness the tragedy of an oppressed people yearning to be free, and the manner in which the Iranian government is scrambling to regain its iron-fisted control of the situation. Central to this effort is their disinformation campaign. And while nobody in our country is being slaughtered over health care controversies, the situation is rife with ominous signs of a government/media propaganda blitz that rivals anything ever concocted by Tass or Pravda.
Furthermore, though the violence in Iran is not likely to be recounted in our communities, particularly with respect to medical care, ominous patterns of governmental coercion, and suppression of all opposition are already beginning to unfold here. And if the poisoned seeds of impending tyranny are any indication, it is chilling to ponder the bitter fruit that they may bear if not immediately checked.
It is not necessary to delve into ideological parallels between Obama and the ruthless Iranian leadership. Clearly, his Cairo speech revealed an appalling willingness to laud the Islamic world in a manner that he never proffers on behalf of America and the rest of Western Civilization. Anyone who doubts this need only to contrast that speech against the venom and anti-American hatred of the “Reverend” Jeremiah Wright, under whose spiritual leadership Obama willingly sat for more than two decades.
Still, with respect to healthcare, the underlying ideology is a secondary issue. It makes no difference why Obama and his kind are so intent on lowering the quality of American healthcare to levels reflective of nightmarish and dysfunctional Euro-socialist states. Their willingness to employ fraud and overreaches of power speaks volumes in itself. The results of this approach are entirely predictable. Any program that is implemented through such thuggish tactics cannot possibly redound to the benefit of America’s greatness or the former freedoms enjoyed by its people.
Pivotal to the onset of unrest among Iranian citizens was the obvious tampering of election results, ensuring the reelection of Islamist puppet Mahmoud Ahmadinejad. On the Iranian street, it was a given that Ahmadinejad’s rival, Mir Hossein Mousavi, was far more popular. Yet the “election” results painted a completely different picture, and predictably, one that the “religious” autocracy had intended from the beginning.
Of course nothing like that could happen here in America, or could it? On June 20, just in time for Obama’s big healthcare propaganda blitz, an “independent” CBS News/New York Times poll was released which claims that an amazing 72% of Americans are in support of putting their medical care under the complete control of the government. Apparently, the monstrosity of a socialist bureaucracy enjoys even more popularity on mainstreet than Ahmadinejad does in Tehran.
However, on closer examination, it turns out that, by a two to one margin, participants chosen for the poll were Obama supporters. By resorting to such absurdly skewed “sampling” pollsters can easily manufacture “overwhelming” public support or opposition on any topic they choose. Thus has CBS/New York Times revealed its willingness to sway public opinion by generating the illusion of political momentum.
Equally significant is that, in this role, CBS/New York Times is clearly disseminating misinformation in concert with the agenda of Obama and the Democrats. These formerly respectable establishments of the press have abdicated their time-honored role of protecting liberty and national integrity by keeping the public informed. Instead, they have assumed the dark mantle of demagogues and propagandists for the state. Joseph Goebbels would be proud.
Much worse is yet to come. At least CBS/New York Times still felt compelled to do their dirty deed under the guise of an objective poll. In comparison, the actions of ABC “News” vastly eclipse any previous sellout of the public trust by the press. Not content to merely parrot the Obama/Democrat party line, on Wednesday June 24, ABC News conducted a government “healthcare” infomercial from inside the White House. Comically denying any partiality, this broadcast was clearly crafted to advance Obama’s socialist cause, denying any opposing viewpoint from being presented, even during paid commercials.
In a sad post-mortem on the demise of the American Republic, CBS News/New York Times, along with ABC News, would not be memorialized as principled martyrs who lost a valiant fight to keep spreading truth among the people of the country. Rather, descending to the point of becoming ideological brothels from which any “informational” service can be purchased for the right price, these once great institutions willingly abandoned their rightful purpose, and now publicly strut their wares for the right bidder.
Despite all of this, the path to a takeover of the medical system is far from certain. Obama’s own desperation, revealed in such antics as the ABC News publicity stunt, stand as evidence that huge obstacles remain before Americans will consign their physical well being to the insipient madness of liberal bureaucracies. In response, Obama has been driven to mimic the tactics of those Iranian Ayatollahs who feel their grip on power slipping away. While insisting that the plan is a “done deal,” he demeans any who oppose it as “not logical.” In doing so, he demeans himself and the office he holds.
Next week, this country will be celebrating the two hundred and thirty third anniversary of its founding. Those courageous individuals who crafted and signed the Declaration of Independence birthed a nation on principles so wise and noble that it has since risen to the pinnacle of civilization. But if such ideals are abandoned, it cannot exist forever on the mere momentum of its glorious founding.
It seems wholly unlikely that Americans may ever face the prospect of blood running in the streets of their cities. But the specter of a government run healthcare system, and the sinister manner in which it is being advanced, represent a dangerous departure from the nation’s former greatness.
SOURCE
Monday, July 06, 2009
A deadly organ-donor system
by Jeff Jacoby
RIGHT ON THE HEELS of the recent news that Apple CEO Steve Jobs underwent a liver transplant came the speculation that he had somehow gamed the organ donation system in order to jump to the head of the waiting list. It was widely noted that Jobs's transplant took place at a hospital in Tennessee, some 2,000 miles from his home in California. That suggests he had registered with more than one regional transplant center. Multiple registrations aren't against the rules but they can be an expensive proposition, since the patient must be able to travel at a moment's notice when the organ becomes available, and since insurance companies generally won't pay for evaluations at more than one hospital. Jobs, a billionaire, may thus have benefited, frets USA Today, from "a loophole that favors the rich."
Had Jobs traveled to Tennessee to consult a highly sought-after medical specialist, or to acquire a piece of cutting-edge medical equipment, or to undergo a rare and difficult brain operation -- or to buy a Smoky Mountains mansion, for that matter -- nobody would be grumbling about loopholes or wondering whether rules had been manipulated. When it comes to doctors' services or medical technology or surgical procedures -- or real estate -- people understand that suppliers generally charge what the market will bear.
The same economic system that generally makes good health care available to all does price certain products and services high enough that only the wealthy can afford them. It isn't news that the world's finest surgeon commands a high fee, or that the latest "miracle" drugs tend to be expensive, or that billionaires can afford things that mere mortals can't.
Yet when it comes to the donation of human organs, countless people believe that the market must be prevented from functioning.
Under current law, an organ may be transplanted to save a patient's life only if it was donated for free. Federal law makes it "unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation." The surgeon who performed Jobs's liver transplant, the hepatologist who diagnosed him, the anesthesiologist who managed his pain, the nurse who assisted during the procedure, the medical center that provided the facilities, the pharmacy that supplied his medications, even the driver who brought him to the hospital -- all of them were paid for the benefits they rendered. Only the organ donor (or the donor's family, if the liver came from a cadaver) could receive nothing except the satisfaction that comes from performing an act of kindness.
That, many say, is as it should be: Organs should be donated out of goodness alone; otherwise the rich might exploit the poor. Others flatly oppose any hint of commerce in human organs. Opening the door to "financial incentives," declared the Institute of Medicine in 2006, could "lead people to view organs as commodities and diminish donations from altruistic motives."
Unfortunately, altruistic motives aren't enough. I carry an organ donor card and think everyone should, but only 38 percent of licensed drivers have designated themselves as organ donors. Thousands of organs that could be used to save lives and restore health are lost each year, buried or cremated with bodies that will never need them again.
No one would dream of suggesting that medical care is too vital or sacred to be treated as a commodity, or to be bought and sold like any other service. If the law prohibited any "valuable consideration" for healing the sick, and allowed doctors to practice medicine only if they did so for free, the result would be far fewer doctors and far more sickness and death.
The result of our misguided altruism-only organ donation system is much the same: too few organs and too much death. More than 100,000 Americans are currently on the national organ waiting list. Last year, 28,000 transplants were performed, but 49,000 new patients were added to the queue. As the list grows longer, the wait grows deadlier, and the shortage of available organs grows more acute. Last year, 6,600 people died while awaiting the kidney or liver or heart that could have kept them alive. Another 18 people will die today. And another 18 tomorrow. And another 18 every day, until Congress fixes the law that causes so many valuable organs to be wasted, and so many lives to be needlessly lost.
SOURCE
Lack of NHS cash puts British bottom of league for fertility treatment
Couples in the UK have less chance of IVF treatment than those in Montenegro
Poor NHS funding of IVF means that infertile British couples are among the least likely in Europe to receive the treatment they need to start a family, new official figures have shown. The latest European league table of access to fertility treatment has placed Britain 11th of 13 countries providing data for 2006, with only Germany and Montenegro providing fewer cycles of IVF in proportion to their population.
Infertile couples in Denmark and Belgium, which finish first and second in the table, are more than three times more likely to have IVF than those living in Britain, the new figures collected by the European Society of Human Reproduction and Embryology show. While Denmark conducts 2,337 IVF cycles per million inhabitants and Belgium conducts 2,187, Britain conducts just 729.
The UK’s performance reflects a lack of funding for IVF on the NHS. While the National Institute for Health and Clinical Excellence (NICE) recommends that primary care trusts should offer three free cycles of treatment to most infertile couples, only a quarter meet this standard. In 2006 only nine of the 161 trusts in England and Wales offered three free cycles. Many trusts also impose further restrictions, such as refusing to fund treatment when people have children from a previous relationship, and the NHS will only pay when women are under the age of 40. In Denmark and Belgium, up to six cycles of IVF are reimbursed by the state. Other leading performers in the league table, such as Iceland, Finland and Sweden, also offer more generous funding than the UK.
Clare Lewis-Jones, chief executive of the patient group Infertility Network UK, said: “We are angry that although the UK pioneered infertility treatment, we are still among the lowest providers in Europe, and these figures show that availability in the UK is less than one third of that in Denmark. “To be so far behind other countries in Europe in the provision of fertility treatment is totally intolerable. “Although there has been an improvement recently in the provision of treatment by some PCTs, there still remains considerable variation in the criteria used to determine whether or not couples can access treatment.”
Anders Nyboe Andersen, of Copenhagen University Hospital in Denmark, who led the research and presented it today at the ESHRE conference in Amsterdam, said that while funding was a major explanation for different countries’ performance, it was not the only one.
More here
Top doctor in Western Australia claims that colleagues operated 'without proper qualifications'
And another bullying Health Dept. that tries to get back at whistleblowers
A top surgeon at WA's biggest [government] hospital claims two doctors were conducting critical surgery without proper qualifications, The Sunday Times has discovered. Cardiothoracic surgeon John Manuel Alvarez has lodged an internal complaint in which he claims last year he warned bosses at Sir Charles Gairdner Hospital that he feared two of his peers were underqualified for the major surgery they were performing. The Sunday Times understands that some of the concerns related to whether or not the two doctors had passed specialist examinations. Both doctors are no longer at the hospital. One has left WA.
Dr Alvarez himself is being investigated by the Health Department over misconduct allegations. The Health Department started investigating him in July last year after he raised doubts about the ability of the two doctors. The Sunday Times understands that Dr Alvarez believes the inquiry is a witch hunt and was not properly conducted.
Dr Alvarez filed a writ last week seeking to restrain the Health Department from continuing with an investigation and publishing or acting on its findings of misconduct against him. He also wants to stop any future investigation of him by the department. Dr Alvarez named WA Health Minister Kim Hames as the first defendant and Kenneth John Trainer as the second defendant in the action which was filed last Friday. Mr Trainer was the independent investigator hired by the Health Department. Dr Alvarez wants damages for breach of contract with the writ alleging the investigation breached his employment contract dated July 28, 2005.
A SCGH spokeswoman confirmed that Dr Alvarez had made complaints about the quality of some of his peers who were conducting critical surgery last year. She said the hospital was unable to comment specifically on the investigation into Dr Alvarez as the matter was before the courts.
SOURCE
Healthcare Reform: Will Obama Let You Into His Lifeboat?
Tough luck for the elderly, smokers, big alcohol drinkers and people who don't exercise. If you are any of those, think carefully about your vote next year
The term “lifeboat ethics” is used to describe ethical issues that arise in situations involving the allocation of limited resources. It originally came out of a landmark 1974 article by philosopher Garrett Harden in connection with ethical questions surrounding the issue of providing food aid to underdeveloped nations. He pictured wealthier nations as being like so many lifeboats---all with limited capacity, of course---afloat in a sea surrounded by many swimmers who need saving: the residents of poorer nations. His discussion there concerned the ethical guidelines that ought to govern who, if anyone, should be picked up and saved by those in the lifeboats.
The picture of the lifeboat is, quite obviously, an analogy. And from a logician’s perspective, an analogy is a tool used in a particular type of argument. If I am using an analogy to convince you of something, then I am arguing that two things, A and B, are alike in certain important respects, hence they should be seen as being alike in at least one more relevant respect: that which represents the conclusion of my argument. As a logical tool, an analogy works where it works. Its applicability is not necessarily tied down to only one situation or ethical position.
The lifeboat analogy has surfaced in several ways in the Health Care community and is relevant to the current debate over Health Care Reform. Here we are also dealing with the allocation of limited resources.
Perhaps the most legitimate use of this analogy in health care situations concerns triage decisions in disasters, both natural and man-made [what used to be called “Terrorist Incidents”]: “During overwhelming disasters, health systems must be considered lifeboats with insufficient capacity to minister to all, and thus decisions regarding who is best served by the lifeboat must be made.”
These “high-consequence event” situations have something in common with the original analogy that is so obvious it may easily be overlooked. The lifeboats and the individual swimmers are in the water because a disaster has just occurred; a ship has slipped beneath the waves. Sometimes I think that using lifeboat ethics type cases as if they should furnish us with generally applicable moral guidelines is a little like bringing up the experience of the Donner Party to introduce a discussion about whether cannibalism should be seen to be more acceptable morally than is generally recognized.
Lifeboat ethics cases do not provide us with examples for general moral guidance but instead present situations that are so extreme that they force us to raise questions about whether, in them, some generally accepted moral guidelines and ordinary standards of professional ethics may justifiably be suspended. Indeed, the Homeland Security study mentioned above recognizes this:
The translation of the above is that under the extreme circumstances it finds itself in, the staff will just have to do the best it can with what resources it has and cannot morally or reasonable be expected to do much more.
But not everyone agrees with my view that Lifeboat Ethics cases are best used to discuss exceptions to general moral guidelines rather than to set the guidelines themselves. And since Obama has insisted on many occasions in the past, especially when running in the primaries against Hillary Clinton, that it is his health care plan we are considering when we discuss the plan soon to be presented to Congress, it is I think reasonable to now ask relative to some important situations, whether Obama would let you into his lifeboat.
Situation One: Are you over 70 years old? If so, then you have real reason to worry about whether he will let you in. Developers of his plan understand that the bulk of the nation’s health care resources are used by senior citizens and they are looking for ways to ration care to the elderly.
In our last article we looked at an argument they favor which would ration care to the elderly and terminally ill based on a Cost-Benefit Analysis. Another plan now being seriously considered here and in Great Britain is to set an arbitrary age cap on receiving health benefits. This hearkens back to an idea originally espoused as far back as 1987 by Daniel Callahan, that humans have an average expected life span (figures of 70 yrs. to 85 yrs. have been mentioned in discussions of this point) and persons who have lived up to this age have no right to expect that we extend them medical care beyond it.
In other words, we are not here talking about a situation where, for example, if two patients, a 75 year old and a 25 year old were competing for the same donated liver, then the relative age of the patients would be one factor health care workers could take into account when making the decision as to who gets the organ. This proposed policy would instead use age alone as the sole criterion for denial of care. And it would not be health care workers but government who would exclude the 75 year old by setting a standard which would deny him/her from receiving health benefits on the basis of age alone!
A point made in these discussions is that such a person has put in enough innings in the game of life and its time to pull them out of the game and put another younger person in, whether they want to come out or not. They will thus not be brought on board the lifeboat of health care.
Situation Two: Are you ill as the result of a lifestyle choice? For example, have you been a heavy smoker or drinker and now things have caught up with you? You should have serious worries about whether Obama will let you into his lifeboat, even if you are not now at an advanced age. Hershel Elliot, an ardent supporter of Harden’s work, succinctly summarized its relevance to healthcare rationing by lifestyle in a 2003 article when he said, “You are unlikely to learn to take care of your health, if you are free to abuse your body by overeating, lack of exercise, and dangerous behavior while society must pay the costs of restoring your health. When individuals are free to damage their own health and society has to pay the costs of curing them, medical costs can spiral out of control.”
Of course, his conclusion is that since these individuals’ health situations came about as a result of their own behavior arising from their lifestyle choices, then society has no moral responsibility to bring them aboard the lifeboat of healthcare and is justified in leaving them alone in the water to suffer the consequences of their choices. Not only will care be rationed on the basis of lifestyle choices in the proposed Obama plan, but government bureaucrats will use the threat of denial of care as the basis for meddlesome intervention into people’s private lifestyle choices. If the government is picking up the bill, either in whole or in part, then these choices are not private anymore!
Curiously, the one application of Garrett Harden’s Lifeboat analogy that his followers judiciously choose to leave out when they apply his views to healthcare, but which might be the most relevant, is the one he himself made in his original article in connection with our moral obligation to supply food aid to poor nations. And that point, which is just as applicable to healthcare, is that Marxist-inspired, redistributionist ethics won’t work. If we apply the Marxist principle of “to each according to his needs” and bring 100 additional needy swimmers out of the water into a nearly full lifeboat that only holds 60, then the lifeboat sinks and everyone loses out.
And sadly, this could be the impact of the Obama, socialist-inspired, universal healthcare plan: it will either sink the US healthcare system lifeboat or drain the economy that keeps it afloat.
SOURCE
by Jeff Jacoby
RIGHT ON THE HEELS of the recent news that Apple CEO Steve Jobs underwent a liver transplant came the speculation that he had somehow gamed the organ donation system in order to jump to the head of the waiting list. It was widely noted that Jobs's transplant took place at a hospital in Tennessee, some 2,000 miles from his home in California. That suggests he had registered with more than one regional transplant center. Multiple registrations aren't against the rules but they can be an expensive proposition, since the patient must be able to travel at a moment's notice when the organ becomes available, and since insurance companies generally won't pay for evaluations at more than one hospital. Jobs, a billionaire, may thus have benefited, frets USA Today, from "a loophole that favors the rich."
Had Jobs traveled to Tennessee to consult a highly sought-after medical specialist, or to acquire a piece of cutting-edge medical equipment, or to undergo a rare and difficult brain operation -- or to buy a Smoky Mountains mansion, for that matter -- nobody would be grumbling about loopholes or wondering whether rules had been manipulated. When it comes to doctors' services or medical technology or surgical procedures -- or real estate -- people understand that suppliers generally charge what the market will bear.
The same economic system that generally makes good health care available to all does price certain products and services high enough that only the wealthy can afford them. It isn't news that the world's finest surgeon commands a high fee, or that the latest "miracle" drugs tend to be expensive, or that billionaires can afford things that mere mortals can't.
Yet when it comes to the donation of human organs, countless people believe that the market must be prevented from functioning.
Under current law, an organ may be transplanted to save a patient's life only if it was donated for free. Federal law makes it "unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation." The surgeon who performed Jobs's liver transplant, the hepatologist who diagnosed him, the anesthesiologist who managed his pain, the nurse who assisted during the procedure, the medical center that provided the facilities, the pharmacy that supplied his medications, even the driver who brought him to the hospital -- all of them were paid for the benefits they rendered. Only the organ donor (or the donor's family, if the liver came from a cadaver) could receive nothing except the satisfaction that comes from performing an act of kindness.
That, many say, is as it should be: Organs should be donated out of goodness alone; otherwise the rich might exploit the poor. Others flatly oppose any hint of commerce in human organs. Opening the door to "financial incentives," declared the Institute of Medicine in 2006, could "lead people to view organs as commodities and diminish donations from altruistic motives."
Unfortunately, altruistic motives aren't enough. I carry an organ donor card and think everyone should, but only 38 percent of licensed drivers have designated themselves as organ donors. Thousands of organs that could be used to save lives and restore health are lost each year, buried or cremated with bodies that will never need them again.
No one would dream of suggesting that medical care is too vital or sacred to be treated as a commodity, or to be bought and sold like any other service. If the law prohibited any "valuable consideration" for healing the sick, and allowed doctors to practice medicine only if they did so for free, the result would be far fewer doctors and far more sickness and death.
The result of our misguided altruism-only organ donation system is much the same: too few organs and too much death. More than 100,000 Americans are currently on the national organ waiting list. Last year, 28,000 transplants were performed, but 49,000 new patients were added to the queue. As the list grows longer, the wait grows deadlier, and the shortage of available organs grows more acute. Last year, 6,600 people died while awaiting the kidney or liver or heart that could have kept them alive. Another 18 people will die today. And another 18 tomorrow. And another 18 every day, until Congress fixes the law that causes so many valuable organs to be wasted, and so many lives to be needlessly lost.
SOURCE
Lack of NHS cash puts British bottom of league for fertility treatment
Couples in the UK have less chance of IVF treatment than those in Montenegro
Poor NHS funding of IVF means that infertile British couples are among the least likely in Europe to receive the treatment they need to start a family, new official figures have shown. The latest European league table of access to fertility treatment has placed Britain 11th of 13 countries providing data for 2006, with only Germany and Montenegro providing fewer cycles of IVF in proportion to their population.
Infertile couples in Denmark and Belgium, which finish first and second in the table, are more than three times more likely to have IVF than those living in Britain, the new figures collected by the European Society of Human Reproduction and Embryology show. While Denmark conducts 2,337 IVF cycles per million inhabitants and Belgium conducts 2,187, Britain conducts just 729.
The UK’s performance reflects a lack of funding for IVF on the NHS. While the National Institute for Health and Clinical Excellence (NICE) recommends that primary care trusts should offer three free cycles of treatment to most infertile couples, only a quarter meet this standard. In 2006 only nine of the 161 trusts in England and Wales offered three free cycles. Many trusts also impose further restrictions, such as refusing to fund treatment when people have children from a previous relationship, and the NHS will only pay when women are under the age of 40. In Denmark and Belgium, up to six cycles of IVF are reimbursed by the state. Other leading performers in the league table, such as Iceland, Finland and Sweden, also offer more generous funding than the UK.
Clare Lewis-Jones, chief executive of the patient group Infertility Network UK, said: “We are angry that although the UK pioneered infertility treatment, we are still among the lowest providers in Europe, and these figures show that availability in the UK is less than one third of that in Denmark. “To be so far behind other countries in Europe in the provision of fertility treatment is totally intolerable. “Although there has been an improvement recently in the provision of treatment by some PCTs, there still remains considerable variation in the criteria used to determine whether or not couples can access treatment.”
Anders Nyboe Andersen, of Copenhagen University Hospital in Denmark, who led the research and presented it today at the ESHRE conference in Amsterdam, said that while funding was a major explanation for different countries’ performance, it was not the only one.
More here
Top doctor in Western Australia claims that colleagues operated 'without proper qualifications'
And another bullying Health Dept. that tries to get back at whistleblowers
A top surgeon at WA's biggest [government] hospital claims two doctors were conducting critical surgery without proper qualifications, The Sunday Times has discovered. Cardiothoracic surgeon John Manuel Alvarez has lodged an internal complaint in which he claims last year he warned bosses at Sir Charles Gairdner Hospital that he feared two of his peers were underqualified for the major surgery they were performing. The Sunday Times understands that some of the concerns related to whether or not the two doctors had passed specialist examinations. Both doctors are no longer at the hospital. One has left WA.
Dr Alvarez himself is being investigated by the Health Department over misconduct allegations. The Health Department started investigating him in July last year after he raised doubts about the ability of the two doctors. The Sunday Times understands that Dr Alvarez believes the inquiry is a witch hunt and was not properly conducted.
Dr Alvarez filed a writ last week seeking to restrain the Health Department from continuing with an investigation and publishing or acting on its findings of misconduct against him. He also wants to stop any future investigation of him by the department. Dr Alvarez named WA Health Minister Kim Hames as the first defendant and Kenneth John Trainer as the second defendant in the action which was filed last Friday. Mr Trainer was the independent investigator hired by the Health Department. Dr Alvarez wants damages for breach of contract with the writ alleging the investigation breached his employment contract dated July 28, 2005.
A SCGH spokeswoman confirmed that Dr Alvarez had made complaints about the quality of some of his peers who were conducting critical surgery last year. She said the hospital was unable to comment specifically on the investigation into Dr Alvarez as the matter was before the courts.
SOURCE
Healthcare Reform: Will Obama Let You Into His Lifeboat?
Tough luck for the elderly, smokers, big alcohol drinkers and people who don't exercise. If you are any of those, think carefully about your vote next year
The term “lifeboat ethics” is used to describe ethical issues that arise in situations involving the allocation of limited resources. It originally came out of a landmark 1974 article by philosopher Garrett Harden in connection with ethical questions surrounding the issue of providing food aid to underdeveloped nations. He pictured wealthier nations as being like so many lifeboats---all with limited capacity, of course---afloat in a sea surrounded by many swimmers who need saving: the residents of poorer nations. His discussion there concerned the ethical guidelines that ought to govern who, if anyone, should be picked up and saved by those in the lifeboats.
The picture of the lifeboat is, quite obviously, an analogy. And from a logician’s perspective, an analogy is a tool used in a particular type of argument. If I am using an analogy to convince you of something, then I am arguing that two things, A and B, are alike in certain important respects, hence they should be seen as being alike in at least one more relevant respect: that which represents the conclusion of my argument. As a logical tool, an analogy works where it works. Its applicability is not necessarily tied down to only one situation or ethical position.
The lifeboat analogy has surfaced in several ways in the Health Care community and is relevant to the current debate over Health Care Reform. Here we are also dealing with the allocation of limited resources.
Perhaps the most legitimate use of this analogy in health care situations concerns triage decisions in disasters, both natural and man-made [what used to be called “Terrorist Incidents”]: “During overwhelming disasters, health systems must be considered lifeboats with insufficient capacity to minister to all, and thus decisions regarding who is best served by the lifeboat must be made.”
These “high-consequence event” situations have something in common with the original analogy that is so obvious it may easily be overlooked. The lifeboats and the individual swimmers are in the water because a disaster has just occurred; a ship has slipped beneath the waves. Sometimes I think that using lifeboat ethics type cases as if they should furnish us with generally applicable moral guidelines is a little like bringing up the experience of the Donner Party to introduce a discussion about whether cannibalism should be seen to be more acceptable morally than is generally recognized.
Lifeboat ethics cases do not provide us with examples for general moral guidance but instead present situations that are so extreme that they force us to raise questions about whether, in them, some generally accepted moral guidelines and ordinary standards of professional ethics may justifiably be suspended. Indeed, the Homeland Security study mentioned above recognizes this:
“The threshold for what constitutes life-sustaining care could also be lowered if staff degradation and or physical plant damage prevent the delivery of advanced acute and critical care therapies. Depending on the scope, magnitude, and duration of the disaster, sufficiency of care could mean little more than providing intravenous fluids or ventilator-assisted breathing.”
The translation of the above is that under the extreme circumstances it finds itself in, the staff will just have to do the best it can with what resources it has and cannot morally or reasonable be expected to do much more.
But not everyone agrees with my view that Lifeboat Ethics cases are best used to discuss exceptions to general moral guidelines rather than to set the guidelines themselves. And since Obama has insisted on many occasions in the past, especially when running in the primaries against Hillary Clinton, that it is his health care plan we are considering when we discuss the plan soon to be presented to Congress, it is I think reasonable to now ask relative to some important situations, whether Obama would let you into his lifeboat.
Situation One: Are you over 70 years old? If so, then you have real reason to worry about whether he will let you in. Developers of his plan understand that the bulk of the nation’s health care resources are used by senior citizens and they are looking for ways to ration care to the elderly.
In our last article we looked at an argument they favor which would ration care to the elderly and terminally ill based on a Cost-Benefit Analysis. Another plan now being seriously considered here and in Great Britain is to set an arbitrary age cap on receiving health benefits. This hearkens back to an idea originally espoused as far back as 1987 by Daniel Callahan, that humans have an average expected life span (figures of 70 yrs. to 85 yrs. have been mentioned in discussions of this point) and persons who have lived up to this age have no right to expect that we extend them medical care beyond it.
In other words, we are not here talking about a situation where, for example, if two patients, a 75 year old and a 25 year old were competing for the same donated liver, then the relative age of the patients would be one factor health care workers could take into account when making the decision as to who gets the organ. This proposed policy would instead use age alone as the sole criterion for denial of care. And it would not be health care workers but government who would exclude the 75 year old by setting a standard which would deny him/her from receiving health benefits on the basis of age alone!
A point made in these discussions is that such a person has put in enough innings in the game of life and its time to pull them out of the game and put another younger person in, whether they want to come out or not. They will thus not be brought on board the lifeboat of health care.
Situation Two: Are you ill as the result of a lifestyle choice? For example, have you been a heavy smoker or drinker and now things have caught up with you? You should have serious worries about whether Obama will let you into his lifeboat, even if you are not now at an advanced age. Hershel Elliot, an ardent supporter of Harden’s work, succinctly summarized its relevance to healthcare rationing by lifestyle in a 2003 article when he said, “You are unlikely to learn to take care of your health, if you are free to abuse your body by overeating, lack of exercise, and dangerous behavior while society must pay the costs of restoring your health. When individuals are free to damage their own health and society has to pay the costs of curing them, medical costs can spiral out of control.”
Of course, his conclusion is that since these individuals’ health situations came about as a result of their own behavior arising from their lifestyle choices, then society has no moral responsibility to bring them aboard the lifeboat of healthcare and is justified in leaving them alone in the water to suffer the consequences of their choices. Not only will care be rationed on the basis of lifestyle choices in the proposed Obama plan, but government bureaucrats will use the threat of denial of care as the basis for meddlesome intervention into people’s private lifestyle choices. If the government is picking up the bill, either in whole or in part, then these choices are not private anymore!
Curiously, the one application of Garrett Harden’s Lifeboat analogy that his followers judiciously choose to leave out when they apply his views to healthcare, but which might be the most relevant, is the one he himself made in his original article in connection with our moral obligation to supply food aid to poor nations. And that point, which is just as applicable to healthcare, is that Marxist-inspired, redistributionist ethics won’t work. If we apply the Marxist principle of “to each according to his needs” and bring 100 additional needy swimmers out of the water into a nearly full lifeboat that only holds 60, then the lifeboat sinks and everyone loses out.
And sadly, this could be the impact of the Obama, socialist-inspired, universal healthcare plan: it will either sink the US healthcare system lifeboat or drain the economy that keeps it afloat.
SOURCE
Sunday, July 05, 2009
British doctors punished over appointment times by patient survey
This is British bureaucracy at its most moronic. Doctors will just reduce the number of patients they see if this goes through. Britons will end up having as much trouble finding a doctor as they already do in finding a dentist. In Britain, an NHS doctor has a "list" and you have to be on his list to be treated by him. If this goes through, doctors will close their lists and, as the elderly who take most of a doctor's time drop off the list through death, he will soon have a smaller list and be able to see all of them promptly. Nobody wants to work for nothing, which is what the new system imposes. Socialist bureaucracy will be as destructive as usual.
People with no doctor will then flood hospital emergency rooms and then what will become of the bureaucratic "targets" there? Will 4 hour waits transmogrify into 4 day waits? Bureaucracy will have made the problem worse instead of better -- as usual. Another possibility is that doctors will spend less time with each patient, thus causing things to be missed and allowing problems to develop -- with the patient ending up severely ill in hospital when that could have been avoided. Once again the strain on the already overburdened hospitals will be increased
Family doctors will lose millions of pounds in funding because of complaints from patients over the waiting times for appointments. Most general practices around the country are expected to suffer losses — some as much as £25,000 — when the results of a survey are released today.
The GP Patient Survey, the first to financially penalise doctors who receive negative responses, is expected to cost practitioners more than £10 million and in the worst cases could force cutbacks such as staff redundancies.
The estimated cost to surgeries in Birmingham has been calculated at more than £1 million, while those in Northern Ireland and Wales are likely to lose similar sums. In Greater Manchester, about half of GP practices have been told they will lose up to £10,000.
The system, designed to encourage a better service from GPs, has been widely criticised for punishing some practices that need more help. Doctors have also raised concerns about being judged on a small number of responses and queried why just two of the survey’s 49 questions — concerning access to a GP in 48 hours and more advanced appointments — carried all the financial penalties.
In Scotland, where patient responses were processed last month, some practices serving more than 10,000 patients were hit with five-figure penalties as a result of the responses of only 50 patients.
Laurence Buckman, chairman of the British Medical Association’s GPs’ committee, said that the lengthy survey did not encourage responses, and a few negative patients could skew the perception of a good practice. This was particularly likely in inner-city areas, where high numbers of patients could not be bothered to respond. “Some practices are going to be very badly hit with huge amounts of money on the say-so of very small numbers of patients,” Dr Buckman said. “We know in England that there are going to be similar results as there were in Scotland. “If you reduce money, you are reducing the services, not improving them. Because of the way payment is geared you can only have the money taken away. We will be looking at thousands of practices that will be adversely, and in some cases, unfairly hit.”
Describing the survey’s flawed methodology, Dr Buckman said that most questions were angled negatively to seek out underperformers while none covered simple issues such as “how good is your doctor?” He said that the process “was so long that most people would just get worn out and give up”.
Practices that receive less than 60 per cent of positive responses to the two key questions would sacrifice all the money available as part of the Quality and Outcomes Framework, which pays doctors for achieving service targets. The BMA predicted an average-sized practice could face losses of £7,500, while larger lists could lose more than £10,000. Hundreds of practices are expected to appeal.
In Glasgow, 170 of 270 practices will appeal. GPs’ leaders in Scotland said that few practices had escaped losses entirely.
David Stout, the Primary Care Trust network director at the NHS Confederation, said that money taken from GP budgets would be reinvested by trusts in other services. He said that PCTs had discretionary powers to reduce the penalties if they felt that a practice had been treated unfairly.
“If it’s over-zealous then [the Government] will want to look at that in the cold light of day and if it needs to be re-examined it will.”
A Department of Health spokesman denied that the survey was flawed, adding that it had been agreed by stakeholders and would be an accurate reflection of patient perceptions.
SOURCE
Alice in Healthcareland
Most political and media discussions of medical care have an air of unreality reminiscent of Alice in Wonderland. There is an abundance of catch-phrases but remarkably few coherent arguments. Let's start at square one. Why is there alarm about American medical care? The most usual reason given is because its cost is high and rising.
That is certainly true. We were not spending nearly as much on high-tech medical procedures in the past because there were not nearly as many of them, and we were not spending anything at all on some of the new pharmaceutical drugs because they didn't exist. This general pattern is not peculiar to medical care. Cars didn't cost nearly as much in the past, when they didn't have air-conditioning, power steering and high-tech safety features. Homes were cheaper when they were smaller, had fewer bathrooms and lacked such conveniences as built-in microwave ovens.
We would like to have all these things without the rising costs that come with them. But only with medical care is such wishful thinking taken seriously, with government regarded as a sort of fairy godmother who will give us the benefits without the costs.
A cynic is said to be someone who knows the price of everything and the value of nothing. If so, then it is political cynicism to point to other countries that spend less on medical care, including some countries where there is "universal health care" provided "free" by their governments. Just as medical care, houses and cars were all cheaper when they lacked things that they have today, so medical care in other countries is cheaper when they lack many things that are more readily available in the United States.
There are more than four times as many Magnetic Resonance Imaging units (MRIs) per capita in the United States as in Britain or Canada, where there are government-run medical systems. There are more than twice as many CT scanners per capita in the United States as in Canada and more than four times as many per capita as in Britain. Is it surprising that such things cost money?
The cost of developing a new pharmaceutical drug is now about a billion dollars. Neither political rhetoric nor government bureaucracies will make those costs go away.
We can, of course, refuse to pay these and other medical costs, just as we can refuse to buy air-conditioned homes with built-in microwave ovens. But that just means we pay attention only to prices and not to the value of what we get for those prices. We can even refuse to pay for so many doctors. But that just means that we will have to wait longer to see a doctor— as people do in countries with government-run medical systems.
In Canada, 27 percent of the people who have surgery wait four months or more. In Britain, 38 percent wait that long. But only 5 percent of Americans wait that long for surgery. Surgery may well cost less in countries with government-run medical systems— if you count only the money cost, and not the time the patients have to endure the ailments that require surgery, or the fact that some conditions become worse, or even fatal, while waiting.
A recent report from the Fraser Institute in Canada shows that patients there wait an average of ten weeks to get an MRI, just to find out what is wrong with them. A lot of bad things can happen in 10 weeks, ranging from suffering to death.
Politicians may talk about "bringing down the cost of medical care," but they seldom even attempt to bring down the costs. What they bring down is the price— which is to say, they refuse to pay the costs. Anybody can refuse to pay any cost. But don't be surprised if you get less when you pay less. None of this is rocket science. But it does require us to stop and think before jumping on a bandwagon.
The great haste with which the latest government expansion into medical care is being rushed through Congress suggests that the politicians don't want us to stop and think. That makes sense, from their point of view, but not from ours.
SOURCE
Public medicine looks a lot like public school
With our son approaching school age, my wife and I are considering a variety of options: charter, private, homeschooling. Just about the only option not on the list, even though we're forced to pay for it anyway, are public schools. We're not only unimpressed with the results achieved by local public schools, but we also don't like their one-size-fits-all structure. As things stand, we're concerned that, a few years from now, we'll face a similar situation with health care, forcing us to pay for coverage that we don't want in addition to care that we actually choose.
That's the big problem with government-sponsored versions of anything. No matter the quality of the ultimate product, everybody has to pay for it, even if it doesn't suit their personal needs and preferences. Just imagine if dining out was a state-provided service. Given popular preferences, at best, we'd end up with reasonably decent steak and burger joints from sea to shining sea -- and that's it. Good luck to vegetarians and fanciers of exotic ethnic foods.
Of course, at worst, you'd be forced to pay for the food quality of a high school cafeteria mixed with the service you've come to love at the Department of Motor Vehicles.
That worst-case scenario came to pass in Canada, where the country's Supreme Court ruled in 2005 that the quality of medical care provided by the state system in Quebec was so terrible that the province's law against private health insurance couldn't be allowed to stand. While the ruling doesn't apply elsewhere, private -- and arguably illegal -- clinics are springing up around the country to provide care to people who'd rather pay for medicine twice than accept the government's prescription.
Private medicine is legal in the United Kingdom, where about 11.5% of Britons (up from 5% in 1980) carry private insurance in addition to the taxes they pay for the National Health Service. Government-provided dentistry is such a shambles that people have fled the system, and dentists now make more from private-pay patients than from the state system.
But if other country's medical systems have troubles, so does the American system. After all, The World Health Organization gave America's health care a miserable 37th-place ranking out of 191 countries, right?
Well ... not so much. Actually, when economist Glen Whitman looked at WHO's rankings, he concluded:
Basically, WHO front-loaded its ratings with criteria that guaranteed high rankings to tax-supported systems, and low rankings to systems where people pay for their own care. Said Whitman, "To use the existing WHO rankings to justify more government involvement in health care--such as via a single-payer health care system--is therefore to engage in circular reasoning because the rankings are designed in a manner that favors greater government involvement."
Plenty of people share WHO's biases -- many Canadians and Europeans are happy with what they get, and lots of Americans say they want the same thing. But plenty of people don't share WHO's biases. If you implement a state-sponsored health care system, everybody gets drafted into the one-size-fits-all scheme, without consideration for their personal preferences.
Actually, "draft" is the right word. Since state-supported schemes are supported by taxes picked from all our pockets, they're basically conscription with limited -- or expensive -- opportunities for conscientious objectors (and sayonara to voluntary alternatives). That's true of public schools, and it may soon be true of health care.
Right now, President Obama and his allies in Congress say they have no plans to displace private medicine, only to create a public plan that would compete with and "discipline" private insurers.
Right. What do you think would happen to Burger King if McDonald's not only ran its own restaurants, but also had the power to charge everybody for Big Macs whether they ate under the golden arches or not, and could regulate all fast-food joints? That's the sort of "discipline" you get from a government plan.
I expect that, in years to come, my wife and I will be looking at our options for escaping not just public education, but also public medicine. And, as it already is for Britons and Canadians, that choice will be expensive and limited by a government that doesn't put a lot of value on personal choice.
SOURCE
Obama healthcare poison pill
In his crusade to bring health care - one-sixth of the country's economy - under government control, President Obama is asking Americans to swallow a huge and potentially poisonous policy pill.
Just as many Canadian politicians and their families have, hypocritically, come to the U.S. when they prefer our advanced, private health care over their own socialized system, President Obama got caught last night in a "do as I say not as I do" moment. In a special broadcast on ABC, the president refused to pledge that he'd limit his own family to the tests and treatments that the general public would have to confine themselves to under his proposed health care "public option" restrictions.
Obama dismisses as "fear tactics" charges that his program amounts to "socialized medicine" similar to Canada, the United Kingdom and Sweden. Yet, ironically, Canada, the United Kingdom and Sweden are all beginning to open their socialized systems to private care due to citizen protests that critical treatments are delayed or denied. The past president of the Canadian Medical Association says that in Canada, "¦a dog can get a hip replaced in under a week but a human may wait two to three years."
None of this deters Obama from his insistence on government-run health care. And while he bases the need for reform on cost savings and universal coverage, the Congressional Budget Office recently estimated that Obamacare would increase the federal deficit by more than $1.6-trillion over ten years even while leaving 30 million people uninsured.
This week, Obama is leading a charge to use Democrats to ram through draft health reform legislation in the Senate, excluding Republican input. Obama's rush to pass health care reform by August 1 is the centerpiece of his plan to do a "community reorganization" of America by putting more of the private sector under government control and tying the middle class to government with the major entitlement of health insurance.
But according to Michael Cannon, writing in National Review, "there aren't enough Americans earning more than $250,000 to finance [Obamacare] reform would mean higher taxes for the middle class, violating another promise Obama made during the presidential campaign." Further, "if Congress used Medicare's payment rates and opened the new program to everyone, it could pull 120 million Americans out of private insurance more than half of the private market" and boost the government rolls by an even larger number. Two-thirds of Americans would depend on government for their health care, compared with just over one-quarter today. That would strike a historic blow against even the possibility of limited government."
The public's worries are growing about Obama's overreach. A new Washington Post-ABC News poll finds that "Most respondents are 'very concerned' that health-care reform would lead to higher costs, lower quality, fewer choices, a bigger deficit, diminished insurance coverage and more government bureaucracy." When those polled find out that government-funded health care could put many private insurers out of business because of an inability to compete with Uncle Sam, support for government control sinks to 37 percent.
Medicare and Medicaid illustrate the potential for Obamacare to bankrupt individual states en route to bankrupting the nation and transforming the country into a welfare continent like Europe. Medicare and Medicaid waste, fraud, mismanagement and runaway costs threaten the financial viability of many states, including California and New York. Just as with Obamacare, Medicare and Medicaid use ostensible cost controls mandated by Big Government. But the result has been that patients, hospitals, doctors, pharmaceutical companies and the government itself game the crazy incentives of the system to overuse and overprescribe medicine while stifling more cost efficiency and innovation in medical care.
Obama is selling his health care plan as a way to reform all that. But what he's not telling you is that the price you'll pay (when you're not paying it in higher taxes) includes rationing: of medical procedures, patient-doctor choices, and access to cutting edge new drug" which will all be restricted by government bureaucrats.
Contrary to Obama (and his echo chamber in the mainstream news media), there are alternative health care plans that can be emulated -- using the private economy. In the June 19 Wall Street Journal, Kimberly Strassel wrote about tens of thousands of Safeway employees enjoying quality, cost-effective health care in a program championed by CEO Steve Burd who "blew up the company's existing health care structure and replaced it with one that embodied market principles -- choice, responsibility, competition and price."
The FOX Forum and others, including the Center for Medicine in the Public Interest, are providing outlets for citizens to debate what kind of health care they prefer.
The antidote of public scrutiny is needed. Otherwise, Obama's health care poison pill could kill the private system that makes American medicine the world's best.
SOURCE
This is British bureaucracy at its most moronic. Doctors will just reduce the number of patients they see if this goes through. Britons will end up having as much trouble finding a doctor as they already do in finding a dentist. In Britain, an NHS doctor has a "list" and you have to be on his list to be treated by him. If this goes through, doctors will close their lists and, as the elderly who take most of a doctor's time drop off the list through death, he will soon have a smaller list and be able to see all of them promptly. Nobody wants to work for nothing, which is what the new system imposes. Socialist bureaucracy will be as destructive as usual.
People with no doctor will then flood hospital emergency rooms and then what will become of the bureaucratic "targets" there? Will 4 hour waits transmogrify into 4 day waits? Bureaucracy will have made the problem worse instead of better -- as usual. Another possibility is that doctors will spend less time with each patient, thus causing things to be missed and allowing problems to develop -- with the patient ending up severely ill in hospital when that could have been avoided. Once again the strain on the already overburdened hospitals will be increased
Family doctors will lose millions of pounds in funding because of complaints from patients over the waiting times for appointments. Most general practices around the country are expected to suffer losses — some as much as £25,000 — when the results of a survey are released today.
The GP Patient Survey, the first to financially penalise doctors who receive negative responses, is expected to cost practitioners more than £10 million and in the worst cases could force cutbacks such as staff redundancies.
The estimated cost to surgeries in Birmingham has been calculated at more than £1 million, while those in Northern Ireland and Wales are likely to lose similar sums. In Greater Manchester, about half of GP practices have been told they will lose up to £10,000.
The system, designed to encourage a better service from GPs, has been widely criticised for punishing some practices that need more help. Doctors have also raised concerns about being judged on a small number of responses and queried why just two of the survey’s 49 questions — concerning access to a GP in 48 hours and more advanced appointments — carried all the financial penalties.
In Scotland, where patient responses were processed last month, some practices serving more than 10,000 patients were hit with five-figure penalties as a result of the responses of only 50 patients.
Laurence Buckman, chairman of the British Medical Association’s GPs’ committee, said that the lengthy survey did not encourage responses, and a few negative patients could skew the perception of a good practice. This was particularly likely in inner-city areas, where high numbers of patients could not be bothered to respond. “Some practices are going to be very badly hit with huge amounts of money on the say-so of very small numbers of patients,” Dr Buckman said. “We know in England that there are going to be similar results as there were in Scotland. “If you reduce money, you are reducing the services, not improving them. Because of the way payment is geared you can only have the money taken away. We will be looking at thousands of practices that will be adversely, and in some cases, unfairly hit.”
Describing the survey’s flawed methodology, Dr Buckman said that most questions were angled negatively to seek out underperformers while none covered simple issues such as “how good is your doctor?” He said that the process “was so long that most people would just get worn out and give up”.
Practices that receive less than 60 per cent of positive responses to the two key questions would sacrifice all the money available as part of the Quality and Outcomes Framework, which pays doctors for achieving service targets. The BMA predicted an average-sized practice could face losses of £7,500, while larger lists could lose more than £10,000. Hundreds of practices are expected to appeal.
In Glasgow, 170 of 270 practices will appeal. GPs’ leaders in Scotland said that few practices had escaped losses entirely.
David Stout, the Primary Care Trust network director at the NHS Confederation, said that money taken from GP budgets would be reinvested by trusts in other services. He said that PCTs had discretionary powers to reduce the penalties if they felt that a practice had been treated unfairly.
“If it’s over-zealous then [the Government] will want to look at that in the cold light of day and if it needs to be re-examined it will.”
A Department of Health spokesman denied that the survey was flawed, adding that it had been agreed by stakeholders and would be an accurate reflection of patient perceptions.
SOURCE
Alice in Healthcareland
Most political and media discussions of medical care have an air of unreality reminiscent of Alice in Wonderland. There is an abundance of catch-phrases but remarkably few coherent arguments. Let's start at square one. Why is there alarm about American medical care? The most usual reason given is because its cost is high and rising.
That is certainly true. We were not spending nearly as much on high-tech medical procedures in the past because there were not nearly as many of them, and we were not spending anything at all on some of the new pharmaceutical drugs because they didn't exist. This general pattern is not peculiar to medical care. Cars didn't cost nearly as much in the past, when they didn't have air-conditioning, power steering and high-tech safety features. Homes were cheaper when they were smaller, had fewer bathrooms and lacked such conveniences as built-in microwave ovens.
We would like to have all these things without the rising costs that come with them. But only with medical care is such wishful thinking taken seriously, with government regarded as a sort of fairy godmother who will give us the benefits without the costs.
A cynic is said to be someone who knows the price of everything and the value of nothing. If so, then it is political cynicism to point to other countries that spend less on medical care, including some countries where there is "universal health care" provided "free" by their governments. Just as medical care, houses and cars were all cheaper when they lacked things that they have today, so medical care in other countries is cheaper when they lack many things that are more readily available in the United States.
There are more than four times as many Magnetic Resonance Imaging units (MRIs) per capita in the United States as in Britain or Canada, where there are government-run medical systems. There are more than twice as many CT scanners per capita in the United States as in Canada and more than four times as many per capita as in Britain. Is it surprising that such things cost money?
The cost of developing a new pharmaceutical drug is now about a billion dollars. Neither political rhetoric nor government bureaucracies will make those costs go away.
We can, of course, refuse to pay these and other medical costs, just as we can refuse to buy air-conditioned homes with built-in microwave ovens. But that just means we pay attention only to prices and not to the value of what we get for those prices. We can even refuse to pay for so many doctors. But that just means that we will have to wait longer to see a doctor— as people do in countries with government-run medical systems.
In Canada, 27 percent of the people who have surgery wait four months or more. In Britain, 38 percent wait that long. But only 5 percent of Americans wait that long for surgery. Surgery may well cost less in countries with government-run medical systems— if you count only the money cost, and not the time the patients have to endure the ailments that require surgery, or the fact that some conditions become worse, or even fatal, while waiting.
A recent report from the Fraser Institute in Canada shows that patients there wait an average of ten weeks to get an MRI, just to find out what is wrong with them. A lot of bad things can happen in 10 weeks, ranging from suffering to death.
Politicians may talk about "bringing down the cost of medical care," but they seldom even attempt to bring down the costs. What they bring down is the price— which is to say, they refuse to pay the costs. Anybody can refuse to pay any cost. But don't be surprised if you get less when you pay less. None of this is rocket science. But it does require us to stop and think before jumping on a bandwagon.
The great haste with which the latest government expansion into medical care is being rushed through Congress suggests that the politicians don't want us to stop and think. That makes sense, from their point of view, but not from ours.
SOURCE
Public medicine looks a lot like public school
With our son approaching school age, my wife and I are considering a variety of options: charter, private, homeschooling. Just about the only option not on the list, even though we're forced to pay for it anyway, are public schools. We're not only unimpressed with the results achieved by local public schools, but we also don't like their one-size-fits-all structure. As things stand, we're concerned that, a few years from now, we'll face a similar situation with health care, forcing us to pay for coverage that we don't want in addition to care that we actually choose.
That's the big problem with government-sponsored versions of anything. No matter the quality of the ultimate product, everybody has to pay for it, even if it doesn't suit their personal needs and preferences. Just imagine if dining out was a state-provided service. Given popular preferences, at best, we'd end up with reasonably decent steak and burger joints from sea to shining sea -- and that's it. Good luck to vegetarians and fanciers of exotic ethnic foods.
Of course, at worst, you'd be forced to pay for the food quality of a high school cafeteria mixed with the service you've come to love at the Department of Motor Vehicles.
That worst-case scenario came to pass in Canada, where the country's Supreme Court ruled in 2005 that the quality of medical care provided by the state system in Quebec was so terrible that the province's law against private health insurance couldn't be allowed to stand. While the ruling doesn't apply elsewhere, private -- and arguably illegal -- clinics are springing up around the country to provide care to people who'd rather pay for medicine twice than accept the government's prescription.
Private medicine is legal in the United Kingdom, where about 11.5% of Britons (up from 5% in 1980) carry private insurance in addition to the taxes they pay for the National Health Service. Government-provided dentistry is such a shambles that people have fled the system, and dentists now make more from private-pay patients than from the state system.
But if other country's medical systems have troubles, so does the American system. After all, The World Health Organization gave America's health care a miserable 37th-place ranking out of 191 countries, right?
Well ... not so much. Actually, when economist Glen Whitman looked at WHO's rankings, he concluded:
The WHO rankings depend crucially on a number of underlying assumptions—some of them logically incoherent, some characterized by substantial uncertainty, and some rooted in ideological beliefs and values that not everyone shares.
The analysts behind the WHO rankings express the hope that their framework "will lay the basis for a shift from ideological discourse on health policy to a more empirical one." Yet the WHO rankings themselves have a strong ideological component. They include factors that are arguably unrelated to actual health performance, some of which could even improve in response to worse health performance.
Basically, WHO front-loaded its ratings with criteria that guaranteed high rankings to tax-supported systems, and low rankings to systems where people pay for their own care. Said Whitman, "To use the existing WHO rankings to justify more government involvement in health care--such as via a single-payer health care system--is therefore to engage in circular reasoning because the rankings are designed in a manner that favors greater government involvement."
Plenty of people share WHO's biases -- many Canadians and Europeans are happy with what they get, and lots of Americans say they want the same thing. But plenty of people don't share WHO's biases. If you implement a state-sponsored health care system, everybody gets drafted into the one-size-fits-all scheme, without consideration for their personal preferences.
Actually, "draft" is the right word. Since state-supported schemes are supported by taxes picked from all our pockets, they're basically conscription with limited -- or expensive -- opportunities for conscientious objectors (and sayonara to voluntary alternatives). That's true of public schools, and it may soon be true of health care.
Right now, President Obama and his allies in Congress say they have no plans to displace private medicine, only to create a public plan that would compete with and "discipline" private insurers.
Right. What do you think would happen to Burger King if McDonald's not only ran its own restaurants, but also had the power to charge everybody for Big Macs whether they ate under the golden arches or not, and could regulate all fast-food joints? That's the sort of "discipline" you get from a government plan.
I expect that, in years to come, my wife and I will be looking at our options for escaping not just public education, but also public medicine. And, as it already is for Britons and Canadians, that choice will be expensive and limited by a government that doesn't put a lot of value on personal choice.
SOURCE
Obama healthcare poison pill
In his crusade to bring health care - one-sixth of the country's economy - under government control, President Obama is asking Americans to swallow a huge and potentially poisonous policy pill.
Just as many Canadian politicians and their families have, hypocritically, come to the U.S. when they prefer our advanced, private health care over their own socialized system, President Obama got caught last night in a "do as I say not as I do" moment. In a special broadcast on ABC, the president refused to pledge that he'd limit his own family to the tests and treatments that the general public would have to confine themselves to under his proposed health care "public option" restrictions.
Obama dismisses as "fear tactics" charges that his program amounts to "socialized medicine" similar to Canada, the United Kingdom and Sweden. Yet, ironically, Canada, the United Kingdom and Sweden are all beginning to open their socialized systems to private care due to citizen protests that critical treatments are delayed or denied. The past president of the Canadian Medical Association says that in Canada, "¦a dog can get a hip replaced in under a week but a human may wait two to three years."
None of this deters Obama from his insistence on government-run health care. And while he bases the need for reform on cost savings and universal coverage, the Congressional Budget Office recently estimated that Obamacare would increase the federal deficit by more than $1.6-trillion over ten years even while leaving 30 million people uninsured.
This week, Obama is leading a charge to use Democrats to ram through draft health reform legislation in the Senate, excluding Republican input. Obama's rush to pass health care reform by August 1 is the centerpiece of his plan to do a "community reorganization" of America by putting more of the private sector under government control and tying the middle class to government with the major entitlement of health insurance.
But according to Michael Cannon, writing in National Review, "there aren't enough Americans earning more than $250,000 to finance [Obamacare] reform would mean higher taxes for the middle class, violating another promise Obama made during the presidential campaign." Further, "if Congress used Medicare's payment rates and opened the new program to everyone, it could pull 120 million Americans out of private insurance more than half of the private market" and boost the government rolls by an even larger number. Two-thirds of Americans would depend on government for their health care, compared with just over one-quarter today. That would strike a historic blow against even the possibility of limited government."
The public's worries are growing about Obama's overreach. A new Washington Post-ABC News poll finds that "Most respondents are 'very concerned' that health-care reform would lead to higher costs, lower quality, fewer choices, a bigger deficit, diminished insurance coverage and more government bureaucracy." When those polled find out that government-funded health care could put many private insurers out of business because of an inability to compete with Uncle Sam, support for government control sinks to 37 percent.
Medicare and Medicaid illustrate the potential for Obamacare to bankrupt individual states en route to bankrupting the nation and transforming the country into a welfare continent like Europe. Medicare and Medicaid waste, fraud, mismanagement and runaway costs threaten the financial viability of many states, including California and New York. Just as with Obamacare, Medicare and Medicaid use ostensible cost controls mandated by Big Government. But the result has been that patients, hospitals, doctors, pharmaceutical companies and the government itself game the crazy incentives of the system to overuse and overprescribe medicine while stifling more cost efficiency and innovation in medical care.
Obama is selling his health care plan as a way to reform all that. But what he's not telling you is that the price you'll pay (when you're not paying it in higher taxes) includes rationing: of medical procedures, patient-doctor choices, and access to cutting edge new drug" which will all be restricted by government bureaucrats.
Contrary to Obama (and his echo chamber in the mainstream news media), there are alternative health care plans that can be emulated -- using the private economy. In the June 19 Wall Street Journal, Kimberly Strassel wrote about tens of thousands of Safeway employees enjoying quality, cost-effective health care in a program championed by CEO Steve Burd who "blew up the company's existing health care structure and replaced it with one that embodied market principles -- choice, responsibility, competition and price."
The FOX Forum and others, including the Center for Medicine in the Public Interest, are providing outlets for citizens to debate what kind of health care they prefer.
The antidote of public scrutiny is needed. Otherwise, Obama's health care poison pill could kill the private system that makes American medicine the world's best.
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