CANCER CAN WAIT IN ENGLAND
A fifth of patients with suspected cancer wait more than a month to be seen by a specialist in England, a report showed on Friday. The National Audit Office (NAO) survey of more than 4,000 cancer patients found widespread improvement in care provided by the National Health Service since the last survey in 2000. But the research also showed that large numbers were waiting weeks or months before being seen by a cancer specialist after visiting their doctor with symptoms. The survey, which includes both patients referred urgently and those not referred urgently, found 58 percent of patients were seen by a specialist within two weeks in 2004 - up from 46 percent in 2000. A further 22 percent of patients were seen by between two weeks and one month, while 20 percent waited longer than one month. A government target states that all patients with suspected cancer referred urgently by their doctor should be seen by a specialist in two weeks.
The report looked at the experience of patients from going to their doctor to support in the community after being discharged from hospital. Patients with the four cancers that account for the greatest number of deaths -- lung, breast, bowel and prostate -- were asked how long they had to wait before being seen by a specialist. Breast cancer patients were most likely to be seen within two weeks -- at 70 percent -- followed by lung cancer patients at 68 percent. Only 51 percent of bowel cancer patients and 32 percent of prostate cancer patients were seen within two weeks, though these were up on the 2000 figures.
Source
GOVERNMENT MEDI-MUDDLING HURTS AMERICAN BUSINESS
American manufacturers are losing their ability to compete in the global marketplace in large measure because of the crushing burden of health care costs, General Motors Corp. chairman and chief executive G. Richard Wagoner Jr. said yesterday as he called on corporate and government leaders to find "some serious medicine" for the nation's ailing health system. In a speech at the Economic Club of Chicago, the auto executive, who is responsible for providing health insurance for more people than any other private employer in the nation, graphically detailed how rising medical bills are eating into his company's bottom line and ultimately threatening the viability of most U.S. firms. "Failing to address the health care crisis would be the worst kind of procrastination," Wagoner said, "the kind that places our children and our grandchildren at risk and threatens the health and global competitiveness of our nation's economy."
After spending several years on the health policy sidelines, Wagoner is launching a mini media blitz, hoping the competitiveness argument will be the one that finally prompts lawmakers to take on an increasingly expensive system rife with inefficiencies and inequities. Wagoner said he intends to press his case personally in Washington and with the nation's governors. Though self-interest may be at the heart of Wagoner's crusade, he and a range of corporate leaders and policy analysts warned that GM's woes are a harbinger of what lies ahead. "GM is the canary in the coal mine for Medicare and everyone else," said Sean P. McAlinden, chief economist at the nonprofit Center for Automotive Research. "There are many, many more companies out there in trouble because of health care costs than just the auto, steel and airline industries."
McAlinden, a labor expert sympathetic to union views, said many in Washington have mistakenly concluded that GM and other carmakers are simply whining about costly union contracts. "GM and the United Auto Workers didn't cause this double-digit inflation in health care," he said. And if GM pushed for sharp reductions in health benefits, the powerful union would likely strike and send the company into Chapter 11 bankruptcy protection, he predicted.
Last year the automaker, known for its innovative approach to health care, spent $5.2 billion to cover 1.1 million retirees, employees and their families. Prescription drugs cost GM $1.9 billion, and the company projects overall medical spending will increase by $400 million this year. That could be offset by a provision in the Medicare drug benefit to pick up a portion of firms' retiree drug costs. But the figure that prompted Wagoner to raise his voice is $1,500. That is the amount of money added to the price of every single vehicle to cover health care, a cost that his foreign competitors do not bear. "The cost of health care in the U.S. is making American businesses extremely uncompetitive versus our global counterparts," he said....
Yesterday, Wagoner broke his silence on an idea proposed by Sen. John F. Kerry (D-Mass.) in the 2004 presidential campaign, saying he supports some type of national catastrophic reinsurance program. Senate Majority Leader Bill Frist (R-Tenn.) has also endorsed the concept of a separate government-backed insurance pool to cover the most expensive medical cases. "If we can create a comprehensive insurance model to better share these catastrophic costs among all consumers, then we can take a big step toward providing affordable health care coverage for all our citizens," Wagoner said.
Wagoner and fellow executives find much to be frustrated with in the health care system. "It's simply not acceptable for over 45 million Americans to be without health care coverage," he said, echoing a point made recently by Jack O. Bovender Jr., chief executive of health care giant HCA Inc. "And it's unfair for those of us who do provide health care benefits to have to pay higher bills to cover the costs of the uninsured.
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Monday, February 28, 2005
Sunday, February 27, 2005
A SOCIALIZED MEDICINE DISGRACE
The b*******s just don't care. A little girl had to go to America to get a false British diagnosis overturned
From the time Tilly Merrell was a year old, doctors told her family she would never have a normal life -- or even a normal meal. British doctors found that the food she swallowed went into her lungs instead of her stomach, causing devastating lung infections. They said she had isolated bulbar palsy, and their solution was to feed her through a stomach tube. Forever. But having a backpack with a food pump wired to her stomach wasn't much of a life for a girl whose favorite smell is bacon frying -- a girl who once broke through a locked kitchen door in an effort to sneak some cheese. So her family got help from their community of Warndon, about 120 miles north of London, raising enough money to take Tilly, now 8, on a 5,000-mile journey they hoped might change her life, a journey to Lucile Salter Packard Children's Hospital at Stanford University.
Doctors at Packard were intrigued that she had no neurological symptoms often associated with the palsy. In all other ways, she was a normal child with a mischievous smile and a truckload of energy. After seeing her Feb. 7, they ran three tests and found out what was wrong with her. Nothing. She had infections, certainly, but they were long gone. And when she swallowed something, it went into her stomach, not her lungs.
Until this month, Tilly often had to go off into another room with her PlayStation during family meals. She would always try to sneak morsels of food, not fully understanding the British doctors' warnings about how much harm they could cause. "Christmastime was the worst," said Tilly's grandmother, Sonia Merrell. "She couldn't eat or drink with us. She used to think we were horrible." Having Tilly go through that for the rest of her life wasn't something that her grandmother was ready to accept. After five years of searching the Internet, Sonia Merrell found a story about how a girl with a similar condition was trying to get treated at Packard....
So Tilly, 13-year-old sister Megan, Amelia, Sonia and grandfather Trevor Merrell got on a plane Feb. 5. Two days later, they were seeing Dr. Kenneth Cox, Packard's chief medical officer and its chief of pediatric gastroenterology. "I felt a little bit of anxiousness when they arrived," he said. "I wondered if there was something I didn't know."
After all, England is not exactly a backward nation when it comes to medicine. Tilly had several cases of severe pneumonia as a baby, and her mother said that doctors in the socialized British system clung to the palsy diagnosis....
Once he met with the family, Cox arranged three tests. Dr. Peter Koltai examined the back of Tilly's throat, looking for evidence that she couldn't swallow properly. Dr. Jin Hahn checked to see if she had any neurological problems. Tilly also needed a modified barium swallow, which allowed occupational therapist Marianna Thorn to track whether food was going into her stomach or lungs. "It showed that Tilly had some very enlarged tonsils," Thorn said, "but nothing that told us she would aspirate on food."
More here. (This post also appears on Blogger News)
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The b*******s just don't care. A little girl had to go to America to get a false British diagnosis overturned
From the time Tilly Merrell was a year old, doctors told her family she would never have a normal life -- or even a normal meal. British doctors found that the food she swallowed went into her lungs instead of her stomach, causing devastating lung infections. They said she had isolated bulbar palsy, and their solution was to feed her through a stomach tube. Forever. But having a backpack with a food pump wired to her stomach wasn't much of a life for a girl whose favorite smell is bacon frying -- a girl who once broke through a locked kitchen door in an effort to sneak some cheese. So her family got help from their community of Warndon, about 120 miles north of London, raising enough money to take Tilly, now 8, on a 5,000-mile journey they hoped might change her life, a journey to Lucile Salter Packard Children's Hospital at Stanford University.
Doctors at Packard were intrigued that she had no neurological symptoms often associated with the palsy. In all other ways, she was a normal child with a mischievous smile and a truckload of energy. After seeing her Feb. 7, they ran three tests and found out what was wrong with her. Nothing. She had infections, certainly, but they were long gone. And when she swallowed something, it went into her stomach, not her lungs.
Until this month, Tilly often had to go off into another room with her PlayStation during family meals. She would always try to sneak morsels of food, not fully understanding the British doctors' warnings about how much harm they could cause. "Christmastime was the worst," said Tilly's grandmother, Sonia Merrell. "She couldn't eat or drink with us. She used to think we were horrible." Having Tilly go through that for the rest of her life wasn't something that her grandmother was ready to accept. After five years of searching the Internet, Sonia Merrell found a story about how a girl with a similar condition was trying to get treated at Packard....
So Tilly, 13-year-old sister Megan, Amelia, Sonia and grandfather Trevor Merrell got on a plane Feb. 5. Two days later, they were seeing Dr. Kenneth Cox, Packard's chief medical officer and its chief of pediatric gastroenterology. "I felt a little bit of anxiousness when they arrived," he said. "I wondered if there was something I didn't know."
After all, England is not exactly a backward nation when it comes to medicine. Tilly had several cases of severe pneumonia as a baby, and her mother said that doctors in the socialized British system clung to the palsy diagnosis....
Once he met with the family, Cox arranged three tests. Dr. Peter Koltai examined the back of Tilly's throat, looking for evidence that she couldn't swallow properly. Dr. Jin Hahn checked to see if she had any neurological problems. Tilly also needed a modified barium swallow, which allowed occupational therapist Marianna Thorn to track whether food was going into her stomach or lungs. "It showed that Tilly had some very enlarged tonsils," Thorn said, "but nothing that told us she would aspirate on food."
More here. (This post also appears on Blogger News)
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Saturday, February 26, 2005
AN UNHEALTHY HEALTH ORGANIZATION
Unfortunately, like most U.N. agencies, the WHO's activities have long been captive to a highly political agenda. For instance, earlier this year the organization claimed that a third of childhood deaths in Europe were due to environmental causes. It's a preposterous claim. European analysts Jaap Hanekamp and Julian Morris observe: "few of these deaths were actually caused by problems generally associated with 'the environment.' Out of 100,000 total deaths, 75,000 were caused by accidents -- e.g. drowning, fires, falls and other hazards of childhood. Of the remaining 25,000 deaths, nearly all of them in poor countries such as Turkey and Russia, most were caused by a combination of dirty water, poor sanitation, malaria and indoor air pollution."
But the facts didn't stop the WHO. It was particularly upset about the presumed threat of global warming, which, it claimed, would result in "more widespread and severe" deaths due to diarrhea, floods, malaria, and nutritional problems. Yet, Hanekamp and Morris archly observe, "No scientific evidence was offered to support these claims -- perhaps because none exists."
Nevertheless, the World Health organization is advancing its so-called Children's Environment and Health Action Plan for Europe which, naturally, advocated more regulations over technology, such as fossil fuels, pesticides, and plastics. The result will be to make us all poorer, yet wealth is one of the most important determinants of health. Wealthier societies are better able to care for those who are most vulnerable to illness.
For instance, the pesticide DDT is one of the most effective mechanisms to kill mosquitoes, which spread malaria. Cheaper energy lowers the cost of producing food. Important medical devices are made from plastics. Under the guise of promoting the "precautionary principle," the WHO is ignoring problems that today kill millions while fretting over worst-case scenarios for the future that are unlikely ever to occur. Simply providing clean water and improving sanitation would do more to help Third World peoples than do most of the WHO's highly publicized initiatives.
The WHO has organized the "Roll Back Malaria" program, along with UNICEF, the World Bank, and the U.S. Agency for International Development. Unlike global warming, malaria actually does kill. Yet the WHO has been spending scarce resources on two drugs which have been found to be no longer effective in Africa. Other choices are available, but so far the WHO bureaucracy hasn't bothered to adjust.
Moreover, complain Robert Bate and Richard Tren, respectively a British and a South African health care analyst, "Roll Back Malaria partners are unwilling to fund interventions that work but upset environmentalists, such as indoor insecticide spraying." Although widespread outdoor use of DDT years ago did have adverse environmental consequences, poor nations throughout Africa and South Asia are literally begging for assistance in undertaking carefully targeted indoor spraying.
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Unfortunately, like most U.N. agencies, the WHO's activities have long been captive to a highly political agenda. For instance, earlier this year the organization claimed that a third of childhood deaths in Europe were due to environmental causes. It's a preposterous claim. European analysts Jaap Hanekamp and Julian Morris observe: "few of these deaths were actually caused by problems generally associated with 'the environment.' Out of 100,000 total deaths, 75,000 were caused by accidents -- e.g. drowning, fires, falls and other hazards of childhood. Of the remaining 25,000 deaths, nearly all of them in poor countries such as Turkey and Russia, most were caused by a combination of dirty water, poor sanitation, malaria and indoor air pollution."
But the facts didn't stop the WHO. It was particularly upset about the presumed threat of global warming, which, it claimed, would result in "more widespread and severe" deaths due to diarrhea, floods, malaria, and nutritional problems. Yet, Hanekamp and Morris archly observe, "No scientific evidence was offered to support these claims -- perhaps because none exists."
Nevertheless, the World Health organization is advancing its so-called Children's Environment and Health Action Plan for Europe which, naturally, advocated more regulations over technology, such as fossil fuels, pesticides, and plastics. The result will be to make us all poorer, yet wealth is one of the most important determinants of health. Wealthier societies are better able to care for those who are most vulnerable to illness.
For instance, the pesticide DDT is one of the most effective mechanisms to kill mosquitoes, which spread malaria. Cheaper energy lowers the cost of producing food. Important medical devices are made from plastics. Under the guise of promoting the "precautionary principle," the WHO is ignoring problems that today kill millions while fretting over worst-case scenarios for the future that are unlikely ever to occur. Simply providing clean water and improving sanitation would do more to help Third World peoples than do most of the WHO's highly publicized initiatives.
The WHO has organized the "Roll Back Malaria" program, along with UNICEF, the World Bank, and the U.S. Agency for International Development. Unlike global warming, malaria actually does kill. Yet the WHO has been spending scarce resources on two drugs which have been found to be no longer effective in Africa. Other choices are available, but so far the WHO bureaucracy hasn't bothered to adjust.
Moreover, complain Robert Bate and Richard Tren, respectively a British and a South African health care analyst, "Roll Back Malaria partners are unwilling to fund interventions that work but upset environmentalists, such as indoor insecticide spraying." Although widespread outdoor use of DDT years ago did have adverse environmental consequences, poor nations throughout Africa and South Asia are literally begging for assistance in undertaking carefully targeted indoor spraying.
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Friday, February 25, 2005
MEDICARE WILL BANKRUPT THE STATE GOVERNMENTS
Texas Gov. Rick Perry last week became the umpteenth -- if not the umpty-umpteenth -- state official to warn of the financial catastrophe awaiting us in the absence of conscientious attempts to overhaul federally subsidized health care. "We are experiencing a government takeover of health care," said the governor. That's no prissy, finger-wagging ideological declaration. The state-federal Medicaid program presently gobbles up a quarter of' Texas' budget. From 1994 to 2003, the state's share of Medicaid costs nearly doubled; the total state budget, by contrast, grew 65 percent. Medicaid now pays for half of all Texas births.
How sweet and compassionate, you say? That's only if we view the subsidizing of health care as the primary function of state government. "If these trends continue," said Perry, addressing the Texas Hospital Association, "and if federal leaders do not make reform of Medicaid a top priority, subsidized health care is going to one day bankrupt the states."
A troublesome law of life asserts itself: You can't spend money you haven't got. All around the country, the warning sirens have been howling. In 2003, Tennessee overran its Medicare budget by $966 million, New Jersey by $236 billion, New York by $1.7 billion, California by $723 billion. Reform proposals are sprouting this winter like golden daffodils. Out in California, Arnold Schwarzenegger talks of moving some Medicaid beneficiaries to managed care. New York Gov. George Pataki seeks $1.1 billion in Medicaid cuts. Tennessee's Democratic governor, Phil Bredesen, says 323,000 people must be excised from the rolls of TennCare, the state's extravagantly generous alternative to Medicaid. Into the program, the state presently pours fully a third of its budget.
In Florida, where Medicaid spending has grown an average 13 percent a year for the past six years, an especially dramatic reform program is in the works. At the center is customer choice. Gov. Jeb Bush would empower Medicaid clients to purchase specific services from managed-care organizations, using state-supplied premiums. Those who lead healthy lives would receive even larger grants. The Bush plan also contemplates private flexible spending accounts, where the owners could park tax-deductible money for future medical expenses. "Our proposals," Gov. Bush said, "put the focus back on the patient by encouraging strong patient-doctor relationships and allowing competition in the market to drive access and quality of care." Florida's Republican-controlled legislature can be expected to give the governor most of what he seeks. (The federal government must likewise provide some waivers.) The alternative: a Medicaid obligation projected at three-fifths of state spending in just 10 years.
The Social Security shout fest ("It's going bankrupt!" -- "No, it's not, you liar!") might have prepared us for the grueling challenge we confront with federal medical programs. The United States is beginning to pay the price, not for the 1933-41 New Deal, rather for the post-New Deal obsession with converting relatively modest measures of government-paid relief into costly programs of permanent social insurance. For nakedly political reasons (voters more handsomely reward lawmakers who give them money than they do those who withhold it), Social Security changed from a fallback, minimal-guarantee system into a full-fledged pension program, based on entitlement. Benefits, and the taxes to support them, soared higher than the Capitol dome. Came the '60s. Lyndon Johnson turned health care into a federal entitlement.
Our appetites proved in the end larger than the resources required to support them. Politicians taught us -- and, oh, what eager pupils we proved! -- to see the provision of daily needs as a basic function of government, never mind what our tougher, pricklier forebears had asserted to the contrary. The day of reckoning is at hand, and the sight isn't pretty. Who can wonder at that? Not the growing numbers who listen anxiously to political leaders telling us what we should have known all along: There ain't no such thing as a free lunch.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Texas Gov. Rick Perry last week became the umpteenth -- if not the umpty-umpteenth -- state official to warn of the financial catastrophe awaiting us in the absence of conscientious attempts to overhaul federally subsidized health care. "We are experiencing a government takeover of health care," said the governor. That's no prissy, finger-wagging ideological declaration. The state-federal Medicaid program presently gobbles up a quarter of' Texas' budget. From 1994 to 2003, the state's share of Medicaid costs nearly doubled; the total state budget, by contrast, grew 65 percent. Medicaid now pays for half of all Texas births.
How sweet and compassionate, you say? That's only if we view the subsidizing of health care as the primary function of state government. "If these trends continue," said Perry, addressing the Texas Hospital Association, "and if federal leaders do not make reform of Medicaid a top priority, subsidized health care is going to one day bankrupt the states."
A troublesome law of life asserts itself: You can't spend money you haven't got. All around the country, the warning sirens have been howling. In 2003, Tennessee overran its Medicare budget by $966 million, New Jersey by $236 billion, New York by $1.7 billion, California by $723 billion. Reform proposals are sprouting this winter like golden daffodils. Out in California, Arnold Schwarzenegger talks of moving some Medicaid beneficiaries to managed care. New York Gov. George Pataki seeks $1.1 billion in Medicaid cuts. Tennessee's Democratic governor, Phil Bredesen, says 323,000 people must be excised from the rolls of TennCare, the state's extravagantly generous alternative to Medicaid. Into the program, the state presently pours fully a third of its budget.
In Florida, where Medicaid spending has grown an average 13 percent a year for the past six years, an especially dramatic reform program is in the works. At the center is customer choice. Gov. Jeb Bush would empower Medicaid clients to purchase specific services from managed-care organizations, using state-supplied premiums. Those who lead healthy lives would receive even larger grants. The Bush plan also contemplates private flexible spending accounts, where the owners could park tax-deductible money for future medical expenses. "Our proposals," Gov. Bush said, "put the focus back on the patient by encouraging strong patient-doctor relationships and allowing competition in the market to drive access and quality of care." Florida's Republican-controlled legislature can be expected to give the governor most of what he seeks. (The federal government must likewise provide some waivers.) The alternative: a Medicaid obligation projected at three-fifths of state spending in just 10 years.
The Social Security shout fest ("It's going bankrupt!" -- "No, it's not, you liar!") might have prepared us for the grueling challenge we confront with federal medical programs. The United States is beginning to pay the price, not for the 1933-41 New Deal, rather for the post-New Deal obsession with converting relatively modest measures of government-paid relief into costly programs of permanent social insurance. For nakedly political reasons (voters more handsomely reward lawmakers who give them money than they do those who withhold it), Social Security changed from a fallback, minimal-guarantee system into a full-fledged pension program, based on entitlement. Benefits, and the taxes to support them, soared higher than the Capitol dome. Came the '60s. Lyndon Johnson turned health care into a federal entitlement.
Our appetites proved in the end larger than the resources required to support them. Politicians taught us -- and, oh, what eager pupils we proved! -- to see the provision of daily needs as a basic function of government, never mind what our tougher, pricklier forebears had asserted to the contrary. The day of reckoning is at hand, and the sight isn't pretty. Who can wonder at that? Not the growing numbers who listen anxiously to political leaders telling us what we should have known all along: There ain't no such thing as a free lunch.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Thursday, February 24, 2005
FEISTY AUSTRALIAN PROFESSOR TELLS IT LIKE IT IS
A leading hospital's director of surgery has resigned in disgust, saying it is ethically, "if not criminally", wrong to force cancer patients to wait up to six months for an operation. Professor David Morris, who stepped down as divisional director at St George Hospital last month, but continues to operate, said: "I am aware of two patients that have died waiting and others whose cancer has progressed, and I do not think that is appropriate."
As senior doctors prepare to overhaul the state's surgical services in an attempt to fix lengthy waiting times, a fight has broken out at the hospital over delays in potentially life-saving surgery for cancer patients. Trauma surgery at the hospital is also under enormous pressure, while waiting lists continue to deteriorate, according to Professor Morris. He said 732 people had waited more than a year for an operation and 185 of those classed as most urgent had waited more than the recommended one month. "We have two theatres empty every day, and that is purely funding, not staffing," Professor Morris said, blaming "lethargic" hospital administrators. "In fact, 56 per cent of [the most urgent cases] did not get their surgery within one month - these figures are likely to deteriorate further because the only administrative approach to budget overruns is to cut elective surgery."
But the head of South East and Illawarra Area Health Service, Deborah Picone, said the hospital had no record of patients dying while on the waiting list and that many patients classed as urgent were often wrongly classified by doctors who either did not understand the categories or were eager to push their patient up the list. People waiting for carpal tunnel and varicose vein operations as well as haemorrhoidectomies were on the most current urgent list, she said, but would be removed when they were properly classified as less urgent. "From time to time the list blows out and we have to put in a concerted effort to bring it in," Professor Picone said. "We are doing the same amount of surgery as we were doing this time last year ... and we are going to move to do additional lists over the Easter period."
A dispute over funding for specialist surgery known as a peritonectomy, for metastatic colorectal cancer, is fuelling the debate over St George waiting times. Professor Morris told the Herald he was "struggling" to get funding from the state and federal governments to develop his new surgical program. Other experts, such as the head of the NSW Cancer Institute, Jim Bishop, have called for more evidence before the procedure receives further funding.
The chairman of the NSW Government's surgical services task force and the director of surgery for Wentworth Area Health Service, Patrick Cregan, said that while there were "enormous problems with waiting lists" it was a unique situation to have people dying while waiting for surgery. "This is not the universal experience," Dr Cregan said. "The big problems are in the less urgent categories." The task force was examining ways of improving the system to ensure patients' conditions were correctly classified and that their social situation was considered. "The current classification system ... is a fairly crude implement," he said.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
A leading hospital's director of surgery has resigned in disgust, saying it is ethically, "if not criminally", wrong to force cancer patients to wait up to six months for an operation. Professor David Morris, who stepped down as divisional director at St George Hospital last month, but continues to operate, said: "I am aware of two patients that have died waiting and others whose cancer has progressed, and I do not think that is appropriate."
As senior doctors prepare to overhaul the state's surgical services in an attempt to fix lengthy waiting times, a fight has broken out at the hospital over delays in potentially life-saving surgery for cancer patients. Trauma surgery at the hospital is also under enormous pressure, while waiting lists continue to deteriorate, according to Professor Morris. He said 732 people had waited more than a year for an operation and 185 of those classed as most urgent had waited more than the recommended one month. "We have two theatres empty every day, and that is purely funding, not staffing," Professor Morris said, blaming "lethargic" hospital administrators. "In fact, 56 per cent of [the most urgent cases] did not get their surgery within one month - these figures are likely to deteriorate further because the only administrative approach to budget overruns is to cut elective surgery."
But the head of South East and Illawarra Area Health Service, Deborah Picone, said the hospital had no record of patients dying while on the waiting list and that many patients classed as urgent were often wrongly classified by doctors who either did not understand the categories or were eager to push their patient up the list. People waiting for carpal tunnel and varicose vein operations as well as haemorrhoidectomies were on the most current urgent list, she said, but would be removed when they were properly classified as less urgent. "From time to time the list blows out and we have to put in a concerted effort to bring it in," Professor Picone said. "We are doing the same amount of surgery as we were doing this time last year ... and we are going to move to do additional lists over the Easter period."
A dispute over funding for specialist surgery known as a peritonectomy, for metastatic colorectal cancer, is fuelling the debate over St George waiting times. Professor Morris told the Herald he was "struggling" to get funding from the state and federal governments to develop his new surgical program. Other experts, such as the head of the NSW Cancer Institute, Jim Bishop, have called for more evidence before the procedure receives further funding.
The chairman of the NSW Government's surgical services task force and the director of surgery for Wentworth Area Health Service, Patrick Cregan, said that while there were "enormous problems with waiting lists" it was a unique situation to have people dying while waiting for surgery. "This is not the universal experience," Dr Cregan said. "The big problems are in the less urgent categories." The task force was examining ways of improving the system to ensure patients' conditions were correctly classified and that their social situation was considered. "The current classification system ... is a fairly crude implement," he said.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Wednesday, February 23, 2005
BABIES, BATHWATER AND MEDICINES
Modern life is a risky business--and medicine is no different. We accept peril on a daily basis without even thinking about it. For the convenience of being able to zip from place to place, we drive possibly dangerous, gasoline-guzzling contraptions called cars. In return for the gift of flight, we accept not only the danger of plane crashes but also a potential heightened risk of cancer for frequent flyers, who spend more time close to the sun and its gene-mutating radiation.
Then there's the tremendous risk you take every time you swallow a pill--and the tough job facing a panel of academics called by the U.S. Food And Drug Administration to examine the safety of popular pain pills.
Medicines are chemicals that alter the way the body works. "Give me a drug without a side effect," a drug researcher once said, "and I'll show you a drug that doesn't work." This is true for most life-saving medicines. Chemotherapy kills cancer, but sometimes it will also kill the patient, perhaps by lowering white blood cell counts so much that infection is a risk. Cholesterol drugs such as Pfizer's Lipitor or Merck's Zocor cut the odds of heart attack or stroke in high-risk patients by a third, but they also can cause side effects that destroy muscle tissue and, eventually, the liver.
Coumadin, a Bristol-Myers Squibb blood thinner, prevents strokes but also increases the risk of bleeding and interacts with everything from other drugs to broccoli and spinach. The allergy pill Allegra, from Aventis, might stop your runny nose but it can also give you a backache.
Patients are often more than willing to take big risks. Amgen faced a chorus of protest from patients and doctors after it stopped developing a medicine for Parkinson's disease because of its onerous side effects. When GlaxoSmithKline recalled an irritable bowel syndrome drug, patient groups made such a clamor that the medicine went back on the market. (Heavy restrictions were placed on its use.)
What we need is a way of balancing risk against benefit better, because for some medicines, the dangers will never justify the gains. Vioxx, for instance, got on the market with one proven advantage--it reduced the risk of ulcers. For the vast majority of patients, a heart attack risk might very well outweigh any benefit from the drug.
Now, many are increasingly convinced that Celebrex and Bextra have similar risks, especially after the publication last night of the full studies implicating the drugs, and two blistering editorials, in The New England Journal of Medicine.
Australia's medical regulators have already slapped warnings on both drugs. By Friday, the panel of academics will give its opinion, and the FDA is likely to follow its recommendations as to whether the drugs stay on the market--and in what form.
But an even more difficult task lies ahead. The FDA needs to be fixed. But how do we avoid throwing out the baby with the bathwater? It's estimated that 100,000 Americans die each year because of adverse drug reactions, but that's no reason to dump the medicine box down the toilet. Some 100,000 U.S. patients also die each year from medical errors, but we keep doctors and nurses around for the simple reason that, as a society, we're better off with them than without them.
The same is true of medicines--at least by and large. Like everything else in life, pill popping is an odds game. The challenge is to make sure that the odds are in our favor.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Modern life is a risky business--and medicine is no different. We accept peril on a daily basis without even thinking about it. For the convenience of being able to zip from place to place, we drive possibly dangerous, gasoline-guzzling contraptions called cars. In return for the gift of flight, we accept not only the danger of plane crashes but also a potential heightened risk of cancer for frequent flyers, who spend more time close to the sun and its gene-mutating radiation.
Then there's the tremendous risk you take every time you swallow a pill--and the tough job facing a panel of academics called by the U.S. Food And Drug Administration to examine the safety of popular pain pills.
Medicines are chemicals that alter the way the body works. "Give me a drug without a side effect," a drug researcher once said, "and I'll show you a drug that doesn't work." This is true for most life-saving medicines. Chemotherapy kills cancer, but sometimes it will also kill the patient, perhaps by lowering white blood cell counts so much that infection is a risk. Cholesterol drugs such as Pfizer's Lipitor or Merck's Zocor cut the odds of heart attack or stroke in high-risk patients by a third, but they also can cause side effects that destroy muscle tissue and, eventually, the liver.
Coumadin, a Bristol-Myers Squibb blood thinner, prevents strokes but also increases the risk of bleeding and interacts with everything from other drugs to broccoli and spinach. The allergy pill Allegra, from Aventis, might stop your runny nose but it can also give you a backache.
Patients are often more than willing to take big risks. Amgen faced a chorus of protest from patients and doctors after it stopped developing a medicine for Parkinson's disease because of its onerous side effects. When GlaxoSmithKline recalled an irritable bowel syndrome drug, patient groups made such a clamor that the medicine went back on the market. (Heavy restrictions were placed on its use.)
What we need is a way of balancing risk against benefit better, because for some medicines, the dangers will never justify the gains. Vioxx, for instance, got on the market with one proven advantage--it reduced the risk of ulcers. For the vast majority of patients, a heart attack risk might very well outweigh any benefit from the drug.
Now, many are increasingly convinced that Celebrex and Bextra have similar risks, especially after the publication last night of the full studies implicating the drugs, and two blistering editorials, in The New England Journal of Medicine.
Australia's medical regulators have already slapped warnings on both drugs. By Friday, the panel of academics will give its opinion, and the FDA is likely to follow its recommendations as to whether the drugs stay on the market--and in what form.
But an even more difficult task lies ahead. The FDA needs to be fixed. But how do we avoid throwing out the baby with the bathwater? It's estimated that 100,000 Americans die each year because of adverse drug reactions, but that's no reason to dump the medicine box down the toilet. Some 100,000 U.S. patients also die each year from medical errors, but we keep doctors and nurses around for the simple reason that, as a society, we're better off with them than without them.
The same is true of medicines--at least by and large. Like everything else in life, pill popping is an odds game. The challenge is to make sure that the odds are in our favor.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Tuesday, February 22, 2005
The next great battle between socialism and capitalism will be waged over human health
By Harvard economist Kenneth Rogoff. He recognizes that existing socialized medicine systems are already disastrous but still thinks the U.S. needs more socialism. What a nut! The best way to control costs is to get government OUT of the picture, not to get it more involved
"US healthcare costs have already reached 15 percent of annual national income and could exceed 30 percent by the middle of this century – and other industrialized nations are not far behind. Certainly, an aging population is part of the story. But if economic productivity keeps growing at its current extraordinary pace, Europeans, Japanese, and Americans could triple their current income per person by 2050. Inevitably, we will spend a lot of that income on improving and maintaining our health.
Which brings us to Marx. When the price of medical care takes up just a small percentage of national income, it is hard to argue with the notion that everyone should enjoy similar medical treatment. Sure, critics may gripe that the higher taxes needed to pay for universal health coverage may cut into economic growth a bit, but so what? A little redistribution won't suddenly transform the United States into a failed, Soviet-style "workers' paradise." But as health costs creep up to, say, 25 percent of national income, things get more complicated. Americans would see their tax bills more than double, while total taxes could reach 75 percent of many Europeans' income. With oppressive tax burdens and heavy state intervention in health – already the largest sector of the economy – socialism would have crept in through the back door.
Of course, smug Europeans, Canadians, or Japanese may think that exploding healthcare costs are a purely US problem. Certainly, the British and Canadian governments successfully wield their monopolies over healthcare to hold down both doctors' incomes and prescription drug prices. And part of the rise in US healthcare costs stems from the breakdown of the checks and balances that more centralized systems provide. (For example, Americans are several times more likely to receive heart bypass surgery than Canadians, where the procedure is reserved for extreme cases. Yet several studies suggest that patients are no worse off in Canada than in the United States). And even the most fanatical free marketers recognize that healthcare is different from other markets, and that the standard supply-and-demand principles don't necessarily apply. Consumers have poor information, and there is an obvious case for greater government involvement than in other markets.
But if all countries squeezed profits in the health sector the way Europe and Canada do, there would be much less global innovation in medical technology. Today, the whole world benefits freely from advances in health technology that are driven largely by the allure of the profitable US market. If the United States joins other nations in having more socialized medicine, the current pace of technology improvements might well grind to a halt. Even as the status quo persists, I wonder how content Europeans and Canadians will remain as their healthcare needs become more expensive and diverse. There are already signs of growing dissatisfaction with the quality of all but the most basic services. In Canada, the horrific delays for elective surgery remind one of waiting for a car in the old Soviet bloc. And despite British Chancellor Gordon Brown's determined efforts to rebuild the country's scandalously dilapidated public hospital system, anyone who can afford to go elsewhere usually does. With public healthcare systems fraying at the edges, many countries outside the United States increasingly face the need to allow a greater play of market forces.
During the next few decades, modern societies will wrestle with very tough questions and tradeoffs: What, exactly, are people's basic health needs in an era where medical technology relentlessly advances the frontiers of the possible? How do we help people while still giving them the incentive to economize on their use of scarce healthcare resources? And who plays God – the bureaucrats, the doctors, or the forces of the market?
Ultimately, the case for some government intervention and regulation in health care is compelling on the grounds of efficiency (because costs are out of control) and moral justice (because our societies rightly take a more egalitarian view of health than of material possessions). The issue is precisely how much redistribution of income and government intervention is warranted. With the health sector on track to make up almost a third of economic activity later this century, the next great battle between capitalism and socialism is already underway".
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
By Harvard economist Kenneth Rogoff. He recognizes that existing socialized medicine systems are already disastrous but still thinks the U.S. needs more socialism. What a nut! The best way to control costs is to get government OUT of the picture, not to get it more involved
"US healthcare costs have already reached 15 percent of annual national income and could exceed 30 percent by the middle of this century – and other industrialized nations are not far behind. Certainly, an aging population is part of the story. But if economic productivity keeps growing at its current extraordinary pace, Europeans, Japanese, and Americans could triple their current income per person by 2050. Inevitably, we will spend a lot of that income on improving and maintaining our health.
Which brings us to Marx. When the price of medical care takes up just a small percentage of national income, it is hard to argue with the notion that everyone should enjoy similar medical treatment. Sure, critics may gripe that the higher taxes needed to pay for universal health coverage may cut into economic growth a bit, but so what? A little redistribution won't suddenly transform the United States into a failed, Soviet-style "workers' paradise." But as health costs creep up to, say, 25 percent of national income, things get more complicated. Americans would see their tax bills more than double, while total taxes could reach 75 percent of many Europeans' income. With oppressive tax burdens and heavy state intervention in health – already the largest sector of the economy – socialism would have crept in through the back door.
Of course, smug Europeans, Canadians, or Japanese may think that exploding healthcare costs are a purely US problem. Certainly, the British and Canadian governments successfully wield their monopolies over healthcare to hold down both doctors' incomes and prescription drug prices. And part of the rise in US healthcare costs stems from the breakdown of the checks and balances that more centralized systems provide. (For example, Americans are several times more likely to receive heart bypass surgery than Canadians, where the procedure is reserved for extreme cases. Yet several studies suggest that patients are no worse off in Canada than in the United States). And even the most fanatical free marketers recognize that healthcare is different from other markets, and that the standard supply-and-demand principles don't necessarily apply. Consumers have poor information, and there is an obvious case for greater government involvement than in other markets.
But if all countries squeezed profits in the health sector the way Europe and Canada do, there would be much less global innovation in medical technology. Today, the whole world benefits freely from advances in health technology that are driven largely by the allure of the profitable US market. If the United States joins other nations in having more socialized medicine, the current pace of technology improvements might well grind to a halt. Even as the status quo persists, I wonder how content Europeans and Canadians will remain as their healthcare needs become more expensive and diverse. There are already signs of growing dissatisfaction with the quality of all but the most basic services. In Canada, the horrific delays for elective surgery remind one of waiting for a car in the old Soviet bloc. And despite British Chancellor Gordon Brown's determined efforts to rebuild the country's scandalously dilapidated public hospital system, anyone who can afford to go elsewhere usually does. With public healthcare systems fraying at the edges, many countries outside the United States increasingly face the need to allow a greater play of market forces.
During the next few decades, modern societies will wrestle with very tough questions and tradeoffs: What, exactly, are people's basic health needs in an era where medical technology relentlessly advances the frontiers of the possible? How do we help people while still giving them the incentive to economize on their use of scarce healthcare resources? And who plays God – the bureaucrats, the doctors, or the forces of the market?
Ultimately, the case for some government intervention and regulation in health care is compelling on the grounds of efficiency (because costs are out of control) and moral justice (because our societies rightly take a more egalitarian view of health than of material possessions). The issue is precisely how much redistribution of income and government intervention is warranted. With the health sector on track to make up almost a third of economic activity later this century, the next great battle between capitalism and socialism is already underway".
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Monday, February 21, 2005
MEDICAID DIES IN MISSISSIPPI
Medicaid will no longer exist in the state of Mississippi as of Feb. 28, due to the state’s overspending. This change in health care is causing problems for many citizens depending on the free medicine. According to Michael Boland, a physician at the Baptist Memorial Hospital, as many as 1,500 patients will be affected just from his office alone. Patients have been notified of this situation and are not happy about the change. “They are poor people who can’t afford medicine,” Boland said. Boland is sympathetic to his patients who are stuck in the middle of a bad situation and offers this piece of advice. He encourages them to educate themselves about the problem and talk to politicians who do things that are not always in their best interest.
The cause of the problem is simple. The state spent more money than it had, thus causing bankruptcy, Boland said. He knows of no solutions as of yet, but says that it is the government’s responsibility, as well as society in general, to think of one. For those who cannot afford health care due to this cessation of Medicaid, non-compensated care will still be offered to patients. Not only does this sudden change affect patients, but health care providers like Boland have had to hire more full-time employees just to fill out paperwork. It has increased the cost of his practice significantly, so he knows firsthand the effect that Medicaid is having statewide. Boland said Mississippi has more low-income citizens per capita than any other state; therefore, Medicaid will hit its citizens hard.
Jeffrey Dennis, a doctor at Internal Medicine Associates of Oxford, agrees the discontinuance of Medicaid is causing a huge crisis in the state, and Oxford is no exception. Despite this challenge, he believes that doctors should not compromise care for their patients. “The true challenge is not letting people get medicine who could find other ways of getting it,” Dennis said. “We need to identify those who really need it.” Although Dennis is facing an uphill battle in the office, he is encouraged by pharmaceutical companies’ support and generous donations. One company, Navartis, has been providing Dennis with free samples.
Dennis is questioned every day by concerned patients who don’t know the future of their health care. The only comfort he can provide, however, is small. He tells them to have faith in the legislature – that they will come up with a system to take care of patients. He supports any plan to raise the cost of cigarettes where funds would go toward aiding in the Medicaid problem. Dennis also offers to help his patients in any way he can through medications and doctor visits.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Medicaid will no longer exist in the state of Mississippi as of Feb. 28, due to the state’s overspending. This change in health care is causing problems for many citizens depending on the free medicine. According to Michael Boland, a physician at the Baptist Memorial Hospital, as many as 1,500 patients will be affected just from his office alone. Patients have been notified of this situation and are not happy about the change. “They are poor people who can’t afford medicine,” Boland said. Boland is sympathetic to his patients who are stuck in the middle of a bad situation and offers this piece of advice. He encourages them to educate themselves about the problem and talk to politicians who do things that are not always in their best interest.
The cause of the problem is simple. The state spent more money than it had, thus causing bankruptcy, Boland said. He knows of no solutions as of yet, but says that it is the government’s responsibility, as well as society in general, to think of one. For those who cannot afford health care due to this cessation of Medicaid, non-compensated care will still be offered to patients. Not only does this sudden change affect patients, but health care providers like Boland have had to hire more full-time employees just to fill out paperwork. It has increased the cost of his practice significantly, so he knows firsthand the effect that Medicaid is having statewide. Boland said Mississippi has more low-income citizens per capita than any other state; therefore, Medicaid will hit its citizens hard.
Jeffrey Dennis, a doctor at Internal Medicine Associates of Oxford, agrees the discontinuance of Medicaid is causing a huge crisis in the state, and Oxford is no exception. Despite this challenge, he believes that doctors should not compromise care for their patients. “The true challenge is not letting people get medicine who could find other ways of getting it,” Dennis said. “We need to identify those who really need it.” Although Dennis is facing an uphill battle in the office, he is encouraged by pharmaceutical companies’ support and generous donations. One company, Navartis, has been providing Dennis with free samples.
Dennis is questioned every day by concerned patients who don’t know the future of their health care. The only comfort he can provide, however, is small. He tells them to have faith in the legislature – that they will come up with a system to take care of patients. He supports any plan to raise the cost of cigarettes where funds would go toward aiding in the Medicaid problem. Dennis also offers to help his patients in any way he can through medications and doctor visits.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Sunday, February 20, 2005
FDA HYSTERIA OVERDONE: SIDE EFFECTS ARE A FACT OF LIFE
Recent events have plunged the beleaguered FDA into turmoil. First, there were claims the labeling of certain antidepressants failed to warn doctors that the drugs triggered suicidal impulses in some adolescents. Then the agency was blind-sided by Chiron Corp.'s inability to provide flu vaccine this season due to contamination at its manufacturing facility, depriving Americans of half the usual supply. Thereafter came questions about side effects from several widely prescribed anti-inflammatory analgesic drugs.
These events have precipitated a frenzy of attacks on the FDA. In November testimony before the Senate Finance Committee, an FDA medical officer accused his own colleagues of discounting recommendations from FDA safety researchers and of being consistently in denial when data indicate safety problems from an approved drug. Sen. Ted Kennedy of Massachusetts, ranking Democrat on the Senate FDA oversight committee, called the agency's drug-safety record "a catastrophic failure."
These blanket condemnations misrepresent the reality and ignore the subtleties of drug testing, evaluation, approval and monitoring. Shepherding a candidate drug from discovery in the lab to the marketplace typically requires 12-15 years and more than $800 million in direct and indirect costs. On average, it involves more than 60 clinical trials with more than 4,000 patients, but even this extensive testing often does not elicit all possible side effects from a new drug, especially if they occur in a vulnerable sub-population. Like death and taxes, drugs' side effects are inevitable. Their exact frequency depends partly on how hard one searches for them and how they are defined, but they are extremely common. In the United Kingdom, about 5 percent of hospital admissions are in some way due to an adverse effect of medicine; and between 5 and 10 percent of hospitalized patients are estimated to suffer an adverse drug experience (ADE). In one American study, 6.7 percent of patients had serious side effects during their hospital stay.
Regulators make decisions about marketing approval on the basis of data that are always, in a sense, incomplete: Infrequent ADEs might not show up until hundreds of thousands, or even millions, of patients are exposed to the drug in normal use. Drug companies must report to FDA adverse events and injuries caused by their products, but they depend on practicing physicians to provide these data. Because doctors are unlikely to notice side effects in a small percentage of their patients and have no legal obligation to communicate adverse events, under-reporting is rampant.
The "safety" of a drug is relative. Safety and efficacy, the two criteria required for marketing approval of a drug, are inextricably linked. Regulators' judgments require a global, and often difficult, calculation of risk and benefit. Regulators and doctors tolerate greater uncertainty and more severe side effects for a potential cure for pancreatic cancer or AIDS, for example, than for treating age spots or indigestion.
When FDA grants marketing approval, the drug is deemed safe and effective for the conditions on the label. The company and FDA painstakingly discuss the labeling, to specify uses, dosage, warnings and side effects. And at the end of the day, if FDA isn't completely satisfied, there's no label -- and no approval.
FDA is not the only gatekeeper restricting consumer access to prescription drugs: Physicians must prescribe them and, for many Americans whose drugs are paid for by an HMO plan, the health insurance formularies must include them.
Visiting a doctor is not like going to the supermarket, where you put in your cart whatever you want: Physicians are (or should be) accustomed to saying no to patients who demand specific therapies. Many doctors now firmly -- and correctly -- deny patients unneeded and ineffective antibiotics for virus-induced colds, and routinely do the same for other drugs.
The efficient detection of ADEs is essential, and the United States needs improved pharmacovigilance -- monitoring the safety of approved drugs. This should be done not by creating a new, independent agency, but by fixing the FDA. However, it is questionable if the newly announced FDA Drug Safety Oversight Board, which will monitor approved medicines' safety, is the answer.
We need better data rather than more bureaucrats. In any case, public health is more imperiled by lack of drugs in the development pipeline -- a legacy of decades of FDA over-regulation -- than by side effects from approved drugs.
To improve pharmacoviligance, we need to encourage physicians to report side effects, perhaps by rewarding them with the Continuing Medical Education credits needed to retain licensure; to contract with organizations that treat large patient populations to monitor and report adverse events; and to share data with foreign regulators. We might also consider some variation of the U.K.'s "yellow card" system, in which doctors, dentists and pharmacists report ADEs to federal regulators (on a small, simple yellow card, of course).
Our drug development and regulation system needs reform. But we must make sure the cure isn't worse than the disease.
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Recent events have plunged the beleaguered FDA into turmoil. First, there were claims the labeling of certain antidepressants failed to warn doctors that the drugs triggered suicidal impulses in some adolescents. Then the agency was blind-sided by Chiron Corp.'s inability to provide flu vaccine this season due to contamination at its manufacturing facility, depriving Americans of half the usual supply. Thereafter came questions about side effects from several widely prescribed anti-inflammatory analgesic drugs.
These events have precipitated a frenzy of attacks on the FDA. In November testimony before the Senate Finance Committee, an FDA medical officer accused his own colleagues of discounting recommendations from FDA safety researchers and of being consistently in denial when data indicate safety problems from an approved drug. Sen. Ted Kennedy of Massachusetts, ranking Democrat on the Senate FDA oversight committee, called the agency's drug-safety record "a catastrophic failure."
These blanket condemnations misrepresent the reality and ignore the subtleties of drug testing, evaluation, approval and monitoring. Shepherding a candidate drug from discovery in the lab to the marketplace typically requires 12-15 years and more than $800 million in direct and indirect costs. On average, it involves more than 60 clinical trials with more than 4,000 patients, but even this extensive testing often does not elicit all possible side effects from a new drug, especially if they occur in a vulnerable sub-population. Like death and taxes, drugs' side effects are inevitable. Their exact frequency depends partly on how hard one searches for them and how they are defined, but they are extremely common. In the United Kingdom, about 5 percent of hospital admissions are in some way due to an adverse effect of medicine; and between 5 and 10 percent of hospitalized patients are estimated to suffer an adverse drug experience (ADE). In one American study, 6.7 percent of patients had serious side effects during their hospital stay.
Regulators make decisions about marketing approval on the basis of data that are always, in a sense, incomplete: Infrequent ADEs might not show up until hundreds of thousands, or even millions, of patients are exposed to the drug in normal use. Drug companies must report to FDA adverse events and injuries caused by their products, but they depend on practicing physicians to provide these data. Because doctors are unlikely to notice side effects in a small percentage of their patients and have no legal obligation to communicate adverse events, under-reporting is rampant.
The "safety" of a drug is relative. Safety and efficacy, the two criteria required for marketing approval of a drug, are inextricably linked. Regulators' judgments require a global, and often difficult, calculation of risk and benefit. Regulators and doctors tolerate greater uncertainty and more severe side effects for a potential cure for pancreatic cancer or AIDS, for example, than for treating age spots or indigestion.
When FDA grants marketing approval, the drug is deemed safe and effective for the conditions on the label. The company and FDA painstakingly discuss the labeling, to specify uses, dosage, warnings and side effects. And at the end of the day, if FDA isn't completely satisfied, there's no label -- and no approval.
FDA is not the only gatekeeper restricting consumer access to prescription drugs: Physicians must prescribe them and, for many Americans whose drugs are paid for by an HMO plan, the health insurance formularies must include them.
Visiting a doctor is not like going to the supermarket, where you put in your cart whatever you want: Physicians are (or should be) accustomed to saying no to patients who demand specific therapies. Many doctors now firmly -- and correctly -- deny patients unneeded and ineffective antibiotics for virus-induced colds, and routinely do the same for other drugs.
The efficient detection of ADEs is essential, and the United States needs improved pharmacovigilance -- monitoring the safety of approved drugs. This should be done not by creating a new, independent agency, but by fixing the FDA. However, it is questionable if the newly announced FDA Drug Safety Oversight Board, which will monitor approved medicines' safety, is the answer.
We need better data rather than more bureaucrats. In any case, public health is more imperiled by lack of drugs in the development pipeline -- a legacy of decades of FDA over-regulation -- than by side effects from approved drugs.
To improve pharmacoviligance, we need to encourage physicians to report side effects, perhaps by rewarding them with the Continuing Medical Education credits needed to retain licensure; to contract with organizations that treat large patient populations to monitor and report adverse events; and to share data with foreign regulators. We might also consider some variation of the U.K.'s "yellow card" system, in which doctors, dentists and pharmacists report ADEs to federal regulators (on a small, simple yellow card, of course).
Our drug development and regulation system needs reform. But we must make sure the cure isn't worse than the disease.
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Saturday, February 19, 2005
EVEN MATERNITY FACILITIES ARE SHRINKING
And not just because of insurance costs. The Australian State of New South Wales again:
Camden Hospital's maternity unit - which was opened in a marginal south-west Sydney electorate with great fanfare just months before the state election in 2003 - will be effectively closed and births transferred to Campbelltown Hospital. The move comes as the Health Care Complaints Commission indicated it would bring disciplinary charges against a nurse and doctor over the death of a baby, Natalia Lalic, at the unit in March 2003. A document the commission sent to the child's mother, Vera, this week said there had been "a number of departures from an acceptable standard of care" by one nurse and disciplinary proceedings were pending against the nurse and a doctor.
The Opposition Leader, John Brogden, accused the Government of "dirty and grubby tactics" in announcing the changes at Camden at a time which masked the impact of the commission's disciplinary actions.
But the Health Minister, Morris Iemma, yesterday delivered the death blow to the unit, citing medical workforce shortages in anaesthetics, pediatrics and obstetrics. For two years "we have done all we can to maintain the current service model but the changing circumstances of Camden Hospital demand that the services we provide also reflect the current situation", Mr Iemma said. Pregnant women in the area will now travel to Campbelltown Hospital, 14 kilometres from Camden, and transfer back to the Camden unit, in some cases two hours after a birth. Camden will ultimately become a hospital where nursing midwives assist at "non-complicated" births, while complex cases or emergencies go to Campbelltown. Mr Iemma denied the change resulted from a hasty political decision before the 2003 election. "The commitment was there to try and make it work, but two years down the track, after two inquiries, it's clear it's not sustainable due to these shortages of specialists," he said.
Last month the head of the NSW Pregnancy and Newborn Services Network, David Henderson-Smart, investigated the viability of the unit. Professor Henderson-Smart's inquiry last year recommended Camden continue with low-risk births, a proposal strongly criticised by local obstetricians and anaesthetists.
Mr Brogden said the original move was an "election con". The Government knew before the election that opening the unit was unsafe for mothers and their babies, Mr Brogden said. "Lives were put at risk in the rush to open the maternity unit, and in the tragic case of baby Natalia Lalic, lives were lost," he said.
Mr Iemma refused to discuss the Lalic case, saying it was the subject of a coronial inquiry and a commission complaint.
The letter to Natalie's mother from the acting commissioner, Ken Taylor, said one nurse had been counselled and no action taken against another. But it said the evidence indicated a third nurse "appeared to focus exclusively on your physical needs, without showing any insight into your emotional needs at the time".
The executive officer of the Australian College of Midwives, Barbara Vernon, rejected the Opposition's claim that Camden was unsafe, citing national statistics that showed it had an error rate well below the average.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
And not just because of insurance costs. The Australian State of New South Wales again:
Camden Hospital's maternity unit - which was opened in a marginal south-west Sydney electorate with great fanfare just months before the state election in 2003 - will be effectively closed and births transferred to Campbelltown Hospital. The move comes as the Health Care Complaints Commission indicated it would bring disciplinary charges against a nurse and doctor over the death of a baby, Natalia Lalic, at the unit in March 2003. A document the commission sent to the child's mother, Vera, this week said there had been "a number of departures from an acceptable standard of care" by one nurse and disciplinary proceedings were pending against the nurse and a doctor.
The Opposition Leader, John Brogden, accused the Government of "dirty and grubby tactics" in announcing the changes at Camden at a time which masked the impact of the commission's disciplinary actions.
But the Health Minister, Morris Iemma, yesterday delivered the death blow to the unit, citing medical workforce shortages in anaesthetics, pediatrics and obstetrics. For two years "we have done all we can to maintain the current service model but the changing circumstances of Camden Hospital demand that the services we provide also reflect the current situation", Mr Iemma said. Pregnant women in the area will now travel to Campbelltown Hospital, 14 kilometres from Camden, and transfer back to the Camden unit, in some cases two hours after a birth. Camden will ultimately become a hospital where nursing midwives assist at "non-complicated" births, while complex cases or emergencies go to Campbelltown. Mr Iemma denied the change resulted from a hasty political decision before the 2003 election. "The commitment was there to try and make it work, but two years down the track, after two inquiries, it's clear it's not sustainable due to these shortages of specialists," he said.
Last month the head of the NSW Pregnancy and Newborn Services Network, David Henderson-Smart, investigated the viability of the unit. Professor Henderson-Smart's inquiry last year recommended Camden continue with low-risk births, a proposal strongly criticised by local obstetricians and anaesthetists.
Mr Brogden said the original move was an "election con". The Government knew before the election that opening the unit was unsafe for mothers and their babies, Mr Brogden said. "Lives were put at risk in the rush to open the maternity unit, and in the tragic case of baby Natalia Lalic, lives were lost," he said.
Mr Iemma refused to discuss the Lalic case, saying it was the subject of a coronial inquiry and a commission complaint.
The letter to Natalie's mother from the acting commissioner, Ken Taylor, said one nurse had been counselled and no action taken against another. But it said the evidence indicated a third nurse "appeared to focus exclusively on your physical needs, without showing any insight into your emotional needs at the time".
The executive officer of the Australian College of Midwives, Barbara Vernon, rejected the Opposition's claim that Camden was unsafe, citing national statistics that showed it had an error rate well below the average.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Friday, February 18, 2005
AN "ACCOUNTABLE" PUBLIC HOSPITAL AT WORK
How to kill a healthy baby and get away with it
"Nursing staff at Perth's main maternity hospital hampered a possible murder investigation into the death of a four-month-old baby, refusing to be interviewed and failing to provide statements until more than a year after the tragedy. The boy died on March 1, 2001, after being given a massive unprescribed overdose of paracetemol and codeine when he was just one week old and in the care of the King Edward Memorial Hospital. When his respiratory system collapsed, medical staff initially thought he was a victim of sudden infant death syndrome. But by accident, tests uncovered the lethal levels of paracetemol and codeine in his system.
At an inquest into the death yesterday, state coroner Alastair Hope was told the baby's mother was interviewed by police shortly after the overdose and denied ever giving her son any drugs. Sharon Anderson, described as a softly spoken and unsophisticated Aboriginal woman, had been prescribed panadeine forte following the birth of her son. The coroner heard the fatal overdose could only have been administered if the drugs had been completely dissolved or made into a paste. Investigating officer Detective Sergeant Martin Crane, based with the police child investigation unit at the time of the death, admitted yesterday that the case should have been handled differently.
Ms Anderson's son, who is not named for cultural reasons, was born a thriving and generally healthy baby on November 8, 2001. But seven days later, the boy went into respiratory collapse and suffered substantial brain damage. He never recovered and did not leave hospital during his short life, dying 18 weeks later at Princess Margaret Hospital for Children. Ms Anderson, who has no history of post-natal depression and has never been suspected of abusing her three other children, returned to her home in the remote mining town of Wiluna to tend to her family two days later. During a 90-minute interview with police on November 20, she repeatedly denied giving her son any drugs.
Detective Sergeant Crane said hospital management initially assured police that staff would fully co-operate with the inquiry. But he said that within days, the nursing staff had been given legal advice through their union, the Australian Nursing Federation, that they should not take part in interviews while the baby was alive. Detective Sergeant Crane said the boy was not expected to live longer than a few days, but he did not die until March 1 when life-support was removed. During that time, police distributed a questionnaire to staff, but the line of investigation came under fire from ANF secretary Mark Olson, and not one nurse returned the form.
Five days after the baby's death, a memorandum was sent to relevant staff requesting they submit statements to the police. But Detective Sergeant Crane said that six months later he had yet to receive most statements. He told the inquiry that a clinical governance co-ordinator appointed to liaise with police said the hospital was under-staffed and the statements were "not a priority". Most of the statements were not given to police until more than a year after the overdose, which created problems in piecing together the events that led to the baby's death. "It was unsatisfactory, it made it difficult," Detective Sergeant Crane said. "It was frustrating. Again, if I did the job today, I would do it differently."
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
How to kill a healthy baby and get away with it
"Nursing staff at Perth's main maternity hospital hampered a possible murder investigation into the death of a four-month-old baby, refusing to be interviewed and failing to provide statements until more than a year after the tragedy. The boy died on March 1, 2001, after being given a massive unprescribed overdose of paracetemol and codeine when he was just one week old and in the care of the King Edward Memorial Hospital. When his respiratory system collapsed, medical staff initially thought he was a victim of sudden infant death syndrome. But by accident, tests uncovered the lethal levels of paracetemol and codeine in his system.
At an inquest into the death yesterday, state coroner Alastair Hope was told the baby's mother was interviewed by police shortly after the overdose and denied ever giving her son any drugs. Sharon Anderson, described as a softly spoken and unsophisticated Aboriginal woman, had been prescribed panadeine forte following the birth of her son. The coroner heard the fatal overdose could only have been administered if the drugs had been completely dissolved or made into a paste. Investigating officer Detective Sergeant Martin Crane, based with the police child investigation unit at the time of the death, admitted yesterday that the case should have been handled differently.
Ms Anderson's son, who is not named for cultural reasons, was born a thriving and generally healthy baby on November 8, 2001. But seven days later, the boy went into respiratory collapse and suffered substantial brain damage. He never recovered and did not leave hospital during his short life, dying 18 weeks later at Princess Margaret Hospital for Children. Ms Anderson, who has no history of post-natal depression and has never been suspected of abusing her three other children, returned to her home in the remote mining town of Wiluna to tend to her family two days later. During a 90-minute interview with police on November 20, she repeatedly denied giving her son any drugs.
Detective Sergeant Crane said hospital management initially assured police that staff would fully co-operate with the inquiry. But he said that within days, the nursing staff had been given legal advice through their union, the Australian Nursing Federation, that they should not take part in interviews while the baby was alive. Detective Sergeant Crane said the boy was not expected to live longer than a few days, but he did not die until March 1 when life-support was removed. During that time, police distributed a questionnaire to staff, but the line of investigation came under fire from ANF secretary Mark Olson, and not one nurse returned the form.
Five days after the baby's death, a memorandum was sent to relevant staff requesting they submit statements to the police. But Detective Sergeant Crane said that six months later he had yet to receive most statements. He told the inquiry that a clinical governance co-ordinator appointed to liaise with police said the hospital was under-staffed and the statements were "not a priority". Most of the statements were not given to police until more than a year after the overdose, which created problems in piecing together the events that led to the baby's death. "It was unsatisfactory, it made it difficult," Detective Sergeant Crane said. "It was frustrating. Again, if I did the job today, I would do it differently."
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Thursday, February 17, 2005
FROM THE UK: MORE PROOF THAT SOCIALIZED MEDICINE IS BAD FOR YOUR HEALTH
Post lifed bodily from Reliapundit
According to today's BBC, the UK will soon have only half the surgeons it will need to meet demand:
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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Post lifed bodily from Reliapundit
According to today's BBC, the UK will soon have only half the surgeons it will need to meet demand:
ALSO from the BBC: The death rates for most diseases is MUCH higher in the UK than the USA; here's one example:Thousands of extra surgeons are going to be needed over the next few years to meet demand, a report warns. The Royal College of Surgeons (RCS) said there would be a 2,760 shortfall by 2010 because of early retirement and new working practices. The figure amounts to 50% of the current number of surgeons and takes into account surgeons who will graduate from training in the coming years. The study said action was needed now as it takes 10 years to train a surgeon. ... However, the government missed its target of increasing consultants [medical specialists which includes surgeons] by 7,500 by 2004. A Department of Health spokeswoman said the government was looking to increase the number of surgeons. "It is something we are working towards. We know we have more work to do here.
That means your have a 50% greater chance of dying from cancer sooner/younger in the UK, than in the USA. Which is a win-win for the UK socialists: the government saves money by spending less to save your life, and they ALSO pocket the receipts from your retirement taxes since you won't be around to collect the benefit!"There are 17,000 deaths from the cancer in Britain each year and the five year survival rate for sufferers is just 40%, compared to 60% in America."
MORE PROOF from THE OBSERVER/Guardian:
An authoritative study to be published later this year will demonstrate that the chances of survival after undergoing a major operation are far greater in an American hospital. The authors conclude that NHS waiting lists, the lack of specialist-led care and the fact that many patients do not go routinely to intensive care contribute largely to the difference. A team from University College London (UCL) and a team from Columbia University in New York jointly studied the medical fortunes of more than 1,000 patients at the Mount Sinai Hospital in Manhattan and compared them with nearly 1,100 patients who had undergone the same sort of major surgery at the Queen Alexandra Hospital in Portsmouth. The results, which surprised even the researchers, showed that 2.5 per cent ofyone would go into a critical care bed - they go into a highly monitored environment. That doesn't happen routinely in the UK.'
So, based on these facts, WHY WOULD ANY SANE PERSON WANT TO SOCIALIZE MEDICINE IN THE USA?!?!? Well, the answer is, NO SANE PERSON DOES WANT TO SOCIALIZE MEDICINE; ONLY INSANE LEFTIES WANT TO DO THAT!
And insane Lefties would rather enforce an equal outcome which is LOWER and WORSE for EVERYONE, than have a system in which outcomes may vary. Which is yet another reason why the road to socialism is ALWAYS the road to MEDIOCRITY as well as the road the poverty and servitude; IOW: the road to serfdom.
UPDATE: Last week, COMMON SENSE AND WONDER posted excerpts from an article on socialized healthcare in the UK, from THE SPECTATOR. Here a few tidbits:
Suppose you come down with one of the big killer illnesses like cancer. Where do you want to be — London or New York? In Lincoln, Nebraska or Lincoln, Lincolnshire? Forget the money — we will come back to that — where do you have the best chance of staying alive? The answer is clear. If you are a woman with breast cancer in Britain, you have (or at least a few years ago you had, since all medical statistics are a few years old) a 46 per cent chance of dying from it. In America, your chances of dying are far lower — only 25 per cent. Britain has one of the worst survival rates in the advanced world and America has the best.
If you are a man and you are diagnosed as having cancer of the prostate in Britain, you are more likely to die of it than not. You have a 57 per cent chance of departing this life. But in America you are likely to live. Your chances of dying from the disease are only 19 per cent. Once again, Britain is at the bottom of the class and America at the top. How about colon cancer? In Britain, 40 per cent survive for five years after diagnosis. In America, 60 per cent do. With cancer of the oesophagus, survival rates are low all round the world. In Britain, a mere 7 per cent of patients live for five years after diagnosis. In America, the survival rate is still low, but much better at 12 per cent.
The more one looks at the figures for survival, the more obvious it is that if you have a medical problem your chances are dramatically better in America than in Britain. That is why those who are rich enough often go to America, leaving behind even private British healthcare. One reason is wonderfully simple. In America, you are more likely to be treated. And going back a stage further, you are more likely to get the diagnostic tests which lead to treatment.
CONCLUSION: socialized medicine sucks - if you measure the RESULTS.
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Wednesday, February 16, 2005
"COMPASSIONATE" SOCIALIZED MEDICINE AT WORK
Pray that YOU never have to depend on it
Each of the holes in four-year-old Kalissa McMahon's teeth was the size of a grain of rice. The pain kept her up at night, she was on a diet of mashed vegetables and Panadol and she had taught herself to use toothpicks to mine food out of her cavities. But it took a year before her wait on a public hospital queue finally ended last week. "Why can't you help me? Why do I have to wait?" she would ask her parents, who could not afford private care and were left with no answers.
An operation such as Kalissa's would cost an uninsured family about $3400. While children such as her are entitled to free dental treatment, in the public system there are too few dentists for the growing numbers of patients. The number of children under four who are admitted to hospital for dental treatment in NSW has risen by more than 80 per cent in the past decade, although the problem is largely confined to families who cannot afford insurance or private dental visits.
The head of pediatric dentistry at Westmead Hospital, Dr Angus Cameron, said four out of five children with decay were from poorer backgrounds. "Fluoride has helped rates of decay go down, but the decay that is left is in 20 per cent of the population," he said. "These are people who do not have access to medical services and have a lack of awareness of dentistry and oral hygiene."
Although Kalissa's teeth were brushed every day, she developed "nursing bottle caries", a common form of tooth decay caused by sleeping with full bottles. For children, multiple extractions or fillings are performed under general anesthetic. Kalissa was anaesthetised for 40 minutes while she had four teeth removed and two capped. Her mother, Tracy McMahon, had to explain that "going under" did not mean she would be "going underwater" and that "you will wake up again".
Ms McMahon and her husband, Errol Carusi, from Ingleburn, were originally told there was a six-month wait for surgery at Westmead. Instead, it took 12. In the meantime, the holes in Kalissa's teeth grew and she could not breathe without pain. "The nerve was exposing and anything she ate she had to be able to squash with her tongue without using her teeth," Mr Carusi said. "They said you have to wait your turn but this is a child ... Kalissa doesn't understand."
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Pray that YOU never have to depend on it
Each of the holes in four-year-old Kalissa McMahon's teeth was the size of a grain of rice. The pain kept her up at night, she was on a diet of mashed vegetables and Panadol and she had taught herself to use toothpicks to mine food out of her cavities. But it took a year before her wait on a public hospital queue finally ended last week. "Why can't you help me? Why do I have to wait?" she would ask her parents, who could not afford private care and were left with no answers.
An operation such as Kalissa's would cost an uninsured family about $3400. While children such as her are entitled to free dental treatment, in the public system there are too few dentists for the growing numbers of patients. The number of children under four who are admitted to hospital for dental treatment in NSW has risen by more than 80 per cent in the past decade, although the problem is largely confined to families who cannot afford insurance or private dental visits.
The head of pediatric dentistry at Westmead Hospital, Dr Angus Cameron, said four out of five children with decay were from poorer backgrounds. "Fluoride has helped rates of decay go down, but the decay that is left is in 20 per cent of the population," he said. "These are people who do not have access to medical services and have a lack of awareness of dentistry and oral hygiene."
Although Kalissa's teeth were brushed every day, she developed "nursing bottle caries", a common form of tooth decay caused by sleeping with full bottles. For children, multiple extractions or fillings are performed under general anesthetic. Kalissa was anaesthetised for 40 minutes while she had four teeth removed and two capped. Her mother, Tracy McMahon, had to explain that "going under" did not mean she would be "going underwater" and that "you will wake up again".
Ms McMahon and her husband, Errol Carusi, from Ingleburn, were originally told there was a six-month wait for surgery at Westmead. Instead, it took 12. In the meantime, the holes in Kalissa's teeth grew and she could not breathe without pain. "The nerve was exposing and anything she ate she had to be able to squash with her tongue without using her teeth," Mr Carusi said. "They said you have to wait your turn but this is a child ... Kalissa doesn't understand."
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Tuesday, February 15, 2005
COMPULSORY UNIVERSAL HEALTH INSURANCE
It should at least get some money out of the free-riders. Australia has it already
Two state assemblymen told health officials in La Jolla on Tuesday that they plan to propose a sweeping health-care reform package in Sacramento on Thursday that would likely require all Californians to have health insurance. State Assemblymen Joe Nation, D-Marin, and Dr. Keith Richman, R-Chatsworth, told health officials who gathered at UC San Diego to discuss the future of health care that they had been working on the comprehensive reform package that would "shake up the status quo," for more than a year.
Health-care officials, meanwhile, representing insurers, hospitals, doctors, county health services, academics and think-tank groups said California's, and the nation's, health-care system was broken and costs are spiraling out of control ---- in part because too many people don't have health insurance. Officials said people without health insurance, or not enough health insurance, can't pay for their medical coverage. That, they said, forces insurers, hospitals and doctors to try to make up shortfalls by passing the costs on to patients who have health insurance ---- an action that contributes to a continuing upward spiral in the cost of health care for everyone.
Neither assemblyman would go into the details of exactly what their "multi-bill" plan would entail. But they strongly hinted that it would, if passed, require all Californians to have health-insurance coverage ----- just like car insurance. "The system is crumbling," Richman said. "It's 6.4 million people (in California) who are currently not in the system who are not contributing to the financial stability of our entire health-care system." Officials said that health-care costs in California have risen to $150 billion, and that the annual health-care costs for a family of four is roughly $10,000.
Richman and health experts on the panel of experts at Tuesday's seminar hosted by the Rand Corp. and the Communications Institute said there were multiple reasons why health-care costs continue to rapidly increase. Those reasons include:
State and federal health insurance for the poor ---- Medi-Cal and Medicare ---- are too complicated, need to be simplified and "streamlined," and do not pay doctors and hospitals enough to cover medical service. The cost of prescription drugs, pushed by incessant television marketing, continues to rise at double-digit percentages each year. That patients over-use expensive drugs ---- rather than generics ---- and medical treatments, such as Magnetic Resonance Imaging and surgical procedures such as "stomach stapling," that they do not necessarily need. That a significant portion of California's, and the nation's, population is getting older, meaning they need and use health-care services more often. That expensive technological advancements such as hip, knee and other joint replacements continue to be used more and more. In addition, Dana Goldman, a senior economist with the Rand Corp., and others said people are living longer than ever before, giving them a chance to be stricken with aging illnesses such as heart and lung disease that are often expensive to treat.
Michael Murphy, president and chief executive officer of Sharp Healthcare, said, "The system isn't working ... only one-third of hospitals in the state are making money. There have been eight hospital closures in the state of California in the last six months."
Surprisingly, Goldman said, many people who do not have health insurance are not poor. He said recent studies show that more than one-third of the population who are uninsured have income levels that are twice the federal poverty level. Those same studies showed that 55 percent of those who are uninsured are young ---- between the ages of 18 and 34.
San Diego's Dr. Bob Hertzka, president of the California Medical Association, said the association believes that a partial solution is for the government to mandate "individual health insurance coverage" ---- meaning that everyone in the state would be required to pay for health insurance.
Goldman said that could possibly be just for "catastrophic coverage," to start out with, just to prevent hospitals from having to eat the cost of expensive treatment for uninsured people who suffer traumatic car wrecks or serious illnesses.
Richman, meanwhile, said he agreed with all the observations at Tuesday's seminar. He said the legislative package he and Nation plan to unveil Thursday would be far-reaching and would not "just be talking about a mandate for universal coverage." "When I started in the Legislature in 2000-2001, health care was a crisis," Richman said. "And it's only gotten worse. I really believe that this is the opportunity to make some real changes in our health-care system. We're going to roll out something on Thursday ... I think it will shake up the system."
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
It should at least get some money out of the free-riders. Australia has it already
Two state assemblymen told health officials in La Jolla on Tuesday that they plan to propose a sweeping health-care reform package in Sacramento on Thursday that would likely require all Californians to have health insurance. State Assemblymen Joe Nation, D-Marin, and Dr. Keith Richman, R-Chatsworth, told health officials who gathered at UC San Diego to discuss the future of health care that they had been working on the comprehensive reform package that would "shake up the status quo," for more than a year.
Health-care officials, meanwhile, representing insurers, hospitals, doctors, county health services, academics and think-tank groups said California's, and the nation's, health-care system was broken and costs are spiraling out of control ---- in part because too many people don't have health insurance. Officials said people without health insurance, or not enough health insurance, can't pay for their medical coverage. That, they said, forces insurers, hospitals and doctors to try to make up shortfalls by passing the costs on to patients who have health insurance ---- an action that contributes to a continuing upward spiral in the cost of health care for everyone.
Neither assemblyman would go into the details of exactly what their "multi-bill" plan would entail. But they strongly hinted that it would, if passed, require all Californians to have health-insurance coverage ----- just like car insurance. "The system is crumbling," Richman said. "It's 6.4 million people (in California) who are currently not in the system who are not contributing to the financial stability of our entire health-care system." Officials said that health-care costs in California have risen to $150 billion, and that the annual health-care costs for a family of four is roughly $10,000.
Richman and health experts on the panel of experts at Tuesday's seminar hosted by the Rand Corp. and the Communications Institute said there were multiple reasons why health-care costs continue to rapidly increase. Those reasons include:
State and federal health insurance for the poor ---- Medi-Cal and Medicare ---- are too complicated, need to be simplified and "streamlined," and do not pay doctors and hospitals enough to cover medical service. The cost of prescription drugs, pushed by incessant television marketing, continues to rise at double-digit percentages each year. That patients over-use expensive drugs ---- rather than generics ---- and medical treatments, such as Magnetic Resonance Imaging and surgical procedures such as "stomach stapling," that they do not necessarily need. That a significant portion of California's, and the nation's, population is getting older, meaning they need and use health-care services more often. That expensive technological advancements such as hip, knee and other joint replacements continue to be used more and more. In addition, Dana Goldman, a senior economist with the Rand Corp., and others said people are living longer than ever before, giving them a chance to be stricken with aging illnesses such as heart and lung disease that are often expensive to treat.
Michael Murphy, president and chief executive officer of Sharp Healthcare, said, "The system isn't working ... only one-third of hospitals in the state are making money. There have been eight hospital closures in the state of California in the last six months."
Surprisingly, Goldman said, many people who do not have health insurance are not poor. He said recent studies show that more than one-third of the population who are uninsured have income levels that are twice the federal poverty level. Those same studies showed that 55 percent of those who are uninsured are young ---- between the ages of 18 and 34.
San Diego's Dr. Bob Hertzka, president of the California Medical Association, said the association believes that a partial solution is for the government to mandate "individual health insurance coverage" ---- meaning that everyone in the state would be required to pay for health insurance.
Goldman said that could possibly be just for "catastrophic coverage," to start out with, just to prevent hospitals from having to eat the cost of expensive treatment for uninsured people who suffer traumatic car wrecks or serious illnesses.
Richman, meanwhile, said he agreed with all the observations at Tuesday's seminar. He said the legislative package he and Nation plan to unveil Thursday would be far-reaching and would not "just be talking about a mandate for universal coverage." "When I started in the Legislature in 2000-2001, health care was a crisis," Richman said. "And it's only gotten worse. I really believe that this is the opportunity to make some real changes in our health-care system. We're going to roll out something on Thursday ... I think it will shake up the system."
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Monday, February 14, 2005
MEDICAL BANKRUPTCY SCARE
The usual Leftist misrepresentation
"Half of Bankruptcy Due to Medical Bills - US Study." At least so said the Reuters headline in last week's story. And similar stories in newspapers across the country agree. Soon it will be repeated as gospel on Capitol Hill and by the chattering classes everywhere. Understandably, middle-class Americans have started to feel a little queasy about their health and about the adequacy of their health insurance.
The fundamental problem is that it isn't true. Despite what the authors have encouraged us to believe, the Harvard study, entitled "Illness and Injuries As Contributors to Bankruptcy," isn't really about medical bills, crushing or otherwise. It's about bankruptcies that can - at least if you're willing to stretch things a bit - be classified as medically related. It finds that 54.5 percent of all bankruptcies have "a medical cause." But "medical cause" is used as a term of art here. In fact, the study does not claim that injury or illness was the primary cause of those bankruptcies. And, perhaps more importantly, it does not claim that the bankruptcies were caused by the crush of medical bills.
Don't get me wrong. Some bankruptcies are caused by crushing medical debt. But they aren't half of all bankruptcies, and the only way to create the impression they are is to jimmy the figures. For example, the study classifies "uncontrolled gambling," "drug addiction," "alcohol addiction," and the birth or adoption of a child as "a medical cause," regardless of whether medical bills are involved. Yes, there may be situations in which a researcher might legitimately want to classify those conditions as "medical," but a study that is being used to prove that Americans are going bankrupt as a result of crushing medical bills is not one of them. A father who has gambled away his family's mortgage payment is not likely the victim of crushing medical bills. Similarly, new parents who find they can no longer afford their previous lifestyle now that one of them has to stay home with the baby will usually find the obstetrician's bill the least of their problems. Babies are a financial hardship even when hospitals give them away free.
Maybe that's why only 28.3 percent of the surveyed debtors themselves agreed with the authors that their bankruptcy was substantially caused by "illness or injury." The rest put the blame elsewhere, even when the study labeled their problems as at least in part "medical."
Buried in the study is the fact that only 27 percent of the surveyed debtors had unreimbursed medical expenses exceeding $1,000 over the course of the two years prior to their bankruptcy. Presumably 73 percent - the vast majority - had medical expenses during that two-year period of $1,000 or less. Had that figure been recited up front, it would have been obvious that the proportion of bankruptcies driven by unmanageable medical debt was nowhere near half....
What would be significant for the public to know is how common the cases of bankruptcy due to crushing medical debt actually are - debt in the range of $10,000 or more in single year. That, however, is something the study is careful not to disclose, even though the raw data behind the study would appear to be sufficient to make such computations possible. Instead, at every turn, the authors present the data in ways that encourage the reader to misidentify medical expenses as the leading cause of bankruptcy.....
At least one of the authors - Dr. Steffie Woolhandler, a Cambridge Hospital internist and associate professor of medicine at Harvard, makes it clear that she does indeed have an agenda - health-care coverage that is universal and comprehensive. "Covering the uninsured isn't enough. We must also upgrade and guarantee continuous coverage for those who have insurance," she said in a statement. She went on to condemn employers and politicians who advocate what she called "stripped-down plans, so riddled with co-payments, deductibles and exclusions that serious illness leads straight to bankruptcy."
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The usual Leftist misrepresentation
"Half of Bankruptcy Due to Medical Bills - US Study." At least so said the Reuters headline in last week's story. And similar stories in newspapers across the country agree. Soon it will be repeated as gospel on Capitol Hill and by the chattering classes everywhere. Understandably, middle-class Americans have started to feel a little queasy about their health and about the adequacy of their health insurance.
The fundamental problem is that it isn't true. Despite what the authors have encouraged us to believe, the Harvard study, entitled "Illness and Injuries As Contributors to Bankruptcy," isn't really about medical bills, crushing or otherwise. It's about bankruptcies that can - at least if you're willing to stretch things a bit - be classified as medically related. It finds that 54.5 percent of all bankruptcies have "a medical cause." But "medical cause" is used as a term of art here. In fact, the study does not claim that injury or illness was the primary cause of those bankruptcies. And, perhaps more importantly, it does not claim that the bankruptcies were caused by the crush of medical bills.
Don't get me wrong. Some bankruptcies are caused by crushing medical debt. But they aren't half of all bankruptcies, and the only way to create the impression they are is to jimmy the figures. For example, the study classifies "uncontrolled gambling," "drug addiction," "alcohol addiction," and the birth or adoption of a child as "a medical cause," regardless of whether medical bills are involved. Yes, there may be situations in which a researcher might legitimately want to classify those conditions as "medical," but a study that is being used to prove that Americans are going bankrupt as a result of crushing medical bills is not one of them. A father who has gambled away his family's mortgage payment is not likely the victim of crushing medical bills. Similarly, new parents who find they can no longer afford their previous lifestyle now that one of them has to stay home with the baby will usually find the obstetrician's bill the least of their problems. Babies are a financial hardship even when hospitals give them away free.
Maybe that's why only 28.3 percent of the surveyed debtors themselves agreed with the authors that their bankruptcy was substantially caused by "illness or injury." The rest put the blame elsewhere, even when the study labeled their problems as at least in part "medical."
Buried in the study is the fact that only 27 percent of the surveyed debtors had unreimbursed medical expenses exceeding $1,000 over the course of the two years prior to their bankruptcy. Presumably 73 percent - the vast majority - had medical expenses during that two-year period of $1,000 or less. Had that figure been recited up front, it would have been obvious that the proportion of bankruptcies driven by unmanageable medical debt was nowhere near half....
What would be significant for the public to know is how common the cases of bankruptcy due to crushing medical debt actually are - debt in the range of $10,000 or more in single year. That, however, is something the study is careful not to disclose, even though the raw data behind the study would appear to be sufficient to make such computations possible. Instead, at every turn, the authors present the data in ways that encourage the reader to misidentify medical expenses as the leading cause of bankruptcy.....
At least one of the authors - Dr. Steffie Woolhandler, a Cambridge Hospital internist and associate professor of medicine at Harvard, makes it clear that she does indeed have an agenda - health-care coverage that is universal and comprehensive. "Covering the uninsured isn't enough. We must also upgrade and guarantee continuous coverage for those who have insurance," she said in a statement. She went on to condemn employers and politicians who advocate what she called "stripped-down plans, so riddled with co-payments, deductibles and exclusions that serious illness leads straight to bankruptcy."
More here
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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
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Sunday, February 13, 2005
BREDESEN: MEDICAID = SOCIALISM
Gov. Phil Bredesen said Tuesday the nation’s Medicaid program shares more with socialism than practicality and needs fundamental reform. "The way in which Medicaid pays for services has more in common with a socialist economy than the commonsense economic and business principles that do such a good job allocating resources efficiently in other parts of our American life," the governor said. His remarks came at a conference in Raleigh, N.C., of policymakers studying health care issues. The governor has proposed substantial cuts in benefits and enrollees in TennCare, the state’s expanded Medicaid program for the poor and uninsured. Te nnCare now covers some 1.3 million people at a combined state and federal cost of $8.7 billion. The governor wants to drop 323,000 non-Medicaid eligible people from the program and save $575 million in state dollars next year.
Attending Tuesday’s conference in Raleigh was Ron Pollack, executive director of Families USA, a Washington-based advocacy group which has criticized Mr. Bredesen’s approach to curbing TennCare costs. Mr. Pollack said he did a "double take" when he heard Gov. Bredesen compare Medicaid to socialism. "I don’t know what he was smoking before he gave his speech. But I think he had a pretty high dosage of whatever it was," he said. "It’s hard to give a straight-faced comment about it." The nation’s health care system is "overwhelmingly a private health care system," Mr. Pollack said. "What we do is provide a safety net for people who can’t get coverage in the private sector." Under Gov. Bredesen, that "safety net is becoming much more hole than webbing," Mr. Pollack said. "To talk about it as a socialistic health care system, I think someone should inform him the Cold War is over."
The governor, locked in an increasingly bitter legal and political struggle to overhaul TennCare, said changes to the current federal system should have three guiding principles: "Everybody pays something; pay first for what is most important; pay for what works." "Our hearts are there," Gov. Bredesen said. "What I want to say today is our heads need to get there, too."
However, Mr. Pollack said when he heard the governor speak, he didn’t recognize anything the governor was doing in Tennessee. "He didn’t say anything about cutting 323,000 people from the program," he said.
President Bush, meanwhile, is moving forward with plans to curb Medicaid spending at the national level. His new budget recommends cutting federal spending in Medicaid by $45 billion over the next 10 years.
In his remarks Gov. Bredesen said that while Tennessee has a "particularly acute problem because of the scope of our program, we are just the leading edge of what is happening across the nation." He said one study estimates that 22 states can expect to allocate more than half of all new tax revenue in the next five years to Medicaid. "Medicaid is a clear and present danger to the budgets and priorities of the states," he said.....
Gov. Bredesen said charging patients even a token fee for each visit to a doctor would add "economic tension" and be a start toward reform. "This is not about being hardhearted," he said. "It’s a basic truth (that) people value the things they pay for and don’t value what is free." He also recommended prioritizing medical care. For example, he said, the government should pay for prenatal care and necessary surgery before covering the costs of antihistamines and heartburn medication. Tennessee spends more than $200 million a year on those two categories of drugs alone, he said. He also said that states should reject paying for some medicines that haven’t been proven to be effective.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Gov. Phil Bredesen said Tuesday the nation’s Medicaid program shares more with socialism than practicality and needs fundamental reform. "The way in which Medicaid pays for services has more in common with a socialist economy than the commonsense economic and business principles that do such a good job allocating resources efficiently in other parts of our American life," the governor said. His remarks came at a conference in Raleigh, N.C., of policymakers studying health care issues. The governor has proposed substantial cuts in benefits and enrollees in TennCare, the state’s expanded Medicaid program for the poor and uninsured. Te nnCare now covers some 1.3 million people at a combined state and federal cost of $8.7 billion. The governor wants to drop 323,000 non-Medicaid eligible people from the program and save $575 million in state dollars next year.
Attending Tuesday’s conference in Raleigh was Ron Pollack, executive director of Families USA, a Washington-based advocacy group which has criticized Mr. Bredesen’s approach to curbing TennCare costs. Mr. Pollack said he did a "double take" when he heard Gov. Bredesen compare Medicaid to socialism. "I don’t know what he was smoking before he gave his speech. But I think he had a pretty high dosage of whatever it was," he said. "It’s hard to give a straight-faced comment about it." The nation’s health care system is "overwhelmingly a private health care system," Mr. Pollack said. "What we do is provide a safety net for people who can’t get coverage in the private sector." Under Gov. Bredesen, that "safety net is becoming much more hole than webbing," Mr. Pollack said. "To talk about it as a socialistic health care system, I think someone should inform him the Cold War is over."
The governor, locked in an increasingly bitter legal and political struggle to overhaul TennCare, said changes to the current federal system should have three guiding principles: "Everybody pays something; pay first for what is most important; pay for what works." "Our hearts are there," Gov. Bredesen said. "What I want to say today is our heads need to get there, too."
However, Mr. Pollack said when he heard the governor speak, he didn’t recognize anything the governor was doing in Tennessee. "He didn’t say anything about cutting 323,000 people from the program," he said.
President Bush, meanwhile, is moving forward with plans to curb Medicaid spending at the national level. His new budget recommends cutting federal spending in Medicaid by $45 billion over the next 10 years.
In his remarks Gov. Bredesen said that while Tennessee has a "particularly acute problem because of the scope of our program, we are just the leading edge of what is happening across the nation." He said one study estimates that 22 states can expect to allocate more than half of all new tax revenue in the next five years to Medicaid. "Medicaid is a clear and present danger to the budgets and priorities of the states," he said.....
Gov. Bredesen said charging patients even a token fee for each visit to a doctor would add "economic tension" and be a start toward reform. "This is not about being hardhearted," he said. "It’s a basic truth (that) people value the things they pay for and don’t value what is free." He also recommended prioritizing medical care. For example, he said, the government should pay for prenatal care and necessary surgery before covering the costs of antihistamines and heartburn medication. Tennessee spends more than $200 million a year on those two categories of drugs alone, he said. He also said that states should reject paying for some medicines that haven’t been proven to be effective.
Source
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Saturday, February 12, 2005
Study finds that half of health care dollars are wasted
About 50 percent of health care spending is eaten up by waste, excessive prices and fraud, according to a report set for release today by Boston University researchers. Major sources of unnecessary spending include administrative costs and profit in the insurance industry, high prices of prescription drugs and health services and, to a smaller extent, theft and fraud, according to the study.
U.S. health spending is projected to reach $1.9 trillion in 2005. "If half of health care spending is wasted now, that's $950 billion this year. If we could save even a third of waste, we'd save over $300 billion this year," said Alan Sager, co-director of the health reform program at Boston University's School of Public Health and co-author of the report. The report, which uses data collected by other researchers and from the government, warns that the nation's fast-growing health care tab is consuming an ever-greater share of the America's overall economic resources. Health care will consume 15.5 percent of the U.S. economy this year, up from 13.2 percent in 2002, the study notes.
Sager and co-author Deborah Socolar arrived at their 50 percent waste estimate by culling published material such as comparisons of U.S. medical costs with those of other countries and estimates of administrative expenses in the U.S. health care system. Sager argued that waste needs to be curbed and doctors need to make more careful decisions to control runaway spending. "We know there is enough money to take care of everyone, but not if we keep practicing blank-check mentality and using cost controls that have failed for decades," he said. The report's criticisms of administrative expenses are based on a study last year by Harvard Medical School that determined that bureaucratic inefficiency on the part of insurance companies, doctors, hospitals, nursing homes and other institutions cost the country $399.4 billion in 2003.
A spokeswoman for the trade group that represents health insurers described administrative cost estimates for the industry as "very vague and generally exaggerated." Susan Pisano of the America's Health Insurance Plans said it's difficult to calculate administrative costs because much of that spending benefits consumers by providing better quality care and finding ways to save money.
The report placed much of the responsibility for reform on doctors because it contends that decisions made by physicians determine about 87 percent of personal health spending. "We certainly make decisions about what care or what treatment the patient needs ... but (we) don't control the prices charged by the pharmaceutical companies or the hospitals," said Dr. Michael Sexton, a Marin County physician and president-elect of the California Medical Association. Sexton said doctors in general try to make the best and most efficient decisions on behalf of their patients. "Some of the solutions are going to require us as a nation to invest in technology that will help us learn what is the best care for the least cost," he said.....
U.S. health spending per person in 2002 was 2.1 times the average in Canada, France, Germany, Italy, Japan and the United Kingdom. Source: "Health Costs Absorb One-Quarter of Economic Growth, 200-2005," Boston University.
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
About 50 percent of health care spending is eaten up by waste, excessive prices and fraud, according to a report set for release today by Boston University researchers. Major sources of unnecessary spending include administrative costs and profit in the insurance industry, high prices of prescription drugs and health services and, to a smaller extent, theft and fraud, according to the study.
U.S. health spending is projected to reach $1.9 trillion in 2005. "If half of health care spending is wasted now, that's $950 billion this year. If we could save even a third of waste, we'd save over $300 billion this year," said Alan Sager, co-director of the health reform program at Boston University's School of Public Health and co-author of the report. The report, which uses data collected by other researchers and from the government, warns that the nation's fast-growing health care tab is consuming an ever-greater share of the America's overall economic resources. Health care will consume 15.5 percent of the U.S. economy this year, up from 13.2 percent in 2002, the study notes.
Sager and co-author Deborah Socolar arrived at their 50 percent waste estimate by culling published material such as comparisons of U.S. medical costs with those of other countries and estimates of administrative expenses in the U.S. health care system. Sager argued that waste needs to be curbed and doctors need to make more careful decisions to control runaway spending. "We know there is enough money to take care of everyone, but not if we keep practicing blank-check mentality and using cost controls that have failed for decades," he said. The report's criticisms of administrative expenses are based on a study last year by Harvard Medical School that determined that bureaucratic inefficiency on the part of insurance companies, doctors, hospitals, nursing homes and other institutions cost the country $399.4 billion in 2003.
A spokeswoman for the trade group that represents health insurers described administrative cost estimates for the industry as "very vague and generally exaggerated." Susan Pisano of the America's Health Insurance Plans said it's difficult to calculate administrative costs because much of that spending benefits consumers by providing better quality care and finding ways to save money.
The report placed much of the responsibility for reform on doctors because it contends that decisions made by physicians determine about 87 percent of personal health spending. "We certainly make decisions about what care or what treatment the patient needs ... but (we) don't control the prices charged by the pharmaceutical companies or the hospitals," said Dr. Michael Sexton, a Marin County physician and president-elect of the California Medical Association. Sexton said doctors in general try to make the best and most efficient decisions on behalf of their patients. "Some of the solutions are going to require us as a nation to invest in technology that will help us learn what is the best care for the least cost," he said.....
U.S. health spending per person in 2002 was 2.1 times the average in Canada, France, Germany, Italy, Japan and the United Kingdom. Source: "Health Costs Absorb One-Quarter of Economic Growth, 200-2005," Boston University.
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Friday, February 11, 2005
BRITAIN'S "OVERSTRETCHED" NATIONAL HEALTH
A system in trouble
South African doctors have become the latest long- distance recruits to join Britain's overstretched GP workforce. Riaan Vlok, a family doctor from South Africa's North West Province, said that the benefits on offer in Britain were such that he had decided to abandon private practice in his homeland for locum work on the NHS. Dr Vlok, 49, is part of a growing foreign workforce brought in to help to support primary care services as more British GPs give up out-of-hours work and the profession struggles to attract junior doctors to general practice.
Health recruitment agencies in rural South Africa said that the number of doctors expressing an interest in working in Britain had risen sharply in recent months as word got round on how much they could earn. The influx follows the recruitment of GPs from Germany and Polish dentists. On GPNet, a website directory of family doctors in South Africa, advertisements offer doctors 7,300 pounds to work for a month or 16,000 pounds for ten weeks' work. Other attractions offered include free flights, a "meet and greet" on arrival in Britain and the chance to travel around Europe.
Dr Vlok now spends a month at a time working as GP cover in surgeries in Mansfield and Ashfield in Nottinghamshire. He returns home for a fortnight's holiday every four weeks. He said that although the hours could be long and the climate less agreeable, he enjoyed the contrast of British life with that on his ranch near Pretoria, where he lives with his wife and son. "I love my job," he said. "It is like night and day. A change is as good as a holiday."
While family doctors in South Africa earn similar salaries to those in Britain - around 75,000 pounds a year - the hourly locum rate is much higher and comes without the overheads of running a surgery. Dr Vlok said that he was paid 200 pounds for seeing 16 patients in a two-hour session and he normally worked about 12 sessions each week, earning 2,400 pounds. "It is similar to South Africa," said Dr Vlok, who practised in his homeland for 18 years. "But here I keep what I make and walk out. I can make more money as a temporary GP here than operating a private practice back home."
John Howard, chairman of the Royal College of GPs International Committee, said that hiring from abroad did not address the essential problem. "With a current shortage of GPs the profession is placed in the position of having to recruit from abroad," he said. "We understand GPs from South Africa are recruited and feel this is unfortunate as South Africa, along with other African countries, does need its doctors. We would like to see more doctors in the UK training to be GPs."
Source
AND AN EXPERIENCE FROM THE HEART OF THE ENGLISH BEAST
Spear Shaker emails me as follows:
John, I felt the need to rant. I realize that everyone can cite a horror-story, but in this case it hits home. My father-in-law, living in Oxfordshire, has had the following NHS service over the last year:
When diagnosed with a Brain Tumor, was put on a 10-month long NHS waiting list to get the appropriate tests. Since his balance was being impaired by the tumor, he had to pay for private testing, diagnosis, and ultimately surgery to arrest its growth, rather than wait for it to grow and metastasize.
When diagnosed with severe angina and a potential arterial blockage, he was put on a 6-month long waiting list to get an angiogram. He was then prescribed the wrong medication (in lieu of tests) which almost caused him to die, lowering his heart rate to 36 beats per minute and requiring an ambulance/emergency room visit. Instead of waiting the 6 months, he is now paying for a private angiogram.
How can this system continue? Brain tumors and heart pains are elective conditions. I am stunned that the Brits just keep taking it. . .
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
A system in trouble
South African doctors have become the latest long- distance recruits to join Britain's overstretched GP workforce. Riaan Vlok, a family doctor from South Africa's North West Province, said that the benefits on offer in Britain were such that he had decided to abandon private practice in his homeland for locum work on the NHS. Dr Vlok, 49, is part of a growing foreign workforce brought in to help to support primary care services as more British GPs give up out-of-hours work and the profession struggles to attract junior doctors to general practice.
Health recruitment agencies in rural South Africa said that the number of doctors expressing an interest in working in Britain had risen sharply in recent months as word got round on how much they could earn. The influx follows the recruitment of GPs from Germany and Polish dentists. On GPNet, a website directory of family doctors in South Africa, advertisements offer doctors 7,300 pounds to work for a month or 16,000 pounds for ten weeks' work. Other attractions offered include free flights, a "meet and greet" on arrival in Britain and the chance to travel around Europe.
Dr Vlok now spends a month at a time working as GP cover in surgeries in Mansfield and Ashfield in Nottinghamshire. He returns home for a fortnight's holiday every four weeks. He said that although the hours could be long and the climate less agreeable, he enjoyed the contrast of British life with that on his ranch near Pretoria, where he lives with his wife and son. "I love my job," he said. "It is like night and day. A change is as good as a holiday."
While family doctors in South Africa earn similar salaries to those in Britain - around 75,000 pounds a year - the hourly locum rate is much higher and comes without the overheads of running a surgery. Dr Vlok said that he was paid 200 pounds for seeing 16 patients in a two-hour session and he normally worked about 12 sessions each week, earning 2,400 pounds. "It is similar to South Africa," said Dr Vlok, who practised in his homeland for 18 years. "But here I keep what I make and walk out. I can make more money as a temporary GP here than operating a private practice back home."
John Howard, chairman of the Royal College of GPs International Committee, said that hiring from abroad did not address the essential problem. "With a current shortage of GPs the profession is placed in the position of having to recruit from abroad," he said. "We understand GPs from South Africa are recruited and feel this is unfortunate as South Africa, along with other African countries, does need its doctors. We would like to see more doctors in the UK training to be GPs."
Source
AND AN EXPERIENCE FROM THE HEART OF THE ENGLISH BEAST
Spear Shaker emails me as follows:
John, I felt the need to rant. I realize that everyone can cite a horror-story, but in this case it hits home. My father-in-law, living in Oxfordshire, has had the following NHS service over the last year:
When diagnosed with a Brain Tumor, was put on a 10-month long NHS waiting list to get the appropriate tests. Since his balance was being impaired by the tumor, he had to pay for private testing, diagnosis, and ultimately surgery to arrest its growth, rather than wait for it to grow and metastasize.
When diagnosed with severe angina and a potential arterial blockage, he was put on a 6-month long waiting list to get an angiogram. He was then prescribed the wrong medication (in lieu of tests) which almost caused him to die, lowering his heart rate to 36 beats per minute and requiring an ambulance/emergency room visit. Instead of waiting the 6 months, he is now paying for a private angiogram.
How can this system continue? Brain tumors and heart pains are elective conditions. I am stunned that the Brits just keep taking it. . .
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Thursday, February 10, 2005
DRUG COMPANIES GET SAVVY ON REIMPORTATION
When prices are artificially set by government price controls there will always be ways around it
Could this be the beginning of the end of the debate over drug re-importation? Advocates of the practice argue that American consumers, particularly seniors, could benefit from legal re-importation of prescription drugs from abroad, which in some instances are sold at lower prices than in the United States. Opponents contend these lower prices result from price controls and that allowing price controls into one of the world’s few remaining free markets for pharmaceuticals would deter investment in developing new drugs.
To date, there’s been an impasse. Re-importation is technically illegal, though many Americans buy prescription drugs from Canada and other countries. Their savings have made re-importation a rallying issue for some groups, especially senior groups who argue that the lack of an “adequate” drug benefit in Medicare has forced many seniors to look elsewhere for their medications. But are the tides already changing? The Associated Press reports that Americans buying drugs from abroad aren’t saving what they used to. The average price of drugs purchased in Canada rose 23 percent over the past year and a half, compared to an increase of only 8 percent at U.S. pharmacies.
One small part of the problem is the weakening U.S. dollar. Also, it turns out the land of the Maple Leaf is subject to market forces, too. “Higher acquisition costs” are wrecking Canadian pharmacies’ margins, and many have responded by raising prices for foreign buyers or curtailing sales abroad altogether.
While American drug companies cannot determine what their drugs will sell for in Canada, they can control the amount of drugs they ship across the border. Many have chosen to send less to reduce available surplus that could be diverted to U.S. consumers. Fewer surplus drugs in Canada means Internet pharmacies -- major international sellers -- have to purchase drugs from bricks-and-mortar pharmacies, at prices well above wholesale, or re-import drug supplies from other countries, further increasing their costs and exposing U.S. consumers to safety risks. Already, according to recent reports, Canadian health officials have begun to take steps to protect supplies north of the border.....
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
When prices are artificially set by government price controls there will always be ways around it
Could this be the beginning of the end of the debate over drug re-importation? Advocates of the practice argue that American consumers, particularly seniors, could benefit from legal re-importation of prescription drugs from abroad, which in some instances are sold at lower prices than in the United States. Opponents contend these lower prices result from price controls and that allowing price controls into one of the world’s few remaining free markets for pharmaceuticals would deter investment in developing new drugs.
To date, there’s been an impasse. Re-importation is technically illegal, though many Americans buy prescription drugs from Canada and other countries. Their savings have made re-importation a rallying issue for some groups, especially senior groups who argue that the lack of an “adequate” drug benefit in Medicare has forced many seniors to look elsewhere for their medications. But are the tides already changing? The Associated Press reports that Americans buying drugs from abroad aren’t saving what they used to. The average price of drugs purchased in Canada rose 23 percent over the past year and a half, compared to an increase of only 8 percent at U.S. pharmacies.
One small part of the problem is the weakening U.S. dollar. Also, it turns out the land of the Maple Leaf is subject to market forces, too. “Higher acquisition costs” are wrecking Canadian pharmacies’ margins, and many have responded by raising prices for foreign buyers or curtailing sales abroad altogether.
While American drug companies cannot determine what their drugs will sell for in Canada, they can control the amount of drugs they ship across the border. Many have chosen to send less to reduce available surplus that could be diverted to U.S. consumers. Fewer surplus drugs in Canada means Internet pharmacies -- major international sellers -- have to purchase drugs from bricks-and-mortar pharmacies, at prices well above wholesale, or re-import drug supplies from other countries, further increasing their costs and exposing U.S. consumers to safety risks. Already, according to recent reports, Canadian health officials have begun to take steps to protect supplies north of the border.....
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Wednesday, February 09, 2005
BRITAIN'S "NATIONAL HEALTH" SO HOPELESS THAT PEOPLE GO TO INDIA FOR SURGERY INSTEAD!
Three months ago George Marshall fretted about the choice offered by his doctor in Britain. Diagnosed with coronary heart disease, the violin repairer from Bradford was told he could either wait up to six months for a heart bypass operation on the National Health Service or pay œ19,000 to go under the scalpel immediately.
In the end, Mr Marshall chose to outsource his operation to India. Last month he flew 5,000 miles to the southern Indian city of Bangalore where surgeons at the Wockhardt hospital and heart institute took a piece of vein from his arm to repair the thinning arteries of his heart. The cost was œ4,800, including the flight. "Everyone's been really great here. I have been in the NHS and gone private in Britain in the past, but I can say that the care and facilities in India are easily comparable," says Mr Marshall, sitting in hospital-blue pyjamas. "I'd have no problem coming again."
The 73-year-old found the hospital in Bangalore after a few hours surfing the internet. Mr Marshall decided to come after an email conversation with Wockhardt's vice-president and a chat with other "medical tourists" from Britain who had undergone surgery in the hospital. "Once I knew others had come I thought, why not? In Europe hospitals in Germany and Belgium would do the operation for less than doctors in Britain. But Europe was still more expensive than here. And the staff speak English in India."
With patients such as Mr Marshall willing to travel across the globe to get treatment sooner or more cheaply than they could at home, Indian hospital groups see a huge market for their services.....
Many say that it is not just cost but competency that is India's selling point. Naresh Trehan, who earned $2m (œ1.06m) a year as a heart surgeon in Manhattan but returned to start Escorts hospital group in India, said that his hospital in Delhi completed 4,200 heart operations last year. "That is more than anyone else in the world. The death rate for coronary bypass patients at Escorts is 0.8% and the infection rate is 0.3%. This is well below the first-world averages of 1.2% for the death rate and 1% for infections," says Dr Trehan. "Nobody questions the capability of an Indian doctor, because there isn't a big hospital in the United States or Britain where there isn't an Indian doctor working."
Most foreign patients who come to the subcontinent are from other developing countries in Africa, south-east Asia and the Middle East where western-trained doctors and western-quality hospitals are either hard to find or prohibitively expensive.
What little Mr Marshall knew about the country was not favourable and at first he was shocked by the organised chaos of India. "There are so many people here. When I was in the car coming from the airport we got stuck in really heavy traffic. It was hot, there were horns going off and people shouting. I thought, 'Oh hell, I've made a mistake.'" But once in his airconditioned room, with cable television and a personalised nursing service, the 73-year-old says that his stay has been "pretty relaxing. I go for a walk in the morning when it is cool but really I don't have to deal with what's outside".
How many patients will come from Britain ultimately will depend on the NHS, which has begun sending patients for treatment to Europe to cope with its backlog of cases. At present the NHS restricts referrals to hospitals within three hours' flying time - but Indian hospitals say this barrier will eventually be lifted. "It is inevitable. In the west you have rising healthcare costs and an ageing population," says Habil Khoraiwallah, chairman of Wockhardt, who plans to open five hospitals in India next year, including a new 350-bed hospital in Bangalore. "People are already discovering the benefits themselves. Governments will follow."
More here
I cannot help comparing the unfortunate Mr Marshall's experience with my own. I discoved a skin lump on my arm (probably a squamous cell carcinoma -- a dangerous form of skin cancer) a week ago and had it removed by a plastic surgeon yesterday. The hospital I went to is 10 minutes drive away from where I live and I went into surgery within 5 minutes of arriving. I was away from home for less than an hour in all!. I had surgery in less time that it takes many people to go to the supermarket. That is private medicine in Brisbane for you. Total cost: About $250 in U.S. dollars and I get a part of that back from insurance. Sure beats going to India!
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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Three months ago George Marshall fretted about the choice offered by his doctor in Britain. Diagnosed with coronary heart disease, the violin repairer from Bradford was told he could either wait up to six months for a heart bypass operation on the National Health Service or pay œ19,000 to go under the scalpel immediately.
In the end, Mr Marshall chose to outsource his operation to India. Last month he flew 5,000 miles to the southern Indian city of Bangalore where surgeons at the Wockhardt hospital and heart institute took a piece of vein from his arm to repair the thinning arteries of his heart. The cost was œ4,800, including the flight. "Everyone's been really great here. I have been in the NHS and gone private in Britain in the past, but I can say that the care and facilities in India are easily comparable," says Mr Marshall, sitting in hospital-blue pyjamas. "I'd have no problem coming again."
The 73-year-old found the hospital in Bangalore after a few hours surfing the internet. Mr Marshall decided to come after an email conversation with Wockhardt's vice-president and a chat with other "medical tourists" from Britain who had undergone surgery in the hospital. "Once I knew others had come I thought, why not? In Europe hospitals in Germany and Belgium would do the operation for less than doctors in Britain. But Europe was still more expensive than here. And the staff speak English in India."
With patients such as Mr Marshall willing to travel across the globe to get treatment sooner or more cheaply than they could at home, Indian hospital groups see a huge market for their services.....
Many say that it is not just cost but competency that is India's selling point. Naresh Trehan, who earned $2m (œ1.06m) a year as a heart surgeon in Manhattan but returned to start Escorts hospital group in India, said that his hospital in Delhi completed 4,200 heart operations last year. "That is more than anyone else in the world. The death rate for coronary bypass patients at Escorts is 0.8% and the infection rate is 0.3%. This is well below the first-world averages of 1.2% for the death rate and 1% for infections," says Dr Trehan. "Nobody questions the capability of an Indian doctor, because there isn't a big hospital in the United States or Britain where there isn't an Indian doctor working."
Most foreign patients who come to the subcontinent are from other developing countries in Africa, south-east Asia and the Middle East where western-trained doctors and western-quality hospitals are either hard to find or prohibitively expensive.
What little Mr Marshall knew about the country was not favourable and at first he was shocked by the organised chaos of India. "There are so many people here. When I was in the car coming from the airport we got stuck in really heavy traffic. It was hot, there were horns going off and people shouting. I thought, 'Oh hell, I've made a mistake.'" But once in his airconditioned room, with cable television and a personalised nursing service, the 73-year-old says that his stay has been "pretty relaxing. I go for a walk in the morning when it is cool but really I don't have to deal with what's outside".
How many patients will come from Britain ultimately will depend on the NHS, which has begun sending patients for treatment to Europe to cope with its backlog of cases. At present the NHS restricts referrals to hospitals within three hours' flying time - but Indian hospitals say this barrier will eventually be lifted. "It is inevitable. In the west you have rising healthcare costs and an ageing population," says Habil Khoraiwallah, chairman of Wockhardt, who plans to open five hospitals in India next year, including a new 350-bed hospital in Bangalore. "People are already discovering the benefits themselves. Governments will follow."
More here
I cannot help comparing the unfortunate Mr Marshall's experience with my own. I discoved a skin lump on my arm (probably a squamous cell carcinoma -- a dangerous form of skin cancer) a week ago and had it removed by a plastic surgeon yesterday. The hospital I went to is 10 minutes drive away from where I live and I went into surgery within 5 minutes of arriving. I was away from home for less than an hour in all!. I had surgery in less time that it takes many people to go to the supermarket. That is private medicine in Brisbane for you. Total cost: About $250 in U.S. dollars and I get a part of that back from insurance. Sure beats going to India!
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Tuesday, February 08, 2005
SOCIALIZED DENTISTRY A JOKE
In the Australian State of Victoria
On April 13, 1999, a Victorian went onto a waiting list to see a dentist in the public system. Last Christmas, that person was still waiting. Waiting times for an appointment to see a dentist have grown steadily in recent years with an average waiting time of 30.98 months at the end of December 2004, according to a document supplied to The Age. The person waiting the longest, as of a few weeks ago, was the April 13 patient who has been waiting for an appointment for almost six years.
Denture delays are longer, with an average 34.6-month wait, also up from the end of last financial year. The longest denture wait at the end of 2004 was for a person whoser name went on the list on June 22, 1999.
Opposition health spokesman David Davis said the waiting times were ludicrous. He called on the Government to urgently fix the problem. "Nobody should be waiting for dental treatment after all those years; it is simply cruel," Mr Davis said. "Dental pain can be one of the most excruciating and debilitating health problems. Poor dental health impacts directly on to general health . . . Scrimping on dental care will lead to more patients lining up at our public hospitals." Mr Davis said Victoria spent less per head on public dental care than other major states. "Steve Bracks should have properly funded dental services, instead of letting them run down to crisis point. He certainly has not played the tooth fairy for those waiting for treatment since early 1999," he said. Mr Davis also criticised the Government for removing details of waiting times at the state's 61 dental clinics from a Government website in mid-2003.
Figures obtained by The Age under freedom of information laws showed that at October 31, 2004, there were waits of more than five years in Warrnambool and Portland for a dental appointment. In almost half the rural clinics the wait was more than three years. Denture waits were more than five years in Springvale, Portland and Warrnambool, and patients faced a four-year-plus wait in six rural and nine metropolitan clinics.
At the November 2002 state election, the Government pledged to cut dental waiting times, saying: "Oral health is vital to social wellbeing, self-esteem and sound nutrition. Expanding these services and improving access will continue to be a priority for our next term of government."
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
In the Australian State of Victoria
On April 13, 1999, a Victorian went onto a waiting list to see a dentist in the public system. Last Christmas, that person was still waiting. Waiting times for an appointment to see a dentist have grown steadily in recent years with an average waiting time of 30.98 months at the end of December 2004, according to a document supplied to The Age. The person waiting the longest, as of a few weeks ago, was the April 13 patient who has been waiting for an appointment for almost six years.
Denture delays are longer, with an average 34.6-month wait, also up from the end of last financial year. The longest denture wait at the end of 2004 was for a person whoser name went on the list on June 22, 1999.
Opposition health spokesman David Davis said the waiting times were ludicrous. He called on the Government to urgently fix the problem. "Nobody should be waiting for dental treatment after all those years; it is simply cruel," Mr Davis said. "Dental pain can be one of the most excruciating and debilitating health problems. Poor dental health impacts directly on to general health . . . Scrimping on dental care will lead to more patients lining up at our public hospitals." Mr Davis said Victoria spent less per head on public dental care than other major states. "Steve Bracks should have properly funded dental services, instead of letting them run down to crisis point. He certainly has not played the tooth fairy for those waiting for treatment since early 1999," he said. Mr Davis also criticised the Government for removing details of waiting times at the state's 61 dental clinics from a Government website in mid-2003.
Figures obtained by The Age under freedom of information laws showed that at October 31, 2004, there were waits of more than five years in Warrnambool and Portland for a dental appointment. In almost half the rural clinics the wait was more than three years. Denture waits were more than five years in Springvale, Portland and Warrnambool, and patients faced a four-year-plus wait in six rural and nine metropolitan clinics.
At the November 2002 state election, the Government pledged to cut dental waiting times, saying: "Oral health is vital to social wellbeing, self-esteem and sound nutrition. Expanding these services and improving access will continue to be a priority for our next term of government."
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Monday, February 07, 2005
MEDICAID: AMERICA'S VERY OWN SOCIALIZED MEDICINE SYSTEM
Given the huge variations in costs from place to place (note my post of 5th.), it is clear that most of the money is wasted on bureaucracy and inefficiency generally. GWB obviously wants the States to clean up their act
Its costs are spiraling upward, draining state coffers as well as the federal treasury. The primary reason is that as more people lose private insurance, they end up in the Medicaid safety net. Over the past four years, the Medicaid rolls have jumped more than 30 percent. Combine that with the growing number of elderly in nursing homes, and you get a runaway fiscal train that both the states and federal governments agree has to be stopped. But there's a major fight brewing over how to do it.
On Monday, President Bush is expected to propose limiting the federal government's share of the Medicaid bill - perhaps cutting as much as $50 billion over five years. Federal spending on the program is now $180 billion a year. He'd do it by capping the federal allotment in exchange for giving states more flexibility in running their programs. Many governors say that's no solution, since it primarily shifts the financial burden onto the states, most of which are struggling to keep their Medicaid costs in check. In the past year, all 50 states have cut benefits, restricted eligibility, or increased co-pays to keep the program's spending manageable. Some states, like Tennessee are simply cutting large numbers of people from the program.
Other states are experimenting with different ways to rein in spending. In Florida, for example, Gov. Jeb Bush is proposing essentially privatizing much of Medicaid by contracting private health organizations to provide services.
"We could well be on a collision course where state revenues are not expanding enough to meet the needs of the program at the same time the federal contributions are being cut back," says Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured. "The end result will be fewer people or services covered. There's no safety net below Medicaid."
In what could be seen as a preemptive warning to the administration, the National Governors Association sent a letter to congressional leaders last month letting them know that reforming Medicaid is their highest priority this year. But it also urged them to reject any proposed reform that just shifts "additional costs to states." The $120 billion states spend annually on Medicaid is already more than they spend for K-12 education. It now accounts for an average of 22 percent of state budgets.
But the Bush administration is taking a hard line. This week the new secretary of Health and Human Services Mike Leavitt charged that some states use "loopholes" and "gimmicks" essentially to get the federal government to pay a larger share of the program than it should. In a speech to the World Health Congress on Tuesday, he called them the "seven harmful habits of highly desperate states." They include such things as overpaying providers, charging the federal government for the overpayment, and then having it returned to them so they can spend it for other purposes. For their part, the states argue that overall the program is already extremely efficient compared to other healthcare programs. While private health-insurance premiums went up more than 12 percent, Medicaid's annual spending per capita was up only 4.5 percent.
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
Given the huge variations in costs from place to place (note my post of 5th.), it is clear that most of the money is wasted on bureaucracy and inefficiency generally. GWB obviously wants the States to clean up their act
Its costs are spiraling upward, draining state coffers as well as the federal treasury. The primary reason is that as more people lose private insurance, they end up in the Medicaid safety net. Over the past four years, the Medicaid rolls have jumped more than 30 percent. Combine that with the growing number of elderly in nursing homes, and you get a runaway fiscal train that both the states and federal governments agree has to be stopped. But there's a major fight brewing over how to do it.
On Monday, President Bush is expected to propose limiting the federal government's share of the Medicaid bill - perhaps cutting as much as $50 billion over five years. Federal spending on the program is now $180 billion a year. He'd do it by capping the federal allotment in exchange for giving states more flexibility in running their programs. Many governors say that's no solution, since it primarily shifts the financial burden onto the states, most of which are struggling to keep their Medicaid costs in check. In the past year, all 50 states have cut benefits, restricted eligibility, or increased co-pays to keep the program's spending manageable. Some states, like Tennessee are simply cutting large numbers of people from the program.
Other states are experimenting with different ways to rein in spending. In Florida, for example, Gov. Jeb Bush is proposing essentially privatizing much of Medicaid by contracting private health organizations to provide services.
"We could well be on a collision course where state revenues are not expanding enough to meet the needs of the program at the same time the federal contributions are being cut back," says Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured. "The end result will be fewer people or services covered. There's no safety net below Medicaid."
In what could be seen as a preemptive warning to the administration, the National Governors Association sent a letter to congressional leaders last month letting them know that reforming Medicaid is their highest priority this year. But it also urged them to reject any proposed reform that just shifts "additional costs to states." The $120 billion states spend annually on Medicaid is already more than they spend for K-12 education. It now accounts for an average of 22 percent of state budgets.
But the Bush administration is taking a hard line. This week the new secretary of Health and Human Services Mike Leavitt charged that some states use "loopholes" and "gimmicks" essentially to get the federal government to pay a larger share of the program than it should. In a speech to the World Health Congress on Tuesday, he called them the "seven harmful habits of highly desperate states." They include such things as overpaying providers, charging the federal government for the overpayment, and then having it returned to them so they can spend it for other purposes. For their part, the states argue that overall the program is already extremely efficient compared to other healthcare programs. While private health-insurance premiums went up more than 12 percent, Medicaid's annual spending per capita was up only 4.5 percent.
More here
***************************
For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
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