PUBLIC HOSPITALS PREVENT URGENT OPERATIONS

Cancer patients are being forced to wait up to a year for life-saving surgery while other Australians are missing out altogether on long-awaited operations, the Royal Australian College of Surgeons has warned. President-elect Russell Stitz delivered a blistering attack on state and federal governments over "slipping" surgical standards and claimed waiting times were blowing out as teams of hospital administrators imposed tight budgets. Dr Stitz claimed surgeons' hours had been cut at many metropolitan hospitals and said he knew of patients who had been prepared for surgery only to be sent home to reduce surgical teams' hours. "Surgeons want to operate but they won't let us," he said. "We don't believe progress is happening and our surgeons out there are telling us, at the workplace, that patients are being compromised. There is no question that standards of care in this country will drop."

The college called for 200 more trainee surgeons, bringing the national total to 1000, and demanded improved mentoring for overseas-trained doctors. The surgeons claim the situation for patients on hospital waiting lists is worst in NSW and Queensland, but figures released by both state governments showed there have been recent improvements in waiting times. In NSW, the surgical waiting list dropped from 68,500 in January to 66,500 at the end of March, but 10,300 people had been waiting for surgery for more than 12 months. A spokesman for NSW Health Minister Morris Iemma said the $10 million injection of funds he recently announced would reduce the state's waiting lists by 4500 by September.

In Queensland, there were 34,016 people on the surgical waiting lists in April - slightly less than in the same month last year. A spokesman for Queensland Health Minister Gordon Nuttall said successive reports by the Australian Institute of Health and Welfare had deemed surgical waiting times in Queensland the shortest in the nation. The most recent institute report on waiting times found that in Queensland in 2002-03 there were almost 110,000 people on surgical waiting lists, but only 2.6 per cent waited more than a year.

Tasmanian patients were the most likely to wait more than a year for surgery - 10.9 per cent of the more than 12,500 patients on the state's lists in 2002-03 waited more than a year. In NSW during the same period, there were almost 186,000 people on surgical waiting lists and 4.2 per cent waited a year. In Victoria, there were 117,000 people on waiting lists and 4.2 per cent also waited more than a year.

The college's claims about surgical standards and waiting times comes as the Cardiac Society of Australia and New Zealand repeated its claims that up to four Queenslanders a month were dying either because they were being left too long on cardiac waiting lists or because of delays in transferring them from regional to city hospitals. Society chairman Con Aroney recently resigned as a senior cardiologist at Brisbane's Prince Charles Hospital and went into private practice, claiming he had lost confidence in the health department administration after a battle over aspects of the public health system, including the waiting lists


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HEALTH SAVINGS ACCOUNTS TAKING OFF

Health savings accounts were not designed to be the sole solution to the 45 million uninsured in the United States, but as the country observes Cover the Uninsured Week, this new insurance genre appears to be the best -- and at the moment, only -- option going. The Bush administration's best estimates when HSAs came about as part of the Medicare Modernization Act of 2003 were that perhaps 7 million people would pick up on the idea of combining a tax-free savings account for healthcare expenses with a less expensive, high-deductible health insurance plan. The thought was to let people build up the savings account, with their own contributions or money from employers, which they would spend until meeting the deductible -- making them more price-conscious shoppers for healthcare services because they could keep any savings account money leftover at year's end.

It was a surprise for many this week, then, when America's Health Insurance Plans rolled out its latest statistics showing in the 14 months since their inception, HSAs have been opened by 1.03 million Americans -- and virtually all health plans belonging to AHIP now offer HSA options to individuals, as well as to small and large group employers. "It's astonishing," remarked Greg Scandlen of the Galen Institute, a non-profit public policy group, in response to the AHIP numbers. "It's happening now, in the real world ... and Washington needs to pay attention to it." AHIP's survey found 37 percent of the individual policies -- some 204,374 -- were sold to people who were previously uninsured; and 27 percent of the small group market plans, representing 37,868 covered lives, were bought by companies that had not previously offered a health insurance benefit to workers. So roughly 242,000 people went off the uninsured list because of HSAs.....

Bush already has proposed expanding HSAs to make them more attractive to small business, by offering tax credits to those that offer the benefit, and to allow people to deduct from their taxes the cost of the high deductible insurance policy....

HSAs' overall popularity will be tested through 2005-2006 as large group employers offer the product to employees for the first time. As a product for the uninsured, the jury is still out -- but the outcome could well depend on how successful the administration is in pushing through initiatives to help small businesses offer and lower-income adults afford HSAs. How much employers contribute to each worker's savings account also will be a telling factor -- because for many people that might be the only way they can both pay the insurance premium and build up a savings nest.

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.

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