RESTORE PRICE-AWARENESS BY MAKING TAX FAIRER
Prices are advertised everywhere. From newspapers to billboards to websites, we are forever being told how much things cost. Want to buy contact lenses? A cruise to Alaska? A pedicure? The price of almost any product or service is readily available, and vendors vie for business by keeping their prices competitive.
But not when it comes to health care. How much does your local hospital charge to deliver a baby? Which blood pressure drugs are the most affordable? What is the going rate for a pediatric checkup? Most of us couldn't begin to answer such questions. Hospitals and physicians rarely advertise their rates because patients rarely care to learn them. For the majority of Americans under age 65, medical bills are something insurance companies take care of. Few patients have any incentive to focus on price, so few health care providers have any incentive to compete on price. Result: ever-higher health care costs, leading to ever-higher insurance costs.
It may seem natural to rely on insurance to pay for ordinary health needs, but it isn't. After all, we don't use auto insurance for tuneups or tires. Homeowners insurance doesn't cover paint jobs or new applicances. Those kinds of costs we pay out of pocket, which is why we do things like get written estimates or check Consumer Reports. When we're footing the bill, price and value matter.
So why are medical expenses different? The answer has nothing to do with health care -- and everything to do with the tax code. For more than 60 years, federal law has excluded the value of employer-provided health insurance from the employee's taxable income. Buy your own health insurance, and you pay for it with after-tax dollars. Get health insurance through your employer, and it's tax-free. This policy dates from World War II, when a labor shortage caused by wage controls led employers to offer health insurance in lieu of cash as a way to recruit and retain employees. When the IRS agreed to go along with the legal fiction that this employer-paid benefit wasn't really income, it triggered a radical -- but unintended -- change in the way Americans paid for health care. Within 10 years, the number of people with health insurance had soared from fewer than 3 million to nearly 80 million. And instead of the limited coverage that used to be the norm -- typically, only hospitalization was insured against -- health insurance gradually expanded to cover day-to-day medical costs.
Economics and human nature don't change when it comes to health care: Insulate consumers from the cost of the choices they make, and those choices tend to become more extravagant and oblivious to price. Give them a reason to care about the bottom line, and their spending becomes more cost-conscious and careful. Which is why real health care reform starts with tax reform.
After 60 years, it's too late to repeal the tax shelter for employer-provided health insurance. But why not extend that favorable treatment to individuals' own health expenditures? The goal should be to alter the way people buy health care by giving them a financial stake in its cost. That would be the result of leveling the playing field between medical benefits provided by an employer and those that taxpayers provide for themselves.
As John Cogan and Daniel Kessler of Stanford's Hoover Institution and R. Glenn Hubbard of Columbia have proposed, all medical expenses should be made tax-deductible for everyone, so long as they are covered for catastrophic health care. Medical expenses would include an employee's contribution to employer-provided insurance or the cost of insurance purchased individually, as well as out-of-pocket spending. Taxpayers would be free to stick with their employer's expensive health plan if they wished, but now there would be no tax incentive to do so. Most employees would choose to switch to a cheaper health plan with higher deductibles and co-pays. Employers' health care costs would fall sharply, and market pressures would ensure that those savings returned to employees in the form of higher wages.
Higher co-pays will make consumers "more cost-conscious and more willing to take greater control of health care decisions," write Cogan, Kessler, and Hubbard. "Ultimately, consumers will make better health care choices, achieving improved . . . outcomes and considerable savings." Based on RAND Corporation research, they estimate that making medical expenses deductible would reduce health care spending by $40 billion -- all without forcing a single benefit cut on anyone.
With health care no longer a function of employment, concerns about portability would vanish -- your benefits would go wherever you went. Because insurance would be more affordable, fewer Americans would remain uninsured. Above all, consumers would be in charge of their own health care. As a result, providers would compete for their business and prices would come out of the shadows. Would it be the last word in health care reform? Far from it. But it would make a terrific first step.
From Jeff Jacoby
Comment from a medical specialist on yesterday's post:
"Great story on clinics at Target etc. No doubt these clinics will refer difficult cases to an ER - liability would be high if they didn't. But the majority of ER visits could be handled by a nurse anyway. But don't count liability out - Target will be a bigger target than any hospital (pun intended) - the deep pockets of Target or Wal Mart will be irresistable to legal predators, which may be the undoing of this common sense solution to long lines in doctors' offices and ERs.
But such clinics will NEVER be viable in the inner city. Our ER is totally overwhelmed by mental patients -- many of them "homeless" who simply want shelter and a handout, but ER doctors are afraid of just telling them to "get lost" because of liability -- most know how to pretend they are suicidal, guaranteeing them food, shelter, etc. So everyone else waits in line".
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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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Thursday, June 30, 2005
Wednesday, June 29, 2005
New Kind of Clinic in Supermarkets, Stores Offering Swift Treatment for Simple Illnesses
When Ann Theisen's 6-year-old daughter, Hannah, had a sore throat, she didn't take the little girl to the family doctor. Instead, she went to the Cub Foods store down the street from her house, lured by the prospect of faster treatment at a MinuteClinic tucked into a corner of the supermarket. Within about 15 minutes -- no appointment necessary -- they were seen and had the results of a rapid strep test: negative. "It's the convenience factor," Theisen said.
MinuteClinic, based in Minneapolis, is on the leading edge of a new kind of clinic that offers swift treatment for simple illnesses. MinuteClinic operates in 22 locations in the Twin Cities and Baltimore, most of them in Target Corp., the nation's second-largest discount department store chain; Cub Foods, operated by grocery retailer Supervalu Inc.; and CVS Corp. stores. The company has big plans to open more than 80 clinics in 12 major metropolitan areas east of the Rockies by year's end, and to push westward next year. "The demand for this is so amazingly consistent," said chief executive Michael Howe, the former Arby's head who joined the company earlier this month. "It's really something we've all been looking for -- making health care a little more convenient and affordable for everyone."
At the quick-service clinics, nurse practitioners diagnose and treat strep throat, pink eye, bronchitis and other common ailments. Howe and other MinuteClinic executives say their business is to health care what ATMs are to banks -- making ordinary transactions easier while freeing up traditional providers for more complicated cases. It is a low-tech, low-cost innovation that could catch on, said Matt Eyring of Innosight, a consulting company that tracks health care trends. The average MinuteClinic visit does not require an appointment and costs the patient less than $50, Howe said. The cost can be shaved down to the same co-payment as a doctor visit under several major health insurance plans. "This is something that makes medicine much more available to consumers," Eyring said. "This kind of service will spread."
MinuteClinic was founded five years ago. Its competitors include MediMin, which operates in the Cleveland area, FastCare in Louisville, Ky., and QuickClinic in Akron, Ohio. Howe would not disclose MinuteClinic's annual sales or profit. Each clinic treats an average of 30 to 35 patients a day, he said. More than three-quarters of those who visit the clinics have health insurance. Major plans -- including Blue Cross Blue Shield, UnitedHealth Group and Medicare -- include MinuteClinics in their networks in the Twin Cities.
Some employers have lowered insurance co-payments for MinuteClinic visits because they cost less than traditional doctor visits, Howe said. And some companies -- including electronics retailer Best Buy Co., Carlson Cos. and medical device maker Guidant Corp. -- host MinuteClinic operations at their corporate locations in the Twin Cities.
The American Medical Association and the American Hospital Association are wary of the trend. What is best for patients, they say, is an ongoing relationship with a doctor. "We don't want to see nursing care substituted for physician care," said Dr. Edward Hill, president-elect of the AMA. "This type of clinic might not lend itself very well for continuity."
But Mai Pham, a senior researcher at the nonpartisan Center for Studying Health System Change, said the clinics could provide a better alternative for patients who might otherwise go to an emergency room for care or skip it altogether. "It's clearly meeting a market need, but there's also concerns about why it is there is such a need," Pham said.
Howe said MinuteClinics limit their work to common illnesses and are quick to send patients to emergency rooms or back to their primary doctors if other symptoms turn up. The clinics also pass records on to patients' doctors and help those who do not have a physician find one. Strep tests are the most common procedure performed at the clinics. That's what Theisen, a nurse who lives in the Minneapolis suburb of Maple Grove, wanted for her daughter in a hurry. "If we would have gone to our doctor, it would take an hour longer," she said.
The trip to the MinuteClinic cost Theisen an insurance co-payment -- the same amount she would have paid to see their regular doctor. "I grocery-shopped while I was waiting," she 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.
***************************
When Ann Theisen's 6-year-old daughter, Hannah, had a sore throat, she didn't take the little girl to the family doctor. Instead, she went to the Cub Foods store down the street from her house, lured by the prospect of faster treatment at a MinuteClinic tucked into a corner of the supermarket. Within about 15 minutes -- no appointment necessary -- they were seen and had the results of a rapid strep test: negative. "It's the convenience factor," Theisen said.
MinuteClinic, based in Minneapolis, is on the leading edge of a new kind of clinic that offers swift treatment for simple illnesses. MinuteClinic operates in 22 locations in the Twin Cities and Baltimore, most of them in Target Corp., the nation's second-largest discount department store chain; Cub Foods, operated by grocery retailer Supervalu Inc.; and CVS Corp. stores. The company has big plans to open more than 80 clinics in 12 major metropolitan areas east of the Rockies by year's end, and to push westward next year. "The demand for this is so amazingly consistent," said chief executive Michael Howe, the former Arby's head who joined the company earlier this month. "It's really something we've all been looking for -- making health care a little more convenient and affordable for everyone."
At the quick-service clinics, nurse practitioners diagnose and treat strep throat, pink eye, bronchitis and other common ailments. Howe and other MinuteClinic executives say their business is to health care what ATMs are to banks -- making ordinary transactions easier while freeing up traditional providers for more complicated cases. It is a low-tech, low-cost innovation that could catch on, said Matt Eyring of Innosight, a consulting company that tracks health care trends. The average MinuteClinic visit does not require an appointment and costs the patient less than $50, Howe said. The cost can be shaved down to the same co-payment as a doctor visit under several major health insurance plans. "This is something that makes medicine much more available to consumers," Eyring said. "This kind of service will spread."
MinuteClinic was founded five years ago. Its competitors include MediMin, which operates in the Cleveland area, FastCare in Louisville, Ky., and QuickClinic in Akron, Ohio. Howe would not disclose MinuteClinic's annual sales or profit. Each clinic treats an average of 30 to 35 patients a day, he said. More than three-quarters of those who visit the clinics have health insurance. Major plans -- including Blue Cross Blue Shield, UnitedHealth Group and Medicare -- include MinuteClinics in their networks in the Twin Cities.
Some employers have lowered insurance co-payments for MinuteClinic visits because they cost less than traditional doctor visits, Howe said. And some companies -- including electronics retailer Best Buy Co., Carlson Cos. and medical device maker Guidant Corp. -- host MinuteClinic operations at their corporate locations in the Twin Cities.
The American Medical Association and the American Hospital Association are wary of the trend. What is best for patients, they say, is an ongoing relationship with a doctor. "We don't want to see nursing care substituted for physician care," said Dr. Edward Hill, president-elect of the AMA. "This type of clinic might not lend itself very well for continuity."
But Mai Pham, a senior researcher at the nonpartisan Center for Studying Health System Change, said the clinics could provide a better alternative for patients who might otherwise go to an emergency room for care or skip it altogether. "It's clearly meeting a market need, but there's also concerns about why it is there is such a need," Pham said.
Howe said MinuteClinics limit their work to common illnesses and are quick to send patients to emergency rooms or back to their primary doctors if other symptoms turn up. The clinics also pass records on to patients' doctors and help those who do not have a physician find one. Strep tests are the most common procedure performed at the clinics. That's what Theisen, a nurse who lives in the Minneapolis suburb of Maple Grove, wanted for her daughter in a hurry. "If we would have gone to our doctor, it would take an hour longer," she said.
The trip to the MinuteClinic cost Theisen an insurance co-payment -- the same amount she would have paid to see their regular doctor. "I grocery-shopped while I was waiting," she 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.
***************************
Tuesday, June 28, 2005
BUREAUCRATIC KNOW-ALLS HIT A ROCK
They leapt to judgment on the basis of statistics and now find that they haven't even got enough evidence to file charges. Are the Feds going to pay for the huge losses they caused? Not likely
The FBI's case against two prominent Redding physicians, suspected of performing hundreds of unnecessary heart procedures, appears to have stalled. Despite repeated rumors of impending criminal indictments against the doctors the past two years, no fraud charges have been filed by the U.S. attorney's office. The delay has frustrated lawyers whose own legal interests may be affected by the outcome of a federal case.
In late October 2003, the FBI dropped a bombshell on Northern California with its 80-page affidavit detailing the alleged operating room shenanigans of two of Redding's most revered doctors. Over the next 2 1/2 years, the allegations against cardiologist Chae Hyun Moon and cardiac surgeon Fidel Realyvasquez Jr. would divide the Shasta County community, garner national media attention, shutter a lucrative cardiac surgery program and result in more than $400 million in settlement payments for victims of the alleged wrongdoing.
A spokeswoman for the U.S. attorney's office in Sacramento did not respond to inquiries on the delay. But several observers suggested an investigating federal grand jury may be hampered by the complexity of the medical procedures in question and the range of opinion about what constitutes the accepted standard of care. "In today's world, you can find competing experts," said McGeorge School of Law professor Mike Vitiello. "It's difficult to make reasoned decisions about highly technical matters when expert opinions are in stark contrast to one another." Moon, for example, was known to forgo more conventional diagnostic tools, such as the treadmill stress test, to determine a patient's risk for heart attack. Instead, he often used the intravascular ultrasound, or IVUS, a costly and rarely used technology known to produce results only specially trained experts can decipher. Moon claimed the IVUS was superior to the less expensive approaches, but experts consulted early in the investigation said the surgeries Moon recommended based on his IVUS analyses were unnecessary.
According to the FBI affidavit, Realyvasquez and Moon performed excessive numbers of costly and invasive diagnostic procedures and heart surgeries compared with their counterparts in Northern California. Agents said Realyvasquez was ranked No. 1 on a Medicare list of 50 cardiologists paid in Northern California between July 2001 and July 2002. In that 12-month period he billed the federal government more than $3.5 million and was paid $767,600. For his part, Moon billed Medicare $3.9 million and was paid $1.6 million.
To convict the doctors of fraud, federal prosecutors would have to prove that Moon and Realyvasquez intended to deceive the government by knowingly performing unnecessary operations, then billing Medicaid or Medicare for their services. Proving medical malpractice is less complex and the stakes are lower, experts said. "The purpose of the criminal justice system is to take bad people who have done bad things and segregate them from society," said Vitiello. "If a doctor is careless, do we really want to hold over their head the risk of going to prison for that mistake?"
The civil cases against the doctors have moved more quickly. In January, Moon and three other Redding cardiologists settled with hundreds of patients for $24 million. Tenet Healthcare Corp., which owned Redding Medical Center, where the surgeries took place, paid $395 million to patients and $54 million to the federal government.
Realyvasquez and three other surgeons have refused to settle the civil cases, and a trial is scheduled to begin in September. "I have an absolute and firm belief that Doctor Realyvasquez only acted for the benefit of his patients," said Malcolm Segal, one of the surgeon's attorneys. Segal said he hopes the criminal matter is resolved before the civil trial starts in the fall. "It would be much easier to handle the civil litigation if the federal inquiry had concluded without any charges filed," he said.
The surgeon's ability to practice medicine remains tenuous. Although the Medical Board of California never filed a formal accusation against him, Realyvasquez has not practiced medicine since February 2003. "The allegations and the efforts refuting the statements made by others has consumed an enormous amount of his time," Segal said. "It has been extraordinarily expensive for him." Moon, who faces a formal board accusation, agreed to a temporary license suspension in June 2003, and it remains in effect pending the outcome of any criminal proceeding. His attorney did not return telephone calls.
Stephen Boreman, the deputy attorney general in charge of the medical board's case, said that while everyone involved would like to know how the U.S. attorney's office will proceed, he's confident the public is being well-served. "The public is protected because (the doctors) are not practicing medicine," he said. "I don't view this as anything negative for the people of California." [Since loss of highly skilled medical services to a community can only be detrimental, this is nothing more than prejudging the doctors as guilty]
Source
Bad medicine: "History is full of failed experiments in government control of the distribution of goods and services; some are still ongoing (Cuba). The results speak for themselves: wherever free trade and economic rights are stifled, shortages abound. We can even find examples of that here in the US: Nixon's attempts at price and wage controls as well as today's health care 'crisis' caused not by the private practice of medicine but by government's growing influence in this sector."
***************************
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.
***************************
They leapt to judgment on the basis of statistics and now find that they haven't even got enough evidence to file charges. Are the Feds going to pay for the huge losses they caused? Not likely
The FBI's case against two prominent Redding physicians, suspected of performing hundreds of unnecessary heart procedures, appears to have stalled. Despite repeated rumors of impending criminal indictments against the doctors the past two years, no fraud charges have been filed by the U.S. attorney's office. The delay has frustrated lawyers whose own legal interests may be affected by the outcome of a federal case.
In late October 2003, the FBI dropped a bombshell on Northern California with its 80-page affidavit detailing the alleged operating room shenanigans of two of Redding's most revered doctors. Over the next 2 1/2 years, the allegations against cardiologist Chae Hyun Moon and cardiac surgeon Fidel Realyvasquez Jr. would divide the Shasta County community, garner national media attention, shutter a lucrative cardiac surgery program and result in more than $400 million in settlement payments for victims of the alleged wrongdoing.
A spokeswoman for the U.S. attorney's office in Sacramento did not respond to inquiries on the delay. But several observers suggested an investigating federal grand jury may be hampered by the complexity of the medical procedures in question and the range of opinion about what constitutes the accepted standard of care. "In today's world, you can find competing experts," said McGeorge School of Law professor Mike Vitiello. "It's difficult to make reasoned decisions about highly technical matters when expert opinions are in stark contrast to one another." Moon, for example, was known to forgo more conventional diagnostic tools, such as the treadmill stress test, to determine a patient's risk for heart attack. Instead, he often used the intravascular ultrasound, or IVUS, a costly and rarely used technology known to produce results only specially trained experts can decipher. Moon claimed the IVUS was superior to the less expensive approaches, but experts consulted early in the investigation said the surgeries Moon recommended based on his IVUS analyses were unnecessary.
According to the FBI affidavit, Realyvasquez and Moon performed excessive numbers of costly and invasive diagnostic procedures and heart surgeries compared with their counterparts in Northern California. Agents said Realyvasquez was ranked No. 1 on a Medicare list of 50 cardiologists paid in Northern California between July 2001 and July 2002. In that 12-month period he billed the federal government more than $3.5 million and was paid $767,600. For his part, Moon billed Medicare $3.9 million and was paid $1.6 million.
To convict the doctors of fraud, federal prosecutors would have to prove that Moon and Realyvasquez intended to deceive the government by knowingly performing unnecessary operations, then billing Medicaid or Medicare for their services. Proving medical malpractice is less complex and the stakes are lower, experts said. "The purpose of the criminal justice system is to take bad people who have done bad things and segregate them from society," said Vitiello. "If a doctor is careless, do we really want to hold over their head the risk of going to prison for that mistake?"
The civil cases against the doctors have moved more quickly. In January, Moon and three other Redding cardiologists settled with hundreds of patients for $24 million. Tenet Healthcare Corp., which owned Redding Medical Center, where the surgeries took place, paid $395 million to patients and $54 million to the federal government.
Realyvasquez and three other surgeons have refused to settle the civil cases, and a trial is scheduled to begin in September. "I have an absolute and firm belief that Doctor Realyvasquez only acted for the benefit of his patients," said Malcolm Segal, one of the surgeon's attorneys. Segal said he hopes the criminal matter is resolved before the civil trial starts in the fall. "It would be much easier to handle the civil litigation if the federal inquiry had concluded without any charges filed," he said.
The surgeon's ability to practice medicine remains tenuous. Although the Medical Board of California never filed a formal accusation against him, Realyvasquez has not practiced medicine since February 2003. "The allegations and the efforts refuting the statements made by others has consumed an enormous amount of his time," Segal said. "It has been extraordinarily expensive for him." Moon, who faces a formal board accusation, agreed to a temporary license suspension in June 2003, and it remains in effect pending the outcome of any criminal proceeding. His attorney did not return telephone calls.
Stephen Boreman, the deputy attorney general in charge of the medical board's case, said that while everyone involved would like to know how the U.S. attorney's office will proceed, he's confident the public is being well-served. "The public is protected because (the doctors) are not practicing medicine," he said. "I don't view this as anything negative for the people of California." [Since loss of highly skilled medical services to a community can only be detrimental, this is nothing more than prejudging the doctors as guilty]
Source
Bad medicine: "History is full of failed experiments in government control of the distribution of goods and services; some are still ongoing (Cuba). The results speak for themselves: wherever free trade and economic rights are stifled, shortages abound. We can even find examples of that here in the US: Nixon's attempts at price and wage controls as well as today's health care 'crisis' caused not by the private practice of medicine but by government's growing influence in this sector."
***************************
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, June 27, 2005
CANADIANS GETTING FED UP WITH DANGEROUS DENIAL OF MEDICAL SERVICES
Breast cancer patients sue over radiotherapy wait times
Quebec Superior Court Justice John Bishop has authorized a class action suit on behalf of 10 000 Quebec breast cancer patients who contend they had to wait too long for radiotherapy. "This is the first time someone has taken action against waiting lists," says Montréal lawyer Michel Savonitto, who filed the suit in 2000 at the request of a Montréal woman. Bishop's precedent-setting ruling could open the door to similar lawsuits across Canada.
Anahit Cilinger had a partial mastectomy with lymph node removal in October 1999 and was put on a waiting list for radiotherapy. Twelve weeks later, she was still waiting. There was no place in Quebec where she could receive radiotherapy, and she couldn't get confirmation of plans to send her to the US. Angry and anxious, she returned to her native Turkey, where she paid US$12 000 for radiotherapy at an Istanbul hospital. "Nobody could tell her what the final delay would be," says Savonitto. "For her, it was unacceptable."
Cilinger spearheaded the class action suit. "I don't want other women to suffer the way I did while I was waiting for my treatment," she said. If the suit is successful, Savonitto estimates it could cost hospitals $25 million to $50 million. Savonitto filed more than a dozen medical articles to back his case. The evidence convinced Bishop that a medically acceptable delay between breast cancer surgery and radiotherapy ranges from 8 to 12 weeks. In his 41-page decision, delivered Mar. 9, he acknowledged a higher risk of breast cancer recurrence exists after longer delays.
Hospital administrators at the dozen Quebec hospitals named in the lawsuit may have to defend their decisions in court. The court must decide what constitutes an acceptable standard of care for women who need radiotherapy after breast cancer surgery. The real question, says Margaret Somerville, founding director of the McGill Centre for Medicine, Ethics and Law, is whether failing at that standard constitutes negligence. "These time periods seem very important," she admits, "but this is a zero-sum game. There's only so much money [in the health care system]. What do we do?"
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.
***************************
Breast cancer patients sue over radiotherapy wait times
Quebec Superior Court Justice John Bishop has authorized a class action suit on behalf of 10 000 Quebec breast cancer patients who contend they had to wait too long for radiotherapy. "This is the first time someone has taken action against waiting lists," says Montréal lawyer Michel Savonitto, who filed the suit in 2000 at the request of a Montréal woman. Bishop's precedent-setting ruling could open the door to similar lawsuits across Canada.
Anahit Cilinger had a partial mastectomy with lymph node removal in October 1999 and was put on a waiting list for radiotherapy. Twelve weeks later, she was still waiting. There was no place in Quebec where she could receive radiotherapy, and she couldn't get confirmation of plans to send her to the US. Angry and anxious, she returned to her native Turkey, where she paid US$12 000 for radiotherapy at an Istanbul hospital. "Nobody could tell her what the final delay would be," says Savonitto. "For her, it was unacceptable."
Cilinger spearheaded the class action suit. "I don't want other women to suffer the way I did while I was waiting for my treatment," she said. If the suit is successful, Savonitto estimates it could cost hospitals $25 million to $50 million. Savonitto filed more than a dozen medical articles to back his case. The evidence convinced Bishop that a medically acceptable delay between breast cancer surgery and radiotherapy ranges from 8 to 12 weeks. In his 41-page decision, delivered Mar. 9, he acknowledged a higher risk of breast cancer recurrence exists after longer delays.
Hospital administrators at the dozen Quebec hospitals named in the lawsuit may have to defend their decisions in court. The court must decide what constitutes an acceptable standard of care for women who need radiotherapy after breast cancer surgery. The real question, says Margaret Somerville, founding director of the McGill Centre for Medicine, Ethics and Law, is whether failing at that standard constitutes negligence. "These time periods seem very important," she admits, "but this is a zero-sum game. There's only so much money [in the health care system]. What do we do?"
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, June 26, 2005
Hope snatched from dying child by government medical system
In Australia's notorious State of New South Wales, unsurprisingly
After being told two months ago nothing could be done to save her, a little girl received an extraordinary second chance at life, only to have it taken away. Kayla Hilderbrandt's health improved just enough to ensure she could survive surgery to replace her faulty heart valve. Her doctors and parents seized the window of opportunity, booking her in for urgent surgery at Sydney's Westmead Children's Hospital.
Since being admitted last week, her life-saving operation has been cancelled three times because the hospital had no intensive care beds available. She is angry, her parents are angry, but the hospital says there is nothing they can do about it. "I felt angry because they made me fast and not drink and my stomach gets all upset," Kayla said from her hospital bed yesterday. "The medicine was disgusting and made me feel like wanting to be sick."
It has been an emotional roller coaster for the 13-year-old from Mangrove Mountain on the NSW Central Coast, who has been too ill to go to school for most of this year. She is terrified about the surgery and has been even more anxious each of the three nights before her scheduled operations, which required fasting and special anti-bacterial bathing.
Kayla's mother Gina was especially distressed yesterday, saying the cancellation of her child's surgery was "absolutely disgusting". "They are using the ICU as an overflow from the emergency department, so there is no room for any of the surgical patients," she said. "All the kids who needed heart operations were cancelled the same day that Kayla was. "Kayla needs this surgery now while she is well enough to have it. Two months ago we were told there was no hope for her."
Mrs Hilderbrandt said her daughter suffered from high blood pressure, which had been managed with medication for four years. This year the medication stopped working, leaving Kayla's liver and kidneys congested because her heart was so weak. Doctors have told the family Kayla needs her mitral valve replaced - one of the heart's major valves.
Her operation has been rescheduled for Wednesday, with no guarantees it will definitely go ahead. "I just want a yes/no answer," Kayla's father Kit said. "I don't want her prepared for surgery only to have it cancelled again." Westmead Children's Hospital CEO Professor Kim Oates said the hospital would "move heaven and earth" to ensure Kayla's booking for surgery on Wednesday morning will go ahead. Professor Oates said Kayla's surgery was cancelled because the ICU was full because of the problems caused by the busy winter period. "It's not a financial problem, it's a staffing problem," he said. "We won't do heart surgery unless we have a fully-staffed ICU bed for the next 72 hours."
Kayla is just one of up to 30 per cent of surgical patients across the state whose operations are cancelled on the day because an intensive care bed is not available for them. Dr Patrick Cregan, chair of the NSW Health's Surgical Services Taskforce, established last year to manage surgery patients, said Westmead Hospital's cancellation rate was close to 30 per cent for patients needing an intensive care bed after their operation. "It is always terribly distressing for the patient to be cancelled on the day of their operation," he said. "The patients for which it happens more frequently is those needing intensive care beds."
Source
AMBULANCES UNDER ATTACK IN BRITAIN
The number of ambulances could be halved within the next six years as part of an overhaul of emergency care in the NHS. A government review of ambulance services to be published next week is expected to recommend a sharp reduction in the number of people taken to accident and emergency departments. Non-urgent call-outs, such as a cut finger or earache, are to be given to a growing army of emergency care practitioners (ECPs), who are trained to treat minor ailments outside hospital. Peter Bradley, the national ambulance adviser to the Department of Health and leader of the review, told a conference last week that he could envisage a significant decrease in ambulance use.
A cut in the number of ambulances is not suggested in the review, although it will outline the importance of a significant reallocation of resources to make the service more focused on "treatment than transport". It is known that Mr Bradley and George Alberti, the national director for emergency access, hope to increase the use of ECPs, who combine elements of nursing, medicine and the role of paramedics. ECPs travel alone in people carriers carrying the basic equipment for their work.
The national ambulance review will outline ways to reduce the number of patients taken to accident and emergency departments by a million a year. Mr Bradley, the chief executive of the London Ambulance Service Trust, said that he wanted to see the service becoming a "mobile unit of the NHS taking healthcare to patients". His vision, outlined at the NHS Confederation conference and reported in Health Service Journal, includes doctors dealing with 999 calls in call centres, with ECPs taking on extra services such as diagnostics and blood sampling. "We are going to see a big shift from not only providing clinical guidance in the field but also in the control centres - dealing with patients at source rather than elsewhere," he said. Mr Bradley said that in London ECPs could rise from 3 to 30 per cent of the NHS workforce by 2011. Less than half of all callers would be taken to A&E, compared with three-quarters now. "Maybe in 2011 we'll have only half as many (ambulances)," he said. "We'll have ECPs singly responding in people carriers. We'll be a lot less reliant on a big 3-tonne ambulance going out at o140,000 apiece."
Last night the Department of Health denied that any ambulances would be cut as part of the overhaul of emergency care. The BBC Radio 4 Today programme yesterday highlighted discrepancies in ambulance response times by different trusts. The programme claimed that many trusts do not start the clock until 1® or 2 minutes after the call is received, and in at least one case the delay may be as much as 3 or 4 minutes, distorting results
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.
***************************
In Australia's notorious State of New South Wales, unsurprisingly
After being told two months ago nothing could be done to save her, a little girl received an extraordinary second chance at life, only to have it taken away. Kayla Hilderbrandt's health improved just enough to ensure she could survive surgery to replace her faulty heart valve. Her doctors and parents seized the window of opportunity, booking her in for urgent surgery at Sydney's Westmead Children's Hospital.
Since being admitted last week, her life-saving operation has been cancelled three times because the hospital had no intensive care beds available. She is angry, her parents are angry, but the hospital says there is nothing they can do about it. "I felt angry because they made me fast and not drink and my stomach gets all upset," Kayla said from her hospital bed yesterday. "The medicine was disgusting and made me feel like wanting to be sick."
It has been an emotional roller coaster for the 13-year-old from Mangrove Mountain on the NSW Central Coast, who has been too ill to go to school for most of this year. She is terrified about the surgery and has been even more anxious each of the three nights before her scheduled operations, which required fasting and special anti-bacterial bathing.
Kayla's mother Gina was especially distressed yesterday, saying the cancellation of her child's surgery was "absolutely disgusting". "They are using the ICU as an overflow from the emergency department, so there is no room for any of the surgical patients," she said. "All the kids who needed heart operations were cancelled the same day that Kayla was. "Kayla needs this surgery now while she is well enough to have it. Two months ago we were told there was no hope for her."
Mrs Hilderbrandt said her daughter suffered from high blood pressure, which had been managed with medication for four years. This year the medication stopped working, leaving Kayla's liver and kidneys congested because her heart was so weak. Doctors have told the family Kayla needs her mitral valve replaced - one of the heart's major valves.
Her operation has been rescheduled for Wednesday, with no guarantees it will definitely go ahead. "I just want a yes/no answer," Kayla's father Kit said. "I don't want her prepared for surgery only to have it cancelled again." Westmead Children's Hospital CEO Professor Kim Oates said the hospital would "move heaven and earth" to ensure Kayla's booking for surgery on Wednesday morning will go ahead. Professor Oates said Kayla's surgery was cancelled because the ICU was full because of the problems caused by the busy winter period. "It's not a financial problem, it's a staffing problem," he said. "We won't do heart surgery unless we have a fully-staffed ICU bed for the next 72 hours."
Kayla is just one of up to 30 per cent of surgical patients across the state whose operations are cancelled on the day because an intensive care bed is not available for them. Dr Patrick Cregan, chair of the NSW Health's Surgical Services Taskforce, established last year to manage surgery patients, said Westmead Hospital's cancellation rate was close to 30 per cent for patients needing an intensive care bed after their operation. "It is always terribly distressing for the patient to be cancelled on the day of their operation," he said. "The patients for which it happens more frequently is those needing intensive care beds."
Source
AMBULANCES UNDER ATTACK IN BRITAIN
The number of ambulances could be halved within the next six years as part of an overhaul of emergency care in the NHS. A government review of ambulance services to be published next week is expected to recommend a sharp reduction in the number of people taken to accident and emergency departments. Non-urgent call-outs, such as a cut finger or earache, are to be given to a growing army of emergency care practitioners (ECPs), who are trained to treat minor ailments outside hospital. Peter Bradley, the national ambulance adviser to the Department of Health and leader of the review, told a conference last week that he could envisage a significant decrease in ambulance use.
A cut in the number of ambulances is not suggested in the review, although it will outline the importance of a significant reallocation of resources to make the service more focused on "treatment than transport". It is known that Mr Bradley and George Alberti, the national director for emergency access, hope to increase the use of ECPs, who combine elements of nursing, medicine and the role of paramedics. ECPs travel alone in people carriers carrying the basic equipment for their work.
The national ambulance review will outline ways to reduce the number of patients taken to accident and emergency departments by a million a year. Mr Bradley, the chief executive of the London Ambulance Service Trust, said that he wanted to see the service becoming a "mobile unit of the NHS taking healthcare to patients". His vision, outlined at the NHS Confederation conference and reported in Health Service Journal, includes doctors dealing with 999 calls in call centres, with ECPs taking on extra services such as diagnostics and blood sampling. "We are going to see a big shift from not only providing clinical guidance in the field but also in the control centres - dealing with patients at source rather than elsewhere," he said. Mr Bradley said that in London ECPs could rise from 3 to 30 per cent of the NHS workforce by 2011. Less than half of all callers would be taken to A&E, compared with three-quarters now. "Maybe in 2011 we'll have only half as many (ambulances)," he said. "We'll have ECPs singly responding in people carriers. We'll be a lot less reliant on a big 3-tonne ambulance going out at o140,000 apiece."
Last night the Department of Health denied that any ambulances would be cut as part of the overhaul of emergency care. The BBC Radio 4 Today programme yesterday highlighted discrepancies in ambulance response times by different trusts. The programme claimed that many trusts do not start the clock until 1® or 2 minutes after the call is received, and in at least one case the delay may be as much as 3 or 4 minutes, distorting results
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, June 25, 2005
AUSTRALIA: A TOTALLY CORRUPT PUBLIC MEDICINE SYSTEM
In the State of Queensland
Elective surgery lists at Bundaberg hospital were given priority by how much money operations brought in rather than the health needs of patients, the health inquiry has heard. Inquiry commissioner Tony Morris, QC, said he was "physically sickened" by evidence showing that staff at the public hospital were under pressure to meet surgery "targets" in order to get more funding from head office.
The inquiry was told previously that more complex operations helped the hospital reach its targets sooner, which encouraged Bundaberg Base Hospital's former director of surgery Dr Jayant Patel to perform procedures outside his and the hospital's scope. Mr Morris identified the policy yesterday as evidence of a systemic problem and said he did not necessarily blame the hospital's stood-aside director of medical services, Dr Darren Keating, for urging staff to meet the targets. "I am physically sickened by the thought that patients are being treated as units of commerce to be pushed through to get extra money," he said.
In another development last night, Mr Morris indicated that the hospital's director of nursing Linda Mulligan would not face criminal charges or referral to the Crime and Misconduct Commission on the "evidence so far", saying that allegations and criticisms against her concerned her management style and inaccessibility. Mr Morris said the inquiry could not descend into the minutiae of claims and counter-claims about how Ms Mulligan managed staff. But he said he could not extend the same qualified clearance to Dr Keating and district manager Peter Leck.
Earlier, senior Bundaberg hospital operating theatre nurse Jenny White said despite the extra workload placed on staff by the hospital's money-hungry structure, the resulting cash was rarely spent on increasing staff numbers, providing more training for nurses or getting new equipment.
Queensland Nurses Union lawyer John Allen tendered a February 2005 e-mail from Dr Keating to chief operating theatre nurse Gail Doherty, in which he stressed the hospital was behind its target and therefore risked missing out on more than $750,000. "Should the target not be achieved, BHSD (Bundaberg hospital) will not get another chance to upgrade the target and hence lose flexibility and significant dollars (with increased scrutiny of all dollars spent in OT)," Dr Keating wrote. "Therefore it is imperative that everyone continue to pull together and maximise elective surgery thruput (sic) until Jun (sic) 30. "All cancellations should be minimal with these cases pushed thru (sic) as much as possible."
The inquiry has already heard that Bundaberg surgeon Jayant Patel bragged to staff that he was untouchable because he generated so much money for the hospital's management through the high number of operations he performed. Dr Patel fled Australia in April and has since been linked to the deaths of at least 87 patients.
Ms White, who stood down from her position as nurse-in-charge of the operating theatre last year but still works in the unit, said the staffing and funding problems she complained about still existed. Queensland Health barrister David Boddice put it to Ms White last night that surgery was not performed with the priority of earning money, but she refused to agree. She also did not agree with his assertion that elective surgery targets went up and down each year – she said they were always increasing.
Source
Massachusetts: Romney eyes tax penalties for uninsured: "Massachusetts residents who choose not to obtain health insurance would face tax penalties and even the garnishing of their wages under a proposal Governor Mitt Romney unveiled yesterday. Romney says the 'individual mandate' he is proposing, part of his broader plan to cover the roughly 500,000 people who are uninsured, would not cost the state any money. But some healthcare specialists say the approach might cost hundreds of millions of dollars more than state taxpayers currently provide for government health coverage. Romney's plan would require all residents in Massachusetts to have some form of health insurance or agree to pay their medical bills out of their own pockets. No other state has such a requirement, and if Romney manages to make it law, it would be a compelling accomplishment he could point to if he runs for president."
***************************
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 State of Queensland
Elective surgery lists at Bundaberg hospital were given priority by how much money operations brought in rather than the health needs of patients, the health inquiry has heard. Inquiry commissioner Tony Morris, QC, said he was "physically sickened" by evidence showing that staff at the public hospital were under pressure to meet surgery "targets" in order to get more funding from head office.
The inquiry was told previously that more complex operations helped the hospital reach its targets sooner, which encouraged Bundaberg Base Hospital's former director of surgery Dr Jayant Patel to perform procedures outside his and the hospital's scope. Mr Morris identified the policy yesterday as evidence of a systemic problem and said he did not necessarily blame the hospital's stood-aside director of medical services, Dr Darren Keating, for urging staff to meet the targets. "I am physically sickened by the thought that patients are being treated as units of commerce to be pushed through to get extra money," he said.
In another development last night, Mr Morris indicated that the hospital's director of nursing Linda Mulligan would not face criminal charges or referral to the Crime and Misconduct Commission on the "evidence so far", saying that allegations and criticisms against her concerned her management style and inaccessibility. Mr Morris said the inquiry could not descend into the minutiae of claims and counter-claims about how Ms Mulligan managed staff. But he said he could not extend the same qualified clearance to Dr Keating and district manager Peter Leck.
Earlier, senior Bundaberg hospital operating theatre nurse Jenny White said despite the extra workload placed on staff by the hospital's money-hungry structure, the resulting cash was rarely spent on increasing staff numbers, providing more training for nurses or getting new equipment.
Queensland Nurses Union lawyer John Allen tendered a February 2005 e-mail from Dr Keating to chief operating theatre nurse Gail Doherty, in which he stressed the hospital was behind its target and therefore risked missing out on more than $750,000. "Should the target not be achieved, BHSD (Bundaberg hospital) will not get another chance to upgrade the target and hence lose flexibility and significant dollars (with increased scrutiny of all dollars spent in OT)," Dr Keating wrote. "Therefore it is imperative that everyone continue to pull together and maximise elective surgery thruput (sic) until Jun (sic) 30. "All cancellations should be minimal with these cases pushed thru (sic) as much as possible."
The inquiry has already heard that Bundaberg surgeon Jayant Patel bragged to staff that he was untouchable because he generated so much money for the hospital's management through the high number of operations he performed. Dr Patel fled Australia in April and has since been linked to the deaths of at least 87 patients.
Ms White, who stood down from her position as nurse-in-charge of the operating theatre last year but still works in the unit, said the staffing and funding problems she complained about still existed. Queensland Health barrister David Boddice put it to Ms White last night that surgery was not performed with the priority of earning money, but she refused to agree. She also did not agree with his assertion that elective surgery targets went up and down each year – she said they were always increasing.
Source
Massachusetts: Romney eyes tax penalties for uninsured: "Massachusetts residents who choose not to obtain health insurance would face tax penalties and even the garnishing of their wages under a proposal Governor Mitt Romney unveiled yesterday. Romney says the 'individual mandate' he is proposing, part of his broader plan to cover the roughly 500,000 people who are uninsured, would not cost the state any money. But some healthcare specialists say the approach might cost hundreds of millions of dollars more than state taxpayers currently provide for government health coverage. Romney's plan would require all residents in Massachusetts to have some form of health insurance or agree to pay their medical bills out of their own pockets. No other state has such a requirement, and if Romney manages to make it law, it would be a compelling accomplishment he could point to if he runs for president."
***************************
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, June 24, 2005
New strains of superbug hit unclean British public hospitals
Patients are being exposed to an unknown number of potentially lethal hospital superbugs because of the Government's failure to address a "fog of ignorance" in the NHS, a powerful group of MPs said yesterday. The Public Accounts Committee (PAC) has condemned the lack of adequate monitoring of hospital-acquired infections and the Government's reliance on "rough and ready" figures that are up to 20 years out of date. Infections picked up in healthcare environments are said to amount to at least 300,000 a year in England, with an estimated 5,000 deaths and costing the NHS as much as 1 billion pounds.
Only figures for MRSA - methicillin-resistant Staphylo-coccus aureus - are now published after mandatory surveillance. The committee said that this accounted for less than 6 per cent of all hospital- acquired infections (HAIs). The PAC said that four years had passed since it first highlighted the shortage of information about the bugs, yet a full surveillance programme had still not been put in place. Monitoring of four other infections has been introduced over the past two years, including the potentially fatal Clos-tridium difficile, but no findings have yet been published.
The Royal Devon and Exeter Hospital yesterday confirmed that a virulent strain of C. difficile was a factor in the deaths of 13 patients since the beginning of this year. The announcement came a week after it emerged that 12 people treated at Stoke Mandeville Hospital, Buckinghamshire, have also died from the infection. The Government recently introduced mandatory surveillance for the bug, as well as for glycopeptide-resistant enterococci and surgical site infections, but the measures still only cover 20 per cent of HAIs, MPs said yesterday. Their report, entitled Improving Patient Care by Reducing the Risk of Hospital-Acquired Infection, came as the Department of Health published new figures showing falling rates of the MRSA superbug.
The rate of MRSA bloodstream infections in English hospitals fell by 6.1 per cent in 2004-05 compared with 2003-04 - down 472 to a total of 7,212. While ministers hailed the rate as the lowest since mandatory recording began in April 2001, critics pointed out that MRSA prevalence in 40 per cent of hospitals had actually increased, despite the Government's efforts. The PAC said that it remained alarmingly unclear how the 80 per cent or so of infections not covered by current programmes would be measured and managed.
Edward Leigh, MP, the chairman of the committee in the last Parliament, said that more than four years had passed since the PAC first highlighted the shortage of information on the extent and cost of hospital-acquired infections. "Today we find that little has been done to dispel this fog of ignorance," he said. "There is still no mandatory national surveillance and reporting scheme for all hospital-acquired infections. The only mandatory reporting scheme for which data has been published is for MRSA bloodstream infections, which account for less than 6 per cent of all hospital-acquired infections. These data show that our MRSA infection rate ranks among the worst in Europe." Mr Leigh said that the much-quoted figure of 5,000 deaths a year from hospital-acquired infections was "rough and ready" and dated from the 1980s. "It must be updated," he said. "The Department [of Health] has now proposed changes that should ensure that deaths linked to hospital-acquired infections are more readily identifiable. These proposals must be implemented without delay."
The committee said that the national prevalence figure estimating that at any one time 9 per cent of patients have a hospital-acquired infection was at least ten years old, and a survey commissioned by the department should be published within the coming year.
The report found that progress in preventing and reducing infections continued to be constrained by the lack of robust data and limited progress in bringing in a national mandatory surveillance programme, as recommended by a previous committee.
The MRSA surveillance showed that reported S. aureus bloodstream infections rose by 5 per cent over three years, with the proportion that were resistant to the powerful antibiotic methicillin standing at 40 per cent. The report said that England had 70 times the MRSA proportion in Denmark and 40 times the proportion in the Netherlands and Sweden.
The MPs concluded that compliance with good infection-control practice such as hand hygiene was "patchy" and "poor", especially among doctors. They noted that the Government had made infection rates and hospital cleanliness a priority, with a number of schemes to tackle the problem. Jane Kennedy, the Health Minister, said that she welcomed the report but rejected the accusations that the ignorance over superbugs was not being addressed
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.
***************************
Patients are being exposed to an unknown number of potentially lethal hospital superbugs because of the Government's failure to address a "fog of ignorance" in the NHS, a powerful group of MPs said yesterday. The Public Accounts Committee (PAC) has condemned the lack of adequate monitoring of hospital-acquired infections and the Government's reliance on "rough and ready" figures that are up to 20 years out of date. Infections picked up in healthcare environments are said to amount to at least 300,000 a year in England, with an estimated 5,000 deaths and costing the NHS as much as 1 billion pounds.
Only figures for MRSA - methicillin-resistant Staphylo-coccus aureus - are now published after mandatory surveillance. The committee said that this accounted for less than 6 per cent of all hospital- acquired infections (HAIs). The PAC said that four years had passed since it first highlighted the shortage of information about the bugs, yet a full surveillance programme had still not been put in place. Monitoring of four other infections has been introduced over the past two years, including the potentially fatal Clos-tridium difficile, but no findings have yet been published.
The Royal Devon and Exeter Hospital yesterday confirmed that a virulent strain of C. difficile was a factor in the deaths of 13 patients since the beginning of this year. The announcement came a week after it emerged that 12 people treated at Stoke Mandeville Hospital, Buckinghamshire, have also died from the infection. The Government recently introduced mandatory surveillance for the bug, as well as for glycopeptide-resistant enterococci and surgical site infections, but the measures still only cover 20 per cent of HAIs, MPs said yesterday. Their report, entitled Improving Patient Care by Reducing the Risk of Hospital-Acquired Infection, came as the Department of Health published new figures showing falling rates of the MRSA superbug.
The rate of MRSA bloodstream infections in English hospitals fell by 6.1 per cent in 2004-05 compared with 2003-04 - down 472 to a total of 7,212. While ministers hailed the rate as the lowest since mandatory recording began in April 2001, critics pointed out that MRSA prevalence in 40 per cent of hospitals had actually increased, despite the Government's efforts. The PAC said that it remained alarmingly unclear how the 80 per cent or so of infections not covered by current programmes would be measured and managed.
Edward Leigh, MP, the chairman of the committee in the last Parliament, said that more than four years had passed since the PAC first highlighted the shortage of information on the extent and cost of hospital-acquired infections. "Today we find that little has been done to dispel this fog of ignorance," he said. "There is still no mandatory national surveillance and reporting scheme for all hospital-acquired infections. The only mandatory reporting scheme for which data has been published is for MRSA bloodstream infections, which account for less than 6 per cent of all hospital-acquired infections. These data show that our MRSA infection rate ranks among the worst in Europe." Mr Leigh said that the much-quoted figure of 5,000 deaths a year from hospital-acquired infections was "rough and ready" and dated from the 1980s. "It must be updated," he said. "The Department [of Health] has now proposed changes that should ensure that deaths linked to hospital-acquired infections are more readily identifiable. These proposals must be implemented without delay."
The committee said that the national prevalence figure estimating that at any one time 9 per cent of patients have a hospital-acquired infection was at least ten years old, and a survey commissioned by the department should be published within the coming year.
The report found that progress in preventing and reducing infections continued to be constrained by the lack of robust data and limited progress in bringing in a national mandatory surveillance programme, as recommended by a previous committee.
The MRSA surveillance showed that reported S. aureus bloodstream infections rose by 5 per cent over three years, with the proportion that were resistant to the powerful antibiotic methicillin standing at 40 per cent. The report said that England had 70 times the MRSA proportion in Denmark and 40 times the proportion in the Netherlands and Sweden.
The MPs concluded that compliance with good infection-control practice such as hand hygiene was "patchy" and "poor", especially among doctors. They noted that the Government had made infection rates and hospital cleanliness a priority, with a number of schemes to tackle the problem. Jane Kennedy, the Health Minister, said that she welcomed the report but rejected the accusations that the ignorance over superbugs was not being addressed
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, June 23, 2005
BRITISH GOVERNMENT ALL TALK ABOUT DANGEROUS HOSPITALS
Independent health investigators will launch a blitz on hospital cleanliness amid concerns that the Government has been too slow to act over the MRSA superbug. Despite pledges to send in "hit squads" to establish which are Britain's dirty hospitals, no action has been taken. Last year John Reid, the Health Secretary at the time, ordered hospitals to cut rates of MRSA bloodstream infection by half by March 2008. Now the independent Healthcare Commission has taken the initiative, telling hospital chief executives that it will carry out unannounced assessments of about 100 NHS and private hospitals. The Commission believes that fears over MRSA (methicillin resistant Staphylococcus aureus) and other hospital bugs are seriously damaging confidence in the health industry.
Andrew Lansley, the Shadow Health Secretary said last night that it was about time that a sense of urgency was injected into the issue of hospital cleanliness. Almost 1,000 deaths a year are directly attributed to MRSA. The number of deaths in which it was a factor have doubled in five years.
The Healthcare Commission, the main regulator for the health service and independent care, plans to name badly performing hospitals in a report to be produced by autumn of this year. Inspectors will give no warning of visits and staff will be expected to co-operate fully in the examinations of wards, outpatient areas and accident and emergency departments. The commission plans to follow the spot checks with a three-year review of infection and control. Hospitals identified as bad performers will be rechecked again to see if they have cleaned themselves up.
Mr Lansley said: "As long as it is backed up with support from the health department and with the necessary resources and technology to deliver infection control, we might see real progress." The move comes as the Government prepares to publish the latest figures on MRSA this week and days before a critical parliamentary committee report on the issue. Inspectors will go to 100 acute, community and mental health hospitals in both the public and private sectors; there are around 1,000 NHS and 400 independent hospitals in all. The audit, designed to give a picture of hospital cleanliness in Britain, will concentrate on trusts that have been identified as poor performers. It will also include some of the best performers to show how they have improved standards
From The Times
***************************
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.
***************************
Independent health investigators will launch a blitz on hospital cleanliness amid concerns that the Government has been too slow to act over the MRSA superbug. Despite pledges to send in "hit squads" to establish which are Britain's dirty hospitals, no action has been taken. Last year John Reid, the Health Secretary at the time, ordered hospitals to cut rates of MRSA bloodstream infection by half by March 2008. Now the independent Healthcare Commission has taken the initiative, telling hospital chief executives that it will carry out unannounced assessments of about 100 NHS and private hospitals. The Commission believes that fears over MRSA (methicillin resistant Staphylococcus aureus) and other hospital bugs are seriously damaging confidence in the health industry.
Andrew Lansley, the Shadow Health Secretary said last night that it was about time that a sense of urgency was injected into the issue of hospital cleanliness. Almost 1,000 deaths a year are directly attributed to MRSA. The number of deaths in which it was a factor have doubled in five years.
The Healthcare Commission, the main regulator for the health service and independent care, plans to name badly performing hospitals in a report to be produced by autumn of this year. Inspectors will give no warning of visits and staff will be expected to co-operate fully in the examinations of wards, outpatient areas and accident and emergency departments. The commission plans to follow the spot checks with a three-year review of infection and control. Hospitals identified as bad performers will be rechecked again to see if they have cleaned themselves up.
Mr Lansley said: "As long as it is backed up with support from the health department and with the necessary resources and technology to deliver infection control, we might see real progress." The move comes as the Government prepares to publish the latest figures on MRSA this week and days before a critical parliamentary committee report on the issue. Inspectors will go to 100 acute, community and mental health hospitals in both the public and private sectors; there are around 1,000 NHS and 400 independent hospitals in all. The audit, designed to give a picture of hospital cleanliness in Britain, will concentrate on trusts that have been identified as poor performers. It will also include some of the best performers to show how they have improved standards
From The Times
***************************
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, June 22, 2005
CANADA'S MEDICAL GULAG
Canada is not a communist country. Really, it's not — except when it comes to medical care. While some Americans argue that our health care system should be copying Canada's single-payer national (read: government-controlled) health care system, a recent ruling by Canada's Supreme Court ought to cause some serious reconsideration. Deadly serious reconsideration. Canada is the only industrialized country that actually prohibits citizens from privately contracting for medical care. In other words, no matter how much money Canadians can afford to pay, they're stuck in the public's health care system waiting and waiting and waiting for care. Or, when they can afford it, giving up on waiting and traveling to the U.S. to get it.
How long are the waits? In a case brought by Jacques Chaoulli, a Montreal family doctor, and George Zeliotis, a patient forced to wait a year to have his hip replaced, Canada's Supreme Court found that the evidence "shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care." The court thus concluded that Canada's invasive, idiotic and totalitarian prohibition of private health insurance and medical care — of almost anything outside the government-run system — is unconstitutional. The long waiting periods in the government system violated the "life and personal security, inviolability and freedom" of patients under Quebec's charter of human rights and freedoms. So ruled the court.
Yet, the court actually split — three to three — as to whether the killer waits of the nationalized health care system also violated the Canadian Charter of Rights and Freedoms. So, at least for now, the ruling only applies in the province of Quebec. Still, most experts seem to think this ruling will likely be expanded through lawsuits in the other provinces. Lorne Sossin, dean of the University of Toronto law school argues, "The language of the ruling will encourage more and more lawsuits and those suits have a greater likelihood of success in light of this ruling."
Leaders of the various provinces have long sought to allow health care alternatives, but they've found themselves with all the freedoms of a cat writhing in a sack. As The New York Times reported, "The federal government has threatened to hold back financial aid to provinces that press ahead with private health care. . . ." But since Quebec, by court order, cannot prevent private medicine, the cat is now out of the bag. As Dr. Chaoulli pointedly asked, "How could you imagine that Quebeckers may live and the English Canadian has to die?"
Chaoulli, according the The Times, "has long been viewed as a gadfly in political and medical circles." In 1997, he went on a hunger strike after authorities forced him to abandon a private emergency house call service. (Wouldn't you like to find a family doctor with some of this gadfly stuff in him?) It seems that Canada's nationalized medical establishment has fought a long life-and-death battle against individual initiative in health care.
Enter Prime Minister Paul Martin. He sees the ruling, as well as the necessary response, quite differently. He's trying to re-bag that cat. Pooh-poohing the idea that Canada must permit private health care, Martin said, "What today's decision does do, however, is accentuate just how important it is to act immediately, how urgent this situation is." Yet, what is his new urgency? To save lives? Or to save the system? After all, the unhealthy waits have been around for quite some time. It's not a secret. The only thing new is the court decision allowing private medicine. The prime minister adds, "What we want to do is strengthen the public health care system."
But what about the sick? We can be sure that Mr. Martin doesn't want sick people to suffer or die. He is all for saving lives. It's just that his commitment to the national health care system comes first. In this way, he sounds strikingly like so many American educrats, who, when shown for the umpteenth time that American schools are failing, still refuse even to consider allowing the children an alternative for their education. Instead, the educrats demand ever more money to make the public schools work, somehow, no matter how many children are failed in the process.
Granted, America's education system isn't totally parallel to the Canadian medical system. Thankfully, Americans can still spend their own money to purchase the education unavailable in the public system. But similar indeed is the attitude that puts the system before the people it is supposed to serve. In emphatic arrogance, Martin asserted, "We are not going to have a two-tier health care system in this country. Nobody wants that." Well, nobody except the people dying for lack of care . . . or almost any Canadian with a lick of sense.
Source
PUBLIC HOSPITAL BLAMES "THE WORLD" FOR ITS DEFICIENCIES
Six key surgeons have threatened to quit the Melbourne Royal Children's Hospital in frustration that 500 children are stuck on waiting lists for life-changing surgery. The children need operations to treat debilitating conditions including cerebral palsy, club foot, hip degeneration and scoliosis. But the youngsters face long waits - reportedly up to 2 1/2 years - because of a shortage of orthopedic specialists at the hospital. The six orthopedic surgeons have threatened to resign en masse, Opposition health spokesman David Davis said yesterday.
Royal Children's Hospital head Tony Cull said he had heard of the resignation threats only indirectly, but admitted the surgeons were upset. Dr Cull said the hospital faced spiralling demand for orthopedic surgery and a world shortage of specialists in the field had thwarted recruitment attempts. "The waiting list (for orthopedic surgery) is about 500 and it is one of our largest waiting lists," he said. The lengthy delays have reportedly caused some sick children to suffer further complications. Dr Cull also admitted an influx of emergency patients had led him to suggest surgeons consider limiting elective surgery.
"We are under pressure at winter time," he said. "You have children pouring in with acute problems and I have suggested to people they think carefully about the number of elective surgery patients they deal with." But he denied it was a crisis. "These are all difficult issues and we are dealing with them and it is anything but doom and gloom. I would be very surprised if all our orthopedic surgeons do resign as they promise." Dr Cull said the hospital needed at least one more full time orthopedic surgeon.
Mr Davis said the situation was a disaster in the making. "All the indications are there is a real situation developing at the Royal Children's Hospital," he said. "That's a disaster for Victoria and many of the sickest children in Victoria. The Government has got to step in and make sure this doesn't get out of control." Department of Human Services spokesman Bram Alexander said the hospital would gain a large part of a $30 million injection from this year's budget to deal with the waiting lists.
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.
***************************
Canada is not a communist country. Really, it's not — except when it comes to medical care. While some Americans argue that our health care system should be copying Canada's single-payer national (read: government-controlled) health care system, a recent ruling by Canada's Supreme Court ought to cause some serious reconsideration. Deadly serious reconsideration. Canada is the only industrialized country that actually prohibits citizens from privately contracting for medical care. In other words, no matter how much money Canadians can afford to pay, they're stuck in the public's health care system waiting and waiting and waiting for care. Or, when they can afford it, giving up on waiting and traveling to the U.S. to get it.
How long are the waits? In a case brought by Jacques Chaoulli, a Montreal family doctor, and George Zeliotis, a patient forced to wait a year to have his hip replaced, Canada's Supreme Court found that the evidence "shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care." The court thus concluded that Canada's invasive, idiotic and totalitarian prohibition of private health insurance and medical care — of almost anything outside the government-run system — is unconstitutional. The long waiting periods in the government system violated the "life and personal security, inviolability and freedom" of patients under Quebec's charter of human rights and freedoms. So ruled the court.
Yet, the court actually split — three to three — as to whether the killer waits of the nationalized health care system also violated the Canadian Charter of Rights and Freedoms. So, at least for now, the ruling only applies in the province of Quebec. Still, most experts seem to think this ruling will likely be expanded through lawsuits in the other provinces. Lorne Sossin, dean of the University of Toronto law school argues, "The language of the ruling will encourage more and more lawsuits and those suits have a greater likelihood of success in light of this ruling."
Leaders of the various provinces have long sought to allow health care alternatives, but they've found themselves with all the freedoms of a cat writhing in a sack. As The New York Times reported, "The federal government has threatened to hold back financial aid to provinces that press ahead with private health care. . . ." But since Quebec, by court order, cannot prevent private medicine, the cat is now out of the bag. As Dr. Chaoulli pointedly asked, "How could you imagine that Quebeckers may live and the English Canadian has to die?"
Chaoulli, according the The Times, "has long been viewed as a gadfly in political and medical circles." In 1997, he went on a hunger strike after authorities forced him to abandon a private emergency house call service. (Wouldn't you like to find a family doctor with some of this gadfly stuff in him?) It seems that Canada's nationalized medical establishment has fought a long life-and-death battle against individual initiative in health care.
Enter Prime Minister Paul Martin. He sees the ruling, as well as the necessary response, quite differently. He's trying to re-bag that cat. Pooh-poohing the idea that Canada must permit private health care, Martin said, "What today's decision does do, however, is accentuate just how important it is to act immediately, how urgent this situation is." Yet, what is his new urgency? To save lives? Or to save the system? After all, the unhealthy waits have been around for quite some time. It's not a secret. The only thing new is the court decision allowing private medicine. The prime minister adds, "What we want to do is strengthen the public health care system."
But what about the sick? We can be sure that Mr. Martin doesn't want sick people to suffer or die. He is all for saving lives. It's just that his commitment to the national health care system comes first. In this way, he sounds strikingly like so many American educrats, who, when shown for the umpteenth time that American schools are failing, still refuse even to consider allowing the children an alternative for their education. Instead, the educrats demand ever more money to make the public schools work, somehow, no matter how many children are failed in the process.
Granted, America's education system isn't totally parallel to the Canadian medical system. Thankfully, Americans can still spend their own money to purchase the education unavailable in the public system. But similar indeed is the attitude that puts the system before the people it is supposed to serve. In emphatic arrogance, Martin asserted, "We are not going to have a two-tier health care system in this country. Nobody wants that." Well, nobody except the people dying for lack of care . . . or almost any Canadian with a lick of sense.
Source
PUBLIC HOSPITAL BLAMES "THE WORLD" FOR ITS DEFICIENCIES
Six key surgeons have threatened to quit the Melbourne Royal Children's Hospital in frustration that 500 children are stuck on waiting lists for life-changing surgery. The children need operations to treat debilitating conditions including cerebral palsy, club foot, hip degeneration and scoliosis. But the youngsters face long waits - reportedly up to 2 1/2 years - because of a shortage of orthopedic specialists at the hospital. The six orthopedic surgeons have threatened to resign en masse, Opposition health spokesman David Davis said yesterday.
Royal Children's Hospital head Tony Cull said he had heard of the resignation threats only indirectly, but admitted the surgeons were upset. Dr Cull said the hospital faced spiralling demand for orthopedic surgery and a world shortage of specialists in the field had thwarted recruitment attempts. "The waiting list (for orthopedic surgery) is about 500 and it is one of our largest waiting lists," he said. The lengthy delays have reportedly caused some sick children to suffer further complications. Dr Cull also admitted an influx of emergency patients had led him to suggest surgeons consider limiting elective surgery.
"We are under pressure at winter time," he said. "You have children pouring in with acute problems and I have suggested to people they think carefully about the number of elective surgery patients they deal with." But he denied it was a crisis. "These are all difficult issues and we are dealing with them and it is anything but doom and gloom. I would be very surprised if all our orthopedic surgeons do resign as they promise." Dr Cull said the hospital needed at least one more full time orthopedic surgeon.
Mr Davis said the situation was a disaster in the making. "All the indications are there is a real situation developing at the Royal Children's Hospital," he said. "That's a disaster for Victoria and many of the sickest children in Victoria. The Government has got to step in and make sure this doesn't get out of control." Department of Human Services spokesman Bram Alexander said the hospital would gain a large part of a $30 million injection from this year's budget to deal with the waiting lists.
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, June 21, 2005
BRITISH NOW EFFECTIVELY REFUSING PEOPLE "FREE" CARE
Too bad that they have already paid for the care via higher taxes
A hospital told a road accident victim that she would have to wait a year and a half for an NHS brain scan, but could have the procedure done privately at the same unit in two weeks, The Times has learnt. In a case that highlights the crisis in diagnostic tests, King’s College Hospital, London, warned Rachel King that, because of “heavy demand”, the MRI scan that her consultant had sought could be delayed for 80 weeks. But a handwritten note at the end of the letter gave a telephone number for the hospital’s “self-pay” private clinic, where she could have the procedure in two weeks for £983.
Ms King’s case is the starkest example yet of widespread delays in diagnostic tests across the health service. One in five trusts has waiting times of more than a year for MRI scans, and two in five have waits of more than six months. A quarter of trusts said that 25 per cent or more of their scanning capacity was not used but lack of staff and resources prevent increased usage. To cut the backlog, the Department of Health has signed a £90 million contract with Alliance Medical Ltd to provide mobile MRI scanners. The contract has proved controversial, but both AML and the department claim it is now working well and cutting waiting times.
Ms King, 32, from Erith, Kent, was knocked down by a car in January. She suffered a broken collarbone, five broken ribs, a shoulder blade broken in three places and head injuries. She was in hospital for 17 days. After she suffered dizzy spells and reduced vision, her consultant referred her for an MRI scan. She said that she was appalled to receive the letter from King’s, saying that, because of “heavy demand”, the scan would be delayed. What added insult to injury was the handwritten note on the bottom, which read: “If you want to go privately call 0845 6080991 for prices.” When she did, the telephone was answered by King’s College Self Pay, who said that the cost of such a scan was £983, and she could have the procedure in a couple of weeks. It’s insulting” she said. “I was absolutely distraught. I need reassurance that the damage isn’t permanent. All I want is to know if it is going to get better. “I still have falls, and I can’t return to work or drive. I’ve never signed on the dole in my life but I have had to now.”
King’s College Hospital said in a statement that it recognised that an 80-week wait for scans was unacceptable. It had recently received funds to expand its services, with the aim of getting waiting times down to 26 weeks by next March. Patients identified as clinically urgent by referring doctors would be seen sooner, the statement said. It added that the handwritten note had been included because Ms King had discussed with her consultant the possibility of going private. “It is not considered best practice to have handwritten additions to letters and internal processes will be reviewed in the light of this letter,” it said.
Steve Webb, the Liberal Democrat Shadow Health Secretary, said: “It is simply appalling that while ministers crow about the drop in treatment waiting times, there are still thousands of people languishing for months, or even years, on hidden waiting lists
Source
PUBLIC HOSPITAL CUTBACKS -- TOO BAD ABOUT THE PATIENTS
With long waiting lists for services, what is this Australian State going to do? Sack doctors!
NSW Government plans to cut orthopaedic surgeon numbers in Sydney's public hospitals will mean people live in pain for longer, the state opposition said. South Eastern-Illawarra Area Health Service plan to make up to eight orthopaedic surgeons redundant from the Prince of Wales, St George, Sydney and Sutherland hospitals, the Sydney Morning Herald reported today.
Opposition health spokesman Barry O'Farrell today said the plans to cut surgeons from some of Sydney's busiest hospitals highlighted the Government's hypocrisy on elective surgery waiting lists. Waiting lists remained significantly longer than at the time of the last election in March 2003, Mr O'Farrell said. The latest figures show the number of people on the waiting list in April was 66,114, while in March 2003 it was 55,324 - an increase of almost 20 per cent. "The Government shouldn't be cherry-picking elective surgery," Mr O'Farrell told reporters in Sydney. "It shouldn't simply be doing the easy cases and leaving those people, who have difficult surgery and are living in pain, to go wait for months and months and months."
Mr O'Farrell called on the NSW Health Minister Morris Iemma to rule out the number of surgeons being reduced in the South Eastern-Illawarra Area Health Service and elsewhere in the state. Instead of cuts to front-line services, the Government should slash the bloated health bureaucracy, 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.
***************************
Too bad that they have already paid for the care via higher taxes
A hospital told a road accident victim that she would have to wait a year and a half for an NHS brain scan, but could have the procedure done privately at the same unit in two weeks, The Times has learnt. In a case that highlights the crisis in diagnostic tests, King’s College Hospital, London, warned Rachel King that, because of “heavy demand”, the MRI scan that her consultant had sought could be delayed for 80 weeks. But a handwritten note at the end of the letter gave a telephone number for the hospital’s “self-pay” private clinic, where she could have the procedure in two weeks for £983.
Ms King’s case is the starkest example yet of widespread delays in diagnostic tests across the health service. One in five trusts has waiting times of more than a year for MRI scans, and two in five have waits of more than six months. A quarter of trusts said that 25 per cent or more of their scanning capacity was not used but lack of staff and resources prevent increased usage. To cut the backlog, the Department of Health has signed a £90 million contract with Alliance Medical Ltd to provide mobile MRI scanners. The contract has proved controversial, but both AML and the department claim it is now working well and cutting waiting times.
Ms King, 32, from Erith, Kent, was knocked down by a car in January. She suffered a broken collarbone, five broken ribs, a shoulder blade broken in three places and head injuries. She was in hospital for 17 days. After she suffered dizzy spells and reduced vision, her consultant referred her for an MRI scan. She said that she was appalled to receive the letter from King’s, saying that, because of “heavy demand”, the scan would be delayed. What added insult to injury was the handwritten note on the bottom, which read: “If you want to go privately call 0845 6080991 for prices.” When she did, the telephone was answered by King’s College Self Pay, who said that the cost of such a scan was £983, and she could have the procedure in a couple of weeks. It’s insulting” she said. “I was absolutely distraught. I need reassurance that the damage isn’t permanent. All I want is to know if it is going to get better. “I still have falls, and I can’t return to work or drive. I’ve never signed on the dole in my life but I have had to now.”
King’s College Hospital said in a statement that it recognised that an 80-week wait for scans was unacceptable. It had recently received funds to expand its services, with the aim of getting waiting times down to 26 weeks by next March. Patients identified as clinically urgent by referring doctors would be seen sooner, the statement said. It added that the handwritten note had been included because Ms King had discussed with her consultant the possibility of going private. “It is not considered best practice to have handwritten additions to letters and internal processes will be reviewed in the light of this letter,” it said.
Steve Webb, the Liberal Democrat Shadow Health Secretary, said: “It is simply appalling that while ministers crow about the drop in treatment waiting times, there are still thousands of people languishing for months, or even years, on hidden waiting lists
Source
PUBLIC HOSPITAL CUTBACKS -- TOO BAD ABOUT THE PATIENTS
With long waiting lists for services, what is this Australian State going to do? Sack doctors!
NSW Government plans to cut orthopaedic surgeon numbers in Sydney's public hospitals will mean people live in pain for longer, the state opposition said. South Eastern-Illawarra Area Health Service plan to make up to eight orthopaedic surgeons redundant from the Prince of Wales, St George, Sydney and Sutherland hospitals, the Sydney Morning Herald reported today.
Opposition health spokesman Barry O'Farrell today said the plans to cut surgeons from some of Sydney's busiest hospitals highlighted the Government's hypocrisy on elective surgery waiting lists. Waiting lists remained significantly longer than at the time of the last election in March 2003, Mr O'Farrell said. The latest figures show the number of people on the waiting list in April was 66,114, while in March 2003 it was 55,324 - an increase of almost 20 per cent. "The Government shouldn't be cherry-picking elective surgery," Mr O'Farrell told reporters in Sydney. "It shouldn't simply be doing the easy cases and leaving those people, who have difficult surgery and are living in pain, to go wait for months and months and months."
Mr O'Farrell called on the NSW Health Minister Morris Iemma to rule out the number of surgeons being reduced in the South Eastern-Illawarra Area Health Service and elsewhere in the state. Instead of cuts to front-line services, the Government should slash the bloated health bureaucracy, 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.
***************************
Monday, June 20, 2005
Canada Sending Pregnant Women to U.S. for Care
Post lifted from Interested Participant
Almost continuously, advocates of socialized medicine in the U.S. point to the success of the Canadian health care system and, all the while, example after example of failures of the Canadian system are in the news. Here's something recent:
Toronto Star:
The phrase "no room for her last week in hospitals in Toronto, London, Hamilton and Kingston" is disturbing and probably an indication that the current system is already functioning at maximum capacity, i.e. no room for another baby. It's not exactly clear why there isn't public outrage. Sending patients to another facility is common and understandable. Sending patients to another country because there's "no room at the inn" means that the entire health care system is deficient.
I wonder if the Canadian taxpayers know that they are paying the bills for treating Canadians in the U.S. Nevertheless, when viewed in conjunction with a doctor shortage, a nurse shortage, and exorbitant waiting times, the fact that patients are now routinely sent out of the country for necessary treatment has to tarnish the brilliance of the utopian socialized medical care system in Canada.
Just as a reminder, the waiting times are so long that notifications for appointments are accompanied with computer-generated condolences to the family in the event the patient died while waiting.
In conclusion, people keep pointing to Canada and heralding the socialized health care system while failing to adequately expose its deficiencies. In total, it's not a utopian dream come true, it's a state-run bureaucracy constantly bandaging broken promises to a population that's less than the size of California's.
***************************
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 lifted from Interested Participant
Almost continuously, advocates of socialized medicine in the U.S. point to the success of the Canadian health care system and, all the while, example after example of failures of the Canadian system are in the news. Here's something recent:
Toronto Star:
Another pregnant woman in Ontario was sent to the United States last week because there weren't enough intensive care beds for babies in the province, the Toronto Star has learned. She is the third pregnant woman to be sent south of the border for care since April 1. "She was only there two days, she didn't deliver and she was discharged home," said Wendi MacKay, communications specialist for the CritiCall Program, the emergency medical service that helps manage patient flow in Ontario. MacKay would not confirm the woman was sent to the U.S., citing privacy concerns, but a source familiar with the case said the woman was transferred stateside.
The woman was moved because she needed to be cared for in a hospital that also had a neo-natal intensive care bed, known as level 3 care, in case she delivered early. There was no room for her last week in hospitals in Toronto, London, Hamilton and Kingston offering that level of care. When medically necessary, CritiCall is authorized to access care outside the province.
The woman's transfer is a sign that a shortage of neo-natal intensive care beds in the province may be getting worse. From April 2004 to March this year, only two expectant women were sent to the U.S.
The phrase "no room for her last week in hospitals in Toronto, London, Hamilton and Kingston" is disturbing and probably an indication that the current system is already functioning at maximum capacity, i.e. no room for another baby. It's not exactly clear why there isn't public outrage. Sending patients to another facility is common and understandable. Sending patients to another country because there's "no room at the inn" means that the entire health care system is deficient.
I wonder if the Canadian taxpayers know that they are paying the bills for treating Canadians in the U.S. Nevertheless, when viewed in conjunction with a doctor shortage, a nurse shortage, and exorbitant waiting times, the fact that patients are now routinely sent out of the country for necessary treatment has to tarnish the brilliance of the utopian socialized medical care system in Canada.
Just as a reminder, the waiting times are so long that notifications for appointments are accompanied with computer-generated condolences to the family in the event the patient died while waiting.
In conclusion, people keep pointing to Canada and heralding the socialized health care system while failing to adequately expose its deficiencies. In total, it's not a utopian dream come true, it's a state-run bureaucracy constantly bandaging broken promises to a population that's less than the size of California's.
***************************
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, June 19, 2005
REPLY TO THE GOEBBELS OF THE NYT
Post lifted from The American Spectator
There he goes again. Last Monday Paul Krugman made another ill-fated venture into health care. Like his other columns, it is a bevy of distortions and disinformation.
Krugman begins his column with a tired lefty trope:
The People vs. the Special Interests! If originality were water, you could die of thirst reading his column. Actually, it was 67% who supported government-guaranteed health insurance in the Pew survey, but we all know about Krugman's carelessness with numbers. But it matters little, since such polls are meaningless. Government-run health insurance is one of those issues that the public supports heavily in polls and opposes just as heavily at the ballot box. In 1994 Californians voted 73-27% against Proposition 186 that would have provided universal coverage in the Golden State. In the state of Oregon -- not exactly red county central -- voters rejected a similar measure even more handily, 79-21%, during the 2002 election. Krugman may think the time is ripe for universal coverage, but the voters have other ideas.
Next, Krugman displays his typical respect for those who disagree with him:
Well, if Ted Kennedy says so, I feel confident, don't you? In seriousness, it's not so clear how successful Medicare is. Although the number of Medicare patients having trouble finding a physician has stabilized some in recent years, surveys conducted by the Center for Health System Change showed that the number of Medicare patients who had trouble getting treatment increased heavily from late 1997 to 2001. The primary reason is that fewer doctors were treating new Medicare patients during that same period.
The Association of American Physicians and Surgeons (AAPS) regularly conducts a less rigorous survey on the same topic, but it is telling nonetheless. In its most recent survey AAPS found that 23% of doctors had stopped participating in Medicare, while another 33% had stopped taking new Medicare patients. The reasons doctors cited for either discontinuing or restricting their participation in Medicare are hardly surprising to anyone who studies bureaucracy: billing and regulatory requirements, hassles and/or threats from Medicare carriers/government, and fear of prosecution or civil action.
Finally, Krugman trots out the usual nonsense about government-run health care being cheaper than private care:
As I've noted before, the reason Medicare has lower administrative costs is that it is able to require the private sector to bear the cost of complying with Medicare regulations. Indeed, according to the AAPS survey, doctors "estimate that they and their staff spend 22% of their time on compliance with Medicare regulations, and that it costs, on average, $22 to process a Medicare claim, compared to $14 for a private claim."
Furthermore, money is not the only kind of "cost." Another kind is the pain and suffering due to long waits for treatment. The Fraser Institute releases an annual report on wait times in Canada. From 1993 to 2004, the median wait between seeing a general practitioner and receiving treatment increased 92%, from 9.3 weeks to 17.9. From general surgery to internal medicine to radiation oncology, wait times increased in every category except elective heart surgery. One has to wonder whether the "costs" saved by Canada's health care system aren't offset by lost productivity among workers waiting for treatment.
But none of that matters to those intent on bringing a universal-coverage nirvana to the U.S. Fortunately, with voters having rejected it at the ballot box and the GOP in charge in Washington, the time is anything but ripe for government-run health care. Krugman is deluding himself if he believes otherwise.
***************************
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 lifted from The American Spectator
There he goes again. Last Monday Paul Krugman made another ill-fated venture into health care. Like his other columns, it is a bevy of distortions and disinformation.
Krugman begins his column with a tired lefty trope:
So the time will soon be ripe for another try at universal coverage. Public opinion is already favorable: a 2003 Pew poll found that 72 percent of Americans favored government-guaranteed health insurance for all. But special interests will, once again, stand in the way.
The People vs. the Special Interests! If originality were water, you could die of thirst reading his column. Actually, it was 67% who supported government-guaranteed health insurance in the Pew survey, but we all know about Krugman's carelessness with numbers. But it matters little, since such polls are meaningless. Government-run health insurance is one of those issues that the public supports heavily in polls and opposes just as heavily at the ballot box. In 1994 Californians voted 73-27% against Proposition 186 that would have provided universal coverage in the Golden State. In the state of Oregon -- not exactly red county central -- voters rejected a similar measure even more handily, 79-21%, during the 2002 election. Krugman may think the time is ripe for universal coverage, but the voters have other ideas.
Next, Krugman displays his typical respect for those who disagree with him:
Let's ignore those who believe that private medical accounts -- basically tax shelters for the healthy and wealthy -- can solve our health care problems through the magic of the marketplace.Yes, let's dismiss it because it isn't true that health savings accounts (HSAs) are only for the healthy and wealthy. A recent report by America's Health Insurance Plans showed that 37% of those purchasing HSAs had previously been uninsured. A study by Assurant Health from last year showed that 19% of HSA purchasers had family incomes of less than $40,000, while an eHealthInsurance study found that nearly the same percentage had less than $35,000 in income. That same eHealthInsurance report found that just under 50% of HSA purchasers were over 40, while the Assurant study found that 70% were over 40. Given that older people tend to be sicker than the young, this strongly suggests HSAs are not just for the healthy.Krugman also has an odd choice for a pitchman for his dream of socialized medicine:
A system in which the government provides universal health insurance is often referred to as "single payer," but I like Ted Kennedy's slogan "Medicare for all." It reminds voters that America already has a highly successful, popular single-payer program, albeit only for the elderly.
Well, if Ted Kennedy says so, I feel confident, don't you? In seriousness, it's not so clear how successful Medicare is. Although the number of Medicare patients having trouble finding a physician has stabilized some in recent years, surveys conducted by the Center for Health System Change showed that the number of Medicare patients who had trouble getting treatment increased heavily from late 1997 to 2001. The primary reason is that fewer doctors were treating new Medicare patients during that same period.
The Association of American Physicians and Surgeons (AAPS) regularly conducts a less rigorous survey on the same topic, but it is telling nonetheless. In its most recent survey AAPS found that 23% of doctors had stopped participating in Medicare, while another 33% had stopped taking new Medicare patients. The reasons doctors cited for either discontinuing or restricting their participation in Medicare are hardly surprising to anyone who studies bureaucracy: billing and regulatory requirements, hassles and/or threats from Medicare carriers/government, and fear of prosecution or civil action.
Finally, Krugman trots out the usual nonsense about government-run health care being cheaper than private care:
The great advantage of universal, government-provided health insurance is lower costs. Canada's government-run insurance system has much less bureaucracy and much lower administrative costs than our largely private system. Medicare has much lower administrative costs than private insurance. The reason is that single-payer systems don't devote large resources to screening out high-risk clients or charging them higher fees. The savings from a single-payer system would probably exceed $200 billion a year, far more than the cost of covering all of those now uninsured.
As I've noted before, the reason Medicare has lower administrative costs is that it is able to require the private sector to bear the cost of complying with Medicare regulations. Indeed, according to the AAPS survey, doctors "estimate that they and their staff spend 22% of their time on compliance with Medicare regulations, and that it costs, on average, $22 to process a Medicare claim, compared to $14 for a private claim."
Furthermore, money is not the only kind of "cost." Another kind is the pain and suffering due to long waits for treatment. The Fraser Institute releases an annual report on wait times in Canada. From 1993 to 2004, the median wait between seeing a general practitioner and receiving treatment increased 92%, from 9.3 weeks to 17.9. From general surgery to internal medicine to radiation oncology, wait times increased in every category except elective heart surgery. One has to wonder whether the "costs" saved by Canada's health care system aren't offset by lost productivity among workers waiting for treatment.
But none of that matters to those intent on bringing a universal-coverage nirvana to the U.S. Fortunately, with voters having rejected it at the ballot box and the GOP in charge in Washington, the time is anything but ripe for government-run health care. Krugman is deluding himself if he believes otherwise.
***************************
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, June 18, 2005
GM'S HEALTH-CARE PROBLEM IS ALSO AMERICA'S
Is General Motors an automobile manufacturer that provides health-care benefits for its workers? Or is it a health-insurance provider that also happens to make cars? The question is facetious, but there's nothing funny about GM's predicament. At the company's annual meeting in Detroit last week, CEO Rick Wagoner told shareholders that health benefits add a staggering $1,500 to the price of every vehicle GM makes....
The health benefits GM provides are generous to the point of recklessness. While its salaried employees pay 27 percent of their health-care costs, the nearly 120,000 workers who belong to the United Auto Workers pay a minuscule 7 percent. They have no deductibles, no monthly premiums -- only modest co-pays for doctor's visits and prescriptions. Benefits that lavish might have been tolerable back when GM was king of the automotive hill and could count on selling enough cars to defray such a huge expense. But GM today sells only about one-fourth of the cars bought in America -- down from nearly half in the 1950s.
All of which helps explain why GM lost $1.3 billion in the first quarter of this year, why its credit rating (along with Ford's) was recently cut to "junk" status by Standard & Poor's, and why the price of its shares, notwithstanding a surge in recent days, has been sinking for months. At the annual meeting, Wagoner warned that the exploding cost of health-care benefits is "perhaps the most challenging element" of GM's looming financial crisis. Is it ever.
Of course GM has other problems, too. Union rules block it from shutting down underused plants. It takes 34 hours to build a GM vehicle, while Toyota can build a car in 28. Sales of high-profit SUVs and pickups have been depressed by rising gas prices. And as critic after critic has complained, GM's array of brands is too large and indistinct. How many non-car buffs can distinguish a Buick from a Pontiac? Or a Saturn SUV from one made by Chevrolet? "One has to wonder," writes auto industry analyst Maryann Keller, "why it has been so hard for GM to figure out what car buyers want and then give it to them."
Well, part of the reason is surely all those billions GM is spending on first-dollar health coverage for its legion of retirees. When $1,500 per vehicle is earmarked for Lipitor and knee replacements, that's $1,500 not being spent designing cars that drivers will fall in love with. Wagoner indicated last week that he intends to force down health care costs whether the union likes it or not -- "our strongly preferred approach is to do this in cooperation with the UAW," he said, implying that other approaches are available if necessary. Sure enough, The New York Times reported on Wednesday that GM has given the UAW until the end of June to agree to health-care concessions or face unilateral action by management.
GM's hourly workers undoubtedly have a sweet deal -- who wouldn't love health insurance that comes with a $0 deductible and no premiums? But such sweet deals drive up the cost of health care for everyone. When somebody else is picking up the tab, there is little incentive to economize -- that is as true of medical care as of anything else. The price of prescription drugs, hospital stays, and medical procedures has skyrocketed in part because tens of millions of Americans are insured through their employers with low-deductible medical plans. Why *not* run to the doctor for every minor ailment when the out-of-pocket cost to do so is minimal? Why inquire whether a procedure can be performed less expensively when it'll be covered by insurance either way?
In no other area do we rely on insurance for routine expenses or repairs. Auto insurance doesn't cover oil changes; no one uses homeowner's insurance to repoint the chimney. That's because most of us pay for those policies ourselves, and therefore get only the insurance we really need -- generally against catastrophic events, like a car being stolen or a house burning down.
Only when it comes to health care do we expect insurance to cover nearly everything. The problem may be especially acute at GM, but most of us have gotten used to having a faceless third party pick up the lion's share of our medical tab. GM's board of trustees can play hardball with the union. But ultimately this isn't a problem that a single company can fix. So long as Americans don't expect to pay for their health care themselves, what's no good for General Motors won't be good for America, either.
From Jeff Jacoby
***************************
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.
***************************
Is General Motors an automobile manufacturer that provides health-care benefits for its workers? Or is it a health-insurance provider that also happens to make cars? The question is facetious, but there's nothing funny about GM's predicament. At the company's annual meeting in Detroit last week, CEO Rick Wagoner told shareholders that health benefits add a staggering $1,500 to the price of every vehicle GM makes....
The health benefits GM provides are generous to the point of recklessness. While its salaried employees pay 27 percent of their health-care costs, the nearly 120,000 workers who belong to the United Auto Workers pay a minuscule 7 percent. They have no deductibles, no monthly premiums -- only modest co-pays for doctor's visits and prescriptions. Benefits that lavish might have been tolerable back when GM was king of the automotive hill and could count on selling enough cars to defray such a huge expense. But GM today sells only about one-fourth of the cars bought in America -- down from nearly half in the 1950s.
All of which helps explain why GM lost $1.3 billion in the first quarter of this year, why its credit rating (along with Ford's) was recently cut to "junk" status by Standard & Poor's, and why the price of its shares, notwithstanding a surge in recent days, has been sinking for months. At the annual meeting, Wagoner warned that the exploding cost of health-care benefits is "perhaps the most challenging element" of GM's looming financial crisis. Is it ever.
Of course GM has other problems, too. Union rules block it from shutting down underused plants. It takes 34 hours to build a GM vehicle, while Toyota can build a car in 28. Sales of high-profit SUVs and pickups have been depressed by rising gas prices. And as critic after critic has complained, GM's array of brands is too large and indistinct. How many non-car buffs can distinguish a Buick from a Pontiac? Or a Saturn SUV from one made by Chevrolet? "One has to wonder," writes auto industry analyst Maryann Keller, "why it has been so hard for GM to figure out what car buyers want and then give it to them."
Well, part of the reason is surely all those billions GM is spending on first-dollar health coverage for its legion of retirees. When $1,500 per vehicle is earmarked for Lipitor and knee replacements, that's $1,500 not being spent designing cars that drivers will fall in love with. Wagoner indicated last week that he intends to force down health care costs whether the union likes it or not -- "our strongly preferred approach is to do this in cooperation with the UAW," he said, implying that other approaches are available if necessary. Sure enough, The New York Times reported on Wednesday that GM has given the UAW until the end of June to agree to health-care concessions or face unilateral action by management.
GM's hourly workers undoubtedly have a sweet deal -- who wouldn't love health insurance that comes with a $0 deductible and no premiums? But such sweet deals drive up the cost of health care for everyone. When somebody else is picking up the tab, there is little incentive to economize -- that is as true of medical care as of anything else. The price of prescription drugs, hospital stays, and medical procedures has skyrocketed in part because tens of millions of Americans are insured through their employers with low-deductible medical plans. Why *not* run to the doctor for every minor ailment when the out-of-pocket cost to do so is minimal? Why inquire whether a procedure can be performed less expensively when it'll be covered by insurance either way?
In no other area do we rely on insurance for routine expenses or repairs. Auto insurance doesn't cover oil changes; no one uses homeowner's insurance to repoint the chimney. That's because most of us pay for those policies ourselves, and therefore get only the insurance we really need -- generally against catastrophic events, like a car being stolen or a house burning down.
Only when it comes to health care do we expect insurance to cover nearly everything. The problem may be especially acute at GM, but most of us have gotten used to having a faceless third party pick up the lion's share of our medical tab. GM's board of trustees can play hardball with the union. But ultimately this isn't a problem that a single company can fix. So long as Americans don't expect to pay for their health care themselves, what's no good for General Motors won't be good for America, either.
From Jeff Jacoby
***************************
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, June 17, 2005
Medi-Cal growth 'unsustainable': Study says revenue can't meet costs as 5% of clients require 60% of the spending
And California's legislators are trying at the moment to socialize their medical care even further!
Medi-Cal costs are likely to rise faster than state revenue and could consume one out of every five dollars the state spends by 2015, according to a study the Public Policy Institute of California released Tuesday. The Schwarzenegger administration said the findings supported the governor's controversial plan to save money by moving 500,000 aged and disabled Medi-Cal recipients into managed care. The projected growth in the program is "unsustainable," said California Health and Human Services Secretary S. Kimberly Belshe, who asked the institute to perform the study.
Though about 6 million Californians are enrolled in Medi-Cal, the study also found that only 5 percent of Medi-Cal recipients accounted for 60 percent of the spending among enrollees who are not in a managed-care plan. Data for recipients enrolled in managed care were not available. Medi-Cal, the state's most costly program after education, is often described as a government insurance program for the poor, but it also covers those with severe disabilities and the elderly in nursing homes. Those older, sicker patients account for most of the spending, the study found. Among the biggest cost drivers: nursing home care, hospital services and prescription drugs.
The small group of top consumers uses so many resources that even if benefits for the healthiest 75 percent of Medi-Cal recipients were cut in half, the state would save only 3 percent of the multibillion-dollar Medi-Cal budget, the study found. The state currently spends 15 percent of its general fund budget, about $13 billion, on Medi-Cal. The federal government contributes an additional $19 billion annually in Medicaid funds.
The study comes at a time when the federal government is pressuring states to rein in Medicaid costs. The study predicted that Medi-Cal costs could grow by 8.5 percent a year over the next few years, outstripping a 6 percent annual growth in revenue. Gov. Arnold Schwarzenegger's plan for a Medi-Cal overhaul - recently rejected in part by legislative budget committees - would expand managed care, cap dental benefits and start charging premiums for some enrollees. The state Department of Health Services is also emphasizing better case management for chronically ill Medi-Cal recipients, Belshe said. "These are all examples of things we need to be doing, targeting these high-use, high-cost users," she said.
But the Republican governor's proposed managed-care expansion has met with opposition from some who say it could provide less care for people with serious health needs and would not necessarily save money.
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.
***************************
And California's legislators are trying at the moment to socialize their medical care even further!
Medi-Cal costs are likely to rise faster than state revenue and could consume one out of every five dollars the state spends by 2015, according to a study the Public Policy Institute of California released Tuesday. The Schwarzenegger administration said the findings supported the governor's controversial plan to save money by moving 500,000 aged and disabled Medi-Cal recipients into managed care. The projected growth in the program is "unsustainable," said California Health and Human Services Secretary S. Kimberly Belshe, who asked the institute to perform the study.
Though about 6 million Californians are enrolled in Medi-Cal, the study also found that only 5 percent of Medi-Cal recipients accounted for 60 percent of the spending among enrollees who are not in a managed-care plan. Data for recipients enrolled in managed care were not available. Medi-Cal, the state's most costly program after education, is often described as a government insurance program for the poor, but it also covers those with severe disabilities and the elderly in nursing homes. Those older, sicker patients account for most of the spending, the study found. Among the biggest cost drivers: nursing home care, hospital services and prescription drugs.
The small group of top consumers uses so many resources that even if benefits for the healthiest 75 percent of Medi-Cal recipients were cut in half, the state would save only 3 percent of the multibillion-dollar Medi-Cal budget, the study found. The state currently spends 15 percent of its general fund budget, about $13 billion, on Medi-Cal. The federal government contributes an additional $19 billion annually in Medicaid funds.
The study comes at a time when the federal government is pressuring states to rein in Medicaid costs. The study predicted that Medi-Cal costs could grow by 8.5 percent a year over the next few years, outstripping a 6 percent annual growth in revenue. Gov. Arnold Schwarzenegger's plan for a Medi-Cal overhaul - recently rejected in part by legislative budget committees - would expand managed care, cap dental benefits and start charging premiums for some enrollees. The state Department of Health Services is also emphasizing better case management for chronically ill Medi-Cal recipients, Belshe said. "These are all examples of things we need to be doing, targeting these high-use, high-cost users," she said.
But the Republican governor's proposed managed-care expansion has met with opposition from some who say it could provide less care for people with serious health needs and would not necessarily save money.
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.
***************************
Thursday, June 16, 2005
MORE CANADIAN CARING
A Kelowna man who drove an unconscious man to the parking lot of his local hospital couldn't believe his ears when medical staff told him to call 911 and wait for an ambulance.
Ralph Vogel and his wife had been letting a homeless man sleep in their motor home, but became alarmed when they couldn't wake him Wednesday morning. So Vogel powered up the motor home and drove the man to the Kelowna General Hospital. He ran inside and told medical staff that a man was either dying or dead in his motor home. When staff told him to call 911 and wait for an ambulance, he told them that the man was just outside in the parking lot. He was still told to call 911. By the time the ambulance arrived, it was much too late. The man had already been dead for several hours.
The hospital now admits that staff made a mistake by refusing to treat the man in the parking lot, just in case there was a chance he could still be saved.
This isn't the first time Kelowna General Hospital staff have refused to treat someone just outside their doors. Three years ago, a woman who collapsed just metres away from the emergency room doors also had to wait for an ambulance.
Alison Paine of the Interior Health Authority says policy changes have been made since that embarrassing incident. But she said the policy's conditions for helping someone in need of emergency care were not fulfilled in this case. "It is not only [hospital] policy, but Interior Health policy, that if somebody is in need of emergency care in the parking lot, that we go out and help them," Paine said. "But obviously something has gone wrong here."
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 Kelowna man who drove an unconscious man to the parking lot of his local hospital couldn't believe his ears when medical staff told him to call 911 and wait for an ambulance.
Ralph Vogel and his wife had been letting a homeless man sleep in their motor home, but became alarmed when they couldn't wake him Wednesday morning. So Vogel powered up the motor home and drove the man to the Kelowna General Hospital. He ran inside and told medical staff that a man was either dying or dead in his motor home. When staff told him to call 911 and wait for an ambulance, he told them that the man was just outside in the parking lot. He was still told to call 911. By the time the ambulance arrived, it was much too late. The man had already been dead for several hours.
The hospital now admits that staff made a mistake by refusing to treat the man in the parking lot, just in case there was a chance he could still be saved.
This isn't the first time Kelowna General Hospital staff have refused to treat someone just outside their doors. Three years ago, a woman who collapsed just metres away from the emergency room doors also had to wait for an ambulance.
Alison Paine of the Interior Health Authority says policy changes have been made since that embarrassing incident. But she said the policy's conditions for helping someone in need of emergency care were not fulfilled in this case. "It is not only [hospital] policy, but Interior Health policy, that if somebody is in need of emergency care in the parking lot, that we go out and help them," Paine said. "But obviously something has gone wrong here."
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, June 15, 2005
HEALTH SAVINGS ACCOUNTS ARE WORKING
How many times have you heard that health care costs are rising at record rates? Well, they aren't any more. The Bureau of Labor Statistics reports that health care costs rose 7.5 percent in 2004, well under the 11.4 percent rise in 2002. The BLS also reports that costs for employers for health insurance per employee per hour worked has slowed down even more. From March 2001 to March 2002, it rose 11 perecnt; from March 2002 to March 2004, it rose 9 percent each year. But from March 2004 to December 2004, it rose only 3 percent.
Something is going on out there. Politicians and political commentators always assume that government must do something new and different if health care costs are to be held down to bearable increases. But the evidence is that health care costs are being held down, by the workings of the marketplace, partly in response to health care legislation passed in the last four years.
One thing that is going on is that employers are offering and employees are choosing health savings accounts and high-deductible health insurance in greater numbers. HSAs were given a big boost in the Medicare prescription drug bill passed in November 2003; indeed that was the reason that most Republicans voted for a bill that also included the biggest new entitlement program since Medicare was passed in 1965.
HSAs seem to be gaining in popularity. A survey by Watson Wyatt and the National Business Group on Health found that 8 percent of employers are offering health savings accounts in 2005, and 18 percent plan to offer them in 2006. Large majorities of employers believe that HSAs will help lower overall health care costs and that they will expand options for employees.
The number of people covered by HSAs and high-deductible insurance policies increased from 438,000 in September 2004 to 1,031,000 in March 2005. Nearly half of these are people over 40 -- though some predicted that such policies would not be attractive to them.
One thing that HSAs and high-deductible health insurance help do is to make employees more cost-conscious when it comes to health care decisions. HSAs allow employees to keep money they don't spend on health care this year and to roll it over to next year, and on and on -- therefore, there is an incentive not to fritter it away. High-deductible health insurance operates the same way high-deductible auto insurance does: It does not pay for the equivalent of your oil change but does pay you when your car is totaled.
For many years, the World War II decision to make health insurance coverage tax-deductible for employers and non-taxable to employees has driven health insurance to a different model, one that pays for virtually every procedure but in a surprising number of cases does not cover catastrophic costs.
But increasingly that makes no sense. As Wall Street Journal columnist Holman Jenkins points out, the tax subsidy to employees, while worth a lot to high-income earners, is worth very little to those whose income tax liability is low or, as in the case of Earned Income Tax Credit recipients, nonexistent. To them, it is hardly worthwhile to pay an insurance company to process their claims for predictable items like annual checkups and routine pediatric care, yet to be left with a policy that, to hold down employers' costs, doesn't provide catastrophic coverage.
The other interesting development is the emergence of health insurance policies that encourage healthy behavior. Health care experts note that the increasing incidence of diabetes and other obesity-related diseases threatens to hugely increase health care costs in future years.
Old-style health insurance policies provide no incentive to behaviors that tend to reduce the incidence of such disease. In a previous column, I looked at one company that provides such policies, including health club membership for employees. These policies may provide a long-term answer to problems that health care analysts of all political stripes are concerned about.
The overriding assumption in much commentary on health care finance is that individuals and companies are helpless automata waiting for government action before anything can be done anything about health care costs. But recent developments suggest that, in fact, employers and employees are active players, and that provisions of recent legislation that were not much noticed by the commentariat have enabled them to take action that reduces costs and provides increased benefits and incentives for healthier behavior. We have problems, yes, but we are not helpless.
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 many times have you heard that health care costs are rising at record rates? Well, they aren't any more. The Bureau of Labor Statistics reports that health care costs rose 7.5 percent in 2004, well under the 11.4 percent rise in 2002. The BLS also reports that costs for employers for health insurance per employee per hour worked has slowed down even more. From March 2001 to March 2002, it rose 11 perecnt; from March 2002 to March 2004, it rose 9 percent each year. But from March 2004 to December 2004, it rose only 3 percent.
Something is going on out there. Politicians and political commentators always assume that government must do something new and different if health care costs are to be held down to bearable increases. But the evidence is that health care costs are being held down, by the workings of the marketplace, partly in response to health care legislation passed in the last four years.
One thing that is going on is that employers are offering and employees are choosing health savings accounts and high-deductible health insurance in greater numbers. HSAs were given a big boost in the Medicare prescription drug bill passed in November 2003; indeed that was the reason that most Republicans voted for a bill that also included the biggest new entitlement program since Medicare was passed in 1965.
HSAs seem to be gaining in popularity. A survey by Watson Wyatt and the National Business Group on Health found that 8 percent of employers are offering health savings accounts in 2005, and 18 percent plan to offer them in 2006. Large majorities of employers believe that HSAs will help lower overall health care costs and that they will expand options for employees.
The number of people covered by HSAs and high-deductible insurance policies increased from 438,000 in September 2004 to 1,031,000 in March 2005. Nearly half of these are people over 40 -- though some predicted that such policies would not be attractive to them.
One thing that HSAs and high-deductible health insurance help do is to make employees more cost-conscious when it comes to health care decisions. HSAs allow employees to keep money they don't spend on health care this year and to roll it over to next year, and on and on -- therefore, there is an incentive not to fritter it away. High-deductible health insurance operates the same way high-deductible auto insurance does: It does not pay for the equivalent of your oil change but does pay you when your car is totaled.
For many years, the World War II decision to make health insurance coverage tax-deductible for employers and non-taxable to employees has driven health insurance to a different model, one that pays for virtually every procedure but in a surprising number of cases does not cover catastrophic costs.
But increasingly that makes no sense. As Wall Street Journal columnist Holman Jenkins points out, the tax subsidy to employees, while worth a lot to high-income earners, is worth very little to those whose income tax liability is low or, as in the case of Earned Income Tax Credit recipients, nonexistent. To them, it is hardly worthwhile to pay an insurance company to process their claims for predictable items like annual checkups and routine pediatric care, yet to be left with a policy that, to hold down employers' costs, doesn't provide catastrophic coverage.
The other interesting development is the emergence of health insurance policies that encourage healthy behavior. Health care experts note that the increasing incidence of diabetes and other obesity-related diseases threatens to hugely increase health care costs in future years.
Old-style health insurance policies provide no incentive to behaviors that tend to reduce the incidence of such disease. In a previous column, I looked at one company that provides such policies, including health club membership for employees. These policies may provide a long-term answer to problems that health care analysts of all political stripes are concerned about.
The overriding assumption in much commentary on health care finance is that individuals and companies are helpless automata waiting for government action before anything can be done anything about health care costs. But recent developments suggest that, in fact, employers and employees are active players, and that provisions of recent legislation that were not much noticed by the commentariat have enabled them to take action that reduces costs and provides increased benefits and incentives for healthier behavior. We have problems, yes, but we are not helpless.
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, June 14, 2005
The things you need to do to get heart surgery in Canada
A New Brunswick man who told police that a friendly dog scuttled his plan for a bloody shooting rampage was sentenced Wednesday to three years in prison after admitting it was all a ploy to get life-saving surgery while in jail. Ontario Court Justice Brent Knazan described James Stanson as a "manipulative, duplicitous, entitled con-man" who headed east to Toronto last June "to hatch a plan that would lead to his detention (and) the medical treatment he needed." "It is important that I give a sentence that denounces (Stanson's) conduct and deters anyone else from doing the same," Knazan said, rejecting the defence's request for a sentence of one year less a day.
Stanson, who was found with a veritable arsenal of firearms and ammunition in his car, originally told police he'd been planning a mass murder in an east Toronto neighbourhood, but changed his mind after meeting a friendly dog. The 44-year-old former jail guard has since told court he invented the story because he wanted to be detained so he could receive heart surgery -- surgery he got last November, while in custody. Stanson changed his story three times during his trial, eventually pleading guilty to eight weapons charges.
In his ruling, Knazan said he could not be convinced beyond a reasonable doubt that Stanson had the intent to kill, but did find enough corroborating evidence to suggest Stanson had threatened to carry out the plan. The court also heard that Stanson's self-serving lies were consistent with a psychiatrist's diagnosis of a personality disorder with narcissistic, manipulative and anti-social features. Stanson was sentenced to three years in prison minus 13 months for timed served, followed by three years of probation.
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 New Brunswick man who told police that a friendly dog scuttled his plan for a bloody shooting rampage was sentenced Wednesday to three years in prison after admitting it was all a ploy to get life-saving surgery while in jail. Ontario Court Justice Brent Knazan described James Stanson as a "manipulative, duplicitous, entitled con-man" who headed east to Toronto last June "to hatch a plan that would lead to his detention (and) the medical treatment he needed." "It is important that I give a sentence that denounces (Stanson's) conduct and deters anyone else from doing the same," Knazan said, rejecting the defence's request for a sentence of one year less a day.
Stanson, who was found with a veritable arsenal of firearms and ammunition in his car, originally told police he'd been planning a mass murder in an east Toronto neighbourhood, but changed his mind after meeting a friendly dog. The 44-year-old former jail guard has since told court he invented the story because he wanted to be detained so he could receive heart surgery -- surgery he got last November, while in custody. Stanson changed his story three times during his trial, eventually pleading guilty to eight weapons charges.
In his ruling, Knazan said he could not be convinced beyond a reasonable doubt that Stanson had the intent to kill, but did find enough corroborating evidence to suggest Stanson had threatened to carry out the plan. The court also heard that Stanson's self-serving lies were consistent with a psychiatrist's diagnosis of a personality disorder with narcissistic, manipulative and anti-social features. Stanson was sentenced to three years in prison minus 13 months for timed served, followed by three years of probation.
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, June 13, 2005
SUPERBUG IN AUSTRALIAN PUBLIC HOSPITALS
Doctors will ask the Government to launch a national surveillance plan for deadly strains of golden staph, amid new evidence the bacteria are spreading faster and further. A group of specialists in infectious diseases will meet the chief medical officer, John Horvath, this month to develop strategies to stop the spread of methicillin-resistant Staphylococcus aureus (MRSA). A high proportion of the new bacterial strains carry a potentially lethal toxin. John Turnidge, the head of laboratory medicine at Adelaide's Women's and Children's Hospital, said the Government should stop doctors overprescribing antibiotics for mild infections. This altered the balance of healthy bacteria in the skin and digestive tract, allowing people to be colonised by aggressive strains of golden staph. Though not usually a problem, these strains could, in rare cases, enter the bloodstream or lungs and cause a serious disease. Professor Turnidge said a system was needed to collate automatically details of bacteria identified across the country. "You need to get those big numbers in from the labs to provide an early-warning system" for new variants.
Recent samples from people with severe pneumonia or blood-poisoning showed a fast-spreading strain of MRSA, rife in Western Australia, had acquired the Panton-Valentine leukocidin toxin, which can destroy tissue and white blood cells. Professor Turnidge said that a three-year-old girl had died in Adelaide this year from pneumonia caused by a PVL-positive version of the West Australian strain. She was the second fatality in Australia from an illness related to that toxin. Until now, the toxin had been linked to two strains that occur mainly in the eastern states.
The head of microbiology and infectious diseases at Royal Perth Hospital, Keryn Christiansen, said laboratories should be obliged to report all cases of MRSA that occured outside hospitals. "The Federal Government should show leadership here. I think there is a good reason to fast-track this. It's a serious enough problem," he said.
A spokeswoman for the Health Department, Kay McNiece, said that although mandatory reporting of infectious diseases was a states matter, "the Commonwealth is still very concerned and wants to know what's going on".
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.
***************************
Doctors will ask the Government to launch a national surveillance plan for deadly strains of golden staph, amid new evidence the bacteria are spreading faster and further. A group of specialists in infectious diseases will meet the chief medical officer, John Horvath, this month to develop strategies to stop the spread of methicillin-resistant Staphylococcus aureus (MRSA). A high proportion of the new bacterial strains carry a potentially lethal toxin. John Turnidge, the head of laboratory medicine at Adelaide's Women's and Children's Hospital, said the Government should stop doctors overprescribing antibiotics for mild infections. This altered the balance of healthy bacteria in the skin and digestive tract, allowing people to be colonised by aggressive strains of golden staph. Though not usually a problem, these strains could, in rare cases, enter the bloodstream or lungs and cause a serious disease. Professor Turnidge said a system was needed to collate automatically details of bacteria identified across the country. "You need to get those big numbers in from the labs to provide an early-warning system" for new variants.
Recent samples from people with severe pneumonia or blood-poisoning showed a fast-spreading strain of MRSA, rife in Western Australia, had acquired the Panton-Valentine leukocidin toxin, which can destroy tissue and white blood cells. Professor Turnidge said that a three-year-old girl had died in Adelaide this year from pneumonia caused by a PVL-positive version of the West Australian strain. She was the second fatality in Australia from an illness related to that toxin. Until now, the toxin had been linked to two strains that occur mainly in the eastern states.
The head of microbiology and infectious diseases at Royal Perth Hospital, Keryn Christiansen, said laboratories should be obliged to report all cases of MRSA that occured outside hospitals. "The Federal Government should show leadership here. I think there is a good reason to fast-track this. It's a serious enough problem," he said.
A spokeswoman for the Health Department, Kay McNiece, said that although mandatory reporting of infectious diseases was a states matter, "the Commonwealth is still very concerned and wants to know what's going on".
Source
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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.
***************************
Sunday, June 12, 2005
ANOTHER CANADIAN HORROR
It certainly shows the dangers of State-controlled medicine
Baruch Tegegne, the man credited with rescuing hundreds if not thousands of his fellow Ethiopian Jews from famine and death, is now in a fight for his own life. In the second group of Ethiopian Jews brought to Israel in the 1950's by Israel's second president Yitzhak Ben-Tzvi and educated in AMIT religious schools, Baruch met a Canadian Jewish woman in Israel. They married and moved to Montreal 1979. His dramatic escape by foot from Ethiopia in 1974 to get to Israel and his activism for rescue of Ethiopian Jews was featured in the 1983 documentary "Falasha: Exile of the Black Jews." Among those supportive of Baruch's rescue efforts was Rabbi Moshe Feinstein, considered by many to be the leading Orthodox rabbinic scholar of the last half of the 20th century.
Now 61, Baruch has advanced kidney disease caused by diabetes. He undergoes dialysis four times a week at the Jewish General Hospital. His health is rapidly deteriorating. But his fight is against more than advanced kidney disease. It is against the state-controlled Canadian health system.
A group of his friends led by Emmy Award winning filmmaker Simcha Jacobovici searched for a person willing to donate a kidney to a complete stranger. They found one, Shree Dhar, through a website that connects live persons willing to donate an organ - without compensation - to strangers. But Montreal's Royal Victoria Hospital refuses to do the transplant for what it claims are "ethical" reasons. Dr. Douglas Keith, head of the hospital's living donor transplant program, says the hospital could not be sure there is no "quid pro quo" agreement between Tegegne and Dhar. He also says the donation looks suspicious because the donor is from the Third World and contact was made on the Internet.
Dhar has repeatedly stated that his motives are pure, and that he is not looking for money or to immigrate to Canada. He says he is motivated by religious conviction and is moved by Tegegne's story. Dhar also wants to honor his grandfather, an Indian army general who died of kidney disease. "I believe G-d will be with me," he said. Canada has no law prohibiting altruistic donations from unrelated persons. Calls to American transplant centers confirmed that altruistic donations of this type are regularly accepted throughout the United States.
A leading opponent of altruistic transplants is leading Canadian bio-ethicist and professor of philosophy Dr. Arthur Shafer. Shafer's take on the Terri Schiavo case is telling - he was quoted as saying that Schiavo's brain stem had "turned to mush" and that Schiavo - who was starved to death by court order two months ago - was a "vegetable." In Tegene's case, Canada's Doctor of Death is no less clear. While smirking on Canadian television Dr. Schafer asserted that if Tegegne's potential donor was "truly altruistic," he would donate his kidney to someone closer to home. Following that convoluted logic, no altruistic live-donor organ donation could ever take place.
Jacobovici accuses Royal Victoria Hospital of "arrogance, paranoia and racism" because, [like Dr. Schafer,] "it assumes that anyone donating kidney, especially if they are from the Third World, are doing it for the money and not for noble reasons. "They're treating live donors as guilty until proven innocent and thousands of Canadians are left to die as a result." Each year, 200 Canadians die waiting for transplants.
The Canadian healthcare system is often held up as a model for a proposed national healthcare plan in the United States like the one then-First Lady Hillary Clinton proposed in 1994. Few Americans realize the corrosive effect the Canadian system has on the quality of healthcare provided - or not - to Canada's citizens. Inordinately long wait-times and rationing of services are the norm. Canadians wait months for coronary bypass surgery. Some die waiting. A needed MRI can require a six-month wait. And many cutting-edge procedures, drugs and treatments are simply not prescribed because they are not included in the basket of benefits Canadian's receive. And under federal law, private clinics are not legally allowed to provide services covered by the Canada Health Act, so there is no competition - and nowhere else to turn for help.
Canada is also alleged to hold down drug prices by extorting American pharmaceutical companies: Sell Canada drugs below wholesale cost (and sometimes below actual cost) or Canada will buy so-called grey market knock-offs from China. But in Baruch Tegegne's case, the Canadian system becomes even more bizarre. A live donor, altruistic transplant with a donor found over the Internet has been done at Toronto General Hospital. But Tegegne cannot simply fly to Toronto to save his life. Canadian national healthcare is not portable. Toronto is in the provence of Ontario. Montreal is in Quebec. Except for emergency, non-elective care, Toronto will not pay for a Montreal citizen's healthcare. Even though Tegegne needs the transplant to save his life, the transplant is not considered emergency care, so the man who risked his life to save hundreds from certain death now waits quietly for his own.
Michael Bergman, a noted Montreal lawyer is providing pro bono representation for Tegegne. But Tegegne's health makes a protracted legal battle impossible. He simply doesn't have the time. So Jacobovici and friends have begun raising $200,000 to pay for a transplant outside of Canada. They launched a website, www.TransplantNow.org, and got to work. An Israeli hospital agreed has agreed to do the transplant. It also cut $70,000 from its fee. The Ethiopian Jewish community in Israel - the poorest of Israel's poor - raised $20,000 from its own members. And donations have come in from those who have found Baruch's story on the Internet. Still, $100,000 is still needed. "We're at the crunch point now," Jacobovici notes. "We've got about a month to get this done."
Tegegne's story clearly demonstrates the danger of a state-controlled healthcare system. But it also provides the opportunity to send a message and demonstrate that protecting human life is the most important moral value, one that trumps socialized medicine and doctors of death every time.
Direct, secure online donations can be made through the Sha'arei Dayah Foundation: https://www.charitybox.com/sdf or www.BoutiqueTzedaka.org and are tax deductible in the United States. All funds received will go directly to Tegegne's transplant.
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.
***************************
It certainly shows the dangers of State-controlled medicine
Baruch Tegegne, the man credited with rescuing hundreds if not thousands of his fellow Ethiopian Jews from famine and death, is now in a fight for his own life. In the second group of Ethiopian Jews brought to Israel in the 1950's by Israel's second president Yitzhak Ben-Tzvi and educated in AMIT religious schools, Baruch met a Canadian Jewish woman in Israel. They married and moved to Montreal 1979. His dramatic escape by foot from Ethiopia in 1974 to get to Israel and his activism for rescue of Ethiopian Jews was featured in the 1983 documentary "Falasha: Exile of the Black Jews." Among those supportive of Baruch's rescue efforts was Rabbi Moshe Feinstein, considered by many to be the leading Orthodox rabbinic scholar of the last half of the 20th century.
Now 61, Baruch has advanced kidney disease caused by diabetes. He undergoes dialysis four times a week at the Jewish General Hospital. His health is rapidly deteriorating. But his fight is against more than advanced kidney disease. It is against the state-controlled Canadian health system.
A group of his friends led by Emmy Award winning filmmaker Simcha Jacobovici searched for a person willing to donate a kidney to a complete stranger. They found one, Shree Dhar, through a website that connects live persons willing to donate an organ - without compensation - to strangers. But Montreal's Royal Victoria Hospital refuses to do the transplant for what it claims are "ethical" reasons. Dr. Douglas Keith, head of the hospital's living donor transplant program, says the hospital could not be sure there is no "quid pro quo" agreement between Tegegne and Dhar. He also says the donation looks suspicious because the donor is from the Third World and contact was made on the Internet.
Dhar has repeatedly stated that his motives are pure, and that he is not looking for money or to immigrate to Canada. He says he is motivated by religious conviction and is moved by Tegegne's story. Dhar also wants to honor his grandfather, an Indian army general who died of kidney disease. "I believe G-d will be with me," he said. Canada has no law prohibiting altruistic donations from unrelated persons. Calls to American transplant centers confirmed that altruistic donations of this type are regularly accepted throughout the United States.
A leading opponent of altruistic transplants is leading Canadian bio-ethicist and professor of philosophy Dr. Arthur Shafer. Shafer's take on the Terri Schiavo case is telling - he was quoted as saying that Schiavo's brain stem had "turned to mush" and that Schiavo - who was starved to death by court order two months ago - was a "vegetable." In Tegene's case, Canada's Doctor of Death is no less clear. While smirking on Canadian television Dr. Schafer asserted that if Tegegne's potential donor was "truly altruistic," he would donate his kidney to someone closer to home. Following that convoluted logic, no altruistic live-donor organ donation could ever take place.
Jacobovici accuses Royal Victoria Hospital of "arrogance, paranoia and racism" because, [like Dr. Schafer,] "it assumes that anyone donating kidney, especially if they are from the Third World, are doing it for the money and not for noble reasons. "They're treating live donors as guilty until proven innocent and thousands of Canadians are left to die as a result." Each year, 200 Canadians die waiting for transplants.
The Canadian healthcare system is often held up as a model for a proposed national healthcare plan in the United States like the one then-First Lady Hillary Clinton proposed in 1994. Few Americans realize the corrosive effect the Canadian system has on the quality of healthcare provided - or not - to Canada's citizens. Inordinately long wait-times and rationing of services are the norm. Canadians wait months for coronary bypass surgery. Some die waiting. A needed MRI can require a six-month wait. And many cutting-edge procedures, drugs and treatments are simply not prescribed because they are not included in the basket of benefits Canadian's receive. And under federal law, private clinics are not legally allowed to provide services covered by the Canada Health Act, so there is no competition - and nowhere else to turn for help.
Canada is also alleged to hold down drug prices by extorting American pharmaceutical companies: Sell Canada drugs below wholesale cost (and sometimes below actual cost) or Canada will buy so-called grey market knock-offs from China. But in Baruch Tegegne's case, the Canadian system becomes even more bizarre. A live donor, altruistic transplant with a donor found over the Internet has been done at Toronto General Hospital. But Tegegne cannot simply fly to Toronto to save his life. Canadian national healthcare is not portable. Toronto is in the provence of Ontario. Montreal is in Quebec. Except for emergency, non-elective care, Toronto will not pay for a Montreal citizen's healthcare. Even though Tegegne needs the transplant to save his life, the transplant is not considered emergency care, so the man who risked his life to save hundreds from certain death now waits quietly for his own.
Michael Bergman, a noted Montreal lawyer is providing pro bono representation for Tegegne. But Tegegne's health makes a protracted legal battle impossible. He simply doesn't have the time. So Jacobovici and friends have begun raising $200,000 to pay for a transplant outside of Canada. They launched a website, www.TransplantNow.org, and got to work. An Israeli hospital agreed has agreed to do the transplant. It also cut $70,000 from its fee. The Ethiopian Jewish community in Israel - the poorest of Israel's poor - raised $20,000 from its own members. And donations have come in from those who have found Baruch's story on the Internet. Still, $100,000 is still needed. "We're at the crunch point now," Jacobovici notes. "We've got about a month to get this done."
Tegegne's story clearly demonstrates the danger of a state-controlled healthcare system. But it also provides the opportunity to send a message and demonstrate that protecting human life is the most important moral value, one that trumps socialized medicine and doctors of death every time.
Direct, secure online donations can be made through the Sha'arei Dayah Foundation: https://www.charitybox.com/sdf or www.BoutiqueTzedaka.org and are tax deductible in the United States. All funds received will go directly to Tegegne's transplant.
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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