Health reform: Three states, two basic approaches
Now Vermont has entered the statewide healthcare reform arena, with a perspective remarkably similar to that of its neighboring state, Massachusetts. The announcement of the Green Mountain State’s efforts to curb Medicare costs, while promoting “full insurance” for its citizens, comes on the heels of the Bay State program recently approved (with some reservations) by the House, Senate and Governor in the Commonwealth below Vermont geographically. Alongside these two attempts is the program currently being considered in Tennessee, which has a lot farther to go in recovering from its disastrous TennCare mistake. This column seeks to compare and contrast the three approaches, in hopes of defining what is and is not likely to work in each of them.
What they all have in common is a focus on insuring everyone, rather than on providing low-cost medical care per se. They also seek to convince everyone to sign up, as employer and as individual, choosing among whatever options they and the insurance companies devise for allegedly baseline healthcare coverage, and in some way or another, they seek to penalize members at least one of those categories if they do not obey. However, there are two aspects of Tennessee’s CoverTN plan that set it aside from the other two: the emphasis on portability, and the shared cost of the coverage by the working person.
Vermont, following the lead of its neighbor to the immediate south, is focused on REQUIRING everyone to get insured. Somehow the state that prides itself on having self-defined socialist Bernie Sanders as its Independent Congressman would seem likely to take that route of forcing compliance rather than offering incentives for it, as Taxyourwhatsis has already blazed the pathway for. Although Mass. Governor Mitt Romney complained about the fines for small companies who did not comply (though not about similar requirements for individuals to sign up for the insurance), he did end up signing the bill as it was written, and it will go into effect very soon.
In all three states, the primary goal is to bring at least most of those residents who are not currently covered by health insurance, and who are working for a living (and thus are ineligible for the handout programs), so that they don’t become a greater burden on the taxpayers when some emergency arises. The Vermont and Massachusetts plans, as a Boston Sunday Globe editorial editorial notes, share many other aspects, including expansion of Medicaid, subsidies for people with low incomes and a fine (called a “fee”) for employers who don’t buy into some insurance system for their workers. (However, at $365 in Vt. and $295 in Mass., these annual penalties are a pittance compared to what the companies would be paying to insure someone even at the lowest level, so they are unlikely to deter much non-compliance.)
However, unlike the Bay State plan (which requires any individual resident to become insured by July 1, 2007, or pay a hefty fine), Vermont will not mandate that everyone buy into the program, at least not as individuals; instead the state is setting up Catamount insurance policies through private insurers, designed to attract individual subscribers with subsidized low rates and bare-bones coverage. It is hoped that this will encourage both preventive care and early detection, before problems become serious and require more extensive care.
They also plan to bankroll their program with a boost in cigarette taxes, to as much as 80 cents more per pack over the next couple of years. (Massachusetts legislators think they can make their plan go with cutbacks on existing programs and revenue growth, as well as cost savings overall by containing excessive use of emergency facilities. In a state which has seen property taxes capped via Proposition 2-1/2, and nearly saw its income tax repealed via another referendum a few years ago, finding ways to trim costs and find hidden money is becoming much more familiar to those legislators.)
Meanwhile, down [here] in Tennessee, the first challenge has been to rollback and replace most of the elements of the atrocious and overblown TennCare debacle. Started in 1994, and initially intended to provide blanket coverage for those who needed the care the most (the disabled, the elderly, chronic-pain and disease sufferers, the uninsurable and the indigent), it rapidly expanded and overflowed all of its boundaries. It was abused by out-of-staters establishing false residency, by able-bodied workers who chose the dole over productive endeavor, and finally even by medium and large companies, who saw a way out of paying for their employees health (or paying them more so they could do so themselves?), and became a large part of the problem instead of an aid to solution.
So the first step was the dismantling of the worst parts of TennCare; only then could its replacement, with subsidiary and targeted programs to attack specific aspects of health and wellness, be addressed. And now, after a somewhat ruthless slashing of that behemoth (many aspects of which seemed more politically driven than they were based on common sense!), Governor Bredesen has produced a three-part strategy for fixing the roof and the foundation of the structure. His Cover Tennessee program has been previously commented on in this space, but comparison with the efforts in the two New England states are still in order.
Generally speaking, Cover TN, the portion focusing on the working poor and middle class, is the most innovative here, since it actually encourages a working person to sign up, at relatively low cost, for a policy that is then attached, not to an employer, but to that individual person. The policy, a relatively low-level coverage with significant co-payments required for both doctor visits and prescriptions, is intended to cost about $150 a month, one-third of which would be absorbed by the taxpayers (and be paid for at least in the short term by TennCare budget savings or tobacco-settlement funds). The remaining $100 a month would be paid by some combination of the employer and the employee, or entirely by the individual. Under the plan as it is written, that would be literally a $50/$50 split, though one might expect a smart employer to offer a better deal as an incentive to keep a good worker.
The advantage of this is, the policy could be transferred from job to job, with the next employer assuming some portion of the policy-cost. Or it could exist entirely independent of an employer, allowing a self-employed consultant to afford decent healthcare coverage, instead of having to either budget for a high-cost individual policy, or go with insurance, as many do at present. (It would also phase out the archaic concept of COBRA insurance, whereby an employee leaving a job may continue coverage under a prior plan, for a limited time, but often at five or ten times the cost of the previous policy.)
Right now, while the Massachusetts plan has already been signed into law, and the Vermont one is likely to pass very shortly, the Tennessee one is still being held up, over some subsidiary issues, according to some proponents. While there is very little opposition to the plan as it is presented, there are some battles being waged on its periphery: a recent attempt to tie medical malpractice suit limits to the bill had to be defeated last week, and now the push is on to address the issue of an estimated 67,000 uninsurable Tennesseans (with pre-existing medical conditions), who were dropped from TennCare and are still now without assistance.
One does feel for their plight, and the issue should be addressed (perhaps with the first piece from those extra TennCare funds, which should continue to grow as this CoverTN program takes hold); however, it is to be fervently hoped that this experimental new paradigm in health coverage does not get derailed by this side-issue. The possible ramifications of freeing workers from their somewhat willingly accepted chains, moving away from “healthcare benefits too good to lose,” and chasing their own individual dreams … are just too wondrous to imagine!
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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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Wednesday, May 31, 2006
Tuesday, May 30, 2006
Dumb but Leftist: Your future doctor
Medical schools are giving students coveted university training places based on "personality assessments" that include asking for their views on the Iraq war and gay marriage. Less academically gifted students are leapfrogging those with better marks by signing up for coaching programs that school them in handling the interview questions - fuelling critics' claims that the personality tests are skewing the selection process for the nation's future doctors away from the best and brightest.
Some interviewees have been asked to debate the rights and wrongs of providing in-vitro fertilisation services to gay people. Other questions include what applicants' parents do for a living and whether they went to a private school.
Some senior doctors are now accusing universities of attempting to "socially engineer" medical school intakes by giving preference to candidates who reflect the interviewers' views, allegedly often left-wing. The interviews - usually conducted by a panel comprising members of the public as well as doctors - often ask applicants to talk about their earliest memories, or discuss their biggest disappointment in life and how they coped with it. The process is supposed to identify "well-rounded personalities" that some claim will make better doctors.
Greg Deacon, president of the Australian Society of Anesthetists, described the situation as "absolutely appalling" and said he had been "speaking to a number of people who have been upset" at the way the interview process at a number of universities - including the University of NSW and Newcastle University - has been conducted. "Questions that are being asked, and that should never be asked, are questions such as 'What does your father do?', 'What does your mother do?', 'Where do you live?' and 'What school did you go to?'," Dr Deacon said. "If you went to a private school, or your father is a doctor, you are simply not going to be selected. The justification is the personal biases of those doing the interviews - they are trying to engineer the selection of medical undergraduates to further their own desires." He said he knew of one student whose HSC results put her in the state's top 40. "She was asked these questions," he said. "Because her father was a specialist doctor and went to private school, she didn't get in. It's hard to comprehend."
Dr Deacon said students' views on Iraq or gay marriage had "nothing to do with ability to be a doctor", and the risk was that interviewers would frown on candidates whose views clashed with their own. But these latest claims are rejected by the heads of Australia's 17 medical schools, which are already under pressure over assertions that the teaching of sciences, including anatomy and pathology, has been cut back to dangerous levels. The medical schools say interviewers are trained to judge an applicant's ability to reason and argue intelligently, not the position they take. But at least one university is scrapping the interview process after finding no evidence that the students selected by panels performed any better during the course.
And experts who assess personalities have cast doubts on the validity of the interviews. A NSW forensic psychiatrist, Julian Parmegiani, does personality assessments in situations such as parole applications and court-ordered psychiatric evaluations. He writes in the latest issue of NSW Doctor, the magazine of the NSW Australian Medical Association, that the interviews "will not identify altruistic, kind and empathetic doctors" but merely the students best able to divine what interviewers wanted to hear. "Successful students might be just a tad more psychopathic, manipulative and intent on recouping their investments," Dr Parmegiani writes.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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.
***************************
Medical schools are giving students coveted university training places based on "personality assessments" that include asking for their views on the Iraq war and gay marriage. Less academically gifted students are leapfrogging those with better marks by signing up for coaching programs that school them in handling the interview questions - fuelling critics' claims that the personality tests are skewing the selection process for the nation's future doctors away from the best and brightest.
Some interviewees have been asked to debate the rights and wrongs of providing in-vitro fertilisation services to gay people. Other questions include what applicants' parents do for a living and whether they went to a private school.
Some senior doctors are now accusing universities of attempting to "socially engineer" medical school intakes by giving preference to candidates who reflect the interviewers' views, allegedly often left-wing. The interviews - usually conducted by a panel comprising members of the public as well as doctors - often ask applicants to talk about their earliest memories, or discuss their biggest disappointment in life and how they coped with it. The process is supposed to identify "well-rounded personalities" that some claim will make better doctors.
Greg Deacon, president of the Australian Society of Anesthetists, described the situation as "absolutely appalling" and said he had been "speaking to a number of people who have been upset" at the way the interview process at a number of universities - including the University of NSW and Newcastle University - has been conducted. "Questions that are being asked, and that should never be asked, are questions such as 'What does your father do?', 'What does your mother do?', 'Where do you live?' and 'What school did you go to?'," Dr Deacon said. "If you went to a private school, or your father is a doctor, you are simply not going to be selected. The justification is the personal biases of those doing the interviews - they are trying to engineer the selection of medical undergraduates to further their own desires." He said he knew of one student whose HSC results put her in the state's top 40. "She was asked these questions," he said. "Because her father was a specialist doctor and went to private school, she didn't get in. It's hard to comprehend."
Dr Deacon said students' views on Iraq or gay marriage had "nothing to do with ability to be a doctor", and the risk was that interviewers would frown on candidates whose views clashed with their own. But these latest claims are rejected by the heads of Australia's 17 medical schools, which are already under pressure over assertions that the teaching of sciences, including anatomy and pathology, has been cut back to dangerous levels. The medical schools say interviewers are trained to judge an applicant's ability to reason and argue intelligently, not the position they take. But at least one university is scrapping the interview process after finding no evidence that the students selected by panels performed any better during the course.
And experts who assess personalities have cast doubts on the validity of the interviews. A NSW forensic psychiatrist, Julian Parmegiani, does personality assessments in situations such as parole applications and court-ordered psychiatric evaluations. He writes in the latest issue of NSW Doctor, the magazine of the NSW Australian Medical Association, that the interviews "will not identify altruistic, kind and empathetic doctors" but merely the students best able to divine what interviewers wanted to hear. "Successful students might be just a tad more psychopathic, manipulative and intent on recouping their investments," Dr Parmegiani writes.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 29, 2006
Your regulators will protect you: Yet another botch from Queensland Health
A cosmetic surgeon who quit Victoria after botching seven operations has been disciplined in Queensland over another surgery bungle. Gold Coast-based Graydon Ronald Van Houten was found guilty of unsatisfactory professional conduct over an operation to remove a cyst from the ear of Browns Plains retiree Bob Martin in August 2001. The wound failed to heal and specialists had to remove part of Mr Martin's ear after a routine check-up three months later showed the cyst was a carcinoma.
The incident has raised concerns about how Dr Van Houten was allowed to practise in Queensland despite the adverse findings against him in Victoria. Mr Martin, 64, reached an out-of-court settlement with Dr Van Houten which prevented him from naming the surgeon. But searches of public documents, which name Dr Van Houten, reveal The Medical Board of Queensland in January ruled the 60-year-old not be allowed to perform various skin procedures until he completed courses on skin cancer practice.
Mr Martin said the ordeal had devastated him. "When I walk into shopping centres now people point at me say, 'Look at that man, he has only half an ear.' People are always saying, 'What happened to you?' " Mr Martin said. He said the compensation amounted to "chicken feed" after his legal and hospital bills were paid.
In its findings, the panel noted the Medical Practitioners Board of Victoria in October 2002 had found Dr Van Houten had engaged in unprofessional conduct of a serious nature in the treatment of four patients and unprofessional conduct not of a serious nature in the treatment of three other patients. He escaped suspension because he had moved to Queensland and his Victorian registration had lapsed.
Mr Martin's lawyer Bruce Simmonds said the Queensland panel, despite being aware of the Victorian cases, had imposed little punishment on the doctor apart from requiring him to undergo some training. "I understand he is offering the same types of services here which led to the complaints in Victoria," Mr Simmonds said.
Marilyn Van Houten, a practice manager at her husband's surgery, defended him. "He has no problems that he isn't working through. He's addressed the issues at hand," she said. "Why aren't the newspapers supporting doctors . . . we're not talking about Dr Patel here." The Medical Board of Queensland said recent changes in legislation had led to improved checks on interstate doctors and a public register being established where patients could check doctors' records.
Source
Federal Health Minister Abbott blasts Queensland hospital ban on Bible
Queensland Health are much better at political correctness than they are at medical correctness
Federal Health Minister Tony Abbott has accused Queensland hospital bosses of "losing the plot" after they banned the Bible from bedsides. An outraged Mr Abbott launched his scathing attack, following a Sunday Mail report which revealed the religious books had been removed amid fears of offending non-Christians. Mr Abbott said the Federal Government was giving $9 billion to Queensland to run public hospitals efficiently - not to ban the Bible.
The Royal Brisbane and Princess Alexandra hospitals are among those in the firing line. Staff said the Bibles had been removed because they were no longer in keeping with the "multicultural approach to chaplaincy", while some claimed the books were a source of infection. Mr Abbott told Federal Parliament: "This is not an infection control measure, it is a thought control measure - it is political correctness gone crazy. "I say to public hospital administrators: Stop worrying about offending people and start running public hospitals properly, and give people Bibles at a time when they probably most want to see them."
Gideons International, which distributes the Bibles, has offered to supply hospitals with hardcover copies which could be wiped to reduce infection fears, but health bosses have rejected the offer. This week they denied that Bibles had been banned from bedsides. "Bibles are available in all hospitals, either at the bedside or on request," Queensland Health Director-General Uschi Schreiber said.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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 cosmetic surgeon who quit Victoria after botching seven operations has been disciplined in Queensland over another surgery bungle. Gold Coast-based Graydon Ronald Van Houten was found guilty of unsatisfactory professional conduct over an operation to remove a cyst from the ear of Browns Plains retiree Bob Martin in August 2001. The wound failed to heal and specialists had to remove part of Mr Martin's ear after a routine check-up three months later showed the cyst was a carcinoma.
The incident has raised concerns about how Dr Van Houten was allowed to practise in Queensland despite the adverse findings against him in Victoria. Mr Martin, 64, reached an out-of-court settlement with Dr Van Houten which prevented him from naming the surgeon. But searches of public documents, which name Dr Van Houten, reveal The Medical Board of Queensland in January ruled the 60-year-old not be allowed to perform various skin procedures until he completed courses on skin cancer practice.
Mr Martin said the ordeal had devastated him. "When I walk into shopping centres now people point at me say, 'Look at that man, he has only half an ear.' People are always saying, 'What happened to you?' " Mr Martin said. He said the compensation amounted to "chicken feed" after his legal and hospital bills were paid.
In its findings, the panel noted the Medical Practitioners Board of Victoria in October 2002 had found Dr Van Houten had engaged in unprofessional conduct of a serious nature in the treatment of four patients and unprofessional conduct not of a serious nature in the treatment of three other patients. He escaped suspension because he had moved to Queensland and his Victorian registration had lapsed.
Mr Martin's lawyer Bruce Simmonds said the Queensland panel, despite being aware of the Victorian cases, had imposed little punishment on the doctor apart from requiring him to undergo some training. "I understand he is offering the same types of services here which led to the complaints in Victoria," Mr Simmonds said.
Marilyn Van Houten, a practice manager at her husband's surgery, defended him. "He has no problems that he isn't working through. He's addressed the issues at hand," she said. "Why aren't the newspapers supporting doctors . . . we're not talking about Dr Patel here." The Medical Board of Queensland said recent changes in legislation had led to improved checks on interstate doctors and a public register being established where patients could check doctors' records.
Source
Federal Health Minister Abbott blasts Queensland hospital ban on Bible
Queensland Health are much better at political correctness than they are at medical correctness
Federal Health Minister Tony Abbott has accused Queensland hospital bosses of "losing the plot" after they banned the Bible from bedsides. An outraged Mr Abbott launched his scathing attack, following a Sunday Mail report which revealed the religious books had been removed amid fears of offending non-Christians. Mr Abbott said the Federal Government was giving $9 billion to Queensland to run public hospitals efficiently - not to ban the Bible.
The Royal Brisbane and Princess Alexandra hospitals are among those in the firing line. Staff said the Bibles had been removed because they were no longer in keeping with the "multicultural approach to chaplaincy", while some claimed the books were a source of infection. Mr Abbott told Federal Parliament: "This is not an infection control measure, it is a thought control measure - it is political correctness gone crazy. "I say to public hospital administrators: Stop worrying about offending people and start running public hospitals properly, and give people Bibles at a time when they probably most want to see them."
Gideons International, which distributes the Bibles, has offered to supply hospitals with hardcover copies which could be wiped to reduce infection fears, but health bosses have rejected the offer. This week they denied that Bibles had been banned from bedsides. "Bibles are available in all hospitals, either at the bedside or on request," Queensland Health Director-General Uschi Schreiber said.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 28, 2006
Bright idea in New Jersey: Make hospital care even more expensive!
As New Jersey's July 1 deadline to adopt a state budget looms, hospital groups and some legislators are fighting to stop a new tax that Gov. Jon Corzine (D) has proposed in an effort to reduce the state's $4 billion deficit. In his budget proposal this year, Corzine suggested imposing a bed tax on all 74 hospitals operating in public-private partnership with the state. The measure is expected to raise approximately $430 million by forcing hospitals to pay an average of $1,424 a month per bed and might bring in some matching Medicaid funds from the federal government.
Corzine wants to split the $430 million in half, giving $215 million back to hospitals at rates dependent on their Medicaid utilization and putting the other half into the state's general fund in order to seek the federal matching funds. The plan has the health care industry crying foul because it hurts large hospitals with low rates of Medicaid usage and unfairly benefits small ones with large numbers of Medicaid patients.
Not only is it a bad idea that could cause division in the hospital industry, said New Jersey Hospital Association spokesman Ron Czajkowski, it's an example of horrible timing because the industry is on "spongy, if not fragile, financial turf." The average nonprofit hospital in the state has an operating margin of 1 percent. "We have a high charity-care caseload," Czajkowski said. "Medicare and Medicaid don't pay dollar for dollar, and we're dealing with the impact of the illegal immigrant population that costs $250 million a year. In addition, we have the same problems the rest of the country has with managed [care], where they are still slow or no-pay contributors to hospitals. "Forty-two percent of the state's hospitals operated in the red last year, and if a tax like this goes through, there will be cutbacks on services and layoffs," Czajkowski continued. "Some of those that are already in bad shape might close down."
Under current New Jersey law, hospitals are required to care for all patients seeking medical attention, regardless of whether they have insurance. In 2005, the state budgeted $583.4 million to reimburse hospitals for those charity-care cases, said Department of Health and Senior Services spokeswoman Gretchen Michael--an amount Corzine proposes keeping the same in the FY 2007 budget. But Suzanne Ianni, executive director of the Hospital Alliance of New Jersey, pointed out in her April 3 testimony before the state Senate Budget and Appropriations Committee that the amount is inadequate because it's based on 2002 data. Over the past four years, the state's charity-care costs have risen from $778 million to more than $1 billion, she said. Medicaid doesn't reimburse dollar for dollar, so the 2002 estimates were low to begin with.
"People receive care whether or not they have health insurance because of hospitals' public-private partnership with the state," Ianni said. "We know that Gov. Corzine wants a responsible budget this year but ignoring the substantial increases in charity-care delivery is irresponsible of this budget. Our government must meet its responsibility to ensure health care for its citizens."
The Trenton Times pointed out in an April 9 editorial that if the tax is approved, it will most likely result in even higher health care costs for consumers as hospitals pass the cost along to their patients, ultimately through higher insurance premiums. State Sen. Paul A. Sarlo (D-Wood-Ridge) opposed the tax. "We can't solve our charity-care problem on the backs of hospitals who serve our working residents who have health insurance," he told NorthJersey.com on April 8.
At press time, the state legislature was still in discussions with Corzine. The governor's press office referred calls for comment to Ms. Michael at the Department of Health and Senior Services.
Source
Nowhere for her to give birth
What happens when you rely on the great god "Gubmint" and their wonderful "planning": An interstate trip to give birth!
A critical bed shortage has led to a pregnant mother expecting twins having to travel to Canberra Hospital yesterday because of a gridlock in infant intensive care wards. A rush of multiple births - including triplets at Nepean Hospital - put pressure on an over-burdened system. The woman was flown by air ambulance to Canberra early yesterday morning. High occupancy rates in maternity and neo-natal wards across Sydney caused a serious shortage across the state.
A spokesman for ACT Health confirmed they received a NSW patient early yesterday, and said interstate transfers were "routine". "A pregnant woman was transported to the Canberra Hospital from Sydney because there were no neo-natal beds available elsewhere in Sydney," he said.
A NSW Health spokeswoman said there was a shortage in both maternity and intensive care cots across the state. "From time to time we do need to transfer patients and their babies to specialist services outside of Sydney," she said. "When the patient and her children are stable, they will be offered transfer back to Sydney."
A lack of specialist nurses is aggravating the situation, prompting one Sydney hospital on Thursday night to call in off-duty nurses. "This is a recurrent problem, it happens all the time," one specialist told The Saturday Daily Telegraph. There are currently more than 140 positions vacant in NSW in this specialist nursing field, causing major problems in all hospitals with neonatal intensive care units. "This is a highly specialised area and these babies need one on one care 24-7," an expert said. "There is not enough nurses to match the beds."
The fact women are having children later in life means there are more premature babies than ever before and technology can keep a premature infant alive at 23 weeks. About 2 per cent of all babies born in NSW are treated in one of the state's nine specialist units. There are 125 intensive care cots across NSW and the ACT. Survival rates for babies admitted to neonatal intensive care units have risen from 87 per cent in 1997 to 92 per cent in 2005.
Opposition health spokeswoman Jillian Skinner said it was an outrage a woman was made to travel during a stressful and vulnerable time.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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.
***************************
As New Jersey's July 1 deadline to adopt a state budget looms, hospital groups and some legislators are fighting to stop a new tax that Gov. Jon Corzine (D) has proposed in an effort to reduce the state's $4 billion deficit. In his budget proposal this year, Corzine suggested imposing a bed tax on all 74 hospitals operating in public-private partnership with the state. The measure is expected to raise approximately $430 million by forcing hospitals to pay an average of $1,424 a month per bed and might bring in some matching Medicaid funds from the federal government.
Corzine wants to split the $430 million in half, giving $215 million back to hospitals at rates dependent on their Medicaid utilization and putting the other half into the state's general fund in order to seek the federal matching funds. The plan has the health care industry crying foul because it hurts large hospitals with low rates of Medicaid usage and unfairly benefits small ones with large numbers of Medicaid patients.
Not only is it a bad idea that could cause division in the hospital industry, said New Jersey Hospital Association spokesman Ron Czajkowski, it's an example of horrible timing because the industry is on "spongy, if not fragile, financial turf." The average nonprofit hospital in the state has an operating margin of 1 percent. "We have a high charity-care caseload," Czajkowski said. "Medicare and Medicaid don't pay dollar for dollar, and we're dealing with the impact of the illegal immigrant population that costs $250 million a year. In addition, we have the same problems the rest of the country has with managed [care], where they are still slow or no-pay contributors to hospitals. "Forty-two percent of the state's hospitals operated in the red last year, and if a tax like this goes through, there will be cutbacks on services and layoffs," Czajkowski continued. "Some of those that are already in bad shape might close down."
Under current New Jersey law, hospitals are required to care for all patients seeking medical attention, regardless of whether they have insurance. In 2005, the state budgeted $583.4 million to reimburse hospitals for those charity-care cases, said Department of Health and Senior Services spokeswoman Gretchen Michael--an amount Corzine proposes keeping the same in the FY 2007 budget. But Suzanne Ianni, executive director of the Hospital Alliance of New Jersey, pointed out in her April 3 testimony before the state Senate Budget and Appropriations Committee that the amount is inadequate because it's based on 2002 data. Over the past four years, the state's charity-care costs have risen from $778 million to more than $1 billion, she said. Medicaid doesn't reimburse dollar for dollar, so the 2002 estimates were low to begin with.
"People receive care whether or not they have health insurance because of hospitals' public-private partnership with the state," Ianni said. "We know that Gov. Corzine wants a responsible budget this year but ignoring the substantial increases in charity-care delivery is irresponsible of this budget. Our government must meet its responsibility to ensure health care for its citizens."
The Trenton Times pointed out in an April 9 editorial that if the tax is approved, it will most likely result in even higher health care costs for consumers as hospitals pass the cost along to their patients, ultimately through higher insurance premiums. State Sen. Paul A. Sarlo (D-Wood-Ridge) opposed the tax. "We can't solve our charity-care problem on the backs of hospitals who serve our working residents who have health insurance," he told NorthJersey.com on April 8.
At press time, the state legislature was still in discussions with Corzine. The governor's press office referred calls for comment to Ms. Michael at the Department of Health and Senior Services.
Source
Nowhere for her to give birth
What happens when you rely on the great god "Gubmint" and their wonderful "planning": An interstate trip to give birth!
A critical bed shortage has led to a pregnant mother expecting twins having to travel to Canberra Hospital yesterday because of a gridlock in infant intensive care wards. A rush of multiple births - including triplets at Nepean Hospital - put pressure on an over-burdened system. The woman was flown by air ambulance to Canberra early yesterday morning. High occupancy rates in maternity and neo-natal wards across Sydney caused a serious shortage across the state.
A spokesman for ACT Health confirmed they received a NSW patient early yesterday, and said interstate transfers were "routine". "A pregnant woman was transported to the Canberra Hospital from Sydney because there were no neo-natal beds available elsewhere in Sydney," he said.
A NSW Health spokeswoman said there was a shortage in both maternity and intensive care cots across the state. "From time to time we do need to transfer patients and their babies to specialist services outside of Sydney," she said. "When the patient and her children are stable, they will be offered transfer back to Sydney."
A lack of specialist nurses is aggravating the situation, prompting one Sydney hospital on Thursday night to call in off-duty nurses. "This is a recurrent problem, it happens all the time," one specialist told The Saturday Daily Telegraph. There are currently more than 140 positions vacant in NSW in this specialist nursing field, causing major problems in all hospitals with neonatal intensive care units. "This is a highly specialised area and these babies need one on one care 24-7," an expert said. "There is not enough nurses to match the beds."
The fact women are having children later in life means there are more premature babies than ever before and technology can keep a premature infant alive at 23 weeks. About 2 per cent of all babies born in NSW are treated in one of the state's nine specialist units. There are 125 intensive care cots across NSW and the ACT. Survival rates for babies admitted to neonatal intensive care units have risen from 87 per cent in 1997 to 92 per cent in 2005.
Opposition health spokeswoman Jillian Skinner said it was an outrage a woman was made to travel during a stressful and vulnerable time.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 27, 2006
NHS HEADS CANNOT STOMACH THE POLITICAL DECEITS AND BUNGLES
The management crisis in the health service has worsened with the resignation of a senior director who accused ministers of “deceit over reform”. Professor Aidan Halligan, director of clinical governance, stood down this week, leaving another vacancy at the top of the NHS, The Times has learnt. Nine senior positions are filled at present by temporary replacements or new appointees for staff who have resigned. The news came as the problems over jobs in the NHS increased, with another health trust announcing yesterday that it was losing 600 posts.
Professor Halligan shocked ministers last month when he condemned their failure to overhaul the NHS as they poured in billions of pounds of extra cash. His remarks were used in the Commons by David Cameron, the Conservative leader, to embarrass Tony Blair. The resignation of Professor Halligan comes two months after the sudden departure of Sir Nigel Crisp, the chief executive of the NHS and Permanent Secretary at the Department of Health. Andrew Foster, another senior department figure, also recently announced that he was leaving.
Andrew Lansley, the Shadow Health Secretary, said: “The Department of Health is a department without leadership, without direction and without any effective financial control. It is not surprising in the context of Mr Blair’s failing Government. “The ministers must take responsibility. There is a crisis of confidence between NHS staff on the one hand and the ministers and Department of Health on the other, because of the latter’s failure to articulate a clear and effective policy.”
It remains unclear why Sir Nigel resigned at a time of increasing pressure on the NHS caused by worsening deficits. But within weeks of the announcement it emerged that Mr Foster, the head of workforce planning at the department and another figure central to its reform programme, was stepping down. The department said that Mr Foster had chosen to leave to pursue other health service interests.
Professor Halligan, who was until last year the country’s second-most senior doctor when he served as deputy Chief Medical Officer, has decided to leave public service altogether. In a letter on Monday to Sir Liam Donaldson, the Chief Medical Officer, Professor Halligan thanked him for all his “support, encouragement and many kindnesses over the years”. Professor Halligan, a former lecturer in obstetrics, used an interview in a health service journal last month to criticise what he said was a failure to reform the NHS. “We have learnt that throwing money at the problem only allows us to do more of what we have always done,” he said. “Any suggestion of real reform has been a deceit. Working patterns, practice and custom are at the heart of many capacity issues [in the NHS] and have never been challenged.”
Oxford Radcliffe Hospitals confirmed plans yesterday to cut 600 jobs in an attempt to save 33 million pounds. The trust said that it could not rule out compulsory redundancies, although it has 600 vacancies
The Times
U.K. Regulators slam drug trial firm
Drug regulators have heavily criticised the firm which carried out the drug trial which left six men seriously ill. Parexel - who deny any wrongdoing - failed to follow proper procedures the Medicines and Healthcare products Regulatory Agency have reported. But the agency said the adverse reaction, which left the men with multiple organ failure, was the result of an "unexpected biological effect".
Experts slammed the conclusion, saying the outcome could have been predicted. At the time of the trial, Professor Herman Scholtz, from Parexel, said the clinical research organisation had followed regulatory, medical and clinical research guidelines during the study.
All six previously healthy men who took part suffered multiple organ failure after being given TGN1412, which is designed to treat rheumatoid arthritis, leukaemia and multiple sclerosis. One is still in Northwick Park hospital, and is said to be making steady progress. The solicitor representing two of the men has called the MHRA report "totally inadequate" and said it was "a whitewash".
The MHRA found the drug was given in correct doses and there was no sign of contamination or manufacturing errors. But it lists a catalogue of administrative errors. Parexel failed to complete the full medical background of a trial subject and the medical history of one of the volunteers was not updated. There was also no contract in place between TeGenero, the makers of the drug, and Parexel at the beginning of the trial. In addition, the MHRA reported one of the doctors involved did not have adequate training or experience. And two of the volunteers were allowed to leave before it was confirmed they had received the placebo
The German manufacturers of the drug TeGenero have maintained that the men's reactions were "completely unexpected" and did not reflect the results obtained from the earlier laboratory studies.
Dr David Glover, an independent consultant and industry expert on the development of antibody and other biological drugs said: "Today's report is inadequate and completely misses the point. "The report concluded the problem was due to an unexpected biological effect, but this is absolute nonsense. "The trial volunteers' response was predictable from preceding literature and data supplied by the company and should not have come as a surprise."
But Professor Kent Woods, MHRA Chief Executive told the BBC other monoclonal antibodies, like TGN1412, had been tested safely before, and there had been substantial safety measures built in to the study's development." However he admitted: "The number of volunteers is something that has to be reconsidered. "But even if one volunteer had been affected, it would have been a disastrous outcome." He added: "We are satisfied that the adverse incidents which occurred were not as a result of any errors made in the manufacture of TGN1412, its formulation, dilution or administration to trial participants."
It its interim report last month, the MHRA said it would take a "precautionary approach" to future trials of drugs like TGN1412. But Ann Alexander, the lawyer representing the two most seriously affected victims of the drug trial, condemned the report as "totally inadequate". "Today's report is a whitewash and leaves many questions unanswered. It gives no detailed information about the pre-clinical trials, about which there has been conflicting information." Ms Alexander, of Irwin Mitchell solicitors, questioned the finding that the reaction produced by the drug was unpredictable and called for an independent enquiry.
She added that a Health Select Committee report published last year had found a lack of transparency in the MHRA. "The concerns of the select committee seem to have been confirmed by the MHRA's investigations. "I now have little faith in the MHRA's ability to seek, obtain or make public detailed and relevant information about the clinical history of this trial or the manner in which it was conducted," she added.
The Department of Health has said the expert group will produce an interim report within three months of starting work. It will provide advice on how future trials of monoclonal antibodies should be designed.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The management crisis in the health service has worsened with the resignation of a senior director who accused ministers of “deceit over reform”. Professor Aidan Halligan, director of clinical governance, stood down this week, leaving another vacancy at the top of the NHS, The Times has learnt. Nine senior positions are filled at present by temporary replacements or new appointees for staff who have resigned. The news came as the problems over jobs in the NHS increased, with another health trust announcing yesterday that it was losing 600 posts.
Professor Halligan shocked ministers last month when he condemned their failure to overhaul the NHS as they poured in billions of pounds of extra cash. His remarks were used in the Commons by David Cameron, the Conservative leader, to embarrass Tony Blair. The resignation of Professor Halligan comes two months after the sudden departure of Sir Nigel Crisp, the chief executive of the NHS and Permanent Secretary at the Department of Health. Andrew Foster, another senior department figure, also recently announced that he was leaving.
Andrew Lansley, the Shadow Health Secretary, said: “The Department of Health is a department without leadership, without direction and without any effective financial control. It is not surprising in the context of Mr Blair’s failing Government. “The ministers must take responsibility. There is a crisis of confidence between NHS staff on the one hand and the ministers and Department of Health on the other, because of the latter’s failure to articulate a clear and effective policy.”
It remains unclear why Sir Nigel resigned at a time of increasing pressure on the NHS caused by worsening deficits. But within weeks of the announcement it emerged that Mr Foster, the head of workforce planning at the department and another figure central to its reform programme, was stepping down. The department said that Mr Foster had chosen to leave to pursue other health service interests.
Professor Halligan, who was until last year the country’s second-most senior doctor when he served as deputy Chief Medical Officer, has decided to leave public service altogether. In a letter on Monday to Sir Liam Donaldson, the Chief Medical Officer, Professor Halligan thanked him for all his “support, encouragement and many kindnesses over the years”. Professor Halligan, a former lecturer in obstetrics, used an interview in a health service journal last month to criticise what he said was a failure to reform the NHS. “We have learnt that throwing money at the problem only allows us to do more of what we have always done,” he said. “Any suggestion of real reform has been a deceit. Working patterns, practice and custom are at the heart of many capacity issues [in the NHS] and have never been challenged.”
Oxford Radcliffe Hospitals confirmed plans yesterday to cut 600 jobs in an attempt to save 33 million pounds. The trust said that it could not rule out compulsory redundancies, although it has 600 vacancies
The Times
U.K. Regulators slam drug trial firm
Drug regulators have heavily criticised the firm which carried out the drug trial which left six men seriously ill. Parexel - who deny any wrongdoing - failed to follow proper procedures the Medicines and Healthcare products Regulatory Agency have reported. But the agency said the adverse reaction, which left the men with multiple organ failure, was the result of an "unexpected biological effect".
Experts slammed the conclusion, saying the outcome could have been predicted. At the time of the trial, Professor Herman Scholtz, from Parexel, said the clinical research organisation had followed regulatory, medical and clinical research guidelines during the study.
All six previously healthy men who took part suffered multiple organ failure after being given TGN1412, which is designed to treat rheumatoid arthritis, leukaemia and multiple sclerosis. One is still in Northwick Park hospital, and is said to be making steady progress. The solicitor representing two of the men has called the MHRA report "totally inadequate" and said it was "a whitewash".
The MHRA found the drug was given in correct doses and there was no sign of contamination or manufacturing errors. But it lists a catalogue of administrative errors. Parexel failed to complete the full medical background of a trial subject and the medical history of one of the volunteers was not updated. There was also no contract in place between TeGenero, the makers of the drug, and Parexel at the beginning of the trial. In addition, the MHRA reported one of the doctors involved did not have adequate training or experience. And two of the volunteers were allowed to leave before it was confirmed they had received the placebo
The German manufacturers of the drug TeGenero have maintained that the men's reactions were "completely unexpected" and did not reflect the results obtained from the earlier laboratory studies.
Dr David Glover, an independent consultant and industry expert on the development of antibody and other biological drugs said: "Today's report is inadequate and completely misses the point. "The report concluded the problem was due to an unexpected biological effect, but this is absolute nonsense. "The trial volunteers' response was predictable from preceding literature and data supplied by the company and should not have come as a surprise."
But Professor Kent Woods, MHRA Chief Executive told the BBC other monoclonal antibodies, like TGN1412, had been tested safely before, and there had been substantial safety measures built in to the study's development." However he admitted: "The number of volunteers is something that has to be reconsidered. "But even if one volunteer had been affected, it would have been a disastrous outcome." He added: "We are satisfied that the adverse incidents which occurred were not as a result of any errors made in the manufacture of TGN1412, its formulation, dilution or administration to trial participants."
It its interim report last month, the MHRA said it would take a "precautionary approach" to future trials of drugs like TGN1412. But Ann Alexander, the lawyer representing the two most seriously affected victims of the drug trial, condemned the report as "totally inadequate". "Today's report is a whitewash and leaves many questions unanswered. It gives no detailed information about the pre-clinical trials, about which there has been conflicting information." Ms Alexander, of Irwin Mitchell solicitors, questioned the finding that the reaction produced by the drug was unpredictable and called for an independent enquiry.
She added that a Health Select Committee report published last year had found a lack of transparency in the MHRA. "The concerns of the select committee seem to have been confirmed by the MHRA's investigations. "I now have little faith in the MHRA's ability to seek, obtain or make public detailed and relevant information about the clinical history of this trial or the manner in which it was conducted," she added.
The Department of Health has said the expert group will produce an interim report within three months of starting work. It will provide advice on how future trials of monoclonal antibodies should be designed.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 26, 2006
BRITS GET HERCEPTIN AT LAST
Only after enormous pressure
Herceptin, the breast cancer drug so promising that patients have gone to court to demand treatment with it, is likely to be approved for widespread use on the NHS within the next few weeks. The drug received its UK licence for treatment of early-stage breast cancer yesterday. Many health trusts that had denied patients the drug argued that its safety remained unproven. The move means that Herceptin will probably be approved by the National Institute for Health and Clinical Excellence (NICE), which recommends on best treatments for the NHS, within the next month. It is bringing forward an announcement, originally planned for July, as a result of the record speed with which the licence has been granted.
News of the licence, which is valid across the European Union and was granted by the European Commission on the advice of its regulator, was welcomed yesterday by patients. Health trusts have said that the funding implications of the treatment, which costs about 20,000 pounds a year a patient, will be significant and not easily resolved. [sack a few bureaucrats!]
The drug is effective for the HER2-positive type of the disease, which affects about 20 to 25 per cent of women in whom breast cancer is newly diagnosed — a total of 10,000 patients annually. Research published in The New England Journal of Medicine last October showed that Herceptin reduced the risk of disease returning in women with early-stage HER2-positive cancer by 46 per cent. Breast cancer is diagnosed in more than 41,000 women every year, and more than 13,000 die each year.
Andrew Dillon, the chief executive of NICE, said that its appraisal of the clinical and cost-effectiveness of Herceptin was under way. “We are working hard to ensure our review is completed as soon as possible,” he said. “We are keen to ensure that guidance is available in a matter of weeks.” Barbara Clark, 50, who won a High Court battle for Herceptin in October, described yesterday’s announcement as great news. “I feel this is the end of a tremendous fight,” she said.
Ms Clark, from Bridgwater, Somerset, faced having to sell her home to pay privately for the drug. She is now in remission. She said that once the drug was approved by NICE, health trusts will be forced to act. “Health trusts will then have three months to put their policies in place to give the drug and if they don’t, women will have a real fight on their hands,” she said. “(The trusts) won’t be able to refuse.” Elisabeth Cooke, 60, from Southmead, Bristol, was absolutely delighted by the news. A High Court ruling in March put her case on hold but allowed her to continue receiving the drug pending her legal outcome. “Perhaps now all the scapegoating for all these women who need Herceptin will end,” she said.
Joanne Rule, the chief executive of the Cancerbackup charity, described yesterday’s decision as offering women a clear path to access a vital treatment. “Breast cancer patients across England and Wales are currently experiencing a dreadful postcode lottery — denied Herceptin because of where they live or how ‘exceptional’ their lives are deemed to be,” she said. “This can stop now.” She added that the Department of Health should assist primary care trusts by announcing an innovation fund to help local areas to absorb the costs. Professor Ian Smith, head of the breast unit at the Royal Marsden Hospital, southwest London, said that, for women with HER2-positive breast cancer, Herceptin was “one of the most important developments we have ever seen”.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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.
***************************
Only after enormous pressure
Herceptin, the breast cancer drug so promising that patients have gone to court to demand treatment with it, is likely to be approved for widespread use on the NHS within the next few weeks. The drug received its UK licence for treatment of early-stage breast cancer yesterday. Many health trusts that had denied patients the drug argued that its safety remained unproven. The move means that Herceptin will probably be approved by the National Institute for Health and Clinical Excellence (NICE), which recommends on best treatments for the NHS, within the next month. It is bringing forward an announcement, originally planned for July, as a result of the record speed with which the licence has been granted.
News of the licence, which is valid across the European Union and was granted by the European Commission on the advice of its regulator, was welcomed yesterday by patients. Health trusts have said that the funding implications of the treatment, which costs about 20,000 pounds a year a patient, will be significant and not easily resolved. [sack a few bureaucrats!]
The drug is effective for the HER2-positive type of the disease, which affects about 20 to 25 per cent of women in whom breast cancer is newly diagnosed — a total of 10,000 patients annually. Research published in The New England Journal of Medicine last October showed that Herceptin reduced the risk of disease returning in women with early-stage HER2-positive cancer by 46 per cent. Breast cancer is diagnosed in more than 41,000 women every year, and more than 13,000 die each year.
Andrew Dillon, the chief executive of NICE, said that its appraisal of the clinical and cost-effectiveness of Herceptin was under way. “We are working hard to ensure our review is completed as soon as possible,” he said. “We are keen to ensure that guidance is available in a matter of weeks.” Barbara Clark, 50, who won a High Court battle for Herceptin in October, described yesterday’s announcement as great news. “I feel this is the end of a tremendous fight,” she said.
Ms Clark, from Bridgwater, Somerset, faced having to sell her home to pay privately for the drug. She is now in remission. She said that once the drug was approved by NICE, health trusts will be forced to act. “Health trusts will then have three months to put their policies in place to give the drug and if they don’t, women will have a real fight on their hands,” she said. “(The trusts) won’t be able to refuse.” Elisabeth Cooke, 60, from Southmead, Bristol, was absolutely delighted by the news. A High Court ruling in March put her case on hold but allowed her to continue receiving the drug pending her legal outcome. “Perhaps now all the scapegoating for all these women who need Herceptin will end,” she said.
Joanne Rule, the chief executive of the Cancerbackup charity, described yesterday’s decision as offering women a clear path to access a vital treatment. “Breast cancer patients across England and Wales are currently experiencing a dreadful postcode lottery — denied Herceptin because of where they live or how ‘exceptional’ their lives are deemed to be,” she said. “This can stop now.” She added that the Department of Health should assist primary care trusts by announcing an innovation fund to help local areas to absorb the costs. Professor Ian Smith, head of the breast unit at the Royal Marsden Hospital, southwest London, said that, for women with HER2-positive breast cancer, Herceptin was “one of the most important developments we have ever seen”.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 25, 2006
U.K.: Hepatitis C care 'fails patients'
The NHS approach to hepatitis C needs overhauling, MPs and doctors have said. A report by the All-Party Parliamentary Hepatology Group said care was a "postcode lottery" with many trusts not following official guidelines. And a second report by top doctors said the UK was lagging behind its European neighbours which had set up specialist diagnosis and treatment centres. Campaigners said the failures were costing lives, but the government said services were improving.
The hepatitis C virus, if untreated, can cause cirrhosis, liver failure or liver cancer. Most people who contract the infection can be successfully treated, but - as the virus often does not produce early symptoms- it can go undetected, often for years. The virus is spread through contact with infected blood. Most people contract it through sharing needles to inject drugs.
The All-Party Parliamentary Hepatology Group found that 92% of 191 primary care trusts had failed to fully implement a 2004 Department of Health action plan to tackle the disease. And nearly half of the 107 hospitals quizzed said there were significant delays of up to a year for patients waiting for treatment. Brian Iddon, a Labour member of the cross party group, said the infection was a "hidden timebomb". Campaigners believe about 400,000 people are infected but unaware of it - although the government says its half this number. By the end of 2005, 54,000 people had been diagnosed.
Doctors
The report by leading doctors, which was published to coincide with the MPs' study, said the UK had not responded as well as its European neighbours and management of the virus in the UK was "both unstructured and under-funded". The report details seven recommendations for the government, including developing a detailed strategy for managing the virus; appointing somebody to oversee it; raising awareness and improving testing. It also called for specialist centres to be set up as they have been in France, Germany and Italy to provide diagnosis and treatment.
Report author Professor William Rosenberg, professor of hepatology at the University of Southampton, said: "We are lagging behind many countries and that in not acceptable." Charles Core, chief executive of the Hepatitis C Trust, which commissioned the report by doctors, said lives were being lost because of the failings. "If we do not seize this opportunity we will look back and know that by our inaction we let it happen."
A Department of Health spokeswoman said: "We recognise the importance of hepatitis C as a public health issue." And she said early indications were that awareness campaigns and the national framework were having an impact as more people were being diagnosed. But she added: "The results of the survey may serve as a useful focus for discussion by local NHS organisations."
Source
ANOTHER NHS FAILURE
The parents of Victoria Climbie called on the Government today not to let her death be in "vain" after a survey discovered many NHS trusts had not implemented all the key recommendations proposed after her killing. Francis and Berthe Climbie urged Health Minister Patricia Hewitt to take "responsibility" for the situation following the poll which highlighted concerns in the child protection system. Lord Laming, who headed the public inquiry into the eight-year-old's death, said it was "unacceptable" to find the system working well in some areas and not in others.
The survey of NHS acute hospital trusts was conducted by Five News correspondent Catherine Jacob, who also interviewed the Climbies. Mr Climbie, speaking from Abidjan on the Ivory Coast, told the programme: "The Government can give all the money it likes, but if the services do not communicate with each other, then it's logical - the child protection system will always fail. "Yes, I have a message for the Health Minister. You are a representative of the Government. You can really change things. If the people who work in your health system are unhappy, then the child protection system will not work. You must take responsibility for it. Protecting children is everyone's responsibility. "When Victoria died, the then Health Secretary Alan Milburn promised us her death would not be in vain. Do not let Victoria's death be in vain."
Victoria, who died in February 2000, had 128 injuries to her body. She had endured months of torture and abuse by her great aunt Marie Therese Kouao and her boyfriend Carl Manning despite being in the care of social services and police. The couple were jailed for life in January 2001 for her murder.
Lord Laming's public inquiry found child protection services had missed at least 12 chances to save her life. The Government later accepted all but one of his 108 recommendations Five News polled 175 NHS acute hospital trusts across England and received responses from 62 of them. In each case the designated and named child protection doctors and nurses were asked whether Lord Laming's nine key recommendations had been put in place. More than two thirds of respondents (71 per cent) said they had not introduced all of them. Nearly half (48 per cent) said recommendation 78, which crucially states health professionals should work from a single set of records for each child, was still not in place.
Asked the question: "Post Laming, do you feel enough is being done to modernise child protection services within the NHS," a third (33 per cent) of respondents said no. Amongst anonymous comments made by NHS staff during the survey, one said: "As far as I'm concerned child protection in this country takes a back seat... until another tragedy occurs."
Commenting on the survey's finding, Lord Laming told Five News: "It vividly illustrates just how far we've got to go before the recommendations of the report have become a reality and there are better outcomes for children across the country. "It is, in my view, unacceptable that in this day and age we are in a situation where in some places the system is working well and therefore within the available resources it is possible to do it, but in other parts of the country, the system is not working well."
Victoria's mother Berthe said: "Six years on, I still find it incredible in such a great country that something like that could happen. "Today, here in the Ivory Coast, when you see a child who you suspect is being badly treated, you do all you can to help them. "But with Victoria, in Great Britain, nobody noticed. Nobody helped her. They didn't see her. She was alone. "You have to put children first. They are still innocent. They do not deserve to be harmed. Remember Victoria."
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The NHS approach to hepatitis C needs overhauling, MPs and doctors have said. A report by the All-Party Parliamentary Hepatology Group said care was a "postcode lottery" with many trusts not following official guidelines. And a second report by top doctors said the UK was lagging behind its European neighbours which had set up specialist diagnosis and treatment centres. Campaigners said the failures were costing lives, but the government said services were improving.
The hepatitis C virus, if untreated, can cause cirrhosis, liver failure or liver cancer. Most people who contract the infection can be successfully treated, but - as the virus often does not produce early symptoms- it can go undetected, often for years. The virus is spread through contact with infected blood. Most people contract it through sharing needles to inject drugs.
The All-Party Parliamentary Hepatology Group found that 92% of 191 primary care trusts had failed to fully implement a 2004 Department of Health action plan to tackle the disease. And nearly half of the 107 hospitals quizzed said there were significant delays of up to a year for patients waiting for treatment. Brian Iddon, a Labour member of the cross party group, said the infection was a "hidden timebomb". Campaigners believe about 400,000 people are infected but unaware of it - although the government says its half this number. By the end of 2005, 54,000 people had been diagnosed.
Doctors
The report by leading doctors, which was published to coincide with the MPs' study, said the UK had not responded as well as its European neighbours and management of the virus in the UK was "both unstructured and under-funded". The report details seven recommendations for the government, including developing a detailed strategy for managing the virus; appointing somebody to oversee it; raising awareness and improving testing. It also called for specialist centres to be set up as they have been in France, Germany and Italy to provide diagnosis and treatment.
Report author Professor William Rosenberg, professor of hepatology at the University of Southampton, said: "We are lagging behind many countries and that in not acceptable." Charles Core, chief executive of the Hepatitis C Trust, which commissioned the report by doctors, said lives were being lost because of the failings. "If we do not seize this opportunity we will look back and know that by our inaction we let it happen."
A Department of Health spokeswoman said: "We recognise the importance of hepatitis C as a public health issue." And she said early indications were that awareness campaigns and the national framework were having an impact as more people were being diagnosed. But she added: "The results of the survey may serve as a useful focus for discussion by local NHS organisations."
Source
ANOTHER NHS FAILURE
The parents of Victoria Climbie called on the Government today not to let her death be in "vain" after a survey discovered many NHS trusts had not implemented all the key recommendations proposed after her killing. Francis and Berthe Climbie urged Health Minister Patricia Hewitt to take "responsibility" for the situation following the poll which highlighted concerns in the child protection system. Lord Laming, who headed the public inquiry into the eight-year-old's death, said it was "unacceptable" to find the system working well in some areas and not in others.
The survey of NHS acute hospital trusts was conducted by Five News correspondent Catherine Jacob, who also interviewed the Climbies. Mr Climbie, speaking from Abidjan on the Ivory Coast, told the programme: "The Government can give all the money it likes, but if the services do not communicate with each other, then it's logical - the child protection system will always fail. "Yes, I have a message for the Health Minister. You are a representative of the Government. You can really change things. If the people who work in your health system are unhappy, then the child protection system will not work. You must take responsibility for it. Protecting children is everyone's responsibility. "When Victoria died, the then Health Secretary Alan Milburn promised us her death would not be in vain. Do not let Victoria's death be in vain."
Victoria, who died in February 2000, had 128 injuries to her body. She had endured months of torture and abuse by her great aunt Marie Therese Kouao and her boyfriend Carl Manning despite being in the care of social services and police. The couple were jailed for life in January 2001 for her murder.
Lord Laming's public inquiry found child protection services had missed at least 12 chances to save her life. The Government later accepted all but one of his 108 recommendations Five News polled 175 NHS acute hospital trusts across England and received responses from 62 of them. In each case the designated and named child protection doctors and nurses were asked whether Lord Laming's nine key recommendations had been put in place. More than two thirds of respondents (71 per cent) said they had not introduced all of them. Nearly half (48 per cent) said recommendation 78, which crucially states health professionals should work from a single set of records for each child, was still not in place.
Asked the question: "Post Laming, do you feel enough is being done to modernise child protection services within the NHS," a third (33 per cent) of respondents said no. Amongst anonymous comments made by NHS staff during the survey, one said: "As far as I'm concerned child protection in this country takes a back seat... until another tragedy occurs."
Commenting on the survey's finding, Lord Laming told Five News: "It vividly illustrates just how far we've got to go before the recommendations of the report have become a reality and there are better outcomes for children across the country. "It is, in my view, unacceptable that in this day and age we are in a situation where in some places the system is working well and therefore within the available resources it is possible to do it, but in other parts of the country, the system is not working well."
Victoria's mother Berthe said: "Six years on, I still find it incredible in such a great country that something like that could happen. "Today, here in the Ivory Coast, when you see a child who you suspect is being badly treated, you do all you can to help them. "But with Victoria, in Great Britain, nobody noticed. Nobody helped her. They didn't see her. She was alone. "You have to put children first. They are still innocent. They do not deserve to be harmed. Remember Victoria."
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 24, 2006
NHS WASTES MONEY ON DUBIOUS TREATMENTS WHILE DENYING PATIENTS PROVEN TREATMENTS
A group of Britain's leading doctors has urged every NHS trust to stop paying for alternative medicine and to use the money for conventional treatments. Their appeal is a direct challenge to the Prince of Wales's outspoken campaign to widen access to complementary therapies. Public funding of "unproven or disproved treatments" such as homoeopathy and reflexology, which are promoted by the Prince, is unacceptable while huge NHS deficits are forcing trusts to sack nurses and limit access to life-saving drugs, the doctors say.
The 13 scientists, who include some of the most eminent names in British medicine, have written to the chief executives of all 476 acute and primary care trusts to demand that only evidence-based therapies are provided free to patients. Their letter, seen by The Times, has been sent as the Prince today steps up his crusade for increased provision of alternative treatments with a controversial speech to the World Health Organisation assembly in Geneva. The Prince, who was yesterday given a lesson in crystal therapy while touring a complementary health unit in Merthyr Tydfil, will ask the WHO to embrace alternative therapies in the fight against serious disease. His views have outraged clinicians and researchers, who claim that many of the therapies that he advocates have been shown to be ineffective in trials or have never been properly tested.
The letter criticises two of his flagship initiatives on complementary medicine: a government-funded patient guide prepared by his Foundation for Integrated Medicine, and the Smallwood report last year, which he commissioned to make a financial case for increasing NHS provision. Both documents, it is claimed, give misleading information about scientific support for therapies such as homoeopathy, described as "an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness". The letter's signatories include Sir James Black, who won the Nobel Prize for Medicine in 1988, and Sir Keith Peters, president of the Academy of Medical Science, which represents Britain's leading clinical researchers.
It was organised by Michael Baum, Emeritus Professor of Surgery at University College London, and other supporters include six Fellows of the Royal Society, Britain's national academy of science, and Professor Edzard Ernst, of the Peninsula Medical School in Exeter, who holds the UK's first chair in complementary medicine. The doctors ask trust chief executives to review their policies so that patients are given accurate information, and not to waste scarce resources on therapies that have not been shown to work by rigorous clinical trials. They conclude: "At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence."
Professor Baum, a cancer specialist, said that he had organised the letter because of his "utter despair" at growing NHS acceptance of alternative treatments while drugs of proven effectiveness are being withheld. "At a time when we are struggling to gain access for our patients to Herceptin, which is absolutely proven to extend survival in breast cancer, I find it appalling that the NHS should be funding a therapy like homoeopathy that is utterly bogus," he said. He said that he was happy for the NHS to offer the treatments once research has proven them effective, such as acupuncture for pain relief, but that very few had reached the required standards "If people want to spend their own money on it, fine, but it shouldn't be NHS money."
The Department of Health does not keep figures on the total NHS spending on alternative medicine, but Britain's total market is estimated at 1.6 billion pounds.
Source
CARELESS NHS SURGICAL TRAGEDY
What a culture of quotas and minimal accountability produces. In private medicine, doctors are much more likely to listen to patients
A surgeon "in a hurry" removed the wrong kidney from a patient and left her dependent on dialysis because he did not bother to read her medical notes, a disciplinary hearing was told yesterday. The General Medical Council was told how Jerome Blanchard took out his patient's transplant kidney, which was still functioning, instead of her diseased natural kidney.
Although both kidneys were on the patient's right side, she had told the surgeon that it was the painful polycystic organ that was to be removed. The fitness to practise panel was also told that Dr Blanchard did not bother to discuss the operation properly with the woman when obtaining her consent for surgery at the Middlesex Hospital, Central London, in March 2004.
Lydia Barnfather, for the council, said that if Dr Blanchard had discussed the operation sufficiently with the patient it would have become clear what operation needed to be performed. "The impression he gave her was that he was in a hurry," she said. "Dr Blanchard examined her and while he was doing so Patient A told him it was her enlarged polycystic kidney that was to be removed and she demonstrated the region of that."
But it was only when the patient's daughter noticed after surgery that there was no catheter to support the transplant kidney that Dr Blanchard realised that he had taken out the wrong organ, the GMC panel, sitting in London, was told. Although the transplanted kidney, which the patient received in 1994, was going to have to be removed eventually, the patient still had plenty of time before it needed to be taken out.
There were other factors, including confusion on the theatre list, that contributed to the wrong organ being removed, the panel was told. "The mistake would never have been made if Dr Blanchard had been carrying out his own duties with regard to getting an informed consent," Ms Barnfather added.
The patient, a mother of three who is now on dialysis for four hours three times a week, said that her diseased kidney needed to be removed because she was in constant pain and had a swollen stomach. She told the panel that she had been expecting to see Dr Blanchard the evening she went into hospital but did not see him until shortly before the operation the next day, after she attended an outpatient appointment for a thyroid condition.
"He examined my stomach and he kept asking me where is my transplant kidney and I said, `It's here'. I said to him, `You know it's the big polycystic kidney that is coming out'," she said, and added that he did not seem to respond. "My whole stomach was out there. You couldn't miss it," she said.
The GMC was told that an abbreviation for transplant was marked on the consent form that the surgeon gave Patient A to sign. The patient said that she had not noticed the abbreviation, and would not have let the operation go ahead if she had seen it. "I just signed it because I trusted him," she said. "He didn't say anything about what operation he was going to perform." She was now back on the transplant list, but did not know how long it would be before another kidney became available.
Dr Blanchard has admitted to removing the wrong kidney but denies misconduct relating to a failure properly to discuss the procedure with the patient or ensuring that he was performing the appropriate surgery. The hearing continues.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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 group of Britain's leading doctors has urged every NHS trust to stop paying for alternative medicine and to use the money for conventional treatments. Their appeal is a direct challenge to the Prince of Wales's outspoken campaign to widen access to complementary therapies. Public funding of "unproven or disproved treatments" such as homoeopathy and reflexology, which are promoted by the Prince, is unacceptable while huge NHS deficits are forcing trusts to sack nurses and limit access to life-saving drugs, the doctors say.
The 13 scientists, who include some of the most eminent names in British medicine, have written to the chief executives of all 476 acute and primary care trusts to demand that only evidence-based therapies are provided free to patients. Their letter, seen by The Times, has been sent as the Prince today steps up his crusade for increased provision of alternative treatments with a controversial speech to the World Health Organisation assembly in Geneva. The Prince, who was yesterday given a lesson in crystal therapy while touring a complementary health unit in Merthyr Tydfil, will ask the WHO to embrace alternative therapies in the fight against serious disease. His views have outraged clinicians and researchers, who claim that many of the therapies that he advocates have been shown to be ineffective in trials or have never been properly tested.
The letter criticises two of his flagship initiatives on complementary medicine: a government-funded patient guide prepared by his Foundation for Integrated Medicine, and the Smallwood report last year, which he commissioned to make a financial case for increasing NHS provision. Both documents, it is claimed, give misleading information about scientific support for therapies such as homoeopathy, described as "an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness". The letter's signatories include Sir James Black, who won the Nobel Prize for Medicine in 1988, and Sir Keith Peters, president of the Academy of Medical Science, which represents Britain's leading clinical researchers.
It was organised by Michael Baum, Emeritus Professor of Surgery at University College London, and other supporters include six Fellows of the Royal Society, Britain's national academy of science, and Professor Edzard Ernst, of the Peninsula Medical School in Exeter, who holds the UK's first chair in complementary medicine. The doctors ask trust chief executives to review their policies so that patients are given accurate information, and not to waste scarce resources on therapies that have not been shown to work by rigorous clinical trials. They conclude: "At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence."
Professor Baum, a cancer specialist, said that he had organised the letter because of his "utter despair" at growing NHS acceptance of alternative treatments while drugs of proven effectiveness are being withheld. "At a time when we are struggling to gain access for our patients to Herceptin, which is absolutely proven to extend survival in breast cancer, I find it appalling that the NHS should be funding a therapy like homoeopathy that is utterly bogus," he said. He said that he was happy for the NHS to offer the treatments once research has proven them effective, such as acupuncture for pain relief, but that very few had reached the required standards "If people want to spend their own money on it, fine, but it shouldn't be NHS money."
The Department of Health does not keep figures on the total NHS spending on alternative medicine, but Britain's total market is estimated at 1.6 billion pounds.
Source
CARELESS NHS SURGICAL TRAGEDY
What a culture of quotas and minimal accountability produces. In private medicine, doctors are much more likely to listen to patients
A surgeon "in a hurry" removed the wrong kidney from a patient and left her dependent on dialysis because he did not bother to read her medical notes, a disciplinary hearing was told yesterday. The General Medical Council was told how Jerome Blanchard took out his patient's transplant kidney, which was still functioning, instead of her diseased natural kidney.
Although both kidneys were on the patient's right side, she had told the surgeon that it was the painful polycystic organ that was to be removed. The fitness to practise panel was also told that Dr Blanchard did not bother to discuss the operation properly with the woman when obtaining her consent for surgery at the Middlesex Hospital, Central London, in March 2004.
Lydia Barnfather, for the council, said that if Dr Blanchard had discussed the operation sufficiently with the patient it would have become clear what operation needed to be performed. "The impression he gave her was that he was in a hurry," she said. "Dr Blanchard examined her and while he was doing so Patient A told him it was her enlarged polycystic kidney that was to be removed and she demonstrated the region of that."
But it was only when the patient's daughter noticed after surgery that there was no catheter to support the transplant kidney that Dr Blanchard realised that he had taken out the wrong organ, the GMC panel, sitting in London, was told. Although the transplanted kidney, which the patient received in 1994, was going to have to be removed eventually, the patient still had plenty of time before it needed to be taken out.
There were other factors, including confusion on the theatre list, that contributed to the wrong organ being removed, the panel was told. "The mistake would never have been made if Dr Blanchard had been carrying out his own duties with regard to getting an informed consent," Ms Barnfather added.
The patient, a mother of three who is now on dialysis for four hours three times a week, said that her diseased kidney needed to be removed because she was in constant pain and had a swollen stomach. She told the panel that she had been expecting to see Dr Blanchard the evening she went into hospital but did not see him until shortly before the operation the next day, after she attended an outpatient appointment for a thyroid condition.
"He examined my stomach and he kept asking me where is my transplant kidney and I said, `It's here'. I said to him, `You know it's the big polycystic kidney that is coming out'," she said, and added that he did not seem to respond. "My whole stomach was out there. You couldn't miss it," she said.
The GMC was told that an abbreviation for transplant was marked on the consent form that the surgeon gave Patient A to sign. The patient said that she had not noticed the abbreviation, and would not have let the operation go ahead if she had seen it. "I just signed it because I trusted him," she said. "He didn't say anything about what operation he was going to perform." She was now back on the transplant list, but did not know how long it would be before another kidney became available.
Dr Blanchard has admitted to removing the wrong kidney but denies misconduct relating to a failure properly to discuss the procedure with the patient or ensuring that he was performing the appropriate surgery. The hearing continues.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 23, 2006
AN ALTERNATIVE FOR THE DENTALLY DEPRIVED BRITISH?
Colin Lamont is all smiles after saving $45,000 -- a 75 per cent discount -- by having major dental work overseas. The former state MP, whose teeth were damaged by a terrorist's bomb 30 years ago, is so impressed he's now booking Australian patients into a Philippines dental clinic. Mr Lamont, 64, from the Gold Coast, was quoted $60,i?00 by his local dentist for extensive work that included several implants, 29 crowns, three bridges and seven root canals.
"The cost was astronomical. By going to the Philippines I could save $45,000 -- that's what I call a saving," he said. "I wanted a Western-trained English-speaking dentist, with a guaranteed standard of hygiene. Once I had a name, I booked."
He decided to explore the overseas option after reading a report in The Sunday Mail about cheaper dental surgery in Asia. Fish shop worker Harry Sharpe, from Currumbin on the Gold Coast, had been quoted $15,000 by a local dentist for two bridges, a crown and four fillings, only to pay $1200 for the same work at a private clinic in the Philippines.
In the report, the Australian Dental Association warned people to do their research, because while they might initially save money there could be the need for corrective surgery on their return. The report sparked numerous calls to The Sunday Mail from Queenslanders seeking the cheaper surgery but not sure who to book with. And it made Mr Lamont take extreme care in choosing an overseas dentist.
"They are dead right. That's why we have set up a service to offer reassuring testimonials for Australians who really want to go," he said. "Manila is a great place. It's clean, inexpensive, the dentists are English-speaking and Western trained. You can save 75 per cent of dental costs, have a holiday with the savings and still have money left over. My wife is delighted. She thinks she's married to a piano."
Mr Lamont, the Liberal MP for South Brisbane from 1974 to 1978 and the former Queensland chairman of the Australian Council for Education Standards, has set up a company dealing in dental tours. He said several people had booked and he had at least a dozen messages here from people waiting for bookings. "It's not for people who have one crown or a couple of root canals, but once the price gets over $5000 the savings are worthwhile."
Mr Lamont's extensive dental work was due to long-term problems caused from a terrorist attack in Hong Kong in 1976. The then young detective inspector of police was attempting to dismantle a home-made bomb when it exploded a metre away. "I had 11 teeth knocked out and both my ear drums were blasted," he said.
The above article appeared in the Brisbane "Sunday Mail" on May 21, 2006
***************************
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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.
***************************
Colin Lamont is all smiles after saving $45,000 -- a 75 per cent discount -- by having major dental work overseas. The former state MP, whose teeth were damaged by a terrorist's bomb 30 years ago, is so impressed he's now booking Australian patients into a Philippines dental clinic. Mr Lamont, 64, from the Gold Coast, was quoted $60,i?00 by his local dentist for extensive work that included several implants, 29 crowns, three bridges and seven root canals.
"The cost was astronomical. By going to the Philippines I could save $45,000 -- that's what I call a saving," he said. "I wanted a Western-trained English-speaking dentist, with a guaranteed standard of hygiene. Once I had a name, I booked."
He decided to explore the overseas option after reading a report in The Sunday Mail about cheaper dental surgery in Asia. Fish shop worker Harry Sharpe, from Currumbin on the Gold Coast, had been quoted $15,000 by a local dentist for two bridges, a crown and four fillings, only to pay $1200 for the same work at a private clinic in the Philippines.
In the report, the Australian Dental Association warned people to do their research, because while they might initially save money there could be the need for corrective surgery on their return. The report sparked numerous calls to The Sunday Mail from Queenslanders seeking the cheaper surgery but not sure who to book with. And it made Mr Lamont take extreme care in choosing an overseas dentist.
"They are dead right. That's why we have set up a service to offer reassuring testimonials for Australians who really want to go," he said. "Manila is a great place. It's clean, inexpensive, the dentists are English-speaking and Western trained. You can save 75 per cent of dental costs, have a holiday with the savings and still have money left over. My wife is delighted. She thinks she's married to a piano."
Mr Lamont, the Liberal MP for South Brisbane from 1974 to 1978 and the former Queensland chairman of the Australian Council for Education Standards, has set up a company dealing in dental tours. He said several people had booked and he had at least a dozen messages here from people waiting for bookings. "It's not for people who have one crown or a couple of root canals, but once the price gets over $5000 the savings are worthwhile."
Mr Lamont's extensive dental work was due to long-term problems caused from a terrorist attack in Hong Kong in 1976. The then young detective inspector of police was attempting to dismantle a home-made bomb when it exploded a metre away. "I had 11 teeth knocked out and both my ear drums were blasted," he said.
The above article appeared in the Brisbane "Sunday Mail" on May 21, 2006
***************************
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 22, 2006
Can "Left and Right" meet over 'health and wellness'?
Can free-market healthcare really happen, given the essential Balkanization of political views in America? On so many issues, hardline positions on some aspect of the question have been preventing even civility from prevailing, let alone allowing the synergy of issue-based coalitions to form.
However, health concerns might finally be one of those areas where agreement across conventional barriers might actually become possible. The fact that we are all human, and all mortal, is starting to unite people who would normally cross the street to avoid confronting one another (or at the other extreme, be prepared to draw down at the slightest provocation?), around the concepts of wellness, self-responsibility and community-based and voluntarily funded healthcare.
Examples abound. In fact just in today's (Tuesday) stories, right here in the Medical Freedom Channel, there are encouraging signs. The five commentaries are about vaccinations and mercury poisoning; the misuse of power in the AIDS battle (comparing it to the War on Iraq); the dangers of ADHD medications; the Massachusetts healthcare reform proposal; and . an advice column on healthy exercise in "pollen season." Four out of five are current-event topics in the news today. The irony is the sources of those four pieces .
The vaccination story comes, not from the expected "right-wing" sources, but from the progressive site, Common Dreams. Similarly, the AIDS story is from Lew Rockwell.com, normally seen as conservative or right-libertarian in nature, but taking a rather "progressive" view on this subject. And the other two are also unexpected: ADHD meds is attacked by a Sierra Times poster, while MassCare is under scrutiny from a columnist who normally splits time among the Boston Globe and more progressive sources like The American Prospect.
Where am I going with this? Essentially I am noticing more and more often that the traditional left-right schisms are blessedly beginning to fade, at least among those who truly do believe they are fighting a battle intended to increase liberty and allow freer exercise of our lives. It may well be that, even while the imperialist neo-cons (and the liberal-socialists who purport to "oppose" them) continue to have "slap fights" over how to divide their power - as the Leviathan state just keeps on growing and denying our liberties - a coalition of erstwhile enemies is forming around them, perhaps creating bridges that might end up leading us to a freer and healthier world in spite of the power-brokers. And it may also be that the healthcare issue might be the catalyst for creating this unity.
If progressives can be concerned about "purity of essence" and cry out against additives in vaccinations . If conservatives can be concerned about the impurities in our foods and embrace "natural healing" options . If there is common ground between the absolutist positions on birth control and emergency contraception methods, or on hospital clinics and health insurance .
What if healthcare issues turned out to be the thing that wakes up Americans, and others around the world who truly care about freedom and the right to make choices, and begins leading us to that brighter future we all say we want to create? What if the simple act of putting power battles aside, and focusing our attention on promoting self-responsibility, compassion for others and a sense of prosperity that knows that "there is enough" to go around . leads us to the free(r) society so many of us claim we really want?
Source
Medicare Beneficiaries Rush To Enroll
After procrastinating for weeks, Medicare beneficiaries flocked to senior centers across the country and made frantic telephone calls to insurers Monday to beat the deadline for getting prescription drug coverage as the initial enrollment period ended. "There seems to be a panic out there right now," said Brian D. Caswell, who runs a pharmacy in rural Baxter Springs, Kan. "Many of the people who waited this long spend only $30 a month on drugs, and they're being asked to spend about $30 a month on premiums for a prescription drug plan."
Carol H. Carter, an insurance counselor at LIFE Senior Services in Tulsa, Okla., said Monday: "It's pretty crazy around here. We are overwhelmed. We can't help everyone who has called. At the end of the day, there will be some people who do not receive individual help because they waited to the last minute."
First lady Laura Bush and Michael O. Leavitt, the secretary of health and human services, went to a church here to broadcast a final message. "Even if you are not taking any medications, it's really important to go ahead and sign up now," Bush said. "As you age, it's likely that you will add medications to your health care." Leavitt said the administration opposed extension of the deadline, and he defended the financial penalty that will be imposed on most people who are eligible now but defer enrollment to 2007 or later.
Others in the administration and members of Congress from both parties said they supported the idea of waiving the late enrollment penalty for 2006. The penalty will increase future premiums 7 percent or more, for an expected surcharge of $2.50 a month next year.
For months, the Bush administration has been urging insurers to hire additional telephone operators to cope with the expected last-minute surge in enrollment. But stark differences were evident at the two biggest Medicare insurers, UnitedHealth Group and Humana, which together have 45 percent of the market. Calls to United's toll-free number on Monday were generally answered within two minutes. People calling Humana's line often had to wait more than 30 minutes. The wait on Medicare's toll-free line often exceeded 15 minutes.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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.
***************************
Can free-market healthcare really happen, given the essential Balkanization of political views in America? On so many issues, hardline positions on some aspect of the question have been preventing even civility from prevailing, let alone allowing the synergy of issue-based coalitions to form.
However, health concerns might finally be one of those areas where agreement across conventional barriers might actually become possible. The fact that we are all human, and all mortal, is starting to unite people who would normally cross the street to avoid confronting one another (or at the other extreme, be prepared to draw down at the slightest provocation?), around the concepts of wellness, self-responsibility and community-based and voluntarily funded healthcare.
Examples abound. In fact just in today's (Tuesday) stories, right here in the Medical Freedom Channel, there are encouraging signs. The five commentaries are about vaccinations and mercury poisoning; the misuse of power in the AIDS battle (comparing it to the War on Iraq); the dangers of ADHD medications; the Massachusetts healthcare reform proposal; and . an advice column on healthy exercise in "pollen season." Four out of five are current-event topics in the news today. The irony is the sources of those four pieces .
The vaccination story comes, not from the expected "right-wing" sources, but from the progressive site, Common Dreams. Similarly, the AIDS story is from Lew Rockwell.com, normally seen as conservative or right-libertarian in nature, but taking a rather "progressive" view on this subject. And the other two are also unexpected: ADHD meds is attacked by a Sierra Times poster, while MassCare is under scrutiny from a columnist who normally splits time among the Boston Globe and more progressive sources like The American Prospect.
Where am I going with this? Essentially I am noticing more and more often that the traditional left-right schisms are blessedly beginning to fade, at least among those who truly do believe they are fighting a battle intended to increase liberty and allow freer exercise of our lives. It may well be that, even while the imperialist neo-cons (and the liberal-socialists who purport to "oppose" them) continue to have "slap fights" over how to divide their power - as the Leviathan state just keeps on growing and denying our liberties - a coalition of erstwhile enemies is forming around them, perhaps creating bridges that might end up leading us to a freer and healthier world in spite of the power-brokers. And it may also be that the healthcare issue might be the catalyst for creating this unity.
If progressives can be concerned about "purity of essence" and cry out against additives in vaccinations . If conservatives can be concerned about the impurities in our foods and embrace "natural healing" options . If there is common ground between the absolutist positions on birth control and emergency contraception methods, or on hospital clinics and health insurance .
What if healthcare issues turned out to be the thing that wakes up Americans, and others around the world who truly care about freedom and the right to make choices, and begins leading us to that brighter future we all say we want to create? What if the simple act of putting power battles aside, and focusing our attention on promoting self-responsibility, compassion for others and a sense of prosperity that knows that "there is enough" to go around . leads us to the free(r) society so many of us claim we really want?
Source
Medicare Beneficiaries Rush To Enroll
After procrastinating for weeks, Medicare beneficiaries flocked to senior centers across the country and made frantic telephone calls to insurers Monday to beat the deadline for getting prescription drug coverage as the initial enrollment period ended. "There seems to be a panic out there right now," said Brian D. Caswell, who runs a pharmacy in rural Baxter Springs, Kan. "Many of the people who waited this long spend only $30 a month on drugs, and they're being asked to spend about $30 a month on premiums for a prescription drug plan."
Carol H. Carter, an insurance counselor at LIFE Senior Services in Tulsa, Okla., said Monday: "It's pretty crazy around here. We are overwhelmed. We can't help everyone who has called. At the end of the day, there will be some people who do not receive individual help because they waited to the last minute."
First lady Laura Bush and Michael O. Leavitt, the secretary of health and human services, went to a church here to broadcast a final message. "Even if you are not taking any medications, it's really important to go ahead and sign up now," Bush said. "As you age, it's likely that you will add medications to your health care." Leavitt said the administration opposed extension of the deadline, and he defended the financial penalty that will be imposed on most people who are eligible now but defer enrollment to 2007 or later.
Others in the administration and members of Congress from both parties said they supported the idea of waiving the late enrollment penalty for 2006. The penalty will increase future premiums 7 percent or more, for an expected surcharge of $2.50 a month next year.
For months, the Bush administration has been urging insurers to hire additional telephone operators to cope with the expected last-minute surge in enrollment. But stark differences were evident at the two biggest Medicare insurers, UnitedHealth Group and Humana, which together have 45 percent of the market. Calls to United's toll-free number on Monday were generally answered within two minutes. People calling Humana's line often had to wait more than 30 minutes. The wait on Medicare's toll-free line often exceeded 15 minutes.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 21, 2006
U.K.: WHAT'S A FEW BILLION BETWEEN FRIENDS?
A new generation of hospitals will overshoot its original budget by at least 3.5 billion pounds because of unrealistic planning and expensive delays, The Times has learnt. Most hospital projects are running at more than double their projected cost. The spiralling overspending is being blamed on a lack of financial scrutiny by the Government and local health trusts.
The average bill for the 18 largest schemes under development has risen by 117 per cent. All of them started with budgets of at least 75 million pounds. The Department of Health said initially that all budgets predicted to overrun by more than 10 per cent would be appraised immediately. But action was taken only recently. The National Audit Office (NAO) will publish a damning critique today of a 1 billion pound project to build a health "campus" in Paddington, West London. After six years of planning, arguing and miscalculation, the project was cancelled last May, at a cost of 15 million, leaving the area with the same three rundown hospitals with which it started.
The report says that the failure was a lesson for everyone involved in the NHS's capital investment programme and illustrated the need for far more rigorous Government monitoring. Britain is building more large hospitals than all the other G7 nations put together. Economists are concerned that many will come into use just as annual NHS spending increases slow in 2008. The 300 million Paddington scheme, which involved the redevelopment of St Mary's, Harefield and the Royal Brompton, fell apart after its budget tripled and a proposed completion date slipped by seven years to 2013. The partners in the project could not acquire enough land, could not agree whether the scheme was affordable and planning eventually forecast a reduced demand for beds in the area.
Projects of a similar size are under way at the Royal London Hospital, Barts and in Birmingham and Leicester. Another 14, all worth more than 75 million, are running at more than double their initial budgets. About 5 billion worth of Private Finance Initiative (PFI) hospitals have been built or are under construction. The cost, which is "off-budget", is paid back by trusts over several decades. Another 6 billion of projects are out to tender and have had their strategic outline cases approved.
In January, after a government "reappraisal" of PFI costs, Patricia Hewitt, the Health Secretary, said that the future plans would be cut back by between 25 and 40 per cent. It is not yet known how such savings will be made. In the NAO report on the Paddington fiasco, the Auditor General, Sir John Bourn, highlighted fatal flaws missed by officials at local and national levels.
More here
Another attempted coverup in Queensland that is not going to work
It will all come out in court
A former whistleblower who was suspended after complaining about the treatment of people with disabilities at Brisbane's Basil Stafford Centre has been sacked. In February, The Courier-Mail reported that Kerry Crossingham, a residential care officer who worked with residents at the notorious facility, had been suspended on full pay since last July after alleging people with intellectual disabilities were being isolated and locked up for long periods. The treatment contravenes Disability Services Queensland's statutory requirements and policies.
Yesterday Mr Crossingham said he had received a letter of dismissal, the grounds for which included him harassing DSQ executive director Evan Klatt by sending emails relating to his complaints to Mr Klatt's home computer, and failing to follow a direction to supply his current home address to the department.
Mr Crossingham, who was nominated for an award for his work in 2004, said the Basil Stafford resident about whose treatment he had complained was still being "detained illegally". "They have no legal authorisation to lock him up and he is one of a number of intellectually disabled people whose liberty is currently being deprived illegally by DSQ," he said. "There is no statutory authority stating that residential care officers are authorised to lock these people up virtually, in some cases, in solitary confinement."
Mr Crossingham said he would take his case to the Queensland Industrial Relations Commission.
Source. More on the Basil Stafford Centre for the intellectually disabled 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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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 generation of hospitals will overshoot its original budget by at least 3.5 billion pounds because of unrealistic planning and expensive delays, The Times has learnt. Most hospital projects are running at more than double their projected cost. The spiralling overspending is being blamed on a lack of financial scrutiny by the Government and local health trusts.
The average bill for the 18 largest schemes under development has risen by 117 per cent. All of them started with budgets of at least 75 million pounds. The Department of Health said initially that all budgets predicted to overrun by more than 10 per cent would be appraised immediately. But action was taken only recently. The National Audit Office (NAO) will publish a damning critique today of a 1 billion pound project to build a health "campus" in Paddington, West London. After six years of planning, arguing and miscalculation, the project was cancelled last May, at a cost of 15 million, leaving the area with the same three rundown hospitals with which it started.
The report says that the failure was a lesson for everyone involved in the NHS's capital investment programme and illustrated the need for far more rigorous Government monitoring. Britain is building more large hospitals than all the other G7 nations put together. Economists are concerned that many will come into use just as annual NHS spending increases slow in 2008. The 300 million Paddington scheme, which involved the redevelopment of St Mary's, Harefield and the Royal Brompton, fell apart after its budget tripled and a proposed completion date slipped by seven years to 2013. The partners in the project could not acquire enough land, could not agree whether the scheme was affordable and planning eventually forecast a reduced demand for beds in the area.
Projects of a similar size are under way at the Royal London Hospital, Barts and in Birmingham and Leicester. Another 14, all worth more than 75 million, are running at more than double their initial budgets. About 5 billion worth of Private Finance Initiative (PFI) hospitals have been built or are under construction. The cost, which is "off-budget", is paid back by trusts over several decades. Another 6 billion of projects are out to tender and have had their strategic outline cases approved.
In January, after a government "reappraisal" of PFI costs, Patricia Hewitt, the Health Secretary, said that the future plans would be cut back by between 25 and 40 per cent. It is not yet known how such savings will be made. In the NAO report on the Paddington fiasco, the Auditor General, Sir John Bourn, highlighted fatal flaws missed by officials at local and national levels.
More here
Another attempted coverup in Queensland that is not going to work
It will all come out in court
A former whistleblower who was suspended after complaining about the treatment of people with disabilities at Brisbane's Basil Stafford Centre has been sacked. In February, The Courier-Mail reported that Kerry Crossingham, a residential care officer who worked with residents at the notorious facility, had been suspended on full pay since last July after alleging people with intellectual disabilities were being isolated and locked up for long periods. The treatment contravenes Disability Services Queensland's statutory requirements and policies.
Yesterday Mr Crossingham said he had received a letter of dismissal, the grounds for which included him harassing DSQ executive director Evan Klatt by sending emails relating to his complaints to Mr Klatt's home computer, and failing to follow a direction to supply his current home address to the department.
Mr Crossingham, who was nominated for an award for his work in 2004, said the Basil Stafford resident about whose treatment he had complained was still being "detained illegally". "They have no legal authorisation to lock him up and he is one of a number of intellectually disabled people whose liberty is currently being deprived illegally by DSQ," he said. "There is no statutory authority stating that residential care officers are authorised to lock these people up virtually, in some cases, in solitary confinement."
Mr Crossingham said he would take his case to the Queensland Industrial Relations Commission.
Source. More on the Basil Stafford Centre for the intellectually disabled 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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 20, 2006
Medicaid reforms in Oklahoma -- offering choice
The state Legislature here is working to finalize an agreement for Medicaid reform legislation creating personal health accounts (PHAs) for Medicaid enrollees. This comes hard on the heels of similar innovations in South Carolina and Florida. Reform is in the air--much the way it was when Wisconsin revolutionized its welfare system in the early 1990s, forerunning a stunning national success. Are we on the verge of consumer revolution in health care?
It is of course too soon to tell, but the Oklahoma case study is auspicious. The state's antiquated Medicaid bureaucracy has fostered, by turns, a lack of patient choice, provider dissatisfaction, a 9.5% payment error rate, and an escalating price tag of some $3.5 billion. Against these discouraging trends, state leaders spent six months last year formulating stopgap measures with state agencies, policy innovators, providers and beneficiaries.
Instead of assuming the indigent are incapable of decision-making, Oklahoma legislators proposed that Medicaid beneficiaries be given a risk-adjusted allowance to purchase private health insurance. A PHA would be established for annual out-of-pocket expenses without a "use it or lose it" penalty--that is, the unspent balance could be used for future health-care needs. They state would not mandate a homogenous set of benefits; instead, it would provide financial assistance and patient counseling.
The reform passed the Oklahoma State House in March and recently won Oklahoma State Senate approval. The bill's sponsors, Republican Rep. Kris Steele, and Democratic Sen. Tom Adelson, are working to craft a durable bill to send to the governor by the end of this year.
Oklahoma is simply coming to grips with reality--Medicaid needs fundamental change. Although the program subsidizes care for 52 million low-income people, Medicaid's price tag threatens the financial stability of many states. South Carolina's expenses, for instance, have virtually doubled in the past decade, and may consume nearly one-fourth of the state's budget in 2010. Nationwide, Medicaid spending grew 9.1% in 2004 alone, and is projected to be at nearly half a trillion dollars in less than a decade. Fiscally conscious governors and state legislatures have traditionally controlled Medicaid expenses through reductions in enrollment, benefits and provider reimbursement. Tennessee governor Phil Bredesen, for instance, culled 190,000 from the Medicaid rolls.
But Oklahoma, South Carolina and Florida have embarked on a path that is at once less draconian and yet more radical. All three states have taken the step of permitting Medicaid enrollees to choose health services and providers for themselves. South Carolina, for example, puts a set amount every year into each enrollee's PHA, to be spent as he or she sees fit. The benefits of this simple but revolutionary system will be enormous: Health costs remain low, government outlays stable and state finances healthy. Private accounts will introduce market incentives into the Medicaid system, lightening obligations all around.
Medicaid enrollees can shop for care and increase their chances of receiving the care they need. (Not surprisingly, current Medicaid enrollees have more unmet needs than similar adults with private health insurance.) Health-care providers, compelled to compete for Medicaid customers will likely offer more consumer-oriented services at competitive costs.
Critics of Medicaid choice argue that such plans have several intrinsic flaws. Some view the plan as wasteful, citing Medicaid's already low per-patient cost. But these "low costs" come at the participants' expense. Physicians, scared off by the drastically low level of state reimbursement for Medicaid providers, refuse to take them on as clients. In South Carolina, 30% of physicians refuse to accept any new Medicaid enrollees. With the new regime, physicians will have increased freedom to price competitively.
What about the common charges that Medicaid choice works only in states with numerous managed care providers? One need only look at Georgia and Ohio to refute this claim. Both states drew enthusiastic crowds of providers after they enacted Medicaid choice plans, including Goliaths of the business like Aetna, United Health and Anthem.
But these are side issues for the real opponents of Medicaid choice. They inevitably trot out a familiar, patronizing argument. Medicaid enrollees, they claim, are either not educated enough to be trusted with their own health, or lack access to necessary sources of information. Yet patients make intelligent decisions--when we let them do it. For instance, disabled people in government-run "cash and counseling" programs--monthly, need-based health allowances, spent at the discretion of the participants--consistently receive better care than those who lack discretion.
Even in the private sector, evidence favors consumer-driven plans. Definity Health and Cigna, both providers of consumer-driven insurance policies, have actually documented a reduction in flare-ups among their diabetic and asthmatic enrollees due to increased testing and drug compliance. McKinsey & Co. found that members of consumer-driven health plans were more likely to follow the complicated treatment routines necessary to hold chronic diseases at bay.
Conventional wisdom is usually posed against reform; and it seems even less trustworthy regarding Medicaid. We now stand at a crossroads, similar to the one 15 years ago regarding welfare. Strong-arming enrollees and providers with rationing tactics is not the only way, and surely not the best way, to control Medicaid costs.
We can move beyond the "Scrooge" option. Letting consumers drive the system is better both for the health of patients and the solvency of their home states. Oklahoma is the latest example of an encouraging trend.
Source
In the Australian State of Victoria, the sick suffer while the wait grows and grows
An average of 83 seriously ill or injured people each day are stranded on emergency department trolleys for more than 12 hours. Secret figures obtained by the Sunday Herald Sun show 30,332 Victorians in 2005 waited on trolleys for more than 12 hours before being admitted to wards. That is nearly three times the 1999 total of 12,603. The damning statistics were obtained through a Freedom of Information request. The State Government ditched trolley figures from its public statement on hospitals' performance in 2004.
Health experts say the system is at breaking point, with hospitals running at 96-99 per cent occupancy, when they should be at 85 per cent. Opposition health spokeswoman Helen Shardey said emergency departments were in meltdown because of Labor Government neglect. "The Government spends millions of dollars on health advertising and goes to extraordinary lengths to hide the truth about what's happening in our hospitals. It it time they were held to account," she said.
The Sunday Herald Sun found:
* AN 82-year-old woman with a broken arm waited six hours without painkillers before medics even bandaged her in one emergency department.
* SEVERAL patients walked out of an emergency waiting room after an elderly woman was left lying in faeces on a trolley for more than an hour.
* AN AVERAGE of nine people a day were last year stranded on trolleys for more than 12 hours at Northern Hospital, which produced the state's worst figures.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
***************************
The state Legislature here is working to finalize an agreement for Medicaid reform legislation creating personal health accounts (PHAs) for Medicaid enrollees. This comes hard on the heels of similar innovations in South Carolina and Florida. Reform is in the air--much the way it was when Wisconsin revolutionized its welfare system in the early 1990s, forerunning a stunning national success. Are we on the verge of consumer revolution in health care?
It is of course too soon to tell, but the Oklahoma case study is auspicious. The state's antiquated Medicaid bureaucracy has fostered, by turns, a lack of patient choice, provider dissatisfaction, a 9.5% payment error rate, and an escalating price tag of some $3.5 billion. Against these discouraging trends, state leaders spent six months last year formulating stopgap measures with state agencies, policy innovators, providers and beneficiaries.
Instead of assuming the indigent are incapable of decision-making, Oklahoma legislators proposed that Medicaid beneficiaries be given a risk-adjusted allowance to purchase private health insurance. A PHA would be established for annual out-of-pocket expenses without a "use it or lose it" penalty--that is, the unspent balance could be used for future health-care needs. They state would not mandate a homogenous set of benefits; instead, it would provide financial assistance and patient counseling.
The reform passed the Oklahoma State House in March and recently won Oklahoma State Senate approval. The bill's sponsors, Republican Rep. Kris Steele, and Democratic Sen. Tom Adelson, are working to craft a durable bill to send to the governor by the end of this year.
Oklahoma is simply coming to grips with reality--Medicaid needs fundamental change. Although the program subsidizes care for 52 million low-income people, Medicaid's price tag threatens the financial stability of many states. South Carolina's expenses, for instance, have virtually doubled in the past decade, and may consume nearly one-fourth of the state's budget in 2010. Nationwide, Medicaid spending grew 9.1% in 2004 alone, and is projected to be at nearly half a trillion dollars in less than a decade. Fiscally conscious governors and state legislatures have traditionally controlled Medicaid expenses through reductions in enrollment, benefits and provider reimbursement. Tennessee governor Phil Bredesen, for instance, culled 190,000 from the Medicaid rolls.
But Oklahoma, South Carolina and Florida have embarked on a path that is at once less draconian and yet more radical. All three states have taken the step of permitting Medicaid enrollees to choose health services and providers for themselves. South Carolina, for example, puts a set amount every year into each enrollee's PHA, to be spent as he or she sees fit. The benefits of this simple but revolutionary system will be enormous: Health costs remain low, government outlays stable and state finances healthy. Private accounts will introduce market incentives into the Medicaid system, lightening obligations all around.
Medicaid enrollees can shop for care and increase their chances of receiving the care they need. (Not surprisingly, current Medicaid enrollees have more unmet needs than similar adults with private health insurance.) Health-care providers, compelled to compete for Medicaid customers will likely offer more consumer-oriented services at competitive costs.
Critics of Medicaid choice argue that such plans have several intrinsic flaws. Some view the plan as wasteful, citing Medicaid's already low per-patient cost. But these "low costs" come at the participants' expense. Physicians, scared off by the drastically low level of state reimbursement for Medicaid providers, refuse to take them on as clients. In South Carolina, 30% of physicians refuse to accept any new Medicaid enrollees. With the new regime, physicians will have increased freedom to price competitively.
What about the common charges that Medicaid choice works only in states with numerous managed care providers? One need only look at Georgia and Ohio to refute this claim. Both states drew enthusiastic crowds of providers after they enacted Medicaid choice plans, including Goliaths of the business like Aetna, United Health and Anthem.
But these are side issues for the real opponents of Medicaid choice. They inevitably trot out a familiar, patronizing argument. Medicaid enrollees, they claim, are either not educated enough to be trusted with their own health, or lack access to necessary sources of information. Yet patients make intelligent decisions--when we let them do it. For instance, disabled people in government-run "cash and counseling" programs--monthly, need-based health allowances, spent at the discretion of the participants--consistently receive better care than those who lack discretion.
Even in the private sector, evidence favors consumer-driven plans. Definity Health and Cigna, both providers of consumer-driven insurance policies, have actually documented a reduction in flare-ups among their diabetic and asthmatic enrollees due to increased testing and drug compliance. McKinsey & Co. found that members of consumer-driven health plans were more likely to follow the complicated treatment routines necessary to hold chronic diseases at bay.
Conventional wisdom is usually posed against reform; and it seems even less trustworthy regarding Medicaid. We now stand at a crossroads, similar to the one 15 years ago regarding welfare. Strong-arming enrollees and providers with rationing tactics is not the only way, and surely not the best way, to control Medicaid costs.
We can move beyond the "Scrooge" option. Letting consumers drive the system is better both for the health of patients and the solvency of their home states. Oklahoma is the latest example of an encouraging trend.
Source
In the Australian State of Victoria, the sick suffer while the wait grows and grows
An average of 83 seriously ill or injured people each day are stranded on emergency department trolleys for more than 12 hours. Secret figures obtained by the Sunday Herald Sun show 30,332 Victorians in 2005 waited on trolleys for more than 12 hours before being admitted to wards. That is nearly three times the 1999 total of 12,603. The damning statistics were obtained through a Freedom of Information request. The State Government ditched trolley figures from its public statement on hospitals' performance in 2004.
Health experts say the system is at breaking point, with hospitals running at 96-99 per cent occupancy, when they should be at 85 per cent. Opposition health spokeswoman Helen Shardey said emergency departments were in meltdown because of Labor Government neglect. "The Government spends millions of dollars on health advertising and goes to extraordinary lengths to hide the truth about what's happening in our hospitals. It it time they were held to account," she said.
The Sunday Herald Sun found:
* AN 82-year-old woman with a broken arm waited six hours without painkillers before medics even bandaged her in one emergency department.
* SEVERAL patients walked out of an emergency waiting room after an elderly woman was left lying in faeces on a trolley for more than an hour.
* AN AVERAGE of nine people a day were last year stranded on trolleys for more than 12 hours at Northern Hospital, which produced the state's worst figures.
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 19, 2006
NHS EYE DRUG DISGRACE
Who cares if you lose your sight? Not the bloated NHS bureaucracy!
Thousands of patients whose sight could be saved by a new drug are being denied treatment on the NHS on the ground of cost. Macugen, a new treatment for age-related macular degeneration, is launched today but primary care trusts (PCTs) are already telling patients that they will not pay for it. A quarter of a million people in Britain suffer from "wet" AMD, the form of the disease that Macugen can treat. Every year, 21,000 more people, mostly over 60, have this form of the disease diagnosed. But Macugen has not yet been cleared by NICE, the National Institute for Health and Clinical Excellence, and will not be for at least another year.
Specialists fear that many patients will go blind while they wait. The delay has been condemned by the Royal National Institute of the Blind (RNIB)which has given warning that many patients will lose their sight before a decision is made on approving the drug. "We already have evidence that this drug is not getting to patients because PCTs are hiding behind NICE, saying that they can't approve a treatment until NICE makes a ruling on its effectiveness, said Steve Winyard, head of research for the RNIB. "If this happens across the country then we are going to see many people lose their sight and their independence to do things like drive and go shopping, so we are urging health trusts to think long and hard before they say no to patients getting Macugen."
Ophthalmologists are excited by Macugen, the first of a new class of treatments that can attack the underlying cause of the disease. A second medicine, Lucentis, which some specialists believe will prove even more effective, is awaiting licensing in the US and Europe. But both are relatively expensive - Macugen costs 4,000 pounds per patient a year - and a NICE ruling on their cost-effectiveness is not expected until August next year. Kevin Gregory-Evans, a consultant at the Western Eye Hospital in London, said of Macugen: "This really is a major step forward in fighting AMD. "Previously we had very little to offer patients once the disease started to become active, and so severe loss of vision was an inevitable consequence of developing AMD. So to have an effective drug is absolutely marvellous."
Both drugs are monoclonal antibodies that target VEGF (vascular endothelial growth factor), a protein that helps the formation of new blood vessels. In the eye, high levels of VEGF can cause proliferation of blood vessels and fluid leakage, the characteristics of "wet" AMD. Sufferers begin to lose central vision, making it impossible for them to read or drive. Although they may retain sufficient vision for independent life, their quality of life is very seriously damaged. "Unlike glaucoma or cataracts, very few people have heard of wet AMD - yet it has a major impact on patients' daily lives, depriving them of their central vision, independence and ability to complete every day activities, such as driving, shopping and cooking," said Philip Hykin, Consultant Ophthalmologist at Moorfields Eye Hospital, London.
Macugen, made by Pfizer, is given by injections into the eye every six weeks.
More here
FDA to be bypassed to save lives?: "On May 2, a three judge panel of the D.C. Circuit recognized that 'a terminally ill, mentally competent adult patient's informed access to potentially life-saving ... new drugs ... warrants protection under the Due Process Clause.' The decision stemmed from a case challenging FDA regulations, which require experimental drugs to go through a lengthy series of FDA managed clinical trials before they are available to patients. That red tape can be a death sentence for patients in dire need, whose lives may well depend on access to the new medicine. Following some of the language of the D.C. Circuit's opinion, law professor-bloggers Jonathan Adler and Orin Kerr then described the case as a decision that recognizes a new 'right to experimental drugs.' A Washington Post editorial went further, charging that the D.C. Circuit pulled this right to experimental drugs 'out of thin air,' 'call[ing] into question the whole fabric of drug regulation.'
***************************
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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.
***************************
Who cares if you lose your sight? Not the bloated NHS bureaucracy!
Thousands of patients whose sight could be saved by a new drug are being denied treatment on the NHS on the ground of cost. Macugen, a new treatment for age-related macular degeneration, is launched today but primary care trusts (PCTs) are already telling patients that they will not pay for it. A quarter of a million people in Britain suffer from "wet" AMD, the form of the disease that Macugen can treat. Every year, 21,000 more people, mostly over 60, have this form of the disease diagnosed. But Macugen has not yet been cleared by NICE, the National Institute for Health and Clinical Excellence, and will not be for at least another year.
Specialists fear that many patients will go blind while they wait. The delay has been condemned by the Royal National Institute of the Blind (RNIB)which has given warning that many patients will lose their sight before a decision is made on approving the drug. "We already have evidence that this drug is not getting to patients because PCTs are hiding behind NICE, saying that they can't approve a treatment until NICE makes a ruling on its effectiveness, said Steve Winyard, head of research for the RNIB. "If this happens across the country then we are going to see many people lose their sight and their independence to do things like drive and go shopping, so we are urging health trusts to think long and hard before they say no to patients getting Macugen."
Ophthalmologists are excited by Macugen, the first of a new class of treatments that can attack the underlying cause of the disease. A second medicine, Lucentis, which some specialists believe will prove even more effective, is awaiting licensing in the US and Europe. But both are relatively expensive - Macugen costs 4,000 pounds per patient a year - and a NICE ruling on their cost-effectiveness is not expected until August next year. Kevin Gregory-Evans, a consultant at the Western Eye Hospital in London, said of Macugen: "This really is a major step forward in fighting AMD. "Previously we had very little to offer patients once the disease started to become active, and so severe loss of vision was an inevitable consequence of developing AMD. So to have an effective drug is absolutely marvellous."
Both drugs are monoclonal antibodies that target VEGF (vascular endothelial growth factor), a protein that helps the formation of new blood vessels. In the eye, high levels of VEGF can cause proliferation of blood vessels and fluid leakage, the characteristics of "wet" AMD. Sufferers begin to lose central vision, making it impossible for them to read or drive. Although they may retain sufficient vision for independent life, their quality of life is very seriously damaged. "Unlike glaucoma or cataracts, very few people have heard of wet AMD - yet it has a major impact on patients' daily lives, depriving them of their central vision, independence and ability to complete every day activities, such as driving, shopping and cooking," said Philip Hykin, Consultant Ophthalmologist at Moorfields Eye Hospital, London.
Macugen, made by Pfizer, is given by injections into the eye every six weeks.
More here
FDA to be bypassed to save lives?: "On May 2, a three judge panel of the D.C. Circuit recognized that 'a terminally ill, mentally competent adult patient's informed access to potentially life-saving ... new drugs ... warrants protection under the Due Process Clause.' The decision stemmed from a case challenging FDA regulations, which require experimental drugs to go through a lengthy series of FDA managed clinical trials before they are available to patients. That red tape can be a death sentence for patients in dire need, whose lives may well depend on access to the new medicine. Following some of the language of the D.C. Circuit's opinion, law professor-bloggers Jonathan Adler and Orin Kerr then described the case as a decision that recognizes a new 'right to experimental drugs.' A Washington Post editorial went further, charging that the D.C. Circuit pulled this right to experimental drugs 'out of thin air,' 'call[ing] into question the whole fabric of drug regulation.'
***************************
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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, May 18, 2006
Massachusetts's health plan affects privacy and liberty
People across the nation are applauding the Massachusetts effort to increase access to health care, improve its quality, and reduce costs by forcing every resident to purchase medical insurance. It's going to be an interesting and important task to measure objectively how the Massachusetts experiment actually works-or doesn't-to achieve those goals during the coming years.
But some results we don't need to wait for. It's crystal clear (upon reading the actual bill text) that the plan invades everyone's privacy by requiring insurers and health-care providers to submit patient data to a centralized clearinghouse (a new council). And it's clear that forcing Americans to buy a product from a limited number of government-approved insurers limits their freedom of choice. There is a huge difference between freedom and choice: freedom means one is free to choose from an array of options not artificially limited by the government, while choice may include only an artificially limited number of options.
Also, it's obvious that the Massachusetts plan will interfere with every citizen's right to maintain private contracts with health-care providers. If providers are forced to submit patients' data to a centralized clearinghouse, there is no way for patients and their providers to maintain truly confidential relationships.
Perhaps New Hampshire and other surrounding states should make sure their laws uphold the precious ethics of privacy and consent. Then at least some Massachusetts residents (those with means to do so) would be free to go out of state to maintain confidential doctor-patient relationships. And after all, New Hampshire's state motto is "Live Free or Die." Better yet, all states' policies should encourage citizens to live free and thrive! Laws that uphold the ethics of privacy and consent can ensure that.
Source
Massachusetts Health-Insurance Bill Mandates New Taxes and Privacy Invasions
On Tuesday, April 4, the Massachusetts House and Senate Conference Committee reached a compromise on a first-of-its-kind legislation that requires everyone in the state to have health insurance or pay a fine... The plan includes new taxes on businesses that don't provide insurance, a requirement that everyone purchase health insurance or be penalized and chilling new invasions into personal privacy.
The legislation includes new Medicaid expansions and the "Connector," modeled after the Federal Employees Health Benefits Program, a per-person business "assessment" (read: tax) on firms not offering insurance. Most problematic, the bill provides new government authority to extensively track each person's private health insurance and medical data. "This program is being sold by the governor as a 'free market' proposal," stated JP Wieske, State Affairs Director for the Council for Affordable Health Insurance (CAHI). "But this plan is a roadmap for a single-payer system that will be a disaster for Massachusetts taxpayers and patients."
The legislation gives the government broad new invasion-of-privacy rights:
* Individuals must provide "Health Insurance Responsibility Disclosure" forms-signed under oath-that can be investigated by the insurance commissioner. The bill also includes other extensive data-reporting requirements. Business owners must also sign the disclosure.
* The "Connector"-a non-state entity-and other information-gathering agencies can request any information on the business and its employees they deem necessary. Employers not providing insurance not only pay a $295 tax [per employee], but once their employees' and dependents' state-paid health care costs exceed $50,000, employers are responsible for between 10 and 100% of the bill....
"After years of debate over health-care reform, is this the best Massachusetts can do!?" asked Dr. Merrill Matthews, Director of CAHI...."It's not a model for reform, but a costly, invasive boondoggle..."
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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.
***************************
People across the nation are applauding the Massachusetts effort to increase access to health care, improve its quality, and reduce costs by forcing every resident to purchase medical insurance. It's going to be an interesting and important task to measure objectively how the Massachusetts experiment actually works-or doesn't-to achieve those goals during the coming years.
But some results we don't need to wait for. It's crystal clear (upon reading the actual bill text) that the plan invades everyone's privacy by requiring insurers and health-care providers to submit patient data to a centralized clearinghouse (a new council). And it's clear that forcing Americans to buy a product from a limited number of government-approved insurers limits their freedom of choice. There is a huge difference between freedom and choice: freedom means one is free to choose from an array of options not artificially limited by the government, while choice may include only an artificially limited number of options.
Also, it's obvious that the Massachusetts plan will interfere with every citizen's right to maintain private contracts with health-care providers. If providers are forced to submit patients' data to a centralized clearinghouse, there is no way for patients and their providers to maintain truly confidential relationships.
Perhaps New Hampshire and other surrounding states should make sure their laws uphold the precious ethics of privacy and consent. Then at least some Massachusetts residents (those with means to do so) would be free to go out of state to maintain confidential doctor-patient relationships. And after all, New Hampshire's state motto is "Live Free or Die." Better yet, all states' policies should encourage citizens to live free and thrive! Laws that uphold the ethics of privacy and consent can ensure that.
Source
Massachusetts Health-Insurance Bill Mandates New Taxes and Privacy Invasions
On Tuesday, April 4, the Massachusetts House and Senate Conference Committee reached a compromise on a first-of-its-kind legislation that requires everyone in the state to have health insurance or pay a fine... The plan includes new taxes on businesses that don't provide insurance, a requirement that everyone purchase health insurance or be penalized and chilling new invasions into personal privacy.
The legislation includes new Medicaid expansions and the "Connector," modeled after the Federal Employees Health Benefits Program, a per-person business "assessment" (read: tax) on firms not offering insurance. Most problematic, the bill provides new government authority to extensively track each person's private health insurance and medical data. "This program is being sold by the governor as a 'free market' proposal," stated JP Wieske, State Affairs Director for the Council for Affordable Health Insurance (CAHI). "But this plan is a roadmap for a single-payer system that will be a disaster for Massachusetts taxpayers and patients."
The legislation gives the government broad new invasion-of-privacy rights:
* Individuals must provide "Health Insurance Responsibility Disclosure" forms-signed under oath-that can be investigated by the insurance commissioner. The bill also includes other extensive data-reporting requirements. Business owners must also sign the disclosure.
* The "Connector"-a non-state entity-and other information-gathering agencies can request any information on the business and its employees they deem necessary. Employers not providing insurance not only pay a $295 tax [per employee], but once their employees' and dependents' state-paid health care costs exceed $50,000, employers are responsible for between 10 and 100% of the bill....
"After years of debate over health-care reform, is this the best Massachusetts can do!?" asked Dr. Merrill Matthews, Director of CAHI...."It's not a model for reform, but a costly, invasive boondoggle..."
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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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Wednesday, May 17, 2006
BRAINLESS BRITISH AMBULANCE SERVICE
Put your brain out of gear (and forget how to read a map, and don't listen to anybody) when you go to work for the government
An ambulance took almost two hours to take an injured girl to hospital after it was misdirected to the scene of the accident by its satellite navigation system. Chloe Banks, 10, was left lying in the road in the village of Greenside, near Gateshead, for almost an hour waiting for an ambulance after she was injured in a car smash. The crew then took such a circuitous route to the accident and emergency department of the Queen Elizabeth Hospital that the child’s older brother, Colin, 20, questioned the driver. He was told that they were following the directions of the satellite navigation system.
Maggie Banks, 39, the injured child’s mother, has complained that Chloe was knocked down three weeks ago outside a new skate park in the village at 1.30pm, but did not arrive at the hospital until 3.20pm. She was treated at the scene by a rapid-response paramedic within six minutes and is now on holiday with her family in Spain and making a full recovery. Mrs Banks said: “Fortunately, her injuries were not more serious. I would not even like to think about how it could have been.”
A subsequent inquiry by the North-East Ambulance Service established that there were no ambulance crews in Gateshead to ferry the child to hospital. A crew from Sunderland were called at 1.54pm after they dropped off a patient in Newcastle. The crew, who were unfamiliar with the area, were further delayed when the satellite navigation system guided them down a road in nearby Ryton that was too narrow for the ambulance. Although within sight of the scene, the crew were forced to back up and find another way, finally arriving at 2.26pm.
Mrs Banks, who travelled in the ambulance, was shocked when the ten-mile journey to the hospital took another 40 minutes. The navigational aide directed the crew along a B-road, rather than the more direct route along the dual-carriageway A695. Mrs Banks, a cleaner, said: “Chloe was lying on the ground vomiting and bleeding and she kept saying to me, ‘Mum, am I going to die?’. We had to wait almost an hour for the ambulance to come and take her. “I thought then we would go straight to the QE but they went around Rowlands Gill and Swalwell. My son told the crew it would have been quicker going to Ryton on the bypass, but the lady who was driving said she was going off the navigational system.” Mrs Banks, married to Colin, 43, a driver, has raised concerns about the system with the ambulance trust.
A North-East Ambulance Service spokesman said that they understood Mrs Bank’s concerns. However, he emphasised that paramedics arrived within six minutes and the child was treated at the scene. It was the transportation rather than emergency treatment that was subject to a delay. The journey from Newcastle to Greenside is 10.3 miles and should take no more than 20 to 25 minutes. A reporter drove from the crash site to the hospital yesterday, using local knowledge, in 22 minutes.
Source
BRITAIN: RED TAPE FOR CHOCOLATES NOW!
Nurses may be more used to monitoring heart rates, breathing patterns and blood pressure, but a new and rather more surreal target has now been added to their duties. Clearly dissatisfied with the findings of countless annual surveys, targets and inspections, audit-hungry hospital managers in the West Country have hit upon what they believe is a more accurate indicator: chocolate. Bemused staff have been instructed to complete a “chocolate audit” of gifts that they have received from grateful patients — from boxes of Milk Tray and bottles of wine to cards and flowers.
Every time a nurse receives a present — a “gesture of gratitude” — they are now required to fill out a form stating what it is, who it is from, and how much it is worth. While managers at Royal Cornwall Hospital NHS Trust claim that the audit provides a good picture of patient satisfaction, the move has been criticised by staff representatives and health watchdogs for increasing the burden on overworked staff.
Managers said that the “gestures of gratitude” count is already helping to refine hospital care. Records in 2004-05 for the trust’s three acute hospitals — in Treliske, Penzance and Hayle — reveal that there were 8,000 gestures of gratitude, including gifts and letters. There were, however, 316 complaints. “Keeping records of how many boxes of chocolates and thank you cards we get might seem trivial and a waste of time,” a spokesperson said. “But such gestures are a good way of measuring patient satisfaction and receiving feedback. We also carry out patient surveys. “It’s important staff know their efforts are appreciated by the public, and it doesn’t take very long to carry out.”
But the scheme, which is also up and running at Derriford Hospital, a part of Plymouth Hospitals NHS Trust, has not been universally welcomed. Jono Broad, of North Devon Patient and Public Involvement Forum, described the measure, at a trust that is £8 million in debt and facing 300 redundancies, as “management madness in the extreme”. ”If the staff don’t fill out the forms recording the gifts they get into trouble with management,” he said. “They have to record how much the gift is worth, who it came from and then it’s all shoved in a cupboard.”
Nursing leaders also dismissed the idea. Howard Catton, head of policy at the Royal College of Nursing, said that keeping a log of gifts was “about as useful as a chocolate teapot”. “The process of auditing performance in a hospital is crucial but trying to do so by counting biscuits is completely useless,” he said. A spokesman for Unison, the public sector trade union, described registering gifts as an unfathomable waste of time. She said: “Nurses need to spend all their available time with patients, carrying out their duties. Visit any hospital and you will see nurses rushing around with enough to do. “They work exceptionally hard and that is the true measure of performance, not who decides to give them a box of Maltesers.”
More here
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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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.
***************************
Put your brain out of gear (and forget how to read a map, and don't listen to anybody) when you go to work for the government
An ambulance took almost two hours to take an injured girl to hospital after it was misdirected to the scene of the accident by its satellite navigation system. Chloe Banks, 10, was left lying in the road in the village of Greenside, near Gateshead, for almost an hour waiting for an ambulance after she was injured in a car smash. The crew then took such a circuitous route to the accident and emergency department of the Queen Elizabeth Hospital that the child’s older brother, Colin, 20, questioned the driver. He was told that they were following the directions of the satellite navigation system.
Maggie Banks, 39, the injured child’s mother, has complained that Chloe was knocked down three weeks ago outside a new skate park in the village at 1.30pm, but did not arrive at the hospital until 3.20pm. She was treated at the scene by a rapid-response paramedic within six minutes and is now on holiday with her family in Spain and making a full recovery. Mrs Banks said: “Fortunately, her injuries were not more serious. I would not even like to think about how it could have been.”
A subsequent inquiry by the North-East Ambulance Service established that there were no ambulance crews in Gateshead to ferry the child to hospital. A crew from Sunderland were called at 1.54pm after they dropped off a patient in Newcastle. The crew, who were unfamiliar with the area, were further delayed when the satellite navigation system guided them down a road in nearby Ryton that was too narrow for the ambulance. Although within sight of the scene, the crew were forced to back up and find another way, finally arriving at 2.26pm.
Mrs Banks, who travelled in the ambulance, was shocked when the ten-mile journey to the hospital took another 40 minutes. The navigational aide directed the crew along a B-road, rather than the more direct route along the dual-carriageway A695. Mrs Banks, a cleaner, said: “Chloe was lying on the ground vomiting and bleeding and she kept saying to me, ‘Mum, am I going to die?’. We had to wait almost an hour for the ambulance to come and take her. “I thought then we would go straight to the QE but they went around Rowlands Gill and Swalwell. My son told the crew it would have been quicker going to Ryton on the bypass, but the lady who was driving said she was going off the navigational system.” Mrs Banks, married to Colin, 43, a driver, has raised concerns about the system with the ambulance trust.
A North-East Ambulance Service spokesman said that they understood Mrs Bank’s concerns. However, he emphasised that paramedics arrived within six minutes and the child was treated at the scene. It was the transportation rather than emergency treatment that was subject to a delay. The journey from Newcastle to Greenside is 10.3 miles and should take no more than 20 to 25 minutes. A reporter drove from the crash site to the hospital yesterday, using local knowledge, in 22 minutes.
Source
BRITAIN: RED TAPE FOR CHOCOLATES NOW!
Nurses may be more used to monitoring heart rates, breathing patterns and blood pressure, but a new and rather more surreal target has now been added to their duties. Clearly dissatisfied with the findings of countless annual surveys, targets and inspections, audit-hungry hospital managers in the West Country have hit upon what they believe is a more accurate indicator: chocolate. Bemused staff have been instructed to complete a “chocolate audit” of gifts that they have received from grateful patients — from boxes of Milk Tray and bottles of wine to cards and flowers.
Every time a nurse receives a present — a “gesture of gratitude” — they are now required to fill out a form stating what it is, who it is from, and how much it is worth. While managers at Royal Cornwall Hospital NHS Trust claim that the audit provides a good picture of patient satisfaction, the move has been criticised by staff representatives and health watchdogs for increasing the burden on overworked staff.
Managers said that the “gestures of gratitude” count is already helping to refine hospital care. Records in 2004-05 for the trust’s three acute hospitals — in Treliske, Penzance and Hayle — reveal that there were 8,000 gestures of gratitude, including gifts and letters. There were, however, 316 complaints. “Keeping records of how many boxes of chocolates and thank you cards we get might seem trivial and a waste of time,” a spokesperson said. “But such gestures are a good way of measuring patient satisfaction and receiving feedback. We also carry out patient surveys. “It’s important staff know their efforts are appreciated by the public, and it doesn’t take very long to carry out.”
But the scheme, which is also up and running at Derriford Hospital, a part of Plymouth Hospitals NHS Trust, has not been universally welcomed. Jono Broad, of North Devon Patient and Public Involvement Forum, described the measure, at a trust that is £8 million in debt and facing 300 redundancies, as “management madness in the extreme”. ”If the staff don’t fill out the forms recording the gifts they get into trouble with management,” he said. “They have to record how much the gift is worth, who it came from and then it’s all shoved in a cupboard.”
Nursing leaders also dismissed the idea. Howard Catton, head of policy at the Royal College of Nursing, said that keeping a log of gifts was “about as useful as a chocolate teapot”. “The process of auditing performance in a hospital is crucial but trying to do so by counting biscuits is completely useless,” he said. A spokesman for Unison, the public sector trade union, described registering gifts as an unfathomable waste of time. She said: “Nurses need to spend all their available time with patients, carrying out their duties. Visit any hospital and you will see nurses rushing around with enough to do. “They work exceptionally hard and that is the true measure of performance, not who decides to give them a box of Maltesers.”
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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?
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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