GOING BLIND? WHO CARES? THE NHS DOESN'T!

This is the sort of thing the Democrats are wishing onto Americans -- people being sent blind by a system that refuses to treat them

A former MP who is going blind is set to sue the NHS after it refused to give her a new drug that could help save her sight, it emerged yesterday. Veteran left-winger Alice Mahon has lost most of the sight in one eye while waiting for treatment. The former Labour MP - and thorn in Tony Blair's side - is now preparing to go to the High Court to make the Health Service pay for a drug that can help her.

Miss Mahon, aged 69, was told by her consultant in November that she should get Lucentis - one of a new generation of drugs for wet age-related macular degeneration (AMD). The drug, which costs 12,000 pounds for a year's treatment, stabilises vision loss and may reverse the damage, but needs to be given quickly because the sight can rapidly deteriorate. But an urgent application for funding from Calderdale primary care trust (PCT) was rejected because the Government's 'rationing' body had not yet approved the drug for NHS use.

Although Mrs Mahon is wating for the outcome of an appeal, she lost much of the vision in her left eye in the nine weeks since the original application. She has now been forced to pay more than 5,000 pounds for private treatment to stop herself going blind. The former Halifax Labour MP is now taking legal action in a move that could help an estimated 18,000 Britons who go blind each year due to wet AMD, with some denied funding by cash-strapped PCTs.

Mrs Mahon said: "I have been an ardent supporter of the NHS all my life, and now feel totally let down. "The excuses that PCTs are giving for not funding treatment are scandalously lame. "Everyone has a right to free treatment on the NHS for a condition that results in blindness and devastates lives. "Supporting people who are blind or partially sighted, who may need home help and suffer injuries from falls, is far more expensive than the treatment. "The Chancellor must ensure the NHS budget is large enough to fund such a basic health care need. "I have written personally to Gordon Brown, and not as yet received a reply."

Mrs Mahon, who is being treated at Calderdale Royal Hospital and has a "dry" form of AMD in her right eye, was turned down for funding in December by the PCT's exceptional cases committee. However, a patient leaflet prepared by the PCT last autumn claimed those using the drug "were very likely to enjoy stable vision" and over one-third got a significant improvement.

A study published in the New England Journal of Medicine showed 30 per cent of patients receiving monthly injections of the drug into the affected eye had a "marked improvement" in vision. It prevented vision loss in nine out of 10 patients. The drug targets abnormal blood vessels that grow behind the eyeball - these vessels can leak and cause damage to parts of the eye responsible for central vision.

Lucentis was licensed earlier this month but, along with another wet AMD drug called Macugen, will not be considered for approval by the National Institute for Health and Clinical Excellence (NICE) until October. [Take your time boys! Nothing is ever urgent in a bureaucracy!] However, Health Secretary Patricia Hewitt has made clear to PCTs that they cannot withhold NHS funding simply on the grounds that NICE has not made a decision.

Mrs Mahon's solicitor, Yogi Amin, from Irwin Mitchell, wrote to her PCT in Calderdale and also Kirklees PCT, which share an exceptional cases committee, saying their refusal to fund the drug breaches her human rights. The letter says the PCTs have until today to overturn their decision or "we will proceed with an application for judicial review in the High Court". It says "Mrs Mahon has been forced to fund her urgent treatment privately, for which she has had to pay the amount of 5,325 pounds in order to avoid losing her eyesight while her application was and her appeal is being considered." Mrs Mahon will be joined by other MPS in Parliament today to speak out against the refusal to fund treatment for wet AMD patients.

The Royal National Institute for the Blind (RNIB) has been campaigning to stop people going needlessly blind. It says PCTs can use their discretion when deciding whether to fund the drugs, yet some have imposed an outright ban while others wait until the patient has gone blind in one eye before treating the other. Steve Winyard, head of campaigns at the RNIB, said "Fifty people a day are being condemned to blindness because PCTs are refusing to fund a licensed treatment, even though it could save patients" sight. "The actions of these PCTs are simply unacceptable."

In the UK, 220,000 people with AMD registered blind or partially sighted. According to the RNIB, 57 per cent of all people newly-registered blind or partially sighted in the UK have AMD. A spokeswoman for Calderdale PCT said it did not comment on individual cases.

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The U.S. tax-code quirk and the health care mess

Wading into the fraught issue of health care during his State of the Union address, President Bush noted that for most Americans, "private health insurance is the best way to meet their needs. But many Americans cannot afford a health insurance policy."

Why is health insurance so expensive? One explanation is that the extraordinary gains medical science has made over the last few decades come with hefty price tags. The revolution in cardiac care, the myriad new drugs, the invention of CAT scanners and MRIs, the ability to transplant organs -- these and so many other lifesaving medical miracles didn't come cheap. It stands to reason that insurance covering the cost of such miracles doesn't come cheap either.

But wait -- *does* it stand to reason? Information technology has exploded in recent decades too, yet computers have never been as affordable as they are now. Agriculture is far more advanced, and the quality and variety of food available to consumers far greater, than they were 50 years ago, yet the real cost of food has plummeted. The price of a primitive color television in 1954 was equal to three months' wages for an average American worker; today that worker gets a sparkling picture on a 25-inch screen for just three days of work.

"Why is it," asks David Gratzer, a physician and scholar at the Manhattan Institute, "that in every other field where enormous technological strides have been made, total costs have fallen over time, but in health care they have increased?" The answer, he writes in The Cure, a lively and engrossing new book on the American health care mess, is simple: Health care costs so much because most of us pay so little for it. And we pay so little -- out-of-pocket expenses amount to just 14 cents of every health dollar spent in this country -- because a third party nearly always picks up the tab. For most working Americans, that third party is an insurance company paid by their employers. (For the poor and elderly who rely on programs such as Medicare and Medicaid, it's the government.)

Why does it matter whether Americans pay for medical care directly or let insurers cover their bills? Because thrift and price awareness usually go out the window when we're spending other people's money. Under the present setup, most Americans have little incentive to be economical consumers of health care. As a result, health care expenditures -- and insurance premiums -- have been racing ahead at three and four times the rate of inflation.

All of this is due to a quirk in tax policy dating to World War II, when employers looking for a way to enhance workers' salaries without running afoul of federal wage controls hit on the idea of providing medical benefits. When the IRS agreed not to treat such benefits as taxable income, it triggered a far-reaching change in the way Americans paid for health care.

What had been a relatively free market in medical services, with patients transacting directly with doctors and hospitals, gave way to a third-party system, in which employers paid the insurance companies, and insurance companies paid the bills. Americans increasingly used insurance to cover routine medical expenses, not just major unexpected costs like hospitalization or surgery. Imagine what automobile insurance would cost, writes Gratzer, "if people insisted on plans that had [low] deductibles . . . or policies that included not just major body work, but also oil changes and gas."

To properly disentangle this snarl, Congress ought to end the tax exclusion that causes it. Employers don't generally provide workers with homeowner's or auto insurance, or for that matter with food, clothing, or housing. Ideally, medical treatment would be handled no differently, and Americans would benefit from a far more robust and competitive healthcare market than they do now.

But after 60 years, it's probably infeasible to simply eliminate the tax deduction altogether, so the president has proposed a second-best alternative: eliminating the bias for employer-provided health insurance by giving every family with health insurance a $15,000 deduction ($7,500 for individuals) -- no matter where their insurance comes from or how little it costs. Employer-sponsored insurance would become taxable income -- but since most insurance policies cost less than $15,000, most employees would enjoy a significant tax break.

Under the Bush plan, the tax code would no longer penalize Americans who don't get health insurance through their employers, since they too would be eligible for the $15,000 tax deduction. Millions of others would have an incentive to shop around for a health plan less pricey than the one available through work, since cheaper insurance would end up meaning a bigger tax break. That would put pressure on insurers to develop more high-deductible, low-premium plans -- and on health care consumers to start paying attention to prices. Bush's prescription won't cure everything that ails American health care. But there's no question it would make an excellent start.

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?

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