Sunday, August 05, 2007

Sink that SCHIP!

GWB seems set to veto it, fortunately

Let’s revise the old saw about knowing when politicians lie. Instead of “when his lips are moving,” it should be “when he says it’s ‘for the kids.’ ” Exhibit A is the debate on reauthorizing the State Children’s Health Insurance Program. This Clinton administration creation provides tax-paid health insurance for families earning up to 200 percent of the official poverty level but who aren’t covered by Medicaid. SCHIP originated as “Kids First,” the backup plan to the Hillarycare monstrosity of 1993. The Clintonistas calculated that, if Hillarycare’s complete socialization of U.S. health care was rejected, their fallback position was a long march to the same end, starting with Kids First.

As usual, spineless Republicans in Congress approved a watered-down version of the Kids First program — hence the SCHIP acronym — in 1997. They should have instead passed a consumer-choice system guaranteeing access for everybody to private health insurance, then dared Hillary’s hubby to veto it.

Now that Democrats control Congress, they want to double SCHIP spending and cover families making up to 400 percent of the poverty baseline. This would put up to three-fourths of all families under a government-run health care program, marking a major step toward Hillarycare’s original goal.

Democrats should ’fess up that their real goal is to socialize American medicine. Then they won’t have to hide behind such transparent falsehoods as Rep. Frank Pallone’s “this is not an expansion of the program.” As chairman of a House health subcommittee, the New Jersey Democrat knows full well that “expansion” is exactly the right term to describe his party’s SCHIP proposal.

They also should admit they’ve spun their budget projections to conceal the fact they will have to raise taxes to pay for their proposal, regardless of whether they ultimately go with the House Democrats’ $50 billion expansion or the $60 billion hike being debated this week in the Senate. Senate Democrats in particular are blowing smoke by claiming they can pay for their SCHIP expansion with a new tax on tobacco products.

Finally, wouldn’t it be refreshing to hear something besides the usual green-eyeshade GOP offer of a token budget increase — $5 billion in this case — while threatening to veto a far more generous Democratic proposal? For a change, why don’t Bush and the Republicans say something like this: “Let’s get government out of our doctors’ offices and give every American family a tax credit so they — not some Washington bureaucrat — can decide what health insurance works best for them.” Do that now, and in a few years SCHIP will be Hillarycare history.


NHS kills two more patients

Understaffing makes this sort of thing a certainty.

Two cancer patients died after hospital staff gave them an overdose of a drug used to ease the side effects of chemotherapy. Baljit Singh Sunner, 36, and Paul Richards, 35, died within hours of each other after treatment in an oncology ward of Birmingham Heartlands Hospital on July 20. It is believed they were given up to five times the correct dose of medication.

The hospital confirmed that a “mistake” was made over the men’s treatment and said that it was carrying out a detailed investigation. A hospital spokesman said: “The doctor and two nurses involved have not been suspended but are currently not working within the area and are deeply upset by the deaths. “It has already been established that the two men received a higher dosage than normal. The coroner will look at whether the mistake made was directly responsible for the patients dying or a causational factor.”

In a statement, Mark Goldman, the hospital chief executive, said: “Following the deaths of two patients we are carrying out a detailed investigation into the clinical care given to them. This will be presented to both families and to the coroner, and it will form part of the coroner’s inquiries.”


Your medical regulators will protect you -- again

The regulators are a useless lot in South Australia, too

The Health Department will investigate how a privately run public hospital employed an overseas-trained forensic pathologist as a specialist. The inquiry was launched yesterday after State Coroner Mark Johns found the Iraqi-trained doctor failed to order tests on a patient who died from a brain aneurism despite a written request for a CT scan from the man's doctor.

An inquest into the death of Peter Roy Gillam, 44, of Tea Tree Gully, heard Dr Al-Khalfa had not practised medicine for almost 20 years before he was employed by Modbury Hospital in December, 2004. His curriculum vitae revealed he graduated with a medical degree from Baghdad University in 1984 but only served as a medical intern before studying to become a full-time forensic pathologist. Mr Johns said it was "therefore open" to find he had not practised medicine "in a clinical sense between 1984 when he worked in a Baghdad teaching hospital and 2004 when he commenced working in Modbury Hospital in South Australia". "If that is correct, it is difficult to escape the conclusion that he was a relatively inexperienced clinician when he saw Mr Gillam," he said.

Mr Johns said that, while forensic medicine "is, of course, a most highly skilled discipline, it involves a quite different set of medical skills from those required in dealing with patients in an ordinary clinical setting". "I have considerable reservations about the adequacy of Dr Al-Khalfa's experience as a clinician to perform the role assigned to him at Modbury Hospital," Mr Johns said. He said coronial police officers had been unable to find Dr Al-Khalfa to question him about Mr Gillam's death.

Modbury Hospital did not keep records on doctors' movements after they resigned. "It has been assumed by Modbury Hospital that Dr Al-Khalfa is no longer in Australia," he said. "I believe that is a reasonable assumption. "It is most unfortunate that Dr Al-Khalfa was no longer in Australia and could not be called upon to explain why he acted as he did on 17 December, 2004."

The inquest heard Mr Gillam first was taken to Modbury Hospital by his father, Thomas, after 5pm on December 16, 2004, after he had been to his GP, who wrote a note requesting a brain scan. A male nurse, however, told the pair the X-ray department was closed and they would have to pay for it to be reopened or return the next morning.

Mr Gillam returned to the hospital and was seen by Dr Al-Khalfa who, rather than ordering a brain scan, told him he was suffering from depression and said he should see a psychiatrist. Mr Gillam saw his GP again on Monday, December 20, before collapsing the following day in his bedroom. He was again taken to Modbury Hospital before being rushed to the Royal Adelaide Hospital. He died there following emergency surgery for internal brain damage.

Mr Gillam's father last night said the recruitment procedures for overseas-trained doctors needed to be overhauled. "This bloke had many qualifications but, unfortunately, they weren't the right ones to be working where he was," he said. "All doctors have certain basic training and it doesn't matter which field they follow, they are still doctors. "But 20 years as a forensic pathologist isn't the type of person who should be working in the emergency department of a public hospital. "He just shouldn't have been in that job."

Mr Gillam said he had received a letter from Modbury Hospital detailing changes it had implemented following his son's death. A Health Department spokeswoman said Dr Al-Khalfa had been employed at Modbury Hospital when it was operated by a private contractor, Healthscope. "Given that the employment of this doctor occurred when the hospital was run by the private operator Healthscope, the SA Health Department will need to investigate the reasons behind Healthscope employing the doctor, as recommended by the Coroner," she said.

The adverse findings against Dr Al-Khalfa come amid intense national scrutiny of the recruitment of overseas-trained doctors following last month's detention of alleged terrorism suspect Dr Mohamed Haneef in Queensland.



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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