Friday, June 05, 2009

Obama sets August deadline for destruction of American medicine

President Barack Obama called the next few months a “make-or-break period” for health-care legislation in Congress, as his aides left the door open to a tax on benefits to pay for overhauling the U.S. system. Democratic senators, who met with the president at the White House yesterday, promised they would meet the deadline even as two contentious issues -- taxing employer-paid health insurance and setting up a government plan -- are unresolved. “Soaring health-care costs are unsustainable for families, they are unsustainable for businesses, and they are unsustainable for governments,” Obama said before the meeting with lawmakers. “This is the time where we’ve got to get this done.”

The administration is kicking off a campaign to push Congress to meet Obama’s deadline of finishing work on drafting a measure before Congress leaves for its August recess. That would give lawmakers time for final negotiations and passage after they return to Washington in September. Top Democrats in the House and Senate said they would meet that timetable.

Democrats, who control both the House and Senate, are considering proposals that would require employers to cover all full-time workers or pay a penalty to the government; create a “health exchange” to allow consumers to buy insurance at lower, group rates; set up a new government-run plan to cover some of the uninsured; and levy new taxes to pay for universal coverage.

Max Baucus, Democrat of Montana and chairman of the Senate Finance Committee, made it clear yesterday that he wants to consider taxing at least some portion of employer-provided health-care benefits for workers. He said lawmakers should consider “an appropriate limit” on benefits that are free to employees, and beyond that, there should be a tax to help pay for health-care overhaul legislation. Obama aides said the president, who opposed such a plan during his election campaign, is focused on paying for his proposals through other means. Still, they refused to rule out he would sign legislation that included such a tax.

“The president has serious concerns about taxing benefits,” Linda Douglass, the communications director for the White House Office of Health Reform, said in an interview today. “He doesn’t like it.” “While all options should be considered while they are talking about the different components of health reform,” Douglass said, “he believes that those options should include the revenue proposals that he had in his budget.”

In the meeting with senators, Obama reinforced his support to help finance a health-care overhaul by reducing itemized deductions for charitable contributions and limiting deductions on mortgage-interest payments for the wealthy, past of the administration’s budget package. “That is a proposal that he’s very serious about, and that is what he was pushing,” Douglass said.

Baucus got a key ally on the tax issue in Republican Senator Judd Gregg of New Hampshire. Gregg, the senior Republican on the Health, Education, Labor and Pensions Committee, offered a measure that would pay for the overhaul by capping the tax exclusion for employer-provided benefits. His legislation would include in employees’ taxable income any contributions employees and employers made for health-care coverage that, taken together, exceed $11,500 a year for family coverage or $5,000 a year for individual coverage.

Even with the differences over how to pay for the health- care plan, Baucus said lawmakers will meet Obama’s deadline. “We will pass a comprehensive, meaningful health-care reform bill this year,” the Montana Democrat said. Representative Charles Rangel of New York, chairman of the House Ways and Means Committee, said he expected the House legislation would be finished in July and that a bill could be on the president’s desk by Oct. 1.

Another point of debate is whether to establish a government-run insurance plan to make sure coverage is universal. Senator Sherrod Brown, an Ohio Democrat, said the “sentiment in the room at the White House meeting was that Democrats want a strong public plan. Senator Bernie Sanders, a Vermont independent, said Obama expressed support for a public option. “He understands that in order to at least police the private insurance companies we need a strong public plan,” Sanders said.

That will run into strong opposition from Republicans. Charles Grassley of Iowa, the top Republican on the Senate Finance Committee, said any attempt to win Republican votes on a compromise will be tough if Democrats push through a public insurance system that will compete with private insurers.

Grassley said he was dismayed that Republicans weren’t invited to this afternoon’s White House meeting. Grassley said that, at a lunch he had with Obama a month ago, the president indicated he wanted support from both parties. Obama said he would rather get 85 percent of what he wants to achieve if it has bipartisan backing, rather than win everything with only Democratic support, according to Grassley. “I think this president, when he says he wants bipartisanship, is very sincere,” Grassley said. “But he’s got people of his party in Congress who have been out of power for 14 years, and they know what they want and they’re going to get it and disregard their president.”

Grassley said the meeting today provides a “fork in the road,” where Democrats can decide to proceed with a bipartisan plan, or to go it alone on legislation.


South Wales NHS chiefs told to apologise in person for fatal blunder

The heads of an NHS trust were told to apologise in person to the parents of a cancer patient who bled to death after a breathing tube was inserted incorrectly in his neck. The Public Services Ombudsman for Wales, Peter Tyndall, criticised the Cwm Taf NHS Trust severely, saying that the actions of its staff “directly resulted” in the premature death of Myron Hall, a 47-year-old electrician. Mr Hall’s parents called for the police to investigate whether the trust, in South Wales, or any individuals should face criminal charges.

Mr Hall was referred to the former North Glamorgan NHS Trust in September 2006 by his GP because of a suspicious lump in his neck. It took three months to diagnose a malignant tumour and doctors decided the best way to treat him was to remove half his tongue. A tracheostomy tube was put in his windpipe to help him to breathe, but surgeons stopped the operation when they found that the tumour had spread too far.

Mr Hall later began bleeding from a replacement tube that was inserted in the wrong place while he waited to be transferred to a specialist cancer centre for chemotherapy. The wound was stitched when it was noticed the tube was not in the right place, but four days after returning to the ward Mr Hall suffered a “catastrophic bleed” caused by the tube wearing through the wall of an artery. He died despite the efforts of staff at the Royal Glamorgan Hospital, in Llantrisant, to resuscitate him.

His parents, Denzil and Janet Tilley, of Porthcawl, arrived at the hospital seconds before he died. In the report, Mr Tilley compares the scene at his son’s bed to a “horror movie”.

The report says the initial investigation of Mr Hall’s tumour was “slow and inadequate” and the nursing he received in relation to his tracheostomy “fell below a standard one could reasonably expect”. Although he was admitted to hospital with a very serious and potentially life-threatening condition, Mr Tyndall says he has “no doubt whatsoever that the actions of the Trust directly resulted in Mr H’s premature death”. “Not only was Mr H’s death avoidable, it occurred as a direct result of the action (or inaction) of Trust staff and should not have happened,” the report adds.

Mr Tyndall said: “Whilst no amount of apologising can compensate a parent for the loss of a son in such horrendous circumstances, I have nevertheless recommended that both the chair and the chief executive of Cwm Taf Trust should provide Mr H’s parents with an unequivocal apology for the failings that occurred during the care of their son.” Cwm Taf Trust, which took over from North Glamorgan and the former Pontypridd and Rhondda Trust, told the Ombudsman it could not meet his request for an apology in person but would write to Mr Hall’s parents — a stance he calls “unreasonable”.

Mr and Mrs Tilley’s solicitor, Astrid Coates, said: “Failures by the trust led to the death of Mr Hall and his family want to know that this will not happen to someone else’s son. “We will be calling upon the coroner to ascertain exactly what action has been taken by the Trust to prevent similar fatalities and to withhold this information when it may assist Mr and Mrs Tilley in dealing with their grief is inexplicable.”


Australia: Public hospital paperwork kills woman

So much paperwork, the nurse missed the important bit

A nurse caring for a woman who died from excessive bleeding after undergoing a caesarean section had been too busy to read an operation report that identified a tear in the woman's uterus, an inquest has heard.

Rebecca Murray, 29, died a day after giving birth to her third child at Bathurst Base Hospital on June 24, 2007. She had lost about one litre of blood - enough blood to soak through two pads, sheets and bed linen - and was forced to wait almost 20 minutes after nurses observed the blood loss before being given any fluids or before nurses called a doctor.

At Westmead Coroner's court today, Jane Thompson, an anaesthetic nurse who was present during Mrs Murray's caesarean and was responsible for her in recovery, said she had not been aware that Mrs Murray's uterus had torn during the procedure or that she had a low platelet count, which could result in severe bleeding if such a tear had occurred. She said she did not "have time" to read completely a set of post-operative notes that included details about the tear. "If I had time to sit down and read the notes I wouldn't attend to the patient," she said.

"I suggest to you, nurse, that the word 'tear' would have leapt to your eye ... and would have concerned you, being responsible in recovery for the patient," counsel assisting the inquest, Gail Furness, said.

Ms Thompson said part of the problem was that she had not been told about it. She would have read the operation report in full "if I had time".

"Are you suggesting that with one patient in recovery you didn't have time to read eight additional lines?" Ms Furness asked.

"I had my own paperwork to complete," Ms Thompson replied.


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