Tuesday, June 02, 2009

Three health care myths

While advocates of big government continue to speak of the need for "universal health care," those who understand the free market have pulled away the curtain to reveal the truth behind it.

For all its window dressing, "Universal health care" is merely a code word for socialized medicine. With leadership in both major parties shouting about the "health care crisis", it is vitally important that freedom loving-Americans know the facts and prepare themselves to counter the falsehoods that are being spread on this topic. Let us tackle some of the health care myths used by the proponents of big government in their advocacy for government run health care.

Myth #1 There are 47 Million Uninsured Americans in Crisis Today

Perhaps the most often quoted and thereby misleading statistic by the advocates of big government is the sheer number of people in America who currently have no insurance. The numbers have been used and misused by politicians in both major political parties.

While the number of Americans without insurance is 47 million at first glance, more than nine million are not American citizens. Taking this into account, the number drops to approximately 38 million. Of those now remaining, an additional nine million people make over $75,000 a year, nearly double the median household income in the United States.

If they desire it these individuals should be able to afford basic health insurance. Adjusting for this factor, the number slides to approximately 29 million.

With an additional eight million Americans making between $50,000 and $75,000 a year, still more than the average American, these individuals should be able to afford basic health insurance if they choose to purchase it. This drops the number even further to just over 20 million people.

And yet the "new" number of 20 million uninsured Americans may even be too high.

The number of true "uninsured" Americans could perhaps be lowered again with the estimation that almost half of those uninsured will have insurance within four months. Many individuals not covered due to transitional periods between jobs will receive insurance through their employer and would be covered upon taking the new position. It is estimated that 45% of those without insurance will have it within four months.

So where do the exact numbers stand? There is no way to be certain, although some estimates put the number as low as eight million people; a significant difference from the "47 million" the proponents of big government would have you believe.

Myth #2: Switching to Electronic Records will Save Lives

The idea of shifting from paper records to electronic records is not a new concept. The idea has been implemented by countless clinics and hospitals already, and numerous politicians encourage the practice.

The problem arises from bureaucrats' pledge to have government mandate the program for health care providers. Contrary to what the advocates of socialized medicine suggest, changing the way records are kept will not save lives.

According to a study published in the July 9th edition of the Archives of Internal Medicine, records being kept electronically had little impact on the overall quality of care when it came to walk-in doctor visits. "In clinic visits in which doctors did use and didn't use electronic health records, we didn't find clear evidence that EHR [Electronic Health Record] use was associated with better quality," said study lead author Dr. Jeffrey Linder.

To test the effectiveness of electronic health records, Linder and his staff evaluated visits to physicians' offices that only required outpatient care. They then cross-referenced the visits against 17 factors they determined were most important to the quality of the care. Overall, the study determined that electronic health records were not directly associated with a better quality of care. In some cases, such as the prescription of statins to patients with high cholesterol, the study found that electronic health records actually provided a lower quality of care.

Myth #3: U.S. Health Care is Inferior to the Rest of the World

One of the major arguments used by the proponents of socialized medicine is the substantial cost of health care in the United States as compared to other industrialized countries, mainly Canada and Europe. Advocates of socialized medicine constantly assert the superiority of other nations over the US based on the false belief that health care is inexpensive to citizens of these countries. Many even claim that health care in those countries is universal or "free."

In reality there is nothing free about it. The Health Care system in France is funded through a 13.55 percent payroll tax, a 5.25 percent income tax and other taxes on tobacco, alcohol and drug-company revenues. And the system is still running a deficit equivalent to more than 15 billion dollars.

In the United Kingdom we see more of the same: perceived low costs with hidden expenses that increase price and decrease quality. The UK's National Health Service (NHS) serves as a reminder of what can happen when competition begins to fade and socialized medicine takes over.

When it comes to the medical field, private industry leads to new and effective treatments and medicines. With no competition, government control over health care would lead to higher prices and a massive decline in quality. Some hospitals in Great Britain are being forced to cut services in order to cut costs. Controlled by the NHS, some hospitals have resorted to asking patients to bring drugs in from home, or removing every third light bulb from hallways. One government-controlled hospital even encouraged staff to save money on laundry costs by flipping over dirty bed sheets between patients instead of washing them.

Merely saying that people have health insurance is meaningless. Many countries provide universal insurance but deny critical procedures to people who become nothing more than numbers in a database. In Sweden some patients have had to wait more than six months for heart surgery, a procedure that from start to finish would take a matter of days in the U.S.

Private companies are responsible for the medical innovations we see today. The private sector gives us flat screen televisions and digital cameras while the government gives us the Post Office and the Department of Motor Vehicles. Private industry generates healthy competition that leads to better quality products and a reduced cost for consumers.

Government control limits the choices people have when looking for care and it prevents patients from receiving the best care possible. By allowing the free market to work we produce the best available products and the best service possible. The benefits of government intervention in the health care sector are grossly exaggerated and based solely on myth, not on fact.


Don't get old in Britain

Elderly left at risk by NHS bidding wars to find cheapest care with reverse auctions

An online auction system developed for councils to buy cheap wheelie bins and stationery is being used to buy end-of-life and dementia care for vulnerable elderly people. The NHS in London has held a series of 30 “reverse e-auctions”, where bids are driven down instead of up, for £195 million worth of contracts for palliative and dementia care for patients leaving hospital.

Reverse auctions to buy care for the elderly are relatively new and The Times has found that standards and quality have deteriorated rapidly where they have been used. In one case a company that won a local authority’s reverse auction in the North East of England was struck off the national register of approved providers weeks later because the palliative care it offered was of such poor quality. The results of another auction in South Lanarkshire to buy domiciliary care were so disastrous for elderly people that the Scottish Parliament is to hold an inquiry into whether they should be banned.

Companies who took part in the London NHS auction told The Times that they were asked hardly any questions about the quality of palliative or dementia care that they provided, beyond whether they complied with minimum standards.

During the e-auction, companies were invited to reduce their prices for one bed with round-the-clock specialist care for one week by £8 a time.

The NHS and local authorities are under increasing pressure to drive the hardest bargain they can for services, such as care for the elderly, which they buy in from the private sector. Reverse e-auctions, though, were intended to be used to drive down prices for basic goods such as office furniture, IT or stationery, which have limited and exact specifications and where quality is not a serious concern. Critics of care e-auctions say that those who hold them are aware that driving prices down affects the quality of care.

Richard Jones, director of adult social services for Lancashire County Council, said that he would never use an auction to buy care. “If you put your providers into an auction, pushing them to a lower and lower price, somebody is going to lose out, and the losers in this case are vulnerable elderly people and their carers,” he said.

Information given to The Times by the BBC programme Panorama showed that four local authorities — Walsall, Bedfordshire, South Lanarkshire and Edinburgh — had used the system to buy care for elderly people.

In Walsall, the Working Together Specialist Care Agency won a contract to provide palliative care to elderly people in the last few months of their life. Within weeks, the local authority stopped the company taking on any new cases, and then terminated the contract after it emerged that dying people were not receiving the pain relief and help with feeding and washing that they required. The Care Quality Commission (CQC), the health regulator, confirmed that the agency had been deregistered after an investigation. The agency could not be reached for comment.

Walsall said that price was not the sole consideration in awarding the contract to Working Together. Sue Ryder Care, the specialist charity that held the palliative care contract before the auction, said that it could not even afford to start bidding at the opening price because it was so low.

In South Lanarkshire, Panorama found that services deteriorated sharply when Domiciliary Care, the company that won the reverse e-auction, started work. The half-hour appointments for elderly people were reduced routinely so that workers could make all their calls, and one man was fed on crisps and sandwiches. Domiciliary Care has since been taken over by Choices Care Group, which said that it was appalled by what Panorama found and had apologised for the shortcomings. The Scottish Parliament has started a cross-party investigation into the use of reverse e-actions with a view to having them banned for purchasing care.

In England, the CQC warned NHS purchasers and local authorities that it would examine closely what happened to standards of care in areas where e-auctions were used. “We’ll be keeping a very close eye on standards across the health and adult social care sector. Where we see standards slipping, we won’t hesitate to act,” a spokesman said. Martin Green, chief executive of the English Community Care Association, has written to Alan Johnson, the Health Secretary, to alert him to the practice.

The London Procurement Programme, which ran the NHS reverse e-auction, defended its use of the system. Stuart Saw, chairman of the steering board, said: “We are confident the framework will deliver consistent high-quality standards in nursing home care across the capital. Quality has been embedded throughout the procurement process while making the most of taxpayers’ money.”


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