Friday, July 24, 2009

£100m blood filter treatment that stops CJD is ‘too expensive for NHS patients’

Just firing a few of their army of clerks and administrators would enable them to afford it easily

A medical breakthrough that prevents the spread of the human form of mad cow disease via blood transfusions may be denied to NHS patients because it costs too much. More than 60 adults having surgery have received blood free of the risk of variant CJD in trials overseen by the National Blood and Transplant Authority. The advance centres on a filter that can remove the rogue vCJD protein, called a prion, from blood in just 30 minutes - eliminating the patient’s risk of catching the brain disease.

The filter could restore faith in British blood supplies which are proven to be tainted with vCJD after several deaths related to transfusions. But documents reveal it has been branded ‘not cost-effective’ and experts warn it will double the price of producing red blood cells, leaving a bill for an extra £100million.

Donors who do not realise they are carrying the disease, which can have an incubation period of up to 50 years before showing symptoms, risk passing on vCJD when they give blood. It is feared as many as one in 4,000 could be carriers. There is no reliable way of testing stored blood to see if it is infected.

The filter simply clips on to the blood collection bag and red cells are slowly dripped through it into an empty bag underneath. Any prions are captured in a mesh containing resins that are designed to ‘attract’ amino acids found on the surface of vCJD proteins. Animal studies have proved it prevents transmission of the deadly disease through blood transfusions.

But minutes of the advisory committee on the Safety of Blood Tissues and Organs (SaBTO) record: ‘Implementation of prion filtration is not cost-effective under the majority of scenarios modelled for risk.’

One proposal is for filtered blood to be initially given only to under 16s, on grounds of cost, as they are least likely to have been exposed to ‘mad cow’ disease through eating BSE-infected meat.

Estimates from the National Blood and Transplant Authority say the cost to the NHS of producing one unit of blood - about a pint - would double, from £50 to around £100 using the filter, meaning it could cost about £100million to introduce.

However, while declining to give exact figures, manufacturer MacoPharma says its P-Capt filter - which is classed as a medical device and was awarded the European CE quality mark in 2006 - would probably cost the health service half this amount.

Judy Kenny, wife of Deryck Kenny, 69, who died in 2003 after contracting vCJD through a blood transfusion, said: ‘As a nurse, I know there has to be good evidence it is safe and it works. ‘As the wife of someone who died after contracting vCJD through blood, I think cost should not be a reason to stop it being introduced.’

A spokesman for the Health Department said: ‘Cost benefit analysis is carried out on all new measures to assist SaBTO in its decision and is one of several factors it will consider. ‘This does not mean prion filtration will be turned down purely on the basis of cost.’


West Australian public hospital patient waited 'more than 45 hours' for a bed

A WA emergency patient recently waited more than 45 hours for a hospital bed, according to a national report. The report, a snapshot compiled for the Australian College of Emergency Medicine, found WA still had the worst emergency department overcrowding in Australia. The snapshot of 79 emergency departments Australia-wide was undertaken at 10am on Monday, June 1. Eight WA hospitals took part in the snapshot.

WA emergency departments recorded the worst overcrowding in the country. About 35 per cent of patients in WA emergency departments waited longer than eight hours for treatment, with one patient waiting longer than 45 hours. There were nine WA patients who had been waiting longer than 24 hours for a hospital bed.

Queensland had the best record with only 15 per cent of emergency patients waiting longer than eight hours for a hospital bed. Forty-four patients in 22 hospitals included the report had a patient that had waited more than 24 hours for a hospital.

“Half of Australia’s training hospitals have patients waiting for an inpatient bed more than 12 hours after that bed was formally requested,” ACEM president Sally McCarthy said. “Even though politicians and health departments have been shown the facts and even though patients are still dying while waiting for beds, there has been no significant improvement in access block since this time last year.”

All 94 emergency departments accredited for training were contacted, and 79 responded with details of their activity. Associate Professor Drew Richardson, author of the study, said there was no statistically significant improvement in access block compared to last year. “Of the 66 EDs which answered both the 2008 and 2009 surveys, 33 reported an improvement and 33 a worsening of access block: whilst there may be pockets of better practice, the net effect nationwide has been nil.”

WA Health Minister Kim Hames said the emergency department figures were concerning. Dr Hames said the Health Department had started overhauling emergency departments in preparation for the introduction of the four hour rule. Under the rule, 98 per cent of emergency patients must be admitted or discharged within four hours. The state's major tertiary hospitals, like Royal Perth Hospital and Sir Charles Gairdner Hospital, have 18 months to meet the demand. WA is the only state in Australia introducing the scheme.


ObamaCare in Trouble


Polls are turning against President Barack Obama’s health-care plan. The political calendar is, too. On Monday, the Washington Post/ABC poll reported that 49% of Americans approve of his handling of health care while 44% disapprove. What many people missed is that those who strongly disapprove of the president’s approach on health care now outnumber those who strongly approve by 33% to 25%. That presages further decline. Already, 49% of independents disapprove of the president’s approach, up from 30% in April, a staggering shift in 11 weeks.

Mr. Obama is also slipping on the economy. Those who strongly disapprove now outnumber those who strongly approve of his handling of the economy (35% to 29%), of deficits (38% to 19%), and of unemployment (31% to 26%). On Tuesday, Gallup showed Mr. Obama’s personal approval was 55%, down from more than 60% a few weeks ago and lower than the 56% George W. Bush had at this point in his first term.

The polls are crumbling because of a flood of bad news about Mr. Obama’s health-care proposals. One batch of such news came from a July 17 study by the Lewin Group that was commissioned by the Heritage Foundation. It projects that if the House bill becomes law, 83.4 million people—nearly half of those with private coverage—will lose private insurance as employers drop their plans. Mr. Obama’s promise that you can keep your plan is being left on the cutting room floor with nary a peep from the president.

Another batch of bad news came this week as Democratic governors from Colorado, Tennessee, New Mexico and Washington joined GOP colleagues at the National Governors Association summer meeting to blast the administration for plans to shift millions of families into Medicaid. That could stick states with $440 billion in new costs over the next decade.

But the most damaging news came from Congressional Budget Office (CBO) Director Douglas Elmendorf, who said last week that the White House’s health-care proposals would not “reduce the trajectory of federal health spending by a significant amount.” This shattered the central claim Mr. Obama has been making: that his health-care plan controls costs. In a July 17 letter, Mr. Elmendorf added that the House’s health-care bill would result in a “net increase in the federal budget deficit of $239 billion” over 10 years. That’s likely a low-ball estimate because it assumes that Congress will increase taxes by $583 billion over the next decade.

Ways and Means Committee Chairman Charlie Rangel says he’ll pay for the Obama health proposal by raising taxes on Americans making $280,000 a year ($350,000 for couples). Most of those stuck with higher taxes will be small business owners. Even Democrats don’t like that approach: 21 of 39 freshmen House Democrats penned a letter opposing the tax hike. Many are among the 66 Democrats from districts that either Mr. Bush or John McCain carried in recent presidential elections. Mr. Obama shrugged off the letter by saying that the surtax would only force some to pay “a little bit more.”

The Democratic National Committee is now running ads pressuring Democrats to vote for the president’s health-care plans, including new ads in the districts of House Ways and Means Committee Democrats who have raised questions about the health-care bill. It is hard to think of a more obvious sign of weakness than attacking members of your own party.

Team Obama was rushing to pass health care before the August recess out of fear that allowing members to go home for an extended spell before voting on the bill would give them an opportunity to hear from their constituents. They fear that the 300 protestors who showed up at a town hall meeting in Panama City, Fla. held June 30 by Democrat Rep. Allen Boyd shortly after he voted for the cap and trade energy tax) are only the start of a larger backlash.

Democratic leaders, including the president, are now backing away from a vote on health care before August. But that’s not likely to decrease voter angst. Americans for Prosperity and others are already organizing voters to attend public meetings with members of Congress this summer. My guess is that members of Congress are about to hear a lot from their voters on the government takeover of health care, new energy taxes, the failed stimulus, record deficits, and growing joblessness.


What if I don’t want health insurance?

I'm one of the nearly 50 million Americans who don't have health insurance. I don't want it, either. But the bill the House of Representatives is debating would force me to buy it. How good can any product be if Congress compels me to purchase it?

Politicians and interest groups have been trying virtually all my life to foist medical insurance on me. But their proposals rest on mistaken and even insulting assumptions.

First, they presume that everyone wants, needs, and should have abundant medical attention. But I come from a long-lived and healthy family, I've been a vegetarian since childhood because I've never liked the way meat tastes, I don't smoke, and I love to hike – the more miles the better.

I am disgustingly healthy, so much so that the only doctors I see – or try to: I'm near-sighted – are ophthalmologists. Could I be hit by a bus tomorrow when I head out for my daily walk? Possibly. But that's such an unlikely disaster that I've chosen to spend my money on more personally pressing needs than medical insurance.

On the other hand, unlikely disasters do happen. So I might purchase catastrophic coverage if it were reasonably priced – just as I might visit doctors for lesser complaints if their care were reasonably priced.

But the government's meddling is what helped mess-up the medical market to begin with. The federal government perverts costs with its Medicare and Medicaid programs: Recipients of this largess have no incentive to save money since someone else pays their bills.

In fact, the incentives run the opposite way as patients demand more procedures and tests while magnifying problems I resolve out of my medicine cabinet into emergency-room runs. Doctors who get away with charging Medicare hundreds for diagnosing Grandpa's indigestion would charge me the same.

Meanwhile, state governments shackle the insurance industry, mandating that policies cover everything from chiropractic care to hormone replacement. These launch premiums into the stratosphere. I'd much rather pick and choose the coverage I want at a price I'm willing to pay than buy the plan bureaucrats and special interests decree.

But the universal-healthcare crowd thinks it knows better than I do how to spend my money. Why can't they leave me alone? I'm not forcing them to eat flaxseed and bike to meetings instead of hopping into their limousines. It's time for them to return the favor.

Besides, if that bus does hit me tomorrow, I want – and will pay for – top-notch care. And that's not what government-run medical systems dispense. Delays, expedient rather than proper treatment, and double standards of care depending on who you are and whom you know characterize universal-healthcare systems.

Which makes sense. We live in a world of finite resources and infinite desires, where medical care must be "rationed" like all other products and services.

Though we can't choose whether goods are rationed, we can choose how they are. Either the politicians and bureaucrats who bring us long lines at DMVs, failing public schools, and the endless war in Iraq will decide who gets what kind of treatment, or the free market will.

Fans of universal healthcare deride the market: They say it's cold and cruel because we each have to pay for the care we demand. But government healthcare can be far colder and crueler. Its care is inferior: Contrast an inferior, run-down veteran's hospital with a general one. And it's expensive. Dr. Jeffrey Anderson recently wrote in Investor's Business Daily, "Since 1970 – even without the prescription drug benefit – Medicare's costs have risen 34 percent more, per patient, than the combined costs of all health care in America apart from Medicare and Medicaid…."

Absent such meddling, the price of medical care would return to reasonable levels. It benefits no provider of any service to charge such astronomical fees that customers can't afford to patronize him. Then, too, in a market free of the state's stranglehold, doctors and hospitals would compete with one another to lower prices and attract the ill or injured.

That doesn't mean everyone could finally buy all the procedures they wanted or even needed – but that's where private charity would come in. Humanitarians who send inner-city kids to summer camp and volunteer their time or money at soup kitchens would strive to ensure that needy Americans received medical care.

President Obama says, "We have no choice but to fix the healthcare system because right now it's broken for too many Americans." But the only fix we need is for government to get out of medicine.


Fascist healthcare coming

Much of the so-called “debate” over ObamaCare is a diversion. In addition to the technocratic jargon and minute market manipulations being talked about, the Obama Administration is softening up the American public by propagandizing them on the horrors of the current healthcare system. The president has created an entire website that overwhelms people with ObamaTales of Healthcare Terror.

The ObamaTales cast employers, insurance companies, pharmaceutical companies and hospitals as the ogres in the drama. It is essential, therefore, that once people get over the powerful emotional reaction they will have from viewing the sad stories depicted in the videos, they need to consider that the insurance companies, pharmaceutical companies and hospitals portrayed as the bad guys in the ObamaTales are the very entities Obama is presently cutting a deal with behind the scenes to provide the backbone and infrastructure of his government-run system.

“The president refuses to reveal his true preferences for healthcare reform. Will it have a government option to “compete” with private plans; will it have an individual or employer mandate; will it have a rationing board disguised as a board of standards and effectiveness; will it have strict criteria and mandates on private health insurance? No matter what form ObamaCare ultimately assumes after the Congress is finished with its sausage making, it is a certainty that nationalized healthcare in America will have a private-sector facade on it—true to the fascist model Republicans gave us in the Medicare-Part-D prescription-drugs program for seniors—using employers, private insurance companies, private hospitals and pharmaceutical companies essentially as government contractors.

So, just as with the banks in the financial bailout and just like the automotive bailout, nationalized healthcare will end up being more fascist than socialist, a huge “public-private partnership” where the government calls the shots, the private contractors get the goodies, and American citizens pay the tab in higher taxes, more public debt and rationed healthcare. If you think the private companies and employers portrayed in the Obama’s Terror Tales are behaving badly now, just wait until they have the sanction of the federal government behind their delays, denials and rationing of care.

Evidence of the way this saga will end abound. Earlier this week, White House Chief of Staff Rahm Emanuel admitted the prime objective of healthcare reform is to get control of insurance companies. He said, "The goal is to have a means and a mechanism to keep the private insurers honest. The goal is non-negotiable; the path is" negotiable.”

Emanuel specifically mentioned a White House willingness to move away from the “public option” favored by most liberals and adopting instead a version of the fascist Republican model used in Medicare Part D. Obama’s chief of staff said that one of several ways to meet President Barack Obama's goals is to adopt a mechanism under which a public plan is put into effect only if the marketplace fails to provide sufficient competition on its own. This is precisely the trigger mechanism Republicans used when they created a prescription-drug benefit for Medicare in 2003.

Any part of such a deal between the federal government and big insurance companies, of course, would have to entail a guarantee that the insurance companies be sheltered from paying the costs of the plan by shifting them onto healthcare consumers.

And guess who will pay? SENIORS FIRST. That is why it was no coincidence that the $155 billion “cost-saving” deal Obama struck with hospitals entails a decade’s worth of reductions to Medicare and charity-care payments for hospitals.

So there you have it: A stealth government takeover of big insurance companies, pharmaceutical companies, hospitals and even private employers along with more cuts to Medicare. When the government and private industry go into partnership, it is invariably the people who get kneecapped. The fascist healthcare system being teed up in Washington will be no exception.


No comments: