Thursday, July 09, 2009

British tumour patient was treated in corridor

As Barbara McVernon was wheeled to the operation for brain surgery, she broke into song: "Wish me luck, as you wave me goodbye..." It was a typical gesture from an exuberant, sociable woman, who at the age of 76 was showing no signs of slowing down. If the keen artist and charity fund-raiser from Wokingham was fearful about the surgery to remove a tumour from her eye socket and temple, she was determined not to show it, recalls her daughter Lynne.

After the surgery, at the John Radcliffe Hospital, Oxford, in April 2006, Mrs McVernon remained in good spirits, laughing and joking with family and friends. However, further tests revealed that the growth – as well as pains in Mrs McVernon's hips, which her local hospital, the Royal Berkshire in Reading, had mistaken for arthritis – was in fact caused by multiple myeloma, cancer of the bone marrow. Nonetheless her specialist was optimistic: if the will was there, the pensioner could survive five years.

Soon after Mrs McVernon was transferred back to the Royal Berkshire, one of her hips broke. She was sent to a specialist NHS hospital, The Nuffield Orthopaedic Centre, in Oxford, for surgery the following month. It went well. Yet in the days following the operation, the outgoing, lively woman became increasingly confused and depressed.

Amid repeated concerns raised by her family, staff insisted her behaviour was normal – until 11 days after the operation, when a doctor diagnosed diabetes. An investigation found staff had made a "critical error" when the elderly woman was admitted to the hospital, by keeping her on a high dose of steroids which should have lasted for just four days. The findings, which included an admission that the mistake could have caused the onset of diabetes, reached Lynne on the day her mother died.

In her last few weeks, the increasingly weak pensioner had been transferred back to the Royal Berkshire Hospital, soon after her family found out that she was suffering from MRSA, which she had already been carrying before treatment at the Nuffield.

Hours after the transfer, her daughter found her being treated in a corridor, before a bed could be found. As the quality of her life deteriorated, and amid chaotic care, Mrs McVernon lost the will to continue, says her daughter. "She was having hourly blood tests because of the diabetes, her hands were caked with blood, she had bed sores, she was upset, confused and disorientated because her blood sugar levels were see-sawing. "It was hard to believe Mum was the same woman who had been singing on her way to surgery."

On June 22, Mrs McVernon died of pneumonia, multiple myeloma and MRSA.

A spokesman for Nuffield Orthopaedic Centre Trust said patient safety was its top priority, and that it regretted that the McVernons' experiences did not fulfil its usual standards. It said the trust had been open about the findings of its investigation, and learned lessons from the case. The Royal Berkshire trust said it was "deeply disappointed" that the family had not raised any concerns since Mrs McVernon's death, so that any failings could be investigated.


NHS units exposed over unacceptable conditions

This is a total whitewash. What they say about the food tells you that. British hospitals are notorious for inedible food

At least a dozen NHS units in England are treating patients in poor or unacceptable conditions, an official report says today. A national survey of 1,265 medical sites found that the vast majority of facilities scored either “excellent” (24 per cent) or “good” (60 per cent) for standards of cleanliness, decoration, linen, furniture and general state of repair. But of the rest, more than one in six sites (15 per cent) had only “acceptable” working conditions, while nine sites were rated “poor” by the local Patient Environment Action Team (PEAT) assessments.

Three sites — all rehabilitation units for mental health patients — were rated “unacceptable” for their environment: Windmill House in Bushey, West Hertfordshire; Norfolk Lodge, in Colliers Wood, South London; and Lodge Causeway, in Bristol.

The National Patient Safety Agency, which publishes the scores, said that poorly-performing sites would be followed up by the regional health authorities or the Care Quality Commission, the NHS regulator, to make sure standards were improved.

The PEAT programme was established in 2000 to assess all NHS hospitals with more than ten beds every year on a range of standards including food and whether patients were treated with dignity and privacy. The assessment teams consist of NHS staff, including nurses, matrons, doctors, catering and domestic service managers, executive and non-executive directors, dietitians and estates directors. Most also include patients and members of the public.

A total of 94 per cent of sites scored ‘excellent’ or ‘good’ ratings for levels of privacy and dignity, which examined the quality of their sleeping accommodation as well as toilet and bathroom facilities.

But Thorneywood Unit, a child mental health clinic run by Nottinghamshire Healthcare NHS Trust, and Norfolk Lodge, part of South West London and St George’s Mental Health NHS Trust were rated unacceptable.

On food, 95 per cent of sites achieved an "excellent" or "good" ratings for quality, choice and availability of their menus [By British hospital standards, maybe]. Just one unit, Ogden House in Ramsgate, a mental health inpatient unit, was rated unacceptable for its food.

Ann Keen, the Health Minister, said that the increase in trusts achieving good results was “great news for NHS staff and patients”. “Cleanliness is a top patient priority and these results show that the measures we have in place are working. We are also delighted to see such high scores in the area of privacy and dignity.” Ms Keen said that she expected to see further improvements in next year’s results after a drive to eliminate mixed-sex accommodation in the NHS.


More poison, not an antidote: Mandating employer health insurance

President Obama is either misinformed or lying about health care. He said the “free market has not worked perfectly.” There’s a market, but it’s not free. It’s infested with harmful political meddling. One example is government’s favoring employer-provided insurance, a poison to affordable medical care and insurance.

But unions and Congressional Democrats want to intensify the dose with a “pay or play” employer mandate. This would penalize employers for not buying medical insurance for their employees. This is not “reform;” it just entrenches flawed policies. It would violate rights, lower wages, and threaten jobs of minority single moms

Government’s favoring employer-sponsored insurance is the problem, not the solution. When your employer buys your insurance, it’s a non-taxable corporate expense. Employers save by “paying” you with insurance instead of higher wages.

This tax policy coddles insurance companies. They need only please your employer, not you. Most employers offer just one or two plans. Want more choices? If you prefer one of the many plans available at, you face a stiff tax penalty. Or try changing jobs. Insurers know you’re essentially stuck with your employer’s plan, so why should they please you?

Tax-discounted insurance has turned insurance into prepaid health care. If car insurance worked this way, it would cover predictable expenses like oil changes and replacement tires. You wouldn’t price compare or consider whether services were really necessary. Rather, you’d ask if “it’s covered.” Costs would soar. This has happened with medical care.

The tax bias for employer-sponsored insurance punishes those who incur medical conditions and then lose their job. A pre-existing condition can make them uninsurable.

This can create “job lock,” which stifles entrepreneurship. As Business Week describes: “fear of losing coverage keeps people at jobs … so many workers will keep hanging on to jobs they hate. … One single mom in New York, for example, is sticking with her graphic design job solely to retain the health coverage for herself and her son. … Her wish? To start a business doing bath and body products. ‘I feel stuck,’ she says.”

An employer mandate would further stifle entrepreneurs and destroy jobs. It would require a growing business to provide insurance when hiring its 10th or 20th employee. Since the additional employee would impose a huge cost, it might not hire anyone.

In response to an employer mandate, employers would shift this cost to employees by lowering wages. It’s worse for those with near-minimum wage jobs. These workers are “at substantial risk of unemployment if their employers were required to offer insurance,” write economists Katherine Baicker and Helen Levy. Employees “most harmed by mandated employer-paid healthcare are…more likely to be a minority, a single parent, and unmarried.” The employer mandate surely wouldn’t threaten union jobs, as unions support it.

An employer mandate would also violate our rights. Employers create jobs, and hence have the right to hire on terms mutually acceptable to both employer and employee. Politicians should not interfere with this private matter between consenting adults.

Tax-favored employer-sponsored insurance has created enough problems. Mandating it makes them worse. Politicians should not dictate whether you buy insurance directly from an insurer, through a membership group (like AAA), or through your employer. Legislators should both eliminate the tax exemption and decrease tax rates commensurately.

Second-best would be to make all medical insurance and expenses tax-exempt. This would remove tax bias toward excessive insurance coverage. Health Savings Accounts are a step in this direction, but they should be eligible to everyone, regardless of their insurance plan. Such “Large HSAs” would allow consumers to buy medical care and insurance with tax-free earnings.

Removing the tax code’s bias for employer-sponsored insurance can alleviate problems with job lock and pre-existing conditions. While some employers would offer insurance to attract employees, more people would buy policies directly from insurers when still healthy. Customers could choose — as many already do — a guaranteed-renewable policy, so the insurer cannot terminate coverage or raise premiums because you get sick.

The rigorous competition of a free insurance market could yield innovative products that protect against pre-existing conditions. For example, “health-status insurance” would pay for increases in your insurance premiums should your health status change, and you’d retain the freedom to buy a policy from insurers competing for your business. To learn more, look up “‘Health Status Insurance’ Provides Real Alternative to Universal Care.”

Mandating employer-sponsored insurance is wrong. It’s not a cure, but more of the disease: government’s bias for employer-provided insurance. This just benefits unions and politicians at our expense.


Obama’s job-killing health care tax

On June 15th, the Congressional Budget Office issued a crushing blow to President Barack Obama’s health care plan, placing a $1 trillion price tag on the Senate Health, Education, Labor and Pensions (HELP) committee’s draft legislation. And what did Americans get for their $1 trillion in new debt? A measly16 million net decrease in the number of people uninsured. Liberals in Washington decried the CBO’s findings, complaining that they had scored an incomplete version of the bill.

So this past Friday the CBO released a fuller scoring of HELP’s legislation, and indeed, the overall impact on our nation’s debt is lower: a mere $597 billion would be added to federal budget deficits over the 2010-2019 period.

How did HELP lower the bill’s budget busting total? Did they “bend the curve” on health care costs? Did they weed out administrative costs? Eliminate waste? Nope. The Washington Post reports:
Committee staffers reworked the bill — and added a new provision requiring most employers to contribute to the cost of health insurance — to arrive at the lower estimate. Under the new proposal, any business with more than 25 workers would be required to offer coverage or pay a $750 penalty per employee.

In other words, the HELP committee wants to pay for their health care plan in classic “tax-and-spend” liberal fashion: by instituting a crippling new tax on our nation’s businesses. And not just any new tax. A tax directed like a heat seeking missile at job creation: an employer mandate. But don’t take our word for it. President Obama’s White House National Economic Council Director Larry Summers wrote in 1989:
Mandated benefits are like public programs financed by benefit taxes… There is no sense in which benefits become ‘free’ just because the government mandates that employers offer them to workers. … [Minimum] wages cannot fall to offset employers’ cost of providing a mandated benefit, so it is likely to create unemployment.

And the HELP committee bill is still incomplete. Even its most current incarnation still would cover just 39% of uninsured Americans. So the Obama administration is also pushing for a further expansion of Medicaid. Add those costs into the mix and the final price tag shoots back up to $1.3 trillion. Wonder who the administration plans to tax to make up for that final trillion?

Defending his administration’s economic performance on ABC’s This Week, Vice President Joe Biden told George Stephanopolos: “There was a misreading of just how bad an economy we inherited.” The Obama administration can not blame President Bush forever. They can’t run around threatening to enact a $400 billion tax on employment and then blame others for double-digit unemployment rates. There is an alternative to government run budget busting health care. Some of which the Obama Administration even supports like removing the tax benefit of employer-sponsored health care coverage which will untie Americans health care coverage from their employers and help move the country towards a truly market based consumer driven health care model. Health care coverage can be expanded in a cost-efficient manner, but only by empowering Americans to make health care decisions with their doctors.


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