Sunday, July 26, 2009

Heart valve patients recalled after three die from deadly bug infection following operations at same British government hospital

More than 100 heart surgery patients are being recalled for urgent tests after three died from an infection. A further five patients given new heart valves at Nottingham City Hospital face having repeat operations. All were suffering from staphylococcal infection, similar to the antibiotic-resistant MRSA which has killed hundreds of hospital patients in recent years.

Nottingham University-Hospitals NHS Trust says it is sure the infection, which is common and carried on the skin, was not spread via contaminated operating theatres. One of the most likely routes of transmission was via a surgeon who transferred it to patients during surgery, possibly through poor hygiene or contaminated equipment.

The 'precautionary' recall involves all patients who have received heart valve replacements at the hospital's Trent Cardiac Centre since January. The deaths occurred between May and this month. Dr Stephen Fowlie, medical director of the trust, said no other types of heart operations or other surgery have shown any cause for concern.

Results are awaited from checks on a further 28 patients who had very similar operations, with one patient still being sought. In addition, 79 patients who had a different kind of heart valve operation at the heart centre this year are being contacted but they are considered low-risk. All patients are aged between their early 60s and 80s and the deaths happened between May and July.

Dr Stephen Fowlie, medical director at Nottingham University Hospitals NHS Trust, said 'It is with great regret that we confirm that some patients who underwent heart valve operations since January developed an infection with the same bug. 'There have been eight confirmed cases so far, three of whom have died. The other five are receiving treatment and remain stable.

More here

Common Sense May Sink ObamaCare

It turns out the president misjudged the nation’s mood


This is big, what’s happening. President Obama appears to have misstepped on a major initiative and defining issue. He has misjudged the nation’s mood, which itself is news: He rose from nothing to everything with the help of his fine-tuned antennae. Resistance to the Democratic health-care plans is in the air, showing up more now on YouTube than in the polls, but it will be in the polls soon enough. The president, in short, may be facing a real loss. This will be interesting in a number of ways and for a number of reasons, among them that we’ve never seen him publicly defeated before, because he hasn’t been. So we may be entering new territory, with new struggles shaped by new dynamics.

His news conference the other night was bad. He was filibustery and spinny and gave long and largely unfollowable answers that seemed aimed at limiting the number of questions asked and running out the clock. You don’t do that when you’re fully confident. Far more seriously, he didn’t seem to be telling the truth. We need to create a new national health-care program in order to cut down on government spending? Who would believe that? Would anybody?

The common wisdom the past week has been that whatever challenges health care faces, the president will at least get something because he has a Democratic House and Senate and they’re not going to let their guy die. He’ll get this or that, maybe not a new nationalized system but some things, and he’ll be able to declare some degree of victory.

And this makes sense. But after the news conference, I found myself wondering if he’d get anything.

I think the plan is being slowed and may well be stopped not by ideology, or even by philosophy in a strict sense, but by simple American common sense. I suspect voters, the past few weeks, have been giving themselves an internal Q-and-A that goes something like this:

Will whatever health care bill is produced by Congress increase the deficit? “Of course.” Will it mean tax increases? “Of course.” Will it mean new fees or fines? “Probably.” Can I afford it right now? “No, I’m already getting clobbered.” Will it make the marketplace freer and better? “Probably not.” Is our health care system in crisis? “Yeah, it has been for years.” Is it the most pressing crisis right now? “No, the economy is.” Will a health-care bill improve the economy? “I doubt it.”

The White House misread the national mood. The problem isn’t that they didn’t “bend the curve,” or didn’t sell it right. The problem is that the national mood has changed since the president was elected. Back then the mood was “change is for the good.” But that altered as the full implications of the financial crash seeped in. The crash gave everyone a diminished sense of their own margin for error. It gave them a diminished sense of their country’s margin for error. Americans are not in a chance-taking mood. They’re not in a spending mood, not after the unprecedented spending of the past year, from the end of the Bush era through the first six months of Obama. Here the Congressional Budget Office report that a health care bill would not save money but would instead cost more than a trillion dollars in the next decade was decisive. People say bureaucrats never do anything. The bureaucrats of CBO might have killed health care.

The final bill, with all its complexities, will probably be huge, a thousand pages or so. Americans don’t fear the devil’s in the details, they fear hell is. Do they want the same people running health care who gave us the Department of Motor Vehicles, the post office and the invasion of Iraq?

Let me throw forward three other things that I suspect lessen , or will lessen, support for full health-care reform, two of them not quantifiable.

The first has to do with the doctors throughout the country who give patients a break, who quietly underbill someone they know is in trouble, or don’t charge for their services. Also the emergency rooms that provide excellent service for the uninsured in medical crisis. People don’t talk about this much because they’re afraid if they do they’ll lose it, that some government genius will come along and make it illegal for a doctor not to charge or a hospital to fudge around, with mercy, in its billing. People are afraid of losing the parts of the system that sometimes work—the unquantifiable parts, the human parts.

Second, and this is big, some of the bills being worked on in Congress will allow for or mandate taxpayer funding of abortion. Speaking only and narrowly in political terms, this is so ignorant as to be astounding. A good portion of the support for national health care comes from a sort of European Christian Democrat spirit of community, of “We are all in this together.” This spirit potentially unites Democrats, leftists, some Republicans and GOP populists, the politically unaffiliated and those of whatever view with low incomes. But putting abortion in the mix takes the Christian out of Christian Democrat. It breaks and jangles the coalition, telling those who believe abortion is evil that they not only have to accept its legality but now have to pay for it in a brand new plan, for which they’ll be more highly taxed. This is taking a knife to your own supporters.

The third point is largely unspoken but I suspect gives some people real pause. We are living in a time in which educated people who are at the top of American life feel they have the right to make very public criticisms of . . . let’s call it the private, pleasurable but health-related choices of others. They shame smokers and the overweight. Drinking will be next. Mr. Obama’s own choice for surgeon general has come under criticism as too heavy.

Only a generation ago such criticisms would have been considered rude and unacceptable. But they are part of the ugly, chafing price of having the government in something: Suddenly it can make big and very personal demands on you. Those who live in a way that isn’t sufficiently healthy “cost us money” and “drive up premiums.” Mr. Obama himself said something like it in his press conference, when he spoke of a person who might not buy health insurance. If he gets hit by a bus, “the rest of us have to pay for it.”

Under a national health-care plan we might be hearing that a lot. You don’t exercise, you smoke, you drink, you eat too much, and “the rest of us have to pay for it.”

It is a new opportunity for new class professionals (an old phrase that should make a comeback) to shame others, which appears to be one of their hobbies. (It may even be one of their addictions. Let’s stage an intervention.) Every time I hear Kathleen Sebelius talk about “transitioning” from “treating disease” to “preventing disease,” I start thinking of how they’ll use this as an excuse to judge, shame and intrude.

So this might be an unarticulated public fear: When everyone pays for the same health-care system, the overseers will feel more and more a right to tell you how to live, which simple joys are allowed and which are not.

Americans in the most personal, daily ways feel they are less free than they used to be. And they are right, they are less free. Who wants more of that?


Obama's proposals fail to do anything about rising health costs due to medical advances

Forget the wonkery. Let’s get primeval. Rising health care costs are a stampede of big ugly rhinos. They are trampling your crops, stomping on your children’s play areas and spoiling your hunting grounds. President Obama wasn’t exaggerating when he said this cost onslaught is unsustainable. The rhinos have been roaming unchecked for a generation. We’ve thrown research projects, legislative and corporate reforms at them, all in an effort to tamp down health care inflation. But the rhinos keep coming. They are ubiquitous, powerful, protean and inexorable.

They feed on fuel sources deep in our system: expensive technological progress, the self-interest of the millions of people who make their living off the system, the public’s desire to get the best care for nothing, the fee-for-service payment system and so on. The rhinos are closing off your future. As the White House folks say, health care premiums have doubled over the last decade. The government is saddled with $36 trillion in unfunded liabilities.

So your only question should be: Where do you find a tool or weapon big enough to stop the rhino stampedes? You know the problem is big, and you figure the response had better be gigantic. Then you look on Capitol Hill and you see a bunch of popguns. The politicians describe these big ugly problems, but when it comes time to talk about their remedies they tell you: Don’t worry. Nothing’s going to change. In other words, we’re going to eliminate the biggest, hairiest, most entrenched problem in the country without fundamentally changing the system and without asking for sacrifice from anybody. Good luck.

Then you talk to the health care experts promoting the bills and they are very honest: We don’t know exactly how to slow health care inflation. But we think we have some good ideas. We’re going to put some innovations, information clearinghouses and pilot projects in this legislation, and over the next 10 years we will see what works to really bring down costs. We’re going to go on a voyage of discovery to learn about rhino eradication. And, indeed, some of the ideas do sound good: more information technology, comparative effectiveness research, conducting experiments to bundle hospital payments so they are based on outcomes. Some of the providers that do things right, like the Mayo Clinic, really are getting results.

But some of these ideas have been watered down in the legislation. And you’re not a complete idiot. You know there is a big difference between finding islands of excellence and creating a national system based on them. Besides, you’ve got a bunch of big, evil rhinos stomping around! You want more than some promising ideas to pinpoint waste, fraud and abuse. You want some big heavy hammers to clock those suckers in the head.

Now that the first wave of legislation is bogging down, you want to take the seeds of cost control and you want to do more. You want to eliminate or cap the tax exemption on employee health benefits. This is a big way to crush one of the core drivers of health care inflation. You’re willing to give MedPAC-style technocrats a chance to take control of Medicare spending away from Congressional spendthrifts.

You want to loosen federal regulations so that states have more room to experiment — not tighten them, as the current legislation does, so that states have less. You want reforms throughout the system that will cut down on first-dollar reimbursement in exchange for catastrophic protection. You want to tie Medicare subsidies to income. You want to look at anything that will move us away from a fee-for-service model, the core perversion in the system. You want to change incentives at both ends.

The legislators who drew up the first bills want to change the provider’s incentives. But big cost savings can also come if consumers have choices and incentives to hunt for cheaper coverage. The Wyden-Bennett bill gives people a chance to choose the best option, instead of imprisoning people in existing coverage, as the current legislation does. The Medicare Part D reform has produced impressive reductions by allowing consumers to pocket prescription drug savings. Other proposals would give people tax credits and allow them to go to any trusted community group — like AARP or a union or a religious group — that wanted to compete to offer coverage.

Not everything is compatible with everything else. But the point is that you have rhinos at the door! You’ll try anything that works. You want a political class that no longer perpetuates the myth that people can get everything for nothing. You know that it was political pandering that got us into this mess in the first place. Obama is right. Things will be bad if we don’t tackle the problem this year. Things will be worse if we add to the costs without beating the rhinos.


Stocks Surge as Obamacare Implodes

An interesting comment from economist Larry Kudlow

Hate to say it but Obama’s disastrous press conference last night is a big contributor to today’s roaring stock market. The Dow opened strong and is now up over 200 points, continuing a very bullish rally that is breaking new high ground for shares this year.

Politics is not everything, but I believe that the shrinking probability of a new government insurance plan that would lead to nationalized health care — along with the demise of cap-and-trade that would nationalize energy — is very bullish for stocks.

Hat tip to Bill Kristol for the phrase “docs and cops,” that latter of which were attacked by Obama last night. It looked real bad. In fact his whole garbled, inconsistent, and baffling defense of health care looked real bad. The president’s polls have been falling, especially on his policies. And markets see the possibility that free-market capitalism will live to see another day.

Of course, there are a lot of positives going on inside the economy and markets. Earnings continue to surprise on the upside and a profits bottom following a nasty two-year decline is upon us.

This morning, the weekly jobless-claims figure — a key leading indicator of future employment — did rise 30,000. But that does not erase the near 100,000 downward spike on a four-week moving average. The chart has gone from 660,000 claims to 566,000. It could well mean that businesses cut too many jobs in the first half of the year. Planned layoffs are falling, and the July jobs figure may be better than we think. The unemployment rate might actually level off.

Meanwhile, Ben Bernanke is signaling an accommodative Fed policy for as far as the eye can see. And in the money and bond markets, credit-risk spreads have now fallen back to the pre-Lehman levels of late last summer. Economist Joe LaVorgna thinks stock prices could go back to pre-Lehman levels, too, which would be about 1,250 on the S&P — nearly 30 percent higher than today’s 977 level.

I’m not predicting a return to the all-time S&P high, which was over 1,500. There are still too many government threats to free-market capitalism emanating from Democratic Washington. But the political tide is clearly turning for the better. And so are the economic stats. If the July employment report wipes out some of the negatives of the June report, this market could really roar.


Texas governor raises possibility of states' rights showdown with White House over healthcare

Gov. Rick Perry, raising the specter of a showdown with the Obama administration, suggested Thursday that he would consider invoking states’ rights protections under the 10th Amendment to resist the president’s healthcare plan, which he said would be "disastrous" for Texas. Interviewed by conservative talk show host Mark Davis of Dallas’ WBAP/820 AM, Perry said his first hope is that Congress will defeat the plan, which both Perry and Davis described as "Obama Care." But should it pass, Perry predicted that Texas and a "number" of states might resist the federal health mandate.

"I think you’ll hear states and governors standing up and saying 'no’ to this type of encroachment on the states with their healthcare," Perry said. "So my hope is that we never have to have that stand-up. But I’m certainly willing and ready for the fight if this administration continues to try to force their very expansive government philosophy down our collective throats."

Perry, the state’s longest-serving governor, has made defiance of Washington a hallmark of his state administration as well as his emerging re-election campaign against U.S. Sen. Kay Bailey Hutchison in the 2010 Republican primary. Earlier this year, Perry refused $555 million in federal unemployment stimulus money, saying it would subject Texas to long-term costs after the federal dollars ended.

Interviewed after returning from a trip to Iraq and Afghanistan, Perry spoke out against President Barack Obama’s healthcare package less than 24 hours after the president used a prime-time news conference Wednesday night to try to sell the massive legislative package to Congress and the public. "It really is a state issue, and if there was ever an argument for the 10th Amendment and for letting the states find a solution to their problems, this may be at the top of the class," Perry said. "A government-run healthcare system is financially unstable. It’s not the solution."

Perry heartily backed an unsuccessful resolution in this year’s legislative session that would have affirmed the belief that Texas has sovereignty under the 10th Amendment over all powers not otherwise granted to the federal government. In expressing "unwavering support" for the 10th Amendment resolution by state Rep. Brandon Creighton, R-Conroe, Perry said "federal government has become oppressive in its size, its intrusion into the lives of our citizens and its interference with the affairs of our state." Returning to the "letter and spirit" of the 10th Amendment, he said in April, "will free our state from undue regulations and ultimately strengthen our union."

Perry, in his on-air interview Thursday with Davis, did not specify how he might use the 10th Amendment in opposing the Obama health plan. His spokeswoman, Allison Castle, said that the governor’s first goal is to defeat the plan in Congress and that any discussion of options beyond that would be "hypothetical."

"I don’t think it’s surprising that the governor is taking a stand against it," said Anne Dunkelberg, associate director of the Center for Public Policy Priorities, an Austin-based research organization that supports the House version of Obama’s plan. "Unfortunately, the national dialogue on health reform has been extraordinarily partisan and polarized."

The White House Media Affairs Office, asked to comment on Perry’s statements, did not have an immediate response. In his remarks to the nation Wednesday, Obama restated his midsummer deadline for passage of the bill in Congress, saying it is urgently needed to help families "that are being clobbered by healthcare costs."

Texas has a higher percentage of uninsured people than any other state, with 1 in 4 Texans lacking health coverage. Dunkelberg, whose organization supports policies to help low- and modest-income Texans, said the House version would create a "predictable and comprehensive benefits package" for thousands of struggling middle-income Texans.

Former Rep. Arlene Wohlgemuth of Burleson, a senior fellow for healthcare at the conservative Texas Public Policy Foundation, echoed Perry’s assertion that the Obama plan is the wrong approach and could have disastrous financial consequences for Texas. Under the Senate version of the bill, she said, an expansion of the joint federal-state Medicaid program for the poor could cost Texas $4 billion a year. "There are good solutions" to the country’s healthcare problems, Wohlgemuth said. "This isn’t it."

Perry said the plan is another example of the Obama administration’s "massive takeover of the private-sector economy." "I hope our leaders will look for solutions that don’t dig our country further into debt," he said. Perry called on Texans in the House and Senate to oppose the plan. "I can’t imagine that anyone from Texas who cares about this state would vote for Obama Care. I don’t care whether you’re Democrat or Republican," he said.

Of those Texans who might consider supporting the plan, he said: "This may sound a little bit harsh, but they might ought to consider representing some other state because they’re sure not representing Texas."


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