Thursday, August 06, 2009

Australia: Slap on the wrist for butcher surgeon

Why not prosecute the b*stard? Aren't you relieved at how well regulators protect you? I guess that they think they have to tolerate any trash in public hospitals. When healthcare is "free", you are scratching to find enough doctors to meet the demand for treatment so any doctor will have to do

A EUROPEAN-trained surgeon has been banned from practising in Queensland for three years after a string of botched procedures - including the mistaken removal of a woman's ovary. Brisbane's Health Practitioners Tribunal suspended Ivan Lubenov Popov over adverse health outcomes experienced by six female patients between June 2006 and April 2007.

The tribunal, headed by District Court judge Julie Dick, found Dr Popov had demonstrated unsatisfactory professional conduct in five out of six complaints against him. The Queensland Medical Board did not request Dr Popov, an obstetrician and gynaecologist, be disciplined over a sixth complaint due to lack of sufficient evidence.

Dr Popov, who moved to South Africa shortly after an investigation was launched into his professional conduct, committed the breaches at the Caboolture Hospital, on Brisbane's northern outskirts.

The tribunal was told in May that Dr Popov removed the healthy ovary from a woman on April 24, 2007. Dr Popov "incorrectly and/or inappropriately advised the patient that her right ovary was covered in cysts, diseased and required removal," the tribunal was told. "This was not true. "It was alleged that this amounted to Dr Popov knowingly and actively providing misleading and/or incorrect information to the patient and Dr Popov knowingly and actively falsified medical records." Dr Popov even failed to inform the patient about the mistake, despite the direction of a superior supervising specialist.

The tribunal was told that Dr Popov also lied to other patients and misled staff about his procedures to try to cover up botched and potentially illegal procedures.

Four other female patients suffered complications following "inappropriate surgery", which the Medical Board of Queensland claimed should not have been performed at a provincial hospital given the women's medical history and potential for the operations to be complicated.

In another case, Dr Popov carried out a medical procedure on a pregnant woman that he knew would result in a termination of her pregnancy.

The tribunal ruled Dr Popov's registration be cancelled for three years, that he undertake further professional training and a course on professional responsibilities and ethics, at his expense, before being allowed to reregister in Queensland. "The findings of the tribunal in respect of charges individually and cumulatively amount to unsatisfactory professional conduct," the tribunal said.

In his defence, in a written affidavit, Dr Popov accepted he had made mistakes and, in particular in the case of the removal of a healthy ovary, had panicked and falsified notes.


Democrats’ Proposal to Tax ‘Cadillac’ Health Coverage Will Hit Lower and Middle Classes Hardest

As the Senate Finance Committee takes its health care overhaul negotiations into the August recess, President Obama and key Senate negotiators are still struggling to find a way to afford the flagging health care overhaul proposal’s trillion dollar price tag. Their latest proposal, a new tax on so-called “gold-plated, Cadillac” health insurance policies, is receiving broad support from legislators and administration officials who see it as yet another opportunity to pay for an expansion of government by soaking the “rich” – a perception that is, thanks in large part to existing government policies, incredibly wrong.

The term “Cadillac” has been used for years to refer to health insurance policies that cover an inordinate number of unnecessary treatments and procedures. Sen. Charles Grassley (R-IA), ranking minority member of the Senate Finance Committee and the Republican most closely working with the Democratic majority to pass President Obama’s health overhaul, said negotiators are “taking an intense look at” the proposal as a way of raising revenues to offset the $1 trillion the Finance overhaul bill is expected to cost.

Senator Olympia Snowe (R-ME), also a Finance Committee member, called the idea a “practical option” for “creating disincentives for the most expensive [health insurance] policies,” and Sen. John Kerry (D-MA) said his proposal to tie the maximum permitted coverage to the average level of benefits provided federal employees, and to tax the health insurance of those whose policies cost or cover more, is “gaining support” in the Senate.

This is being shopped to the public as just another tax on the super-wealthy, with Obama administration officials pointing to the “$40,000-a-year health insurance policies” carried by a handful of top Wall Street executives as examples of such unnecessarily luxurious coverage. However, a tax on “Cadillac” health insurance policies would end up disproportionately affecting middle- and lower-income Americans across the board, as well as the entire insured populations of several states.

The reason for this is the profusion of mandatory minimum coverages state governments require to be included in health insurance policies sold within their states’ borders. This results in residents being forced into uniformly high-priced, coverage-heavy “Cadillac” insurance policies as a result of state law, not their own choice.

Rhode Island leads the nation with 70 treatments and procedures that every policy sold there must cover, including asthma education and in vitro fertilization – one of the most expensive medical procedures health insurance can cover. While there is no doubt these coverages are both useful to and desired by some consumers, all insured residents of the Ocean State are forced to pay for asthma ed and IVF insurance, even if they aren’t potential consumers of either. Rhode Islanders’ premiums are is also higher than they otherwise would be because every policy sold there is required by law to cover the cost of smoking cessation, hair prosthesis, and acupuncture – along with 65 other treatments, procedures, and conditions.

States with fewer mandates than Rhode Island are hardly more consumer-friendly. Minnesota, for example, has coverage for birthmark removal, chiropractics, visits to a registered dietician, and visits from a social worker among its 68 mandates. Arkansas’ 43 mandates include requiring insurance to cover the costs of hiring a personal trainer and a drug abuse counselor; New Mexico’s 57 include circumcision, contraceptives, and “Oriental medicine” – a category that includes such “nontraditional” remedies to medical conditions as acupuncture, holistic medicine, and visits to the neighborhood herbalist.

In these and other states whose governments have responded to the influential clamor of special interest groups by packing health insurance plans to the gills with mandated coverages, consumers are left without a lower-cost, lower-coverage insurance option – meaning every citizen who chooses to carry health insurance is forced into a “Cadillac” coverage plan.

This is reinforced by the fact that all fifty states have laws in place prohibiting residents who may want less “gold-plated” coverage at less cost from purchasing insurance in another state. Allowing more personalized insurance policies to be sold within their borders, or transported across state lines, would be a major step toward decreasing both the cost of insurance and the number of individuals who lack coverage, millions of whom are currently uninsured by choice.

The prohibition against the interstate purchase of health insurance, which Rep. John Shadegg (R-AZ) has sought every Congress this decade to have repealed, allows governments to artificially raise the price of their citizens’ coverage by packing policies with all sorts of unwanted mandates without having to worry about competition – and it leaves every resident of affected states open to a federal tax on their involuntarily “Cadillac”-level insurance coverage.

Further, with a blanket requirement that all Americans carry health insurance looming, demand for the increasingly expensive product is poised to become even less elastic than it is now – meaning that states will be free to load policies up with even more mandates, causing the price of coverage to spike and forcing millions of Americans to enroll in a subsidized, government-run “public option” by virtue of having been priced out of the individual private market.

Onerous coverage mandates increase the cost of health insurance and force middle- and lower-income Americans to make an all-or-nothing decision between purchasing outrageously expensive policies that provide coverages they will never need and dropping their health insurance altogether. Imposing a tax increase on these Americans would not only violate one of President Obama’s most oft-repeated campaign promises (not to raise taxes on any American making less than $250,000 a year), but it would add insult to insult by penalizing those who already pay exorbitant insurance premiums for the actions of their state governments.



THE health-reform debate on Capitol Hill is skipping over the key issue: "Universal insurance" means less care for people who have coverage now -- especially the elderly. And the "compromises" now under way only make the problem worse.

Here's a point that's no surprise except to the "reformers": People with insurance use more health care.

President Obama seeks to cover 50 million new people. Where are the extra doctors, nurses and so on going to come from? Neither the administration nor anyone on the Hill has proposed anything to add to the supply of medical services even as they plan vastly to increase the demand.

The politicians are playing a Washington game -- compromising on false or tangential issues while failing to address the central one. It doesn't matter if you reduce or eliminate the mandate for employers to provide coverage, if you're still insuring more people without adding medical personnel and other resources. Same story for whether you replace the "public option" government-run plan with government-run "co-ops."

More, all the bills come up with cash to cover their huge costs by ordering cuts in Medicare -- cuts that Congress could reverse only by affirmative majority votes. Basically, the government will be paying doctors and providers even less to treat the elderly -- at a time when countless doctors are starting to refuse new Medicare patients.

More demand; no added supply; Medicare cuts: It all adds up to rationing -- lower-quality medical care for most Americans, especially for the elderly. A doctor in Massachusetts -- where an Obama-style plan is already in place -- recently told us that she now has to read 60 mammograms a day in the time she once spent on 45. "It keeps me up at night," she told us, "that I might make a mistake, I am so rushed."

For the elderly, it means less care, period. A federal health board will sit in judgment of medical procedures and protocols and impose guidelines on all providers for when to withhold certain kinds of care.

For example, the drug Avastin is widely used in America to treat advanced colon cancer. But it costs $50,000 a year -- so Canada's national-health system doesn't permit its use. As a result, 41 percent of colon-cancer patients in Canada die each year, as opposed to 32 percent in the United States. (Canada's average eight-month wait for colonoscopies, another result of national-health rationing, also contributes to the problem.)

Members of Congress will be home through August to test public opinion. It's up to us to give them an earful.


Network news fails to examine high cost and proven failures of government-run health care

Executive Summary of a study from the Business & Media Institute

President Barack Obama wants a health care reform plan by August and the news media are doing their part to make it happen. ABC, CBS and NBC have boosted the administration’s case with sad stories about children without medical care and cancer patients whose insurance was cancelled. At the same time, those networks are nearly ignoring trillion-dollar cost estimates for a universal health care package, and have been virtually silent on the failures of Medicare the government insurance program that “reform” would be modeled on.

Some network journalists, like ABC medical editor Dr. Tim Johnson, are openly embracing “ObamaCare.” A long-time supporter of government-run health care, this “objective” journalist calls the lack of “universal coverage” a “national shame.” ABC and the other networks are promoting Obama’s “historic” and “ambitious” health care agenda. Stories on ABC, CBS and NBC favored proponents to critics by a margin of more than 2-to-1 (243 to 104).

The Media Research Center’s Business & Media Institute examined 224 stories about health care on the three broadcast networks’ morning and evening shows that aired between Jan. 20, the date of Obama’s inauguration, and June 24, the night of ABC’s prime time town hall special on health care. Here are some additional findings:

* Networks Barely Discuss Cost Complaint: The No. 1 criticism of ObamaCare has been its price tag. The Congressional Budget Office estimates one proposed health care bill would cost $1.6 trillion (while still leaving roughly 36 million people uninsured according to the Washington Times). Yet, only 20 network stories (9 percent) referenced estimates even close to that number.

* Total Number of Uninsured Exaggerated: On April 29, Robin Roberts told “Good Morning America” viewers that “50 million Americans” were uninsured. Her claim was wrong by nearly 14 million people. Network mentions of the total number of uninsured were wrong by a margin of 4-to-1 (80 percent). Only NBC “Nightly News” and ABC “World News” never got it wrong – by not citing the number of uninsured at all.

* Networks Don’t Compare ‘Medicare-like’ Public Option to Medicare’s Track Record: Reporters admitted the public option insurance Obama wants would be “similar to Medicare” in just 11 of the stories (5 percent). But none of those stories pointed out that Medicare is heading toward an “explosive fiscal situation,” according to the CBO, or that the program is a big reason for rising health care costs.

* ABC the Worst: Universal-coverage proponent Dr. Tim Johnson and his blatant support for Obama’s health care plans made ABC’s coverage easily the worst of the three networks. Johnson, who had called the Clintons “almost heroes in my mind” after attempting to reform health care, is ABC’s “expert on health care reform” according to Diane Sawyer. Johnson even praised Obama as “right on target” for reaching out to doctors in Chicago June 15.

* NBC the Best: NBC did a better job than the other networks on a challenging topic. On June 24, Matt Lauer described health reform plans as “exorbitantly expensive” and asked how the president would handle the remaining “35 million” uninsured after promising “universal” coverage. NBC also did a slightly better job of including criticism of government health care than CBS did (25 percent for CBS to 29 percent for NBC) and made far fewer errors about the number of uninsured than CBS (CBS was wrong 8 times, NBC 2 times).

Network coverage of the health care reform plans needs to improve to ensure a fair debate. Here are some recommendations to accomplish that:

* Be Honest about the Cost: Any government plan is going to come at a huge cost to taxpayers. It is the responsibility of reporters to ask what those costs will be and who will be forced to pay them. Journalists should also be skeptical of cost estimates from the government since they have been unreliable in the past.

* Talk to Critics: In the case of health care, proponents of ObamaCare or other government-health care plans were included nearly three times as often as critics. In some cases, critics were given only a few-second sound bite while three or four sound bites from the president were used in the same story. The networks need to include more people skeptical of such plans and treat them equally.

* Expose the Shortcomings of Government Programs: Instead of advocating a new government solution, reporters should be examining problems with health care in Massachusetts and Hawaii, existing federal programs like Medicare and other countries.

* Find Alternatives: Conservative health policy experts advocated less regulation, tax code changes and more freedom of choice. Networks should include such experts and their proposals, not just the administration’s proposals.


Behind the doubts about healthcare reform

I hate the health-care system -- but don't you dare mess with it. That's a pretty apt summary of the American mind-set about health care -- and not just now, but for decades. Something about health care calls forth from the national psyche a deep, almost inexplicable schizophrenia, as the latest, delayed effort to "reform" health care is showing President Barack Obama and the rest of Washington.

Although the public loves to complain about health care, it's no surprise that people are afraid of changing the health care system. Capital Journal columnist Jerry Seib outlines several reasons for the foot-dragging.

Indeed, the quest to fix health care has bedeviled every president since Harry Truman. Arguably, only one -- Lyndon Johnson, when he oversaw the birth of Medicare -- succeeded in making a real dent. Mr. Obama and Congress have, of course, spent much of the summer agonizing over how to alter the system, but this week lawmakers will head home for an August recess without having passed anything in either the House or Senate, largely because of public anxieties.

This seems counterintuitive. People know the system is creaking, frustrating and way too expensive. They complain about it all the time. Yet they can't quite let it go. Why? Like health care itself, the answer is complicated. But there are five big reasons:

* The Marcus Welby factor. Americans maintain a gauzy, almost dreamy image of doctors and nurses. The image of the preternaturally soothing hometown doctor portrayed on television's "Marcus Welby, M.D." is the ideal to which Americans cling.

The clinical discussions of cost-effectiveness, reimbursement rates, insurance exchanges and "best practices" that go along with the health debate are wholly at odds with this image of tailored medical care. Even though today's cost pressures already are slowly strangling Dr. Welby, Americans fear that changes to the system that created him might hasten the process. "Health care is intensely personal," says Bill McInturff, a Republican pollster who co-directs the Wall Street Journal/NBC News poll and has long studied attitudes about health care. "It's not like welfare. It's about me."

* The Rube Goldberg Factor. The very fact that the current system is like one of those overly complicated machines means Americans have no earthly idea how much they're paying for health care, which is even more costly than most realize. Thus, they are stunned when confronted with reform plans that lay out the costs -- not just the new ones, but the existing ones. They get sticker shock.

"So much of the cost of health care is submerged, is invisible, that merely raising it to the surface creates opposition," says Paul Starr, a Princeton University sociologist who advised the Clinton administration's health-overhaul effort. "It's very hard for people to evaluate the alternatives being discussed because they don't understand how expensive it [already] is."

* The Company-Town Factor. It's mostly an accident of history that America has a health-care system in which employers pay most of the cost of insurance. It does so in large measure because the government decided to exempt health insurance from wage and price controls during World War II. That meant companies couldn't give raises to attract workers but could offer health benefits to do so. Then Uncle Sam decided that neither employers nor employees had to pay payroll taxes on the money spent on health benefits, thereby enshrining health insurance as the leading employee benefit.

That, in turn, has fostered a view of employers as either paternalistic guardians who look after our health for mutual benefit, or as powerful overlords with an obligation to do so. Either way, there now is a deep fear of both the notion that individuals would be better off fending for themselves (the conservative impulse) or that government ought to take over the job (the liberal impulse). Those are the two starkest alternatives to the status quo, and both scare people.

* The Post Office Factor. Americans are deeply cynical about government's ability to do anything right. Putting a man on the moon, building an interstate-highway system, fielding history's most lethal army -- nothing has changed that. Even Mr. Obama makes jokes about how standing in line at the post office has convinced him he doesn't want the government running private firms.

Yet a health overhaul inevitably involves a bigger role for government in, if nothing else, setting standards and policing the market. And that's where lots of Americans fall off the reform bandwagon. A survey this summer by the Gallup polling organization, which regularly tests confidence in American institutions, illustrates the problem. Some 36% expressed confidence in the medical system, ranking it in the middle of the broad range of American institutions that were tested. But a mere 17% said they have confidence in Congress, which is where any health overhaul would be created, putting lawmakers second from the bottom on Gallup's list (just a whisker above big business).

* The Job-Machine Factor. This is a vastly underappreciated element of the national psyche. The health system isn't just something that provides medical care; it's now also the largest industry in the land. It provides more than 14 million jobs, the Bureau of Labor Statistics tells us, and seven of the 20 fastest-growing occupations are health-related. More than that, health care will generate a staggering three million new wage and salaried jobs in the next decade or so, more than any other industry.

Health firms, drug companies, hospitals and others within the current health-care system "have such a big stake in it that they can afford a whole hell of a lot of money defending that stake," says Bill Frenzel, a Republican who represented Minnesota in the House for 20 years. In short, lousy as the system may be, lots of people have a direct economic stake in it. Any wonder they don't like the idea of a leap into the unknown?


1 comment:

Janet Brown said...

The private sector and competitive market forces, not the federal government, are the best means to meeting our country’s rapidly expanding health care needs. One of the things I think we can do to help make that happen is support American businesses and the U.S. Chamber of Commerce ( They’re doing things to reach out and show people that they can get involved, too.