More spending on prevention is no solution for Australia's public hospital crisis

by Dr Jeremy Sammut -- with some obvious implications for the USA. See the result of Obama-style medicine already

Public health experts have long claimed the problems in Australia’s public hospital system are due to government policy focusing too much on hospitals rather than on preventive and health promotion strategies. The report on health reform released this week by the National Health and Hospital Reform Commission endorses this idea.

The reality is that average life spans have increased dramatically in the last 40 years. Healthier lifestyles and more effective medications have resulted in significant falls in rates of heart attacks and strokes.

People who once would have entered hospitals and died while in their 50s and 60s now live longer. Improved medical treatments are also enabling people to live to older and older ages. These people inevitably get acutely ill and eventually become users of emergency departments and require admission to hospitals when they are older and sicker.

Overcrowded public hospitals are already bearing the brunt of the inexorable ageing of the population.

Between 2004 and 2007, the number of patients presenting at emergency departments with medical problems requiring unplanned admission increased faster than population growth by 15%.

This was driven mainly by rising admissions by frail and ‘very old’ patients aged 75 years and over. Patients in this age groups accounted for 14% of public hospital admissions in 1996–97. They accounted for 20% of public hospital patients in 2007–08.

The problem is that total public acute beds in Australia now number roughly the same as in 1996 – about 2.5 beds per 1000 population. Public hospitals simply do not have enough beds to care for Australia’s ageing population.

More spending on prevention will not address the tsunami of ageing-related demand that will hit public hospitals across the country in coming decades. For the last twenty-five years, State governments have cut bed numbers while opening offices filled with ‘area health’ bureaucrats. The challenge for policy makers is to reverse this process.

A national hospital voucher system, in combination with the reestablishment of local hospital boards, will close down offices, open beds, and rebuild and equip the hospital system to cope with the unprecedented impact of demographic change.

The above is a press release from the Centre for Independent Studies, dated July 31st. Enquiries to cis@cis.org.au. Snail mail: PO Box 92, St Leonards, NSW, Australia 1590. Telephone ph: +61 2 9438 4377 or fax: +61 2 9439 7310





Healthcare bill stalled for now, future uncertain

No wonder the Democrats are dazzled, frazzled and confused. Harry Reid and Nancy Pelosi are sitting on enormous majorities, but they're at the mercy of an obscure conservative congressman from rural Arkansas and a tiny band of Democratic dogs, some blue and some ol' yaller posing as the more fashionable blue. Bow, wow.

The Democrats are trying to stuff a health care scheme down the throats of Americans who clearly don't like it, don't want it and can't pay for it, and Mr. Ross and his Blue Dogs have stalled it, forcing changes that might make it palatable, or at least less toxic. But now that maybe it's not as bad as it could be, the liberals - who want to be called "progressive," having ruined the label "liberal" - say they don't want it, either.

President Obama, who insisted for months that he had to have his health care "reform" by Aug. 7 or Saturn would collide with Pluto, suddenly insists that there was never anything magic about a date in August. Everybody is free to toil at leisure. Any time in October will be perfectly OK with him. But his leige men in Congress are singing hymns in a different key. Harry Reid, the leader of the Democratic majority in the Senate, met reporters Thursday and risked bustin' his galluses, such was the chemical purity of his dudgeon. "That is a deadline that you created," he told the reporters, his face weary with worry, fatigue and frustration. "It's not like we don't have a product ... the mere fact that this wasn't done by last Friday or by 5 o'clock doesn't mean we're not going to get a quality product."

For her part, Nancy Pelosi, who a fortnight ago mocked the Blue Dogs with a boast that "we've got the votes," rails that "the insurance companies are the villains."

Sen. Richard Durbin, a Reid deputy, dutifully agreed. "There are people out there with a lot of money at stake in this debate," he said, darkly. "The health insurance companies are some of the most profitable businesses in America. By fighting 'change' they're protecting the bottom line." (A business making a profit is practically un-American this season.)

Her handsome Democratic majority has flushed and scattered completely out of Mzz Pelosi's control. The "progressives," who thought that by the Fourth of July they would have America remade in the image of France, or at least look at lot like Luxembourg, can't understand why they haven't.

"I don't think it would pass the House," says Rep. Barney Frank of the compromise. "I wouldn't vote for it." Neither would Rep. Steny Hoyer, the Democratic majority leader, if he means what he says. "We signed a pledge to reject any plan that doesn't have a robust public option," he says, "and this plan doesn't have a robust public option." What Messrs Frank, Hoyer and their like-minded colleagues want is a government scheme that would eliminate private insurance, later if not now, and this is what Mike Ross and his Blue Dogs appear to have stalled, for now if not later.

Like his congressional partisans, the president has been stung by the common sense that has become a rising tide not so slowly sinking the Democratic scheme. Like the effective pol he is, the president understands that once Congress goes home for its long summer recess the tide of common sense will gather lethal force.

"First of all," the president told a selected audience in North Carolina, "nobody is talking about some government takeover of health care. I'm tired of hearing that. I have been as clear as I can be. Under the reform I've proposed, if you like your doctor you keep your doctor. If you like your health care plan, you keep your health care plan. These folks need to stop scaring everybody, you know?"

That sounds promising, but growing numbers of Americans just don't believe him. A poll for the New York Times-CBS News, out Thursday, shows public skepticism of the Democratic health care scheme - and worse, skepticism of the president's ability even to shape the debate, growing significantly. An earlier Gallup Poll showed the president's approval rating dropping to 53 percent, and Rasmussen puts the president's approval rating at 48 percent, the first time his approval rating has fallen below a majority.

SOURCE





Obamacare: Not Waterloo, Just a Tactical Retreat

by Charles Krauthammer

Yesterday, Barack Obama was God. Today, he's fallen from grace, the magic gone, his health care reform dead. If you believed the first idiocy -- and half the mainstream media did -- you'll believe the second. Don't believe either.

Conventional wisdom always makes straight-line projections. They are always wrong. Yes, Obama's aura has diminished, in part because of overweening overexposure. But by year's end he will emerge with something he can call health care reform. The Democrats in Congress will pass it because they must. Otherwise, they'll have slain their own savior in his first year in office. But that bill will look nothing like the massive reform Obama originally intended. The beginning of the retreat was signaled by Obama's curious reference -- made five times -- to "health-insurance reform" in his July 22 news conference.

Reforming the health care system is dead. Cause of death? Blunt trauma administered not by Republicans, not even by Blue Dog Democrats, but by the green eyeshades at the Congressional Budget Office. Three blows:

(1) On June 16, the CBO determined that the Senate Finance Committee bill would cost $1.6 trillion over 10 years, delivering a sticker shock that was near fatal.

(2) Five weeks later, the CBO gave its verdict on the Independent Medicare Advisory Council, Dr. Obama's latest miracle cure, conjured up at the last minute to save Obamacare from fiscal ruin, and consisting of a committee of medical experts highly empowered to make Medicare cuts.

The CBO said that IMAC would do nothing, trimming costs by perhaps 0.2 percent. A 0.2 percent cut is not a solution; it's a punch line.

(3) The final blow came last Sunday when the CBO euthanized the Obama "out years" myth. The administration's argument had been: Sure, Obamacare will initially increase costs and deficits. But it pays for itself in the long run because it bends the curve downward in coming decades.

The CBO put in writing the obvious: In its second decade, Obamacare significantly bends the curve upward -- increasing deficits even more than in the first decade.

This is obvious because Obama's own first-decade numbers were built on arithmetic trickery. New taxes to support the health care plan begin in 2011, but the benefits part of the program doesn't fully kick in until 2015. That excess revenue is, of course, one time only. It makes the first decade numbers look artificially low, but once you pass 2015, the yearly deficits become larger and eternal.

Three CBO strikes and you're out cold. Though it must be admitted that the White House itself added to the farcical nature of its frantic and futile cost-cutting when budget director Peter Orszag held a three-hour brainstorming session with Senate Finance Committee aides trying to find ways to save. "At one point," reports The Wall Street Journal, "they flipped through the tax code, looking for ideas." Looking for ideas? Months into the president's health care drive and just days before his deadline for Congress to pass real legislation? You gonna give this gang the power to remake one-sixth of the U.S. economy?

Not likely. Whatever structural reforms dribble out of Congress before the August recess will likely not survive the year. In the end, Obama will have to settle for something very modest. And indeed it will be health-insurance reform.

To win back the vast constituency that has insurance, is happy with it, and is mightily resisting the fatal lures of Obamacare, the president will in the end simply impose heavy regulations on the insurance companies that will make what you already have secure, portable and imperishable: no policy cancellations, no pre-existing condition requirements, perhaps even a cap on out-of-pocket expenses.

Nirvana. But wouldn't this bankrupt the insurance companies? Of course it would. There will be only one way to make this work: Impose an individual mandate. Force the 18 million Americans between 18 and 34 who (often quite rationally) forgo health insurance to buy it. This will create a huge new pool of customers who rarely get sick but will be paying premiums every month. And those premiums will subsidize nirvana health insurance for older folks.

Net result? Another huge transfer of wealth from the young to the old, the now-routine specialty of the baby boomers; an end to the dream of imposing European-style health care on the U.S.; and a president who before Christmas will wave his pen, proclaim victory and watch as the newest conventional wisdom reaffirms his divinity.

SOURCE







Healthcare bill just the usual moron stuff

By Burt Prelutsky

The other day, a reader sent me an e-mail in which she stated: “Obama is economically illiterate, 100% politically motivated, a bold-faced liar, thin-skinned and completely incompetent. And I must say that, contrary to the majority of the population, I believe he is inarticulate. I don’t know what it is that others are seeing, but it certainly escapes me.” In response, I wrote, “Apparently they see the great and powerful Oz, whereas you and I see the mumbling, bumbling bumpkin that Toto exposed behind the curtain.”

The truth is, it’s not just Obama who confounds me. It’s all liberals. I mean, doesn’t it even occur to them that when a conservative points out that Obama, Pelosi, Schumer and Barney Frank, are burying America in trillions of dollars of debt that saying, “Well, Bush left us with half a trillion dollars of debt” isn’t much of a rejoinder?

Something else that baffles me about those on the Left is that even though one of their major bugaboos over the course of the past hundred years has been the monopoly, a single soulless entity that had the power to determine the price of gasoline or the life of a light bulb, they hail monopolies so long as they’re run by the criminally inept bureaucrats in Washington. I mean, who in his right mind would hire the likes of Chris Dodd, Henry Waxman or Barbara Boxer, to run a hardware store, let alone a major car company or the banking industry?

Perhaps even the Democrats are finally reading the writing on the wall. Obama’s poll numbers are dropping like a rock, and a little more than a year from now every congressman and a third of the senators will be up for re-election. There was a reason that Harry Reid announced that Obama’s health plan wouldn’t come up for a vote until after the summer recess. At the risk of being a cockeyed optimist, it’s my hunch that during the recess the Democrats are going to catch so much flak from their constituents that Obama’s health bill will be buried right next to Bill Clinton’s up there on Capitol Hill.

I’m sure that Obama will continue to blame Bush and the Republicans even if every Democrat votes against the damn thing, but the important thing is to keep socialized medicine where it rightfully belongs -- in England, Canada and Cuba.

It’s not easy determining which aspect of Obama’s bill is the most vile -- the fact that the costs would be astronomical, that health care would get progressively worse or that young illegal aliens would rate higher on the food chain than older American citizens. In fact, considering that the President subscribes to the notion that, instead of a life-saving operation, any old person not holding elective office or named Obama, should just take pain pills for what ails them, you could say that it’s Obama’s final solution for America’s elderly.

I heard Rush Limbaugh say, “This health care plan is the single greatest tool to regulate every aspect of our lives this government could ever have.”

To which my response was, Obama has a great many tools at his disposal, including pork-laden stimulus programs, Cap and Trade and multi-millions earmarked for ACORN, but they all look like shovels with which to bury America.

As for his health care plan, calling it a cure for an ailing system is like calling assisted suicide a cure for heart disease.

SOURCE





Preparing for War: Boning Up on the Left's Health Care Myths

by David Limbaugh

I am gratified that an awakened public has sent Congress an unequivocal message not to socialize our health care system, but note that this war is just beginning. Gen. Barack Obama is not the slightest bit deterred by the public's negative reaction, because he knows more than they do about what's best for them.

As we go forward, it's imperative we recognize that the current hiccup in Obama's momentum is a result of so-called Blue Dog Democrats' refusing to go along with his plan -- and this, largely because their constituents are raining down "tea party" speed bumps on their heads warning them against endorsing this disaster.

But if we're not careful, Obama will negotiate a path around this opposition, and it's important we anticipate it and prepare accordingly. The key lies in understanding the main reason for the Blue Dogs' resistance.

The Blue Dogs see themselves as being all about fiscal responsibility, even though most of them enthusiastically signed on to his budget-busting trillion-dollar porkulus scheme and his cap-and-tax debacle. Those little details aside, they have based their opposition to the bill thus far on their fear that the program wouldn't be able to pay for itself.

If that's true, then all Obama has to do to capture their support (he may already have) is to convince them it will be deficit-neutral -- or better. He can do that either by manipulating the numbers or by making adjustments to create the illusion it would pay for itself.

Let's set aside for now the canard that socialized medicine could be structured to pay for itself even with the diminution in quality and quantity it guarantees. What's relevant here is that Obama might be able to convince the Blue Dogs that it could. Then the bill would regain momentum, setting in motion the inevitable destruction of the world's greatest health care system.

Here's the point. Fiscal concerns aren't the only reason to oppose this Stalinist nightmare. We have to understand that socializing our entire health care system would destroy the great things about our system, much more completely than mandates, regulation and other government intervention already have.

Health care quality, quantity, choice and cost are all in jeopardy. This message has to be communicated effectively to the already skeptical public before Obama negotiates his end run around the fiscal responsibility issue alone -- as if that were the only legitimate objection.

In selling his scheme, Obama has already been promoting the myth that our system is no better than those of other advanced nations. His recent statements have betrayed his openly contemptuous attitude toward American health care and our top-flight medical profession. His attitude is consistent with his revealed general attitude about America, which he denigrates every time he gets a chance, especially on foreign soil.

He enjoys saying -- incorrectly -- Americans pay $6,000 more per year on health care than people of other advanced nations for no better care.

The statement is abominably false. Just as Obama is manipulating the cost and benefit numbers to enlist popular and Blue Dog support for his socialized medicine conspiracy, he distorts statistics to make the specious claim that our health care system isn't far superior to all others.

That's why we opponents of Obama's war against our health care system must bone up on the facts that put the lie to the ongoing liberal hoax concerning the quality of American health care -- as well as to all their other health care myths.

A great place to start is "The Top Ten Myths of American Health Care," by Sally C. Pipes. This is an extraordinarily edifying book that should be must-reading -- a health care mandate even I can agree to -- for every citizen upon whom socialized medicine could be visited and every politician contemplating visiting it upon us -- or properly opposing it.

This book could be so helpful to the national discussion that I intend to devote a number of columns to it. But with the remaining short space in this one, let me highlight just one of its 10 myth-busting chapters, which debunks the notion that government-run health care systems of other countries are superior or even remotely equal to the American system.

I'll address in future columns how the proponents of socialized medicine distort the statistics to hide the overwhelming superiority of the American system, but for now, I'll quote Ms. Pipes on the quality issue: "In measuring the quality of a health care system, what really matters is how well it serves those who are sick. And it's here that American really excels."

Please stay tuned, and in my following columns, I'll give you specific data backing up Pipes' claim -- data that expose President Obama's disgraceful attempt to deceive Americans about American health care quality. And I'll expose you to Pipes' other nine myth-debunking chapters -- and her market-based solutions. The system needs reform, but in the direction of less government, not more.

SOURCE