Tuesday, August 18, 2009

A pathetic Brit relies on lies and innuendo to defame U.S. healthcare

He says that U.S. healthcare "throws out" sickly babies. The truth is absolutely the reverse. It is because U.S. doctors pull out all stops in an attempt to save premature babies that the U.S. has a higher infant mortality rate. Some of those heroic efforts necessarily fail and that is recorded as an infant death. In other countries it would be counted as stillborn or not recorded at all. And he says that he did not go to the top U.S. surgeon because he thought an "apprentice" might operate on him. Did he not think that he could arrange whether or not that would happen? It could not happen without his permission. And in the end he found that the treatment still cost him a bundle on the NHS. His insurer would most likely have given it to him free in the U.S. The guy is just trying to justify his own bad decisions

One of the killer statistics bandied about in the present dogfight over “Obamacare” is that under the UK’s “socialised” medicine, 57 per cent of men with prostate cancer survive to die of something else. In the US, under “free-world” medicine, that figure is 90 per cent. Which means, presumably, that if Abdul Baset Ali al-Megrahi had been incarcerated in a US jail he’d be eating prison chow for years to come, instead of being released on compassionate grounds. Put another way, the NHS kills.

September will be yet another Prostate Cancer Awareness Month. And, as before, awareness about the second leading cause of death among ageing men will remain abysmal. Those pink ribbons for breast cancer win out every time.

The truth is that the only thing that makes a fellow really “aware” is when he hears the ominous words: “I’m sorry to tell you, the biopsy reveals that you have prostate cancer.” I had that message by phone, at 4.25pm on February 17, 2009.

As Dr Johnson said, death sentences concentrate the mind wonderfully. But, of course, it’s not a death sentence. Go to any of the websites for prostate cancer survivors and the first thing you learn is that only one out of six who have this particular carcinoma die of it, even if it’s left untreated. It’s Russian roulette. With the barrel pointed at your testicles. “Do you feel lucky punk? Well do you?” as the man said.

My situation forced me to engage, in a very practical way, with the current arguments over the NHS and American healthcare. I taught for three months in California last winter. While there I had top-notch health coverage. Under enlightened US law, my employer was obliged to continue that coverage, for minimal co-payment, for 18 months after my leaving their employ. No exclusions. I could, therefore, have state-of-the-art treatment at somewhere such as Cedars Sinai. It would cost me not a cent.

But I’m also covered by the NHS, have been since 1948, and by Bupa: but it covers only half the cost of the surgery. What would you choose with killer cells multiplying like homicidal lice in your groin? I decided on surgery. But which nation’s healing scalpel?

One thing that strikes you, after you’ve done some research, is why is the best treatment for prostate cancer always pioneered in America? Nowadays you can pick from radium seeds (what Rudy Giuliani chose); nerve-sparing da Vinci robotic surgery (what John Kerry chose) or Hifu (high-intensity focused ultrasound). What do they have in common? IiA — Invented in America. What else do they have in common? They are hard to come by on the NHS. Not impossible (except for Hifu, which is not approved by the National Institute for Health and Clinical Excellence), but hard.

Why has America led the way against this horrible scourge of elderly men? Follow the money. Males in the red zone for prostate cancer (roughly 50 to 80-year-olds) are the most lucratively insured sector of the US population. American medicine is not a “service” it’s an “industry”, driven by the bottom line. The spin-off? Research and development goes where the dollars are. Old guys strike lucky.

Now cross the Atlantic. You’re holding the NHS pursestrings, and have the following dilemma:

1. A one-month-old baby with a hole in the heart. Cost to cure, £x;

2. A 30-year-old woman with breast cancer. Cost to cure, £x;

3. A 70-year-old man with prostate cancer. Cost to cure, £x;

but you only have £2x to hand out. Whom do you throw overboard? The iron law of triage in the UK tilts the board against the luckless prostate. America throws the (often unremunerative) babies overboard, which is why (as Michael Moore crows) it has higher infant mortality than Cuba. And old guys strike out.

So, being an elderly man, I should have gone American: particularly as I had resolved on robotic prostatectomy. But I didn’t. Why not? The reason is everywhere on websites, where the consensus is: “Go for the very best surgeon. And be sure to choose one who’s done more than a thousand procedures.”

I could have chosen a leading da Vinci specialist in Los Angeles. But so big is the robotic business in the US that those star surgeons have troops of young surgeons in training with them. Well disposed as I am to teaching hospitals, I did not want to be some starlet’s apprentice work.

If I wanted robotic surgery in the UK the best person, I was told, was Professor Roger Kirby. Kirby is forever raising charity money for prostate cancer treatment but — so expensive and in such short supply is the robotic machinery he uses — that he charges. In point of fact, the charge is modest: less than the cost of every second car that passes you in the fast lane on the motorway.

In a few years time I suspect the NHS will be where the US now is on prostate cancer treatment. At the moment, if you want US standards of treatment in the UK you will probably have to pay, out of your pocket or through medical insurance.

There were some painful incisions on my wallet. But the histopathology revealed that the cancer had been expertly scooped out by Professor Kirby and his pal Leonardo. I felt lucky. And very grateful.


Scrap swine flu phone checks says father of British tonsillitis sufferer who died after misdiagnosis

Another death from Britain's careless swine flu procedures

The distraught father of a teenage girl who died after her tonsillitis was deemed to be swine flu is calling for over-the-phone diagnosis to be scrapped. Karl Hartey accused the Government of having 'blood on its hands' after his 16-year-old daughter Charlotte died from complications arising from tonsillitis. The case will further increase concerns that illnesses, some of them serious, are increasingly being misdiagnosed as swine flu.

Following revelations that 16-year-olds are being employed at a swine flu call centre, there are also fears that many of those doling out advice and the anti-viral drug Tamilfu are not qualified to do so. Last week the parents of a girl of two told how their daughter died of meningitis after she was misdiagnosed.

In the latest case Charlotte Hartey was told she had swine flu over the phone by a local GP. She was prescribed Tamiflu but her condition deteriorated and she was admitted to Royal Shrewsbury Hospital on July 29 where she died two days later after her lungs collapsed when bacteria overwhelmed her immune system. A post-mortem found Charlotte, from Oswestry, Shropshire, died from natural causes.

Her father Karl attacked Ministers over the introduction of call centres, manned by teenagers to diagnose potential swine flu cases. Mr Hartey, 42, said: 'The Government has blood on its hands. 'This was tonsillitis. Every child in the country is likely to get it. We have to change the Government policy on this. 'We have got to go back to old-fashioned doctoring.'

Mr Hartey has begun a campaign to end the telephone diagnoses of swine flu, using Charlotte's memorial page on Facebook to gather pledges of support which will be presented to Downing Street. Six-hundred visitors to the site have so far promised their support since it went live last Thursday.

Mr Hartey, an investment adviser, said: 'We have to ban call centres giving medical diagnosis. We want this to go as high as it possibly can, to the Prime Minister. 'I want him to accept that Charlotte was misdiagnosed. I want him to look me in the eye and say sorry for our loss. 'It won't bring Charlotte back, but it will stop other children being misdiagnosed. 'Charlotte had such a life ahead. Her future was enormous and has been snatched away.

'Charlotte is not the first person to have died because of misdiagnosis. We are fighting a war against call centre advice. 'I am not putting blame on the doctors because they follow instructions from the Government, which says not to see swine flu victims. 'This is a breach of our human rights. The Government is restricting us from going to the doctor.'

Two-year-old Georgia Keeling died from meningitis after being misdiagnosed over the phone and by a paramedic. Her parents were repeatedly told she didn't need to go to hospital and she was given Tamiflu and paracetamol. Salesman Paul Sewell, 21, and his wife Tasha, 22, from Norwich, claimed medics had diagnosed her before they looked at her.

Mother-of-three Jasvir Gill, 48, of Leicester, also died this month days after being misdiagnosed with swine flu. She began suffering from a sore throat and vomiting and was told to take Tamiflu in a telephone diagnosis. Around 12 hours later she had a heart attack and died from blood poisoning caused by meningitis.


Australia's Leftist government simply hates private health insurance

The idea that those who work and save get better treatment than those who blow all their money on beer and cigarettes is just anathema to them -- so they are trying to make private health insurance harder to afford

Make no mistake about it. The battle to preserve Australia’s mix of public and private health care will be joined in earnest this week. At stake is a worsening of the shaky health of our public hospitals. At stake also is a direct cost impact for almost half the population who have private health insurance and an indirect, or delayed, impact on those who rely on public hospitals for treatment.

Labor’s attack on private health insurance through this year’s Budget will force substantial numbers of people to drop or downgrade their insurance coverage meaning many, many more people will be seeking treatment at public hospitals. Longer waits in Accident and Emergency Departments, longer waits on lists for surgery lay ahead if this attack succeeds.

Nothing holds the potential to increase the stresses and strains on our hospitals more than the changes to private health insurance rebates contained in the erroneously named Fairer Private Health Insurance Incentives Bills, which are expected to be debated in the Senate this week. Every decision Kevin Rudd has taken since coming to Government will make our public health system worse – making a mockery of his oft-repeated promise that he had a plan to “fix” the nation’s public hospitals.

There is no doubt that the health sector is paying a high price for Labor’s reckless spending over the past nine months which has the nation spinning into massive debt. The Government has targeted many areas of health to claw-back savings, but the targeting of private health insurance rebates carries the added factor of ideology – Labor hates private health insurance - and this is a serious direct attack upon it.

It is also a trashing of numerous promises both Mr Rudd and his now Health Minister Nicola Roxon made before the last election - to both the public and the insurance sector - that Labor would not change these rebates paid to those who take out private health insurance and in so doing relieve the call on public hospitals.

The phasing down of the universal 30 per cent rebate, in three stages, to 20 per cent, 10 per cent and eventually to zero for those earning over $75,000 (singles) and $150,000 (families or couples) will mean 1.7 million Australians will immediately face private health insurance premium increases of between 14 and 43 per cent. One million people are likely to drop or downgrade their insurance cover forcing premium increases for all who maintain insurance.

In seeking to cut the rebate to so-called higher income earners the Rudd Government will hammer low and middle income earners with higher prices. It’s worth noting that a million people – one million Australians, probably many of them elderly – earning less than $26,000 a year make the struggle to pay for private health insurance. Does it want them to also opt out of private insurance and join the queue at our public hospitals? If so what impact could all this have?

The private health sector estimates it could transfer 75,000 treatment episodes from private to public health care. Public hospitals will have to accommodate an extra 190,000 bed days at a cost of $200 million. Four million allied health services would no longer be covered by insurance costing another $200 million. Two million dental care treatments for which private insurance would have paid $100 million would also no longer be covered.

If those estimates even partially come to pass, it creates a huge hole in the $1.9 billion in savings Rudd Labor estimates it will make by changing the rebates. It will also push our public hospitals further toward breaking point.

Reductions in Medicare rebates for cataract surgery and various other treatments, caps on the Extended Medicare Safety Net and the 2008 Budget changes to the Medicare Levy threshold all have implications for adding to pressures on the hospital system – the one that Kevin Rudd said he would “fix” by June this year.

The Coalition will oppose the private health insurance rebate cuts when they come before the Senate this week. The savings needed by this Government to the nation’s bottom-line can be achieved in other ways. The Coalition has proposed an increase in the excise on cigarettes that would more than cover the $1.9 billion in savings projected from the rebate changes. Rudd Labor does not have to further threaten our public hospitals which its State Labor Governments have so dramatically mismanaged for far too many years.


Coverup after negligent Australian public hospital causes two deaths

A HOSPITAL patient, who was discharged and allowed to drive home despite pleas from his family, died minutes later in a car crash that also killed another driver. Rodney Knowles rang his son and brother from Shoalhaven District Hospital in NSW on October 25 last year after having routine dialysis and sounded "delusional". Both separately begged the nurse on the phone not to let him drive home, but he got behind the wheel and had a head-on crash, killing himself and another driver aged in his 50s.

The Health Care Complaints Commission declined to investigate and the NSW Medical Board dismissed a complaint made after the incident. The hospital's doctor, Shanka Karunarathne, acknowledged to the HCCC that he amended Mr Knowles' medical records after Mr Knowles' death to say he offered to admit him, but Mr Knowles declined. Dr Karunarathne said he was the only medical registrar at the hospital at the time and did not have time to complete his notes. "As I was required elsewhere in the hospital at that time, I later made a retrospective entry to confirm the discussion," he wrote in answer to questions from the Health Care Complaints Commission.

Shoalhaven Hospital said Mr Knowles, 71, was medically assessed as competent the day of his death, despite him reporting feeling unwell and skipping some meals. They gave him juice and food which boosted his blood sugar levels prior to him leaving.

The HCCC said an investigation was not warranted because it was unlikely to lead to disciplinary action against the nurse involved, Julie Owen, or any recommendations to Shoalhaven Hospital. The NSW Medical Board also dismissed the complaint against Dr Karunarathne.

Mr Knowles' son Brendan said: "He had kidney failure, we expected at some point he would go, but to happen so tragically and in the circumstances which it happened when we begged them not to let him drive, I just can't fathom how they can turn around and say they couldn't do anything. "We want some answers. We don't want it to happen again. As well as dad being killed there was another gentleman killed, an innocent party. We want some answers for his family too."

Rodney Knowles had been admitted to the emergency department three days before his death with chest pains and was discharged on October 24. He returned the next day for dialysis. Police believe he blacked out and veered onto the wrong side of the road. The coroner said he died "nearly immediately" from traumatic injuries.

Opposition health spokeswoman Jillian Skinner said the family deserved an explanation. "This family has been through hell and deserve a full explanation from Health Minister John Della Bosca," she said. Mr Della Bosca said while he felt for the family, he would not comment on the case until all inquiries had been completed.


Protests force Obama to consider dropping health insurance scheme

BUCKLING under the weight of popular fury, the Obama administration seems ready to ditch one of the central planks of its controversial health reforms - the creation of an insurance scheme funded by taxpayers. At a town hall meeting in Colorado at the weekend, President Obama conceded for the first time that his final reform bill might not include an NHS-style system. Fears of a government bureaucracy deciding who gets medical treatment have provoked confrontations between voters and their representatives in Congress across America in the past two weeks. "The public option - whether we have it or we don't have it - is not the entirety of healthcare reform," Mr Obama told a largely sympathetic crowd at Grand Junction, Colorado.

The message was further amplified yesterday by Kathleen Sebelius, his Health Secretary, who told CNN that the public option was "not an essential element". The concession should help to remove a significant obstacle to the bill's passage through Congress. About 80 per cent of Americans are covered by private insurance schemes. The government-funded Medicare program pays private insurers for the treatment of another 46 million.

Promising to create near-universal healthcare, Mr Obama had sought competition to the much criticised insurance companies through the establishment of a public sector rival. Such plans have, however, sparked fears of creeping socialism.

Apart from ideological objections, even many Medicare patients did not fancy their chances with government-appointed panels scrutinising treatment. Those already insured worried that they would be driven to the cheaper, and supposedly leaner, public scheme. It is often the employer, paying a large part of the premiums, who decide the level of coverage.

Stung by the town hall protests and mounting resistance in Congress, Mr Obama has decided to appeal to voters directly for support. In an emotional outing in Colorado, he evoked the memory of his grandmother to lay rumours about government "death panels" to rest. He said: "I just lost my grandmother last year ... So the notion that somehow I ran for public office, or members of Congress are in this so they can go around pulling the plug on grandma? When you start making arguments like that, that's simply dishonest."

He also took a swipe at the insurance lobby, which funds many of the alarmist adverts against the health reforms. Citing a 2007 survey, Mr Obama said in an article written for The New York Times that "insurance companies discriminated against more than 12 million Americans in the previous three years because they had a pre-existing illness or condition". "We will put an end to these practices," he pledged.

He will be able to do that only if the bill is adopted. In the Senate, Mr Obama needs the votes of all 60 Democrats to prevent the Republicans blocking it and one of his closest allies, Edward Kennedy, is unlikely to be able to help. Mr Kennedy, a lifelong advocate of universal healthcare who is suffering from a brain tumour, has not been seen in public for months.

With the public insurance scheme included, Mr Obama would in any case be far short of the 60 votes required, as a key Democratic senator indicated yesterday. "The fact of the matter is there are not the votes in the United States Senate for the public option," Kent Conrad said on Fox News Sunday. "There never have been. So to continue to chase that rabbit, I think, is just a wasted effort."


American health care expectations are already distorted

The other day, I was in the pharmacy at my local HMO facility picking up a prescription. I know you aren’t supposed to listen to what the people up at the window are saying, but this one guy was virtually shouting and was quite hard to ignore. He was upset with the staff member who was trying to talk him through something that was obviously terribly upsetting. Again, it really wasn’t appropriate to eavesdrop, so please don’t pass this along.

It seems that he was picking up a refill on some meds (my thought was that I hoped they were chill pills of some sort) and he was distressed that a previous prescription of 150 pills was refilled with only 75. Now, it wasn’t the capsule-count that bothered him – he just didn’t want to have to pay the same $10.00 co-pay for the 75 that he did for the 150. Never mind that the co-pay scale is pretty well set and that $10.00 is the bottom-line fee. Nope. He thought he should pay less. Or nothing.

The flustered, yet knowledgeable lady at the window then proceeded to show him how much the medicine would cost if he were to purchase it out of the system. Needless to say it wasn’t 10 bucks, but rather several multiples of it. Yet the guy who was buying medicine at a paid-down price still thought he was paying too much.

It’s a mindset – one that seems to be pervasive. In fact, I suspect he may be one of millions of Americans who seem to think that medicine and medical care should not really cost them personally much of anything. Let the rich people pay for all of us – or the employer, or the government, it’s too expensive for me. Because it costs so much, goes the thinking, I really shouldn’t have to pay. God forbid that any American should have too many out of pocket health care expenses. The logic is: Nobody can afford it; somebody else should pay. Why does that remind me of something Yogi Berra might have once said?

Some time ago, I came to a parting of the ways with an employee. When our human resources person briefed him on COBRA to allow him to continue with health insurance coverage, he balked saying something to the effect: “I’m not paying for that.” Never mind that he had a wife and children and that being uninsured put them all at financial risk, he was unwilling to pay up out of pocket. To him, it was apparently just not something that was a financial priority. At any rate, he had told me and others that he was looking forward to the day when Barack Obama became president and everyone got coverage, whether they worked or not. Of course, under the Obama plan this man would be fined for not having insurance when it was accessible to him.

I got the same kind of response when I put the health care reform issue out to a talk radio audience recently. I asked specifically for callers who had no coverage – wondering how they felt about the whole megilla. Frankly, I was surprised that so many who did not have health insurance actually had access to it, but really didn’t feel it was worth it to pay for it. One caller told me that, at any rate, if he got sick he could just go to the emergency room, indicating that if the bill were too big and he couldn’t pay it would be the hospital’s problem. I suspect that more people think this way than we’d like to admit.

Actually, that kind of thing becomes everyone’s problem. And being lost in this national “teachable moment” are concepts like personal responsibility and living in such a way so as not to be a burden on others.

The reason something as integrity-rich as the idea of paying for what you receive is widely resisted when it comes to health care is because it is, in fact, so very expensive. But maybe if people accepted more personal responsibility and resisted the it-costs-so-much-I-can’t-afford-it-let-them-pay philosophy we might see some common sense enter the discussion.

Here’s an idea, why don’t we reform the system by turning it into one where individuals purchase their own insurance. What if every employer stopped providing health insurance as a benefit and instead translated the actual dollars spent on an employee’s plan into straight income - saying, in effect, “Here’s your health insurance money, you shop and buy your own plan.” This would need to be accompanied of course by market-based reform, eliminating the practice where states deny health plans from other states into their markets, and making such insurance completely portable, not tied to where you work.

The income used for health insurance could be tax exempt. If it wasn’t used to purchase insurance, it could be taxed – creating incentive. And if someone refused to spend the money they had on actually accessible insurance because, say, they wanted to buy a bigger house or car, well, then put a system in place where the government would help the hospital collect a bill over time, in the event of a costly illness. Pay me now or pay me later. Something like this has been described by John McClaughry president of the Ethan Allen Institute in a recent article entitled: What To Do With The Uninsured.

How many Americans would actually pay for health insurance under such circumstances? It’s hard to say. Possibly, we have been so conditioned to having another entity provide and pay for it that we truly see it as something that should be done for us?

It is axiomatic. Failure to act responsibly leads to the intervention of other parties, in the health care case – that would be the government. This intervention always means less autonomy and liberty.

Health insurance as we know it has only been around for about 80 years. With the rise of the New Deal and labor unions in the 1930s and then the economic realities during the crisis of World War II, Americans became increasingly accustomed to having the whole health care thing being part of an employee benefits package. In fact, during the war, when wages were somewhat regulated, the one way an employer could give someone a little more was through the benefits package. Before long it became part of how things were done. You got a job and you got paid in money and stuff like health insurance. Cool.

The problem with it was that it began to put a degree of separation between the consumer and the health care service provider – we moved from a fee for service approach to something much more indirect and impersonal. Someone else was paying the bill. And when the apartment comes with utilities included you don’t look at the thermostat as much. Out of sight, out of mind. It’s no longer a market-driven enterprise.

When I was young boy, my dad had really good insurance because he was a Teamster. It wasn’t really called health insurance, though. It was hospitalization insurance. It was there for the tonsillectomy – not the runny nose. It was there for stitches in the emergency room, not for the yearly physical, or the chicken pox. In fact, when we went to the doctor, mom wrote a check. Doctor visits were not really health insurance issues. Even if people had good insurance, they usually still had to pay out of pocket to go to the family doctor, as with the dentist.

These days, though, with our whole health maintenance and managed care way of thinking, it’s all about minimizing out of pocket expenses. The problem is that this doesn’t eliminate the actual expense – it just takes it from view and increases the costs exponentially behind the scenes. We don’t see the transaction, so it isn’t really there.

Health insurance morphed into a right. Every one should have it and it should only cost those who can afford it. And few can really afford it, so the government should pay. We sure hope they have enough money – oh, what the heck, they’ll just print more. Or tax the rich more. So what if the top 1% of American households fork out more in taxes than the bottom 95% combined.

Our desire never to be out of pocket will one day soon lead to our country being out of pockets.

Putting a so-called public option into the mix is a poorly disguised foot in the door en route to the real goal of a single payer system. And once such a system is in place, it will never go away. Even conservatives in Britain don’t mess with their National Health Service (NHS). It’s part of the national fabric, like Social Security and Medicare are here already. Never mind that cancer patients over there have to wait on treatment so bureaucrats can meet “target” goals or that neurology delays put lives at risk or that some patients will now be paid to go “private” in certain cases.

After all, they have only had 61 years to work the kinks out of a program that is even now facing a funding crisis. Give them time. And surely we’d do better, right? Just look at the Post Office. Or Amtrak.


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