Wednesday, September 30, 2009

Britain's NHS? It's about as good as the health system in Slovenia

The National Health System is on a par with Slovenia and the Czech Republic, according to an analysis by European researchers. The NHS came 14th out of 33 European countries, making it one of the worst systems in Western Europe. The study - the Euro Health Consumer Index - found the NHS performed particularly badly on waiting times, even though these have fallen thanks to Labour targets. The survey says that the NHS is dragged down by waiting lists but the Department of Health claims the report is 'flawed'

It is also one of the least efficient, delivering less service per pound put in. The annual survey is by HealthConsumer Powerhouse, which campaigns for social insurance type systems rather than nationalised models such as the NHS. It ranks 33 systems on 38 factors such as patient rights, waiting times and access to medicines. Total possible score is 1,000 points and the Netherlands tops the list with 875, followed by Denmark (819) and Iceland (811). The UK, with 682 points, ranks just behind Ireland's 701. Lowest ranking of all was Bulgaria's 448 points. The NHS ranking was just above former Communist states Slovenia and the Czech Republic but below France, Germany and Ireland. It did rank better than Italy however.

The Netherlands is the only country which has consistently ranked in the top three during the five years the survey has been carried out.

But the UK's has been steadily increasing. It could have been higher this time, but the report comments: 'A mixed performance is shown by the UK: the overall UK score is dragged down by waiting lists and uneven quality performance'.

A spokesman for the Department of Health said: 'Once again, the European Consumer Health Index report is based on flawed methodology and old data. 'There is a lot of credible and up-to-date evidence available showing just what great strides have been taken, on the back of record investment, in improving NHS services across the country. 'The NHS is treating more people and saving more lives than at any time in its history with waiting times at their lowest levels since records began.' 'Twelve years ago it was not uncommon for patients to have to wait over 18 months for an operation. 'Record investment and dedicated staff have given patients the shortest waits since NHS records began with average waits from referral to start of treatment at around eight weeks for admitted patients and four weeks for non-admitted patients.' [We won't mention the many "fudges" used to produce those figures]


Senior British hospital doctor could face charges after jury rules patient died of gross neglect

A consultant could face a manslaughter investigation after a cancer patient died when she was mistakenly prescribed a lethal overdose of chemotherapy, an inquest heard. Anna McKenna, 56, was given four times the recommended daily amount of Idarubicin to treat her bone marrow cancer. Mother-of-five Mrs McKenna should have taken 60mg of the drug over four days, but was told to take 60mg per day.

Yesterday Avon Deputy Coroner Brian Whitehouse heard a jury return a narrative verdict of manslaughter due to gross neglect after a jury returned a majority decision of eight to two. The ruling now means that the CPS will review its decision that there was no criminal case to answer.

Anna's family told the five-day hearing that blundering doctors ''panicked'' and tried to ''cover up'' the error by refusing to tell them she had been given the wrong medication. The overdose destroyed Anna's infection-fighting white blood cells, leaving her immune system powerless against disease. She developed renal failure and died at the Bristol Oncology Centre three weeks later on April 18 2006.

Dr Jacqueline James, a consultant haematologist at Frenchay Hospital in Bristol, admitted the blunder at the inquest and said she was ''very sorry'' for what happened. Recording a verdict of manslaughter due to gross neglect yesterday, Avon deputy coroner Brian Whitehouse said: ''I offer my sincere condolences to the family."

Mrs McKenna, a housewife from Knowle, Bristol, was diagnosed with multiple myeloma, a cancer of the bone marrow, in March 2006 and prescribed a course of chemotherapy tablets. Her condition was terminal, the treatment was administered in the hope of prolonging her life. Without the medication, doctors gave her just two years to live. But Mrs McKenna was given a prescription for 60mg of Idarubicin per day, instead of the usual 15mg or 20mg per day. The drug left her in agonising pain, suffering with vomiting and diarrhoea. It also sparked a high fever and led to renal failure.

Her daughter Nancy McKenna said: ''It was such a traumatic experience for my whole family seeing our mum like that. You wouldn't treat your dog the way they were treating her. ''Mum was rushed to hospital after being so ill for many days. When we got there we told the doctor that she had been given an overdose and she told me to go home and bring in the medication mum was on. ''I brought it in and the doctor looked at it. I kept on and on as did the rest of the family about the fact she had been overdosed but no one was listening. ''We told the doctors treating mum that we thought she had been given the wrong dose of Idarubicin and we maintain that."

Dr James admitted prescribing four times the recommended dose and said: ''I am very sorry that a mistake was made.'' Verdict: Manslaughter due to gross neglect.

Outside court a family statement, read by solicitor Kerstin Scheel, said: ''The family of Mrs McKenna have been absolutely devastated by her sudden and unnecessary death in April, 2006. ''They feel extremely angry not only that such a serious mistake was made in her prescription but also that this was not found by the pharmacist who was supposed to act as a safety net to the patient. ''They greatly hope that this will never happen again to another patient and that the new safeguards in place will make a difference for others in the future. ''Anna was a devoted wife, mother and grandmother and is sorely missed by her whole family.''

Chris Burton, medical director of North Bristol NHS Trust, said: ''North Bristol NHS Trust would like to take this opportunity to repeat it's sincere apologies and condolences to Mrs McKenna's family and friends. ''The trust has cooperated fully with external investigations into the circumstances surrounding Mrs McKenna's death. ''Patient safety is our priority and following Mrs McKenna's death we made immediate and significant changes to our procedures around prescribing and issuing Idarubicin.''

A spokesman for Avon and Somerset police said: ''South Gloucestershire police investigated the circumstances surrounding the death of Anna McKenna in 2006 and prepared a file for the Crown Prosecution Service. ''After consideration by specialist lawyers, the CPS decided that there was not a criminal case to answer and police submitted a file to the coroner. ''Following the verdict of unlawful killing, the case will be reviewed in liaison with the CPS. South Gloucestershire police again offer their sincere sympathy to the family of Anna McKenna for their loss.''


Poll: Support for Obamacare at New Low

Only 41 percent of voters now support President Barack Obama and the Democrats' healthcare reform proposal — down from 44 percent two weeks ago and the lowest level of support yet measured by Rasmussen Reports. Rasmussen's nationwide telephone survey also found that 56 percent of voters are now opposed to the plan. Just 33 percent of senior citizens favor the plan, while 59 percent are opposed. Other findings of the poll:

# 46 percent of respondents believe the reform plan will likely pass and become law this year, but 47 percent think it will likely not pass, including 15 percent who say it is not at all likely to pass.

# While 23 percent of voters "strongly favor" the legislative effort to reform healthcare, 43 percent are "strongly opposed."

# 24 percent of respondents say the quality of healthcare will improve if the plan passes, and 55 percent say it will get worse.

# 54 percent say passage of the plan will increase the cost of healthcare, and 23 percent say it will lower the cost.

# The overwhelming majority of voters — 78 percent — believe that every American should be able to buy the same health insurance plan that Congress has.

# 53 percent think tort reform will significantly lower the cost of healthcare.

# 48 percent of respondents want a prohibition on abortion in any government subsidized program, and 13 percent want a mandate requiring abortion coverage.

"The most important fundamental is that 68 percent of American voters have health insurance coverage they rate as good or excellent," Scott Rasmussen, president of Rasmussen Reports, wrote recently in The Wall Street Journal. "Most of these voters approach the healthcare reform debate fearing that they have more to lose than to gain."


Blue Dogs in the Doghouse over the Public Option

With the debate over ObamaCare proceeding into the month of October, and still no vote in the House on H.R. 3200, there is no question that House Speaker Nancy Pelosi remains dedicated to pursuing the so-called public “option.” She says it could “save enormous amounts of money.”

Her latest defense of the public “option”—which is not at all optional since it requires every American to have insurance—are a part of her attempts to woo the 52 member House Blue Dog caucus, 40 of whom have sworn up and down not to vote for a plan that adds a single cent to the deficit. The validity of her promise to “save” money is critical.

How much in savings is House leadership promising? According to the Wall Street Journal, “Congressional aides said including a government-run plan for people under 65 in the health overhaul could save as much as $100 billion, if such a plan were to pay health-care providers the low rates used by Medicare…”

Which is funny. The House version of the plan makes eligible some 45 million people not currently covered under government-run health care, taking the number from 80.3 million currently covered to some 125.3 million. It’s simple math. An average premium goes for about $4,700, and adding 45 million to the government rolls, as envisioned under the House bill, would actually add $211.5 billion a year.

Nobody thinks this is deficit-neutral. Except for Barack Obama, the House majority, and a few sycophants who wish to maintain a talking point. By the House majority’s standard, that means the nation will wind up actually “saving” money. “[E]normous amounts of money.” But everyone else knows this will be costly very costly.

And unless House Blue Dogs wish to go from the people’s House to the doghouse, they had better make good on their promise not to add a cent to an already out-of-control debt—now some $11.8 trillion.


Health Care Analogies

It is good that the President has ceased attempting to sell his public option health care initiative on the strength of a comparison to the United States Postal Service. Americans will not soon be convinced of the economic viability of an expansion of public healthcare when it is compared to an entity on track to lose $7 billion this year. This past summer the Government accountability office put the postal service on its high risk list because of its “increasingly shaky financial footing,” and in the spring Post Master General John Potter asked Congress for permission to cut delivery service back to 5 days per week and close 700 offices nation wide. This is not the sort of talk that inspires confidence that a government takeover of the healthcare industry is the answer to our fiscal tribulations.

It is bad that the President, demonstrating what can only be described as intellectual density, has chosen instead to compare his public option to our system of state colleges and universities. This is particularly ironic given the fact that the cost of higher education has been skyrocketing for years and has in fact outpaced that of healthcare. Even more ironic is that according to the College Board's annual tuition survey, the rate of growth of the price of public 4 year colleges has been faster than at private 4 year colleges; a trend that has persisted for 3 decades.

The Los Angeles Times recently reported that the California State Board of Regents has asked for an increase in fees for undergraduate residents that would be 44% higher than they were in 2008. In addition they are considering “ideas to reduce freshman enrollment by an additional 2,300 students…and to charge extra fees for some upper division undergraduate majors, such as business and engineering.” A quick Google search reveals similar stories being reported across the country.

Our public institutions of higher learning struggle with rapidly rising costs and they do so for many of the same reasons as their private competitors, which as it happens are similar to those responsible for increases in the cost of healthcare: inflated demand and over reliance on third party payers and subsidies.

In fairness to the President, one of the points he is trying desperately if unsuccessfully to make is that public and private entities can co-exist. The point his detractors are making with increasing success is that if the problem we are attempting to address is the rising cost of healthcare, a “public option” is not a solution. The presence of a state run university system has not curtailed the rising cost of education in general nor has the “public option” slowed the rise in the cost of Public education specifically.

Of course Obama insists that taxpayers will not be subsidizing his public healthcare option; that it will be “self-sufficient” and “financed solely by the premiums it collects.” Revealing a disturbing lack of economic literacy he insists this can be accomplished because the public option will reduce waste and overhead and will not be burdened by the need to make a profit. (As if profit were some arbitrary and evil charge added onto a product or service. In fact it is the engine that drives the efficiency and cost cutting the president claims to be seeking. If it were not so we would have seen over the years non-profit organizations taking away the customers of profit seeking enterprises. Alas the opposite has been true. But I digress.)

Inquiring minds are dying to know A) why no one else has ever thought to reduce waste and inefficiency and B) what will account for the difference between the true cost of health care services and the price his public option will charge in order to make it “affordable.” Raise your hand if you hear Joe Wilsons voice echoing in the background. Rather like how public universities make higher education affordable to the masses the “public healthcare option” will be subsidized by taxpayers!

And like the public university system, when the government, which will be responsible for setting the price of care (as it sets the price of education at public schools), limits its financial commitment the institution must respond by raising its price and/or cutting and rationing its services. As the price is forced to better reflect the true cost of the service it will become less “affordable,” and like in higher education higher prices will increase the demand for financial aid, which according to both education and health care economists is a major driver of price inflation.

It is not fear of a Black Planet (as has been suggested by several new left apologists) that has sparked public opposition to the President’s ideas for health care reform. For an increasing number of Americans “Obamacare” is analogous with a slow-to-respond or unresponsive bureaucracy, suffering cost over-runs and seeking service reductions, and lay-offs in order to shore up its increasingly “shaky financial footing.”


Democrats unable to quell health care revolt among seniors

Senior citizens are putting the Democratic Party's 2010 election prospects and their health care reform proposals on a collision course. Outraged over Democratic plans to cut between $400 billion and $500 billion from Medicare in the next decade, voters over the age of 65 are poised to make the party suffer even steeper losses at the polls than have already been predicted for the midterm election. "Seniors bear the brunt of these bills as they are currently funded," said Betsey McCaughey, a former Republican lieutenant governor of New York and conservative health care policy expert. "It's a medical assault on seniors."

Democrats argue that Medicare is going bankrupt and must be reined in, and the cuts on the table will for the most part address wasteful spending and not take away benefits. But many seniors, who tend to make up a larger proportion of the electorate in off-year elections, are not convinced. They turned out in huge numbers at town hall meetings this summer, and poll numbers support what appears to be wide opposition among them.

A new survey from Rasmussen Reports found only 33 percent of voters over the age of 65 are in favor of the Democratic health care plan outlined by President Obama -- eight points lower than the electorate as a whole. Of those seniors against the Obama plan, 46 percent said they "strongly oppose" it.

At the center of the debate is a plan to slash spending on a program called Medicare Advantage, which is administered by private insurers and offers benefits beyond regular, government-administered Medicare plans, such as dental and vision coverage in exchange for larger premiums. It is used by about 10 million seniors, roughly 20 percent of all Medicare recipients. In the Senate, lawmakers are drafting a bill that would cut about $123 billion from Medicare Advantage over the next decade, which the Congressional Budget Office estimates would slash extra benefits seniors receive under the Medicare Advantage plans by half and that enrollment would drop by 2.7 million.

Democrats argue that Medicare Advantage costs too much and is driving Medicare toward insolvency, but Republicans are now seeking to protect it, which will undoubtedly help secure votes from this group in 2010.

Overall cuts to Medicare outlined in the Senate bill now being drafted include a $211 billion reduction in payments to hospitals, nursing homes, home help and hospice care, in addition to the cuts in Medicare Advantage. The Medicare reductions are making Democrats nervous, which some health care experts believe will result in a bill with far fewer cuts to the program. Sen. Bill Nelson, D-Fla., has introduced an amendment that would spare those currently enrolled in Medicare Advantage from any new cuts. "I can tell you this senator does not want to be in a position that I am taking away benefits from existing senior citizens," Nelson told the committee.


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