Saturday, October 10, 2009

Briton has badly busted arm but NHS won't fix it

THIS crippled plumber horribly broke his arm TEN months ago and is still waiting for surgery to repair it. Torron Eeles busted his left humerus bone leaving it grotesquely out of shape when he fell down stairs. Today he slammed the NHS for "unacceptable" delays - claiming they have cancelled FOUR separate operations.

His arm hangs limply by his side meaning Torron cannot work for a living and now faces the prospect of losing his home. Torron, from Welham Green, Herts, said he had applied for employment and support allowance but was denied both.

The dad-of-three said: "This whole situation is absolutely disgusting. I have never heard of anyone else having a broken arm for 10 months. "It's been so long the bones have knitted back together. Sleeping is really uncomfortable because whenever I roll over my arm gets in the way. "I'm a kitchen fitter and plumber by trade but I can't even slice a load of bread let alone work."

Torron fractured his arm on December 3, 2008, and rushed straight to casualty where doctors put his arm in plaster. The first two ops were cancelled due to a lack of beds and operating time, claimed Torron. Then two more were delayed because of Torron's high blood pressure and concerns over his smoking.

Nick Carver, the chief executive of the East and North Herts NHS Trust, insisted computer records showed the trust had only cancelled two operations - one in February and a second in May. He said proceeding with the operations could have put Torron's life at risk. Mr Carver said: "Mr Eeles' operation was cancelled only twice - and then both on clinical safety grounds." [Incomprehensible rubbish. Just shallow excuses]


New drug could help 40,000 rheumatoid arthritis sufferers but too dear for NHS dependant Brits

You are just cattle to government health bureaucrats, an impersonal problem

An alternative new drug for rheumatoid athritis may help to ease the painful symptoms of 40,000 patients who do not benefit from current medications. Tocilizumab is the first new treatment for the condition to be developed for ten years, but to treat one patient will cost up to £9,300 a year, and it has yet to be approved for widespread use on the NHS. Five trials involving more than 4,000 patients have shown that the injected treatment can transform the lives of patients who cannot tolerate other therapies or no longer respond to them.

Six times more patients reported that they achieved clinical remission — a return to “normal” quality of life — with tocilizumab than with the standard drug treatment methotrexate. The drug, also known as RoActemra, targets a key signalling molecule that causes painful inflammation around the joints.

But this month the National Institute for health and Clinical Excellence (NICE) which assesses the cost effectiveness of new medicines in England, issued preliminary guidance that rejected the treatment as too expensive for use on the NHS. Without NICE approval, local health authorities are highly unlikely to pay for the drug.

The National Rheumatoid Arthritis Society, a charity supporting sufferers of the disease, described the decision as “extremely bad news”. But NICE could still reverse or alter this decision, before producing its final guidance in February.

Drug manufacturers said yesterday that negotiations with the watchdog were continuing.

Treating rheumatoid arthritis and related illnesses is estimated to cost the NHS more than £4 billion each year, as about 350,000 adults in Britain are estimated to suffer from the condition, many of whom are severely disabled.

Tocilizumab, made by the Japanese company Chugai Pharma and distributed by Roche, targets a specific molecule called Interleukin-6, which plays a key role in the immune system and generates inflammation which can exacerbate the symptoms of rheumatoid arthritis. It may be given either on its own or in combination with traditional anti-rheumatic drugs such as methotrexate, as a second- or third-line treatment where other therapies have failed.

In patients not responding to methotrexate or another altenrnative, anti-TNF (tumour necrosis factor) drugs, tocilizumab achieved 30 per cent remission rates after six months. After two years of treatment, 54 per cent of patients had seen their symptoms eased by the drug, based on their responses to clinical questionnaires.

Alisa Bosworth, chief executive of the NRAS, said: “The availability of this new drug is a significant breakthrough in the treatment of rheumatoid arthritis. Access to new treatment options is crucially important to enable more patients to have an opportunity of slowing disease progression and regaining their quality of life. Without access to these treatments, patients face a life of increasing disability and pain.”


Scottish hospital infested by pests

PEST CONTROLLERS were called in to deal with bats flying around wards at Ninewells Hospital in Dundee on two separate occasions last month, The Courier can exclusively reveal. Bats were seen on the general medical Ward 6 on September 4, and on the surgical Ward 9 five days later.

The shocking revelation is contained in a breakdown of incidents of pests over the last year in Tayside hospitals obtained under Freedom of Information legislation. It shows that between October last year and this September pest controllers were called to NHS Tayside hospital premises on 462 occasions to deal with rats, mice, seagulls, dead birds and even a dead rabbit. The majority of incidents involved insects including, ants, flies, cockroaches, wasps, silverfish, beetles and even hornets.

Last night Dundee-based Labour MSP Marlyn Glen said that patients and their families would find the idea of pest infestations in Tayside hospitals “utterly repellent.”

Among the incidents logged by health officials were mice in the kitchen and main dining room at Stracathro Hospital, rats in Ward 4 of Little Cairnie Hospital in Arbroath, mice in the main kitchen at Ashludie Hospital in Monifieth, rats outside the Queen Mother Wing at Arbroath Infirmary, and a bird’s nest in the personnel office at Ninewells. There were silverfish in the food preparation area at Perth Royal Infirmary, and cockroaches in the dining room at Sunnyside in Montrose. Maggots were also found in the corridor near the kitchen at the hospital. Between October 2008 and the end of July this year NHS Tayside spent £11,137.50 on pest control within hospital premises, including the grounds.

Last night Ms Glen said, “This will be very concerning to patients and their families. “When someone we love goes into hospital we have a right to expect that they will be treated in clean and safe conditions. “The idea that our hospitals are infected with mice, cockroaches and even bats is utterly repellent. “Nicola Sturgeon (health secretary) needs to get on top of this and support staff instead of cutting budgets and piling pressure on our doctors and nurses. “Our hospitals must be properly maintained and made fit for purpose. “How can we have confidence that ministers will succeed in eradicating hospital superbugs such as C. difficile when they can’t deal effectively with bugs and rodents?”

NHS Tayside has a local pest control contract in place, which includes regular inspection of all premises, and pest controllers are called out to deal with outbreaks of pests as they occur.


The Greatest Show on Earth

Step right up: A new entitlement that cuts the deficit!

Washington spent the week waiting for the Congressional Budget Office to roll in with its new cost estimates of the Senate health-care bill, and what a carnival. Behold: a new $829 billion entitlement that will subsidize insurance for tens of millions of people—and reduce deficits by $81 billion at the same time. In the next tent, see the mermaid and a two-headed cow.

The political and media classes are proving they'll believe anything, as they are now pronouncing that this never-before-seen miracle is a "green light" for ObamaCare. (What isn't these days?) The irony is that the CBO's guesstimate exposes the fraudulence and fiscal sleight-of-hand underlying this whole exercise. Anyone who reads beyond the top-line numbers will find that the bill creates massive new spending commitments that will inevitably explode over time, and that this is "paid for" with huge tax increases plus phantom spending cuts that will never happen in practice.

The better part of the 10-year $829 billion overall cost will finance insurance "exchanges" where individuals and families could purchase coverage at heavily subsidized rates. Senate Finance Chairman Max Baucus kept a lid on the cost by making this program non-universal: Enrollment is limited to those who aren't offered employer-sponsored insurance and earn under 400% of the poverty level, or about $88,000 for a family of four. CBO expects some 23 million people to sign up by 2019.

But this "firewall" is unlikely to last even that long. Liberals are demanding heftier subsidies, and once people see the deal their neighbors are getting on "free" health care, they too will want in. Even CBO seems to find this unrealistic, noting "These projections assume that the proposals are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation." Scratch "often."

Then there are the many budget gimmicks. Take the "failsafe budgeting mechanism" that would require automatic cuts in exchange spending if it increases the deficit. CBO expects 15% reductions in exchange subsidies each year from 2015 to 2018, even though the exchanges don't open until 2014. That kind of re-gifting should have been laughed out of the committee room, but the ruse helps to move future spending off the current budget "score."

Mr. Baucus spends $10.9 billion to eliminate the scheduled Medicare cuts to physician payments—but only for next year. In 2011, he assumes they'll be reduced by 25%, with even deeper cuts later. Congress has overridden this "sustainable growth rate" every year since 2003 and will continue to do so because deeper cuts in Medicare's price controls will cause many doctors to quit the program. Fixing this alone would add $245 billion to the bill's costs, according to an earlier CBO estimate.

The Baucus bill also expands ailing Medicaid by $345 billion—even as it busts state budgets by imposing an additional $33 billion unfunded mandate. The only Medicare cut that isn't made merely on paper is $117 billion in Medicare Advantage, which Democrats hate because it gives one of five seniors private insurance options.

Recall that when President Obama started the health-care debate, the goal was "bending the curve"—finding a way to reduce both Medicare and overall health spending. Budget director Peter Orszag talked about "game changers," which CBO has now outed as nonchangers. Comparative effectiveness research about what treatments work best? That will save all of $300 million in Medicare, even as it costs $2.6 billion in new taxes on premiums. More prevention and primary care will increase spending by $4.2 billion.

Meanwhile, the bill piles on new taxes, albeit on health-care businesses so the costs are hidden from customers. Insurance companies offering policies that cost more than $8,000 for individuals and $21,000 for families will pay $201 billion per a 40% excise tax, which will be passed down to all policy holders in higher premiums. Another $180 billion will hit the likes of drug and device makers, including $29 billion because companies won't be allowed to deduct these "fees" from their corporate income taxes. Then there's the $4 billion in penalty payments on those who don't buy insurance because all of ObamaCare's other new taxes and mandates have made it more expensive.

Senate Finance votes next week, and no doubt this freak of political nature will pass amid fanfare and self-congratulation that their new entitlement will reduce deficits. Never mind that such a spectacle has never happened in the history of the republic. P.T. Barnum had nothing on this crowd, and the bill hasn't even hit the Senate floor yet.


The GOP Is Winning the Health-Care Debate

Gallup says independents now favor Republicans by nine points

Passing health-care reform could be harmful to the health of congressional Democrats. Just look at how President Barack Obama's standing has fallen as he has pushed for reform. According to Fox News surveys, the number of independents who oppose health-care reform hit 57% at the end of September, up from 33% in July. Independents are generally a quarter of the vote in off-year congressional elections.

Among college graduates, opposition to health-care reform is now 50%, while only 33% support it, according to Gallup's Sept. 24 poll. College graduates are slightly more than a quarter of the off-year electorate.

Among seniors, opposition to ObamaCare hit 63% in last month's Economist/YouGov Poll. But the number from that poll that should spook Democrats is this: 47% of seniors said they "strongly" oppose health-care reform, just 27% "strongly" support it. Seniors are the biggest consumers of health care, and their family members will probably take their concerns seriously. Seniors will likely cast about 20% of the votes next year.

The trend behind these numbers is that voters are turning away from Democrats. In 2006, the year the GOP lost control of Congress, Democrats enjoyed a double-digit lead in several "generic ballot" polls—a measure of voters' party preference. Democrats held that lead until this year. Today, Gallup's generic ballot shows Democrats have a razor thin 46% to 44% edge. According to Gallop's numbers, independents now favor Republicans by nine points.

The numbers may get worse for Democrats if they pass a health-care bill. Why? Because Senate Finance Committee Chairman Max Baucus (D., Mont.) wants to frontload the reforms with distasteful things. Under his plan, tax hikes and Medicare and Medicaid cuts kick in immediately, while new benefits are delayed for two-and-a-half years. Voters likely won't warm to reforms that slam them next year while promising benefits down the road.

Congressional Democrats could also be the first to feel a backlash against rising federal spending. An early September Gallup poll found that 38% approve and 58% disapprove of Mr. Obama's handling of the deficit (from 49% approve, 44% disapprove in March). In September, a Fox News poll found that 61% of independents think the Obama administration wants to increase spending too much; just 29% thought the amount of spending Mr. Obama wants is "about right."

After a $787 billion stimulus package and other spending binges this year that have the administration planning to double the deficit in five years, many voters are worried about the amount of red ink being spilled.

Voters likely won't react well to the price tag of Mr. Baucus's bill. Yesterday's Congressional Budget Office (CBO) report pegs its cost at $829 billion over the next 10 years. The CBO report claims the bill won't add to the budget deficit until 2015—but the bill only manages that feat by delaying benefits and imposing taxes and Medicare and Medicaid cuts up front.

The CBO report does shed some light on the cost for each person the Baucus plan would add to the ranks of the insured. CBO estimates the plan would insure about 29 million people. If that is right and if the total price tag is also accurate, the average cost per year per person for the seven-and-a-half years benefits will be in force during the program's first decade would be $3,811. That compares favorably to private insurance. On average, a single person now pays $4,824 a year for health coverage and a family of four pays $3,344 per family member per year, according to the Kaiser Permanente Institute for Health Policy.

But the CBO numbers are almost certainly overly optimistic —there has only been one large-scale federal health program that has come in at or under its projected cost, the Medicare prescription drug benefit enacted under the previous administration, which is costing 40% less than estimated.

The good news for the president is that his job approval ratings appear to be stabilizing. The Rasmussen tracking poll for Oct. 2-3 shows 46% of likely voters approve and 50% disapprove of his performance, essentially unchanged over the past month.

Independents, the college educated and seniors may oppose health-care reform, but if Mr. Obama has halted his slide congressional Democrats may be willing to bet on him and go for his whole health-care reform enchilada—public option and all.

This battle is far from over. But what Democrats have to keep in mind is that there are two fights going on here —one over health care and another over which party will control Congress after next year's elections. By waging the first, they may be setting themselves up to lose the second.


Does Medicare Care?

Throughout the health care debate, insurance companies have been cast as greedy villains that gleefully deny medical claims. But when it comes to rejecting claims, they can't hold a candle to the government. Just days before Congress broke for its August recess, House Speaker Nancy Pelosi called the insurance industry's opposition to a government-run health plan "almost immoral" and accused carriers of profiting at the country's expense. "Of course they've been immoral all along in how they have treated the people that they insure," said the San Francisco Democrat who has taken more than $200,000 in political contributions from the insurance industry in the last two election cycles. "They are the villains. They have been part of the problem in a major way."

The complaints lodged toward the industry from the Democratic side are focused primarily on premiums -- too high, government health care supporters say -- and horror stories about private insurers denying care. Neither criticism, however, is fair. Premium rates are affected in no small way by government policy. Mandates handed down by lawmakers add significantly to costs. The Congressional Budget Office believes mandates such as requiring insurers to sell policies to anyone who wants one and rules on what treatments must be covered increase premium costs by 15%. The Council for Affordable Health Insurance says the increase is higher -- 20% in some states and as much as 50% in others.

As for denial of care, Medicare, which we've described as the government's public option for senior citizens, has the highest denial rate in the country, according to the American Medical Association's 2008 National Health Insurer Report Card. From March 1, 2007, to March 10 of last year, Medicare rejected 475,566 of 6.94 million claims for a rate of 6.85%.

Aetna was the only private insurer that had a similar number, denying 43,317 of 637,239 claims for a rate of 6.8%. But the average of seven carriers was 4.05% including Aetna. Dropping Aetna as an outlier takes the denial rate down to 3.08%.

Medicare's biggest reason for rejection (27.8%) was claims lacking information "needed for adjudication," the AMA report says. More than one-fifth (20.9%) of the rejections were in response to procedures deemed not to be a medical necessity by Medicare. Nearly 4% were rejected because they were noncovered services performed during a routine exam or screening. In 3.1% of the cases, Medicare said the expenses were incurred before the patient was covered -- a pre-existing condition. Other claims were denied because the patient wasn't covered by Medicare or couldn't be identified as a Medicare recipient, or there were paperwork problems.

Not surprisingly, the private insurers didn't deny a single claim due to corporate greed, Republican malevolence or any of the other criticisms the left uses to attack the insurance industry.

The lesson here is that a government program, even one as beloved as Medicare, is no more efficient, no more caring, no more morally superior than private coverage.

This isn't the only lesson that can help the public understand why government-run health care, even if it's just a camel's-nose-under-the-tent public option, would be a mistake. But it is part of a larger package of reasons that coherently argue against more intervention from the state, which controls 45% of U.S. health care spending as it is.


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