Friday, October 16, 2009

Horrible British bureaucrats bar ambulance crew from helping girl, 9, with fractured skull 'because they were having their lunch'

And they are not backing down either. To their socialist brains, what they did was right. Fortunately, the paramedics themselves had a conscience

Ambulance staff battling to save a nine-year-old car crash victim were told the nearest back-up crew could not help as they were on their lunch break.

Bethany Dibbs was struck by a car as she crossed the road on her scooter and ended up in a coma with a fractured skull. An ambulance crew arrived and called for help, only to be told by their operator that under strict meal break regulations the closest additional crew still had a few minutes left on their lunch break. The paramedics were informed it would take 20 minutes for another crew to arrive.

In the end one of them called their colleagues directly and they abandoned their lunch and raced to help. They arrived only five minutes after the original crew and took Bethany to hospital.

An ambulance worker, who asked not be named, said: 'There isn't one staff member who would not go, but we have to be given two 30-minute meal breaks and can't be interrupted. It's a joke.'

Bethany's father Stephen 48, of Poole, Dorset, said: 'The world really has gone mad. 'My little girl was lying unconscious in the road and they are quoting statutory health and safety regulations? Every second counts in that situation. 'Bethany is recovering but she's still got a long way to go. We're waiting to find out whether she has any long-term brain damage.' Mr Dibbs added: 'I can't fault the paramedics. They were fantastic. It is the system.'

A spokesman for the South Western Ambulance Service Trust said it took its health and safety duties seriously. He added: 'In line with national guidelines which must be adhered to by all ambulance trusts, it is important all staff have dedicated 30-minute rest breaks which cannot be interrupted.'


Half of British hospitals do not fully meet core care standards, says regulator

Almost half of hospitals fail to meet fully the core standards of care despite a decade of Government investment in the NHS, according to the health regulator’s annual report. The Care Quality Commission (CQC) warns today that more than 40 health trusts are at risk of being refused new licences to operate, which will be issued next April.

The report, an annual assessment of quality of care and financial management of NHS organisations, concludes that while there have been significant improvements in waiting times, tackling superbugs and controlling budgets, many trusts are still failing the basic requirements of good care. These include the number of patients having operations cancelled, heart disease care, record keeping, infection control and child protection.

Cynthia Bower, the chief executive of the CQC, warned that there needed to be rapid improvements to meet the legal demands of the new registration scheme, which could see failing trusts hit with a range of sanctions, including fines, suspension of services and prosecution.

The registration process risks embarrassing the Government, which has spent an extra £50 billion in real terms on the NHS in the past ten years. It will take place weeks before a general election, widely expected for May 6.

The annual appraisals rate every trust in England from “weak” to “excellent” based on information provided by trusts, inspections, patient feedback and audits of hospital finances. Of the 392 organisations assessed in the year to March 2009, including hospital, primary care, mental health and ambulance trusts, only 58 scored “excellent”, compared with 100 last year. However, there was a rise in the number that scored “good” (186) and slight decreases in the numbers that were “fair” (128) and “weak” (20).

Ms Bower said that the most worrying trend was the number of trusts that continued to “bump along the bottom” despite repeated warnings. “They must do better for their patients. I want to ring alarm bells in the boardrooms of these organisations,” she said. She added that part of the fall in top ratings was down to a more rigorous focus on key issues such as hygiene and child protection.

Politicians and health specialists questioned why the NHS was improving so slowly and warned that the current economic climate would only make improvement harder. The Government set out essential care benchmarks to be met by all trusts as a matter of urgency more than five years ago in Standards for Better Health.

Niall Dickson, chief executive of the King’s Fund, said that the minority of trusts that repeatedly failed to sort out basic issues such as hygiene, patient safety and staff training were a cause for concern. He added that given current standards had been achieved in a period of funding growth, the big challenge would be maintaining the status quo.

The CQC raised registration concerns about a total of 47 trusts, 20 of which are rated “weak” and 27 that have not been higher than “fair” over the past four years. It said that the drop in the number of hospitals fully meeting the core standards — from 69 per cent in 2007-08 to 59 per cent this year — also needed highlighting.

A total of 37 trusts were rated “double excellent” on quality and financial management, including the Royal Marsden NHS Foundation Trust, which achieved the standard for the fourth year in a row. Only one trust, Barking Havering and Redbridge University Hospitals Trust, scored a “double weak” — an improvement on the six trusts receiving the rating last year.

The regulator has written to 54 trusts to congratulate them on consistently strong performances or improvements. “Those rated ‘excellent’ deserve to be commended,” Ms Bower said. “But it is clear that some trusts are struggling and that some issues are proving tough nuts to crack. It is clear that many have significant work to do and a short time in which to do it.”

Andrew Lansley, the Conservative health spokesman, said that the regulator’s report showed that the level of improvement was not as it should be. “Given the increases in taxpayers’ money spent on the NHS, patients rightly expect that basic standards will be consistently met and will actually improve year on year,” he said. “This has clearly not happened.”

Mike O’Brien, the Health Minister, said that the “tough assessment” showed improving standards across the NHS. He said that the Government expected “immediate action” to prepare trusts rated as “weak” for the new standards next year.


'We're Going to Let You Die'

Who said it? Hint: It wasn't Sarah Palin

If you're not part of a special interest but just a regular American who hopes one day to grow old (because it beats the alternative), has a timely reminder that proponents of "health-care reform" don't necessarily sympathize with that aspiration. NewsBusters links to another Morgen Richmond YouTube clip, this one of a speech that Robert Reich, who served as President Clinton's labor secretary, delivered on the subject in 2007:
I will actually give you a speech made up entirely--almost at the spur of the moment, of what a candidate for president would say if that candidate did not care about becoming president. In other words, this is what the truth is, and a candidate will never say, but what candidates should say if we were in a kind of democracy where citizens were honored in terms of their practice of citizenship, and they were educated in terms of what the issues were, and they could separate myth from reality in terms of what candidates would tell them:

"Thank you so much for coming this afternoon. I'm so glad to see you, and I would like to be president. Let me tell you a few things on health care. Look, we have the only health-care system in the world that is designed to avoid sick people. [laughter] That's true, and what I'm going to do is I am going to try to reorganize it to be more amenable to treating sick people. But that means you--particularly you young people, particularly you young, healthy people--you're going to have to pay more. [applause] Thank you.

"And by the way, we are going to have to--if you're very old, we're not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It's too expensive, so we're going to let you die. [applause]

"Also, I'm going to use the bargaining leverage of the federal government in terms of Medicare, Medicaid--we already have a lot of bargaining leverage--to force drug companies and insurance companies and medical suppliers to reduce their costs. But that means less innovation, and that means less new products and less new drugs on the market, which means you are probably not going to live that much longer than your parents. [applause] Thank you."

As noted in our transcription, Reich's Berkeley, Calif., audience applauded the idea of taxing the young, killing the old, and stifling lifesaving innovations. One suspects that these ideas would not be greeted as warmly in most other American locales, which is why elected politicians who are actually trying to sell such ideas cloak them in euphemisms about "universal care," "reform," "cost cutting" and so forth.

Liz Hunt of London's Daily Telegraph reports on an even more chilling euphemism used in a country that long ago instituted "health-care reform":
"Mrs ------- has breathing difficulties," the night manager told her. "She needs oxygen. Shall we call an ambulance?"

"What do you mean?" my friend responded. "What's the matter with her?"

"She needs to go to hospital. Do you want that? Or would you prefer that we make her comfortable?"

"Make her comfortable." Here's what that meant:
Befuddled by sleep, she didn't immediately grasp what was being asked of her. Her grandmother is immobilised by a calcified knee joint, which is why she is in the home. She's a little deaf and frail, but otherwise perky. She reads a newspaper every day (without glasses), and is a fan of the darling of daytime television, David Dickinson. Why wouldn't she get medical treatment if she needed it?

Then, the chilling implication of the phone call filtered through--she was being asked whether her grandmother should be allowed to die.

"Call an ambulance now," my friend demanded.

The person at the other end persisted. "Are you sure that's what you want? For her to go to hospital."

"Yes, absolutely. Get her to hospital."

Three hours later, her grandmother was sitting up in A&E [the accident-and-emergency ward], smiling. She had a mild chest infection, was extremely dehydrated, but was responding to oxygen treatment.

As Hunt notes, "Withdrawal of fluids (and drugs) is one of the steps on the controversial palliative care programme known as the Liverpool Care Pathway, which has been adopted by 900 hospitals, hospices and care homes in England."

More here

The destructiveness of mandates

Because of regulations, New Jersey insurance costs are among the highest in the nation

A state requirement that health insurance must cover mammograms has come to play a central role in the New Jersey gubernatorial race between incumbent Democrat John Corzine and Republican challenger Chris Christie.

The Corzine campaign has flooded the airwaves with an ad claiming that "if Chris Christie was governor, insurance companies could drop mammogram coverage." Mr. Christie went from a 28-point lead in August among independent women to a one-point deficit earlier this month, according to the Monmouth University Polling Institute. But how true is the Corzine claim, and how effective are state mandates in improving health coverage?

State mandates make health insurance more comprehensive, but they also make it more expensive. A state can easily increase the cost of a basic health insurance policy by 25%, depending on the number of mandates it has and what they cover. The higher premiums drive some into the ranks of the uninsured.

New Jersey has arguably the highest health insurance premiums in the country, and health insurance mandates (the state currently has 45, about average for the country) are one reason.

In the early 1990s, New Jersey also passed legislation requiring insurers to accept all applicants, regardless of their health status (guaranteed issue) and charge them all the same price (community rating). President Barack Obama wants to do the same thing nationally.

There were repeated warnings that such legislation would drive up health insurance premiums. But New Jersey legislators ignored those warnings. Today, New Jersey residents have relatively few health insurance options, and coverage is significantly more expensive than in most other states. Just across the state line in Pennsylvania, for instance, a family can buy a comparable insurance policy for a quarter to half the price.

Mr. Corzine didn't create the New Jersey health insurance mess, but in the past four years he's done nothing to fix it. Yes, New Jersey has a mammogram mandate that requires insurers to cover the roughly $100 annual procedure. But that's little consolation to an uninsured person who's been priced out of the market for health insurance because of all the other requirements mandated by the state.

In order to address these problems, Mr. Christie has suggested giving people access to policies with fewer or no mandates. New York has done that for lower-income families, and it's been very popular.

In an Oct. 1 debate, Mr. Christie argued that there should be a range of polices available in New Jersey from "high-end" to "more bare-bones," and that "people should make a determination on their own" which policy they want. He emphasized choice, with the ultimate aim of giving patients access to "some kind of insurance rather than continue to have no insurance at all."

Mr. Corzine explicitly defended benefit mandates, even going so far as to claim his position on the issue is "one of the clearest differences between me and my opponent."

As for the Corzine ad about mammogram coverage, Mr. Christie denounced it as "deceitful." He's right. After all, not requiring health insurers to cover mammograms doesn't mean they won't. Large employers that "self-insure" (meaning they pay claims themselves, even though an insurer may handle the paperwork) come under federal, not state, law, and so are not subject to state mandates. And yet most employer-based plans cover mammograms without a government mandate. Why? Because it saves money and lives in the long run.

New Jersey could also allow its citizens to buy health insurance from other states—another Christie proposal. If New Jersey isn't willing to change its laws so that families can get affordable coverage, the state should at least let those families buy coverage in another state.

Mr. Corzine has tried to make the case that he is the only candidate protecting women and fighting breast cancer. Nonsense. His unwillingness after four years to do anything about the high cost of health insurance in New Jersey is increasing the number of uninsured and doing far more harm than any mandate-lite policy could ever do.


Here's what is stopping tort reform

In his September 9, nationally televised speech before a joint session of Congress, President Obama made news by saying that medical-malpractice litigation "may be contributing to unnecessary costs" in the U.S. health-care sys¡©tem.

Since then, trial-lawyer advocates--including their lobbying arm, the American Association for Justice (AAJ), and various allied "consumer" groups such as the Center for Justice and Democracy--have been engaged in a fierce counter-attack. Front-and-center among the lawyer-advocates' arguments is that litigation is too small a piece of the health-care puzzle to make much difference.

In a letter to Senate Finance Committee chairman Max Baucus, such self-styled consumer groups claimed that costs consumed by medical-malpractice litigation represent "less than 0.6 percent of all health care spending."

To reach this number, the groups are playing a deceptive fraction game, in which they embrace a small numerator based on a ridiculously narrow interpretation of litigation costs and a large denominator encompassing every dollar spent on health care.

The lawyer-allies would count as litigation expenses only the malpractice litigation claims paid out directly by insurance companies in a given year. Conveniently, the lawyers' advocates ignore self-insured hospitals and legal-defense costs, not to mention defensive medicine--the cost of excessive tests, procedures, and referrals that doctors order due to fear of liability.

Ninety-three percent of doctors say they have practiced defensive medicine, and the real cost savings from reforming malpractice liability stem from curbing such wasteful practice. Academic researchers have reached different conclusions on how much money tort reforms save by preventing defensive medical practice, ranging from two percent of all health costs in some studies to as much as nine percent in others.

Such a percentage itself is much larger than it might seem. If we look at the difference in U.S. health spending relative to that in other developed countries--such as Canada, Germany, or France--medical-malpractice reform would eliminate anywhere from six to 27 percent of all additional health costs.

While defensive medicine costs a lot, it is hardly the only cost-escalation stemming from lawsuit abuse. The lawyers' advocates try to ignore the vast health-related litigation, apart from medical-malpractice lawsuits, which targets nursing homes, pharmaceutical manufacturers, and HMOs.

And the cost of this litigation matters, too. From 1992 to 2003, the cost of litigation per nursing-home bed rose 700 percent. When trial lawyers almost sued the vaccine manufacturers out of existence in the 1980s, they drove up vaccine prices as much as 4,000 percent.

After that vaccine-liability crisis, Congress acted responsibly to establish an alternative compensation system outside the tort system, which hurt the trial bar's profits but preserved the vaccine markets. But Congress will not take any meaningful steps to curb lawsuit abuse as a part of comprehensive health reform this year, notwithstanding that 83 percent of the American public wants them to do so.

The reason is clear - money. The trial lawyers' political action committee is the second-largest donor to Democrats' federal campaigns, and lawyers gave $127 million to Congressional candidates in the 2008 political cycle--more than doctors and health professionals, hospitals and nursing homes, pharmaceutical companies, and HMOs, combined.

As medical doctor and former Democratic National Committee chairman Howard Dean admitted in a town-hall meeting this summer, "The reason why tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers."

It's a myth to think that liability reform alone could cure the nation's health-care problems, but it is equally a myth to think it doesn't matter. Unfortunately, because of the trial lawyers' stranglehold on Congress, meaningful liability reform, this year, is simply wishful thinking.


Obamacare Means $1,700 More in Insurance Premiums for a Typical Family

Will a young, healthy, childless individual or couple buy health insurance costing 7.5 percent of their income as required by Obama's health legislation? Not until they get sick. Then, they can always buy the insurance -- and the Obama bill requires the insurance companies to give it to them. And, if the premiums come to more than 7.5 percent of their income because they are now sick, no problem. Obama will subsidize it.

Instead, young, healthy, childless people will likely opt to pay the $1,000 fine (a.k.a., slap on the wrist) mandated in the bill. After all, even if they make as little as $50,000 a year, the fine is a lot cheaper than 7.5 percent of their income (or $3,500 a year)!

So ... these young households will not contribute to the coffers of any health insurance company until they are sick and need the coverage. By then, their costs will come to vastly more than their premiums.

Who will subsidize the difference? We will. The insurance industry estimates that the bill will drive up premiums for the average family by $1,700 a year. By the time the bill takes effect in 2013, it estimates that the average annual family health insurance premiums (now $12,300) will rise to $17,200 if the Obama bill is passed, but only to $15,500 if it is defeated. And who do you think the voters will blame for the hike in their premium? The Democrats who passed the bill.

Supporters of the bill are quick to counter that greater efficiency, etc. will hold down premiums. But they have little to answer the argument that, without higher fines, the young and healthy will not consent to pay an arm and a leg for insurance they don't need.

Any lingering motivation to pay the premiums will disappear once the Obama bill requires insurance companies to cover them when they do, finally, limp in the door, desperately in need of insurance. Why pay now when you can always pay later? And, with a government subsidy, you gain nothing by paying for all those years when you don't need insurance.

So Obama's program turns out not to be one to spread insurance and thus spread the risk of costly illness, but one to make people pay 7.5 percent of their incomes once they get sick, with the government picking up their remaining premium and the health insurance customers paying for the medical expenses. Some deal!

So tote up the cost of this bill on the middle class:

-- $1,700 more in insurance premiums for the average family.

-- Medical devices like wheelchairs and hearing aids get taxed.

-- Those who are sick must pay an average of about $600 more a year in income taxes because the bill raises the threshold for deducting medical expenses from 7.5 percent of income to 10 percent.

-- A $404 billion cut in Medicare.

-- Ending the subsidized Medicare Advantage insurance for costs over and above Medicare. Without Medicare Advantage, the elderly can only augment Medicare by buying Medigap coverage for which no subsidy is available and whose premiums are higher (offered, conveniently enough, by Obama's buddies at the AARP).

-- No importation of Canadian medicines and no competitive bidding to hold down prescription drug costs (Obama's deal to get Pharma's support and advertising dollars).

-- A shortage of medical personnel and equipment as 30 million new patients are added without any expansion of the population of doctors and nurses. This shortage will make rationing inevitable, even if it shortens life expectancies among the elderly.

And, all of this assumes that the House bill, which imposes a 4.5 percent payroll tax (which will discourage new employment), does not pass -- and that the cost estimates of this program prove realistic. Despite the Congressional Budget Office's concurrence, one can't help noticing that Massachusetts' program was estimated to cost $200 million in 2005 and now costs $700 million!

This health care bill is, indeed, Obama's first tax on the middle class.


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