Sunday, October 25, 2009

ROUNDUP OF AUSTRALIA'S NEVER-ENDING MEDICAL MAYHEM

Three current reports below. Australia already has "free hospitals" for all, provided by kindly State governments. So why do 40% of Australians take out private insurance and go to Australia's excellent private hospitals instead? See below for a few hints

Unbelievable failure to learn at Queensland's Bundaberg Public Hospital

The deaths and injuries caused by an incompetent Indian doctor at the hospital became a national disgrace but the same casual disregard of qualifications is still happening there. And for all its legions of "administrators", Queensland Health has done nothing about standards at what is one of their own hospitals

A new report by Queensland's health watchdog reveals overseas-trained doctors continue to work at Bundaberg without their credentials being properly checked. And it accuses the hospital of attempting to cover up its credentialling errors.

The Health Quality and Complaints Commission quoted from a review by PricewaterhouseCoopers that said: "The report also found that retrospective granting of credentialling still occurs at Bundaberg Base Hospital. "That is, in some cases practitioners commence work before being formally authorised to do so by the district manager or CEO. "The report pertinently points out the legal and reputational risks involved."

The commission said in one case the hospital could not even find a doctor's employment application. In two other cases there was no evidence of referee checks and and in three cases there was no evidence of more than one referee check.

A second report critical of Bundaberg's emergency department says there are inadequate bays, inadequate staff, inadequate security, inadequate radiology services and inadequate training.

That report, released by Opposition health spokesman Mark McArdle, warns that most medical staff have never been involved in a performance appraisal and that only a quarter of the nurses have "post-basic" qualifications.

The report, by Dr Peter Brennan of Melbourne University, also warns the emergency department was not ideal for children. "The waiting area, triage area security room and reception are very small and cramped," Associate Professor Brennan said. "The environment is not conducive to calm behaviour. The physical layout has given rise to some shortcomings in triage. "There is no separate area for children or babies to wait. The reviewer witnessed toddlers being mixed up with verbally abusive patients."

Dr Brennan said the "failed implementation" of a discharge policy "is clearly an issue of leadership".

Mr McArdle said the State Government had broken its promise to fix Bundaberg Hospital and was attempting to hide problems from the public gaze. The commission was even more scathing of the hospital – and Queensland Health. Its report, by Dr Tim Smart and Dr Jill Newland, found "defects in a number of areas", including "incomplete documents and forms, inadequate database fields, incomplete, out of date, inconsistent and inaccurate database entries, incomplete filing, inadequate bring-up systems, inadequate resources". There was a "lack of clear accountability and active leadership for credentialling".

The Bundaberg Hospital claimed it had reviewed the credentialling process and that improvements had been implemented. "The Dr Smart and Dr Newland reports indicate this could not have been the case," said the commission's chief executive, Cheryl Herbert. In other words, Bundaberg was papering over the cracks.

Ms Herbert reserved some of her harshest criticisms for the department running the hospital. She said: "There is no evidence that Queensland Health assists its facilities by providing uniform and standard databases, training and resources for credentialling ... Further, the Health Quality and Complaints Commission is concerned that Queensland Health does not promote or support a leadership culture that insists on 100 per cent compliance with credentialling at Bundaberg Base Hospital."

Her report last month was ignored by the metropolitan media.

Ms Herbert's sharp words were followed this week by more bad news for the executives of Queensland Health. The Australian Medical Association's annual report card shows the State Government is failing to stem a decline in vital areas of service. There are long waits at emergency departments and intolerable waiting lists for patients waiting for even the most urgent of surgeries.

More than 180,000 Queenslanders are languishing on the so-called waiting list to get on a waiting list, which was exposed during the 2005 health crisis with a total of about 110,000 people waiting.

The AMA said so-called "access block" in emergency departments and bed occupancy levels above the recommended safe level compromised patient care. Again, it's all about the beds. Emergency rooms remain clogged with patients waiting to be admitted. Elective surgery is cancelled when accidents happen because there are not enough beds.

In private hospitals, surgeons start cutting at 7am and often don't finish until 11pm or midnight. In public hospitals, strangled by numbers and union regulations, operations are mostly restricted to nine to five.

Since July 2008, the total number of available beds statewide increased by only 76. This is despite a population growth of more than 1000 a week.

Health Minister Paul Lucas remains invisible. He has been warned the severe shortage of beds in Queensland's public hospitals has contributed to "access block" and hospital bypass, lengthy elective surgery and emergency department waiting times.

Clearly, our public hospitals don't have the capacity to cope. The result is that people are dying needlessly. Successive state governments have failed to repair the system.

SOURCE

NSW bureaucrats think they know more about medical problems than the doctors do

A WOMAN was denied a late-term abortion at a leading Sydney hospital, forcing her to carry a severely deformed foetus with no chance of survival for an extra week, in a decision that has infuriated senior doctors. The doctors at the Royal Hospital for Women in Randwick are angry senior management vetoed their clinical decision and have called for clarification.

The hospital's termination review committee, made up of senior clinicians and hospital managers, considered the case of the woman who was 32 weeks' pregnant. The foetus had severe brain abnormalities and would have had no functional life, the Herald has been told. The abnormalities became evident late in the pregnancy and a termination was sought for the mother's wellbeing and safety.

The Herald understands the hospital's director, William Walters, and its medical superintendent, George Bearham, opposed the termination although others on the committee - including a psychiatrist, a pediatrician and an obstetrician - supported it. The Herald has been told clinicians at the hospital are concerned about the role of the managers in the decision.

NSW Health guidelines on terminations after 20 weeks' gestation call for an assessment to be made by a multi-disciplinary team "with a mix of skills and experience".

The Herald understands the decision was made within the past two weeks. The woman went into labour about a week later and the foetus was stillborn.

A spokeswoman for the South East Sydney Illawarra Health Service said the case was given the "most complete medical attention and consideration by a wide range of highly specialised medical, allied health and nursing professionals'', who collectively did not support the termination. However, the service did not respond to specific questions about whether the clinicians had been overruled.

Lachlan de Crespigny, the doctor at the centre of a late-term abortion controversy in 2000 in Victoria, said: "If this is the way women are treated, what does it say about the state's abortion laws?" He said it was wrong for a woman's life to be put on trial by an anonymous committee and that the decision should be left to the woman and her doctor.

Other specialists told the Herald they feared a clampdown on abortion within state public hospitals. The NSW Government was anxious to avoid a backlash from people opposed to abortion generally or to late-term procedures, they said.

SOURCE

The huge and unproductive costs of Australia's Medicare

Huge explosion of bureaucracy following the introduction of a "public option" for health insurance

By Dr Jeremy Sammut

Under the rubric of stimulus and economic security, the role of government has been significantly expanded across a range of sectors, including education, banking and finance. This new era of regulation and micromanagement threatens to crowd out private enterprise and civil society for a generation.

It is therefore timely to ponder Australia’s last great leap backwards towards socialism in 1984, right at the start of the long period of economic reform of the ’80s, ’90s, and the 2000s. This year marks the 25th anniversary of the establishment of Medicare. This year, the CIS has published a trilogy of papers cataloguing the damage Medicare has done to the Australian hospital system.

The short version of the story is that the era of ‘free’ public hospital care has led to the misallocation of huge amounts of taxpayer’s money to pay for massive and unnecessary growth in the size and cost of the health bureaucracy. The massive government expansion into the health sector has resulted in fewer and fewer health dollars out of ever-increasing hospital budgets reaching the frontline to pay for the health care the community wants and needs.

The decline of public hospitals into their present state of waste and inefficiency is proof, if further proof is needed, of what happens when dynamic and independent parts of our society become subject to the dead hand of statist domination and bureaucratic command-and-control.

We should remember the anniversary of Medicare when we calculate the cost of the GFC. The impact on the national bottom-line won’t only appear on the balance sheets for 2008–09. I fear we will be paying the price for the revenge of the political economy nerds for many years to come.

In 2009, the CIS published Radical Surgery by Professor Wolfgang Kasper (February); Why Public Hospitals are Overcrowded by Dr Jeremy Sammut (August); and The Past is the Future for Public Hospitals by Dr John Graham (October).

The above is part of a press release from the Centre for Independent Studies, dated October 23. Enquiries to cis@cis.org.au. Snail mail: PO Box 92, St Leonards, NSW, Australia 1590. Telephone ph: +61 2 9438 4377 or fax: +61 2 9439 7310







Government Health Care Adds Insult to Injury

In 1997, Brian Booy of Bristol in the United Kingdom was diagnosed with angina, a chest pain caused by coronary heart disease, and was told he needed triple bypass surgery. Unfortunately, he made the grave mistake of getting ill in Great Britain, where government management of the health industry contributes to massive shortages of everything from doctors to hospital beds and vaccines. Mr. Booy waited a year and a half for his life-saving surgery, which he never received; he died of a massive heart attack in January of 1999.

His is just one of the many heartbreaking stories featured in "Shattered Lives: 100 Victims of Government Health Care," by Amy Ridenour and Ryan Balis at The National Center For Public Policy Research. Mr. Booy's case is no anomaly: According to the BBC, Dr. Peter Wilde, clinical director for the Bristol Royal Infirmary's cardiac unit, admitted that same year that "10 patients may have died because they had to wait too long for operations."

Long waits and shortages result from government control of the health sector. There are only so many hospitals, only so many doctors. When government promises that everyone will be treated (ostensibly) gratis, it does not simultaneously conjure more doctors into existence. Instead, doctors face more patients, who are now likely to seek treatment more often because they perceive it to be free. The result is long lines, long waits, substandard care.

But it's worse than that. Not only does the socialization of medicine fail to produce more doctors, it actually shrinks the pool. In our free-market system, being a good doctor can be financially rewarding. This matters, because becoming a good doctor is a long, arduous, expensive proposition. Remove the profit incentive and you are guaranteed to have fewer doctors.

The free market has been good to our doctors: General practitioners in the U.S. have almost twice the average monthly net income as their counterparts in Britain's National Health Service, according to worldsalaries.org. Unfortunately, American doctors see in Britain their future under ObamaCare: increased regulation and taxation coupled with decreased earnings. They are deciding en masse that it may not be worth it: A September 2009 Investor's Business Daily/TIPP poll of practicing physicians found that "hundreds of thousands would think about shutting down their practices or retiring early" if ObamaCare makes it into law.

Think about that. Obama promises to expand coverage to every American, but no new doctors will be co-created for this enterprise. In fact, many doctors are telling us that they will shutter their doors if ObamaCare is enacted.

But at least your medical care will be "free," under the new regime, just like Brian Booy's was.

And on top of it all, government will also add its standard bureaucratic idiocy and insult to the medical-care mix: One year after Mr. Booy died, his wife Pat received a letter saying that her husband had at last been given an appointment for his surgery.

Proponents of government-run health care will tell you that the free market unfairly rations health care by making it unaffordable to some, and that their solution will fix this gross inequity. But resources are always and everywhere rationed because resources are always and everywhere finite. Government control does not fix this it only makes it worse. Just ask the widow Pat Booy.

SOURCE





Pelosi lacks votes for most sweeping public option

Speaker Nancy Pelosi counted votes Thursday night and determined she could not pass a “robust public option” — the most aggressive of the three forms of a public option House Democrats have been considering as part of a national overhaul of health care. The California Democrat's count — coupled with a significant turn of events Thursday during a private White House meeting — points to an increasingly likely compromise for a “trigger” option for a government plan.

Administration officials have been telling POLITICO for weeks now that this is the most likely compromise because it can probably satisfy liberals — albeit only reluctantly and after many vent frustration and some even threaten to walk away from the bill. This would clear the way for backers to sneak a limited public option through the Senate by attracting moderate Democrats and then to win President Barack Obama's signature.

Speaking to reporters Friday after a meeting of House Democrats, Pelosi said “no decision of that kind has been made" on which public option to pursue. "By no means is the count complete or has the decision been made," she said.

"We had a very congenial - is that the word for a caucus? - a very lively, friendly caucus this morning where we are continuing to count the votes on this,” Pelosi said. “A robust public option is the preferred way to go because it saves the most money - $110 billion. It's not the only way to go, and at the end of the day we will have a public option in this legislation to keep the insurance companies honest and to provide real competition. Again, it's good, better, best. We're having that debate."

Obama told Senate Democratic leadership at the White House Thursday evening that his preference is for the trigger championed by Sen. Olympia Snowe (R-Maine) — a plan that would allow a public plan to kick in if private insurers don’t expand coverage fast enough, a top administration official told POLITICO. It’s also sign Obama is interested in maintaining a sense of bipartisanship around the health reform plan.

At that meeting, Obama did not sign on to a plan being floated by Senate Majority Leader Harry Reid (D-Nev.) to include a different variation of the public option in the Senate bill — a plan that would create a national public plan but allow states to “opt out.” Reid now believes he can get 60 votes to bring a bill with that plan to the floor by breaking an expected GOP filibuster — and then secure the 51 votes needed to pass it.

SOURCE






Obama's thug politics dirty health care endgame

So this is what "change we can believe in" done the Chicago way really looks like - Barack Obama and his White House capos muscling recalcitrant opponents and promising to crush those who don't get in line.

Obama has zeroed in on the U.S. Chamber of Commerce, Fox News and doctors. There's nothing coincidental about this trio of targets, either: They are, respectively, the nation's most powerful business lobby, the television voice for Middle Americans worried about where Obama is taking the country, and the professional group with the greatest potential power to kill Obamacare.

How the muscle is applied differs in detail from case to case, but the common message is there for all - you get in line or you pay a steep price for crossing Obama.

Things were different earlier this year when Obama welcomed the chamber's support for his $787 economic stimulus package, and the $3 billion Cash for Clunkers debacle. Now the White House actively encourages an exodus of high-profile firms from the nation's most prominent voice for business, with the prospect of billions of dollars of "green industry" subsidies being a prominent lure.

The goal clearly is to discredit, then bleed the chamber of its lifeblood, membership dues. Thus, Obama's recent attack on the chamber for "spending millions" on "completely false" ads opposing his financial reform proposals came, Politico reported, "on the same day as his energy secretary, Steven Chu, said it was 'wonderful' that companies had left the chamber of climate issues.' "

The message for the doctors was no less subtle. Senate Majority Leader Harry Reid convened a Capitol Hill meeting last week with "nearly a dozen doctors groups," according to the Hill. Chief of Staff Rahm Emanuel and Office of Management and Budget Director Peter Orzag attended just long enough to make clear the White House approved Reid's subsequent message for the doctors.

If the doctors would drop their demand for medical malpractice lawsuit reforms and support Obamacare, Reid would quickly move the $247 billion bill to spare them from scheduled cuts in Medicare reimbursement.

And if the doctors refuse?"Without the freeze, doctors would see their Medicare payments drop by 21 percent next year and by 40 percent by 2016," according to the Hill. Cuts of that magnitude would force many doctors to stop treating Medicare patients, and push others to retire early or stop practicing medicine entirely.

Large majorities of Americans are adamant about protecting their right to choose their doctors and most are outraged at the prospect of having government bureaucrats intervene in the process. But Obama knows that if the doctors say it's OK, opposition to government-run health care will begin to evaporate.

The attack on Fox News is the least likely of the three to succeed, but that may not matter. The White House can inflict serious economic pain on the chamber and the medical profession, but attacking Fox just drives the "fair and balanced" news network's ratings through the roof.

Keynoting the anti-Fox effort with Anita Dunn, an admirer of Chairman Mao - whose genocide total far exceeded those of Hitler and Stalin - was inept. Besides, singling out one news organization still brings back nasty memories of Tricky Dick and the White House enemies list for millions of older Americans.

Obama can't silence Fox, short of going the Hugo Chavez route (which is being tested, by the way, via the Federal Communications Commission). But he also knows that, if he can neutralize the chamber and the doctors, Fox could become just so much noise.

More likely, Obama and the boys are about to be reminded that mere mouse clicks can put Fox's Middle Americans right where they are needed most, on Capitol Hill. And thug politics can't stop them.

SOURCE







No Free Lunch: The True Cost of ObamaCare Report Released

Far from providing "affordable" care for everyone, ObamaCare would result in higher insurance premiums, more and higher taxes, fewer jobs, lower wages, a reduced standard of living and an erosion of privacy and individual liberty. This is the conclusion of a new report, "No Free Lunch: The True Cost of ObamaCare," by policy analyst Matt Patterson just released by the National Center for Public Policy Research.

"Instead of providing 'affordable' health care for everybody, ObamaCare will in fact lead to dramatically higher health insurance premiums, as well as higher taxes, reduced Medicare benefits, lower wages, and fewer jobs for low and middle-income Americans," said Patterson. The paper says adoption of one of the "ObamaCare" proposals percolating in Congress would lead to:

Higher Premiums - Billions in new taxes and fees would be imposed on medical companies and health insurers to pay for ObamaCare - costs which would be passed on to the consumer as higher insurance premiums.

Higher Taxes - ObamaCare would be paid for with massive tax increases, amounting to an estimated increased tax burden of $2.3 trillion in the coming decades.

Lower Wages/Fewer Jobs - New taxes and fees imposed on businesses by ObamaCare would result in fewer jobs and lower wages for low- and middle-income workers.

Standard of Living - The massive government spending required would explode the federal deficit with ruinous consequences for every American's standard of living.

Medicare Benefits - ObamaCare aims to pay for itself, in part, with hundreds of billions in devastating cuts to Medicare and Medicare Advantage.

Privacy - ObamaCare regulations would result in a larger, more powerful IRS and ensure that more personal information is shared with more people.

Your Freedom - ObamaCare would require, under threat of penalty, every American to have insurance whether they want or need it.

"ObamaCare won't save money, nationally or individually," says Patterson. "Instead, it will increase insurance premiums, raise taxes, depress wages, siphon jobs, explode the deficit, reduce living standards, rob privacy and erode personal liberty."

"No Free Lunch: The True Cost of ObamaCare" by Matt Patterson is available at www.nationalcenter.org/NPA590.html.

SOURCE

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