Sunday, November 01, 2009

Big retreat from government medicine in Britain: Patients who wait too long for NHS treatment will get private care

But no mention of how it will be funded: Reminiscent of the current American healthcare bill

Patients who do not get the treatment that they need from the NHS within 18 weeks are to be given the legal right to free private care. The Cabinet agreed this week that the legislation, placing maximum waiting times on the statute book for the first time, should be rushed through Parliament before the next election. Cancer patients, in particular, will receive funding for private treatment if they have not seen an NHS specialist within two weeks of GP referral.

Downing Street says that the two legal rights, which will be unveiled in next month’s Queen’s Speech, are designed to entrench the dramatic reduction of NHS waiting lists over recent years — as well as allowing Gordon Brown to “throw down the gauntlet” to the Conservative Party in the election campaign.

With NHS budget growth likely to be sharply curtailed whichever party is in power, No 10 believes that the legislation will prevent waiting lists drifting back up. “This will send a strong ‘no turning back message’ to voters,” a senior government source said. “David Cameron will have to decide whether he wants to repeal this measure and take rights away from patients.”

The Tories have promised to phase out all NHS targets, including those for waiting times, saying that patients should make “informed choices” about their care without hospitals being forced into a straitjacket of government regulation. “Labour always focuses on the process while we think what really matters is whether you are better after your treatment,” a Conservative spokesman said.

Patients are currently offered a choice from a range of NHS, independent and private provision only at the outset of their treatment. They are obliged to stick with that decision even when their treatment is delayed beyond the existing target time limits. The new rules will allow people to switch to a different hospital, including those in the private sector, if they have been made to wait longer than 18 weeks for treatment by a specialist after seeing their family doctor.

When Labour policy documents published this summer first raised the prospect of a legal entitlement on waiting times, ministers had still not agreed on the timing of legislation and the enforcement mechanism. The Queen’s Speech on November 18, setting out the Government’s legislative programme for the final months before the election, will promise that the measure for England and Wales will be in place within months.

Ministers plan to issue executive regulations that turn key waiting time pledges from the new NHS constitution into legally binding rights. Downing Street suggested yesterday that although parliamentary approval was not needed to amend the Health Bill, MPs were likely to be given a vote. Draft legislation is understood to say that primary care trusts must monitor whether patients are languishing in the queue and inform them of their rights for alternative provision. The trusts will be required to “take all reasonable steps” to ensure patients are treated immediately either by the NHS or the private sector.

According to the latest figures from August, about 37,000 patients had not received treatment from an NHS specialist within 18 weeks of their GP referral. There are legitimate clinical explanations for some — and others are caused by patients cancelling their own operations to go on holiday — but officials believe that about half have been “failed by the system”.

Andy Burnham, the Health Secretary, told Cabinet colleagues this week that the new legislation would mean that underperforming hospitals would lose funding from patients going elsewhere and “act as a powerful challenge for them to raise their game”.

Jennifer Dixon, of the Nuffield Trust, said the plans could be seen as “Tory-proofing” the NHS. “It would not only give patients enforceable health care entitlements but it would also prevent managers and clinicians from controlling waiting times as a way of limiting demand and saving money,” she said. “In the past requirements to make financial savings often resulted in hospitals stopping routine surgery for a couple of months before the end of the financial year.”


Incompetent British doctor ruled still OK to practice -- and to teach!

The family of a teenage girl who died after receiving a massive overdose of radiation while being treated for a brain tumour said last night that it was a “travesty” that the doctor held responsible was allowed to keep his job. A conduct and competence hearing held by the Health Professions Council yesterday ruled that Stuart McNee, who was in charge of planning treatment for Lisa Norris, 16, from Girvan, Ayrshire, “had learnt from his mistakes”.

Lisa died in October 2006. She had been exposed to 19 overdoses during radiotherapy treatment for a brain tumour at the Beatson Oncology Unit in Glasgow nine months earlier. She was given radiation doses that were cumulatively 58 per cent higher than necessary, leaving her with burns on her neck and head. A report by a leading cancer specialist claimed that her chances of long-term survival had been harmed by the error.

Her parents, who attended the hearing at the Western General Hospital in Edinburgh yesterday, branded the process a whitewash and pledged to continue with legal action against NHS Greater Glasgow and Clyde. Mr Norris, 53, said: “I’m very disappointed that a man can do what he did and walk away from it. I was expecting him to at least get reprimanded for it. It doesn’t matter that he had a good, impeccable record. What he did he shouldn’t have done.”

The panel’s chairman, Colin Allies, said that while all allegations of a lack of competence had been proven, it was their opinion that Dr McNee was still fit to practise. He said: “We are confident the registrant has learned from his mistakes and would act differently in similar circumstances today. We took into consideration the lack of staff and a lack of support from senior management.”

The panel agreed that Dr McNee had been responsible for planning the course of radiotherapy and said his biggest failing was not speaking out about staffing pressures and checking that procedures were being followed.

A report by Arthur Johnston, scientific adviser to the Scottish government’s health department, said that the overdose happened after an under-qualified staff member entered a wrong number on a form. Dr McNee also failed to have his proposed treatment plan verified or independently justified by a competent radiologist or radiographer or other trained staff.

Dr McNee is working in a new role at the Western General and Gartnavel hospitals in Glasgow, where he is involved in clinical trials, teaching and research and development. He did not attend yesterday’s hearing.


Australia's Prosperity Index result down because of poor public healthcare

By Greg Lindsay and Roger Bate. Greg Lindsay is the Executive Director of The Centre for Independent Studies in Sydney. Roger Bate is the Legatum Fellow at the American Enterprise Institute in Washington, D.C. The 2009 Legatum Prosperity Index is now available. A majority of Australians rely on "free" government hospitals, where low standards and long waits are common

The 2009 Legatum Prosperity Index rates Australia an impressive sixth out of 104 countries surveyed – the top five are all small Northern European countries with populations of less than 10 million.

However, inefficiencies in public hospitals are hurting Australia’s prosperity. While Australia is very strong on the economic fundamentals required for long-term growth, the nation’s ailing health care system is keeping Australia from reaching its full potential, in terms of both economic progress and quality of life. Legatum ranks Australia a lowly 21st in health care, behind countries like Singapore, Spain, and the Czech Republic; 28th in infant mortality; 47th for number of doctors per capita; and behind Slovakia and Hungary on available beds.

The Australian Medical Association recently found that waiting times far exceed acceptable levels. The median wait for hip surgery in Australian public hospitals is nearly three months. For cataract surgery, it’s more than two months. Major public hospitals throughout Australia are bursting at the seams with bed occupancy rates of well over 100% a daily occurrence.

Overcrowding and inefficiency have compromised patient safety. According to the Queensland University of Technology, $1 billion annually is lost in bed days because of hospital-acquired infections. Medical errors cost an estimated $1 billion–$2 billion annually, with half of these errors classified as ‘potentially preventable.’

These health care problems are draining billions from the Australian economy, both directly by taking money away from players in the health sector and indirectly by compromising worker health and undermining productivity.

Australians are among the most prosperous populations on the planet. But the country’s health sector is in need of significant improvement. Cutting away waste and improving quality in health care would go a long way toward making Australia even stronger.

The above is part of a press release from the Centre for Independent Studies, dated October 30. Enquiries to Snail mail: PO Box 92, St Leonards, NSW, Australia 1590. Telephone ph: +61 2 9438 4377 or fax: +61 2 9439 7310

Best Obamacare Slam: Congressman Rogers (R-MI)

You will not see or hear a better critique of Obamacare than this:

Pelosi Health Care Bill Blows a Kiss to Trial Lawyers

The health care bill recently unveiled by Speaker Nancy Pelosi is over 1,900 pages for a reason. It is much easier to dispense goodies to favored interest groups if they are surrounded by a lot of legislative legalese. For example, check out this juicy morsel to the trial lawyers (page 1431-1433 of the bill):
Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.

So, you can’t try to seek alternatives to lawsuits if you’ve actually done something to implement alternatives to lawsuits. Brilliant! The trial lawyers must be very happy today!

While there is debate over the details, it is clear that medical malpractive lawsuits have some impact on driving health care costs higher. There are likely a number of procedures that are done simply as a defense against future possible litigation. Recall this from the Washington Post:
“Lawmakers could save as much as $54 billion over the next decade by imposing an array of new limits on medical malpractice lawsuits, congressional budget analysts said today — a substantial sum that could help cover the cost of President Obama’s overhaul of the nation’s health system. New research shows that legal reforms would not only lower malpractice insurance premiums for medical providers, but would also spur providers to save money by ordering fewer tests and procedures aimed primarily at defending their decisions in court, Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, wrote in a letter to Sen. Orrin Hatch (R-Utah).”

Stay tuned. There are certainly many more terrible, horrible, no-good, very bad provisions in this massive bill.


Republicans Are Offering Better Solutions to Lower Health Care Costs

by John Boehner

Time after time, Republicans have reached out to President Obama and congressional Democrats to work together on common-sense solutions to lower health care costs for families and small businesses. President Obama promised the American people a bipartisan process. Unfortunately, Democrats have chosen a partisan, go-it-alone approach. It’s yet another broken promise, and it defies the will of the American people.

Through the month of August, the American people let Members of Congress from both parties know that they didn’t want a government takeover of health care. But instead of listening to Americans’ concerns, Speaker Nancy Pelosi (D-CA) and House Democratic leaders ignored them and wrote a bill behind closed doors designed to appease the liberal special interests.

Next week, Speaker Pelosi will attempt to ram through her 1,990-page government takeover of health care through the House of Representatives. This bill will raise the cost of Americans’ health insurance premiums and add to our already skyrocketing debt; it will kill jobs with tax hikes and new mandates; and it will cut seniors’ Medicare benefits.

For the sake of struggling middle-class families, small businesses, and seniors, Republicans are going to do everything we can to fight this monstrosity. We will stand on principle in opposing this bill, and we will offer a better solution to lower costs for families and small businesses.

In the national Republican address today, I am outlining Republicans’ plan for common-sense health care reform our nation can afford, emphasizing four common-sense reforms that will lower health care costs and expand access to quality care without a government takeover of our nation’s health care system that kills jobs, raises taxes on small businesses, or cuts Medicare for seniors.

Here are four smart, fiscally-responsible reforms that we can implement today to lower costs and expand access to quality care:

· Number one: let individuals and families buy health insurance across state lines.

· Number two: allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do.

· Number three: give states the tools to create their own innovative reforms that lower health care costs.

· Number four: end junk lawsuits that contribute to higher health care costs by increasing the number of tests and procedures that physicians sometimes order not because they think it's good medicine, but because they are afraid of being sued.

You can learn more about these and all the health care initiatives Republicans have supported by visiting and you can watch the video of the address HERE.


Premiums to Skyrocket Under Obamacare

Skyrocketing insurance premiums will slam millions of consumers next year because of "indirect taxes" contained in both the House and Senate versions of healthcare reform, according to various medical and insurance industry experts. Healthcare reforms that were supposed to contain costs actually will cause a sharp hike in premiums, they add. In fact, several studies indicate consumers' premiums could more than double next year if healthcare reform takes effect.

"So even though this bill tries to hide these costs as indirect taxes," Sen. Orrin Hatch, R-Utah, recently told a business symposium, "average Americans who purchase health plans, take prescription drugs, or use medical devices will end up footing the bill."

The rate hikes stem from the hundreds of billions in proposed fees and taxes levied on providers. For example, the Finance Committee's proposal would assess $322 billion in taxes and fees on insurance premiums, prescription drugs, and medical devices, according to the Senate's Joint Committee on Taxation. The committee and other experts say virtually all of those costs will be passed along to consumers in all tax brackets — despite President Barack Obama's pledge not to raise taxes "one dime" on those earning less than $250,000 per year.

Another likely frustration for consumers: The premium hikes will take effect right away, while the subsidies and benefits in healthcare reform won't kick in completely until 2014. Scott Gottlieb, a physician and American Enterprise Institute resident fellow, stated Thursday in a New York Post op-ed that, by front-loading the costs and back-loading benefits, Congress is resorting to "a gimmick that imposes a stiff price on the public." That "gimmick," Gottlieb claims: using 10 years of added fees and taxes on providers to offset about five years worth of benefits. Those costs "will immediately shift onto consumers, in the form of higher prices on medical products and rising premiums," he says.

Democrats have promised to insure an additional 35 million Americans, without raising taxes or increasing the tsunami of deficit red ink spilling out of Washington these days.

Douglas Holtz-Eakin, the former director of the Congressional Budget Office, appeared to concur with Gottlieb's assessment in a recent Wall Street Journal op-ed. "These costs will be passed on to consumers by either directly raising insurance premiums, or by fueling higher health-care costs that inevitably lead to higher premiums," he wrote.

The bottom line: Most voters will be paying higher premiums for years before they see any benefits. That could spell serious trouble for Democrats in the 2010 midterm elections.

The Senate bill proposes $2.3 billion in fees on brand-name drugs, $4 billion on medical devices, and $6.7 billion levied on insurance companies, plus more than $100 billion in Medicare reimbursements to medical providers — all costs that would be shifted back onto consumers. Speaker Nancy Pelosi's House bill appears even more expensive. It would impose $150 billion in Medicare cuts on the pharmaceutical industry, and a 2.5 percent tax on companies that manufacture medical devices.

"Most of astounding of all," Holtz-Eakin wrote, "is what this Congress is willing to do to struggling middle-class families. The bill would impose nearly $400 billion in new taxes and fees. Nearly 90 percent of that burden will be shouldered by those making $200,000 or less."

More here

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