Tuesday, November 17, 2009

Thousands of British Parkinson's disease sufferers wrongly diagnosed

Around 6,300 people in the UK who believe they are suffering from Parkinson's disease could have been wrongly diagnosed, a new study has claimed. Researchers in Scotland, who assessed patients on anti-Parkinson's medication, found that five per cent had little more than stiffness or hand tremors.

A report published in the Movement Disorders journal warned that millions of pounds was being wasted on unnecessary drugs each year. While the wrongly prescribed medication was not thought to have any adverse side effects, patients were subjected to years of anxiety.

Dr Keiran Breen, one of the authors of the report said Parkinson's was a notoriously difficult disease to diagnose accurately in its early stages, but recommended all suspected sufferers should be referred to specialists regularly. He said: "No two people with Parkinson's disease will have the same diagnosis. The three main characteristics are tremors, slowness of movement and stiffness, but not everyone will have all three symptoms. The patients should be referred to neurologists with more expertise and they will make a much more accurate diagnosis."

There are around 120,000 sufferers in the UK but during the study more than five per cent were found to have been misdiagnosed. Dr Breen said: "We didn't find evidence that taking drugs caused harm to the patients without Parkinson's but it could mean people were denied the correct drugs to improve their actual condition."


Controversial electronic medical records to be rolled out across Britain

Anybody who trusts the British bureaucracy with their personal information has not been listening. There have been dozens of instances of "lost" records -- and the computer system concerned has long been full of bugs

Every patient in the country will have sensitive medical information uploaded to a controversial central database within two years. Ministers insist that the records will allow patients to be treated more efficiently no matter where they are in the country. But critics have warned that the centralised database could be open to abuse.

Experts said that patients could also feel “forced” to allow highly sensitive material on the system because ministers have decided to include all patients across the country unless they specifically opt out. Patients in London will have their confidential records uploaded by the end of next year on to the NHS computer network known as the Spine. Family doctor practices across every party of the country will be transmitting the data by the end of 2011.

The records will contain vital basic medical information including illnesses, medications and vaccination history. They could also include past conditions patients had suffered and previous medication they were given. Age and address would also be included but not other personal information, such as marital status. Ministers have admitted that extra medical information could also be added in the future, including controversial do not resuscitate orders.

In May, the Government performed a u-turn when they announced that patients would be allowed to delete electronic summaries of their treatment records from the new database. Previously, they had insisted that to do so would be too costly. Doctors have to ask a patients’ permission every time they wish to view their records, except in emergency circumstances, such as when they feel a patient may be at risk. Only medical staff directly involved in a patient’s care will be allowed to look at the information. But all patients will be added on to the database unless they specifically refuse.

Ministers insist that the records will improve care as doctors no longer have to rely on patient’s memories, which can often be incomplete or inaccurate. They claim that elderly and more vulnerable patients, including those who do not have English as a first second language will benefit the most. Pilot projects trialling the Summary Care Records scheme have taken place across the country in recent years and more than 700,000 patients currently have their records uploaded.

Mike O’Brien, the Health Minister, said: “Having the right information at the right time can make all the difference to patients’ experience of urgent care. “Summary Care Records can improve the quality and safety of treatment provided as well as increasing people’s comfort and reassurance. “We are particularly interested in the experience at Bury which has incorporated End of Life wishes for a substantial number of patients. “Moving the NHS from good to great needs improvements such as this.” Ruth Carnall, chief executive of NHS London, said: “Getting hold of health records for London’s highly mobile population often presents real challenges to doctors and nurses when patients need out-of-hours and emergency care.”

But Dr Grant Ingrams, chair of the British Medical Association's GP IT committee, warned that patients could feel that they were being forced to put highly confidential information on the system. He said: “Electronic Summary Care Records have the potential to improve both quality and safety of patient care but it is critical for the programme’s success that all patients receive balanced information and are made aware of their option to opt out. “If patients feel they are being coerced, or have a summary care record created without their knowledge or understanding, it will damage the credibility of the project.”


No Free Lunch: The True Cost of ObamaCare

Far from providing "affordable" care for everyone, ObamaCare would come at a painful price - higher insurance premiums, more and higher taxes, fewer jobs, lower wages, a reduced standard of living and an erosion of privacy and individual liberty. Here's the real cost of ObamaCare.

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

Higher Taxes - Government cannot provide free or subsidized care for someone without taking money from someone else - and that someone else may be you. The Wall Street Journal puts it bluntly: ObamaCare will be paid for with "huge tax increases." How huge? According to Jeffrey H. Anderson, Ph.D, Senior Fellow of Health Care Studies at the Pacific Research Institute, one ObamaCare proposal would "raise taxes by $2.3 trillion" over the next two decades. Yes, trillion.

Lower Wages/Fewer Jobs - New taxes and fees imposed on businesses by ObamaCare would "discourage companies from hiring or continuing to employ low-income and moderate-income workers," according to the Heritage Foundation. And it won't just be low-income workers who see a smaller paycheck - according to FORTUNE magazine's Shawn Tully, ObamaCare would lead to "a steep, shocking decrease" in the incomes of middle-class workers.

Standard of Living - The massive government spending required to finance national health care would explode the federal deficit with ruinous consequences for every American's standard of living. According to the Congressional Budget Office, "Large budget deficits would reduce national saving, leading to more borrowing from abroad and less domestic investment, which in turn would depress income growth in the United States. Over time, the accumulation of debt would seriously harm the economy."

Medicare Benefits - ObamaCare would pay for itself, in part, with hundreds of billions of dollars in cuts to Medicare and Medicare Advantage. But the Congressional Budget Office warns that cuts to Medicare Advantage "could lead many plans to limit the benefits they offer, raise their premiums, or withdraw from the program," devastating seniors' health-care options. The Wall Street Journal confirms, "cuts in Medicare's price controls will cause many doctors to quit the program."

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

According to the Washington Examiner's Byron York, ObamaCare would mean "an expanded and more intrusive IRS," which would be empowered to target and punish violators of the new law. Additionally, an ObamaCare tax on employers would necessitate your boss knowing your family's entire income from all sources, information which would then be shared with the insurance company.

Your Freedom - Think you have the right to decide whether you even want insurance? Guess again. ObamaCare would require, under threat of penalty, every American to have insurance, fundamentally altering the relationship between citizen and state. As the CBO puts it, ObamaCare "would establish a requirement for [legal U.S. residents] to obtain insurance and would in many cases impose a financial penalty on people who did not do so." So much for 'land of the free.'

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

That's the kind of "free" care we just can't afford.


Whose business is your health care?

Our ongoing debate about government’s role in health care is proving worthwhile because it forces people to focus on the real tradeoffs in a system mandated - if not directly operated - by government, rather than one selected by individuals or their employers. Today, our system is a dysfunctional hybrid.

To the extent that we cannot choose the health care coverage we want today, those restrictions are almost always the result of previous government interventions - tax incentives that make it easier for employers to buy insurance than for employees to purchase their own or laws requiring us to purchase coverage we may not need or cannot afford.

President Obama says all insurance policies will be required to cover preventive care and early screening for various maladies, as if he can force insurance companies - or doctors - to give us something for nothing.

Well, he can’t do that anymore than he can require restaurants to serve a free lunch every Thursday. Even under Barack Obama, Americans cannot be compelled to do business at a loss; they always have the right to lock the doors and close up shop.

That’s why there’s no free lunch - or free health care. Politicians aren’t “giving” us these services; they are forcing us to buy them - and to pay more than the actual cost.

It never ceases to amaze when politicians who demagogue against “greedy” insurance companies will, in their next breath, require us to buy things through an insurance company that we could purchase less expensively if we simply paid out of pocket.

If both you and your doctor know that you need a colonoscopy, how can it possibly be cheaper for you to send your payment to an insurance company, while the doctor files a claim with that insurance company, and the insurance company processes the claim and issues payment - rather than for you to simply pay the doctor?

Yet ObamaCare would establish a mandatory list of insurable procedures as well as maximum deductibles. For those with money-saving high-deductible plans and health savings accounts - like the one I’ve had for 12 years - the President’s promise that we can keep the plan we have just doesn’t wash.

Americans who are understandably frustrated by health care costs are recognizing that the more control you give to government the more control you give to government.

Today, if you, your doctor and your insurer agree on a procedure, you make an appointment and “get ‘er done.” And if you can’t agree, you are free to pursue other procedures that you can pay for yourself. (After all, what good is an extra $50,000 in your retirement account if you’re dead?) But if no one practices those alternative procedures because omnipotent health care bureaucrats won’t pay for them, you are out of luck.

The larger point is this: Why is it government’s business how much you pay, what doctor you see, or what treatment you receive, so long as you are paying the bill?

Health care, like any commodity or service, will always be limited by economic reality. Government health care programs are responsible for more cost-shifting than all of the “uninsured.” Yet despite paying below-market prices, Medicare will be insolvent in just seven years and has amassed all by itself a deficit of $37.8 trillion.

If the government is empowered to supervise everyone’s health care, then only two outcomes are possible: either everyone’s health care is rationed to control costs or no one’s health care is rationed and the cost of government health care finally breaks the camel’s back, ushering in a worthless dollar, runaway inflation and skyrocketing interest rates.

In either case, our impoverished children and grandchildren will forever curse our self-centered, shortsighted generation. There can be no health care utopia any more than everyone can enjoy all they want to eat or live in the home of their dreams. Sooner or later, someone must choose between what we want and what we can afford. Who do you want to make those tough choices - yourself or someone in government?


One healthcare reform

Proponents of the current healthcare reform proposal in congress like to accuse critics of not offering any alternatives, of only opposing without offering anything. While that accusation is completely not true, it serve proponents of the fascist system well as a big lie, just as calling it socialist instead of fascist serves as another convenient lie.

Rather than dissect any particular part of the fascist bill, a refutation of the false charge that critics offer nothing is also useful. The reason the proponents say that critics offer nothing is because only big government solutions are allowed to be considered. Anything else is not a "constructive proposal" and thus they can get away with that big lie.

In spite of the psychological block against small government proposals being considered, it is always useful to suggest as many small government solutions as possible. That way the next time someone says that critics of fascist health care never offer solutions the critics can respond with "look at all the solutions I've offered that you refuse to consider."

Given the large number of problems, any single solution fails to address the full problem and appears short sighted. But one aspect is all that can be addressed at once.

One of the problems with the current system is that the patient is not the customer. When a doctor treats a patient, the patient isn't the customer. The insurance pays for the visit, and so the insurance is the customer. And who is the insurance company's customer? Since most people get their insurance through their employer, the employer is the customer and not the employee. It is true that sufficient employee complaints can cause an employer to switch companies, but the customer of the insurance company is the employer.

For a truly responsive insurance company, the patient needs to be the customer of the insurance company. For truly responsive health care, the patient needs to be the customer of the doctor. The only remaining question of this particular solution is how to make it possible. As proponents of fascist health care are quick to point out, the average person cannot afford a catastrophic illness.

The first part of the solution is to transfer the tax incentive for the purchase of health insurance from the employer to the employee. That way, unlike the Obama plan, people have a positive encouragement to purchase insurance instead of a punishment for failure to purchase insurance. Persuasion always being preferable to force, encouraging people to purchase insurance instead of punishing them for failure to purchase insurance is a better solution.

To make insurance affordable enough for a person to purchase it, the price needs to be brought down. That can be done through coercion or through encouragement. To do it through encouragement the best way to do it is through removing the rules that prohibit insurance companies from competing across state lines. Putting individual insurance policies in the hand of the customers while simultaneously increasing the number of companies and policies available, while giving people a tax break for purchasing insurance, will drive down the cost to the point where most people can afford it.

Another way to make insurance affordable is to remember that insurance is supposed to be for the unusual event. The way health insurance currently operates is absurd - it is comparable to using automobile insurance to pay for basic tune-ups, or even to pay for putting gas in the car.

Analyzing a standard insurance statement or doctor's visit statement, one finds that in general a large portion of a standard bill is an insurance negotiated adjustment. Another large portion is the patient co-pay. The smallest part is the payment the insurance company makes to the doctor. Ask most doctors what their cash price is and it turns out it is actually lower than the stated price for a visit.

People need to pay directly for office visits, and a good way to do that is through tax deductible healthcare savings accounts. But not the HSAs currently in use, that have an end of year use-or-lose for the funds. What is needed is a roll-over HSA, that allows people to put in more funds than needed while healthy so that the funds will be there many years later when people need more healthcare funds. This is similar to using a retirement savings account. In order to encourage use of a roll-over HSA account funds put into it should be tax free, just as in the current annual HSA.

That will give our current healthcare system another thirty years of operation before it gets as bad as it currently is.


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