Friday, December 18, 2009

British government hospitals 'are wrong to ban flowers as a health threat'

Hospitals that ban flowers in an attempt to stop infections spreading are actually slowing patients' recovery, researchers have found. They say visitors bringing bouquets to wards do not increase the spread of germs and help speed a patient's return to health. In fact, the biggest hazard posed by flowers could be nurses' irritation at having to change the water.

A growing number of hospitals have introduced 'no flower' policies, with Southend University Hospital bringing in a blanket ban this summer despite protests. Bosses said patients were in favour because of the potential health and safety risk to bedside electrical life support equipment as well as fears over the spread of germs.

But research in the British Medical Journal says the risks have been overplayed. There is no record of an outbreak of infection in a hospital being traced to bacteria found in flower water, according to Giskin Day and Naiome Carter from Imperial College London. Vases might tip over, they admit, but the risk is no greater than that posed by crockery containing food and drink.

The researchers say studies show flowers have immediate and long-term beneficial effects on emotional reactions, mood and memory. One trial found that patients in rooms with plants and flowers needed significantly less pain relief after surgery. They also had lower blood pressure readings, lower rates of pain, anxiety and fatigue and more positive feelings than those who were in flower-less wards.

However, hospitals continue to impose bans on the wards despite the absence of any ruling from the Department of Health.

The study also found evidence of contrasting attitudes to flowers on private and NHS wards, after questioning patients and staff at two London hospitals, the Royal Brompton and the Chelsea & Westminster. Private nurses appeared much keener on flowers than those from the public sector.

Charge nurse Dermot Richards-Scully at the Royal Brompton said: 'I hate them [flowers].' 'My staff don't have time to change stagnant water, spillage is responsible for slips, trips and falls, and they cause hay fever.'

But sister Susan Bunce, in charge of the Sir Reginald Wilson ward for private patients at the same hospital, welcomes them. 'Maintaining flowers doesn't take up any nursing time and they have a positive effect on patients,' she said.

The BMJ article concluded: 'Although flowers can undoubtedly be a time-consuming nuisance, the giving and receiving of flowers is a culturally important transaction.' It recommends bedside lockers be designed to cut the chances of spillage from vases.


Britain: Need urgent help? Dial 111, but you may have to pay

An admission that existing services are failing -- after 60 years to get them right

An 'urgent care' phone number will be set up for sick patients to ease pressure on ambulances, despite fears it could cause confusion and even delay life-saving treatments. Health minister Mike O'Brien will tomorrow outline plans for the phone line - 111 - for those who need treatment but not enough to warrant a 999 call.

It would mean patients deciding whether to call 999, 111, NHS Direct or their GP.

Dr Hamish Meldrum, chairman of the British Medical Association, said: 'We would want to be assured that what is being proposed really does simplify things for patients rather than adding to the confusion as to which part of the NHS they should be going to for care. 'We would certainly not want to see a situation where patients are so confused that genuine life-threatening emergencies are missed.'

Patients may even have to pay to ring the service. Ministers have suggested either a 10p flat fee, or up to 5p a minute - ignoring concerns that poorer patients and pensioners may be put off by the charge.

The Department of Health quotes polling which reveals most patients would be happy to pay a small fee. The 111 number is designed for people who need 'urgent advice, care, treatment and diagnosis'.

The number, which would be piloted from spring 2010 would be staffed, like NHS Direct, with a mixture of call centre workers and clinicians. The Department of Health would not comment last night.


Australia: Impaled woman has long wait for government ambulance

"Ambulance Victoria (AV) will make sure you receive the best possible care", they say. Tell that to the woman below

A WOMAN was impaled on a steel fence for an agonising 47 minutes waiting for an ambulance. The 34-year-old received no pain relief while her body was supported by volunteer emergency services workers during the ordeal at Yarrawonga, in Victoria's north.

Ambulance Victoria has launched an investigation into the delay. It was contacted at 9.42pm on Tuesday and told Kim Broadbent had been impaled through the groin in a fall. A crew did not arrive until 10.29pm. There was no paramedic available in the border town that night and sources said a graduate officer was refused permission to attend.

A crew was sent from Wangaratta, 55km away, but was not cleared to travel over the speed limit or with lights and sirens. By then, Ms Broadbent had spent more than 47 minutes seriously injured, lapsing in and out of consciousness. There is widespread disgust in Yarrawonga at the delay.

Ms Broadbent travelled to Melbourne by air ambulance with a section of fence still lodged inside her. She did not arrive at The Alfred hospital until about three hours after the first call. She was stable last night.

Her mother, Heather Broadbent, attended the scene and said those waiting for the ambulance were supporting her daughter and afraid to move her for fear of doing more damage. Mrs Broadbent said Wangaratta seemed too far away for an emergency job in Yarrawonga.

AV regional general manager Garry Cook said all parts of the case were being examined. Ambulance Employees Australia acting general secretary Phil Cavanagh said the review needed to address a key point: "Yarrawonga had no ambulance. Why?"


Dem Pols Must Ask: Will Yes Health Vote Hurt Them In 2010?

Congressional Democrats face a quandary going into the 2010 midterms. Pass a sweeping health plan that's increasingly unpopular, or do nothing and watch the liberal base stay home election night. Late Monday, Senate Majority Leader Harry Reid, D-Nev., seemed to move Joe Lieberman, I-Conn., closer to supporting the Senate health bill by dropping the Medicare buy-in for those age 55-64. Lieberman now says he is "ready to vote for health care reform." That could provide a boost to sagging morale among Democrats.

That seems to leave Sen. Ben Nelson, D-Neb., who has concerns over abortion funding, as the last holdout to Democrats getting 60 votes to override a GOP filibuster. It's not clear how he's leaning. Several other centrists have let Lieberman and Nelson take the heat for blocking the bill. But they may raise objections now that the bill is close to reality — and if they think they can win concessions.

Many opponents of the bill still think a health bill will pass. "The Democrats are going to do whatever it takes to get this health care bill," said Robert Broadus, who is running for Congress in 2010 as a Republican in Maryland's liberal 4th District, held by Democrat Donna Edwards. Broadus was participating in a "Code Red: Senate Rally" put together by groups in the tea party movement. About 2,000 protestors showed up Tuesday outside the Senate office buildings.

But not all protesters thought the Democrats would succeed. Eileen Hunkins of Virginia said, "I don't think they will pass a health care bill. It's not a health care bill. It's a bill to kill people."

The most recent CNN poll found 61% of respondents opposed the Senate health bill, with 39% in support. A new poll released Monday by Public Policy Polling, a Democratic firm, showed Republicans at 42% and Democrats 44% on a generic 2010 House ballot. In the previous PPP poll the GOP was down by eight points.

"That's the rub for the majority. They are in a bind," said J. Mark Wrighton, associate dean and professor of political science at Southern Mississippi University. "Polling data show that independents are moving toward the GOP. And there is some letdown among the Democratic voters as their high hopes have been dashed on issues like health care."

Leonard Steinhorn, professor of communication at American University, disagrees. "Conventional wisdom 11 months before an election needs to be taken with a grain of salt," he said. "Right now, independents are people who are motivated by a strong sense that Washington doesn't get stuff done. If health care reform is successful and is played as a triumph of the legislative process, it could help the Democrats."

More here

The ObamaCare Leviathan

As the Democrats inexorably slog toward the finish line, lugging and wrenching their malformed health care bill, the most passionate debate has been on contentious issues like abortion, the public option, and Medicare cuts. Yet the overriding danger of the Senate bill and its House counterpart is the massive government bureaucracies that will emerge as the legislation takes effect.

The Democrats' colossal experiment threatens to unleash forces that will ultimately overwhelm the doctor-patient relationship, ration our health care, and stifle innovation and excellence in the medical field. A massive government bureaucracy soon acquires a life of its own, with dominion over its constituency that no politician dares attempt to rein in.

Perhaps the greatest expansion of power will be in the Department of Health and Human Services. The Secretary of HHS will become the monarch of the health care kingdom. The Washington Examiner said the Senate health bill contains the word "secretary" 2,500 times, and that "[t]he legislation lists 1,697 times where the Secretary of Health and Human Services is given the authority to create, determine or define things in the bill."

In a massive power shift, the Secretary of HHS would take over insurance regulation from the states and would define qualified plans, what they cover, what they should cost, and whom should be covered. Competition and choice, the president's favorite buzz words, will disappear as HHS becomes the focal point of central planning for health care.

A second epicenter in the new health care infrastructure will be the IRS, which is poised to assume a powerful role in rulings, collections, and enforcement of health care mandates and taxes. There is a provision in the Senate bill for a reporting requirement similar to the current W-2. It would require, in Section 1502, the name, address, tax ID number, dates insured, and plan qualification, among other things. An expanded IRS is likely to become even more intrusive, dispelling any remaining illusions of a compassionate government-run program.

Embedded in the legislation in section 3403 is the Independent Medicare Advisory Board, one of 118 new boards, commissions, and programs making up a third power center that will have immense control over life and death. This board, with fifteen members appointed by the president, would have extraordinary powers, not subject to judicial review, to dictate what is covered and thus what treatments, drugs, and procedures patients can get. The bill's wording says the purpose of the board is to "reduce the per capita rate of growth in Medicare spending," a simple but chilling statement. With a set budget, the board would become a rationing commission in a "radical change for U.S. health care," as the Wall Street Journal describes it:
... the various health bills stipulate that Congress will arbitrarily decide how much to spend on health care for seniors every year-and then invest an unelected board with extraordinary powers to dictate what is covered ...

The core problem with government-run health care is that it doesn't make decisions in the best interests of patients, but in the best interests of government.

The Senate bill contains a labyrinth of regulations defining the operation of the Medicare Advisory Board -- "target growth rate," "implementation year," "inflationary payment update," "direct subsidy payments," "base beneficiary percentage"...and on and on. The language even includes a note prohibiting "any recommendation to ration health care." Yet as the Journal points out, the hard budget-cap rules mean there "is only so much money to be divvied up for care."

The bill's green eye-shade language may be numbing, but its long-term effect on health care will be devastating, as physician discretion is displaced by government fiat. The mention of "death panels" by Sarah Palin sent the Democrat left over the edge in denying, disparaging, and demonizing, perhaps because that is precisely the effect of what is in the bill.

A fourth empire is the expanded burden of unfunded Medicaid mandates on the states. A massive Medicaid increase will initially be federally subsidized, but after five years, it will be shifted back to the states. The House bill increases Medicaid up to 150% of the poverty level, and the Senate bill increases it up to 133%. Dick Morris summarizes the impact on his web site:
... in California ... the already fiscally beleaguered state would have to increase its Medicaid spending on poor people by 50%, at least an extra $2 billion a year and perhaps more...

In many Southern states, the Medicaid program only covers a portion of those living below the poverty level ... In Arkansas and Louisiana, where swing Senators Pryor, Lincoln, and Landrieu come from, the cost could exceed $1 billion for each state each year.

The question now is whether the governors of the fifty states, particularly the Democrats, are going to sit idly by and let their budgets be destroyed by the health care bill.

Offloading some of the increased insurance cost to the states by adding to the Medicaid rolls further disguises the real cost of the legislation. The American Spectator quotes Sen. Lamar Alexander (R-Tenn.): "There's an air of unreality here. ... The language is, 'we'll shift it back to the states' as if the states had the money or a printing press. But this isn't just a little increase. This is a bankrupting increase for most states."

A fifth enormous burden of a perversely different sort is the rampant Medicare fraud that stands to expand in a Medicare-for-all health system. The federal government has had forty years to figure out how to control Medicare fraud, but it is still pervasive. A Washington Times article quotes an Inspector General saying his office "finds fraud everywhere it looks." The Times quotes another source saying "3 percent to 10 percent of the $800 billion spent on Medicare and Medicaid each year 'is lost to waste, fraud and abuse.'" A recent CNN headline tells the story: "Organized crime's new target: Medicare."

So we have the HHS, the IRS, the Medicare Advisory Commission, expanded Medicaid, and expanded turf for Medicare and Medicaid fraud, each a leviathan of big government excess in its own right.

The Republicans are correct in strongly challenging the Democrats on topical issues, but there are larger forces at work that will have staggering implications on our future as the juggernaut of big government consumes all in its path.


Empty assertions from the NYT

I planned to write on a different subject, but after reading an editorial in Saturday’s New York Times, I decided to continue the subject of my last column on medical costs. The editorial not only contains more nonsense from the “Newspaper of Record,” but also demonstrates how the mainstream print media actively participates in something akin to releasing a dispatch from Orwell’s “Ministry of Truth.”

In urging Congress to pass medical “reform,” the Times claims that this country can “afford” this multitrillion-dollar monstrosity because it ultimately will “cut costs,” lower the federal deficit, and make “affordable medical care available to all: "Over the next two decades, the pending bills would actually reduce deficits by a small amount and reforms in how medical care is delivered and paid for — begun now on a small scale — could significantly reduce future deficits."

My response is simple: How do we know this legislation will accomplish these things? From what I can tell, the Times says we know it because, well, the legislation declares it to be so. In other words, we are supposed to take Congress and the White House at their word because, after all, they allegedly have our best interests at heart, just as Congress and the White House claimed that the Iraq war would be done on the cheap (paid mostly through oil exports from Iraq, something that did not exactly work as planned).

However, the editorial claims that there are real-live portions of the bill that should result in the supposed federal budget savings: "Electronic medical records could eliminate redundant tests; standardized forms and automated claims processing could save hundreds of billions of dollars; “effectiveness” research would help doctors avoid costly treatments that don’t work; various pilot projects devised to foster better coordination of care and a shift away from fee-for-service toward fixed payments for a year’s worth of a patient’s care all show some promise."

In the next paragraph the editorialist admits: "These reforms are mostly untested. And the C.B.O. is properly cautious when it says that it does not see much if any savings for the government during the next decade, in part because of upfront costs and in part because no one knows what will work."

Let me get this straight. The Times is urging us in the name of “cost reduction” to accept a huge new government expense that will affect us all in ways we cannot imagine because the regime in power declares that it will cut costs. It must be so because, well, it must be so.

The mind boggles at this logic. According to those who want government-run medical care (actually, most of medical care today already is run by the government one way or another), profit-seeking medical-insurance, drug, and private-care firms deliberately are driving up their costs in order to become more profitable. If that were true it would be the first time that profitability in a market system was positively related to firms’ artificially raising their own costs.

Indeed, as economists such as Ludwig von Mises and Murray Rothbard clearly demonstrated, firms earn profits by cutting costs, being resourceful, and creating goods and services that consumers want to purchase. The notion that companies become profitable through high production costs turns economic logic on its head.

For example, we have seen prices fall in the production and sale of computers and personal electronics in some of the freest markets on the planet. However, if these firms had adopted a production plan akin to what the Times demands for medical care, we would be paying a fortune for inferior electronic goods and there would be a “cost crisis” in that industry.

Sheldon Richman recently wrote about the “perverse incentives” that government has created in modern medical care, and he said that free markets in health care would better serve people than what we have now. Granted, he is using real economic logic, something that the political classes and their media allies have rejected as politically unsuitable. The rest of us will pay dearly for that arrogance.


Five health reform whoppers

When it comes to health care reform, the White House and its allies on Capitol Hill seem to live in an alternate universe.

The White House Council of Economic Advisers just released a report arguing that the reforms before Congress would reduce the growth in health costs, cut the federal budget deficits and produce thousands of dollars in benefits for the average family. The problem is that just a few days earlier a report from the president's own chief health care actuary concluded that the bill the Senate is considering would actually increase U.S. health spending by $234 billion over the next 10 years and hurt seniors' access to care. But then, reformers have generally had trouble telling fact from fiction. Among the biggest whoppers:

* Health care reform will reduce your insurance premiums. According to the Congressional Budget Office, the Senate bill does little or nothing to reduce insurance premiums. Even if the bill passes, premiums will roughly double by 2016, and keep rising after that. But for millions of Americans, the Senate bill will actually make things worse. According to the CBO, the bill would actually increase insurance premiums by 10 to 13 percent for Americans who don't receive insurance from their employers and buy their own insurance. These increases are over and above any increases that would occur if we did nothing.

* Middle-class taxes won't be raised. The Senate bill raises at least 15 new or increased taxes totaling more than $493 billion. While some, like the increase in the payroll tax, would primarily hit the wealthy, many would fall solidly on the middle class. For example, the bill includes a 40 percent excise tax on so-called "Cadillac" insurance plans, that is, insurance that is more generous than the government thinks it should be. According to the CBO, roughly 19 percent of workers would initially find their plans subject to the tax. However, because the tax threshold is set to increase at a rate slower than medical inflation, as time goes by more and more middle-class workers will be hit by it.

Middle-class taxpayers would be taxed in other ways as well. The Senate bill would require everyone to buy a government-designed insurance plan, even if it were more expensive than their current policy. Failure to comply brings a penalty of up to $6,750 for a family of four. If the government took money directly from you, then turned around and gave it to an insurance company, everyone would agree that you've been taxed. How is that any different from the government mandating that you pay the insurer directly?

* You can keep your current insurance. The Senate bill contains an individual mandate, that is, a requirement that every American must purchase health insurance. But not just any health insurance will satisfy that mandate. To qualify, a plan would have to meet certain government-defined standards. Those standards may be more expensive than your current plan, may include benefits you don't want and may even have benefits you are morally opposed to. As noted above, failure to comply brings a penalty of up to $6,750 for a family of four.

* It will only cost $848 billion. It is true that the CBO officially scored the bill as costing $848 billion. But much of the spending is back-loaded. The bill doesn't start spending until 2014, and only costs $9 billion that year. By 2019, the annual cost hits $196 billion. The minority staff of the Senate Budget Committee reports the cost is closer to $2.5 trillion over 10 years once all budget gimmicks are factored out. If you include costs shifted to individuals, businesses and state governments, the price tag could top $6 trillion.

* It will reduce the budget deficit. The CBO does say that the bill would reduce the deficit by $130 billion over the next 10 years (which is less than the deficit the government ran last month alone). However, even that tiny savings depends on budget gimmicks and the willingness of future Congresses to make huge cuts in Medicare spending. In fact, the CBO makes it clear that it will be "difficult" to achieve the predicted savings.

"Facts," John Adams said, "are stubborn things." As the health care reform debate goes forward, it's worth keeping some of these facts in mind.


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