Tuesday, December 22, 2009

Dying man, 80, is denied care at home as British health chiefs say he's not ill enough for help

But the light of publicity seems to be working, as usual. Too bad if you can't get a major newspaper to campaign for you, though

An 80-year-old man with a terminal disease that has left him immobile and with swallowing difficulties has been denied NHS funding for care at home. Health bosses say Brian Stroud is not ill enough to qualify. The ruling left his 77-year-old wife Eileen, who is herself frail and on crutches, to look after him. The couple have paid £16,000 for extra care in the last six months but their daughter Debbie Hill, 46, says the physical and financial strain is proving too much. They are also struggling with the bureaucracy involved in appealing against the decision.

The Strouds, of Hollandon-Sea, Essex, have been living a nightmare since Mr Stroud was diagnosed with the terminal disease PSP (progressive supranuclear palsy) three years ago. It is a rare and incurable degenerative brain disorder, whose victims included actor Dudley Moore. They applied for NHS Continuing Healthcare funding eight months ago but have been turned down twice by North East Essex Primary Care Trust.

Mrs Hill said: 'All the health service staff who have seen my father say he qualifies for funding but we've been told his needs are only 'moderate'. He can't use his left side, he's virtually immobile and in a wheelchair, he's doubly incontinent and cannot lift his head. 'Swallowing has got more difficult, so has communicating. It seems incredible that he's been turned down. 'It's all about money - and we're disgusted that the PCT chief executive got a three per cent bonus last year for achieving financial targets'.

The Daily Mail's Dignity for the Elderly campaign has repeatedly highlighted the unfairness of the means test system when families need nursing care for conditions such as Alzheimer's. Department of Health criteria on who qualifies for help are subject to interpretation by individual NHS trusts. Many people are denied funding by primary care trusts - which have to foot the bill - because their disease does not automatically make them eligible. Campaigners say requests are unlawfully rejected or mired in the appeal system for months or years.

Mrs Hill, a mother of two, said last night: 'We want justice for dad and mum, and for everyone else in this situation. 'They've been married 52 years, they're devoted to each other, but when they need the NHS it's not there for them.'

Jane Hardy, chief executive of the PSP Association, said refusal of NHS funding was becoming more common. She said there were around 1,250 sufferers diagnosed with this 'absolutely dreadful disease' at any one time. She said: 'It's made more terrible because people with PSP know what's happening to them. 'They are trapped in a broken body, unable to communicate and knowing it's only going to get worse. 'We need a system that's not left to local officials, who often have every incentive to reject applications.'

NHS North East Essex said last night that it will soon be making a new assessment of Mr Stroud's condition as his needs have ' potentially increased'.


British women with signs of breast cancer wait months as Labour government breaks manifesto pledge

Women with signs of breast cancer are waiting months for a diagnosis amid the failure of one of Labour's key manifesto pledges, the Government's cancer tsar has admitted. All patients with symptoms of the disease should be seen by a specialist within two weeks of visiting their GP, following a promise made before the last election. Labour said the NHS would meet the pledge by 2008 – a deadline it later extended to the end of this month.

Now the Government's cancer tsar Prof Mike Richards has disclosed that the health service is about to miss that target, with thousands of worried women waiting weeks and sometimes even months to see a hospital specialist. In an interview with The Sunday Telegraph, he also indicated that figures which will document widespread failings to meet the target are unlikely to be published before a general election.

Charities said last night that they were "deeply concerned" that thousands of women are routinely being left in an anxious limbo, waiting to find out if they have cancer, with delays that could worsen their prognosis and threaten lives. Experts also expressed fury that Labour might not be held to account for failure to meet its high profile pledge.

In 2000, the Government introduced a maximum 2-week waiting limit for those cases where GPs suspected breast cancer. However, research found that family doctors were unable to accurately identify such cases. One study found higher rates of cancer among women whose referrals had not been fast-tracked; latest figures on newly diagnosed breast cancer sufferers show half had not been given an urgent referral.

The newer target, drawn up as part of the 2005 manifesto, means that by the end of this month, all women who see their GP about any kind of "breast symptom" should be seen by a specialist within 2 weeks. Prof Richards admitted the deadline -already postponed from 2008 – will not be hit. "The feedback I am getting is that across the country as a whole we haven't made sufficient progress," he said.

The Department of Health's national cancer director said he was "hopeful" that the commitment would be achieved six months after its deadline. "I am confident we will hit the target but I am not confident we will get there by the date we said," he said.

In a report for the NHS, Prof Richards described "significant concerns" about the NHS' efforts to reduce waiting times for women with symptoms of breast cancer. He told The Sunday Telegraph: "We know that this is a very anxious time for women. If they are being referred to a specialist because of breast symptoms they are going to worry."

Latest quarterly figures show that of more than 9,000 women diagnosed with breast cancer, almost half had not been given an urgent referral by their GP. While data was not yet available to show just how long such women were waiting, "most" would be referred within six to eight weeks of seeing their GP, as part of a wider NHS target which means all treatment should happen within 18 weeks of referral, Prof Richards said. He said shortages of staff in hospitals who could carry out tests such as mammograms were one of the main obstacles to reducing waiting times.

Prof Richards said not all symptoms of breast cancer were easy to recognise. While most women and their doctors recognised a single breast lump as a possible indication of cancer, general lumpiness, and other symptoms including blood and discharge, were less clear indicators.

Many young women worried unduly about breast cancer, while older women tended to dismiss their fears, experts said. Breast cancer is now Britain's most common cancer. Of around 45,000 cases of breast cancer diagnosed each year, more than three quarters involve woman aged 50 or over.

Prof Richards said that although official monitoring of the two week target will start on January 1st, he did not expect to publish figures until May – meaning the extent of the failure on a manifesto pledge is likely to be hidden until after a general election.

Last night Jeremy Hughes, chief executive of charity Breakthrough Breast Cancer, expressed concern about the delays for women and anger about the notion that Labour could go into the next election without being held accountable for a previous manifesto pledge. He said: "We think this is a major concern. It is five years since [then health secretary] John Reid said before the last election that all women would be seen within two weeks of referral, not just those designated as urgent." "Women are being left with enormous anxiety and stress, as well as at increased risk, for those who turn out to have cancer. Once you have gone to see your GP, and they have said you are being referred to a breast cancer clinic, it just isn't something you can forget about for five or six weeks".

The charity is furious that data detailing failure against the target might not be published until after a general election. Mr Hughes said: "We are really concerned about the lack of data on this; we just don't think its acceptable to go into an election without this information".

Dr Jane Maher, Chief Medical Officer at Macmillan Cancer Support, said: "When breast cancer presents and it is not a lump, GPs can find it difficult to assess, so it is really important that all women are sent to a specialist quickly." She said it was equally important that women, especially the elderly, with the highest risk of breast cancer, went to see their GPs if they had concerns about changes to their breasts.

Anna Beckingham, aged 40, from Norwich, visited her GP practice three times because of concerns about a pea-sized lump and pains in her right breast. The mother of two was first told that the changes were "probably hormonal," and related to recent breast feeding. Discharge was dismissed as likely to be caused by an infection. On a third visit, to a different doctor at the practice, she was given a "non-urgent" referral to hospital, but it was not until March 2007 – 14 months after she first saw her GP – that she was finally diagnosed with cancer. By then, she had no option but to have a full mastectomy, to remove a growth which was now five centimetres in diameter, followed by reconstruction surgery.

Mrs Beckingham, who trained as a physiotherapist, fears many women who see their GP about symptoms of breast cancer are brushed away. "I kept saying to the doctors, I really do think this is breast cancer, but every time, they were dismissive. I am quite a confident woman and I know something about medicine so I was prepared to stand up for myself – if I had given up, I think I would be dead by now."


The Fight Over Fascist ObamaCare Is Only Just Beginning

Senate Majority Leader Harry Reid (D-Nev.), who may be unaware that he is currently enjoying his final term in the U.S. Senate, claims to have the 60 votes he needs to muscle ObamaCare through his chamber. God help us if he does.

The current iteration of ObamaCare is classic Mussolini-style Fascism (i.e. corporatism). It forces Americans at gunpoint to purchase health insurance, a requirement never before imposed on the American people. The big insurance companies and the federal government have combined to subject the public to this tyrannical mandate that Americans overwhelmingly oppose. This is the economic essence of Fascism. Shame on them on all.

Nonetheless, William Kristol of the Weekly Standard offers some words of encouragement to the patriotic Americans who still believe in limited government.
Keep fighting on health care. Fight for the next few days in the Senate. Fight the conference report in January in the Senate and the House. Start trying to repeal the worst parts of the bill the moment it passes, if it does.

After all, never before has so unpopular a piece of major legislation been jammed through on a party-line vote. This week, Rasmussen showed 57% of voters nationwide saying that it would be better to pass no health care reform bill this year instead of passing the plan currently being considered by Congress, with only 34% favoring passing that bill. 54% of Americans now believe they will be worse off if reform passes, while just 25% believe they'll be better off. Making the 2010 elections a referendum on health care should work--if Republicans don't let up in the debate over the next year.

Indeed ObamaCare may be the Democrats' undoing. They are betting it all on their healthcare plan, which won't kick in for years to come. A public backlash before then could halt the program in its tracks and kill it, leading to a Bastille Day-like slaughter at the polls for the Democratic powers that be.

Of course, it would be better to abort this monstrosity while in the womb, but the beauty of politics is that the fight is never really over. There will be more battles to come.

As Kristol writes, "Fight on with respect to health care. Fight on other fronts. And recruit new fighters. In a word: Fight. "


ObamaCare for dummies

So the Democrats have reached a "compromise" and ObamaCare is going to pass. So what's it going to cost the taxpayers and what are we going to get out of it? Simple enough questions. But try to find the straight answers to that and you'll feel like the proverbial tiger chasing his tail.

Here's the Congressional Budget Office's "scoring" of the bill: click here if you have the nerve to do so. But we'll make it simple. Jeffrey Anderson, in the Weekly Standard has done the math for us. Here's a capsule of what he found:

The bottomline cost will be $2.5 TRILLION. This according to the CBO. The numbers the Democrats are throwing out are correct but they don't include everything. Bottom line: $2.5 TRILLION.

And remember, We are already out of money; with annual deficits over a TRILLION dollars a year. This bill will add $210 billion to that deficit and even more if Congress does as it has done with other entitlement programs in the past.

"And what would Americans get in return for this staggering sum? Well, the CBO says that health care premiums would rise, and the Chief Actuary at the Centers for Medicare and Medicaid Services says that the percentage of the Gross Domestic Product spent on health care would rise from 17 percent today to 21 percent by the end of 2019. Nationwide health care costs would be $234 billion higher than under current law. How's that for "reform"?"

And while the Weekly Standard does not say it, you can mark our words: health insurance premiums will go UP. Count on it.

And what about those big, nasty insurance companies? They get a $1 TRILLION windfall.


Change Nobody Believes In

A bill so reckless that it has to be rammed through on a partisan vote on Christmas eve

And tidings of comfort and joy from Harry Reid too. The Senate Majority Leader has decided that the last few days before Christmas are the opportune moment for a narrow majority of Democrats to stuff ObamaCare through the Senate to meet an arbitrary White House deadline. Barring some extraordinary reversal, it now seems as if they have the 60 votes they need to jump off this cliff, with one-seventh of the economy in tow.

Mr. Obama promised a new era of transparent good government, yet on Saturday morning Mr. Reid threw out the 2,100-page bill that the world's greatest deliberative body spent just 17 days debating and replaced it with a new "manager's amendment" that was stapled together in covert partisan negotiations. Democrats are barely even bothering to pretend to care what's in it, not that any Senator had the chance to digest it in the 38 hours before the first cloture vote at 1 a.m. this morning. After procedural motions that allow for no amendments, the final vote could come at 9 p.m. on December 24.

Even in World War I there was a Christmas truce.

The rushed, secretive way that a bill this destructive and unpopular is being forced on the country shows that "reform" has devolved into the raw exercise of political power for the single purpose of permanently expanding the American entitlement state. An increasing roll of leaders in health care and business are looking on aghast at a bill that is so large and convoluted that no one can truly understand it, as Finance Chairman Max Baucus admitted on the floor last week. The only goal is to ram it into law while the political window is still open, and clean up the mess later.

• Health costs. From the outset, the White House's core claim was that reform would reduce health costs for individuals and businesses, and they're sticking to that story. "Anyone who says otherwise simply hasn't read the bills," Mr. Obama said over the weekend. This is so utterly disingenuous that we doubt the President really believes it.

The best and most rigorous cost analysis was recently released by the insurer WellPoint, which mined its actuarial data in various regional markets to model the Senate bill. WellPoint found that a healthy 25-year-old in Milwaukee buying coverage on the individual market will see his costs rise by 178%. A small business based in Richmond with eight employees in average health will see a 23% increase. Insurance costs for a 40-year-old family with two kids living in Indianapolis will pay 106% more. And on and on.

These increases are solely the result of ObamaCare—above and far beyond the status quo—because its strict restrictions on underwriting and risk-pooling would distort insurance markets. All but a handful of states have rejected regulations like "community rating" because they encourage younger and healthier buyers to wait until they need expensive care, increasing costs for everyone. Benefits and pricing will now be determined by politics.

As for the White House's line about cutting costs by eliminating supposed "waste," even Victor Fuchs, an eminent economist generally supportive of ObamaCare, warned last week that these political theories are overly simplistic. "The oft-heard promise 'we will find out what works and what does not' scarcely does justice to the complexity of medical practice," the Stanford professor wrote.

• Steep declines in choice and quality. This is all of a piece with the hubris of an Administration that thinks it can substitute government planning for market forces in determining where the $33 trillion the U.S. will spend on medicine over the next decade should go.

This centralized system means above all fewer choices; what works for the political class must work for everyone. With formerly private insurers converted into public utilities, for instance, they'll inevitably be banned from selling products like health savings accounts that encourage more cost-conscious decisions.

Unnoticed by the press corps, the Congressional Budget Office argued recently that the Senate bill would so "substantially reduce flexibility in terms of the types, prices, and number of private sellers of health insurance" that companies like WellPoint might need to "be considered part of the federal budget."

With so large a chunk of the economy and medical practice itself in Washington's hands, quality will decline. Ultimately, "our capacity to innovate and develop new therapies would suffer most of all," as Harvard Medical School Dean Jeffrey Flier recently wrote in our pages. Take the $2 billion annual tax—rising to $3 billion in 2018—that will be leveled against medical device makers, among the most innovative U.S. industries. Democrats believe that more advanced health technologies like MRI machines and drug-coated stents are driving costs too high, though patients and their physicians might disagree.

"The Senate isn't hearing those of us who are closest to the patient and work in the system every day," Brent Eastman, the chairman of the American College of Surgeons, said in a statement for his organization and 18 other speciality societies opposing ObamaCare. For no other reason than ideological animus, doctor-owned hospitals will face harsh new limits on their growth and who they're allowed to treat. Physician Hospitals of America says that ObamaCare will "destroy over 200 of America's best and safest hospitals."

• Blowing up the federal fisc. Even though Medicare's unfunded liabilities are already about 2.6 times larger than the entire U.S. economy in 2008, Democrats are crowing that ObamaCare will cost "only" $871 billion over the next decade while fantastically reducing the deficit by $132 billion, according to CBO.

Yet some 98% of the total cost comes after 2014—remind us why there must absolutely be a vote this week—and most of the taxes start in 2010. That includes the payroll tax increase for individuals earning more than $200,000 that rose to 0.9 from 0.5 percentage points in Mr. Reid's final machinations. Job creation, here we come.

Other deceptions include a new entitlement for long-term care that starts collecting premiums tomorrow but doesn't start paying benefits until late in the decade. But the worst is not accounting for a formula that automatically slashes Medicare payments to doctors by 21.5% next year and deeper after that. Everyone knows the payment cuts won't happen but they remain in the bill to make the cost look lower. The American Medical Association's priority was eliminating this "sustainable growth rate" but all they got in return for their year of ObamaCare cheerleading was a two-month patch snuck into the defense bill that passed over the weekend.

The truth is that no one really knows how much ObamaCare will cost because its assumptions on paper are so unrealistic. To hide the cost increases created by other parts of the bill and transfer them onto the federal balance sheet, the Senate sets up government-run "exchanges" that will subsidize insurance for those earning up to 400% of the poverty level, or $96,000 for a family of four in 2016. Supposedly they would only be offered to those whose employers don't provide insurance or work for small businesses.

As Eugene Steuerle of the left-leaning Urban Institute points out, this system would treat two workers with the same total compensation—whatever the mix of cash wages and benefits—very differently. Under the Senate bill, someone who earned $42,000 would get $5,749 from the current tax exclusion for employer-sponsored coverage but $12,750 in the exchange. A worker making $60,000 would get $8,310 in the exchanges but only $3,758 in the current system.

For this reason Mr. Steuerle concludes that the Senate bill is not just a new health system but also "a new welfare and tax system" that will warp the labor market. Given the incentives of these two-tier subsidies, employers with large numbers of lower-wage workers like Wal-Mart may well convert them into "contractors" or do more outsourcing. As more and more people flood into "free" health care, taxpayer costs will explode.

• Political intimidation. The experts who have pointed out such complications have been ignored or dismissed as "ideologues" by the White House. Those parts of the health-care industry that couldn't be bribed outright, like Big Pharma, were coerced into acceding to this agenda. The White House was able to, er, persuade the likes of the AMA and the hospital lobbies because the federal government will control 55% of total U.S. health spending under ObamaCare, according to the Administration's own Medicare actuaries.

Others got hush money, namely Nebraska's Ben Nelson. Even liberal Governors have been howling for months about ObamaCare's unfunded spending mandates: Other budget priorities like education will be crowded out when about 21% of the U.S. population is on Medicaid, the joint state-federal program intended for the poor. Nebraska Governor Dave Heineman calculates that ObamaCare will result in $2.5 billion in new costs for his state that "will be passed on to citizens through direct or indirect taxes and fees," as he put it in a letter to his state's junior Senator.

So in addition to abortion restrictions, Mr. Nelson won the concession that Congress will pay for 100% of Nebraska Medicaid expansions into perpetuity. His capitulation ought to cost him his political career, but more to the point, what about the other states that don't have a Senator who's the 60th vote for ObamaCare?

"After a nearly century-long struggle we are on the cusp of making health-care reform a reality in the United States of America," Mr. Obama said on Saturday. He's forced to claim the mandate of "history" because he can't claim the mandate of voters. Some 51% of the public is now opposed, according to National Journal's composite of all health polling. The more people know about ObamaCare, the more unpopular it becomes.

The tragedy is that Mr. Obama inherited a consensus that the health-care status quo needs serious reform, and a popular President might have crafted a durable compromise that blended the best ideas from both parties. A more honest and more thoughtful approach might have even done some good. But as Mr. Obama suggested, the Democratic old guard sees this plan as the culmination of 20th-century liberalism.

So instead we have this vast expansion of federal control. Never in our memory has so unpopular a bill been on the verge of passing Congress, never has social and economic legislation of this magnitude been forced through on a purely partisan vote, and never has a party exhibited more sheer political willfulness that is reckless even for Washington or had more warning about the consequences of its actions.

These 60 Democrats are creating a future of epic increases in spending, taxes and command-and-control regulation, in which bureaucracy trumps innovation and transfer payments are more important than private investment and individual decisions. In short, the Obama Democrats have chosen change nobody believes in—outside of themselves—and when it passes America will be paying for it for decades to come.


The Obamacare horror story you won’t hear

by Michelle Malkin

The White House, Democrats, and MoveOn liberals are spreading health care sob stories to sell a government takeover. But there’s one health care policy nightmare you won’t hear the Obamas hyping. It’s a tale of poor, minority patient-dumping in Chicago — with First Lady Michelle Obama’s fingerprints all over it.

Both Republican Sen. Charles Grassley of Iowa and Democrat Rep. Bobby Rush of Chicago have raised red flags about the outsourcing program, run by the University of Chicago Medical Center. The hospital has non-profit status and receives lucrative tax breaks in exchange for providing charity care. Yet, it spent a measly $10 million on charity care for the poor in fiscal 2007 when Mrs. Obama was employed there—1.3 percent of its total hospital expenses, according to an analysis performed for The Washington Post by the non-partisan Center for Tax and Budget Accountability. The figure is below the 2.1 percent average for nonprofit hospitals in surrounding Cook County.

Rep. Rush called for a House investigation last week in response to months of patient-dumping complaints, noting: “Congress has a duty to expend its power to mitigate and prevent this despicable practice from continuing in centers that receive federal funds.”

Don’t expect the president to support a probe. While a top executive at the hospital, Mrs. Obama helped engineer the plan to offload low-income patients with non-urgent health needs. Under the Orwellian banner of an “Urban Health Initiative,” Mrs. Obama sold the scheme to outsource low-income care to other facilities as a way to “dramatically improve health care for thousands of South Side residents.” The program guaranteed “free” shuttle rides to and from the outside clinics.

In truth, it was old-fashioned cost-cutting and favor-trading repackaged as minority aid. Clearing out the poor freed up room for insured (i.e., more lucrative) patients. If a Republican had proposed the very same program and recruited black civic leaders to front it, Michelle Obama and her grievance-mongering friends would be screaming “RAAAAAAAAACISM!” at the top of their lungs.

Joe Stephens of the Washington Post wrote: “To ensure community support, Michelle Obama and others in late 2006 recommended that the hospital hire the firm of David Axelrod, who a few months later became the chief strategist for Barack Obama’s presidential campaign. Axelrod’s firm recommended an aggressive promotional effort modeled on a political campaign—appoint a campaign manager, conduct focus groups, target messages to specific constituencies, then recruit religious leaders and other third-party ‘validators.’ They, in turn, would write and submit opinion pieces to Chicago publications.”

Some health care experts saw through Mrs. Obama and her public relations man, David Axelrod—yes, the same David Axelrod who is now Mr. Obama’s senior adviser at the White House. The University of Chicago Medical Center hired Axelrod’s public relations firm, ASK Public Strategies, to promote Mrs. Obama’s Urban Health Initiative. Axelrod had the blessing of Chicago political guru Valerie Jarrett – now White House senior adviser.

Axelrod’s great contribution: Re-branding! His firm recommended re-naming the initiative after “[i]nternal and external respondents expressed the opinion that the word ‘urban’ is code for ‘black’ or ‘black and poor’….Based on the research, consideration should be given to re-branding the initiative.” Axelrod and the Obama campaign refused to disclose how much his firm received for its genius re-branding services.

In February 2009, outrage in the Obamas’ community exploded after a young boy covered by Medicaid was turned away from the University of Chicago Medical Center. Dontae Adams’ mother, Angela, had sought emergency treatment for him after a pit bull tore off his upper lip. Mrs. Obama’s hospital gave the boy a tetanus shot, antibiotics, and Tylenol and shoved him out the door. The mother and son took an hour-long bus ride to another hospital for surgery.

I’ll guarantee you this: You’ll never see the Adams family featured at an Obama policy summit or seated next to the First Lady at a joint session of Congress to illustrate the failures of the health care system.

Following the Adams incident, the American College of Emergency Physicians (ACEP) blasted Mrs. Obama and Mr. Axelrod’s grand plan. The group released a statement expressing “grave concerns that the University of Chicago’s policy toward emergency patients is dangerously close to ‘patient dumping,’ a practice made illegal by the Emergency Medical Labor and Treatment Act (EMTALA)” – signed by President Reagan, by the way – “and reflected an effort to ‘cherry pick’ wealthy patients over poor.”

Rewarding political cronies at the expense of the poor while posing as guardians of the downtrodden? Welcome to Obamacare.


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