Monday, December 14, 2009

Half of NHS hospitals 'will have to significantly reduce MRSA rates next year'

Half of all hospitals in England will have to significantly reduce MRSA rates next year as part of a crackdown on the potentially deadly superbug. They have been told bring rates down to the national average or reduce the number of case by 20 per cent, whichever has the greater impact.

Ministers are trying to tackle the worst performing hospitals, after successfully halving the overall number of cases across the country.

A report earlier this year from the National Audit Office showed that while rates of the hospital-acquired infections are falling across the country MRSA cases were actually rising in one in 10 hospital trusts.

A spokesman for the Department of Health confirmed that hospitals would not face penalties for missing the target. However, he added, hospitals would continue have their infection rate figures published on the NHS Choices website and could see patients choose to go elsewhere if they consistently had a large numbers of MRSA cases.


Frustrated surgeons walk out of chaotic West Australian public hospital

ONE THIRD of the general surgery team at WA's biggest hospital are so disgruntled they have either quit or are poised to resign, frustrated medicos revealed last night. One senior surgeon, who quit her job at Sir Charles Gairdner Hospital late last month, said she was being forced to compromise care because she felt pressured to "push patients" out the door as quickly as possible.

Senior surgeons, a number of whom have detailed a litany of concerns to The Sunday Times, said they are fed up with management, compromised patient care and unreasonable workloads. The surgeon who quit last month said her resignation from SCGH was one of "many fires burning in the department". She said the departures could be as many as eight - equal to a third of the hospital's general surgery team. "At least seven other surgeons have either left or are in the process of resigning and won't be around after December," the specialist surgeon said. "We're all high-calibre people. You're talking a big-time walkout."

She added: "There is so much pressure to push through patients just for the numbers that you're not being allowed to give the appropriate time to communicate and assist them to the level that they should be." Most of the departing medicos have found new jobs, either in other public hospitals or in the private sector.

Another surgeon said budget cuts were forcing doctors to cancel important surgery. The surgeon, who is planning to quit SCGH within months, said staff who complained were bullied by management. Another doctor, who said he went on leave and would not be returning to the hospital, alleged SCGH was recruiting overseas doctors and forcing them to work unfair hours. "The heads of department are hoping to get rid of local people and get overseas doctors because they're more vulnerable," he said. "They don't know the health system or the area and a lot of them are on special work visas."

Australian Medical Association state president Gary Geelhoed said doctors were finding it increasingly frustrating to work in the public hospitals. "We know that the hospitals are under pressure and it's getting more difficult," he said. "People are finding it harder to work within the public system."

The Sunday Times revealed in July that senior heart doctors at SCGH were locked in a bitter dispute after one doctor, John Alvarez, claimed two of his colleagues weren't qualified. SCGH suspended one of the doctors, Jaffar Shehatha, from duty pending an investigation into 18 of his patient files. The Health Department also launched an investigation into Dr Alveraz, over allegations of misconduct.

Opposition health spokesman Roger Cook called for an inquiry into the ongoing unrest among surgical staff at SCGH. "There is an emerging picture of disquiet at SCGH among the surgeons," Mr Cook said. "We need to make sure we're supporting our professional doctors and nurses as much as possible."

A spokeswoman for the hospital confirmed that three part-time surgeons would be leaving. "The timing of the departures is purely coincidental, and we are unaware of any other planned resignations in the near future," she said. "The hospital has not received a formal complaint from any of these surgeons." She said the hospital was looking to recruit two extra full-time general surgeons as soon as possible.


More moxie needed from the GOP

The Founding Fathers created a Republic, but 60 Senators are poised to take it away. With the pending disaster of the passage in the Senate of a bill nationalizing one sixth of the U.S. economy and our entire healthcare system at a cost of over $2.5 trillion, we are faced with a crucial question: are the Republican senators using every means at their disposal to stop this looming, tyrannical abuse of power? Unfortunately, the answer appears to be “no.”

The Senate, unlike the House of Representatives, has parliamentary rules and procedures that give the minority the ability to stall legislation. In fact, unlike the House, the minority have the ability to virtually paralyze the Senate. Doing so is not something we would want or expect for every bad bill that comes through Congress, but the proposed healthcare legislation is probably the worst piece of legislation ever considered by the United States Congress. It is the most intrusive, most damaging, most costly, most dangerous bill to the economic and personal freedom and liberty of individual Americans that Congress has ever considered. If there is any bill that deserves being stopped by shutting down the Senate, it is this one.

There are a whole series of parliamentary maneuvers that could be used by Republican senators to stop this bill. There is a hard backstop to the current process (Christmas). The Republicans’ goal should be to prevent Reid from passing the bill before that time. If he goes past Christmas and is forced to adjourn or recess, the momentum will shift in favor of those opposing the bill. How could this be done?

To start with, they should stop constantly agreeing to “unanimous consent” requests from the Democrats. Senate Republicans, to date, have allowed Democrats, by unanimous consent, to process 10 amendments. The amendments that have been accepted – Democrat amendments – did not make the over 2000-page atrocity any better. The Republican strategy of trying to pass their own “message” amendments carries no message unless you consider “no strategy to kill the bill” a message. There are no amendments that could possibly make this bill a palatable piece of legislation – and any amendments the Republicans get passed that supposedly make the bill “better” may just make it easier for the Democrats to get final passage. If the Republicans want the news media to cover what they are doing to educate the American people even further about the atrociousness of this bill, they have to create drama on the floor of the Senate. And the only way to do that is through an all-out fight with no holds barred. They need to look like Braveheart, fighting to the end to save freedom. Because, in fact, it is our very freedom and liberty that is at stake.

The most powerful words in the Senate are “I object.” Senate Republicans should have been shouting those two words on the Senate floor early and often from the moment this bill was considered, instead of the complete silence we have heard – other than to constantly agree to conduct business through unanimous consent. Here are just a few ways those words can (and should) be used in a very effective way:

The rules of the Senate require that a quorum be present to transact business. A quorum is 51 Senators. In most instances, outside of roll call votes, there are no more than 4 Senators on the Senate floor. If a Republican Senator suggested the absence of a quorum, Democrats could not transact business on the bill. It is a common courtesy to allow the quorum call to be dispensed with, without requiring 51 members to show up on the Senate floor (to get 51 Senators to appear without a roll call vote is very time consuming). When the Democrats ask unanimous consent that the quorum call be dispensed with, the Republican should immediately shout “I object.”

In 1988, when the Democrats were attempting to pass campaign finance reform, and Republicans refused to help them make a quorum, it took 53 hours for the quorum call to be dispensed with. If at any moment at least 50 Democrats are not on the floor, a Republican Senator could again suggest the absence of a quorum and start the process over again, causing huge delays in the legislative process being able to move forward.

No amendment can automatically or without substantial delay receive a roll call vote without every member of the Senate agreeing. Again, the Senate generally operates on collegial courtesy, but a $2.5 trillion courtesy is too much. Once an amendment is pending, it only takes one Senator to step in front of this freight train. If a Senator objects to ending debate on the amendment or having the amendment set aside, the majority must file cloture on the amendment. First cloture has to ripen and it cannot ripen until the next day’s session of the Senate, so that kills a day of the majority’s time. Assuming 60 Senators vote in favor of ending debate, the Senate is then required to spend 30 hours of its session time before voting on final passage for the amendment. Suffice it to say, if the Republicans had continuously objected from the start, the ten amendments they allowed the majority to process would have taken more days than Harry Reid has on the Senate calendar.

Senators have an obligation to protect the Constitution and the budget and points of order can be raised on both. Many constitutional scholars have pointed out that numerous bill provisions, particularly the individual mandate, are unconstitutional. Under the Senate’s rules, constitutional points of order are debatable. The Republicans should be constantly bringing up constitutional points of order, one after another, on every questionable provision. Reid would presumably be forced to file cloture on the points of order and another three days could be burned up on each one.

The healthcare bill violates § 425(a)(2) of the Budget Act, which prohibits consideration of any legislation that contains an unfunded intergovernmental mandate in excess of $69 million per year. If the point of order is raised and sustained, a simple majority may vote to waive the point of order. But the waiver is debatable and thus would presumably require 60 votes to cloture the motion to waive. This would require them to produce 60 votes at a time when they do not have their deal wrapped up yet, once again burning up three days.

On every vote, including on constantly raised points of order, the Republicans should be objecting that the vote total is incomplete – the Democratic Chair will rule that it is complete and the Republicans then appeal and once again force a vote, delaying the process again and again.

The Republicans should be offering one amendment after another on all of their favorite issues such as guns, abortion, elimination of the death tax, ending the TARP program, and gay marriage in the District of Columbia. Nothing connotes trench warfare like non-germane amendments on hot-button social issues. When you look back at all of the great filibusters of past decades, they almost always involved non-germane, explosive amendments on contentious social and other issues. Republicans should be offering hundreds of such amendments on every topic and using the rules to force votes on every single one. And the Republicans should be forcing the reading of the bill and every single amendment, not consenting to waiving that requirement.

Some might argue that Republicans should not look “obstructionist.” But they are wrong – the vast majority of Americans don’t like this bill and don’t want it to pass. The Tea Party movement was the upheaval of millions of ordinary Americans who are scared and angry about the out-of-control growth of the federal government, federal spending, and the national debt. They want to see the Republicans obstructing passage of this bill and if they think the Republicans are not fighting with every tool they have at their disposal, then any advantage that the Republicans think they will get in next year’s elections from such a bill being passed will evaporate. Conservatives will mount challenges to what they see as weak Republicans, just like what happened in New York’s special congressional race, helping Democrats eek out wins. And other conservative will stay home (like they did in 2008) rather than support GOP incumbents who did not fight.

The view coming out of the Senate of the Republicans has the appearance of business-as-usual – colloquies, speeches, and unanimous consent agreements. It does not convey the sense of urgency that should come with an issue of this magnitude and it does not provide any assurance to the public, including most especially the conservative base that is the heart of the Republican Party, that Republican Senators are willing to do everything it takes to stop this bill. If they don’t starting acting forcefully quickly and immediately, not only will they allow the country’s future to be unalterably damaged, they will be hastening the end to their own careers in the elections coming down the road faster than they can imagine.

Finally, I often hear that Senators express frustration when we dare to tell them how to fight, and that their frequent refrain is “you just don’t understand how the Senate works.” Actually some of us understand better than they do how it should work (whether they agree with every particular parliamentary tactic described or not), and the current frustration they feel with us will be nothing like what they may feel if they don’t stop this bill at all costs and act to preserve our Republic.


Do Democrats Really Believe Most Americans Want To Embarrass Obama?

Last night Sen. Sheldon Whitehouse (D, RI) asserted on the Senate floor that opposition to the Democrats’ health care reform “is about creating a political defeat for the president of the United States,” that it has “nothing to do with health care, entirely about creating a defeat for this new president....”

Also yesterday, reports Real Clear Politics, a new CNN poll found “61% opposed to the health care plan currently working its way through the Senate. Only 36% approve of the legislation.”

I wonder: does Sen Whitehouse believe that the opposition of 61% of “adult Americans” to the Democrats’ plan is based entirely on a desire to embarrass the president, that it has “nothing to do with health care”?

Hmm. So, we have one party opposing and the other party supporting something that 61% of adults oppose. Since politicians opposing something that most people oppose hardly requires a hidden, conspiratorial explanation, isn’t it more likely that it is the supporting party’s support that “has nothing to do with health care” but is based instead on a desire to prevent a defeat for their party and president?


The emerging medical dictatorship

As I have written about in a previous article entitled "Stop the Swine Whine," the public health establishment has used the current swine flu hysteria to try to impose mandatory vaccination laws under the guise of a health crisis. Fortunately, these proposed laws, with the exception of New York's short-lived mandatory health care worker vaccination mandate, have yet to come to fruition. In the case of New York some courageous doctors and nurses filed suit against the dictatorial law and were successful in getting the state government to back down.

While the constitutional crisis that this represented has been temporarily averted, a dangerous precedent has been set. It may be that in the coming months and years that these same government officials will not so easily relent. It may be as soon as the next flu season or the passage of the Obamacare health bill that our medical rights are lost forever.

We may have been granted a temporary reprieve from forced medical treatments this time around, but have we been spared from the government? As usual, the answer is "no". While the government may not be forcing a medicine down our throats or corralling uncooperative people in camps, what they are doing should send shivers down our collective spine. They are creating lists of dissidents and "terrorists". These lists contain detailed information on individuals. And, if ever the laws were changed to permit more coercive action instead of passive data collection then the government would already have the names of the supposed "enemies of the state" on hand.

What evidence of these government lists exists? Most people are aware of the government "no-fly" list, which now includes more than a million possible "terrorist" individuals. Additionally, there are government agencies such as the Department of Homeland Security (DHS) that are creating lists of supposed "domestic terrorists" including Ron Paul supporters, constitutionalists, Federal Reserve skeptics, military veterans, and many more as detailed in the Missouri Information Analysis Center (MIAC) and DHS rightwing extremism reports. More recently, the Obama Whitehouse has created its own enemies list composed of individuals that are opponents to Obama's socialist agenda.

There is also a group of people that range from the upper middle class to the wealthy that are frequently portrayed as "economic terrorists" by the IRS and the media. These people are often depicted as evil, selfish individuals that only acquired their living by parasitically draining it from the public. While there are indeed some individuals that fit this depiction, the vast majority are hard-working, innovative individuals who have accumulated wealth by their own efforts. Unfortunately, the media likes to lump these common Americans in with the likes of Bernie Madoff, who swindled investors out of billions of dollars, thus further engendering the false stereotype of wealthy people as being synonymous with corrupt greedy hucksters. This media and government propaganda garners increased support for forced confiscation of wealth as long as Robin Hood's (or rather the Federal Government's) loot is redistributed to those that have been supposedly wronged. Thus the government bribes one group of people, through promised welfare, unemployment, and medical benefits, to support increased IRS efforts to rob the savings from another smaller, but wealthier, group of Americans.

Although most of you are probably familiar with some of these government lists, many are not aware of the latest and potentially most dangerous data collection effort. Not only is the government seeking to monitor foreign, domestic, and economic terrorists but you can now add medical dissidents to the list. These dissidents include people that don't take the prescribed government treatments, physicians who don't follow the government protocols, and those that openly oppose any government medical measure. Traditionally, these medical dissidents could be found among the lists of conscientious objectors who refused to vaccinate their children as a prerequisite for public school enrollment. But the conscientious objectors are only the beginning.

Unbeknownst to most people that have received the H1N1 flu vaccine, they not only got a painful shot in the arm but also may have suffered a shot to their liberty. For example, as part of getting the vaccination in Texas, people are provided information about the H1N1 swine flu from the Texas Department of State Health Services (DSHS). While the information in the packet all seems innocent the catch comes at the end when patients are required to sign a consent to have their name entered into a government database for at least five years, if not forever.

The reason for this extraordinary period of retention seems to be that the H1N1 flu epidemic has been termed a disaster. In fact, the consent section starts with the title "Consent for retention of Disaster-Related Information and Release of Information to Authorized Entities." Furthermore, as part of the consent patients agree to grant "retention of my (or my child's) disaster-related information by DSHS beyond the 5 year retention period." This information will be stored in "the states central immunization registry ('ImmTrac')" and used for "coordinating communicable disease prevention and control efforts."

The "disaster" justification for encroaching upon our constitutional rights is nothing new. What is new is that this "disaster" has now been exposed as at most over-blown and at worst a fraud. While many experts were predicting up to hundreds of thousands of deaths in both the UK and the U.S., the reality has been that only a few hundred have unfortunately succumbed to the "swine" flu. In addition, over the past few weeks there has been a dramatic decrease in the number of swine flu cases. It is likely that this "disaster" may be already over. Unfortunately, for the poor unsuspecting public the end of their liberty has only just begun.

What will the government do with all this information?

Because this virus has been relatively mild and vaccine compliance has been so low, the government is not likely to gain much epidemiological information. However, despite the fact that the government will glean very little information about the effects of the vaccine, this will not prevent it from monitoring those that are vaccine compliant and vaccine non-compliant. It is this list of vaccine non-compliant people that I fear will be the focus of future government pandemic vaccine intervention.

Unfortunately, the story doesn't stop with vaccinations. Ever since the federal government began to tie reimbursement rates of hospitals with preventative medicine or "best practice" measures has come the potential for non-compliance lists of unheard proportions. It all started with Medicare mandating that hospitals "voluntarily" push pneumococcal, tetanus, and flu vaccinations on their patients or else face financial penalties. It didn't matter if the patient came in for a broken leg, he or she would have a vaccine pushed in their face largely because of the threat of federal financial disincentives. Now the Federal government is beginning to push best practice measures in other areas. These areas include government mandates about supposedly evidence-based best treatment protocols for conditions such as heart attacks, strokes, pneumonia, heart failure, and many others. If hospitals and doctors don't follow the protocol, they face the prospect of future blacklisting and financial hardship from federal regulators and auditors.

If that isn't scary enough, soon these measures will affect your local primary care physician as they face the prospect of having their treatments and compliance/non-compliance to protocols for diabetes, heart failure, hypertension, and many other conditions monitored by federal auditors. In anticipation of this many large physician groups and hospital organizations are already putting this monitoring in place on their own physicians in order to help them be good little obedient physicians so that they will be prepared when the eventual mandates from government arrives.

What has made this sort of control possible is the advent of electronic medical records (EMR). With most EMR systems it is possible to data mine and extract patient non-compliance/compliance and monitor physician adherence to best-practice protocols for many conditions and preventative measures. For example, it is possible for these systems to monitor what percentage of a physician's patients are getting colonoscopies, flu vaccines, mammograms, etc. and with the percentage comes a list of compliant and non-compliant individuals. It is with these lists that non-compliant individuals are beginning to be hounded on a never-ending basis to comply or else. This is because physicians fear economic and even possible professional retribution from state medical boards and the government if their numbers aren't high enough.

The only saving grace right now is that the entire system is highly fragmented due to the large number of EMR systems. However, if a single-payer system becomes the dominant medical system under the current health care reform proposed by the Obama administration then it would be much easier for federal government to gather and monitor this information. It may be that soon both physicians and patients are put in medical straight-jackets where all the treatments are prescribed in advance and physicians become nothing more than desk-clerks, even more so than they already are. That is why it may be that the Obama administration is pushing EMR and why Medicare has threatened to start decreasing physician reimbursement for physicians that are not using these systems. It may have more to do with making sure that future government rationing, treatment protocols, physician compliance, and patient compliance can be strictly monitored than improving the quality of medical care.

Think that this kind monitoring could never happen in America? Well, you would be wrong. In January of 2006, New York City became the first city to require certain diabetes blood tests to be sent to the public health department where patient and physician compliance to diabetes treatment protocols are monitored. If the numbers are not good enough both the patient and physician are liable to be sent a report.

It is not too late to become anxiously engaged in fighting for your health care freedom. Just be aware that the next time you decide to be non-compliant to the treatment protocol that you may unwittingly have become part of a non-compliant list. As a member of the non-compliant list, physicians will be forced to continue to nag you on a seemingly never-ending basis until you become compliant. This is because they don't want their name to be published as a bad physician for not getting enough patients to comply nor do they want their livelihood and certification taken away.

If we are unsuccessful in turning the tide then this system of protocols, electronic medical records, and a single-payer system will inevitably be put in place. Your only hope may be to insist that your physician uses paper and not plastic.


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