Thursday, February 11, 2010

Elderly British patient was abandoned for two days in hospital store cupboard with little food or medication

Confused and in pain, 80-year-old Doris McKeown is kept in a hospital cupboard while she awaits emergency surgery. The pensioner was stored away for 48 hours in a tiny windowless room, with only shelves of hospital supplies for company. On the door outside was a sign saying 'Dignity in Care'.

But inside the store cupboard - called a 'treatment room' by management but a 'broom cupboard' by Mrs McKeown - she suffered the indignity of being overlooked for medication and meals.

She was taken to Norfolk and Norwich Hospital last October needing an urgent operation for compression of the nerves in her spine, which can lead to paralysis. The mother of two said: 'It was a relief to be in hospital as I knew it was a serious condition, but in the middle of the night I was transferred to a storeroom off the main ward because they hadn't got enough beds. It was like a broom cupboard.'

When she was seen by the consultant, he had to squeeze in with two other doctors and Mrs McKeown's daughter Dr Helena McKeown, a GP who is also chairman of the community care committee at the British Medical Association. ' The consultant didn't seem surprised, it seemed to happen regularly,' said Mrs McKeown, whose late husband Joe was a newspaper photographer. 'I had nurses coming in all the time to pick up the supplies and they were very good, but as I wasn't on the proper ward I missed out on some of the rounds for meals and medication. 'I didn't get put on the ward until after the operation two nights later. 'It's extraordinary that patients have to be looked after in a cupboard because the hospital doesn't have enough beds.'

Dr McKeown said: 'My mother needed emergency surgery and she ended up in a cupboard. Where's the dignity in care?' The family is appalled that patients are routinely housed in such rooms as a result of a controversial scheme using private companies to build NHS hospitals for a profit. They claim the Norfolk and Norwich Hospital not only has fewer proper beds than the old building it replaced but that the public will be paying for it for decades.

Dr McKeown has raised her concerns with the hospitals' watchdog, the Care Quality Commission, and last week gave evidence to MPs. She said the Private Finance Initiative (PFI) scheme that funded the hospital was undermining the NHS. 'The PFI scheme is being used throughout the NHS, which pays private companies for a period of 25 to 30 years,' she said. 'It's like a mortgage with a very high rate of interest and maintenance costs that my four children will be paying for 30 years - and they can't even build a hospital with sufficient space for local patients.'

The £229million Norwich hospital, opened in 2001, pays an annual rent of £40million a year. Figures show the NHS will pay out £63billion for privately financed hospitals - £52billion more than they are worth. The first payments for hospital Private Finance Initiatives began in 1999 and the NHS still owes £58billion on 106 contracts over the next three decades. The BMA will today launch a campaign against the 'commercialisation' of the NHS, which it says is putting profits ahead of patients.

Andrew Stronach, of the Norfolk and Norwich Hospital, said it has 1,010 beds - more than the 952 replaced in two old hospitals. But he admitted that 27 wards had such 'treatment rooms'. He added: 'They are not cupboards, they are treatment rooms. They are normally used for patients who are risk assessed before being discharged.'


Australia: Victoria to ape failed British hospital reform

It leads either to "fudging" the figures or to hasty and inappropriate treatment -- causing death in some instances

WAITING times for patients at Victorian hospital emergency wards would be slashed by half to four hours as part of sweeping health reforms. Victoria is already testing a four-hour target for emergency departments in three Melbourne hospitals. The Brumby Government is closely monitoring the trial before deciding whether to roll out a four-hour benchmark across the state.

South Australian Premier Mike Rann - who faces a tough election fight on March 20 - is leading a national push for the four-hour target. He has been lobbying other premiers and Canberra to back the health plan - with mixed success. NSW is understood to be lukewarm, believing it would require thousands of extra hospital beds, but Victoria and Western Australia are proceeding with the target in a bid to clear emergency wards.

The plan comes as Prime Minister Kevin Rudd is finishing a suite of reforms that he hopes the states will sign in the next few months. It is believed the PM is keen to offer the states extra money to speed up elective surgery waiting lists. He also supports a reform suggested by his Health and Hospitals Reform Commission to pay at least 40 per cent of the "efficient cost" of every public patient admission.

Mr Rudd, who has backed away from a threat to take over the public hospitals, yesterday raised the prospect of introducing hospital boards. This would give local communities greater control over their hospitals - but critics claim it would cost tens of millions of dollars in extra bureaucracy.

The Rudd Government has been working through options with the states ahead of a Council of Australian Governments summit, scheduled for March or April. But the states are far from united on the best way forward for health reform. The plan to introduce a four-hour target for emergency departments highlights the national split. Supporters point to the success of a four-hour target introduced by Britain in 2004. The target, along with extra cash, has produced a big [superficial] improvement at UK emergency departments.

Some concerns have been raised that hospital staff had compromised the level of patient care in order to meet the tougher benchmark. At present, patients who have been rushed to emergency departments have to wait up to eight hours to be treated and either discharged or admitted to a hospital bed.

Canberra appears lukewarm to requests from South Australia for extra money. Health Minister Nicola Roxon said the Rudd Government had increased health and hospital funding by 50 per cent to a record $64 billion.


The Canadian Patients’ Remedy for Health Care: Go to America!

One common assertion among the left is that other industrialized nations, such as Canada, achieved great success in health care within their collectivist framework. This, then, begs the question: why is the head of an east coast Canadian province coming to the United States for medical treatment?

Newfoundland Premier Danny Williams is seeking heart surgery in the United States, drawing criticism from “local bloggers and people calling in to the province’s immensely popular open-line radio shows.” Yet his actions are hardly unusual for world leaders. Saudi Arabian King Abdullah bin Abdulaziz is known to have his checkups at the prestigious Mayo Clinic in Rochester, Minn. Italian Prime Minister Silvio Berlusconi had heart surgery at the Cleveland Clinic in 2006 . Even middle-class Canadians are utilizing their proximity to the United States to seek treatment here.

A study by Steven Katz, Diana Verilli, and Morris Barer in Health Affairs examining the Ontario Health Insurance Plan from 1987 to 1995 found “evidence of cross-border care seeking for cardiovascular and orthopedic procedures, mental health services, and cancer treatments,” although not widespread. Examples include the governments of British Columbia and Quebec sending patients to the United States for coronary artery surgery and cancer treatment. Shona Holmes, a Kingston, Ontario resident in need of an endocrinologist and neurologist, crossed the border when she was told to wait “four months for one specialist and six months for the other.” Karen Jepp delivered identical quadruplets in Montana “because of a shortage of neonatal beds in Canada,” with the Calgary health system picking up the tab.

Perhaps Canadians’ health care migration patterns are a result of their own centralized system of government health care planning and “free care” crashing into the government’s budget constraints. The annual study “Paying More: Getting Less“ produced by the Fraser Institute, a Canadian think tank, found that government-run monopolies established in each province of Canada (simultaneously barring private operators from competing for the delivery of public health services) produce rates of growth in government health care spending that are “not financially sustainable through public means alone.” Each province’s policy of insulating consumers from price signals, such as premiums, co-payments and deductibles, has naturally led to over-consumption of medical treatment. Thus provincial governments, encountering fiscal restraints, must resort to long queues and the rationing of care.

And wait patients must. A hospital survey of five countries (United States, Canada, New Zealand, United Kingdom and Australia), conducted by Robert Blendon and colleagues in Health Affairs found that “waits of six months or more for elective surgeries were reported to occur ‘very often’ or ‘often’ by 26–57 percent of executives in the four non-U.S. countries; only 1 percent of U.S. hospitals reported this. Half of all Canadian hospitals reported an average waiting time of over six months for a 65-year-old male requiring a routine hip replacement; no American hospital administrators reported waits this long.

Perhaps if Canadian provinces adopted a free-market approach to health care, more of their citizens (and politicians) would seek treatment within their borders. This leaves just one question: if the United States adopts government-run health care system, even remotely like that of Canada, with government control of benefits and financing, plus reams of rules specifying what we can and cannot get, which border are we going to cross to get the care we need?


Obama debates straw men

Unlike the jock-sniffers, normal people watching the president's tete-a-tete with the Republicans only wondered why Obama always responds to imaginary arguments no one made, rather than the questions actually being asked. That is Obama's signature move: Invent "people" who are "saying" ridiculous things and then encourage the audience to laugh at these made-up buffoons. Since Obama's reformulations of Republican arguments are always absurd, no further response from him is necessary -- and none is ever forthcoming.

Thus, for example, Obama's description of Republican criticism of his plan to nationalize health care was that "this thing was some Bolshevik plot." No. No one said it was a "plot," Bolshevik or otherwise.

Republicans' objection to national health care could be more accurately portrayed as follows: Obama's plan to nationalize health care was a terrible idea because it would turn over one-sixth of the American economy to Washington bureaucrats, who would run the system as competently as the federal government runs everything else, from airport security to the post office to FEMA.

How about responding to that argument? (And as long as Obama brought it up, can he explain which part of national health care the Bolsheviks would have objected to most strongly?)

This isn't how adults conduct serious political debates; it's how children argue with their parents. Don't have a cow! Liberals hide conservative arguments from the public like teenagers hide contraband from mother under the bed.

Repeatedly positing imaginary attacks by Republicans accusing him of a "plot," Obama said that "the way these issues are being presented by the Republicans is that this is some wild-eyed plot to impose huge government in every aspect of our lives." Again, not a "plot" and certainly not "wild-eyed." The only person accusing anyone of "plotting" here is Obama accusing the GOP of plotting against him. I guess they don't teach irony at Harvard Law School.

If Obama is going to keep imagining others accusing him of "plots," could he provide just one example?

Republicans also did not accuse Obama of trying to "impose huge government in every aspect of our lives." Just the part of it that determines how long we get to live.

Continuing his fantasy battle with imaginary opponents, Obama said, "What you've been telling your constituents is, this guy is doing all kinds of crazy stuff that's going to destroy America." I gather Obama is incapable of responding to his opponents' actual argument, which is that he is proposing all sorts of things that would be very bad for America.

Since he pleads innocence only on the claim that he is doing "crazy stuff that's going to destroy America" -- an argument no one made -- apparently he's guilty as charged on the claim that he's merely doing very bad things to America.

Adopting the pose of limpid nonpartisanship, Obama repeatedly accused Republicans of horrible things using his peculiar straw-man technique. He told Republicans he was "absolutely committed" to working with them, "but it can't just be political assertions that aren't substantiated." Can Obama please name a single "unsubstantiated" political assertion by a Republican before wasting everyone's time by instructing Republicans to stop making them?

I can name a few from Obama! How about the whopper he told about national health care not covering illegal aliens? Or the one about it not covering abortions? Weeks after Obama made those unsubstantiated political assertions before a joint session of Congress, Democrats were in death-match battles with Republicans (and some moderate Democrats) who tried to exclude coverage for illegals and abortion from the very bills Obama said never contained such coverage in the first place.

How about Obama's claim in his State of the Union address last week that a recent Supreme Court ruling would allow "foreign corporations to spend without limit in our elections"? In the case Obama mentioned, the court overruled section 441a of the campaign-finance law, which had banned all corporate spending on elections. The case did not concern, nor did the court address, section 441e, which prohibits foreign corporations from making any "contribution or donation of money or other thing of value ... in connection with a Federal, State or local election."

History will record that these remarks from his State of the Union address were the only case legendary barrister Barack Obama ever argued before the Supreme Court. And he lost.

Even when presented with a short, straightforward, simply stated question by Rep. Mike Pence, Obama couldn't help but to formulate a different question. Pence asked: "Mr. President, will you consider supporting across-the-board tax relief, as President Kennedy did?" The question Obama wanted Pence to ask was: Mr. President, will you join Republicans in cutting taxes of billionaires? Luckily, Obama's reformulation gave him an opening for a killer answer: "What you may consider across-the-board tax cuts could be, for example, greater tax cuts for people who are making a billion dollars. I may not agree to a tax cut for Warren Buffett."

Republicans should take that answer and run like a thief in the night! OK, let's cut taxes on everyone except billionaires. I'd even support a specific tax expressly on Warren Buffett. Now, son, how much will you give us for these magic beans?

If only Republicans could maneuver Obama into answering a question on abortion, we could probably get him to agree to ban all abortions –-- except in the case of teenage girls who have been raped by their fathers. (This is how I assume Obama would rephrase the question.) No conservative argues like this. To the contrary, we're morose that Nexis archives are not more complete, so we can't quote liberals directly more often.


Obama’s Health-Care Summit – Gimmick or Negotiation?

On February 25th, the White House has proposed a bipartisan, half-day televised summit on health care. It is unclear as to whether this is a publicity stunt by the Obama Administration or a good faith effort to negotiate with Republicans to come up with a bipartisan health care reform bill. The Washington Post reports today many Republicans are pushing back and urging the White House to scrap Obamacare as a precondition to any negotiation. House Minority Leader John Boehner (R-OH) and Whip Eric Cantor (R-VA) sent a letter to White House Chief of Staff Rahm Emanuel objecting to the House and Senate versions of Obamacare being the base line bills of the negotiations. Hopefully, this summit meeting is more than the President checking off a campaign promise to have all health care negotiations on C-SPAN.

If this summit is a genuine start to bipartisan negotiations, then a few issues need to be settled before the meeting:

1. Start Over – The American people have rejected Obamacare and they want Congress and the Obama Administration to start over from scratch. The election of Scott Brown as Senator from Massachusetts was a strong message, from a liberal state, that Obamacare is not popular with the American people. An NBC News/Wall Street Journal Poll indicates that 31% think the President’s health care plan is a good idea v. 46% a bad idea. CNN/Opinion Research has the numbers at 38% in favor and 58% opposed. It is clear that a minority in Congress is representing the will of a majority of Americans who think Obamacare is a bad idea and it is time for liberals in Congress and the Obama Administration to start listening to the American people. With the overwhelming weight of polling data and election results in Massachusetts indicating widespread opposition, it is time to start over.

2. Take Reconciliation off the Table – The President needs to state publicly that he will not support partisan efforts in Congress to use reconciliation procedures as a mechanism to railroad through pending versions of Obamacare. Reconciliation, commonly referred to as the Nuclear Option in the Senate, allows the supporters of Obamacare to avoid a filibuster in the Senate and ignore the traditional rules that would allow extended debate and amendment. Using reconciliation and relying on one party’s votes to pass an unpopular approach to health care reform would not translate into a bipartisan solution to comprehensive health care reform.

3. Transparency – Transparency has to be any part of a summit and it does not begin and end with the publicly broadcast meeting. First, what may be necessary is for the Obama Administration, Republican Leaders, Democrat Leaders and Moderate Democrats have a private meeting, before any planned public summit to clear the air. There is nothing wrong with having a private meeting to provide an opportunity for members to speak freely and build some needed trust. Right now, there is no trust and there has been a complete breakdown in communication. Maybe they could sit and discuss the core elements of a true bipartisan plan in private, and then have a public summit to air any agreement over a half day. A meeting and summit does not mitigate the need for public hearings in Congress and other means to transparently consider any new elements of a health care bill. The White House had been actively engaged in closed door negotiations as recently as the first week of this year with lobbyists and congressional leaders in a manner that excluded moderate Democrats, Republicans and the American people. This needs to end. It is reasonable for members of Congress to have informal negotiations at times, yet the work product should be subject to transparent hearings in the House and Senate committees of jurisdiction. Any deal should be vetted with the American people and subject to a transparent process.

The great danger in this process is that the Obama Administration checks off a campaign promise then goes on with business as usual. This summit can’t merely be a gimmick where the President lectures Republicans and Republicans lecture the President, then the President forges forward with the same Obamacare bill that has been rejected by the American people. This summit should be where the President starts the process over and engages in real negotiations with a broad audience.


The ObamaCare Tragedy

Murtha's death is another eerie coincidence


Rep. John Murtha--best known in recent years as a onetime Iraq war supporter who abruptly switched sides--has died, CNN reports: "Murtha of Pennsylvania, a longtime fixture on the House subcommittee that oversees Pentagon spending, died after complications from gallbladder surgery, according to his office. He was 77. The Democratic congressman recently underwent scheduled laparoscopic surgery at National Naval Medical Center in Bethesda, Maryland, to remove his gallbladder. The procedure was "routine minimally invasive surgery," but doctors "hit his intestines," a source close to the late congressman told CNN."

May he rest in peace. After paying their respects, political observers wasted no time before speculating about what this means for ObamaCare. If you think the effort is dead anyway, as we guess we still do, the answer of course is nothing. But the president and congressional Democrats are, at least ostensibly, looking for a way to defy the voters and impose this monstrosity, and Murtha did cast an "aye" vote when the House approved its version of ObamaCare in November, 220-215.

The American Spectator's Philip Klein does the math: "The one Republican who voted for it--Joseph Cao--has indicated that he would not support the bill a second time around given the weaker language on abortion in the Senate version. In addition, Florida Rep. Robert Wexler already retired prematurely. Factor in Murtha's death [yesterday], and [Speaker Nancy] Pelosi is down to 217 votes."

With 433 representatives currently seated, 217 is a bare majority. so that Murtha's death does not immediately deprive Pelosi of a needed vote. But the planned Feb. 28 resignation of Rep. Neil Abercrombie (D., Hawaii), who plans to run for governor, would reduce the number of remaining "ayes" to 216 out of 432, not enough for a majority.

What's more, Murtha's seat, to be filled in a special election, likely on May 18, could go Republican. The Cook Political Report rates the district, which John McCain carried in 2008, as a "toss-up." There's even a chance that Abercrombie's heavily Democratic district, which includes Barack Obama's birthplace, could go to the GOP in a special election. As notes, the GOP candidate, Charles Djou, is expected to face three Democrats, who could split the vote. A plurality would be sufficient to win.

The fate of ObamaCare is starting to have something of the feel of a Greek tragedy. We are not superstitious, but Murtha's death as the result of medical error at a government-run hospital is certainly an eerie coincidence.

And this follows the demise of Ted Kennedy, who worked all his life for "universal" health care, then perished last year just as the realization of this aspiration seemed inevitable. If ObamaCare dies, it will have been because a Republican senator was elected to Kennedy's seat last month. As the Washington Times reports, some Democrats are so upset they can't keep their metaphors straight: "Many of us thought we were really at the one-inch line, then literally it was like being hit by a freight train with about 10 seconds' warning," said Ken Thorpe, a senior Health and Human Services official during the Clinton-era debate."

What does "literally" even mean when it modifies a simile? Anyway, Scott Brown would not be in the U.S. Senate had Massachusetts Democrats not twice fiddled with the procedure for filling a vacant Senate seat in the expectation of realizing a short-term gain.

In 2004, they took away the governor's appointment power (so that Republican Mitt Romney would not be able to replace the haughty, French-looking then-junior senator, who by the way served in Vietnam, had he been elected president). Under the pre-2004 law, Gov. Deval Patrick would have appointed someone to serve until November. Under the post-2004 law, the seat would have remained vacant until a special election. Instead, the law was changed again so that Patrick could appoint someone in the interim. Result: Dems had 60 votes to push ObamaCare through, and Massachusetts voters had the opportunity to cut that number to 59. So it's really less like being hit by a train than like driving your own car off a bridge.

Post columnist E.J. Dionne, meanwhile, employs a peculiar metaphor to argue that Democrats should force ObamaCare through, the voters be damned:
If President Obama gets to sign a health-reform bill, as I believe he will, one reason may be Rep. Jay Inslee's difficult experience renovating his kitchen. . . .

He recounted all the grief he and his family went through while work on their kitchen renovation dragged on and on and on. "During that time, I had blood lust against my contractor," Inslee said. "Six months went by, and he was still arguing with the plumber. Eight months went by, and there were still wires hanging down everywhere, and he was having trouble with the building inspector."

But eventually, the job got done. "And now I love that kitchen," Inslee recalls saying. "I bake bread in that kitchen. My wife cooks great meals in that kitchen. The contractor's now a buddy of mine, and I've had beers with him in that kitchen." Inslee looked at his colleagues and declared: "We've got to finish the kitchen."

Except that Inslee's kitchen was in his own house! A better analogy to ObamaCare would be if some guy down the street is unhappy because his daughter is having a lot of very bad personal problems, so to take his mind off it, he barges into your house and starts tearing apart your kitchen.


1 comment:

Alohaboy said...

No one should get exited about Djou. He has been running for a year and still polling in third - behind the leading Dems.