Friday, March 12, 2010

A doctor savages Obama's healthcare reform plan

Dr Wolf is a distant relative of Obama's

"Primum nil nocere."First, do no harm. This guiding principle is a bedrock of medical care. Sadly, those politicians who would rewrite our health care laws do not live in the same universe as do the doctors and health care professionals who must practice it.

Imagine if, like physicians, politicians were personally held to the incredibly high level of scrutiny that includes civil and financial liability for any unintended consequence of their decisions. Imagine if they were forced to spend tens of thousands of dollars each year on malpractice insurance and still faced the threat of multimillion-dollar lawsuits with every single decision they made. If so, a government takeover of health care would be the furthest thing from their minds.

Obamacare proponents would have us believe that we will add 30 million patients to the system without adding providers, we will see no decline in the quality of care for the millions of Americans currently happy with the system, and -if you act now!- we will save money in the process. But why stop there? Why not promise it will no longer rain on weekends and every day will be a great hair day?

America has the finest health care delivery system in the world. Let's not forget that and put it at risk in the name of reform. Desperate souls across the globe flock to our shores and cross our borders every day to seek our care. Why? Our system provides cures while the government-run systems from which they flee do not. Compare Europe's common cancer mortality rates to America's: breast cancer - 52 percent higher in Germany and 88 percent higher in the United Kingdom; prostate cancer - a staggering 604 percent higher in the United Kingdom and 457 percent higher in Norway; colon cancer - 40 percent higher in the United Kingdom.

Look closer at the United Kingdom. Britain's higher cancer mortality rate results in 25,000 more cancer deaths per year compared to a similar population size in the United States. But because the U.S. population is roughly five times larger than the United Kingdom's, that would translate into 125,000 unnecessary American cancer deaths every year. This is more than all the mothers and fathers, aunts and uncles, cousins and children in Topeka, Kan. And keep in mind, these numbers are for cancer alone. America also has better survival rates for other major killers, such as heart attacks and strokes. Whatever we do, let us not surrender the great gains we have made. First, do no harm. Lives are at stake.

Obamacare: Fixing price at any cost

The justification for Obamacare has been to control costs, but the problem is there is little in Obamacare that will do that. Instead, there are provisions that will ration care and artificially set price. This is a confusion of costs and price.

As one example, consider the implications of Obamacare's financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently - no matter how valid the reasons - he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list. Many doctors will try to avoid the sickest patients, and others will simply refuse to accept Medicare. Already, 42 percent of doctors have chosen that route, and it will get worse. Your mother's shiny government-issued Medicare health card is meaningless without doctors who will accept it.

Obamacare will further diminish access to health care by lowering reimbursements for medical care without regard to the costs of that care. Price controls have failed spectacularly wherever they've been tried. They have turned neighborhoods into slums and have caused supply chains to dry up when producers can no longer profit from providing their goods. Remember the Carter-era gas lines? Medical care is not immune from this economic reality. We cannot hope that our best and brightest will pursue a career in medicine, setting aside years of their lives - for me, 13 years of school and training - to enter a field that might not even pay for the student loans it took to get there.

Giving power back to people

I believe there is a better way. The problems in the American health care system are not caused by a shortage of government intrusion. They will not be solved by more government intrusion. In fact, our current problems were precisely, though unintentionally, created by government.

World War II-era wage-control measures - a form of price controls - ushered in a perverted system in which we turn to our employers for insurance and the government penalizes us if we choose to purchase insurance for ourselves. You are not given the opportunity to be a wise consumer of health care and compare prices as well as quality in any meaningful way. Worse still, your insurance company is not answerable to you because you are not its customer. It is answerable to your employer, whose interests differ from your own.

Insurance companies have been vilified for following the perverse rules that government has created for them. But it gets worse. The government, always knowing best, deploys insurance commissioners across the land to dictate what the insurance companies must provide, whether you want it or not, and each time, your premiums increase. Obamacare will make all of this worse, not better.

One of America's founding principles is our trust in the people and their economic freedom to rule their own lives. We should decouple health insurance from employers and empower patients to be consumers once again. Allow them to determine the insurance plan that best meets their families' needs and which company will provide it. This will unleash a wave of competition that will drive costs down in a way that price controls never have. Eliminate the artificial state boundary rules that protect insurance companies from true competition and watch as voters demand that their state insurance commissioners get the heck out of the way. Innovative companies will drive down costs similar to how Geico and Progressive have worked for automobile insurance. And it won't cost taxpayers a trillion dollars in the process.

This free-market approach has worked for everything from high-definition TVs to breakfast cereals, but will it work for medicine? It already is. Take Lasik eye surgery, for example. Because patients are allowed to be informed consumers and can shop anywhere, doctors work hard for their business. Services, availability and expertise have all increased, and costs have decreased. Should consumers demand it, insurance companies - now answerable to you rather than your employer - would cover it.

Between Barack and a hard place

I have personally trained and practiced in both the government-run and free-market segments of American medicine. The difference is vast. Patients see this for themselves, and this may be why, according to a recent CNN poll, they oppose Obamacare nearly 3 to 1. I am with them. It is difficult for me to speak publicly against the president on his central issue, but too much is at stake.

I wish my cousin Barack the greatest of success in office. But I feel duty-bound to rise in opposition to Obamacare. I must take a stand for my patients, my profession and, ultimately, my country. The problems caused by government will not be solved by growing government. Now that this new era of big-government takeovers has spread to our health care system, it's not just our freedoms or our wallets that are at stake. It's our lives.


Hill Democrats brush back White House health deadline

As House Democratic leaders struggle to round up the 216 votes needed to pass President Obama's health care plan, they have all but set aside the March 18 deadline set by the White House and are hinting the debate could extend well past the upcoming Easter recess. A delay would likely make it even more difficult for the Democrats to pass a bill.

"I believe that if members of Congress go home for two weeks, they will hear from the American people what they really think about the bill and they will be less likely to vote for it when they come back," Senate Republican Conference Chairman Lamar Alexander, R-Tenn., said.

House Majority Leader Steny Hoyer, D-Md., said Democratic leaders have yet to begin negotiating with approximately one dozen pro-life Democrats who comprise one of the biggest obstacles in the House. Hoyer also discounted the deadline put forward last week by White House press secretary Robert Gibbs. "None of us have mentioned the 18th, other than Mr. Gibbs," Hoyer said.

Hoyer said Democrats are still wrangling with how to pass the Senate health care bill in the House and then follow with a smaller bill that makes corrections to the Senate bill. House Democrats are refusing to back the Senate bill unless it is done concurrently with a second bill that would purge several special deals cut for certain senators as well as an excise tax on expensive insurance plans. Hoyer called a pre-Easter vote "an objective, not a deadline."

Without some kind of concurrent passage of both bills, it will be nearly impossible for House Democratic leaders to come up with the votes because House Democrats don't trust the Senate to follow through with the corrections bill once the Senate health care bill is signed into law by Obama. The Senate would have to take up the second bill under budget reconciliation rules in order to pass it with just 51 votes, which could be difficult and politically dangerous, depending on what's in it. But senators on Tuesday said they are committed to taking up the second bill.

"I can tell you this," Sen. Dianne Feinstein, D-Calif., said. "Nobody wants to stab the House in the back. Every one of us understands the position the House is in. I guess what we ask is that the House understand our position as well."

Sen. Ben Nelson, D-Neb., who voted for the Senate version, said the national polls don't matter as much as the sense he gets from his constituents. The majority in Nebraska, he said, "do not" support the Democratic health care plan, but will decide whether to back it as soon as the bill is written and given a price tag by the Congressional Budget Office. "I'm not going to say I'm going to support something I haven't seen," Nelson said.


Obama's Reconciliation Lie

Less than one week ago, President Obama stood before an assembled audience of hand- picked sympathizers on healthcare reform at the White House and called on Congress to pass his healthcare reform package into law... again.

Having spent his entire year long presidency singularly focused on passing a massive, trillion dollar, federal government takeover of the healthcare industry in America, and failed -- Obama had a couple of choices going forward. With an American public now solidly against his healthcare proposal, and his Democrat margins in both houses of Congress now a wee bit slimmer, Obama was forced to choose between either a) substantially altering his healthcare proposal to make it more palatable and bipartisan as he claims is his goal, or b) forging ahead with virtually the same heavy-handed government takeover package and hope to woo skeptical Americans and Democratic lawmakers by the sheer force of his personality.

In Obama’s speech – a rather short one for him of only 21 minutes – he made it clear that he is opting for Plan B. Obama stated: “No matter which approach you favor, I believe the U.S. Congress owes the American people a final vote on healthcare reform. We have debated this issue thoroughly. Not just for the past year, but for decades. Reform has already passed the House with a majority. It has already passed the Senate with a super-majority of 60 votes. And now it deserves the same kind of up-or-down vote that was cast on welfare reform, that was cast on the children’s health insurance program, that was used for cobra health coverage for the unemployed, and by the way for both Bush tax cuts, all of which had to pass Congress with nothing more than a simple majority.”

In other words, he plans to utilize budget reconciliation to pass ObamaCare, which requires only a simple majority in both chambers. And Obama appealed to history, citing five specific examples of major legislation that was passed using reconciliation.

Here’s the only problem with Obama’s appeal: every bill he cited was passed with bipartisan support. This is, of course, precisely the opposite of what is occurring on ObamaCare, where the minority party is unanimously opposed to the entire package. In fact, reconciliation has been used nearly 20 times since it’s origination in 1981, but never once in a completely partisan fashion to pass major social legislation. Not once.

A quick review of the actual legislation Obama cited shows example after example of bipartisan support. Both Bush tax cuts were passed with Democrat votes in both chambers. Cobra was enacted in 1986 with a Republican controlled White House and Senate and a Democrat controlled House. Landmark welfare reform was passed by a Republican controlled Congress (with 125 Democrat votes from both chambers) and signed into law by President Clinton, as was the Children’s Health Program in 1997 within the Balanced Budget Act.

Republican claims that Obama’s intended use of reconciliation to pass his version of healthcare reform is unprecedented (what the word really means, not how Obama uses it) and hyper partisan is absolutely true. It would be complimenting Obama to say he was being merely disingenuous in his stated reason for using reconciliation.

In the same speech noted above, Obama portended to take the high road by maintaining “I do not know how this plays politically, but I know it’s right” and saying he would “provide the leadership” the American people so desperately want on healthcare reform. Perhaps Obama is genuine in stating he does not know how this will play politically, but Americans seem to know instinctively, and they are not calling it leadership, they’re calling it a lie.


Canadian Health Care System Bad Model for USA

During an interview prior to the health care town hall meeting hosted by U.S. Rep. Todd Akin (R-Mo.) this morning in St. Charles, Mo., I spoke with Joe DeVincent, a government retiree from nearby Wentzville, about the prospects of government-run health care (a.k.a., “ObamaCare”). He expressed deep reservations about ObamaCare based, in part, on his own daughter’s experience as the wife of a Canadian citizen living north of the border.

“She doesn’t like it at all,” he said. “You can’t see doctors when you want to see doctors. The few doctors that are even practicing there, their business is just so full…

“One time, my wife and I went with her to see her primary care physician. She had an appointment, and it took three hours to get in. The waiting room was just so jammed, because nobody one can see doctors there.

“The doctors only work until they’ve made a certain amount of money. When they make that amount of money, they don’t get paid anymore,” he continued. “We definitely don’t need this system in the United States.”

The problem is so bad, he said, that his daughter has been forced to come to the United States on more than one occasion.

A fix, he said, would be new legislation that gave everyone the same coverage. “If they want to put a health plan in, make it everybody, including Congressmen, senators, the president, everybody falls in that plan. Then, they’ll put one in there that’ll work.”

Asked if he thought it would ever happen, he was doubtful. “It’ll never happen. They’re gonna take care of themselves and, if this goes in, we’re gonna suffer.”


Dead body was left on bed next to me for eight hours: Patient tells of horror on packed NHS ward

An NHS patient has spoken of her horror after the body of a woman was left in an adjacent bed for up to eight hours. Sarah Stevenson, 64, said staff left the corpse on a packed ward from 1pm until after 8.30pm. Two other patients who died on the same day were also left for several hours behind thin curtains on the ward where Mrs Stevenson was being treated for pneumonia, she said. The three bodies were finally removed in front of distressed families and young children during visiting hours.

Bosses at Heartlands Hospital, in Birmingham, last night apologised. They said the wait was caused by delays in bringing specialist equipment to remove the bodies, but denied they remained for as long as eight hours.

Mrs Stevenson, a great-grandmother from Small Heath, Birmingham, was admitted to hospital on February 15 with suspected pneumonia. She was given a bed on a single-sex ward and was placed in a bay next to another woman. Two days later, at around 1.10pm, she noticed the woman had died. She told a nurse but says the body was not taken away until after 8.30pm. All that divided Mrs Stevenson - whose daughter is a nurse - and the patient was a thin curtain.

She said: 'At about 1.10pm the woman in the bed opposite me, a lady in her late-50s or early-60s, died and I had to alert the nurse that she had passed away. 'Another one died at around 2pm and the third a while later. I was upset because I was so ill myself and to lie next to a dead body all day was my worst nightmare. I don't think they showed the patient any dignity in death. My daughter is a nurse so I know bodies are only supposed to stay on the wards for a maximum of four to six hours, but it was nearly eight hours before they came to take her to the mortuary. 'It was appalling and it should never take that long. The nurses were pushed to the limit and couldn't control a lot of what was going on.'

Mrs Stevenson, who has been married and divorced twice and was a stay-at-home mother to her three children and four step-children, was discharged on February 22. Her allegations came after a damning survey revealed the Third World conditions on overcrowded NHS wards, despite the budget being tripled under Labour over the past ten years.

A survey of 900 nurses this week showed patients are routinely treated in kitchens, corridors, mop cupboards and TV rooms because wards are full. Four in ten told the Nursing Times that patients' dignity and privacy were not protected, while many spoke of chaotic mixed-sex wards where emergency buzzers were left out of reach. The shocking series of anecdotes followed a series of NHS scandals including the unnecessary deaths of up to 1,200 patients at Stafford Hospital.

The Heart of England Foundation Trust has launched an investigation into Mrs Stevenson's claims. Spokesman Charlotte Calder said: 'Three patients did die on the ward on the same day but two of those were further away from Mrs Stevenson. 'One terminally ill patient did unfortunately die in the bay where Mrs Stevenson was being treated. 'It was felt that it would be more respectful to prepare the deceased patient in the bay with the curtain drawn. 'The transfer of this patient took four and a half hours - longer than normal - due to the clinical condition of the deceased patient and the need for specialist equipment.

'We are sorry that this may have disturbed and caused Mrs Stevenson distress. 'Our stance is that no patient's body had been left on the ward for more than five hours but we are investigating the matter.'


NHS 'wasted £21bn tackling life gap between rich and poor'

Billions of pounds may have been wasted on a high-profile Government pledge to reduce the gap in life expectancy between rich and poor, a watchdog revealed yesterday. A total of £21billion - more than a fifth of the entire National Health Service budget - has been set aside to cut inequalities in this financial year alone. But an Audit Commission report says it can't find any evidence that it provides value for money.

The health of people in England has improved since Labour started pumping billions into the NHS, but the health of richer people has improved far more quickly than those in deprived areas. Instead of the Government meeting its much-vaunted goal of reducing health inequalities, the gap has widened.

Ministers pledged that by 2010, they would reduce by 10 per cent the gap in life expectancy at birth between people living in the bottom 20 per cent of the most deprived areas and the population as a whole. But the report has found that 'stark problems remain'. The report said: 'It is hard to see an obvious link between spending and improvement, or get any clear view of value for money. 'Progress in reducing inequalities, and in some aspects of health such as that of very young children, has been disappointing, even if general progress on, for example, life expectancy and other broad measures has been very positive. 'Without such a link, it is hard to argue that higher spending - even if it were an option - would itself result in significant gains.'

The report said problems such as teenage pregnancy 'have proved challenging, despite some progress'. 'New problems have emerged, for example obesity,' it added. 'Problems with alcohol have grown. If today's trends continue, NHS hospitals in England will admit one million patients with alcohol-related conditions in 2011.' A Government target to reduce teenage conceptions by 50 per cent by 2010 has also failed dismally. The rate has fallen by only 13 per cent and in some regions, it has soared by almost 50 per cent.

NHS spending in England rose from £40billion in 1999/2000 to £98billion in 2009/10, the report said. But it is hard to know how much has been spent on reducing health inequalities, or what the impact has been. The report said: 'There needs to be more ruthless targeting of money and services and close attention to outcomes. This requires much clearer sight of what is being spent and much sharper evaluation of its impact.'

The report did congratulate ministers on meeting targets to cut deaths from heart disease and stroke by 2010. It said life expectancy was on the up, and infant death rates were going down.

Andy McKeon, the commission's managing director for health, said: 'We know the health of the nation is improving. But variation in the health of people living in different parts of the country remains stark.'

A Department of Health spokesman said: 'We are pleased the Audit Commission recognises that life expectancy is the highest it has been and infant mortality is at an all-time low, but more needs to be done to narrow the gap between disadvantaged areas and the rest of England.'


No comments: