Sunday, March 21, 2010
Paging Doctor Kildare
If Obamacare becomes law, about 30 percent of the primary care doctors in America will consider leaving the medical profession. That bit of brightness comes from a survey by The Medicus Firm, the results of which were posted by The New England Journal of Medicine. Medicus interviewed more than a thousand American physicians, and 55 percent of them believe the quality of medical care in America will decline if the Democrats pass the current health care reform proposals. Apparently, many of them want no part of it.
Although the media largely ignored the Medicus study, the story is huge. Perhaps as many as 30 million more Americans may have access to health insurance. The question is: Who will treat them? The Bureau of Labor Statistics projects a 22 percent increase in practicing physicians over the next decade. But that will not be enough to treat the universal health care crush, especially if a bunch of doctors now on the job pack it in.
There are essentially two reasons why Obamacare nauseates some doctors. First, control. Medical people simply do not want federal pinheads telling them how to treat their patients. The medical profession attracts intelligent, assertive people who are motivated to help others. This is not a docile crowd.
Second, money. Right now, many doctors are already seeing too many patients in order to pay the bills and provide a decent living for their families. Obamacare does nothing to bring down the outrageous expense of medical malpractice insurance, and it is likely to cut Medicaid and Medicare reimbursements. Doctors can do the math. Their expenses remain high; their incomes decline. Again, these are smart people who could make good money doing something else.
In Canada and Great Britain, where socialized medicine is practiced, it is difficult to actually see a doctor in some places. Instead, nurses, physician assistants and other medical personnel fill the need. That is what could happen in the United States if the feds begin calling the health care shots.
Not since the Iraq war has America been so divided on an issue. Yes, ideology is playing a part. Conservatives despise government intrusion in the marketplace, but liberals love it. Right now, however, most polls show that the majority has turned on Obamacare. The latest Wall Street Journal poll, for example, found 48 percent opposing and just 36 percent supporting.
Here's my question: What would Marcus Welby, M.D., and Dr. Kildare say? These guys usually had the answers, back when wise doctors were the subjects of TV programs and health care seemed to be a glamorous profession. Would Ben Casey support Obamacare? We know the "M*A*S*H" guys would. Dr. Jekyll might like it, but Mr. Hyde? I don't know. What I do know is that many Americans are sick of the whole health care thing. And no prescription on earth will change that.
16,500 more IRS agents needed to enforce Obamacare
New tax mandates and penalties included in Obamacare will cause the greatest expansion of the Internal Revenue Service since World War II, according to a release from Rep. Kevin Brady, R-Texas.
A new analysis by the Joint Economic Committee and the House Ways & Means Committee minority staff estimates up to 16,500 new IRS personnel will be needed to collect, examine and audit new tax information mandated on families and small businesses in the ‘reconciliation’ bill being taken up by the U.S. House of Representatives this weekend. ...
Scores of new federal mandates and fifteen different tax increases totaling $400 billion are imposed under the Democratic House bill. In addition to more complicated tax returns, families and small businesses will be forced to reveal further tax information to the IRS, provide proof of ‘government approved’ health care and submit detailed sales information to comply with new excise taxes.
Americans for Tax Reform has a good breakdown of the bill by the numbers. Isn't it reassuring that at a time of recession, government will do what's necessary to ensure its growth?
The corruption never stops
Health-vote ally Nelson to get new VA hospital for Nebraska
The Obama administration has delivered another budget plum to Democratic Sen. Ben Nelson and the state of Nebraska, adding more than a half-billion dollars for a new veterans hospital in Omaha.
The move reverses a decision by Mr. Obama's own Veterans Administration of a year ago, which called for repairing an existing hospital.
The Veterans Administration made the budget switch during internal deliberations in 2009 at a time when the White House was wooing the moderate Democrat to vote for President Obama's health care overhaul bill.
Mr. Nelson was among the last of the Senate Democrats to sign on to the health bill, deciding to vote "yes" after securing special Medicaid payments for Nebraska in a deal known as the "Cornhusker Kickback." Health care reform opponents have widely panned that deal.
At the time that deal was being made, Mr. Nelson was getting another boost from the VA as it formulated its next budget.
Jake Thompson, a spokesman for Mr. Nelson, rejected the idea the new hospital was awarded in exchange for the senator's health care vote.
"It was never discussed," Mr. Thompson said. "He wasn't discussing the Omaha VA hospital in any relation to health care. The answer is no."
The spokesman added that Mr. Nelson "has been advocating [a new hospital] with this administration, with the previous secretary of the VA and the current secretary of the VA. But in relation to health care, it wasn't discussed at all. I think the VA's own study was the principal reason it was moved up" on the construction priority list.
But Rep. Steve Buyer of Indiana, ranking Republican on the Veterans' Affairs Committee, said, "This one doesn't smell right or feel right."
Mr. Buyer said testimony by VA officials to the Senate last August showed managers recommended renovation and some expansion of the existing Omaha site -- not an entirely new hospital at a much higher cost.
Study Shows ‘ObamaCare’ Could Cost 700K Jobs
As many as 698,000 jobs could be lost if the health care reform plan (a.k.a., “ObamaCare”) being pushed hard by liberal Democrats is passed by Congress and signed into law by President Barack Obama, according to a study released today that was the subject of a blogger conference call this morning.
The executive summary for the study, conducted by the Beacon Hill Institute in conjunction with Americans for Tax Reform, boils down the findings in a nutshell:
Nancy Pelosi, the Speaker of the House of Representatives, has urged passage of the massive health reform plan moving through Congress as a way to create up to 400,000 jobs. Speaker Pelosi bases her claim on a report by the Center for American Progress (CAP) in which the Center estimates that the Patient Protection and Affordable Care Act (PPACA) would create 250,000 to 400,000 jobs per year over 10 years.
This estimate by CAP amounts to a hurried effort to add academic heft to the claim that national health care reform offers a collateral benefit in the form of an economic “stimulus.” It turns out, however, that its methodology, stripped of unsupportable claims about savings in health care costs, shows just the opposite of what CAP intended. PPACA is a job killer, not a job creator.
MORE OF WHAT OBAMACARE HAS IN STORE FOR AMERICANS
Three new reports from just ONE DAY about Britain's NHS below
Life-saving cancer scans delayed in NHS funding crisis
Vital scans for patients who may have cancer are being postponed by up to six weeks as the NHS grapples with a major funding crisis. GPs have also been ordered not send elderly people for osteoporosis scans, to refer children with tonsillitis to specialists - or even allow men to have vasectomies. In addition, wards are threatened with closure and thousands of key staff have been told to work shorter hours or take unpaid 'career breaks'.
Charities and patient groups said the delays could have disastrous consequences if early signs for potentially fatal conditions go undetected. The drastic cutbacks illustrate a funding nightmare threatening to overwhelm the NHS within months, as trusts battle to save millions of pounds in the wake of the credit crunch.
Last night the Royal College of Physicians warned ministers and NHS managers against 'slash and burn' cuts. In a strongly-worded pre-budget briefing to MPs, they said: 'Following a decade of growth, the NHS is being asked to deliver considerable efficiencies. 'There is a risk that without careful management, a supportive rather than confrontational culture and a high degree of medical engagement, any effort to reduce productivity could easily subside into a process where services and posts are indiscriminately slashed and burnt. 'Over-hasty decisions now to cut back on the medical workforce, biomedical research, and audit programmes could have implications for generations.'
Ministers say the NHS needs to save 20billion pounds over the next five years. Although both Labour and the Tories have pledged not to cut NHS funding, rising demand and an ageing population means the money will not go as far as in the past, necessitating cuts.
Dozens of hospitals are already considering closures of A&E departments and maternity wards, while others are asking staff to consider voluntary redundancy and early retirement. The respected King's Fund think tank says it may be necessary to freeze NHS pay until 2014.
One NHS trust under pressure is North East Essex primary care trust, which last month asked its GPs not to refer patients for MRI scans - used to diagnose possible tumours and kidney disease - and other tests until April 1.
Sarah Woolnough of Cancer Research UK said delays in MRI scans could run the risk of early signs of cancer being missed. She said: 'Speedy access to diagnostic tests and quick referral can help to diagnose cancer as early as possible which can ultimately lead to better treatment for patients and improved survival.'
Matt Bushell, director of commissioning at the trust, said: 'As part of the procedures to ensure budgets are balanced at the end of the current financial year, we have, just for the month of March, asked GPs to defer referrals for a very small number of non-urgent, therapeutic services: heel scans, vasectomies, ENT and nonurgent MRI scans. 'We have maintained priority for urgent MRI scans. These arrangements will remain in place only until April 1 2010.'
Other examples of cuts across the NHS include:
* GPs in Hertfordshire being told to get 'approval' before referring patients for hysterectomies, tooth extraction and removal of skin 'lumps and bumps';
* Planned closures of A&E wards at Whittington Hospital in North London, Queen Mary's in Sidcup, Chase Farm in Enfield and others;
* Almost 4,000 workers at Stepping Hill hospital in Stockport, and 2,000 at Scunthorpe general hospital, being asked to consider early retirement, voluntary job cuts or shorter hours.
Tory health spokesman Andrew Lansley said: 'This will be very worrying for patients. The NHS has had increased funding this year, so just where has the money gone?'
Matthew Elliott of the TaxPayers' Alliance said: 'It's infuriating that despite billions of pounds being poured into the NHS, patients are having treatment delayed thanks to a failure to plan properly.'
Blundering NHS surgeon in £10m lawsuit after 100 women patients take him to court
Bungling surgeon George Rowland was allowed to operate for almost FOUR YEARS after the first alarm was raised
More than 100 women suffered botched bladder surgery at the hands of a gynaecologist who continued to work for four years after the alarm was raised. Patients of George Rowland suffered chronic pain or worsening bladder symptoms after he operated on them. But it was only after doctors expressed concern about his behaviour that the scale of his mistakes was realised and he was told to stop carrying out procedures.
Yesterday, as a report criticised managers for not picking up on the problem sooner, it emerged that more than 100 of his patients are taking legal action - leaving the NHS facing a compensation payout of as much as £10million.
Ian Cohen, of Goodmans solicitors which is representing most of the women, said: 'There have been devastating, life-changing outcomes for many patients. We have a substantial number of women who should never have had that surgery, who have been left worse following the surgery. Some have been left in a bad state, with chronic pain. 'Some women have complete difficulty passing urine. 'The trust's board appears to have allowed an obsession with targets and anxiety about potential damage to its reputation - and that of the consultant - to bar earlier action to prevent patient harm.'
Mr Rowland, aged in his 50s, was a respected urogynaecologist performing hundreds of operations a year at Aintree Centre for Women's Health in Liverpool.
In 2004 concerns were raised that he was carrying out more surgery than colleagues, often 'bundling' different procedures into single operations, such as hysterectomies with surgery for incontinence. But it was not until colleagues began expressing concern in 2007 that an investigation was launched. Mr Rowland was not suspended until the following year.
Last year the General Medical Council barred him from performing urogynaecological procedures until further notice, and hundreds of his patients were recalled to the hospital for a further consultation. Some complained they had been left in chronic pain and that their incontinence had not improved. Lawyers representing others say the surgery was simply inappropriate for their conditions.
The highly regarded Liverpool Women's Hospital, which runs the Aintree centre, commissioned an independent report into the affair, and yesterday criticised bosses for not noticing the mistakes earlier. It pointed out that Mr Rowland was responsible for picking up such problems as the clinical governance lead - a clear conflict of interest, the women's lawyers say.
Its report found warning signs dating back to 2004 were not acted upon, criticised the 'cultural divide' between staff at the Aintree centre and the main hospital, and said more needed to be done to stop doctors from working in isolation from their departments. Jonathan Herod, clinical director of gynaecology, admitted Mr Rowland often worked alone. If the case was repeated, 'it would be picked up on straightaway', he added.
Trust chief executive Kathryn Thomson said: 'We decided it was important to look at governance practices more widely to ensure we learnt as much as possible.'
£250,000 victory for war vet who sold home to pay care bill that NHS should never have charged him
NHS bureaucrats don't care about people at all. Saving money is their no.1 priority
The family of a war veteran suffering from Alzheimer's has won more than £250,000 from the NHS for nursing home fees he should never have been charged. The payout, which is believed to be the biggest of its kind, was awarded to relatives of Leslie Terry, 86, whose home was sold to pay for his £3,500-a-month care. Despite being totally immobile - he has not been out of bed for four years - and in need of constant nursing, Mr Terry was denied funding under the NHS's ' Continuing Care' scheme.
The scheme is meant to fully fund patients with health needs resulting from conditions such as Alzheimer's and Parkinson's disease. It applies mainly to those who are in nursing homes, or long-term hospital or home care.
Mr Terry's nephew, Bryan Talbot, 71, from Banbury, Oxfordshire, who mounted a legal challenge to recover the backdated fees covering eight years, said: 'My uncle has been unable to get out of bed for four years, he is at risk of choking, has to be fed, and is unable to communicate verbally. 'I felt it was clear that his health needs meant he should be the responsibility of the Health Service. I am amazed that, despite him having annual assessments, the NHS did not inform me about possible available funding. It's important people take advice. 'We've had a rough ride to get to this point but I want other people to know you don't have to sell your home to get the care you need. He has received first class care from very professional staff at Gloucester House Nursing Home.'
The payout comes after three families last year won a total of £350,000 - with the family home sold in two cases - after being wrongly denied Continuing Care. So far, more than £9million has been recovered by solicitors representing 2,000 families who claim they have been wrongly charged nursing home fees. Under English law, the elderly must pay for residential care unless their needs are health-related, when the whole cost is met.
However, Department of Health criteria on who qualifies for health needs are subject to interpretation by individual NHS trusts. The Daily Mail's Dignity for the Elderly campaign has repeatedly highlighted the unfairness of the system, which means many families of Alzheimer's sufferers are being charged for long-term nursing care. Many are denied funding by Primary Care Trusts, which have to foot the bill, because the disease does not automatically make the patient eligible for NHS 'continuing care'.
Mr Terry, who joined the Army in 1942 and fought in India and Burma, retired from his job as a porter at Sevenoaks Hospital in Kent, in 1983 before succumbing to dementia in his 70s. He never married. Mr Terry also suffers from a severe skin disease, which needs monitoring.
Solicitor Lisa Morgan, of Welsh law firm Hugh James, who acted for him, said: 'Under current government policy, there should be a full assessment on health needs, which determines whether patients pay for their nursing care fees. 'That is not happening in many cases. With the cost of nursing homes averaging £675 per week, families are still being left with huge fees to pay. There is a clear disparity across the country and, despite national guidance, Primary Care Trusts still apply their own judgment.'
Michelle Mitchell, charity director for Age Concern and Help The Aged, said: 'The system for deciding where the line is drawn between free NHS Continuing Care, and paid for social care has been a mess for years. 'We are still very concerned older people may wrongly be forced to pay for their care when it should be free. We strongly encourage anyone who believes they are unfairly missing out to fight for their rights.'
Posted by JR at 2:44 AM