NHS dangerously dependant on Indian doctors
Fears of a brain drain in the NHS have been raised after the Indian government appealed to 15,000 doctors based here to work in new medical centres. Dr Ramesh Mehta, president of the British Association of Physicians of Indian Origin warned that thousands of doctors in Britain will leave in the next few years to work in India. He said around 15,000 British doctors who originated in India will leave to work in new medical centres in India over the next two to four years. A further 10,000 senior doctors of Indian origin are set to retire from the NHS, he said.
The health service has traditionally relied on ties with the subcontinent for a steady stream of doctors with thousands registering every year.
Dr Mehta, who is attending a conference in India, said: "There are around 15,000 young Indian-origin doctors undergoing training in different parts of Britain who will return to India. "Also, at least 10,000 senior doctors of Indian origin who are retiring from their jobs in the UK are set to return to India."
However the figures were questioned by other experts who said it would mean all the doctors of Indian origin in training posts in Britain leaving which they said was highly unlikely.
Dr Mehta said many of them were expected to take up positions in seven new elite medical centres for which the Indian health ministry is looking for quality doctors. The centres will be dotted around the country and modelled on the All India Institute of Medical Sciences (AIIMS), considered India's best state-run research and treatment centre. "We believe that these young doctors who are undergoing training in the UK currently can be of great help in the new AIIMS-like institutes," Dr Mehta said.
New rules now make it more difficult for medical graduates from outside Europe to come and train as doctors in Britain. Training posts have to be offered to an applicant from within the European Economic Area first and if there are none suitable the place can be offered to those outside Europe.
SOURCE
Another NHS failure to do diagnostic testing kills three toddlers
As they cuddled on the sofa, it seemed they had years of growing up to look forward to. But, tragically, the two children in this picture, Rhianna Warner and Kyron Vince, were both to die of meningitis only weeks later - and within 24 hours of each other. Three children have now been killed by the brain condition in less than three weeks in Ipswich.
The other was 11-month-old Ellie Parsons. Health chiefs say they have yet to find a direct link. Investigations have been launched by Ipswich Hospital after it emerged that Rhianna and Ellie were brought in after falling ill but sent home again. Rhianna, aged two, died within hours of being readmitted a day after being discharged on December 30. Her father, Ben Warner, 24, said: 'They thought she just had a high temperature. 'We were told to go home and give her antibiotics because they didn't want to do a blood test.'
Kyron, two, who was blind and had a pre-existing medical condition, became ill on December 31. He died after being transferred to Addenbrooke's Hospital in Cambridge, where an investigation has also been launched.
His grandfather, Adrian Collins, said Kyron's parents Vicky Holland and Mark Vince were 'numb beyond belief'. He added: 'Kyron was a lovely kid. He smiled a lot, laughed and brought a lot of joy to everybody.'
Meanwhile Ellie's parents, Kirsty Ludlow and Darren Parsons, are threatening legal action over the failure of doctors to diagnose their daughter's condition. They suspected she might have meningitis but she was diagnosed with an infection and discharged. She soon returned to hospital and although medics fought for an hour to save her when she stopped breathing, she died on December 14.
Miss Ludlow, 29, said: 'It has been terrible. We should have had her first birthday and then Christmas a few days later but it was all so empty.' Family and friends of the victims have been given antibiotics to limit the risk of any outbreak spreading. It is unusual, but not unheard of, for meningitis to be passed from one person to another.
A spokesman for Ipswich Hospital promised that its investigation would leave 'no stone unturned'.
SOURCE
UFO's More Likely than Health Bill Reducing Deficit
Which is the greater likelihood? That Unidentified Flying Objects (UFO's) are visiting Earth, or that Barack Obama's proposed $2.5 trillion health bill will actually reduce the deficit as promised?
Believe it or not, more Americans believe in UFO's than think legislation taking over the nation's health care system will do anything but add to the nation's insurmountable $12 trillion debt.
According to Rasmussen Reports, "The survey finds that 68% believe the legislation will increase the federal budget deficit. Only 11% say the program will achieve its stated goal of deficit reduction."
Compare that with 34 percent who believe in UFO’s, according to Opinion Dynamics.
Put another way, little green men traveling from across the galaxy are more believable than Barack Obama, who in his now infamous speech to a joint session of Congress said, “The plan will not add to our deficit.”
Astrology (29 percent), ghosts (34 percent), and witches (24 percent) all poll better than specious claims that providing health coverage to 30-45 million additional people will not cost anything.
Which is really not that surprising. The Senate version of the bill — which allegedly removes the “public option” from the plan — will spend some $350 billion more than it takes in through revenues in its first ten years alone, as ALG News has previously reported.
None of which bodes well for Congressional Democrats, especially for some 18 Blue Dogs in the House who promised in a letter not to vote for a bill that was not deficit-neutral, and then did anyway.
They were: Baron Hill (IN-CD9), Gabrielle Giffords (AZ-CD8), Patrick Murphy (PA-CD8), Mike Michaud (ME-CD2), Leonard Boswell (IA-CD3), John Salazar (CO-CD3), Travis Childers (MS-CD1), Christopher Carney (PA-CD10, Jim Cooper (TN-CD5), Sanford Bishop (GA-CD2), Marion Berry (AR-CD1), David Scott (GA-CD13), Kathy Dahlkemper (PA-CD3), Michael Arcuri (NY-CD24), Jim Costa (CA-CD20), Joe Baca (CA-CD43), Dennis Moore (KS-CD3), and Zack Space (OH-CD18).
They may, however, be able to boost their popularity by ordering an investigation of the Roswell “weather balloon” crash of 1947, or attending a few Star Trek conventions. Beam them up, Scotty.
SOURCE
Charity Begins At Home
Part of our current problem in addressing the healthcare legislation is that Americans are a generous people. We like to help each other. We all recognize that sometimes unexpected circumstances can hit the best of us with a mountain of debt and no obvious way out. We want to live by the golden rule – “Do unto others as you would have them do unto you” – because, by and large, we believe that if we help someone else today, someone else will be better able to help us tomorrow. That is an admirable thing. Many times it is the truth as well.(That whole pay it forward deal plays very well into the American ethos.) The problem comes when we try to apply that ethos through the government rather than as individuals and private organizations. Individuals and some private organizations have a Christian mandate to help people and provide charity. Governments have a mandate to govern.
When the government gives charity, it creates no reciprocal obligation in the heart of those who receive that charity. It fosters an attitude that, not only is one a total failure at life who must be grudgingly rescued by his or her betters, but that one is entitled, by the inability to succeed at life, to that charity and need not pay it forward by word or deed. However, if your neighbor or church steps up and pays your mortgage for a hard month, or buys groceries or Christmas presents for a family that can’t afford them, that creates a thankful heart(usually) and a reciprocal obligation to give back to that neighbor or community group in some way.
Perhaps the fact that there is no way to give back to the government is the culprit. Instead of a feeling of thankfulness, the recipient is left with a sense of frustration and failure. With a neighbor or a neighborhood church, there are opportunities to help and return the favor. Taking on supervision of the Sunday school classes, shoveling the helpful neighbor’s walk in the winter or even sharing some fresh baking or inviting them to dinner. This creates a feeling of fulfillment and self sufficiency. It gives the recipient of that charity the opportunity to demonstrate to that church or neighbor that they are someone who was worthy of such charity. That they understand the obligations of a community to care for each other.
This is one of the reasons that government entitlements and charity are a failure and degrading to the overall character of the nation. How does government charity provide a picture of community support, self respect, cheerful giving and true charity when our children see their parents grumbling over the taxes that are taken from us to provide such charity? What message does it send when they see the recipients of government charity grumbling at how it should be better or how it didn’t really meet their needs? What message does it send to the children who are supported by such largesse? How does that encourage our children to continue our tradition of generosity? When our children see that those who are providing this charity (the taxpayers) are made the poorer by it and involuntarily at that.
Voluntary charity is a blessing for both the provider and the recipient. Involuntary charity is not charity, it is wealth redistribution. We the People need to recognize that, while government may be a fine vessel for the governing of a people, it is not a fit vessel for works of charity.
SOURCE
Tuesday, January 05, 2010
Monday, January 04, 2010
Health bills could expand IRS role
Internal Revenue Service agents already try to catch tax cheats and moonshiners. Under the proposed health care legislation, they would get another assignment: checking to see whether Americans have health insurance.
The legislation would require most Americans to have health insurance and to prove it on their federal tax returns. Those who don't would pay a penalty to the IRS. That's one of several key duties the IRS would assume under the bills that have been approved by the House of Representatives and Senate and will be merged by negotiators from both chambers. The agency also would distribute as much as $140 billion a year in new government subsidies to help small employers and as many as 19 million lower-income people buy coverage. In addition, the IRS would collect hundreds of billions of dollars in new fees on employers, drug companies and device makers, according to the non-partisan Congressional Budget Office (CBO).
Some critics of the health bill question whether the IRS, which has struggled in recent years with budget problems, staffing shortages and outdated computer systems, will be up to the job of enforcing the mandate and efficiently handling the subsidies.
"It's hard to see how the IRS could take on the huge responsibility it would be given under pending health care legislation without some real glitches, or worse," said Sen. Chuck Grassley of Iowa, the top Republican on the Senate Finance Committee. He voted against the bill, as did every other Republican senator.
The CBO estimated the IRS would need $5 billion to $10 billion in the first decade to cover the costs of its expanded role. The IRS' annual budget is currently $11.5 billion. Neither the House nor Senate bill includes funding for the IRS, but money could be added by House and Senate negotiators. The IRS already has trouble meeting its primary duty: collecting taxes. By the IRS's own estimates, it failed to collect about $290 billion in taxes in 2005, the latest year for which data are available.
Pete Sepp, spokesman for the National Taxpayers Union, an IRS watchdog group, says the IRS might be the "logical" agency to enforce the mandate, "but that doesn't mean things will go smoothly."
Howard Gleckman of the Urban Institute, an economics and social policy think tank, sees the IRS' proposed new role as a part of a historical pattern. "We are always asking the IRS to do all kinds of social engineering," he said, such as tax credits for new homeowners and renewable-energy companies.
In one of the biggest examples of using the tax code to achieve a social goal, Congress shifted much of its effort to help the poor in the 1990s from direct spending to the Earned Income Tax Credit, an IRS-run program that pays rebates to low-income working people to offset taxes. In 2005, more than 22 million people claimed the credit, resulting in more than $40 billion in payments, a Treasury Department inspector general found last year. The audit found $11.4 billion in improper payments in 2005 — about 28 cents of every dollar paid out.
Grassley has called the program "rife with fraud and abuse." John Dalrymple, a former IRS deputy commissioner, said the tax-credit program — despite its flaws — demonstrates that the IRS has the experience to handle the new subsidy program.
Under the health care legislation, the IRS would determine who qualifies for the insurance subsidies. Those subsidies would apply to people with incomes up to four times the federal poverty level, which is $43,320 for an individual and $88,200 for a family of four. The government would pay insurance companies to help individuals buy policies on the new exchanges. The exchanges, a central feature in both bills, would be a sort of marketplace where small businesses and individuals who don't get employer-sponsored coverage could shop for health plans.
To meet the mandate, Americans would have to provide proof of insurance coverage with their annual tax returns. The mandate would begin in 2013 under the House bill; 2014 in the Senate bill.
The penalty in the Senate bill for not having coverage would start in 2014 at $95 or 0.5% of an individual's income, whichever is greater. It would rise to $750 or 2% of annual income in 2016, up to the cost of the cheapest health plans. The House bill penalty would be up to 2.5% of an individual's income up to the cost of the average health plan.
SOURCE
2 and 2 make 8: Obamacare goes Orwell a few better
In their enthusiasm for passage of a health-care reform package that President Obama can call his own, Congressional Democrats have stumbled upon some new math that would upstage George Orwell himself — and pose a grave threat to the nation’s fragile economic recovery.
Even Winston Smith, the hero of Orwell’s “1984,” was forced no further than the improbable two plus two make five, and it didn’t sit too well with him. Democratic proponents of Obamacare have gone several steps further, arguing that they can slash some $500 million from Medicare over the next decade and then apply that money in two places at once: Against the federal deficit, so as to reduce it by some $132 billion, and for new health-care coverage for millions of Americans without it.
It is as if, by counting each dollar twice, Obamacare’s backers had decided that two and two make eight. But no amount of enthusiasm and accounting legerdemain can hide the fact that two and two still make four. The Democratic projections posit rates of growth that few economists endorse, finance six years of reforms with 10 years of taxes, and make no allowance for the changes in consumer behaviors and insurance markets that are likely to come about as a consequence of their reforms, including a partial collapse of the private insurance system.
As Republican Sen. Jon Kyl of Arizona has aptly put it, “You can’t sell the same pony twice.”
Normally, we’d be inclined to agree with Mr. Kyl, but this administration and the majority in Congress have shown no reluctance to spend money that does not exist. The trillions conjured into existence to pay for corporate bailouts and government control of parts of the banking, automobile and financial services sectors have distorted credit markets, engraved lines of worry on the brows of foreign investors, and are sure to have dire consequences down the road. In such an environment, what’s one more bit of new math? The more we look at the specifics of the health-care “reforms” contained in the House and Senate bills that have won approval, the more we think that the one-time pony is being groomed for a new life as a Trojan horse.
The “savings” that Democrats perceive, and the new revenues they envision, are simply cuts to existing services and new taxes on middle- and upper-income Americans, respectively. When combined with a vast and powerful new bureaucracy, all wrapped in legislation which is designed to admit of neither amendment nor appeal, these “savings” will lead to fewer choices for consumers of health care, longer waits, more forms to complete, higher co-payments, and more forms to fill out, and an inevitable decline in the health of Americans.
Mr. Obama’s oft-repeated assertion that if you like your health plan, you can keep it under the reform he signs into law, is no more true now than it was under any of the previous reform proposals on Capitol Hill. With polls showing nearly two-thirds of Americans opposed to the reform legislation, and Congress poised to return to action this month, the time to raise voices in opposition is now, before the belly of the beast disgorges another wave of destruction upon an economy that is only beginning to rebuild its strength.
SOURCE
If the price is right
At almost 80 years old, Thomas Jefferson foresaw the corruption of a federal government with too much power, when he wrote to William T. Barry in 1822, just a few years before his death: "If ever this vast country is brought under a single government, it will be one of the most extensive corruption[s], indifferent and incapable of wholesome care over so wide of spread of surface." "Wholesome care" like health care?
I waited until after the New Year to write this column because Washington was hoping its Christmas corruption would evade the majority of holiday revelers or become old news to even political junkies and pundits who are now moving onto new issues. (This White House astutely understands and utilizes news cycles and calendars far better than any preceding presidencies.)
While you were with family and friends enjoying the holiday festivities, Congress and the president passed a $1 trillion omnibus bill with more than 5,000 earmarks (and covertly also loaded with far-left anti-family underpinnings). (Mr. Obama, what happened to your promise to eliminate all earmarks?)
The U.S. Senate also passed an $871 billion health care reform bill on Christmas Eve through shady, sweetheart backdoor deals. While you were cutting your Christmas spending because of the recession, Congress charged you and your children's national credit card with another $2 trillion plus.
For those who missed the bloated bureaucratic holiday news, President Obama exclaimed that congressional Democrats "scored a big victory for the American people," but, in fact, it was actually our senators who scored big time through political and personal payoffs. Even the New York Times blew a trumpet about them.
Senate Majority Leader Harry Reid passed out Christmas bonuses, what I call perpetual pork, gifts that keep on giving, unlike those familiar single hits at the public trough. He initiated a new frontier in pork-barrel politics. His corrupt and creative diversions included giving out Medicaid and Medicare credits like another round of pork projects. In 383 pages of changes to the 2,076 page Senate bill HR. 3590, there are dozens of these types of pork rind provisions for senators.
This health-care pork round all started with Sen. Mary Landrieu, D-La., who bragged about receiving a $300 million increase in Medicaid funding for her state (what some are calling the second Louisiana Purchase), which turned out to be only $100 million. (Isn't that a relief?)
Then there was the now infamous Sen. Ben Nelson, D-Neb., who gained his 15 minutes of yuletide fame when he sold out his critical 60th vote to pass Obamacare by accepting a governmental bribe that covers Nebraska's Medicare expansion costs to the tune of $100 million over the next 10 years.
With Obama having told the AARP back on July 28 that he considered Medicare Advantage an example of "wasteful spending," you could bet Obamacare would reflect his commentary. And in a statement released after the Senate health-care bill passed on Dec. 24, Sen. Bill Nelson, D-Fla., confessed his sweetheart deal made behind closed doors: "I was able to pass an amendment to the bill that excluded some 800,000 policyholders all across Florida from cuts to Medicare Advantage."
But wait there's more – much more. Sen. Patrick Leahy, D-Vt., finagled $600 million in additional Medicaid benefits for his state over 10 years.
Sens. Byron Dorgan, D-N.D., and Kent Conrad, D-N.D., secured additional Medicare payments for their rural hospitals
Sen. Tom Harkin, D-Iowa, chairman of the Senate health committee, openly confessed "I fully admit that I was part of it. I put something in the bill that was particular to the state of Iowa. Yes I did," referring to the increase in Medicare payments to eight medium-sized hospitals in his state.
Sen. Max Baucus, D-Mont., chairman of the Finance Committee and a primary architect of the legislation, secured extra Medicare benefits for select Montana residents.
Sen. Bernie Sanders, I-Vt., was opposed to backing the bill until Reid agreed to a $10 billion increase in support for community health centers.
The Manager's Amendment singles out Sens. Daniel Akaka's, D-Hawaii, and Daniel Inouye's, D-Hawaii, home state of Hawaii as the only state to receive a Disproportionate Share Hospital, or DSH, extension.
Hospitals in Sen. Joseph Lieberman's home state of Connecticut, like Carl Levin's, D-Mich., and Debbie Stabenow's, D-Mich., state of Michigan, have the option to benefit under provisions if it means higher payments.
Sen. John Kerry, D-Mass., among senators in other states, won deals for more generous federal payments under the Medicaid program.
At the last minute, Sen. Christopher J. Dodd, D-Conn., inserted a $100 million kickback in the bill to construct a new hospital for the University of Connecticut.
And Sen. Roland Burris, D-Ill., won the super-loser award for claiming credit for the provision in the Reid bill that could eventually provide federal funds again for ACORN!
Another huge beneficiary of the Senate health care bill's monetary benefits are some insurance companies (just when you thought our government was protecting us from those big bad corporate monopolies). A proposal was initially made by Sen. Carl Levin, D-Mich., to exempt non-profit insurance companies from the Senate bill's $6 billion annual excise tax on insurers. Sen. Ben Nelson, D-Neb., (remember the cornhusker kickback?) then sealed that sweetheart deal in a way that only Mutual of Omaha Insurance Company and Blue Cross Blue Shield nonprofit plans in Nebraska and Michigan qualified. By the way, nonprofit insurers in Sen. Levin's home state of Michigan control 76 percent of industry profits. Incidentally, the industry spent $635 million lobbying during the last two years, obtaining a host of concessions at taxpayer expense.
And to secure its shady deals so that no one (and I mean no one) can avert its actions, Congress has inserted one of the most unconstitutional sections I've ever read in a piece of legislation: Section 3403 of Reid's amendment on Page 1,020 reads, "It shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment or conference report that would repeal or otherwise change this subsection."
Of course, Harry Reid merely labeled these backdoor deals as "the art of compromise," but we all know it better as "the art of corruption." He said what they've done with the Senate health-care bill is "no different than other pieces of legislation." I agree with him – that's the problem!
Even David Axelrod, senior adviser to President Obama, minimized the corruption in these senatorial sweetheart deals by saying, "That's the way it has been. That's the way it will always be." Do you share his pessimism? Is that the government you want for your children and grandchildren? And these are the politicians in whose hands you are trusting your and your loved ones' future health care?
Most important is the question Sen. Orrin Hatch, R-Utah, posed to his colleagues, "Who will pay for these special deals?" "The answer is simple – every other state in the union."
It's no surprise that congressional Democrats have mounting opponents even in their own camp, two of the newest opponents are governors from the bluest states in the union, Arnold Schwarzenegger, a moderate Republican, and David Paterson, a liberal Democrat, who oppose the Senate's health-care reform bill because they believe the new Medicaid mandates will lead to the financial ruin of California and New York.
And all the costs haven't even been calculated yet, because the bribery isn't over. The House and Senate leaders will now hold private negotiations this month to merge the Senate's $871 billion and the House's $1 trillion health-care bills. And you don't think that some bribery babble has already been occurring in the closets and corridors of Congress? ...
In November 2010, all 435 House seats will be open for re-election, and one-third of the Senate seats will be open for re-election as well. The time is now to eject the unconstitutional corrupt congressmen, and it's time to let them know what's coming. I agree with Tea party leaders, who are delivering bold ultimatums to all congressional candidates in 2010: "Pledge to repeal the health-care reform bill in its entirety – or you will be booted from office." Congress, you're waking a sleeping giant, and you're not going to like the consequences.
SOURCE
Internal Revenue Service agents already try to catch tax cheats and moonshiners. Under the proposed health care legislation, they would get another assignment: checking to see whether Americans have health insurance.
The legislation would require most Americans to have health insurance and to prove it on their federal tax returns. Those who don't would pay a penalty to the IRS. That's one of several key duties the IRS would assume under the bills that have been approved by the House of Representatives and Senate and will be merged by negotiators from both chambers. The agency also would distribute as much as $140 billion a year in new government subsidies to help small employers and as many as 19 million lower-income people buy coverage. In addition, the IRS would collect hundreds of billions of dollars in new fees on employers, drug companies and device makers, according to the non-partisan Congressional Budget Office (CBO).
Some critics of the health bill question whether the IRS, which has struggled in recent years with budget problems, staffing shortages and outdated computer systems, will be up to the job of enforcing the mandate and efficiently handling the subsidies.
"It's hard to see how the IRS could take on the huge responsibility it would be given under pending health care legislation without some real glitches, or worse," said Sen. Chuck Grassley of Iowa, the top Republican on the Senate Finance Committee. He voted against the bill, as did every other Republican senator.
The CBO estimated the IRS would need $5 billion to $10 billion in the first decade to cover the costs of its expanded role. The IRS' annual budget is currently $11.5 billion. Neither the House nor Senate bill includes funding for the IRS, but money could be added by House and Senate negotiators. The IRS already has trouble meeting its primary duty: collecting taxes. By the IRS's own estimates, it failed to collect about $290 billion in taxes in 2005, the latest year for which data are available.
Pete Sepp, spokesman for the National Taxpayers Union, an IRS watchdog group, says the IRS might be the "logical" agency to enforce the mandate, "but that doesn't mean things will go smoothly."
Howard Gleckman of the Urban Institute, an economics and social policy think tank, sees the IRS' proposed new role as a part of a historical pattern. "We are always asking the IRS to do all kinds of social engineering," he said, such as tax credits for new homeowners and renewable-energy companies.
In one of the biggest examples of using the tax code to achieve a social goal, Congress shifted much of its effort to help the poor in the 1990s from direct spending to the Earned Income Tax Credit, an IRS-run program that pays rebates to low-income working people to offset taxes. In 2005, more than 22 million people claimed the credit, resulting in more than $40 billion in payments, a Treasury Department inspector general found last year. The audit found $11.4 billion in improper payments in 2005 — about 28 cents of every dollar paid out.
Grassley has called the program "rife with fraud and abuse." John Dalrymple, a former IRS deputy commissioner, said the tax-credit program — despite its flaws — demonstrates that the IRS has the experience to handle the new subsidy program.
Under the health care legislation, the IRS would determine who qualifies for the insurance subsidies. Those subsidies would apply to people with incomes up to four times the federal poverty level, which is $43,320 for an individual and $88,200 for a family of four. The government would pay insurance companies to help individuals buy policies on the new exchanges. The exchanges, a central feature in both bills, would be a sort of marketplace where small businesses and individuals who don't get employer-sponsored coverage could shop for health plans.
To meet the mandate, Americans would have to provide proof of insurance coverage with their annual tax returns. The mandate would begin in 2013 under the House bill; 2014 in the Senate bill.
The penalty in the Senate bill for not having coverage would start in 2014 at $95 or 0.5% of an individual's income, whichever is greater. It would rise to $750 or 2% of annual income in 2016, up to the cost of the cheapest health plans. The House bill penalty would be up to 2.5% of an individual's income up to the cost of the average health plan.
SOURCE
2 and 2 make 8: Obamacare goes Orwell a few better
In their enthusiasm for passage of a health-care reform package that President Obama can call his own, Congressional Democrats have stumbled upon some new math that would upstage George Orwell himself — and pose a grave threat to the nation’s fragile economic recovery.
Even Winston Smith, the hero of Orwell’s “1984,” was forced no further than the improbable two plus two make five, and it didn’t sit too well with him. Democratic proponents of Obamacare have gone several steps further, arguing that they can slash some $500 million from Medicare over the next decade and then apply that money in two places at once: Against the federal deficit, so as to reduce it by some $132 billion, and for new health-care coverage for millions of Americans without it.
It is as if, by counting each dollar twice, Obamacare’s backers had decided that two and two make eight. But no amount of enthusiasm and accounting legerdemain can hide the fact that two and two still make four. The Democratic projections posit rates of growth that few economists endorse, finance six years of reforms with 10 years of taxes, and make no allowance for the changes in consumer behaviors and insurance markets that are likely to come about as a consequence of their reforms, including a partial collapse of the private insurance system.
As Republican Sen. Jon Kyl of Arizona has aptly put it, “You can’t sell the same pony twice.”
Normally, we’d be inclined to agree with Mr. Kyl, but this administration and the majority in Congress have shown no reluctance to spend money that does not exist. The trillions conjured into existence to pay for corporate bailouts and government control of parts of the banking, automobile and financial services sectors have distorted credit markets, engraved lines of worry on the brows of foreign investors, and are sure to have dire consequences down the road. In such an environment, what’s one more bit of new math? The more we look at the specifics of the health-care “reforms” contained in the House and Senate bills that have won approval, the more we think that the one-time pony is being groomed for a new life as a Trojan horse.
The “savings” that Democrats perceive, and the new revenues they envision, are simply cuts to existing services and new taxes on middle- and upper-income Americans, respectively. When combined with a vast and powerful new bureaucracy, all wrapped in legislation which is designed to admit of neither amendment nor appeal, these “savings” will lead to fewer choices for consumers of health care, longer waits, more forms to complete, higher co-payments, and more forms to fill out, and an inevitable decline in the health of Americans.
Mr. Obama’s oft-repeated assertion that if you like your health plan, you can keep it under the reform he signs into law, is no more true now than it was under any of the previous reform proposals on Capitol Hill. With polls showing nearly two-thirds of Americans opposed to the reform legislation, and Congress poised to return to action this month, the time to raise voices in opposition is now, before the belly of the beast disgorges another wave of destruction upon an economy that is only beginning to rebuild its strength.
SOURCE
If the price is right
At almost 80 years old, Thomas Jefferson foresaw the corruption of a federal government with too much power, when he wrote to William T. Barry in 1822, just a few years before his death: "If ever this vast country is brought under a single government, it will be one of the most extensive corruption[s], indifferent and incapable of wholesome care over so wide of spread of surface." "Wholesome care" like health care?
I waited until after the New Year to write this column because Washington was hoping its Christmas corruption would evade the majority of holiday revelers or become old news to even political junkies and pundits who are now moving onto new issues. (This White House astutely understands and utilizes news cycles and calendars far better than any preceding presidencies.)
While you were with family and friends enjoying the holiday festivities, Congress and the president passed a $1 trillion omnibus bill with more than 5,000 earmarks (and covertly also loaded with far-left anti-family underpinnings). (Mr. Obama, what happened to your promise to eliminate all earmarks?)
The U.S. Senate also passed an $871 billion health care reform bill on Christmas Eve through shady, sweetheart backdoor deals. While you were cutting your Christmas spending because of the recession, Congress charged you and your children's national credit card with another $2 trillion plus.
For those who missed the bloated bureaucratic holiday news, President Obama exclaimed that congressional Democrats "scored a big victory for the American people," but, in fact, it was actually our senators who scored big time through political and personal payoffs. Even the New York Times blew a trumpet about them.
Senate Majority Leader Harry Reid passed out Christmas bonuses, what I call perpetual pork, gifts that keep on giving, unlike those familiar single hits at the public trough. He initiated a new frontier in pork-barrel politics. His corrupt and creative diversions included giving out Medicaid and Medicare credits like another round of pork projects. In 383 pages of changes to the 2,076 page Senate bill HR. 3590, there are dozens of these types of pork rind provisions for senators.
This health-care pork round all started with Sen. Mary Landrieu, D-La., who bragged about receiving a $300 million increase in Medicaid funding for her state (what some are calling the second Louisiana Purchase), which turned out to be only $100 million. (Isn't that a relief?)
Then there was the now infamous Sen. Ben Nelson, D-Neb., who gained his 15 minutes of yuletide fame when he sold out his critical 60th vote to pass Obamacare by accepting a governmental bribe that covers Nebraska's Medicare expansion costs to the tune of $100 million over the next 10 years.
With Obama having told the AARP back on July 28 that he considered Medicare Advantage an example of "wasteful spending," you could bet Obamacare would reflect his commentary. And in a statement released after the Senate health-care bill passed on Dec. 24, Sen. Bill Nelson, D-Fla., confessed his sweetheart deal made behind closed doors: "I was able to pass an amendment to the bill that excluded some 800,000 policyholders all across Florida from cuts to Medicare Advantage."
But wait there's more – much more. Sen. Patrick Leahy, D-Vt., finagled $600 million in additional Medicaid benefits for his state over 10 years.
Sens. Byron Dorgan, D-N.D., and Kent Conrad, D-N.D., secured additional Medicare payments for their rural hospitals
Sen. Tom Harkin, D-Iowa, chairman of the Senate health committee, openly confessed "I fully admit that I was part of it. I put something in the bill that was particular to the state of Iowa. Yes I did," referring to the increase in Medicare payments to eight medium-sized hospitals in his state.
Sen. Max Baucus, D-Mont., chairman of the Finance Committee and a primary architect of the legislation, secured extra Medicare benefits for select Montana residents.
Sen. Bernie Sanders, I-Vt., was opposed to backing the bill until Reid agreed to a $10 billion increase in support for community health centers.
The Manager's Amendment singles out Sens. Daniel Akaka's, D-Hawaii, and Daniel Inouye's, D-Hawaii, home state of Hawaii as the only state to receive a Disproportionate Share Hospital, or DSH, extension.
Hospitals in Sen. Joseph Lieberman's home state of Connecticut, like Carl Levin's, D-Mich., and Debbie Stabenow's, D-Mich., state of Michigan, have the option to benefit under provisions if it means higher payments.
Sen. John Kerry, D-Mass., among senators in other states, won deals for more generous federal payments under the Medicaid program.
At the last minute, Sen. Christopher J. Dodd, D-Conn., inserted a $100 million kickback in the bill to construct a new hospital for the University of Connecticut.
And Sen. Roland Burris, D-Ill., won the super-loser award for claiming credit for the provision in the Reid bill that could eventually provide federal funds again for ACORN!
Another huge beneficiary of the Senate health care bill's monetary benefits are some insurance companies (just when you thought our government was protecting us from those big bad corporate monopolies). A proposal was initially made by Sen. Carl Levin, D-Mich., to exempt non-profit insurance companies from the Senate bill's $6 billion annual excise tax on insurers. Sen. Ben Nelson, D-Neb., (remember the cornhusker kickback?) then sealed that sweetheart deal in a way that only Mutual of Omaha Insurance Company and Blue Cross Blue Shield nonprofit plans in Nebraska and Michigan qualified. By the way, nonprofit insurers in Sen. Levin's home state of Michigan control 76 percent of industry profits. Incidentally, the industry spent $635 million lobbying during the last two years, obtaining a host of concessions at taxpayer expense.
And to secure its shady deals so that no one (and I mean no one) can avert its actions, Congress has inserted one of the most unconstitutional sections I've ever read in a piece of legislation: Section 3403 of Reid's amendment on Page 1,020 reads, "It shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment or conference report that would repeal or otherwise change this subsection."
Of course, Harry Reid merely labeled these backdoor deals as "the art of compromise," but we all know it better as "the art of corruption." He said what they've done with the Senate health-care bill is "no different than other pieces of legislation." I agree with him – that's the problem!
Even David Axelrod, senior adviser to President Obama, minimized the corruption in these senatorial sweetheart deals by saying, "That's the way it has been. That's the way it will always be." Do you share his pessimism? Is that the government you want for your children and grandchildren? And these are the politicians in whose hands you are trusting your and your loved ones' future health care?
Most important is the question Sen. Orrin Hatch, R-Utah, posed to his colleagues, "Who will pay for these special deals?" "The answer is simple – every other state in the union."
It's no surprise that congressional Democrats have mounting opponents even in their own camp, two of the newest opponents are governors from the bluest states in the union, Arnold Schwarzenegger, a moderate Republican, and David Paterson, a liberal Democrat, who oppose the Senate's health-care reform bill because they believe the new Medicaid mandates will lead to the financial ruin of California and New York.
And all the costs haven't even been calculated yet, because the bribery isn't over. The House and Senate leaders will now hold private negotiations this month to merge the Senate's $871 billion and the House's $1 trillion health-care bills. And you don't think that some bribery babble has already been occurring in the closets and corridors of Congress? ...
In November 2010, all 435 House seats will be open for re-election, and one-third of the Senate seats will be open for re-election as well. The time is now to eject the unconstitutional corrupt congressmen, and it's time to let them know what's coming. I agree with Tea party leaders, who are delivering bold ultimatums to all congressional candidates in 2010: "Pledge to repeal the health-care reform bill in its entirety – or you will be booted from office." Congress, you're waking a sleeping giant, and you're not going to like the consequences.
SOURCE
Sunday, January 03, 2010
Two patients ill with suspected legionnaire's disease at scandal-hit British hospital
And the only result seems to be bureaucratic platitudes
Two patients at a hospital severely criticised for its high mortality rates and poor hygiene standards are feared to have contracted life-threatening legionnaire's disease. Both are receiving urgent treatment after falling ill at Basildon University Hospital in Essex and tests are being conducted to confirm their condition.
It comes just days after the hospital announced that a spot-check by health watchdog the Care Quality Commission confirmed it had improved cleanliness standards on its wards. The CQC visit took place a month after it criticised Basildon and Thurrock University Hospitals Foundation Trust for filthy wards, blood-spattered curtains in A&E, inadequate care, and a death rate that was 30 per cent higher than the national average. The trust has had previous problems with legionella. In 2004, it was fined for failing to control it after a patient fell ill. Weeks later, tests showed the bacteria were still present.
The disease, which causes lung infections and pneumonia, brings symptoms of muscle ache, tiredness, headaches, dry cough and fever. It is found in water systems such as showers and spas and can be lethal for those who are already ill because their immune systems are weakened.
Basildon hospital is the largest in the county with 777 beds. The two patients were in two separate areas of the hospital - one is critically ill and the other is said to be comfortable and stable. A spokesman said the hospital had stepped up its already rigorous treatment of its water system to kill the bacteria and was looking for the source of the suspected outbreak. She insisted patients and their families should not be concerned.
"It is our normal clinical practice to test patients with a suspicious respiratory infection for legionella, because we are aware of the risk of the presence of legionella bacteria in the hospital’s water system. This means that anyone diagnosed with legionnaire's disease is identified quickly and treated with the appropriate medication promptly," the spokesman said.
Barbara Stuttle, Acting chief executive of NHS South West Essex, said Basildon hospital had considerably improved its record of keeping legionella at bay since 2004. "Legionella bacterium is widely distributed in the environment and over the past few years Basildon University Hospital has demonstrated commitment and determination in managing and controlling it in the hospital," she said. "Our own commissioned review of the hospital's practices in June 2009 – carried out by an independent expert – found that Basildon University Hospital was thorough and rigorous in its management of the control of Legionella."
But Katherine Murphy from the Patients' Association said the suspected outbreak showed there was still complacency about patient safety and called for the chief executive Alan Whittle, who has until now escaped sanction for the string of problems on his watch, and his board to be held to account. "Until someone is held to account for the continued failings at this hospital, patients lives will continue to be at risk," she said. "It is astonishing that the so-called improvements that we were reassured had been undertaken have been so ineffective. For the hospital to suggest it is not to blame or that people should not be concerned is ridiculous."
She also questioned the validity of the CQC's spot-check. "The fact that there has been a recent spot-check which found that the trust was meeting the minimum standard for infection control raises serious questions about the CQC's methods and judgement," she said.
A CQC spokesman said the hospital would deal with the problem along with the Health Protection Agency but it would "keep a very close eye" on how it is handled. "Infections will happen in hospitals – it is all about how they are being managed and prevented," she said. "A spot check is not going to prevent this from happening but we will be watching very closely to see how it's being managed and that they are doing everything they should be."
The agent that causes legionnaires' is a bacterium called legionella pneumophilia and is generally killed using heat and chlorine treatment of the water system. It can affect people of all ages, but it mainly hits those over 50 and more men than women.
SOURCE
Senate Obamacare bill depends upon Enron accounting for 'savings'
Senate Majority Leader Harry Reid proudly declares that the Senate health reform bill "saves money and saves Medicare," reducing the budget deficit by $132 billion over 10 years, while extending Medicare's solvency.
In fact, only by double-counting savings from Social Security and Medicare does the Nevada Democrat's plan reduce government borrowing. Without this dubious accounting, the Reid Senate bill increases the non-Social Security/Medicare deficit by almost $250 billion. A surprisingly frank new Congressional Budget Office analysis calls foul on this off-the-books borrowing.
The accounting mischief begins with Social Security. The Reid Senate plan imposes a 40 percent excise tax on so-called "Cadillac" health plans with premiums above $8,500 for singles and $23,000 for families.
But most insurers are smart enough to avoid this tax. Instead, insurers will reduce health premiums below the taxable levels, while increasing co-pays and deductible. Since health premiums are non-taxable, reducing premiums would increase employees' taxable wages, boosting Social Security revenues by $52 billion over 10 years.
Of course, when workers pay more Social Security taxes today, they're owed higher benefits at retirement. But the Reid Senate health bill spends the extra Social Security revenues today, meaning we won't have the cash to pay those larger Social Security benefit bills when they come due.
It's not just balanced-budget purists who condemn this double bookkeeping. Reid himself does -- or at least he used to. In 1990, he asked, "Are we as a country violating a trust by spending Social Security trust fund monies for some purpose other than for which they were intended? The obvious answer is yes." As a lawyer, Reid assured us, someone doing this outside of government would be prosecuted.
It's a good thing Reid is not back in the private sector, since his Senate health care reform bill's accounting abuse of Medicare goes even further. The Reid Senate plan includes $438 billion in cuts to Medicare Advantage plans, hospitals and fee-for-service payments.
The cash savings from these Medicare reductions, like the new Social Security taxes, cover other costs in the health plan, like expanding Medicaid and subsidizing private health insurance premiums.
But more than $300 billion of these cuts are also credited to the Hospital Insurance trust fund. These new federal IOUs extend the fund's life by several years, allowing Democrats to claim the Reid Senate bill helps rather than guts Medicare.
But a Dec. 23 CBO analysis directly undercuts Reid's claims. Under the Senate health bill, CBO writes, "the majority of the HI trust fund savings would be used to pay for other spending ... and would not enhance the ability of the government to redeem the bonds credited to the trust fund to pay for future Medicare benefits."
This is the very definition of a "raid" on the trust fund -- Medicare gives us cash, which we spend, while we give Medicare a series of IOUs backed only by Washington's willingness to raise taxes in the future.
As the Obama administration's own budget documents acknowledge, these trust fund "balances are available for future benefit payments ... only in a bookkeeping sense." There's no real cash there, particularly so when Social Security and Medicare revenues are raised for the very purpose of spending on them on other things.
"The key point," the CBO memo says about the Reid Senate health bill, "is that the savings to the HI trust fund ... would be received by the government only once, so they cannot be set aside to pay for future Medicare spending and, at the same time, pay for current spending on other parts of the legislation or on other programs. ... To describe the full amount of HI trust fund savings as both improving the government's ability to pay future Medicare benefits and financing new spending outside of Medicare would essentially double-count a large share of those savings and thus overstate the improvement in the government's fiscal position."
Medicare's chief actuary Rick Foster similarly said in December that Medicare cuts "cannot be simultaneously used to finance other federal outlays and to extend the trust fund, despite the appearance of this result from the respective accounting conventions." Reid once railed against these dubious accounting conventions, but now embraces them.
In total, the Reid Senate health bill borrows more than $350 billion from Social Security and Medicare. But this borrowing is "off the books," meaning it's not generally reported as part of the government's debt.
This bookkeeping allows Democrats to devote around one-third of the $350 billion bill to reducing the budget deficit, thereby claiming a mantle of fiscal responsibility, while spending the majority on expanded coverage for non-retirees.
The national debt measured in total -- meaning debt held by the public plus debt to Social Security and Medicare -- will unambiguously rise under the Senate bill.
This "off balance sheet borrowing" resembles Wall Street financial scandals, yet without such practices the truth of the Senate health bill would be made clear: It borrows far more than it saves and it weakens the nation's fiscal position at a time when it is already under threat. Dodgy accounting is hardly the only sin in Reid's Senate health plan, but it hides a multitude of other ones.
SOURCE
ObamaCare: Should Republicans Have Negotiated on Health Care Bill?
Writing for Forbes, Bruce Bartlett puts forth an interesting hypothesis that healthcare legislation could have been made better (hopefully he meant to write “less destructive”) if the GOP had been willing to compromise with Democrats: "Democrats desperately wanted a bipartisan bill and would have given a lot to get a few Republicans on board. This undoubtedly would have led to enactment of a better health bill than the one we are likely to get. But Republicans never put forward an alternative health proposal. Instead, they took the position that our current health system is perfect just as it is".
Bruce makes several compelling points in the article, especially when he notes that it will be virtually impossible to repeal a bad bill after 2010 or 2012, but there are good reasons to disagree with his analysis. First, he is wrong in stating that Republicans were united against any compromise. Several GOP senators spent months trying to negotiate something less objectionable, but those discussions were futile. Also, I’m not sure it’s correct to assert Republicans took a the-current-system-is-perfect position.
They may not have offered a full alternative (they did have a few good reforms such as allowing the purchase of insurance across state lines), but their main message was that the Democrats were going to make the current system worse. Strikes me as a perfectly reasonable position, one that I imagine Bruce shares. But let’s further explore Bruce’s core hypothesis: Would compromise have generated a better bill? It’s possible, to be sure, but there are also several reasons why that approach may have backfired:
1. It’s not clear a policy of compromise would have produced a less-objectionable bill. Would Senate Democrats have made more concessions to Grassley and Snowe rather than Lieberman and Nelson (much less whether the “concessions” would have been good policy)? And even if Reid made some significant (and positive) concessions, is there any reason to think those reforms would have survived a conference committee with the House? Yet the compromising Republicans probably would have felt invested in the process and obliged to support the final bill – even if the conference committee produced something worse than the original Senate Democrat proposal.
2. A take-no-prisoners strategy may be high risk, but it can produce high rewards. In the early 1990s, the Republicans took a no-compromise position when fighting Bill Clinton’s health plan (aka, Hillarycare), and that strategy was ultimately successful. We still don’t know the final result of this battle (much less how events would have transpired with a different strategy), but if the long-term goal is to minimize government expansion, a no-compromise approach is perfectly reasonable.
3. A principled opposition to government-run healthcare will help win other fights. The Democrats ultimately may win the healthcare battle, but the leadership will have been forced to spend lots of time and energy, and also use up lots of political chits. Does anyone now think they can pass a “climate change” bill? The answer, almost certainly, is no.
4. A principled approach can be good politics, which can eventually lead to good policy. Democrats wanted a few Republicans on board in part to help give them political cover. The aura of bipartisanship would have given Democrats a good talking point for the 2010 elections (”my opponent is being unreasonable since even X Republicans also supported the legislation”). That fig leaf does not exist now, which makes it more likely that Democrats will pay a heavy price during the mid-term elections. It is impossible to know whether 2010 will be a 1994-style rout, or whether the newly-elected Republicans will quickly morph into Bush-style big-government conservatives (who often do more damage to liberty than Democrats), but at least there is a reasonable likelihood of more pro-liberty lawmakers.
When all is said and done, Bruce’s strategy is not necessarily wrong, but it does guarantee defeat. Government gets bigger and freedom diminishes. For reasons of principle and practicality, Republicans should do the right thing.
SOURCE
First stop the ObamaCare disaster, then talk real reform
By Tom Skoch, editor of The Morning Journal of Ohio
AFTER my column last Sunday about the immediate need to stop ObamaCare from becoming law and destroying America's health care system, I got a letter from the chairman of the Democratic Party in Lorain. It basically said Obama and the Democrats' version of health reform isn't perfect, but it's better than the status quo, and then it asked, "Tell us what a 'good' bill would look like." The letter went on to say, "I have some solutions, but for now let's just try to identify and agree on the problems with the current system then see if we can agree on solutions."
The writer named four general problems with the current health system, as he sees it, but excused himself from specifying the solutions he claims to have. That's like holding one's cards out of sight, while insisting that we critics of ObamaCare show our cards. Well, we have some solutions in our cards too, but this is no time to be distracted into playing cards.
Let's just focus on stopping ObamaCare, since that is the immediate threat to our well-being. If you see a thief running off with a woman's purse, you yell, "Stop, thief" in response to the immediate crisis. Later, you can discuss potential reforms of the criminal justice system to prevent purse-snatching. But the only thing you absolutely must do right at the moment is yell, "Stop, thief" and marshal the good people who will grab the thief and end the crisis. In rushing to pass ObamaCare, the Democratic leaders would steal our personal and national well-being for generations to come. Stop, thief.
Good alternative health reform proposals that are not costly, stifling and damaging like ObamaCare have been put forth already, but they can't get past the Democratic leadership which controls what Congress acts on and when. Unlike ObamaCare, such alternatives would improve health care without trillions more being spent atop our already dangerously huge national debt, without raising premiums and cutting back care, without job-killing taxes and costly non-funded federal mandates on Ohio's health system and without the legion of new federal bureaucrats we will have to pay to run ObamaCare and to determine what medical treatment we get, or don't. The alternatives would not force taxpayers to fund abortion against their will as ObamaCare would.
Details on good alternatives to ObamaCare can be found at http://healthcare.gop.gov.
But all of that can be discussed in greater detail after the arrogant, brazen ramming of ObamaCare through Congress is stopped. Now is the time to hear the outcry of the majority of citizens who are against ObamaCare and who rebel at having it shoved down their throats. As the physician's oath says, "First, do no harm." First, refuse to be bullied into accepting massive changes for the worse in health care.
Do not be distracted from recognizing the dangers to the United States in the Democrats' health reform bills. Do not be distracted from stopping ObamaCare first. Then let's take our time doing health reform right, in a bipartisan fashion, and in the best interests of America's long-term health.
SOURCE
And the only result seems to be bureaucratic platitudes
Two patients at a hospital severely criticised for its high mortality rates and poor hygiene standards are feared to have contracted life-threatening legionnaire's disease. Both are receiving urgent treatment after falling ill at Basildon University Hospital in Essex and tests are being conducted to confirm their condition.
It comes just days after the hospital announced that a spot-check by health watchdog the Care Quality Commission confirmed it had improved cleanliness standards on its wards. The CQC visit took place a month after it criticised Basildon and Thurrock University Hospitals Foundation Trust for filthy wards, blood-spattered curtains in A&E, inadequate care, and a death rate that was 30 per cent higher than the national average. The trust has had previous problems with legionella. In 2004, it was fined for failing to control it after a patient fell ill. Weeks later, tests showed the bacteria were still present.
The disease, which causes lung infections and pneumonia, brings symptoms of muscle ache, tiredness, headaches, dry cough and fever. It is found in water systems such as showers and spas and can be lethal for those who are already ill because their immune systems are weakened.
Basildon hospital is the largest in the county with 777 beds. The two patients were in two separate areas of the hospital - one is critically ill and the other is said to be comfortable and stable. A spokesman said the hospital had stepped up its already rigorous treatment of its water system to kill the bacteria and was looking for the source of the suspected outbreak. She insisted patients and their families should not be concerned.
"It is our normal clinical practice to test patients with a suspicious respiratory infection for legionella, because we are aware of the risk of the presence of legionella bacteria in the hospital’s water system. This means that anyone diagnosed with legionnaire's disease is identified quickly and treated with the appropriate medication promptly," the spokesman said.
Barbara Stuttle, Acting chief executive of NHS South West Essex, said Basildon hospital had considerably improved its record of keeping legionella at bay since 2004. "Legionella bacterium is widely distributed in the environment and over the past few years Basildon University Hospital has demonstrated commitment and determination in managing and controlling it in the hospital," she said. "Our own commissioned review of the hospital's practices in June 2009 – carried out by an independent expert – found that Basildon University Hospital was thorough and rigorous in its management of the control of Legionella."
But Katherine Murphy from the Patients' Association said the suspected outbreak showed there was still complacency about patient safety and called for the chief executive Alan Whittle, who has until now escaped sanction for the string of problems on his watch, and his board to be held to account. "Until someone is held to account for the continued failings at this hospital, patients lives will continue to be at risk," she said. "It is astonishing that the so-called improvements that we were reassured had been undertaken have been so ineffective. For the hospital to suggest it is not to blame or that people should not be concerned is ridiculous."
She also questioned the validity of the CQC's spot-check. "The fact that there has been a recent spot-check which found that the trust was meeting the minimum standard for infection control raises serious questions about the CQC's methods and judgement," she said.
A CQC spokesman said the hospital would deal with the problem along with the Health Protection Agency but it would "keep a very close eye" on how it is handled. "Infections will happen in hospitals – it is all about how they are being managed and prevented," she said. "A spot check is not going to prevent this from happening but we will be watching very closely to see how it's being managed and that they are doing everything they should be."
The agent that causes legionnaires' is a bacterium called legionella pneumophilia and is generally killed using heat and chlorine treatment of the water system. It can affect people of all ages, but it mainly hits those over 50 and more men than women.
SOURCE
Senate Obamacare bill depends upon Enron accounting for 'savings'
Senate Majority Leader Harry Reid proudly declares that the Senate health reform bill "saves money and saves Medicare," reducing the budget deficit by $132 billion over 10 years, while extending Medicare's solvency.
In fact, only by double-counting savings from Social Security and Medicare does the Nevada Democrat's plan reduce government borrowing. Without this dubious accounting, the Reid Senate bill increases the non-Social Security/Medicare deficit by almost $250 billion. A surprisingly frank new Congressional Budget Office analysis calls foul on this off-the-books borrowing.
The accounting mischief begins with Social Security. The Reid Senate plan imposes a 40 percent excise tax on so-called "Cadillac" health plans with premiums above $8,500 for singles and $23,000 for families.
But most insurers are smart enough to avoid this tax. Instead, insurers will reduce health premiums below the taxable levels, while increasing co-pays and deductible. Since health premiums are non-taxable, reducing premiums would increase employees' taxable wages, boosting Social Security revenues by $52 billion over 10 years.
Of course, when workers pay more Social Security taxes today, they're owed higher benefits at retirement. But the Reid Senate health bill spends the extra Social Security revenues today, meaning we won't have the cash to pay those larger Social Security benefit bills when they come due.
It's not just balanced-budget purists who condemn this double bookkeeping. Reid himself does -- or at least he used to. In 1990, he asked, "Are we as a country violating a trust by spending Social Security trust fund monies for some purpose other than for which they were intended? The obvious answer is yes." As a lawyer, Reid assured us, someone doing this outside of government would be prosecuted.
It's a good thing Reid is not back in the private sector, since his Senate health care reform bill's accounting abuse of Medicare goes even further. The Reid Senate plan includes $438 billion in cuts to Medicare Advantage plans, hospitals and fee-for-service payments.
The cash savings from these Medicare reductions, like the new Social Security taxes, cover other costs in the health plan, like expanding Medicaid and subsidizing private health insurance premiums.
But more than $300 billion of these cuts are also credited to the Hospital Insurance trust fund. These new federal IOUs extend the fund's life by several years, allowing Democrats to claim the Reid Senate bill helps rather than guts Medicare.
But a Dec. 23 CBO analysis directly undercuts Reid's claims. Under the Senate health bill, CBO writes, "the majority of the HI trust fund savings would be used to pay for other spending ... and would not enhance the ability of the government to redeem the bonds credited to the trust fund to pay for future Medicare benefits."
This is the very definition of a "raid" on the trust fund -- Medicare gives us cash, which we spend, while we give Medicare a series of IOUs backed only by Washington's willingness to raise taxes in the future.
As the Obama administration's own budget documents acknowledge, these trust fund "balances are available for future benefit payments ... only in a bookkeeping sense." There's no real cash there, particularly so when Social Security and Medicare revenues are raised for the very purpose of spending on them on other things.
"The key point," the CBO memo says about the Reid Senate health bill, "is that the savings to the HI trust fund ... would be received by the government only once, so they cannot be set aside to pay for future Medicare spending and, at the same time, pay for current spending on other parts of the legislation or on other programs. ... To describe the full amount of HI trust fund savings as both improving the government's ability to pay future Medicare benefits and financing new spending outside of Medicare would essentially double-count a large share of those savings and thus overstate the improvement in the government's fiscal position."
Medicare's chief actuary Rick Foster similarly said in December that Medicare cuts "cannot be simultaneously used to finance other federal outlays and to extend the trust fund, despite the appearance of this result from the respective accounting conventions." Reid once railed against these dubious accounting conventions, but now embraces them.
In total, the Reid Senate health bill borrows more than $350 billion from Social Security and Medicare. But this borrowing is "off the books," meaning it's not generally reported as part of the government's debt.
This bookkeeping allows Democrats to devote around one-third of the $350 billion bill to reducing the budget deficit, thereby claiming a mantle of fiscal responsibility, while spending the majority on expanded coverage for non-retirees.
The national debt measured in total -- meaning debt held by the public plus debt to Social Security and Medicare -- will unambiguously rise under the Senate bill.
This "off balance sheet borrowing" resembles Wall Street financial scandals, yet without such practices the truth of the Senate health bill would be made clear: It borrows far more than it saves and it weakens the nation's fiscal position at a time when it is already under threat. Dodgy accounting is hardly the only sin in Reid's Senate health plan, but it hides a multitude of other ones.
SOURCE
ObamaCare: Should Republicans Have Negotiated on Health Care Bill?
Writing for Forbes, Bruce Bartlett puts forth an interesting hypothesis that healthcare legislation could have been made better (hopefully he meant to write “less destructive”) if the GOP had been willing to compromise with Democrats: "Democrats desperately wanted a bipartisan bill and would have given a lot to get a few Republicans on board. This undoubtedly would have led to enactment of a better health bill than the one we are likely to get. But Republicans never put forward an alternative health proposal. Instead, they took the position that our current health system is perfect just as it is".
Bruce makes several compelling points in the article, especially when he notes that it will be virtually impossible to repeal a bad bill after 2010 or 2012, but there are good reasons to disagree with his analysis. First, he is wrong in stating that Republicans were united against any compromise. Several GOP senators spent months trying to negotiate something less objectionable, but those discussions were futile. Also, I’m not sure it’s correct to assert Republicans took a the-current-system-is-perfect position.
They may not have offered a full alternative (they did have a few good reforms such as allowing the purchase of insurance across state lines), but their main message was that the Democrats were going to make the current system worse. Strikes me as a perfectly reasonable position, one that I imagine Bruce shares. But let’s further explore Bruce’s core hypothesis: Would compromise have generated a better bill? It’s possible, to be sure, but there are also several reasons why that approach may have backfired:
1. It’s not clear a policy of compromise would have produced a less-objectionable bill. Would Senate Democrats have made more concessions to Grassley and Snowe rather than Lieberman and Nelson (much less whether the “concessions” would have been good policy)? And even if Reid made some significant (and positive) concessions, is there any reason to think those reforms would have survived a conference committee with the House? Yet the compromising Republicans probably would have felt invested in the process and obliged to support the final bill – even if the conference committee produced something worse than the original Senate Democrat proposal.
2. A take-no-prisoners strategy may be high risk, but it can produce high rewards. In the early 1990s, the Republicans took a no-compromise position when fighting Bill Clinton’s health plan (aka, Hillarycare), and that strategy was ultimately successful. We still don’t know the final result of this battle (much less how events would have transpired with a different strategy), but if the long-term goal is to minimize government expansion, a no-compromise approach is perfectly reasonable.
3. A principled opposition to government-run healthcare will help win other fights. The Democrats ultimately may win the healthcare battle, but the leadership will have been forced to spend lots of time and energy, and also use up lots of political chits. Does anyone now think they can pass a “climate change” bill? The answer, almost certainly, is no.
4. A principled approach can be good politics, which can eventually lead to good policy. Democrats wanted a few Republicans on board in part to help give them political cover. The aura of bipartisanship would have given Democrats a good talking point for the 2010 elections (”my opponent is being unreasonable since even X Republicans also supported the legislation”). That fig leaf does not exist now, which makes it more likely that Democrats will pay a heavy price during the mid-term elections. It is impossible to know whether 2010 will be a 1994-style rout, or whether the newly-elected Republicans will quickly morph into Bush-style big-government conservatives (who often do more damage to liberty than Democrats), but at least there is a reasonable likelihood of more pro-liberty lawmakers.
When all is said and done, Bruce’s strategy is not necessarily wrong, but it does guarantee defeat. Government gets bigger and freedom diminishes. For reasons of principle and practicality, Republicans should do the right thing.
SOURCE
First stop the ObamaCare disaster, then talk real reform
By Tom Skoch, editor of The Morning Journal of Ohio
AFTER my column last Sunday about the immediate need to stop ObamaCare from becoming law and destroying America's health care system, I got a letter from the chairman of the Democratic Party in Lorain. It basically said Obama and the Democrats' version of health reform isn't perfect, but it's better than the status quo, and then it asked, "Tell us what a 'good' bill would look like." The letter went on to say, "I have some solutions, but for now let's just try to identify and agree on the problems with the current system then see if we can agree on solutions."
The writer named four general problems with the current health system, as he sees it, but excused himself from specifying the solutions he claims to have. That's like holding one's cards out of sight, while insisting that we critics of ObamaCare show our cards. Well, we have some solutions in our cards too, but this is no time to be distracted into playing cards.
Let's just focus on stopping ObamaCare, since that is the immediate threat to our well-being. If you see a thief running off with a woman's purse, you yell, "Stop, thief" in response to the immediate crisis. Later, you can discuss potential reforms of the criminal justice system to prevent purse-snatching. But the only thing you absolutely must do right at the moment is yell, "Stop, thief" and marshal the good people who will grab the thief and end the crisis. In rushing to pass ObamaCare, the Democratic leaders would steal our personal and national well-being for generations to come. Stop, thief.
Good alternative health reform proposals that are not costly, stifling and damaging like ObamaCare have been put forth already, but they can't get past the Democratic leadership which controls what Congress acts on and when. Unlike ObamaCare, such alternatives would improve health care without trillions more being spent atop our already dangerously huge national debt, without raising premiums and cutting back care, without job-killing taxes and costly non-funded federal mandates on Ohio's health system and without the legion of new federal bureaucrats we will have to pay to run ObamaCare and to determine what medical treatment we get, or don't. The alternatives would not force taxpayers to fund abortion against their will as ObamaCare would.
Details on good alternatives to ObamaCare can be found at http://healthcare.gop.gov.
But all of that can be discussed in greater detail after the arrogant, brazen ramming of ObamaCare through Congress is stopped. Now is the time to hear the outcry of the majority of citizens who are against ObamaCare and who rebel at having it shoved down their throats. As the physician's oath says, "First, do no harm." First, refuse to be bullied into accepting massive changes for the worse in health care.
Do not be distracted from recognizing the dangers to the United States in the Democrats' health reform bills. Do not be distracted from stopping ObamaCare first. Then let's take our time doing health reform right, in a bipartisan fashion, and in the best interests of America's long-term health.
SOURCE
British National Health Service Drained by Drink
(London) According to a new report, the British health care system (NHS) is being wobbled by the nation's notorious drinking culture.
(London) According to a new report, the British health care system (NHS) is being wobbled by the nation's notorious drinking culture.
The cash-strapped National Health Service - the U.K.'s taxpayer-funded medical system - now spends 2.7 billion pounds ($4.4 billion) a year treating patients for drink-related problems, double the amount five years ago, the report said. Total funding for the health care system is currently around 100 billion pounds ($162 billion) a year.It appears that many British citizens are exceeding the government recommended maximum of four small glasses of beer daily. Imagine that.
The report - published by the NHS Confederation, a health-care providers organization, and the Royal College of Physicians, which represents doctors - warns that about 10.5 million adults in Britain drink above sensible limits, and 1.1 million people have some form of alcohol addiction.
Professor Ian Gilmore, president of the Royal College of Physicians, said the National Health Service could not afford to continue treating alcohol-related problems at current levels, and that health-care providers had to be more proactive in preventing people from drinking too much.As a result, the government's top medical advisor suggests raising the price of alcohol.
"The role of the NHS should not just be about treating the consequences of alcohol-related harm but also about active prevention, early intervention and working in partnership with services in local communities to raise awareness of alcohol-related harm," he said.
Saturday, January 02, 2010
British girl, 15, died from series of heart attacks after being sent home from NHS hospital with 'flu'
A girl of 15 died on Christmas Eve from a series of heart attacks just days after begging doctors to keep her in hospital because she felt so ill. Amy Carter lost a stone in weight over a week after initially falling sick with flu-like symptoms at the start of December. However, she was discharged from hospital after tests showed she was suffering from glandular fever.
Richard and Jacqueline Carter said their daughter had asked a doctor at the Worcestershire Royal Hospital in Worcester: 'Am I going to die?' They said the doctor replied: 'Of course not, don't be silly it's a nasty illness but it's certainly not life-threatening.' She was discharged on December 21, two days after she was admitted, and told to take paracetamol and have plenty of rest.
But the next day, Amy was struggling to breathe and was taken to an out-of-hours care centre where a doctor sent her away with instructions to drink lots of fluid.
On the morning of Christmas Eve, her worried parents called their GP, who said Amy's condition was 'critical' and called an ambulance. Despite being given five adrenalin shots into her heart – one for each cardiac arrest – she died just hours later in hospital.
Mrs Carter, 48, from Stourport-on-Severn, Worcestershire said: 'I'm not medically trained but even I could tell she was seriously ill. 'She hadn't eaten for weeks and lost more than a stone. 'We're extremely bitter and feel we have been let down. Her organs basically all failed one by one and her heart was the last to go. 'She was a healthy girl who should never have died.'
Mr Carter, 43, said: 'Amy was very frightened and really did not want to be moved out of hospital. Her condition was deteriorating every day. She knew something was wrong but the doctors refused to listen to her.'
When Amy first fell ill around four weeks ago, her parents, who both run pet shops, took her to the care centre attached to their nearest hospital in Kidderminster. A doctor said she had sinusitis – an inflammatory condition of the sinuses – and sent Amy home with a one-week course of antibiotics.
Days later her eyes swelled up and Amy was taken to her GP, who said she was suffering an allergic reaction and gave her antihistamines. Over the next few nights the teenager, who has a sister, Sam, 17, and brother, Ben, 24, was unable to keep any food down and developed thrush on her tongue, which was caused by the antibiotics.
She went back to her GP who said she had a bacterial infection at the back of her throat and she was transferred to the hospital on December 19, where tests revealed she had glandular fever. Glandular fever is a type of viral infection that can cause fever, swollen glands, sore throat and fatigue.
Most patients recover without treatment, but in some cases the infection can spread to other parts of the body, causing more serious secondary infections such as pneumonia, meningitis or inflammation of the heart.
The Carters are waiting for the results of tests to discover what happened to their daughter. An inquest has been opened. Her funeral will take place on January 15, with a memorial service on January 24, which would have been her 16th birthday.
A spokesman for Worcestershire Royal Hospital said: 'The case has gone to the coroner so we have no further comment at this time.'
SOURCE
Dems brace for voter backlash on health
Democratic leaders are girding for a political war over the health care overhaul heading in to this year's midterm elections, preparing strategies and raising funds to fend off attacks by Republicans eager to capitalize on voter discontent.
Analysts from both parties predict the sweeping impact of the proposed health care changes, which will affect every American, to be the overriding issue, with the strongest and most personal impact in 2010.
Democratic leaders acknowledged this week in last-minute party fundraising appeals that they expect Republicans to come out with both guns blazing in pursuit of major gains in the House and Senate.
"They will spend the next 11 months spinning our health care victory into a weapon and hitting us with it. We might have the momentum now, but we must show the GOP and the pundits that we can sustain it until the 2010 elections," said Sen. Robert Menendez of New Jersey, chairman of the Democratic Senatorial Campaign Committee.
"Now that they lost this battle, they will be focusing their fight -- and their millions and millions of dollars -- on defeating us," he said.
National polls show strong opposition to the bills that have passed the House and Senate and now must be reconciled in a conference committee before facing a final vote. Polling data compiled by the Senate Republicans' campaign committee shows that Democrats are trailing their Republican challengers in every battleground state where opposition is strongest.
In the House, between a dozen and two dozen Democrats who voted for the bill are on their party's vulnerable list.
A Rasmussen poll conducted recently shows that Americans were opposed to the Democratic reforms by 55 percent to 40 percent, and think by a 54 percent to 24 percent margin that its enactment would make the quality of medical care worse. "Those figures have remained fairly consistent for months," Rasmussen said this week.
Democratic pollster Mark Mellman, in a strategy memo provided to Democratic senators last week, said the reason for the health care plan's unpopularity resulted from "voters knowing little about the substance of the plan" and the belief that those on the left remain unhappy with the Senate's decision to drop a government-run health insurance option.
Whatever is in the ultimate bill that Congress sends to President Obama next month for his certain signature, voters from all political persuasions will show their dissatisfaction at the ballot box, said health care policy analyst Grace-Marie Turner of the Galen Institute, a free-market think tank opposed to the reform.
SOURCE
Government health measures don't work
They look counterproductive, if anything
About 10 years ago, the government set some lofty health goals for the nation to reach by 2010. So how did we do? By many measures, not so hot. There are more obese Americans than a decade ago, not fewer. We eat more salt and fat, not less. More of us have high blood pressure. More of our children have untreated tooth decay. The nation has made at least some progress on many other goals. Vaccination rates improved. Most workplace injuries are down. And deaths rates from stroke, cancer and heart disease are all dropping.
As we move into a new decade, the government is analyzing how well the nation met the 2010 goals and drawing up a new set of goals for 2020 expected to be more numerous and -- perhaps -- less ambitious. "We need to strike a balance of setting targets that are achievable and also ask the country to reach," said Dr. Howard Koh, the federal health official who oversees the Healthy People project. "That's a balance that's sometimes a challenge to strike."
The Healthy People objectives were first created in the late 1970s to set an agenda for helping Americans to live longer, healthier lives. It was also an attempt to involve the public and emphasize that many health problems are preventable. Every 10 years, the U.S. Department of Health and Human Services reassesses the goals, and reports on progress made in the previous decade.
Many call the effort a success. The report has been imitated by states and other nations. Because of its importance within public health circles, interest groups jockey to add their goals to the document, which is expanding to more than 1,000 targets. And health agency workers have Healthy People goals memorized. "It is something that we think about all the time," said Dr. Lance Rodewald, a vaccination specialist at the U.S. Centers for Disease Control and Prevention.
But after more than 30 years, the goals aren't well-known to the public and only a modest number have been met. About 41 percent of the 1990 measurable goals were achieved. For the 2000 goals, it was just 24 percent. As for the 2010 goals, data is still being collected, and a final report is not due out until 2011. But it looks like the results will be in the neighborhood of 20 percent, according to a preliminary analysis by the CDC's National Center for Health Statistics. The CDC analysis done in the fall found that just 18 percent of those goals have been met so far. Worse, the nation actually retreated from about 23 percent of the goals.
Healthy People 2010 called for the percentage of adults who are obese to drop to 15 percent. That goal was set at a time when nearly a quarter of all adults were obese. Now, about 34 percent of adults are obese. Some other backslides:
• An estimated 28 percent of adults had high blood pressure in 2000. The goal was to reduce that to 16 percent. But the most recent government data say the proportion has risen to 29 percent.
• About 16 percent of young children had untreated tooth decay in 2000. The target was 9 percent. The latest statistic is about 20 percent.
• The proportion of births by Caesarean section increased despite a 2010 goal of lowering them, and the percentage of infants born very small and fragile also increased.
The nation has had better luck raising childhood vaccination rates, lowering cancer death rates, increasing smoking laws and reducing most types of work injuries.
SOURCE
ObamaCare on Drugs
A tax increase that will cause many seniors to lose private benefits
Democrats are starting to mash together the Senate and House health-care bills, all of the negotiations taking place in secret. One reason to keep quiet is so voters don't discover items like the Senate's destructive change in the way retiree health benefits are taxed. This is a revenue grab that will cost many retirees their private drug benefit coverage, with knock-on harm for the federal budget and financial markets.
When the Medicare prescription drug benefit was created in 2003, one concern was that businesses that provided private drug coverage for seniors would dump them into the new taxpayer-funded plan. So Congress created a modest tax subsidy—equal to 28% of the total cost of a drug plan—to encourage employers to maintain coverage for retirees who would otherwise enroll in Medicare. On average, this subsidy will cost the government about $665 per person in 2011, according to the Employee Benefit Research Institute, while the same Medicare coverage would run about $1,209.
Currently, the $665 a business gains by providing benefits—and keeping one senior off Medicare—is not taxed. By instead treating the subsidy as income taxed at the 35% corporate rate, Democrats expect to raise about $5.4 billion for ObamaCare—and while that's a pittance in the scheme of a new multitrillion-dollar price tag, it's also based on a static tax analysis that is surely wrong.
The cost of offering drug benefits will rise by about $233 per retiree, making Medicare a far more attractive option for businesses. Private drug coverage is already on the decline, but Verizon, Xerox, Boeing, Metlife, Caterpillar and other companies are already warning that they may be forced to cut benefits. (Consider this another reward for the Business Roundtable's decision to promote ObamaCare.)
As more employers drop drug coverage, Congress won't be dispensing as many subsidies with the one hand that it can tax with the other, so revenue will fall. The retirees who lose private benefits will simply move onto Medicare, so public drug spending will also rise. The American Benefits Council, which represents the largest employers, estimates the tax will be a net loser for the government if just one out of four retirees is crowded out of private coverage.
That $233 may not sound like a lot, but under an accounting rule established in 1990, companies are required to report and expense their long-term retiree health liabilities on their financial statements, including actual paid claims and certain future payments. The deferred losses from the tax change thus must be immediately reflected on their balance sheets, which would take a huge bite out of reported earnings in 2010. Given the shaky economy, not to mention the political uncertainty that Washington continues to generate, is this really the best idea?
This is merely one example of how careless Democrats have been about the details as they dash to pass ObamaCare, even as they behave as if the results of their major changes to the health market will match perfectly with their perfectly unrealistic rhetoric.
"One of the things I've learned is that the Econ 101 approach to life where all that matters is the direct financial incentives or penalties is just wrong," Obama budget director Peter Orszag said in December. "Not to say that it doesn't matter, but exclusive focus on rational, perfectly optimizing behavior is just not, not where it's at."
When even the budget scorekeeper spurns economic incentives, you know pure politics is in charge. We suspect the White House will discover soon enough that everyone is a lot more rational, and a lot smarter, that it presumes.
SOURCE
The New Health Care Reform and Blacks
A comment from the Left
There was a lot of cheering and back slapping last week when President Obama and the Democratic Party leadership in the Senate pushed through legislation reforming the nation’s health care system. The legislation passed with no support from conservative Republicans who essentially offered no alternative but instead simply tried to kill what Obama and the Democrats were pushing.
The reform is not yet law. The Senate version of health care reform must now be reconciled with the version passed earlier by the House of Representatives. Regardless, the fundamental elements of the reform which will most likely emerge in early 2010 are clear. We at Taylor Media Services have reached the following general conclusion: “Obamacare” represents a step in the right direction. It pushes America closer to major European nations and Canada where health care is virtually universal.
Indeed, what Obama has accomplished is a step which America should have taken nearly 40 years ag Virtually all Americans will be covered by some form of health insurance. Among the estimated 47 million people currently without health insurance, only about 17 million will be left uncovered. Perhaps even more importantly Obama forced acceptance of the basic principle that in the richest nation, it was a travesty of justice and fairness that all Americans did not have affordable health care.
Now, for the bad news. In order to get moderate Democrats to support the reforms, Obama and Democratic Party leadership had to compromise to a degree that significantly undermined real reform. Simply put, the reformers compromised far too much with the very major corporations which caused our health care crisis in the first place. The chief wrong is that there in nothing in the legislation which will work to force down health care costs.
This is because the “public option” will be eliminated. The so-called public option was a low-cost government health care insurance program which would have competed with the big insurance companies and would have worked to force down health care costs. But in order to get major private insurers to support the bill, the public option was dropped thus making sure that the major insurance companies will continue to make insane profits.
Indeed, by requiring that roughly 30 million new Americans buy private health insurance, the legislation will actually make the insurance giants richer. Further, in order to get the big pharmaceutical companies on board, an amendment which would have allowed the legal importation of cheaper drugs from Canada was dropped. Thus, the big drug companies will continue to be able to rake in their insane profits.
The bottom line is that there will be an increase in the number of people with health insurance but all provisions which might have worked to hold prices in place or even force them down were stripped from the bill. Thus, as a nation we will end up slightly healthier but poorer as the already rich soak more money from our pockets.
Finally, there is nothing in the legislation which will work to close the various health gaps between whites and minorities, especially poor minorities. Thus, from diabetes to cancer to heart disease, Blacks will continue to die at faster rates than whites.
All in all, Obamacare moves America in the right direction by taking an important step to putting all Americans under the health care insurance blanket. But it was just a wobbly baby step not a giant leap. Doing too much to satisfy the wants of the giant insurance, pharmaceutical and medical care companies undermined the bill and if history is a guide, it may take years, if not decades, to correct the bill’s wrongs.
SOURCE
How ObamaCare Will Work
The Mayo Clinic has dropped Medicare patients at its Glendale, Arizona clinic -- which means that if those on Medicare want to continue seeing their doctors, they will have to pay out of pocket (so much for the promises about being able to keep your doctor, at least if you're on Medicare!).
This is a warning to all those anticipating the brave new world of ObamaCare. Given all the cuts coming to Medicare to balance the bills costs, many phusicians simply won't be able to afford to see Medicare patients -- the government will be paying them too little to do so.
Contrary to what Democrats want you to believe, the government cannot simply mandate the payments that doctors will receive, without regard to market forces. If they continue to try to do so -- and drive private insurers out of business -- the results will be: Rationing. That's because doctors who can't make a decent living will quit, medical care will be scarcer, and it will be allocated on whatever basis government bureaucrats decide to use.
That may be fine for the government insiders, but it's going to be terrible for ordinary Americans. Let's hope this isn't the shape of things to come -- but it's a lot more likely if ObamaCare becomes law.
SOURCE
A girl of 15 died on Christmas Eve from a series of heart attacks just days after begging doctors to keep her in hospital because she felt so ill. Amy Carter lost a stone in weight over a week after initially falling sick with flu-like symptoms at the start of December. However, she was discharged from hospital after tests showed she was suffering from glandular fever.
Richard and Jacqueline Carter said their daughter had asked a doctor at the Worcestershire Royal Hospital in Worcester: 'Am I going to die?' They said the doctor replied: 'Of course not, don't be silly it's a nasty illness but it's certainly not life-threatening.' She was discharged on December 21, two days after she was admitted, and told to take paracetamol and have plenty of rest.
But the next day, Amy was struggling to breathe and was taken to an out-of-hours care centre where a doctor sent her away with instructions to drink lots of fluid.
On the morning of Christmas Eve, her worried parents called their GP, who said Amy's condition was 'critical' and called an ambulance. Despite being given five adrenalin shots into her heart – one for each cardiac arrest – she died just hours later in hospital.
Mrs Carter, 48, from Stourport-on-Severn, Worcestershire said: 'I'm not medically trained but even I could tell she was seriously ill. 'She hadn't eaten for weeks and lost more than a stone. 'We're extremely bitter and feel we have been let down. Her organs basically all failed one by one and her heart was the last to go. 'She was a healthy girl who should never have died.'
Mr Carter, 43, said: 'Amy was very frightened and really did not want to be moved out of hospital. Her condition was deteriorating every day. She knew something was wrong but the doctors refused to listen to her.'
When Amy first fell ill around four weeks ago, her parents, who both run pet shops, took her to the care centre attached to their nearest hospital in Kidderminster. A doctor said she had sinusitis – an inflammatory condition of the sinuses – and sent Amy home with a one-week course of antibiotics.
Days later her eyes swelled up and Amy was taken to her GP, who said she was suffering an allergic reaction and gave her antihistamines. Over the next few nights the teenager, who has a sister, Sam, 17, and brother, Ben, 24, was unable to keep any food down and developed thrush on her tongue, which was caused by the antibiotics.
She went back to her GP who said she had a bacterial infection at the back of her throat and she was transferred to the hospital on December 19, where tests revealed she had glandular fever. Glandular fever is a type of viral infection that can cause fever, swollen glands, sore throat and fatigue.
Most patients recover without treatment, but in some cases the infection can spread to other parts of the body, causing more serious secondary infections such as pneumonia, meningitis or inflammation of the heart.
The Carters are waiting for the results of tests to discover what happened to their daughter. An inquest has been opened. Her funeral will take place on January 15, with a memorial service on January 24, which would have been her 16th birthday.
A spokesman for Worcestershire Royal Hospital said: 'The case has gone to the coroner so we have no further comment at this time.'
SOURCE
Dems brace for voter backlash on health
Democratic leaders are girding for a political war over the health care overhaul heading in to this year's midterm elections, preparing strategies and raising funds to fend off attacks by Republicans eager to capitalize on voter discontent.
Analysts from both parties predict the sweeping impact of the proposed health care changes, which will affect every American, to be the overriding issue, with the strongest and most personal impact in 2010.
Democratic leaders acknowledged this week in last-minute party fundraising appeals that they expect Republicans to come out with both guns blazing in pursuit of major gains in the House and Senate.
"They will spend the next 11 months spinning our health care victory into a weapon and hitting us with it. We might have the momentum now, but we must show the GOP and the pundits that we can sustain it until the 2010 elections," said Sen. Robert Menendez of New Jersey, chairman of the Democratic Senatorial Campaign Committee.
"Now that they lost this battle, they will be focusing their fight -- and their millions and millions of dollars -- on defeating us," he said.
National polls show strong opposition to the bills that have passed the House and Senate and now must be reconciled in a conference committee before facing a final vote. Polling data compiled by the Senate Republicans' campaign committee shows that Democrats are trailing their Republican challengers in every battleground state where opposition is strongest.
In the House, between a dozen and two dozen Democrats who voted for the bill are on their party's vulnerable list.
A Rasmussen poll conducted recently shows that Americans were opposed to the Democratic reforms by 55 percent to 40 percent, and think by a 54 percent to 24 percent margin that its enactment would make the quality of medical care worse. "Those figures have remained fairly consistent for months," Rasmussen said this week.
Democratic pollster Mark Mellman, in a strategy memo provided to Democratic senators last week, said the reason for the health care plan's unpopularity resulted from "voters knowing little about the substance of the plan" and the belief that those on the left remain unhappy with the Senate's decision to drop a government-run health insurance option.
Whatever is in the ultimate bill that Congress sends to President Obama next month for his certain signature, voters from all political persuasions will show their dissatisfaction at the ballot box, said health care policy analyst Grace-Marie Turner of the Galen Institute, a free-market think tank opposed to the reform.
SOURCE
Government health measures don't work
They look counterproductive, if anything
About 10 years ago, the government set some lofty health goals for the nation to reach by 2010. So how did we do? By many measures, not so hot. There are more obese Americans than a decade ago, not fewer. We eat more salt and fat, not less. More of us have high blood pressure. More of our children have untreated tooth decay. The nation has made at least some progress on many other goals. Vaccination rates improved. Most workplace injuries are down. And deaths rates from stroke, cancer and heart disease are all dropping.
As we move into a new decade, the government is analyzing how well the nation met the 2010 goals and drawing up a new set of goals for 2020 expected to be more numerous and -- perhaps -- less ambitious. "We need to strike a balance of setting targets that are achievable and also ask the country to reach," said Dr. Howard Koh, the federal health official who oversees the Healthy People project. "That's a balance that's sometimes a challenge to strike."
The Healthy People objectives were first created in the late 1970s to set an agenda for helping Americans to live longer, healthier lives. It was also an attempt to involve the public and emphasize that many health problems are preventable. Every 10 years, the U.S. Department of Health and Human Services reassesses the goals, and reports on progress made in the previous decade.
Many call the effort a success. The report has been imitated by states and other nations. Because of its importance within public health circles, interest groups jockey to add their goals to the document, which is expanding to more than 1,000 targets. And health agency workers have Healthy People goals memorized. "It is something that we think about all the time," said Dr. Lance Rodewald, a vaccination specialist at the U.S. Centers for Disease Control and Prevention.
But after more than 30 years, the goals aren't well-known to the public and only a modest number have been met. About 41 percent of the 1990 measurable goals were achieved. For the 2000 goals, it was just 24 percent. As for the 2010 goals, data is still being collected, and a final report is not due out until 2011. But it looks like the results will be in the neighborhood of 20 percent, according to a preliminary analysis by the CDC's National Center for Health Statistics. The CDC analysis done in the fall found that just 18 percent of those goals have been met so far. Worse, the nation actually retreated from about 23 percent of the goals.
Healthy People 2010 called for the percentage of adults who are obese to drop to 15 percent. That goal was set at a time when nearly a quarter of all adults were obese. Now, about 34 percent of adults are obese. Some other backslides:
• An estimated 28 percent of adults had high blood pressure in 2000. The goal was to reduce that to 16 percent. But the most recent government data say the proportion has risen to 29 percent.
• About 16 percent of young children had untreated tooth decay in 2000. The target was 9 percent. The latest statistic is about 20 percent.
• The proportion of births by Caesarean section increased despite a 2010 goal of lowering them, and the percentage of infants born very small and fragile also increased.
The nation has had better luck raising childhood vaccination rates, lowering cancer death rates, increasing smoking laws and reducing most types of work injuries.
SOURCE
ObamaCare on Drugs
A tax increase that will cause many seniors to lose private benefits
Democrats are starting to mash together the Senate and House health-care bills, all of the negotiations taking place in secret. One reason to keep quiet is so voters don't discover items like the Senate's destructive change in the way retiree health benefits are taxed. This is a revenue grab that will cost many retirees their private drug benefit coverage, with knock-on harm for the federal budget and financial markets.
When the Medicare prescription drug benefit was created in 2003, one concern was that businesses that provided private drug coverage for seniors would dump them into the new taxpayer-funded plan. So Congress created a modest tax subsidy—equal to 28% of the total cost of a drug plan—to encourage employers to maintain coverage for retirees who would otherwise enroll in Medicare. On average, this subsidy will cost the government about $665 per person in 2011, according to the Employee Benefit Research Institute, while the same Medicare coverage would run about $1,209.
Currently, the $665 a business gains by providing benefits—and keeping one senior off Medicare—is not taxed. By instead treating the subsidy as income taxed at the 35% corporate rate, Democrats expect to raise about $5.4 billion for ObamaCare—and while that's a pittance in the scheme of a new multitrillion-dollar price tag, it's also based on a static tax analysis that is surely wrong.
The cost of offering drug benefits will rise by about $233 per retiree, making Medicare a far more attractive option for businesses. Private drug coverage is already on the decline, but Verizon, Xerox, Boeing, Metlife, Caterpillar and other companies are already warning that they may be forced to cut benefits. (Consider this another reward for the Business Roundtable's decision to promote ObamaCare.)
As more employers drop drug coverage, Congress won't be dispensing as many subsidies with the one hand that it can tax with the other, so revenue will fall. The retirees who lose private benefits will simply move onto Medicare, so public drug spending will also rise. The American Benefits Council, which represents the largest employers, estimates the tax will be a net loser for the government if just one out of four retirees is crowded out of private coverage.
That $233 may not sound like a lot, but under an accounting rule established in 1990, companies are required to report and expense their long-term retiree health liabilities on their financial statements, including actual paid claims and certain future payments. The deferred losses from the tax change thus must be immediately reflected on their balance sheets, which would take a huge bite out of reported earnings in 2010. Given the shaky economy, not to mention the political uncertainty that Washington continues to generate, is this really the best idea?
This is merely one example of how careless Democrats have been about the details as they dash to pass ObamaCare, even as they behave as if the results of their major changes to the health market will match perfectly with their perfectly unrealistic rhetoric.
"One of the things I've learned is that the Econ 101 approach to life where all that matters is the direct financial incentives or penalties is just wrong," Obama budget director Peter Orszag said in December. "Not to say that it doesn't matter, but exclusive focus on rational, perfectly optimizing behavior is just not, not where it's at."
When even the budget scorekeeper spurns economic incentives, you know pure politics is in charge. We suspect the White House will discover soon enough that everyone is a lot more rational, and a lot smarter, that it presumes.
SOURCE
The New Health Care Reform and Blacks
A comment from the Left
There was a lot of cheering and back slapping last week when President Obama and the Democratic Party leadership in the Senate pushed through legislation reforming the nation’s health care system. The legislation passed with no support from conservative Republicans who essentially offered no alternative but instead simply tried to kill what Obama and the Democrats were pushing.
The reform is not yet law. The Senate version of health care reform must now be reconciled with the version passed earlier by the House of Representatives. Regardless, the fundamental elements of the reform which will most likely emerge in early 2010 are clear. We at Taylor Media Services have reached the following general conclusion: “Obamacare” represents a step in the right direction. It pushes America closer to major European nations and Canada where health care is virtually universal.
Indeed, what Obama has accomplished is a step which America should have taken nearly 40 years ag Virtually all Americans will be covered by some form of health insurance. Among the estimated 47 million people currently without health insurance, only about 17 million will be left uncovered. Perhaps even more importantly Obama forced acceptance of the basic principle that in the richest nation, it was a travesty of justice and fairness that all Americans did not have affordable health care.
Now, for the bad news. In order to get moderate Democrats to support the reforms, Obama and Democratic Party leadership had to compromise to a degree that significantly undermined real reform. Simply put, the reformers compromised far too much with the very major corporations which caused our health care crisis in the first place. The chief wrong is that there in nothing in the legislation which will work to force down health care costs.
This is because the “public option” will be eliminated. The so-called public option was a low-cost government health care insurance program which would have competed with the big insurance companies and would have worked to force down health care costs. But in order to get major private insurers to support the bill, the public option was dropped thus making sure that the major insurance companies will continue to make insane profits.
Indeed, by requiring that roughly 30 million new Americans buy private health insurance, the legislation will actually make the insurance giants richer. Further, in order to get the big pharmaceutical companies on board, an amendment which would have allowed the legal importation of cheaper drugs from Canada was dropped. Thus, the big drug companies will continue to be able to rake in their insane profits.
The bottom line is that there will be an increase in the number of people with health insurance but all provisions which might have worked to hold prices in place or even force them down were stripped from the bill. Thus, as a nation we will end up slightly healthier but poorer as the already rich soak more money from our pockets.
Finally, there is nothing in the legislation which will work to close the various health gaps between whites and minorities, especially poor minorities. Thus, from diabetes to cancer to heart disease, Blacks will continue to die at faster rates than whites.
All in all, Obamacare moves America in the right direction by taking an important step to putting all Americans under the health care insurance blanket. But it was just a wobbly baby step not a giant leap. Doing too much to satisfy the wants of the giant insurance, pharmaceutical and medical care companies undermined the bill and if history is a guide, it may take years, if not decades, to correct the bill’s wrongs.
SOURCE
How ObamaCare Will Work
The Mayo Clinic has dropped Medicare patients at its Glendale, Arizona clinic -- which means that if those on Medicare want to continue seeing their doctors, they will have to pay out of pocket (so much for the promises about being able to keep your doctor, at least if you're on Medicare!).
This is a warning to all those anticipating the brave new world of ObamaCare. Given all the cuts coming to Medicare to balance the bills costs, many phusicians simply won't be able to afford to see Medicare patients -- the government will be paying them too little to do so.
Contrary to what Democrats want you to believe, the government cannot simply mandate the payments that doctors will receive, without regard to market forces. If they continue to try to do so -- and drive private insurers out of business -- the results will be: Rationing. That's because doctors who can't make a decent living will quit, medical care will be scarcer, and it will be allocated on whatever basis government bureaucrats decide to use.
That may be fine for the government insiders, but it's going to be terrible for ordinary Americans. Let's hope this isn't the shape of things to come -- but it's a lot more likely if ObamaCare becomes law.
SOURCE
Friday, January 01, 2010
Chief of British death panel gets a knighthood
The controversial head of the Government body which rations NHS drugs and treatments is today knighted despite patient anger over his organisation’s decisions. Andrew Dillon, chief executive of the National Institute for Health and Clinical Excellence (Nice), received the honour for “services to healthcare”.
Nice is responsible for assessing the cost effectiveness of drugs available on the NHS and has been widely criticised for blocking or delaying potentially life-saving treatments.
Nice has been particularly criticised for blocking access to some Alzheimer’s drugs. Mr Dillon was the founding head of the organisation more than a decade ago and is widely respected in Whitehall for his considered handling of his controversial brief.
Other senior health officials also receive knighthoods. They include Professional Michael Richards, the Government’s cancer tsar responsible for developing the country’s cancer plan. David Nicholson, the chief executive of the NHS, also becomes a knight.
SOURCE
NHS not looking good for the new year
The scale of NHS cuts will become apparent as the year progresses. Already hospitals have been told that they will receive no increase in the amount of money that they are paid per procedure, essentially a real terms cut in the cash they will receive. Overall, the health service has also been set a goal to make between £15 million and £20 million of efficiency savings over the next four years.
The fact that McKinsey, the management consultancy firm, estimates that to achieve such that a goal would take making 10 per cent of NHS staff redundant and abandoning procedures such as varicose vein operations suggests the scale of the challenge.
Nice: Patients' groups will continue to keep a close eye on the Government’s drugs rationing body in 2010. Over the last year the National Institute for Health and Clinical Excellence (Nice) began looking more favourably on drugs which prolong life for terminal patients, as it was instructed to do so by Government.
2009 also saw a number of drug companies come forward with innovative deals that allowed the NHS to pay less for some medicines. But with expensive drugs for cancer and other illnesses coming through the pharmaceutical pipeline at all times patients will continue to monitor how Nice makes decisions about which drugs it will allow on the NHS.
Obesity: The Government will scale up its Change4Life campaign, which so far has concentrated on children and families, to focus on adult obesity. Despite data which suggests that rises in childhood obesity could be levelling off, ministers and health planners are still worried about the strain on the NHS if predictions that half of adults could be heavily overweight by 2050 come true.
SOURCE
Mayo Clinic in Arizona to Stop Treating Some Medicare Patients
The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.
More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.
Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering “the highest quality care at costs well below the national norm.” Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.
“Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”
Medicare Loss
The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.
Mayo’s hospital and four clinics in Arizona, including the Glendale facility, lost $120 million on Medicare patients last year, Yardley said. The program’s payments cover about 50 percent of the cost of treating elderly primary-care patients at the Glendale clinic, he said. “We firmly believe that Medicare needs to be reformed,” Yardley said in a Dec. 23 e-mail. “It has been true for many years that Medicare payments no longer reflect the increasing cost of providing services for patients.” Mayo will assess the financial effect of the decision in Glendale to drop Medicare patients “to see if it could have implications beyond Arizona,” he said.
Nationwide, doctors made about 20 percent less for treating Medicare patients than they did caring for privately insured patients in 2007, a payment gap that has remained stable during the last decade, according to a March report by the Medicare Payment Advisory Commission, a panel that advises Congress on Medicare issues. Congress last week postponed for two months a 21.5 percent cut in Medicare reimbursements for doctors.
National Participation
Medicare covered an estimated 45 million Americans at the end of 2008, according to the Centers for Medicare & Medicaid Services, the agency in charge of the programs. While 92 percent of U.S. family doctors participate in Medicare, only 73 percent of those are accepting new patients under the program, said Heim of the national physicians’ group, citing surveys by the Leawood, Kansas-based organization.
Greater access to primary care is a goal of the broad overhaul supported by Obama that would provide health insurance to about 31 million more Americans. More family doctors are needed to help reduce medical costs by encouraging prevention and early treatment, Obama said in a June 15 speech to the American Medical Association meeting in Chicago. Reid Cherlin, a White House spokesman for health care, declined comment on Mayo’s decision to drop Medicare primary care patients at its Glendale clinic.
Medicare Costs
Mayo’s Medicare losses in Arizona may be worse than typical for doctors across the U.S., Heim said. Physician costs vary depending on business expenses such as office rent and payroll. “It is very common that we hear that Medicare is below costs or barely covering costs,” Heim said.
Mayo will continue to accept Medicare as payment for laboratory services and specialist care such as cardiology and neurology, Yardley said.
Robert Berenson, a fellow at the Urban Institute’s Health Policy Center in Washington, D.C., said physicians’ claims of inadequate reimbursement are overstated. Rather, the program faces a lack of medical providers because not enough new doctors are becoming family doctors, internists and pediatricians who oversee patients’ primary care. “Some primary care doctors don’t have to see Medicare patients because there is an unlimited demand for their services,” Berenson said. When patients with private insurance can be treated at 50 percent to 100 percent higher fees, “then Medicare does indeed look like a poor payer,” he said.
Annual Costs
A Medicare patient who chooses to stay at Mayo’s Glendale clinic will pay about $1,500 a year for an annual physical and three other doctor visits, according to an October letter from the facility. Each patient also will be assessed a $250 annual administrative fee, according to the letter. Medicare patients at the Glendale clinic won’t be allowed to switch to a primary care doctor at another Mayo facility.
A few hundred of the clinic’s Medicare patients have decided to pay cash to continue seeing their primary care doctors, Yardley said. Mayo is helping other patients find new physicians who will accept Medicare. “We’ve had many patients call us and express their unhappiness,” he said. “It’s not been a pleasant experience.”
Mayo’s decision may herald similar moves by other Phoenix- area doctors who cite inadequate Medicare fees as a reason to curtail treatment of the elderly, said John Rivers, chief executive of the Phoenix-based Arizona Hospital and Healthcare Association. “We’ve got doctors who are saying we are not going to deal with Medicare patients in the hospital” because they consider the fees too low, Rivers said. “Or they are saying we are not going to take new ones in our practice.”
SOURCE
13 GOP AGs threaten health bill suit
Thirteen Republican state attorneys general are threatening to file a lawsuit challenging the constitutionality of the Senate health care bill.
In a letter sent to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid on Wednesday, South Carolina Attorney General Henry McMaster said he had “grave concerns” about the deal Senate leaders cut with Sen. Ben Nelson (D-Neb.) to secure his crucial vote for the health care package.
“The current iteration of the bill contains a provision that affords special treatment to the state of Nebraska under the federal Medicaid program,” writes McMaster. “We believe this provision is constitutionally flawed. As chief legal officers of our states we are contemplating a legal challenge to this provision and we ask you to take action to render this challenge unnecessary by striking that provision.”
“In addition to violating the most basic and universally held notions of what is fair and just, we also believe this provision of H.R. 3590 is inconsistent with protections afforded by the United States Constitution against arbitrary legislation,” writes McMaster.
Under the terms of the agreement with Nelson, the federal government will pick up the full tab for all new Medicaid enrollees in Nebraska, a deal that’s expected to cost about $100 million over the next 10 years.
In the letter, McMaster argues that the Nebraska provision should be removed in the upcoming conference committee negotiations.
“We ask that Congress delete the Nebraska provision from the pending legislation, as we prefer to avoid litigation,” writes McMaster. “Because this provision has serious implications for the country and the future of our nation’s legislative process, we urge you to take appropriate steps to protect the Constitution and the rights of the citizens of our nation. We believe this issue is readily resolved by removing the provision in question from the bill, and we ask that you do so.”
Democrats have derided the legal analysis as politically motivated. Several of the state attorneys general that signed the letter — including McMaster — are running for governor.
SOURCE
Yes, Someone Has To Pay for Health Care
Most Americans already have health care insurance, but many middle-class Americans are afraid of losing what they have. The fear is especially profound when a person can work hard and steadily for years, only to find him-or-herself suddenly out of a job and without the means to pay for a costly illness.
There have been too many horror stories about people who responsibly buy personal health plans, only to find out that the plans don't really cover large medical bills. If a person gets a job that provides health care benefits, his or her current health problems may not be covered because they are pre-existing conditions. Washington's catchphrase for the above situation has been, as the fiscal-watchdog group the Concord Coalition wrote in its recent report on health care reform, "doing nothing is not a responsible option."
The other half of the equation, however, is, as the report continued, "It does not follow, however, that doing anything would improve the situation." Alas, doing anything seems to be the one thing at which Washington excels.
Now, I've got issues with the bills passed in the House and Senate when Speaker Nancy Pelosi and Majority Leader Harry Reid kept tossing in benefits while promising to reduce the country's health care tab.
But my new fear is that during conference committee, lawmakers will throw in even more goodies and then, to make everybody happy, reduce the tax increases necessary to fund the plan. The closer they come to President Obama's 2008 campaign rhetoric -- universal health care that only rich people pay for -- the more red ink they will pass on to the next generation.
The House proposes a 5.4 percent tax on workers earning more than $500,000 annually, or $1 million for couples. The Senate relies heavily on what is called hide-the-tax -- excise tax on so-called Cadillac health care plans. The Senate also would increase Medicare taxes on families earning more than $250,000.
The problem with soaking the rich to pay for a health care plan? This is the fastest-shrinking tax imaginable when the economy sours. If California can serve any useful function in this debate, it should be as a warning to the dangers of over-relying on taxes on the rich.
Besides, as the Concord Coalition noted, broadly based taxes "spread the notion that all must contribute something for government benefits -- imposing an important breaker against 'free lunch' spending giveaways." Hence the coalition's support for the tax on so-called Cadillac health care.
While critics on the left complain that the Cadillac tax will squeeze union workers and the middle-class, I have issues with taxing those with health care benefits to pay for those who don't. Better to pass a value-added tax, but at least this excise eventually would make everyone pay for a universal benefit.
Concord Coalition Policy Director Josh Gordon believes, "Once people start feeling the cost of their insurance, they start getting concerned about premiums being too high." He added that if negotiators remove the Senate excise-tax and cost-control measures, the Concord Coalition would have to brand a final bill as "irresponsible legislation."
Note to anti-tax Republicans: If Washington passes a bill, someone has to pay for it. The only question is who, when and how much. Note to soak-the-richers: You can't say that universal health care is a moral imperative, but only other people should pay for it.
SOURCE
The controversial head of the Government body which rations NHS drugs and treatments is today knighted despite patient anger over his organisation’s decisions. Andrew Dillon, chief executive of the National Institute for Health and Clinical Excellence (Nice), received the honour for “services to healthcare”.
Nice is responsible for assessing the cost effectiveness of drugs available on the NHS and has been widely criticised for blocking or delaying potentially life-saving treatments.
Nice has been particularly criticised for blocking access to some Alzheimer’s drugs. Mr Dillon was the founding head of the organisation more than a decade ago and is widely respected in Whitehall for his considered handling of his controversial brief.
Other senior health officials also receive knighthoods. They include Professional Michael Richards, the Government’s cancer tsar responsible for developing the country’s cancer plan. David Nicholson, the chief executive of the NHS, also becomes a knight.
SOURCE
NHS not looking good for the new year
The scale of NHS cuts will become apparent as the year progresses. Already hospitals have been told that they will receive no increase in the amount of money that they are paid per procedure, essentially a real terms cut in the cash they will receive. Overall, the health service has also been set a goal to make between £15 million and £20 million of efficiency savings over the next four years.
The fact that McKinsey, the management consultancy firm, estimates that to achieve such that a goal would take making 10 per cent of NHS staff redundant and abandoning procedures such as varicose vein operations suggests the scale of the challenge.
Nice: Patients' groups will continue to keep a close eye on the Government’s drugs rationing body in 2010. Over the last year the National Institute for Health and Clinical Excellence (Nice) began looking more favourably on drugs which prolong life for terminal patients, as it was instructed to do so by Government.
2009 also saw a number of drug companies come forward with innovative deals that allowed the NHS to pay less for some medicines. But with expensive drugs for cancer and other illnesses coming through the pharmaceutical pipeline at all times patients will continue to monitor how Nice makes decisions about which drugs it will allow on the NHS.
Obesity: The Government will scale up its Change4Life campaign, which so far has concentrated on children and families, to focus on adult obesity. Despite data which suggests that rises in childhood obesity could be levelling off, ministers and health planners are still worried about the strain on the NHS if predictions that half of adults could be heavily overweight by 2050 come true.
SOURCE
Mayo Clinic in Arizona to Stop Treating Some Medicare Patients
The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.
More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.
Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering “the highest quality care at costs well below the national norm.” Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.
“Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”
Medicare Loss
The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.
Mayo’s hospital and four clinics in Arizona, including the Glendale facility, lost $120 million on Medicare patients last year, Yardley said. The program’s payments cover about 50 percent of the cost of treating elderly primary-care patients at the Glendale clinic, he said. “We firmly believe that Medicare needs to be reformed,” Yardley said in a Dec. 23 e-mail. “It has been true for many years that Medicare payments no longer reflect the increasing cost of providing services for patients.” Mayo will assess the financial effect of the decision in Glendale to drop Medicare patients “to see if it could have implications beyond Arizona,” he said.
Nationwide, doctors made about 20 percent less for treating Medicare patients than they did caring for privately insured patients in 2007, a payment gap that has remained stable during the last decade, according to a March report by the Medicare Payment Advisory Commission, a panel that advises Congress on Medicare issues. Congress last week postponed for two months a 21.5 percent cut in Medicare reimbursements for doctors.
National Participation
Medicare covered an estimated 45 million Americans at the end of 2008, according to the Centers for Medicare & Medicaid Services, the agency in charge of the programs. While 92 percent of U.S. family doctors participate in Medicare, only 73 percent of those are accepting new patients under the program, said Heim of the national physicians’ group, citing surveys by the Leawood, Kansas-based organization.
Greater access to primary care is a goal of the broad overhaul supported by Obama that would provide health insurance to about 31 million more Americans. More family doctors are needed to help reduce medical costs by encouraging prevention and early treatment, Obama said in a June 15 speech to the American Medical Association meeting in Chicago. Reid Cherlin, a White House spokesman for health care, declined comment on Mayo’s decision to drop Medicare primary care patients at its Glendale clinic.
Medicare Costs
Mayo’s Medicare losses in Arizona may be worse than typical for doctors across the U.S., Heim said. Physician costs vary depending on business expenses such as office rent and payroll. “It is very common that we hear that Medicare is below costs or barely covering costs,” Heim said.
Mayo will continue to accept Medicare as payment for laboratory services and specialist care such as cardiology and neurology, Yardley said.
Robert Berenson, a fellow at the Urban Institute’s Health Policy Center in Washington, D.C., said physicians’ claims of inadequate reimbursement are overstated. Rather, the program faces a lack of medical providers because not enough new doctors are becoming family doctors, internists and pediatricians who oversee patients’ primary care. “Some primary care doctors don’t have to see Medicare patients because there is an unlimited demand for their services,” Berenson said. When patients with private insurance can be treated at 50 percent to 100 percent higher fees, “then Medicare does indeed look like a poor payer,” he said.
Annual Costs
A Medicare patient who chooses to stay at Mayo’s Glendale clinic will pay about $1,500 a year for an annual physical and three other doctor visits, according to an October letter from the facility. Each patient also will be assessed a $250 annual administrative fee, according to the letter. Medicare patients at the Glendale clinic won’t be allowed to switch to a primary care doctor at another Mayo facility.
A few hundred of the clinic’s Medicare patients have decided to pay cash to continue seeing their primary care doctors, Yardley said. Mayo is helping other patients find new physicians who will accept Medicare. “We’ve had many patients call us and express their unhappiness,” he said. “It’s not been a pleasant experience.”
Mayo’s decision may herald similar moves by other Phoenix- area doctors who cite inadequate Medicare fees as a reason to curtail treatment of the elderly, said John Rivers, chief executive of the Phoenix-based Arizona Hospital and Healthcare Association. “We’ve got doctors who are saying we are not going to deal with Medicare patients in the hospital” because they consider the fees too low, Rivers said. “Or they are saying we are not going to take new ones in our practice.”
SOURCE
13 GOP AGs threaten health bill suit
Thirteen Republican state attorneys general are threatening to file a lawsuit challenging the constitutionality of the Senate health care bill.
In a letter sent to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid on Wednesday, South Carolina Attorney General Henry McMaster said he had “grave concerns” about the deal Senate leaders cut with Sen. Ben Nelson (D-Neb.) to secure his crucial vote for the health care package.
“The current iteration of the bill contains a provision that affords special treatment to the state of Nebraska under the federal Medicaid program,” writes McMaster. “We believe this provision is constitutionally flawed. As chief legal officers of our states we are contemplating a legal challenge to this provision and we ask you to take action to render this challenge unnecessary by striking that provision.”
“In addition to violating the most basic and universally held notions of what is fair and just, we also believe this provision of H.R. 3590 is inconsistent with protections afforded by the United States Constitution against arbitrary legislation,” writes McMaster.
Under the terms of the agreement with Nelson, the federal government will pick up the full tab for all new Medicaid enrollees in Nebraska, a deal that’s expected to cost about $100 million over the next 10 years.
In the letter, McMaster argues that the Nebraska provision should be removed in the upcoming conference committee negotiations.
“We ask that Congress delete the Nebraska provision from the pending legislation, as we prefer to avoid litigation,” writes McMaster. “Because this provision has serious implications for the country and the future of our nation’s legislative process, we urge you to take appropriate steps to protect the Constitution and the rights of the citizens of our nation. We believe this issue is readily resolved by removing the provision in question from the bill, and we ask that you do so.”
Democrats have derided the legal analysis as politically motivated. Several of the state attorneys general that signed the letter — including McMaster — are running for governor.
SOURCE
Yes, Someone Has To Pay for Health Care
Most Americans already have health care insurance, but many middle-class Americans are afraid of losing what they have. The fear is especially profound when a person can work hard and steadily for years, only to find him-or-herself suddenly out of a job and without the means to pay for a costly illness.
There have been too many horror stories about people who responsibly buy personal health plans, only to find out that the plans don't really cover large medical bills. If a person gets a job that provides health care benefits, his or her current health problems may not be covered because they are pre-existing conditions. Washington's catchphrase for the above situation has been, as the fiscal-watchdog group the Concord Coalition wrote in its recent report on health care reform, "doing nothing is not a responsible option."
The other half of the equation, however, is, as the report continued, "It does not follow, however, that doing anything would improve the situation." Alas, doing anything seems to be the one thing at which Washington excels.
Now, I've got issues with the bills passed in the House and Senate when Speaker Nancy Pelosi and Majority Leader Harry Reid kept tossing in benefits while promising to reduce the country's health care tab.
But my new fear is that during conference committee, lawmakers will throw in even more goodies and then, to make everybody happy, reduce the tax increases necessary to fund the plan. The closer they come to President Obama's 2008 campaign rhetoric -- universal health care that only rich people pay for -- the more red ink they will pass on to the next generation.
The House proposes a 5.4 percent tax on workers earning more than $500,000 annually, or $1 million for couples. The Senate relies heavily on what is called hide-the-tax -- excise tax on so-called Cadillac health care plans. The Senate also would increase Medicare taxes on families earning more than $250,000.
The problem with soaking the rich to pay for a health care plan? This is the fastest-shrinking tax imaginable when the economy sours. If California can serve any useful function in this debate, it should be as a warning to the dangers of over-relying on taxes on the rich.
Besides, as the Concord Coalition noted, broadly based taxes "spread the notion that all must contribute something for government benefits -- imposing an important breaker against 'free lunch' spending giveaways." Hence the coalition's support for the tax on so-called Cadillac health care.
While critics on the left complain that the Cadillac tax will squeeze union workers and the middle-class, I have issues with taxing those with health care benefits to pay for those who don't. Better to pass a value-added tax, but at least this excise eventually would make everyone pay for a universal benefit.
Concord Coalition Policy Director Josh Gordon believes, "Once people start feeling the cost of their insurance, they start getting concerned about premiums being too high." He added that if negotiators remove the Senate excise-tax and cost-control measures, the Concord Coalition would have to brand a final bill as "irresponsible legislation."
Note to anti-tax Republicans: If Washington passes a bill, someone has to pay for it. The only question is who, when and how much. Note to soak-the-richers: You can't say that universal health care is a moral imperative, but only other people should pay for it.
SOURCE
Thursday, December 31, 2009
British parents have 90 days to raise £250,000 for cancer treatment to save son
That's socialized medicine at work for you. Big talk, very limited action. No funds even to save a kid's life. And how odd that the best treatment is in America!
The parents of Jamie Inglis, 4, have been told his only hope is expensive treatment in the US which is only available privately and has to be administered within three months of the end of his chemotherapy. Jamie has been diagnosed with an aggressive form of the childhood cancer neuroblastoma, which began with a tumour on his kidney and spread to the rest of his body.
He has had eight sessions of chemotherapy and went through a seven-hour operation to remove the infected kidney, but his cancer is so virulent he is still expected to relapse, which could kill him. However, a new treatment developed in America could help save him. Doctors say it must be administered within 90 days to reduce his chances of relapsing.
Jamie's father John, 37, an environmental health officer for the Royal Medical Corps, was due to be posted to Afghanistan until he and wife Vicky, 34, a teacher, received the news about their young son in April. He said: "After his final treatment yesterday he has a 90 day window to receive the antibody. Children who have received it so far have shown a rapid improvement and it greatly reduces the chance of a relapse. "His body is so fragile after all the chemotherapy and surgery that a relapse would probably be fatal for him."
Recalling Jamie's diagnosis, he said: "One of the many problems with this form of cancer is the symptoms are so subtle. We noticed Jamie would sweat in the night and seemed tired but he didn't seem too serious until he was taken ill at nursery. "He was taken to his GP who referred him to hospital and we were told he had this rare and aggressive form of cancer. You feel like you have been stabbed in the chest. Just a few days earlier he had been happy and playing at his friend's birthday party. "You just want to curl up in a ball and hope it all goes away. He started chemotherapy within a week and has had regular monthly bouts of chemotherapy since he was diagnosed, as well as having one of his kidneys removed."
The antibody treatment is only available at a cancer hospital in New York and, because it is so new, it is expensive only available privately.
Mr Inglis said: "Hopefully in a few years time this treatment will be far more readily available and much cheaper to children like Jamie suffering from neuroblastoma. But that's obviously too late for him." The family, who also have a five-month-old daughter called Poppy, live near Düsseldorf in Germany, where John has been working.
John added: "Jamie is in good spirits and always has been. The one thing that has kept us going is the fact that he is always smiling. He earned the nickname Prince Charming from the nurses at the hospital, he's so cheery and belligerent. "The military community have been fantastic but we need to raise this £250,000. It's a lot of money but we have to do it, anything to give Jamie a better chance of life."
SOURCE
Decline in British diabetic care
Increase in diabetes patients having limbs amputated
The increase in amputations has almost doubled over a 10 year period with up to 100 patients a week losing a leg to complications of the disease. The number of people diagnosed with type-two diabetes the type caused by obesity - has increased greatly in the past decade, which could partly explain the findings, according to researchers. But doctors believe that with better care up to 80 per cent of amputations could be avoided.
Major amputations, above the ankle joint, have risen by 43 per cent and the average age of those having above-ankle amputations fell from 71 to 69 years, which followed the pattern of more people being diagnosed younger.
Dr Eszter Vamos, from Londons Imperial College, who led the study, said they had expected to see long-term complications of diabetes rising because the number of people diagnosed with the condition had increased. "But at the same time there is very strong evidence that you can prevent up to 80 per cent of the amputations.
Along with complications such as heart attacks and strokes, people with diabetes are far more likely to develop foot problems, including ulcers, which can become infected and lead to gangrene. Researchers believe that better checks by doctors and awareness of symptoms by patients could reduce the need for amputation.
The findings in the journal Diabetes Research and Clinical Practice - highlight the importance of frequent foot checks and getting control of blood sugar levels, blood pressure and cholesterol."
Diabetes UK said more early diagnosis was needed, as diabetes could go undetected for more than 10 years and most people already had complications when they were diagnosed. The charity also said too many people with diabetes are walking barefoot around their houses. It warned that diabetes sufferers are at risk of damage to their feet caused by them being numb, a complication of the disease. Damage can lead to foot ulcers and slow- healing wounds which, if they become infected, can result in amputation. Podiatrists recommend that people with diabetes should always wear slippers around the home to reduce the risk of foot injuries.
Caroline Butler, care adviser at Diabetes UK, said: "It's appalling that thousands of people with diabetes in the UK undergo lower limb amputations every year. We want to help reduce that number by getting people with diabetes to wear suitable slippers at home.
SOURCE
Rasmussen: Obamacare Disapproval at New High
Rasmussen's health-care polling results since Senate Majority Leader Harry Reid orchestrated the Christmas Eve vote are full of undeniably bad news for Democrats. In roughly ascending order of bad news (if one is a Democrat)...
Likely voters oppose Obamacare by more than the (18-point) margin by which Ronald Reagan beat Walter Mondale: 58 percent to 39 percent.
There are far more likely voters who "strongly" oppose Obamacare (46 percent) than there are likely voters who support it even "somewhat" (39 percent).
Only 24 percent of likely voters think that the quality of health care would get better under Obamacare, while 54 percent think it would get worse -- a gap of 30 percent.
Only 13 percent of likely voters think that the cost of health would go down under Obamacare, while 63 percent think it would rise -- a gap of 50 percent.
Seniors oppose Obamacare by more than 2 to 1: 63 percent to 31 percent.
And the worst news of all for Democrats...
Independents oppose Obamacare by the head-turning tally of 66 percent to 28 percent.
Lest Democrats try to console themselves with the thought that perhaps Rasmussen has got it wrong, CNN's latest poll, from just a few days before the Christmas Eve vote, showed Americans opposing Obamacare by a similar tally: 56 percent to 42 percent.
In light of these numbers -- and in light of the extreme difficulty that the Democrats had in squeezing a bill tailor-made for the House through the House, and one tailor-made for the Senate through the Senate -- anyone who thinks that either the passage or the subsequent implementation of Obamacare is anything remotely resembling inevitable, is forgetting that Tocqueville's book wasn't called Monarchy in America.
SOURCE
Ten New Reasons Why Obamacare Can Still Be Killed
New reasons emerge almost daily as to why Obamacare can and must be defeated.
1. The American people oppose Obamacare by almost 2 to 1 in the latest CNN poll. Other polls show lopsided opposition to passing either the Senate or House health-care bill.
Public opinion is against the bill because of its obscene costs in higher taxes, burdensome debt, anti-freedom mandates, rationing, and reduced care for seniors. The American people have awakened to the fact that Obamacare is transformational legislation that will drag us against popular will into European-style Socialism.
2. The Democrats' double-counting of Obamacare's financial benefits has been exposed as a colossal lie. Harry Reid told the Senate that his bill strengthens our future by both "cutting our towering national deficit by as much as $1.3 trillion over the next 20 years" AND "strengthening Medicare and extending its life by nearly a decade."
The Congressional Budget Office (CBO) refuted that assertion. CBO said the claim that Obamacare would provide these benefits simultaneously "would essentially double-count a large share of those savings and thus overstate the improvement in the government's fiscal position."
3. Obamacare is unconstitutional because of its mandate that all individuals must carry "approved" health insurance, and all businesses must give health insurance to their employees whether or not the company can afford it. "Universal" coverage will be enforced by the Internal Revenue Service with power to punish those who don't have such a plan.
Constitutional lawyers point out that the Commerce Clause does not give Congress the authority to force Americans to buy health insurance as a condition of living in our country because personal health insurance is not "commerce." The CBO wrote that "a mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action"; the Supreme Court has never upheld any requirement that an individual must participate in economic activity.
4. Since the Senate bill imposes sharp limits on health-insurance companies' ability to raise fees or exclude coverage, it likely will force many of them out of business. Obamacare is unconstitutional because it violates the Bill of Rights protections against takings without just compensation and deprivation of property without due process of law.
5. Other Obamacare provisions blatantly legislate racial and other forms of discrimination. The U.S. Commission on Civil Rights sent two letters to the President and congressional leaders warning about the obnoxious requirements for racist and sexist quotas.
The Senate bill requires that "priority" for federal grants be given to institutions offering "preferential" admissions to minorities (race, national origin, sex, sexual orientation, and religion). Institutions training social workers, psychologists, psychiatrists, behavioral pediatricians, psychiatric nurses, and counselors will be ineligible for federal grants unless they enroll "individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations."
6. Obama's claim that "everybody" will now be covered creates few winners but lots of losers. Universal health insurance will be achieved by forcing young people to pay the additional costs (insurance for the youngest third of the population would rise by 35 percent), and by restricting and rationing care for the elderly.
7. According to Robert Samuelson in the Washington Post, the "wild card is immigration." From 1999 to 2008, 60 percent of the increase in the uninsured occurred among Hispanics, and Obama's refusal to close our borders will make this problem more costly every year.
8. Obamacare gives Medicare bureaucrats the power to ration health care by forcing doctors to prescribe cheaper medical devices and drugs. In the recent case of Hays v. Sebelius, the court ruled that Medicare doesn't have the right to make this rule, but Obamacare takes jurisdiction away from the courts to hear any appeal from decisions of the new Medicare Commission.
The "stick" applied to primary-care doctors is imposing financial penalties if they refer too many patients to specialists. The "carrot" is financial rewards to doctors who give up small practices and consolidate into larger medical groups or become salaried employees of hospitals or other large institutions.
9. The Senate bill contains at least a dozen of what can be described as bribes. Senator Mary Landrieu received a $300 million increase in Medicaid funding for her state (known as the Second Louisiana Purchase), and a $100 million bribe to Senator Ben Nelson gives Nebraska a permanent exemption from the costs of Medicaid expansion.
10. The Senate bill even has a four-page section artfully written to enable ACORN to get federal health-care grants. This section describes grant recipients as "community and consumer-focused nonprofit groups" having "existing relationships ... with uninsured and underinsured consumers."
SOURCE
About Those “Death Panels”
It seems inevitable that the government will grab the remains of “private” medical care, so I will look at our medical futures. One development will be the implementation of the infamous “death panels” that socialists swear are a figment of the imaginations of paranoid persons like Sarah Palin.
For example, I received emails from the religious left-wing organization “Sojourners,” which declared that Palin was lying when she made the comment last August 7 in her Facebook page that declared:
In the ensuing firestorm, the New York Times called it a “false rumor,” and the “fact checkers” at the Politifact website named her statement the “Lie of the Year.” Kate Snow of ABC News said the claim was “shocking” and “inflammatory.”
Neither the House nor the Senate bills use the phrase “death panels,” but that is not surprising. None of the other countries that have socialist care actually have committees with that name. However, the “death panel” mentality certainly exists, and it exists precisely because socialist medical care exists not for care of individuals, but rather to enforce larger egalitarian political goals.
Ironically, the New York Times provides the “smoking gun” to the egalitarian mentality that leads to the “death panels” route. The paper last year carried a story about a British woman, Debbie Hirst, who suffered from cancer, but could not receive the medications she needed because the National Health Service declared them too costly.
Hirst decided to raise the money herself by selling her house, but the government said that if she did that, then it would not pay for any of her care:
In other words, unless one can justify one’s treatment under larger socialist purposes, then the government will be happy to let someone die, for enforced egalitarianism trumps actual care. This is not something new. Writing in the November 1993 Freeman, Dr. Jane Orient noted that government medical “cost containment” is another term for denying care:
Thomas Sowell is correct. Entrepreneurs lower real costs by finding ways to create more goods and using fewer resources. Governments “lower” costs via raw force or denying medical care, and if a person offers to pay for the care, well, that defeats the real purpose of socialism. Yet, we are told that private entrepreneurship in medical care is evil and medical socialism is good. People who accept such things as being true also will endorse the presence of “death panels,” even while denying that the panels exist.
SOURCE
Government health care is a children's fable
In the spirit of the Christmas season, let me offer up the following analogy for why health care reform, as envisioned by congressional Democrats, won't work.
Imagine that you're a child and you wake up on Christmas morning. Instead of that bike you wanted, there's a note under the tree saying that a lot of kids want bikes and the elves' workshop is backlogged for years. Don't worry -- you're guaranteed to get a bike, but Santa says that unfortunately he can't tell you where or when you might finally get that bike you're owed. Here's the part where my festive analogy breaks down: If you don't get that bike soon, you might die.
That's the problem with Democrats' health care legislation in a nutshell. It promises coverage for millions of Americans, but a government IOU is a far cry from seeing a doctor when you need one. And yet, the Senate health care legislation promises to expand Medicaid coverage to those making up to 133 percent of the federal poverty level. Do that would make 11 million more Americans dependent on a program that's already broken. The government can't compel doctors to treat Medicaid patients at fixed rates they dictate, at least not yet.
The policy outcome is Econ 101: Price controls always result in scarcity. Over half of all specialists in many major metropolitan areas are refusing to take on new Medicaid patients, according to a 2009 survey by Merritt Hawkins and Associates on physician wait times. "Medicaid is not widely accepted in most markets surveyed, in at least some of the medical specialties reviewed, and, in some cases, all of them," according to the survey.
The practical consequences of the government printing more health care IOUs than doctors can handle are horrifying. The Baltimore Sun recently reported that state auditors found 250 people out of the 17,000 people listed on the state's Medicaid waiting list are deceased. Other states have similarly outsized Medicaid backlogs of people desperate for medical care.
The worst part is that Democrats lean heavily on Medicaid as cost control mechanism in their health care legislation, even though they know it doesn't provide adequate care.
While hashing out the Senate's health care legislation, Democrats rejected a Republican amendment to increase Medicaid reimbursement rates to the same level as Medicare. It didn't pass. Democrats fought with a Republican president over expanding the State Children's Health Insurance Program (SCHIP) just a few years ago.
But Sen. Jay Rockefeller, D-W.V., a multi-millionaire oil scion, axed expanding SCHIP in favor of putting kids in Medicaid, cutting the price tag on the current legislation. The SCHIP program utilizes private insurance and costs more, but that also means there are many more doctors willing to treat kids with SCHIP coverage.
This is the same reason why the Democrats are gutting $122 billion out of the popular Medicare Advantage program. Medicare Advantage allows for private insurance through Medicare, and consequently it's more expensive. In 2003, there were 5.3 million Americans enrolled in Medicare Advantage. As of 2009, there were 10.2 million Americans enrolled in Medicare advantage -- including more than one-in-three Medicare recipients in New York and California. Why the explosion of people enrolled in Medicare advantage? More doctors take private insurance with better reimbursement rates. A 2008 report by the Medicare Payment Advisory Commission found 29 percent of Medicare patients have trouble finding a primary physician.
Health care for all Americans is a noble goal, but adding 11 million more Americans to an overtaxed Medicaid system is not the way to do it. For far too many Americans, the prospect of getting good health care through the government insurance is a lot like Santa Claus. It doesn't exist.
SOURCE
That's socialized medicine at work for you. Big talk, very limited action. No funds even to save a kid's life. And how odd that the best treatment is in America!
The parents of Jamie Inglis, 4, have been told his only hope is expensive treatment in the US which is only available privately and has to be administered within three months of the end of his chemotherapy. Jamie has been diagnosed with an aggressive form of the childhood cancer neuroblastoma, which began with a tumour on his kidney and spread to the rest of his body.
He has had eight sessions of chemotherapy and went through a seven-hour operation to remove the infected kidney, but his cancer is so virulent he is still expected to relapse, which could kill him. However, a new treatment developed in America could help save him. Doctors say it must be administered within 90 days to reduce his chances of relapsing.
Jamie's father John, 37, an environmental health officer for the Royal Medical Corps, was due to be posted to Afghanistan until he and wife Vicky, 34, a teacher, received the news about their young son in April. He said: "After his final treatment yesterday he has a 90 day window to receive the antibody. Children who have received it so far have shown a rapid improvement and it greatly reduces the chance of a relapse. "His body is so fragile after all the chemotherapy and surgery that a relapse would probably be fatal for him."
Recalling Jamie's diagnosis, he said: "One of the many problems with this form of cancer is the symptoms are so subtle. We noticed Jamie would sweat in the night and seemed tired but he didn't seem too serious until he was taken ill at nursery. "He was taken to his GP who referred him to hospital and we were told he had this rare and aggressive form of cancer. You feel like you have been stabbed in the chest. Just a few days earlier he had been happy and playing at his friend's birthday party. "You just want to curl up in a ball and hope it all goes away. He started chemotherapy within a week and has had regular monthly bouts of chemotherapy since he was diagnosed, as well as having one of his kidneys removed."
The antibody treatment is only available at a cancer hospital in New York and, because it is so new, it is expensive only available privately.
Mr Inglis said: "Hopefully in a few years time this treatment will be far more readily available and much cheaper to children like Jamie suffering from neuroblastoma. But that's obviously too late for him." The family, who also have a five-month-old daughter called Poppy, live near Düsseldorf in Germany, where John has been working.
John added: "Jamie is in good spirits and always has been. The one thing that has kept us going is the fact that he is always smiling. He earned the nickname Prince Charming from the nurses at the hospital, he's so cheery and belligerent. "The military community have been fantastic but we need to raise this £250,000. It's a lot of money but we have to do it, anything to give Jamie a better chance of life."
SOURCE
Decline in British diabetic care
Increase in diabetes patients having limbs amputated
The increase in amputations has almost doubled over a 10 year period with up to 100 patients a week losing a leg to complications of the disease. The number of people diagnosed with type-two diabetes the type caused by obesity - has increased greatly in the past decade, which could partly explain the findings, according to researchers. But doctors believe that with better care up to 80 per cent of amputations could be avoided.
Major amputations, above the ankle joint, have risen by 43 per cent and the average age of those having above-ankle amputations fell from 71 to 69 years, which followed the pattern of more people being diagnosed younger.
Dr Eszter Vamos, from Londons Imperial College, who led the study, said they had expected to see long-term complications of diabetes rising because the number of people diagnosed with the condition had increased. "But at the same time there is very strong evidence that you can prevent up to 80 per cent of the amputations.
Along with complications such as heart attacks and strokes, people with diabetes are far more likely to develop foot problems, including ulcers, which can become infected and lead to gangrene. Researchers believe that better checks by doctors and awareness of symptoms by patients could reduce the need for amputation.
The findings in the journal Diabetes Research and Clinical Practice - highlight the importance of frequent foot checks and getting control of blood sugar levels, blood pressure and cholesterol."
Diabetes UK said more early diagnosis was needed, as diabetes could go undetected for more than 10 years and most people already had complications when they were diagnosed. The charity also said too many people with diabetes are walking barefoot around their houses. It warned that diabetes sufferers are at risk of damage to their feet caused by them being numb, a complication of the disease. Damage can lead to foot ulcers and slow- healing wounds which, if they become infected, can result in amputation. Podiatrists recommend that people with diabetes should always wear slippers around the home to reduce the risk of foot injuries.
Caroline Butler, care adviser at Diabetes UK, said: "It's appalling that thousands of people with diabetes in the UK undergo lower limb amputations every year. We want to help reduce that number by getting people with diabetes to wear suitable slippers at home.
SOURCE
Rasmussen: Obamacare Disapproval at New High
Rasmussen's health-care polling results since Senate Majority Leader Harry Reid orchestrated the Christmas Eve vote are full of undeniably bad news for Democrats. In roughly ascending order of bad news (if one is a Democrat)...
Likely voters oppose Obamacare by more than the (18-point) margin by which Ronald Reagan beat Walter Mondale: 58 percent to 39 percent.
There are far more likely voters who "strongly" oppose Obamacare (46 percent) than there are likely voters who support it even "somewhat" (39 percent).
Only 24 percent of likely voters think that the quality of health care would get better under Obamacare, while 54 percent think it would get worse -- a gap of 30 percent.
Only 13 percent of likely voters think that the cost of health would go down under Obamacare, while 63 percent think it would rise -- a gap of 50 percent.
Seniors oppose Obamacare by more than 2 to 1: 63 percent to 31 percent.
And the worst news of all for Democrats...
Independents oppose Obamacare by the head-turning tally of 66 percent to 28 percent.
Lest Democrats try to console themselves with the thought that perhaps Rasmussen has got it wrong, CNN's latest poll, from just a few days before the Christmas Eve vote, showed Americans opposing Obamacare by a similar tally: 56 percent to 42 percent.
In light of these numbers -- and in light of the extreme difficulty that the Democrats had in squeezing a bill tailor-made for the House through the House, and one tailor-made for the Senate through the Senate -- anyone who thinks that either the passage or the subsequent implementation of Obamacare is anything remotely resembling inevitable, is forgetting that Tocqueville's book wasn't called Monarchy in America.
SOURCE
Ten New Reasons Why Obamacare Can Still Be Killed
New reasons emerge almost daily as to why Obamacare can and must be defeated.
1. The American people oppose Obamacare by almost 2 to 1 in the latest CNN poll. Other polls show lopsided opposition to passing either the Senate or House health-care bill.
Public opinion is against the bill because of its obscene costs in higher taxes, burdensome debt, anti-freedom mandates, rationing, and reduced care for seniors. The American people have awakened to the fact that Obamacare is transformational legislation that will drag us against popular will into European-style Socialism.
2. The Democrats' double-counting of Obamacare's financial benefits has been exposed as a colossal lie. Harry Reid told the Senate that his bill strengthens our future by both "cutting our towering national deficit by as much as $1.3 trillion over the next 20 years" AND "strengthening Medicare and extending its life by nearly a decade."
The Congressional Budget Office (CBO) refuted that assertion. CBO said the claim that Obamacare would provide these benefits simultaneously "would essentially double-count a large share of those savings and thus overstate the improvement in the government's fiscal position."
3. Obamacare is unconstitutional because of its mandate that all individuals must carry "approved" health insurance, and all businesses must give health insurance to their employees whether or not the company can afford it. "Universal" coverage will be enforced by the Internal Revenue Service with power to punish those who don't have such a plan.
Constitutional lawyers point out that the Commerce Clause does not give Congress the authority to force Americans to buy health insurance as a condition of living in our country because personal health insurance is not "commerce." The CBO wrote that "a mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action"; the Supreme Court has never upheld any requirement that an individual must participate in economic activity.
4. Since the Senate bill imposes sharp limits on health-insurance companies' ability to raise fees or exclude coverage, it likely will force many of them out of business. Obamacare is unconstitutional because it violates the Bill of Rights protections against takings without just compensation and deprivation of property without due process of law.
5. Other Obamacare provisions blatantly legislate racial and other forms of discrimination. The U.S. Commission on Civil Rights sent two letters to the President and congressional leaders warning about the obnoxious requirements for racist and sexist quotas.
The Senate bill requires that "priority" for federal grants be given to institutions offering "preferential" admissions to minorities (race, national origin, sex, sexual orientation, and religion). Institutions training social workers, psychologists, psychiatrists, behavioral pediatricians, psychiatric nurses, and counselors will be ineligible for federal grants unless they enroll "individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations."
6. Obama's claim that "everybody" will now be covered creates few winners but lots of losers. Universal health insurance will be achieved by forcing young people to pay the additional costs (insurance for the youngest third of the population would rise by 35 percent), and by restricting and rationing care for the elderly.
7. According to Robert Samuelson in the Washington Post, the "wild card is immigration." From 1999 to 2008, 60 percent of the increase in the uninsured occurred among Hispanics, and Obama's refusal to close our borders will make this problem more costly every year.
8. Obamacare gives Medicare bureaucrats the power to ration health care by forcing doctors to prescribe cheaper medical devices and drugs. In the recent case of Hays v. Sebelius, the court ruled that Medicare doesn't have the right to make this rule, but Obamacare takes jurisdiction away from the courts to hear any appeal from decisions of the new Medicare Commission.
The "stick" applied to primary-care doctors is imposing financial penalties if they refer too many patients to specialists. The "carrot" is financial rewards to doctors who give up small practices and consolidate into larger medical groups or become salaried employees of hospitals or other large institutions.
9. The Senate bill contains at least a dozen of what can be described as bribes. Senator Mary Landrieu received a $300 million increase in Medicaid funding for her state (known as the Second Louisiana Purchase), and a $100 million bribe to Senator Ben Nelson gives Nebraska a permanent exemption from the costs of Medicaid expansion.
10. The Senate bill even has a four-page section artfully written to enable ACORN to get federal health-care grants. This section describes grant recipients as "community and consumer-focused nonprofit groups" having "existing relationships ... with uninsured and underinsured consumers."
SOURCE
About Those “Death Panels”
It seems inevitable that the government will grab the remains of “private” medical care, so I will look at our medical futures. One development will be the implementation of the infamous “death panels” that socialists swear are a figment of the imaginations of paranoid persons like Sarah Palin.
For example, I received emails from the religious left-wing organization “Sojourners,” which declared that Palin was lying when she made the comment last August 7 in her Facebook page that declared:
The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.
In the ensuing firestorm, the New York Times called it a “false rumor,” and the “fact checkers” at the Politifact website named her statement the “Lie of the Year.” Kate Snow of ABC News said the claim was “shocking” and “inflammatory.”
Neither the House nor the Senate bills use the phrase “death panels,” but that is not surprising. None of the other countries that have socialist care actually have committees with that name. However, the “death panel” mentality certainly exists, and it exists precisely because socialist medical care exists not for care of individuals, but rather to enforce larger egalitarian political goals.
Ironically, the New York Times provides the “smoking gun” to the egalitarian mentality that leads to the “death panels” route. The paper last year carried a story about a British woman, Debbie Hirst, who suffered from cancer, but could not receive the medications she needed because the National Health Service declared them too costly.
Hirst decided to raise the money herself by selling her house, but the government said that if she did that, then it would not pay for any of her care:
Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.
Patients “cannot, in one episode of treatment, be treated on the N.H.S. and then allowed, as part of the same episode and the same treatment, to pay money for more drugs,” the health secretary, Alan Johnson, told Parliament.
“That way lies the end of the founding principles of the N.H.S.,” Mr. Johnson said.
In other words, unless one can justify one’s treatment under larger socialist purposes, then the government will be happy to let someone die, for enforced egalitarianism trumps actual care. This is not something new. Writing in the November 1993 Freeman, Dr. Jane Orient noted that government medical “cost containment” is another term for denying care:
The global budgeters “contain costs”—ration health care by denying those things that you do need insurance to pay for: heart surgery, radiation treatments for cancer, hip replacements, things like that. Out of “compassion,” reformers may open another exit: the one that leads to the cemetery. Do you think it’s accidental that euthanasia and “universal access” are on the agenda at the same time?
Thomas Sowell is correct. Entrepreneurs lower real costs by finding ways to create more goods and using fewer resources. Governments “lower” costs via raw force or denying medical care, and if a person offers to pay for the care, well, that defeats the real purpose of socialism. Yet, we are told that private entrepreneurship in medical care is evil and medical socialism is good. People who accept such things as being true also will endorse the presence of “death panels,” even while denying that the panels exist.
SOURCE
Government health care is a children's fable
In the spirit of the Christmas season, let me offer up the following analogy for why health care reform, as envisioned by congressional Democrats, won't work.
Imagine that you're a child and you wake up on Christmas morning. Instead of that bike you wanted, there's a note under the tree saying that a lot of kids want bikes and the elves' workshop is backlogged for years. Don't worry -- you're guaranteed to get a bike, but Santa says that unfortunately he can't tell you where or when you might finally get that bike you're owed. Here's the part where my festive analogy breaks down: If you don't get that bike soon, you might die.
That's the problem with Democrats' health care legislation in a nutshell. It promises coverage for millions of Americans, but a government IOU is a far cry from seeing a doctor when you need one. And yet, the Senate health care legislation promises to expand Medicaid coverage to those making up to 133 percent of the federal poverty level. Do that would make 11 million more Americans dependent on a program that's already broken. The government can't compel doctors to treat Medicaid patients at fixed rates they dictate, at least not yet.
The policy outcome is Econ 101: Price controls always result in scarcity. Over half of all specialists in many major metropolitan areas are refusing to take on new Medicaid patients, according to a 2009 survey by Merritt Hawkins and Associates on physician wait times. "Medicaid is not widely accepted in most markets surveyed, in at least some of the medical specialties reviewed, and, in some cases, all of them," according to the survey.
The practical consequences of the government printing more health care IOUs than doctors can handle are horrifying. The Baltimore Sun recently reported that state auditors found 250 people out of the 17,000 people listed on the state's Medicaid waiting list are deceased. Other states have similarly outsized Medicaid backlogs of people desperate for medical care.
The worst part is that Democrats lean heavily on Medicaid as cost control mechanism in their health care legislation, even though they know it doesn't provide adequate care.
While hashing out the Senate's health care legislation, Democrats rejected a Republican amendment to increase Medicaid reimbursement rates to the same level as Medicare. It didn't pass. Democrats fought with a Republican president over expanding the State Children's Health Insurance Program (SCHIP) just a few years ago.
But Sen. Jay Rockefeller, D-W.V., a multi-millionaire oil scion, axed expanding SCHIP in favor of putting kids in Medicaid, cutting the price tag on the current legislation. The SCHIP program utilizes private insurance and costs more, but that also means there are many more doctors willing to treat kids with SCHIP coverage.
This is the same reason why the Democrats are gutting $122 billion out of the popular Medicare Advantage program. Medicare Advantage allows for private insurance through Medicare, and consequently it's more expensive. In 2003, there were 5.3 million Americans enrolled in Medicare Advantage. As of 2009, there were 10.2 million Americans enrolled in Medicare advantage -- including more than one-in-three Medicare recipients in New York and California. Why the explosion of people enrolled in Medicare advantage? More doctors take private insurance with better reimbursement rates. A 2008 report by the Medicare Payment Advisory Commission found 29 percent of Medicare patients have trouble finding a primary physician.
Health care for all Americans is a noble goal, but adding 11 million more Americans to an overtaxed Medicaid system is not the way to do it. For far too many Americans, the prospect of getting good health care through the government insurance is a lot like Santa Claus. It doesn't exist.
SOURCE
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