McConnell blasts regime over Humana “gag order”
The federal government resorted to bullying tactics when it ordered an investigation of Humana -- one of the country's biggest private insurers -- for its decision to send customers a letter alerting them about pending health reform legislation, a leading Republican charged Wednesday.
U.S. health officials launched the probe after the Louisville-based company mailed a letter to patients enrolled in its Medicare Advantage plans -- private options that replace standard Medicare -- warning that President Obama's health overhaul could eliminate important benefits of the program.
Humana said in its letter that if Medicare Advantage funding gets cut, "millions of seniors and disabled individuals ... could lose many of the important benefits and services that make Medicare Advantage health plans so valuable."
Republican Senate Minority leader Mitch McConnell blasted the investigation of Humana on Wednesday, calling it a "federal gag order" that seeks to silence a health provider that disagrees with the administration. McConnell said he's called for a complete legal justification of the probe. "This is so clearly an outrage," McConnell said on the Senate floor. "For explaining to seniors how legislation might affect them, the federal government has now issued a gag order on that company, and any other company that communicates with clients on the issue, telling them to shut up -- or else. "This is precisely the kind of thing Americans are worried about with the administration's health care plan. They're worried that government agencies which were created to enforce violations even-handedly will instead be used against those who voice a different point of view," he said.
The investigation was first suggested by Senate Finance Committee Chairman Max Baucus, whose committee has jurisdiction over Medicare. The Centers for Medicare & Medicaid Services (CMS) -- which officiates over the Medicare program for seniors and Medicare Advantage options -- ordered a "cease and desist" order on all of Humana's health care mailings until the investigation is concluded.
Baucus has called the Humana letter a "scare tactic" meant to distort the current reforms under consideration. The CMS alleges that Humana's letter may have violated federal regulations, but the information distributed by the health provider was supported by the nonpartisan, independent analysis of the Congressional Budget Office.
Obama has insisted that despite planned cuts to Medicare providers, seniors would not see their benefits reduced under a health care overhaul. But CBO Director Douglas Elmendorf contradicted that Tuesday under questioning by Finance Committee Republicans, saying seniors in the private Medicare Advantage plans could see reduced benefits under Baucus' legislation. Proposed changes "would reduce the extra benefits that would be made available to beneficiaries through Medicare Advantage plans," Elmendorf said.
Humana spokesman Jim Turner said Wednesday that the company is cooperating with CMS in its investigation. But, Turner added, "We also believe Medicare Advantage members deserve to know the impact that funding cuts of the magnitude being discussed would have on benefits and premiums."
A Republican aide told FOXNews.com that the investigation is a clear breach of First Amendment rights and said the Republican leader is asking the CMS to provide legal justification for its investigation. The aide said CMS's investigation follows a pattern of intimidation put forth by the administration for any kind of dissent in the health care debate.
The Democratic Senatorial Campaign Committee lashed out at McConnell's charges Wednesday, saying, "If there was ever any doubt who Republicans are looking out for in the health care debate, Mitch McConnell has offered conclusive proof: the insurance companies. "Republicans jeopardize their own credibility when they choose to defend big insurance companies trying to make false claims about senior citizens," the DSCC said in a press release.
Nine months into Obama's administration, no administrator of the CMS has been named -- leading some Republicans to question whether the White House had a direct hand in silencing Humana.
While the administration referred all questions about the investigation to CMS, White House spokesman Reid Cherlin said the confirmation of a CMS administrator "is a priority for the administration." CMS did not immediately answer requests for comment.
House Ways and Means Committee ranking member Rep. Dave Camp, R-Mich., has called on CMS to provide additional information on the so-called gag order, including the person or persons who authorized the agency to issue it. "I have never seen anything like this and I question if politics was the deciding factor," Camp said in a press release. "Given that the administration has failed for more than eight months to nominate a director for CMS, I wonder if undue political pressure may have been applied on the CMS staff. "It is Congress' responsibility to find out the facts and protect the interests of the American people. We need to know who contacted CMS, when they did it and what was said," he said.
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Mandatory insurance: Yes, it’s a tax
By Jeff Jacoby
IT WAS A PERFECTLY straightforward question. The answer was anything but. President Obama vows not to raise taxes on any American family earning less than $250,000 a year. Yet he backs legislation that would force every American to carry health insurance or pay a hefty penalty to the IRS. Such an “individual mandate’’ is included in all the major health care bills making their way through Congress, including the legislation unveiled by Senate Finance Committee Chairman Max Baucus last week. So when ABC’s George Stephanopoulos interviewed the president on Sunday, he raised the obvious challenge: “Under this mandate, the government is forcing people to spend money [to buy insurance], fining you if you don’t. How is that not a tax?’’
Obama replied that the individual mandate “is absolutely not a tax increase,’’ since, in his view, there is good reason to impose it. He stuck to that position even when confronted with Merriam-Webster’s definition of “tax’’ - “a charge, usually of money, imposed by authority on persons or property for public purposes.’’
“George,’’ chided Obama, “the fact that you looked up Merriam’s Dictionary . . . indicates to me that you’re stretching a little bit right now.’’ But the only one “stretching’’ was the president, whose position was at odds with the legislation itself. “The consequence for not maintaining insurance would be an excise tax,’’ notes the committee staff report on the Baucus bill. “The excise tax would be assessed through the tax code and applied as an additional amount of Federal tax owed.’’
Obama isn’t the first politician to maintain that a mandate to buy health insurance isn’t just another middle-class tax. Mitt Romney did so as governor of Massachusetts, boasting in 2006 that thanks to his signature health care law, “every uninsured citizen in Massachusetts will soon have affordable health insurance, and the costs of health care will be reduced. And we will need no new taxes . . . to make this happen.’’ But isn’t the penalty that law imposes on the uninsured - a penalty that this year will run as high as $1,068 per person - a tax? Gosh, no, enthused Romney: “It’s a personal responsibility principle.’’
Whatever it’s called, it hasn’t transformed Massachusetts into an Eden of universal coverage. According to the Department of Revenue, nearly 200,000 state taxpayers remained uninsured at the beginning of 2008. And the individual mandate hasn’t made insurance in the Bay State more affordable: Massachusetts has the highest health insurance premiums in the nation.
Far from holding insurance costs down, “reform’’ in Massachusetts seems to have had the opposite effect. “Insurance premiums rose by 7.4 percent in 2007, 8-12 percent in 2008, and are expected to rise 9 percent this year,’’ notes Michael Tanner of the Cato Institute. “By comparison, nationwide insurance costs rose by 6.1 percent in 2007, just 4.7 percent in 2008, and are projected to increase 6.4 percent this year.’’
However tempting it may seem, universal health coverage cannot be achieved by waving a legislative wand and ordering every citizen to buy insurance. Supporters of an individual health-insurance mandate like to compare it to the nearly universal requirement for auto insurance, but far from proving their point, it undermines it. True, auto insurance is mandatory almost everywhere. Yet nearly 15 percent of motorists remain uninsured.
Requiring that drivers be insured, Obama told Stephanopoulos, “is a fair way to make sure that if you hit my car . . . I’m not covering all the costs.’’ Auto insurance is required, however, only if you choose to own a car and drive it on public roads. Under ObamaCare (as with RomneyCare), health insurance would be compulsory no matter what you did or didn’t do.
It is a myth that those who don’t buy health insurance are basically free riders who unload their medical costs onto the backs of more responsible Americans. In truth, most of the uninsured are young, fit, and unlikely to need medical care. Why should they be forced to pay for expensive insurance they don’t need?
The right way to expand coverage is not to scourge the healthy with new taxes, but to win them over with lower premiums. Deregulation is a far better strategy than compulsion. If insurers were free to compete for business across state lines, for example, and if states would repeal the excessive benefit requirements that have driven up the cost of insurance, premiums would shrink and so would the ranks of the uninsured.
Coercive insurance mandates are a prescription for more misery, not less. Massachusetts is learning that lesson the hard way. The rest of America doesn’t have to.
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Are We Really all Healthcare Collectivists Now?
“We have to do something about health care.” The scariest word in that sentence is not something. It’s we. The first-person plural form is not merely a convenience, as in “We’re in for a cold winter.” It indicates that decisions about “the healthcare system” should be made collectively, with one decision binding everyone. That’s collectivism.
So why is virtually everyone a collectivist when it comes to health care? I do not exaggerate. Every prominent participant in the current debate over how to “reform” the medical industry approaches the issue in collectivist terms. They have differences at the margin–tax increases versus tax credits, a government-run “public option” versus subsidized nonprofit cooperatives–but there is no disagreement that “we” must have a policy.
But why must we do anything about health care? Why can’t you do what you want, I do what I want, and he and she do what they want? Isn’t that what’s supposed to happen in a free society? Reformers would say that costs are rising too much and some people can’t afford insurance. But that is no answer. It tells us only that possibly ameliorable conditions exist, not that collectivism is a good approach.
When we see problems in other important markets, most of us don’t expect televised presidential town-hall meetings, congressional committees, and omnibus legislation to give us the answer. We individually adjust our behavior in the marketplace and anticipate that entrepreneurs will cater to us. Solutions, with inevitable tradeoffs, are micro, marginal, and tailored to individual needs, not macro, holistic, and procrustean. Out of this arises an orderly marketplace–without a conscious overall plan. No one has found a better way to make masses of people better off.
Why is health care different? Must we collectively reinvent the industry? The social knowledge problem that F. A. Hayek spelled out should make us wary of any collective response.
The reformers’ stock answer is that this is something only we, acting through the “democratic process,” can handle. That’s an assertion. Where’s the proof? What if earlier collectivist decisions gave us rising medical and insurance costs?
In fact they did. Nearly every aspect of medicine and health insurance that the politicians say needs fixing is the result of “our”–that is, politicians’–previous attempts to fix something. Much of the escalation of prices comes from consumer demand freed from normal cost constraints thanks to third-party payers: government-privileged insurance companies, Medicare, and Medicaid. While that intervention boosts demand by eliminating cost consciousness, others constrict supply: occupational licensing, insurance mandates and barriers to entry, patents on drugs and devices, FDA regulations, certificate-of-need requirements, and more.
So let’s hear no more about what we–collectively and coercively–must do about health care. If government would get out of the way, we–individually and cooperatively–will figure out what to do. Collectivism and government planning trample freedom and foster social stupidity. Individualism and free markets respect each person’s dignity and liberty while getting the most out of the “wisdom of crowds” in the marketplace.
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Cap and Trade Legislation Would Increase Uninsured By Millions
The U.S. Senate can increase the number of Americans with health insurance by tens of millions -- at zero cost to taxpayers -- by rejecting cap-and-trade legislation passed by the U.S. House, according to a policy analysis just released by The National Center for Public Policy Research.
In June, the U.S. House of Representatives approved the American Clean Energy and Security Act -- commonly referred to as the Waxman-Markey bill after its principal sponsors, Henry Waxman (D-CA) and Edward Markey (D-MA) -- which seeks to reduce U.S. greenhouse gas emissions by more than 80 percent by 2050.
The National Center for Public Policy Research contends the Waxman-Markey bill would increase energy prices, slow the economy and result in higher unemployment. This, in turn, the group says, would increase the number of uninsured.
"For every one percentage point increase in unemployment, 1.1 million Americans lose their health insurance coverage," said David A. Ridenour, Vice President of The National Center for Public Policy Research. "With the Waxman-Markey legislation projected to cost an average of 1.15 million jobs annually between 2012 and 2030, this could translate into tens of millions of Americans losing their health insurance coverage. The best health care reform is doing nothing at all -- at least on cap-and-trade."
Loss of health insurance coverage, however, is only one of the negative health consequences that would result from a Waxman-Markey-style bill, according to Ridenour.
"The stress and loss of self-esteem that accompanies job loss can lead to unhealthy lifestyles, including substance abuse and poor eating habits," said Ridenour. "The unemployed are more likely to be diagnosed for hypertension, heart disease, diabetes and stroke, and because discretionary income drops with the loss of a job, so too do routine screenings that might prevent late-stage diseases."
Ridenour cites a study by Kate Strully of the State University of New York at Albany showing that involuntarily unemployed factory workers are 83 percent more likely to develop a new health problem than those who keep their job.
A full copy of Ridenour's analysis can be found at http://tw0.us/1ou
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How Missouri Cut Junk Lawsuits
By MATT BLUNT
There has been a lot of talk in Washington about cutting wasteful health-care spending, but it is troubling that such talk has not created a sense of urgency for national tort reform. It is especially frustrating because states have already shown that curbing junk lawsuits can cut costs, create jobs, and increase the quality of care available to patients. I know this because that is exactly what happened in Missouri when, as governor, I helped to enact comprehensive reforms.
I took office in January 2005 at a time when runaway lawsuits were driving up the cost of doing business in my state and forcing doctors and other business owners to close their doors. The U.S. Chamber of Commerce Institute for Legal Reform keeps a list of states ranked according to their legal environment. At the time, Missouri ranked among the 10 worst. "Venue-shopping," a tactic that involves shifting a case to a friendly court regardless of where the injury occurred, was common. Defendants could be made to pay 100% of a judgment even if they were only 1% responsible for the injury. And caps on damages had been rendered meaningless by state court decisions.
This legal environment raised the cost of health care for everyone and imposed stiff costs on businesses. It also forced doctors to close their doors. For example, the eastern half of Jackson County, one of Missouri's largest, lost its only neurosurgeons in 2003 due to high malpractice insurance costs. Many other parts of the state suffered from a lack of doctors able to deliver babies. One obstetrician who delivered more than 200 babies annually was forced to quit after his annual insurance premiums skyrocketed 82% in just one year. Making matters worse, few new doctors wanted to move to Missouri. One Kansas City area doctor sent letters to more than 400 physicians finishing their residencies and did not receive a single response back.
To counteract these problems we required that cases be heard in the county where the alleged injury occurred, and we changed the law so that defendants could only be forced to pay a full judgment if their fault exceeded 50%. We put a $350,000 cap on noneconomic damages and created rules to prevent baseless cases from getting off of the ground. Previously, personal injury lawyers could file cases if they got a written affidavit from any qualified health-care provider claiming that there was negligence. We tightened that by requiring that the affidavit come from an active professional practicing substantially the same specialty as the defendant.
We also took another common-sense step. Doctors often express empathy to a suffering patient regardless of fault. Saying you are "sorry" for someone's plight is a testament of good character, and should not be used against you in court. But tort lawyers were claiming that such statements were an admission of guilt. We stopped that abuse.
Tort reform works. Missouri's medical malpractice claims are now at a 30-year low. Average payouts are about $50,000 below the 2005 average. Malpractice insurers are also turning a profit for the fifth year in a row—allowing other insurers to compete for business in Missouri. This will drive down costs, which will save government programs money as well as improve the system for patients. It will also leave doctors with more resources to invest in better care. Since 2005, Missouri has moved up to 31st on the Chamber of Commerce Institute for Legal Reform's list.
Because we passed tort reform, cut taxes and controlled state spending, Missouri's economy is now in better shape than it would have been. During the four years I was in office, about 70,000 net new jobs were created in my state.
Texas has seen similar success from its 2003 tort reforms. The number of doctors applying for a license in that state has increased by 57% and doctors' insurance rates have declined by an average of 27%. There are now more doctors in Texas providing care in previously underserved areas.
There is no reason that the success that Missouri, Texas and other states have experienced cannot be replicated nationally. States are demonstrating that tort reform lowers costs, expands access, and creates jobs. The time to get behind national tort reform is now.
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Friday, September 25, 2009
Thursday, September 24, 2009
NHS vendetta against whistleblower
No concern over whether staff were qualified, apparently. "Shoot the messenger" approach instead
A senior NHS nurse faced a “witchhunt” and was threatened with having her house burnt down if she did not drop a complaint against a colleague, an employment tribunal has been told.
Jenny Fecitt, who worked at an NHS walk-in centre in Wythenshawe, South Manchester, said that at the time of a phone call in which the threat was made she was in dispute with her employer after raising concerns over another nurse’s qualifications.
Mrs Fecitt had complained to bosses at NHS Manchester over one of the staff on her team, Daniel Swift, whom she claimed “misrepresented” his training and should not have been treating adult patients. But her concerns were ignored by trust bosses, it is alleged, and she was subjected to a “character assassination” before receiving the threatening call. “The substance of the call was if I did not drop the case against Daniel Swift that our house would be burnt down,” Mrs Fecitt told the employment tribunal, sitting in Manchester.
Mrs Fecitt, along with Annie Woodcock and Felicity Hughes, her fellow nurses, is taking NHS Manchester to the tribunal, claiming that they were victimised after voicing their concerns. The tribunal heard that problems began on March 3, 2008, after Mrs Woodcock approached her about Mr Swift’s qualifications.
Mrs Fecitt said that during a casual conversation among staff he maintained that he was qualified as both a child and adult nurse. She called the Nursing and Midwifery Council and was told that he was qualified to treat only children. Mrs Fecitt spoke to her line manager and, the next day, Mr Swift is alleged to have called her in an “aggressive and confrontational” manner.
She told the tribunal that it was her “moral and professional” obligation to report Mr Swift to the nursing council. She also contacted the trust’s officer responsible for corporate governance and whistleblowing in April 2008 and an investigation was started. But the following month she was relieved of her management responsibilities.
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Australia: Coverup of bullying at NSW government hospital
The New South Wales Opposition says nurses who have complained of bullying at a far south coast hospital would not mind if findings of an investigation were made public. Bega MP Andrew Constance says an external investigator's report on bullying and operational issues at Pambula Hospital should be given to the community.
The Greater Southern Area Health Service says the report will not be released publicly. However, a summary and set of recommendations will be released. Its eastern sector general manager, Ken Barnett, says staff and appropriate unions will be consulted before it is considered whether to implement recommendations.
Mr Constance says if unions are entitled to know the findings, so should the broader community, and nurses names could be omitted from the documents. "You don't necessarily need to disclose names but the community are entitled to know what occurred at the facility and what is going to be done about it in the future," he said. "The only way that the confidence can be regained by the community in what's occurring at Pambula Hospital is for that availability of the information and that openness and transparency around what's happened."
He says not releasing the investigation findings to the community will further erode public confidence in the health system. "I think nurses want accountability in the system. They want to be able to raise issues of concern and I think there's been enough secrecy clouding the hospital as is without it being furthered by a government not willing to be open and transparent about this report," he said. "The community is aware of the investigation. It's important that the community have the recommendations and the findings of that investigation."
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Barack Obama Cannot Walk on Water, and Neither Can ObamaCare
As Barack Obama travels across the fruited plain and sucks up all the air on every Sunday network news show—except for FOX News Sunday—attempting to repackage his plans to take over the health care industry by force of law, one thing has remained constant. According to Dr. Obama, under his “plan,” tens of millions more Americans will receive taxpayer-subsidized health care, the quality of medical care will increase, and it will all occur at no extra cost to taxpayers. After that, he plans to walk on water.
In reality, of course, there are more than a few problems with the Obama Administration’s claims. Namely, the numbers simply do not add up. Expanding health coverage is a costly venture, and the American people are not fooled. They know they will wind up paying through the nose for this massive expansion of federal entitlements. And that these will add substantially to the national debt, which now totals some $11.8 trillion.
The House plan, which 45 million people qualify for, at an average cost of $4,700 per premium according to the National Coalition on Health Care, would add on $211.5 billion in extra costs to taxpayers every single year once fully implemented. That’s $2.1 trillion over ten years.
It doesn’t get much better even under the so-called “bipartisan compromise” legislation—that not a single Republican supports—now being floated by Montana Democrat Senator Max Baucus. Under his plan, an additional 26 million individuals would receive government-subsidized health care, which at $4,700 for a premium, adds up to $122 billion extra every year, or $1.2 trillion over ten years.
All of which will be piled atop the greatest budget deficit in human history: $1.85 trillion.
Both plans attempt to hide the unfunded entitlement costs by means of a deceptive scheme stalling fuller implementation of the public “option” on the House side, and the government-regulated co-ops on the Senate side. Each is delayed not to start until 2013. This execution is designed purely to keep the ten-year projections of each plan under the $1 trillion mark, thus providing political cover for members from more conservative districts and states.
The Baucus plan in essence attempts to deliver an ObamaCare Lite proposal that subtracts out the so-called public “option,” cutting the proposed increase of coverage by about 20 million individuals. His purpose is to find the votes necessary for Senate Democrats who are queasy about voting for what amounts to government-run socialized medicine.
In truth, they should still feel nauseous about casting Yay votes. The proposal establishes government-run ‘co-ops’ that will provide health care in place of private options. It still has a rationing board. It still requires Americans to be insured or else pay a fine. It still does not allow for competition across state lines to purchase medical insurance. It still expands Medicaid. It still increases taxes. It still has no tort reform. As noted above, it still adds to an already unsustainable debt. And, it will still ultimately result in a government-run system, no matter how much Barack Obama denies it.
Particularly devastating to both plans is that they will still inevitably result in rationing—one way or another. The American people are prospective in their outlook, and they are cautious about supporting a proposal that threatens to decrease the high quality of care they are used to receiving.
And Obama has not helped himself on this front.
Writes Dick Morris in a recent column in response to Barack Obama’s joint session of Congress address, “In his hour long speech on health care, [Obama] failed to spend even a moment rebutting the central critique of his program: His inability to provide quality medical care for 30 million new patients without any additional doctors or nurses… The result of expanding the demand for medical services without augmenting the supply of doctors or nurses must be the rationing of medical care. And rationing will inevitably take its greatest toll among the elderly, forcing them to forgo elective surgery or, if their remaining quality years are likely to be limited, to do without vital life-prolonging treatment. Inevitably, we will all have to wait many more days, weeks, months or years for care we now receive on demand.” During which time, one should add, they will die.
Another reason that both plans will result in rationing is that both contain provisions forcing insurers to take on riskier patients without charging more for the premiums. As a result, the costs will be passed on to everybody and distributed throughout the entire system.
In short, that means rates will go up. At the same time the quality of everyone’s coverage will decrease. And individuals will have no choice but to buy the watered-down plans. Soon, more will be allotted in benefits than can be collected in revenue. The program would then turn to borrowing and printing more money to fund it, as have Medicare and Social Security—a flawed approach that will bankrupt the public treasury.
And in the end, Washington will decide who gets care and who does not.
According to Rasmussen Reports, 56 percent of voters now oppose the plan, demonstrating a growing trend of opposition to the takeover. And Barack Obama’s public disapproval has sunk to the 52 percent mark for the first time in his term.
The fact is, the more Barack Obama parades around on television attempting to redesign and repackage his proposals to make them sound more appealing, the more the American people oppose him and his socialist designs. He has not deviated from the unsustainable path of socialized medicine he has chosen. He still cannot walk on water. Which is why his health care scheme is sinking like a rock.
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Obamacare: Quintessential socialism
The overriding characteristic of President Obama's healthcare proposal is forced equality of consumption, a major step in the direction of egalitarian distribution of income. Emphasis is upon the word forced.
As we see with the widespread town hall protests against the President's proposed healthcare proposals, people do not willingly surrender the fruits of many years' labor to the government in the name of an undefined abstraction called the common good. Particularly is this true when it is liberal-progressive bureaucrats who decide arbitrarily what constitutes the common good.
In a Wall Street Journal op-ed essay, Martin Feldstein, Harvard economics professor and former chairman of President Reagan's Council of Economic Advisors, sums up Obamacare: it's all about the raw power to decide who gets what treatment, while cramming everyone into identical little boxes in order to eliminate any efforts in the direction of individuality. And the bureaucratic mechanism for eliminating individuality is rationing medical care.
Despite the repeated lies by the President and his spokesmen, as Professor Feldstein writes, the healthcare bill pressed by House Speaker Nancy Pelosi clearly contemplates rationing.
Many supporters of Obamacare argue that healthcare already is rationed by money availability, because Medicare, Medicaid, and insurance companies will pay only certain amounts for care and will refuse to pay for some specialized treatments or prescription drugs. This ignores the obvious fact that individuals are free to make choices to pay for such care themselves and that it was individuals who selected the insurance payment programs they have.
Under Obamacare, all private insurance would eventually be compelled to offer exactly the same scope of insurance as the so-called public option. Everybody will be compelled to have the same coverage program, whether he is old, young, in poor health, or in good health.
The argument that medical care already is rationed also reflects a deep-rooted aspect of the liberal-progressive-socialist paradigm: the idea that individuals possessing more money than others is an inherently unjust social condition.
Michael Walzer's analysis of that paradigm is typical. Professsor Walzer, one of liberal-progressive-socialism's most prominent theorists, is co-editor of Dissent, a leading socialist journal.
Walzer contends that possession of money amounts to power and that such power is both unjust and unjustly used. It enables the rich to purchase every sort of social good. Why should these goods be distributed to people who have a talent for making money? This, he says, is morally implausible and unsatisfying.
Nor would it be better if we gave money to people on the basis of their intelligence, strength, or moral rectitude. There is no single talent or combination of talents that entitles a man to every available social good.
In the socialists' view, all that should count is need. If people need certain things (leaving aside how that need is determined), they should simply be given them, without regard to their ability to pay. This is what is meant, in Professor Walzer's sense, by social justice. Whenever equality in this sense does not exist, we have a kind of tyranny in which the strong, the well-born, and the wealthy get social goods in amounts that have little to do with their personal qualities or needs.
With respect to medical care, Walzer believes that it should be distributed only to those who are sick, without regard to wealth, intelligence, or righteousness. But in America today, it closely follows the income curve. "From each according to his abilities, to each according to his needs," would, however, be a fine slogan for medical care, he says. Taxes paid by all of us should pay doctors and other medical care providers. This, says Professor Walzer, necessitates a national health service of a sort to which Obamacare inevitably leads.
It isn't that every man should get what he deserves, as in the old definition of justice. The new standard is egalitarian: that is, everyone should have free and equal access to all the goods and services produced by our economy.
Liberal-progressive-socialists' goal is to restructure our political system to make a society of equals that is worth having. The starting point must be to end the tyranny of personal wealth.
A good doctor deserves society's praise, according to Professor Walzer, but that is no reason to pay him any more than any other worker. Why should a steelworker have to work much longer than a doctor for the money to have a home or an automobile? There are rewards intrinsic to the doctor's job, like the pleasure of using his specialized knowledge for the common good. That ought to be enough. There is no meritocratic defense for differences in pay.
As liberals like Professor Walzer see things, the rewards of the good life are social goods that the rich have habitually taken for themselves, without regard to any personal merit. They are merely the rewards that the upper classes throughout history have been able to seize and hold for themselves. Affirmative-action quotas are a way of redistributing these rewards by redistributing the social places that conventionally get the rewards. National Socialist healthcare is another.
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The truth about the public option
It's a Trojan horse — just look at student loans
When will the press notice President Obama’s hypocrisy when it comes to the “public option”?
Speaking at a community college in Troy, N.Y., on Monday, Obama slammed the banking industry for opposing his education bill, which passed the House last week. The bill would change the way the government subsidizes student loans. Under current law, the federal government insures banks against losses on the fixed-rate student loans known as Stafford loans. The government also pays banks a subsidy on these loans to offset their capital costs. In addition, the government offers a “public option,” under which students can borrow directly from the government at the same rates.
This option has been available since 1993, but students and universities overwhelmingly prefer the banks: The government’s share of new federally backed loan originations peaked at 30 percent right after the direct-lending program was created and has fallen steadily to 20 percent since then.
Obama wants to change that by making the government the sole provider — the “single payer,” if you will — of all federally subsidized student loans. He couches this policy change as cutting off an “unwarranted subsidy for the big banks.” So far, however, the press has failed to make the connection between this rhetoric and Obama’s pitch for health-care reform. The changes he wants in health care would make the market for health insurance look a lot like the market for student loans.
If Obamacare were to become law, everyone would be required to purchase a health plan. Those who couldn’t afford one would get a subsidy. Obama also wants to create a government-run public option so that people could purchase health insurance directly from the government. He says this would promote competition and keep the private insurers honest — which is exactly how Democrats defended the public option in student loans when it was created.
So let’s compare: Obama’s health-care plan would create a subsidy for private health-insurance companies akin to the subsidy for banks that he now calls “unwarranted” — the only difference is that the health-insurance subsidy would be delivered indirectly, by requiring people to purchase care and then paying for those who can’t afford it. Obama’s health-care plan would also let employers and individuals choose between private insurance and a public option, akin to the one the Democrats set up for student loans in 1993.
Here’s the question the press should be asking: If Obama thinks this arrangement is such a wasteful and inefficient way to subsidize student loans, why does he want to make it the way we subsidize health insurance? First, Obama is right to point out that subsidizing student loans costs the government a lot of money. But cutting out the banks merely allows the government to use accounting gimmicks to hide the costs.
Meanwhile, the subsidies are captured by the universities in the form of ever-rising tuition. Whether the government insures banks against default or, as Obama’s bill would do, directly assumes that risk, students who might not be good candidates for college are nevertheless approved for large amounts of financing. The resulting increase in demand has driven the cost of higher education skyward; worse, it has encouraged students to take on enormous debt loads that, depending on their aptitudes, they might not be able to repay. This is one lesson we can draw from the world of student loans and apply to Obama’s health-care plan: Government subsidies drive costs up, not down.
Another, even more important lesson to be drawn is this: “Public options” are Trojan horses for nationalization. Obama’s position on the public option for student loans and his position on the public option for health insurance are directly at odds. Why won’t anyone in the press call him on it?
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No concern over whether staff were qualified, apparently. "Shoot the messenger" approach instead
A senior NHS nurse faced a “witchhunt” and was threatened with having her house burnt down if she did not drop a complaint against a colleague, an employment tribunal has been told.
Jenny Fecitt, who worked at an NHS walk-in centre in Wythenshawe, South Manchester, said that at the time of a phone call in which the threat was made she was in dispute with her employer after raising concerns over another nurse’s qualifications.
Mrs Fecitt had complained to bosses at NHS Manchester over one of the staff on her team, Daniel Swift, whom she claimed “misrepresented” his training and should not have been treating adult patients. But her concerns were ignored by trust bosses, it is alleged, and she was subjected to a “character assassination” before receiving the threatening call. “The substance of the call was if I did not drop the case against Daniel Swift that our house would be burnt down,” Mrs Fecitt told the employment tribunal, sitting in Manchester.
Mrs Fecitt, along with Annie Woodcock and Felicity Hughes, her fellow nurses, is taking NHS Manchester to the tribunal, claiming that they were victimised after voicing their concerns. The tribunal heard that problems began on March 3, 2008, after Mrs Woodcock approached her about Mr Swift’s qualifications.
Mrs Fecitt said that during a casual conversation among staff he maintained that he was qualified as both a child and adult nurse. She called the Nursing and Midwifery Council and was told that he was qualified to treat only children. Mrs Fecitt spoke to her line manager and, the next day, Mr Swift is alleged to have called her in an “aggressive and confrontational” manner.
She told the tribunal that it was her “moral and professional” obligation to report Mr Swift to the nursing council. She also contacted the trust’s officer responsible for corporate governance and whistleblowing in April 2008 and an investigation was started. But the following month she was relieved of her management responsibilities.
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Australia: Coverup of bullying at NSW government hospital
The New South Wales Opposition says nurses who have complained of bullying at a far south coast hospital would not mind if findings of an investigation were made public. Bega MP Andrew Constance says an external investigator's report on bullying and operational issues at Pambula Hospital should be given to the community.
The Greater Southern Area Health Service says the report will not be released publicly. However, a summary and set of recommendations will be released. Its eastern sector general manager, Ken Barnett, says staff and appropriate unions will be consulted before it is considered whether to implement recommendations.
Mr Constance says if unions are entitled to know the findings, so should the broader community, and nurses names could be omitted from the documents. "You don't necessarily need to disclose names but the community are entitled to know what occurred at the facility and what is going to be done about it in the future," he said. "The only way that the confidence can be regained by the community in what's occurring at Pambula Hospital is for that availability of the information and that openness and transparency around what's happened."
He says not releasing the investigation findings to the community will further erode public confidence in the health system. "I think nurses want accountability in the system. They want to be able to raise issues of concern and I think there's been enough secrecy clouding the hospital as is without it being furthered by a government not willing to be open and transparent about this report," he said. "The community is aware of the investigation. It's important that the community have the recommendations and the findings of that investigation."
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Barack Obama Cannot Walk on Water, and Neither Can ObamaCare
As Barack Obama travels across the fruited plain and sucks up all the air on every Sunday network news show—except for FOX News Sunday—attempting to repackage his plans to take over the health care industry by force of law, one thing has remained constant. According to Dr. Obama, under his “plan,” tens of millions more Americans will receive taxpayer-subsidized health care, the quality of medical care will increase, and it will all occur at no extra cost to taxpayers. After that, he plans to walk on water.
In reality, of course, there are more than a few problems with the Obama Administration’s claims. Namely, the numbers simply do not add up. Expanding health coverage is a costly venture, and the American people are not fooled. They know they will wind up paying through the nose for this massive expansion of federal entitlements. And that these will add substantially to the national debt, which now totals some $11.8 trillion.
The House plan, which 45 million people qualify for, at an average cost of $4,700 per premium according to the National Coalition on Health Care, would add on $211.5 billion in extra costs to taxpayers every single year once fully implemented. That’s $2.1 trillion over ten years.
It doesn’t get much better even under the so-called “bipartisan compromise” legislation—that not a single Republican supports—now being floated by Montana Democrat Senator Max Baucus. Under his plan, an additional 26 million individuals would receive government-subsidized health care, which at $4,700 for a premium, adds up to $122 billion extra every year, or $1.2 trillion over ten years.
All of which will be piled atop the greatest budget deficit in human history: $1.85 trillion.
Both plans attempt to hide the unfunded entitlement costs by means of a deceptive scheme stalling fuller implementation of the public “option” on the House side, and the government-regulated co-ops on the Senate side. Each is delayed not to start until 2013. This execution is designed purely to keep the ten-year projections of each plan under the $1 trillion mark, thus providing political cover for members from more conservative districts and states.
The Baucus plan in essence attempts to deliver an ObamaCare Lite proposal that subtracts out the so-called public “option,” cutting the proposed increase of coverage by about 20 million individuals. His purpose is to find the votes necessary for Senate Democrats who are queasy about voting for what amounts to government-run socialized medicine.
In truth, they should still feel nauseous about casting Yay votes. The proposal establishes government-run ‘co-ops’ that will provide health care in place of private options. It still has a rationing board. It still requires Americans to be insured or else pay a fine. It still does not allow for competition across state lines to purchase medical insurance. It still expands Medicaid. It still increases taxes. It still has no tort reform. As noted above, it still adds to an already unsustainable debt. And, it will still ultimately result in a government-run system, no matter how much Barack Obama denies it.
Particularly devastating to both plans is that they will still inevitably result in rationing—one way or another. The American people are prospective in their outlook, and they are cautious about supporting a proposal that threatens to decrease the high quality of care they are used to receiving.
And Obama has not helped himself on this front.
Writes Dick Morris in a recent column in response to Barack Obama’s joint session of Congress address, “In his hour long speech on health care, [Obama] failed to spend even a moment rebutting the central critique of his program: His inability to provide quality medical care for 30 million new patients without any additional doctors or nurses… The result of expanding the demand for medical services without augmenting the supply of doctors or nurses must be the rationing of medical care. And rationing will inevitably take its greatest toll among the elderly, forcing them to forgo elective surgery or, if their remaining quality years are likely to be limited, to do without vital life-prolonging treatment. Inevitably, we will all have to wait many more days, weeks, months or years for care we now receive on demand.” During which time, one should add, they will die.
Another reason that both plans will result in rationing is that both contain provisions forcing insurers to take on riskier patients without charging more for the premiums. As a result, the costs will be passed on to everybody and distributed throughout the entire system.
In short, that means rates will go up. At the same time the quality of everyone’s coverage will decrease. And individuals will have no choice but to buy the watered-down plans. Soon, more will be allotted in benefits than can be collected in revenue. The program would then turn to borrowing and printing more money to fund it, as have Medicare and Social Security—a flawed approach that will bankrupt the public treasury.
And in the end, Washington will decide who gets care and who does not.
According to Rasmussen Reports, 56 percent of voters now oppose the plan, demonstrating a growing trend of opposition to the takeover. And Barack Obama’s public disapproval has sunk to the 52 percent mark for the first time in his term.
The fact is, the more Barack Obama parades around on television attempting to redesign and repackage his proposals to make them sound more appealing, the more the American people oppose him and his socialist designs. He has not deviated from the unsustainable path of socialized medicine he has chosen. He still cannot walk on water. Which is why his health care scheme is sinking like a rock.
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Obamacare: Quintessential socialism
The overriding characteristic of President Obama's healthcare proposal is forced equality of consumption, a major step in the direction of egalitarian distribution of income. Emphasis is upon the word forced.
As we see with the widespread town hall protests against the President's proposed healthcare proposals, people do not willingly surrender the fruits of many years' labor to the government in the name of an undefined abstraction called the common good. Particularly is this true when it is liberal-progressive bureaucrats who decide arbitrarily what constitutes the common good.
In a Wall Street Journal op-ed essay, Martin Feldstein, Harvard economics professor and former chairman of President Reagan's Council of Economic Advisors, sums up Obamacare: it's all about the raw power to decide who gets what treatment, while cramming everyone into identical little boxes in order to eliminate any efforts in the direction of individuality. And the bureaucratic mechanism for eliminating individuality is rationing medical care.
Despite the repeated lies by the President and his spokesmen, as Professor Feldstein writes, the healthcare bill pressed by House Speaker Nancy Pelosi clearly contemplates rationing.
Many supporters of Obamacare argue that healthcare already is rationed by money availability, because Medicare, Medicaid, and insurance companies will pay only certain amounts for care and will refuse to pay for some specialized treatments or prescription drugs. This ignores the obvious fact that individuals are free to make choices to pay for such care themselves and that it was individuals who selected the insurance payment programs they have.
Under Obamacare, all private insurance would eventually be compelled to offer exactly the same scope of insurance as the so-called public option. Everybody will be compelled to have the same coverage program, whether he is old, young, in poor health, or in good health.
The argument that medical care already is rationed also reflects a deep-rooted aspect of the liberal-progressive-socialist paradigm: the idea that individuals possessing more money than others is an inherently unjust social condition.
Michael Walzer's analysis of that paradigm is typical. Professsor Walzer, one of liberal-progressive-socialism's most prominent theorists, is co-editor of Dissent, a leading socialist journal.
Walzer contends that possession of money amounts to power and that such power is both unjust and unjustly used. It enables the rich to purchase every sort of social good. Why should these goods be distributed to people who have a talent for making money? This, he says, is morally implausible and unsatisfying.
Nor would it be better if we gave money to people on the basis of their intelligence, strength, or moral rectitude. There is no single talent or combination of talents that entitles a man to every available social good.
In the socialists' view, all that should count is need. If people need certain things (leaving aside how that need is determined), they should simply be given them, without regard to their ability to pay. This is what is meant, in Professor Walzer's sense, by social justice. Whenever equality in this sense does not exist, we have a kind of tyranny in which the strong, the well-born, and the wealthy get social goods in amounts that have little to do with their personal qualities or needs.
With respect to medical care, Walzer believes that it should be distributed only to those who are sick, without regard to wealth, intelligence, or righteousness. But in America today, it closely follows the income curve. "From each according to his abilities, to each according to his needs," would, however, be a fine slogan for medical care, he says. Taxes paid by all of us should pay doctors and other medical care providers. This, says Professor Walzer, necessitates a national health service of a sort to which Obamacare inevitably leads.
It isn't that every man should get what he deserves, as in the old definition of justice. The new standard is egalitarian: that is, everyone should have free and equal access to all the goods and services produced by our economy.
Liberal-progressive-socialists' goal is to restructure our political system to make a society of equals that is worth having. The starting point must be to end the tyranny of personal wealth.
A good doctor deserves society's praise, according to Professor Walzer, but that is no reason to pay him any more than any other worker. Why should a steelworker have to work much longer than a doctor for the money to have a home or an automobile? There are rewards intrinsic to the doctor's job, like the pleasure of using his specialized knowledge for the common good. That ought to be enough. There is no meritocratic defense for differences in pay.
As liberals like Professor Walzer see things, the rewards of the good life are social goods that the rich have habitually taken for themselves, without regard to any personal merit. They are merely the rewards that the upper classes throughout history have been able to seize and hold for themselves. Affirmative-action quotas are a way of redistributing these rewards by redistributing the social places that conventionally get the rewards. National Socialist healthcare is another.
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The truth about the public option
It's a Trojan horse — just look at student loans
When will the press notice President Obama’s hypocrisy when it comes to the “public option”?
Speaking at a community college in Troy, N.Y., on Monday, Obama slammed the banking industry for opposing his education bill, which passed the House last week. The bill would change the way the government subsidizes student loans. Under current law, the federal government insures banks against losses on the fixed-rate student loans known as Stafford loans. The government also pays banks a subsidy on these loans to offset their capital costs. In addition, the government offers a “public option,” under which students can borrow directly from the government at the same rates.
This option has been available since 1993, but students and universities overwhelmingly prefer the banks: The government’s share of new federally backed loan originations peaked at 30 percent right after the direct-lending program was created and has fallen steadily to 20 percent since then.
Obama wants to change that by making the government the sole provider — the “single payer,” if you will — of all federally subsidized student loans. He couches this policy change as cutting off an “unwarranted subsidy for the big banks.” So far, however, the press has failed to make the connection between this rhetoric and Obama’s pitch for health-care reform. The changes he wants in health care would make the market for health insurance look a lot like the market for student loans.
If Obamacare were to become law, everyone would be required to purchase a health plan. Those who couldn’t afford one would get a subsidy. Obama also wants to create a government-run public option so that people could purchase health insurance directly from the government. He says this would promote competition and keep the private insurers honest — which is exactly how Democrats defended the public option in student loans when it was created.
So let’s compare: Obama’s health-care plan would create a subsidy for private health-insurance companies akin to the subsidy for banks that he now calls “unwarranted” — the only difference is that the health-insurance subsidy would be delivered indirectly, by requiring people to purchase care and then paying for those who can’t afford it. Obama’s health-care plan would also let employers and individuals choose between private insurance and a public option, akin to the one the Democrats set up for student loans in 1993.
Here’s the question the press should be asking: If Obama thinks this arrangement is such a wasteful and inefficient way to subsidize student loans, why does he want to make it the way we subsidize health insurance? First, Obama is right to point out that subsidizing student loans costs the government a lot of money. But cutting out the banks merely allows the government to use accounting gimmicks to hide the costs.
Meanwhile, the subsidies are captured by the universities in the form of ever-rising tuition. Whether the government insures banks against default or, as Obama’s bill would do, directly assumes that risk, students who might not be good candidates for college are nevertheless approved for large amounts of financing. The resulting increase in demand has driven the cost of higher education skyward; worse, it has encouraged students to take on enormous debt loads that, depending on their aptitudes, they might not be able to repay. This is one lesson we can draw from the world of student loans and apply to Obama’s health-care plan: Government subsidies drive costs up, not down.
Another, even more important lesson to be drawn is this: “Public options” are Trojan horses for nationalization. Obama’s position on the public option for student loans and his position on the public option for health insurance are directly at odds. Why won’t anyone in the press call him on it?
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Wednesday, September 23, 2009
One in six NHS patients 'misdiagnosed'
As many as one in six patients treated in NHS hospitals and GPs’ surgeries is being misdiagnosed, experts have warned. Doctors were making mistakes in up to 15 per cent of cases because they were too quick to judge patients’ symptoms, they said, while others were reluctant to ask more senior colleagues for help.
While in most cases the misdiagnosis did not result in the patient suffering serious harm, a sizeable number of the millions of NHS patients were likely to suffer significant health problems as a result, according to figures. It was said that the number of misdiagnoses was “just the tip of the iceberg”, with many people still reluctant to report mistakes by their doctors. There was a call for better reporting methods to ensure that each misdiagnosis was recorded and monitored properly.
Prof Graham Neale, of the Imperial Centre for Patient Safety and Service Quality at Imperial College London, who is carrying out research into cases of misdiagnosis in the NHS, said it was a problem that was not being adequately dealt with. “There is absolutely no doubt that this is being under-reported,” he said. “But more importantly they are not being adequately analysed. “Trainee doctors are too quick to judgment, that is one of the problems that we face.” He added, however, that in many cases, the medical errors were rectified within 48 hours.
The experts drew on research published in the American Journal of Medicine that estimated that up to 15 per cent of all medical cases in developed countries were misdiagnosed.
Earlier this year, the Healthcare Commission found that missed or wrong diagnoses were a major cause of complaints to the NHS. Of more than 9,000 complaints analysed, almost one in 10 related to a delay in diagnosis or the wrong diagnosis being made. Separate research also suggested that one in 10 patients in hospital was harmed because of the care they received.
Peter Walsh, the chief executive of Action Against Medical Accidents, a campaign group, said his charity received 4,000 calls a year from people who thought that their condition had been misdiagnosed. “This is just the tip of the iceberg,” he said. “There is no mandatory reporting of missed diagnoses so the true scale cannot be known. “There are very few reports to the National Patient Safety Agency (NPSA) and we would like to see it become a legal requirement for all missed diagnoses to be reported.”
Dr Robert Hendry, head of medical services at the Medical Protection Society, said misdiagnosis was a factor in two thirds of complaints against GPs. “It’s a very significant problem for the NHS,” he said. The NPSA runs a database that records medical errors, patient incidents, mistakes in medical notes and near-misses on a voluntary basis. Between April 2008 and March 2009 there were 39,500 reports of incidents involving clinical assessment. Those included missed or wrong diagnosis but also related to scans that could have been misinterpreted or where the wrong body part was scanned or tests where patients’ samples could have been mixed up.
Dr Kevin Cleary, the medical director of the NPSA, said there were a number of reasons that a diagnosis could be missed or be inaccurate, including a lack of training, test results that were misinterpreted, poor communication and diseases that had similar symptoms. “Missed diagnosis is one of the most complex issues in medical reporting,” he said. “There are some illnesses, like flu for example, where the symptoms for a number of conditions are very similar, especially early on, so it is not always possible to make a diagnosis immediately.”
A spokesman for the Department of Health said more than one million “patient safety incidents” were reported every year, the vast majority of which caused patients no harm. “We are examining a move to obliging the NHS as a whole to report to the National reporting and learning system run by National Patient Safety Agency,” the spokesman said. “The NHS already collects data on safety incidents including misdiagnoses through the National Patient Safety Agency's reporting system and uses this data to learn from incidents."
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NHS farms surgery out to cowboy private operators
They were trying to get a cheap deal by bypassing the established private hospitals and a cheap deal they got -- not so cheap in the long run, though
People having hip replacements at private treatment centres brought in to cut waiting times are up to 20 times more likely to need painful and expensive repair work. Many operations are having to be redone in NHS hospitals, at great cost and with serious staffing implications for the health service.
A study by orthopaedic surgeons in Cardiff found that of 113 hip operations on patients sent from their NHS trust to Weston-super-Mare NHS Treatment Centre between 2004 and 2006, two thirds showed clear evidence of poor surgical technique, such as poor cementing of the hip. In the three years since the operation, 18 per cent had undergone revision or were awaiting an operation — 20 times the 0.9 per cent NHS-wide revision rate at three years. A study on knee operations at the unit, conducted earlier this year, recorded a tenfold increase in revision rates.
Since the Independent Sector Treatment Centre (ISTC) programme was introduced in 2003, dozens of centres have been set up, mainly conducting orthopaedic surgery, cataracts and diagnostic screening. A total of 44 are described as NHS centres — though they are often staffed by independent sector contracts — and 23 are provided by private companies.
Leading surgeons said that this new data underlined the need for a significent overhaul of the multimillion-pound programme, which was introduced with great fanfare by the Government to reduce waiting times and increase patient choice.
They said a total lack of supervision of the sector and its clinical outcomes was a dereliction of duty by the Government, which had put a premium on reducing numbers rather than patient care. Early concerns about poorly vetted overseas doctors carrying out the work had not been addressed, they said.
The Cardiff study, published in the Journal of Bone and Joint Surgery, offers the most compelling evidence to date of problems with care in the sector, and the lack of proper auditing.Surgeons told The Times that the data backed anecdotal reports from elsewhere in the country, although it was likely to be at the high end. They said that NHS trusts were being left to manage the extra workload created.
While a hip replacement costs £6,000, the more complex repair operations, with more expensive implants, bone grafts and longer hospital stays, cost between £10,000 and £15,000. In an accompanying editorial in the journal, Fares Haddad, a consultant orthopaedic surgeon based at University College Hospital, London, says that the whole programme is in jeopardy because of the lack proper audit and follow-up. He adds that were such performance data available — and even if revision rates were lower — it would still “make the economic argument for ISTCs untenable”.
Mr Haddad told The Times that the disruption caused by the errors had an acute impact on hospitals, budgets and patients. He said that a revision rate of 3 per cent would still be unacceptable as it was “200 per cent greater than the NHS norm”, and even more so given that most treatment centres were sent the easier orthopaedic cases. “We all want to cut waiting lists and give excellent care to patients,” he said. “But this was introduced without data to show that it worked. We are now seeing the studies to show that.
“We have all had work increased by this, and the cost implications are huge too. Revision work costs two or three times the cost of a primary replacement. What is more, the failure of a joint replacement is often worse than the arthritis that led to the original operation. Mr Haddad added that if it were compulsory to register every operation on the National Joint Registry, trends would quickly emerge. “We would start picking up on those that were failing,” he said.
Tony Hui, chairman of the British Orthopaedic Directors Society, which represents heads of NHS orthopaedic departments, said that care in his area of South Teesside had also been affected. “We are seeing patients that have been treated elsewhere and they have problems and end up back at the NHS. The work has been suboptimal, and we have to do the revision which is time consuming, risky and expensive. With each case that comes along it’s another half day of operating — which could be two other patients.”
Steve Cannon, a surgeon at the Royal National Orthopaedic Hospital, Stanmore, northwest London, said the scheme had been about “speed of getting through the numbers” and was an “iniquitous waste of money”.
David Worskett, director of NHS Partners Network, which represents independent providers, said that the sector was being unfairly portrayed by surgeons and many were offering care of an excellent standard. He said that he could not comment on the case of Weston-super-Mare because, although private provision of care was involved, it was organised by the NHS.
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Obamacare Preys on the Young, Flouts the Constitution
Ask the Obama administration why it is pushing legislation to conscript the young, and it will likely deny doing any such thing. But how else to describe individual mandates, the latest twist in the White House's nationalized health care scheme?
It's bad enough that the federal government is expanding its own power in telling citizens that they absolutely must pay for health insurance, like it or not. The most sinister element is that politically unpopular tax increases can be delayed or minimized by taking healthy young people and shoehorning them into a massive entitlement system. The youngest taxpayers would have to swallow their mandated insurance like bad medicine.
We've seen this movie before with Social Security, which has been in a perpetual state of crisis for years and for President George W. Bush became the third rail of politics. Why would Congress want to impose another similarly disastrous scheme on the American people? Probably because it's the only way to ensure the support of special interests in the pursuit of universal health care. Forcing everyone to purchase insurance from government-approved plans would be a boon for the industry: It's not so much guaranteed coverage as it is guaranteed profits.
Too bad for Democrats, there's a higher authority than America's Health Insurance Plans -- the U.S. Constitution. David B. Rivkin Jr. and Lee A. Casey wrote in the Wall Street Journal on Friday that constitutional limitations on congressional power prohibit Sen. Max Baucus, D-Mont.'s, most recent plan.
If the legislative branch wants to remake or reform the health care industry, it must do so according to the Commerce Clause. Regulation can occur only when activities are shown to substantially affect interstate commerce. And charging people to opt out of a federal imposition is mere euphemism for regulating every American into performing what the government wants him to do. With that precedent set, "Congress could evade all constitutional limits by 'taxing' anyone who doesn't follow an order of any kind."
Not that Americans are counting on Democrats to follow the rules anyway. The financial crisis has seen to it that politicians will stop at no law, no limitation on power, to look like they're solving problems. It's only natural when they don't think the American people can solve their own.
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ALG Slams Baucus Bill as "Socialized Medicine in Trick or Treat Garb"
Americans for Limited Government President Bill Wilson today slammed Senator Max Baucus’ “chairman’s mark” on the Senate Finance Committee’s version of the “ObamaCare” proposal as “just another means to the end—socialized medicine in trick or treat garb.” Baucus sought to create a plan without the so-called “public option” as a means of garnering support for health care legislation that could pass this year. Wilson said it doesn’t matter.
“This is still a government takeover of the health care industry,” Wilson said. “The proposal creates government-run ‘co-ops’ to administer care in place of private options. It still sets up a rationing board. It still forces Americans to be insured or else pay a fine. It still does nothing to allow Americans to purchase insurance across state lines. It still expands Medicaid. It still increases taxes. It still has no tort reform. And it still adds to an already unsustainable debt.”
“It may move a little slower toward the goal of a single-payer system, but there is no question that under the Baucus proposal, Americans would be tricked into getting a treat that would crush our health care industry,” Wilson added.
Wilson said the proposal would ultimately result in Americans “being forced off of their current health care plans—which are excellent—and into a government-regulated co-ops that will drastically increase in costs since insurance policies will no longer be based on individual risk.”
Wilson pointed to provisions that force insurers to take on riskier patients without charging more for the premiums. “As a result, the associated risk costs will be passed on to everybody, distributed throughout the system, which means rates will go up. At the same time the quality of everyone’s coverage will be watered down to pay for the uninsurables. And individuals will have no choice but to buy the plans per the mandate.”
Wilson said that the system would not be pay for itself, and would lead to greater taxpayer-subsidized health care. “To make up for the inevitable shortfalls and deficits that will be endemic throughout the system, taxes under the plan will be raised on businesses and individuals.”
The Baucus bill is said insure an additional 26 million individuals that Wilson says could cost as much as $1.22 trillion over ten years. The average cost for an insurance premium is $4,700, according to the National Coalition on Health Care. “That’s about $122 billion extra every year we don’t have. That’s on top of ‘stimulus’ and TARP and all the rest of Barack Obama’s record-setting $1.85 trillion deficit. Under the Baucus proposal, the American people will be dealt yet another unsustainable entitlement that over time will totally consume the public treasury,” Wilson said.
Wilson credited concerned citizen efforts nationwide, including ALG’s 400,000 member activists, who have called, emailed, wrote letters to, and visited with Congressmen at their offices and town hall meetings for persuading many elected officials to vote against the bill. He said public opposition to the bill “is the only reason lawmakers are now considering removing the public ‘option.’ Only, the American people still do not want the total destruction of private health care now being proposed.”
According to Rasmussen Reports, 56 percent of voters now oppose the plan. And Barack Obama’s public disapproval has sunk to the 52 percent mark for the first time in his term.
“Harry Reid still doesn’t have the 60 votes needed in the Senate for cloture on the so-called ‘public option,’ and so Senate Democrats have begun watering down their proposal. Really, this is the beginning of the end—they are fleeing for the lifeboats on a political Titantic. Nobody wants to be left without a seat,” Wilson concluded.
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ObamaCare’s Smoke and Mirrors: Huge Costs Paid for by Imaginary Savings
Obama’s health care plan uses imaginary savings to finance massive new spending. His claim that it will not increase the deficit is based on the notion that he can squeeze $2 trillion in savings out of the current health care system to finance his plan’s huge costs.
Washington Post columnist Charles Krauthammer, who once practiced medicine, points out in his column that these savings aren’t real, and that politicians falsely promise to pay for new programs through imaginary savings all the time:
“Obama said he would largely solve the insoluble cost problem of ObamaCare by eliminating ‘hundreds of billions of dollars in waste and fraud’ from Medicare. . . .That’s just an insult to our intelligence. Waste, fraud and abuse as the all-purpose piggy bank for budget savings has been a joke since Jimmy Carter first used it in 1977. Moreover, if half a trillion is waiting to be squeezed painlessly out of Medicare, why wait for health-care reform? If, as Obama repeatedly insists, Medicare overspending is breaking the budget, why hasn’t he gotten started on the painless billions in ‘waste and fraud’ savings?”
Even staunch Democrats admit the president’s claims are questionable. Tennessee Governor Phil Bredesen (D) is criticizing Obama’s health care plan as “the mother of all unfunded mandates,” saying it will force states to massively raise taxes or run big deficits. Earlier, one of Obama’s own economic advisers said his health care plan would explode the federal budget deficit and lead to “crippling deficits” and “higher taxes.”
The Associated Press said Obama’s proposals would “would drive up the deficit by billions of dollars.” The Washington Post, which hasn’t endorsed a Republican for president since 1952, noted that “the expanded coverage would add more than $1 trillion to the deficit.”
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As many as one in six patients treated in NHS hospitals and GPs’ surgeries is being misdiagnosed, experts have warned. Doctors were making mistakes in up to 15 per cent of cases because they were too quick to judge patients’ symptoms, they said, while others were reluctant to ask more senior colleagues for help.
While in most cases the misdiagnosis did not result in the patient suffering serious harm, a sizeable number of the millions of NHS patients were likely to suffer significant health problems as a result, according to figures. It was said that the number of misdiagnoses was “just the tip of the iceberg”, with many people still reluctant to report mistakes by their doctors. There was a call for better reporting methods to ensure that each misdiagnosis was recorded and monitored properly.
Prof Graham Neale, of the Imperial Centre for Patient Safety and Service Quality at Imperial College London, who is carrying out research into cases of misdiagnosis in the NHS, said it was a problem that was not being adequately dealt with. “There is absolutely no doubt that this is being under-reported,” he said. “But more importantly they are not being adequately analysed. “Trainee doctors are too quick to judgment, that is one of the problems that we face.” He added, however, that in many cases, the medical errors were rectified within 48 hours.
The experts drew on research published in the American Journal of Medicine that estimated that up to 15 per cent of all medical cases in developed countries were misdiagnosed.
Earlier this year, the Healthcare Commission found that missed or wrong diagnoses were a major cause of complaints to the NHS. Of more than 9,000 complaints analysed, almost one in 10 related to a delay in diagnosis or the wrong diagnosis being made. Separate research also suggested that one in 10 patients in hospital was harmed because of the care they received.
Peter Walsh, the chief executive of Action Against Medical Accidents, a campaign group, said his charity received 4,000 calls a year from people who thought that their condition had been misdiagnosed. “This is just the tip of the iceberg,” he said. “There is no mandatory reporting of missed diagnoses so the true scale cannot be known. “There are very few reports to the National Patient Safety Agency (NPSA) and we would like to see it become a legal requirement for all missed diagnoses to be reported.”
Dr Robert Hendry, head of medical services at the Medical Protection Society, said misdiagnosis was a factor in two thirds of complaints against GPs. “It’s a very significant problem for the NHS,” he said. The NPSA runs a database that records medical errors, patient incidents, mistakes in medical notes and near-misses on a voluntary basis. Between April 2008 and March 2009 there were 39,500 reports of incidents involving clinical assessment. Those included missed or wrong diagnosis but also related to scans that could have been misinterpreted or where the wrong body part was scanned or tests where patients’ samples could have been mixed up.
Dr Kevin Cleary, the medical director of the NPSA, said there were a number of reasons that a diagnosis could be missed or be inaccurate, including a lack of training, test results that were misinterpreted, poor communication and diseases that had similar symptoms. “Missed diagnosis is one of the most complex issues in medical reporting,” he said. “There are some illnesses, like flu for example, where the symptoms for a number of conditions are very similar, especially early on, so it is not always possible to make a diagnosis immediately.”
A spokesman for the Department of Health said more than one million “patient safety incidents” were reported every year, the vast majority of which caused patients no harm. “We are examining a move to obliging the NHS as a whole to report to the National reporting and learning system run by National Patient Safety Agency,” the spokesman said. “The NHS already collects data on safety incidents including misdiagnoses through the National Patient Safety Agency's reporting system and uses this data to learn from incidents."
SOURCE
NHS farms surgery out to cowboy private operators
They were trying to get a cheap deal by bypassing the established private hospitals and a cheap deal they got -- not so cheap in the long run, though
People having hip replacements at private treatment centres brought in to cut waiting times are up to 20 times more likely to need painful and expensive repair work. Many operations are having to be redone in NHS hospitals, at great cost and with serious staffing implications for the health service.
A study by orthopaedic surgeons in Cardiff found that of 113 hip operations on patients sent from their NHS trust to Weston-super-Mare NHS Treatment Centre between 2004 and 2006, two thirds showed clear evidence of poor surgical technique, such as poor cementing of the hip. In the three years since the operation, 18 per cent had undergone revision or were awaiting an operation — 20 times the 0.9 per cent NHS-wide revision rate at three years. A study on knee operations at the unit, conducted earlier this year, recorded a tenfold increase in revision rates.
Since the Independent Sector Treatment Centre (ISTC) programme was introduced in 2003, dozens of centres have been set up, mainly conducting orthopaedic surgery, cataracts and diagnostic screening. A total of 44 are described as NHS centres — though they are often staffed by independent sector contracts — and 23 are provided by private companies.
Leading surgeons said that this new data underlined the need for a significent overhaul of the multimillion-pound programme, which was introduced with great fanfare by the Government to reduce waiting times and increase patient choice.
They said a total lack of supervision of the sector and its clinical outcomes was a dereliction of duty by the Government, which had put a premium on reducing numbers rather than patient care. Early concerns about poorly vetted overseas doctors carrying out the work had not been addressed, they said.
The Cardiff study, published in the Journal of Bone and Joint Surgery, offers the most compelling evidence to date of problems with care in the sector, and the lack of proper auditing.Surgeons told The Times that the data backed anecdotal reports from elsewhere in the country, although it was likely to be at the high end. They said that NHS trusts were being left to manage the extra workload created.
While a hip replacement costs £6,000, the more complex repair operations, with more expensive implants, bone grafts and longer hospital stays, cost between £10,000 and £15,000. In an accompanying editorial in the journal, Fares Haddad, a consultant orthopaedic surgeon based at University College Hospital, London, says that the whole programme is in jeopardy because of the lack proper audit and follow-up. He adds that were such performance data available — and even if revision rates were lower — it would still “make the economic argument for ISTCs untenable”.
Mr Haddad told The Times that the disruption caused by the errors had an acute impact on hospitals, budgets and patients. He said that a revision rate of 3 per cent would still be unacceptable as it was “200 per cent greater than the NHS norm”, and even more so given that most treatment centres were sent the easier orthopaedic cases. “We all want to cut waiting lists and give excellent care to patients,” he said. “But this was introduced without data to show that it worked. We are now seeing the studies to show that.
“We have all had work increased by this, and the cost implications are huge too. Revision work costs two or three times the cost of a primary replacement. What is more, the failure of a joint replacement is often worse than the arthritis that led to the original operation. Mr Haddad added that if it were compulsory to register every operation on the National Joint Registry, trends would quickly emerge. “We would start picking up on those that were failing,” he said.
Tony Hui, chairman of the British Orthopaedic Directors Society, which represents heads of NHS orthopaedic departments, said that care in his area of South Teesside had also been affected. “We are seeing patients that have been treated elsewhere and they have problems and end up back at the NHS. The work has been suboptimal, and we have to do the revision which is time consuming, risky and expensive. With each case that comes along it’s another half day of operating — which could be two other patients.”
Steve Cannon, a surgeon at the Royal National Orthopaedic Hospital, Stanmore, northwest London, said the scheme had been about “speed of getting through the numbers” and was an “iniquitous waste of money”.
David Worskett, director of NHS Partners Network, which represents independent providers, said that the sector was being unfairly portrayed by surgeons and many were offering care of an excellent standard. He said that he could not comment on the case of Weston-super-Mare because, although private provision of care was involved, it was organised by the NHS.
SOURCE
Obamacare Preys on the Young, Flouts the Constitution
Ask the Obama administration why it is pushing legislation to conscript the young, and it will likely deny doing any such thing. But how else to describe individual mandates, the latest twist in the White House's nationalized health care scheme?
It's bad enough that the federal government is expanding its own power in telling citizens that they absolutely must pay for health insurance, like it or not. The most sinister element is that politically unpopular tax increases can be delayed or minimized by taking healthy young people and shoehorning them into a massive entitlement system. The youngest taxpayers would have to swallow their mandated insurance like bad medicine.
We've seen this movie before with Social Security, which has been in a perpetual state of crisis for years and for President George W. Bush became the third rail of politics. Why would Congress want to impose another similarly disastrous scheme on the American people? Probably because it's the only way to ensure the support of special interests in the pursuit of universal health care. Forcing everyone to purchase insurance from government-approved plans would be a boon for the industry: It's not so much guaranteed coverage as it is guaranteed profits.
Too bad for Democrats, there's a higher authority than America's Health Insurance Plans -- the U.S. Constitution. David B. Rivkin Jr. and Lee A. Casey wrote in the Wall Street Journal on Friday that constitutional limitations on congressional power prohibit Sen. Max Baucus, D-Mont.'s, most recent plan.
If the legislative branch wants to remake or reform the health care industry, it must do so according to the Commerce Clause. Regulation can occur only when activities are shown to substantially affect interstate commerce. And charging people to opt out of a federal imposition is mere euphemism for regulating every American into performing what the government wants him to do. With that precedent set, "Congress could evade all constitutional limits by 'taxing' anyone who doesn't follow an order of any kind."
Not that Americans are counting on Democrats to follow the rules anyway. The financial crisis has seen to it that politicians will stop at no law, no limitation on power, to look like they're solving problems. It's only natural when they don't think the American people can solve their own.
SOURCE
ALG Slams Baucus Bill as "Socialized Medicine in Trick or Treat Garb"
Americans for Limited Government President Bill Wilson today slammed Senator Max Baucus’ “chairman’s mark” on the Senate Finance Committee’s version of the “ObamaCare” proposal as “just another means to the end—socialized medicine in trick or treat garb.” Baucus sought to create a plan without the so-called “public option” as a means of garnering support for health care legislation that could pass this year. Wilson said it doesn’t matter.
“This is still a government takeover of the health care industry,” Wilson said. “The proposal creates government-run ‘co-ops’ to administer care in place of private options. It still sets up a rationing board. It still forces Americans to be insured or else pay a fine. It still does nothing to allow Americans to purchase insurance across state lines. It still expands Medicaid. It still increases taxes. It still has no tort reform. And it still adds to an already unsustainable debt.”
“It may move a little slower toward the goal of a single-payer system, but there is no question that under the Baucus proposal, Americans would be tricked into getting a treat that would crush our health care industry,” Wilson added.
Wilson said the proposal would ultimately result in Americans “being forced off of their current health care plans—which are excellent—and into a government-regulated co-ops that will drastically increase in costs since insurance policies will no longer be based on individual risk.”
Wilson pointed to provisions that force insurers to take on riskier patients without charging more for the premiums. “As a result, the associated risk costs will be passed on to everybody, distributed throughout the system, which means rates will go up. At the same time the quality of everyone’s coverage will be watered down to pay for the uninsurables. And individuals will have no choice but to buy the plans per the mandate.”
Wilson said that the system would not be pay for itself, and would lead to greater taxpayer-subsidized health care. “To make up for the inevitable shortfalls and deficits that will be endemic throughout the system, taxes under the plan will be raised on businesses and individuals.”
The Baucus bill is said insure an additional 26 million individuals that Wilson says could cost as much as $1.22 trillion over ten years. The average cost for an insurance premium is $4,700, according to the National Coalition on Health Care. “That’s about $122 billion extra every year we don’t have. That’s on top of ‘stimulus’ and TARP and all the rest of Barack Obama’s record-setting $1.85 trillion deficit. Under the Baucus proposal, the American people will be dealt yet another unsustainable entitlement that over time will totally consume the public treasury,” Wilson said.
Wilson credited concerned citizen efforts nationwide, including ALG’s 400,000 member activists, who have called, emailed, wrote letters to, and visited with Congressmen at their offices and town hall meetings for persuading many elected officials to vote against the bill. He said public opposition to the bill “is the only reason lawmakers are now considering removing the public ‘option.’ Only, the American people still do not want the total destruction of private health care now being proposed.”
According to Rasmussen Reports, 56 percent of voters now oppose the plan. And Barack Obama’s public disapproval has sunk to the 52 percent mark for the first time in his term.
“Harry Reid still doesn’t have the 60 votes needed in the Senate for cloture on the so-called ‘public option,’ and so Senate Democrats have begun watering down their proposal. Really, this is the beginning of the end—they are fleeing for the lifeboats on a political Titantic. Nobody wants to be left without a seat,” Wilson concluded.
SOURCE
ObamaCare’s Smoke and Mirrors: Huge Costs Paid for by Imaginary Savings
Obama’s health care plan uses imaginary savings to finance massive new spending. His claim that it will not increase the deficit is based on the notion that he can squeeze $2 trillion in savings out of the current health care system to finance his plan’s huge costs.
Washington Post columnist Charles Krauthammer, who once practiced medicine, points out in his column that these savings aren’t real, and that politicians falsely promise to pay for new programs through imaginary savings all the time:
“Obama said he would largely solve the insoluble cost problem of ObamaCare by eliminating ‘hundreds of billions of dollars in waste and fraud’ from Medicare. . . .That’s just an insult to our intelligence. Waste, fraud and abuse as the all-purpose piggy bank for budget savings has been a joke since Jimmy Carter first used it in 1977. Moreover, if half a trillion is waiting to be squeezed painlessly out of Medicare, why wait for health-care reform? If, as Obama repeatedly insists, Medicare overspending is breaking the budget, why hasn’t he gotten started on the painless billions in ‘waste and fraud’ savings?”
Even staunch Democrats admit the president’s claims are questionable. Tennessee Governor Phil Bredesen (D) is criticizing Obama’s health care plan as “the mother of all unfunded mandates,” saying it will force states to massively raise taxes or run big deficits. Earlier, one of Obama’s own economic advisers said his health care plan would explode the federal budget deficit and lead to “crippling deficits” and “higher taxes.”
The Associated Press said Obama’s proposals would “would drive up the deficit by billions of dollars.” The Washington Post, which hasn’t endorsed a Republican for president since 1952, noted that “the expanded coverage would add more than $1 trillion to the deficit.”
SOURCE
Tuesday, September 22, 2009
Obama: It’s only a tax increase if I call it one
President Obama insists that requiring Americans to get health insurance does not amount to a tax increase. In a testy exchange on ABC's "This Week," broadcast Sunday, Obama rejected the assertion that forcing people to obtain coverage would violate his campaign pledge against raising taxes on middle-class Americans. "For us to say you have to take responsibility to get health insurance is absolutely not a tax increase," Obama said in response to persistent questioning, later adding: "Nobody considers that a tax increase."
A proposal going before the Senate Finance Committee this week includes the mandate for health coverage. Obama has praised the plan in general, and indicated in the interview conducted Friday that he could back the coverage mandate. He noted that consumers currently pay higher health insurance premiums due to the costs run up by hospitals and other facilities providing care to uninsured people.
Those unable to afford health insurance should get government help, Obama said, but others who can afford coverage but choose not to get it should face coverage requirements similar to those for auto insurance. "What it's saying is ... that we're not going to have other people carrying your burdens for you any more than the fact that right now everybody in America, just about, has to get auto insurance," he said. "Nobody considers that a tax increase. People say to themselves, that is a fair way to make sure that, if you hit my car, that I'm not covering all the costs."
Asked again about critics calling the requirement to pay for health insurance a tax increase, Obama said: "My critics say everything is a tax increase."
On another aspect of his desired health care reform, Obama said cutting billions of dollars in government subsidies for Medicare Advantage would not reduce essential coverage for senior citizens in that program. The government cites the proposed subsidy cut for Medicare Advantage -- an enhanced program within Medicare -- as an example of how it can reduce health care spending while expanding coverage to millions of uninsured Americans.
Republican opponents say cutting Medicare costs will reduce benefits for senior citizens, a claim Obama has denied as misinformation. When pressed on that issue in the interview, Obama said Medicare Advantage provided essentially the same level of medical care as regular Medicare while costing the government much more due to the subsidies.
Insurance companies were "overcharging" for the service, Obama said, insisting that the change would mean senior citizens will get the same level of coverage at a lower cost to the government. "Now, they package these things in ways that, in some cases, may make it more convenient for some consumers, but they're overcharging massively for it," Obama said. "There's no competitive bidding under the process."
He said people currently signed up for Medicare Advantage would still get regular Medicare coverage "and the same level of benefits, but they may not be having their insurer get a 14 percent premium." "And will the insurers squawk? You bet," Obama said, rejecting claims that those enrolled in Medicare Advantage would be left with substandard benefits. "These folks are going to be able to get Medicare that is just as good, provides the same benefits, but we're not subsidizing them for $18 billion a year."
Republican response to Obama on Sunday called the president's promises of expanded health coverage at lower costs too good to be true. "It's just not believable," said Michael Steele, the Republican National Committee chairman, on the CBS program "Face the Nation." No matter what Obama says, Steele added, "Taxes are going to go up for the middle class because they have to."
Sen. Lindsey Graham, R-South Carolina, said on the NBC program "Meet the Press" that Obama "is selling something that people quite frankly are not buying." "This is not about tone -- this is about policy," Graham said.
Also appearing on the show, House Minority Leader John Boehner, R-Ohio, said health care reform as proposed by Obama and the Democrats was dead in Congress. "At some point when these big government plans fail -- and it will, the Congress will not pass it -- it's really time for the president to hit the reset button," Boehner said.
For his part, Obama offered a different perspective on the Republican position, telling Univision in an interview broadcast Sunday that Republicans -- for political reasons -- "are just not going to support anything."
SOURCE
There’s no free health care
Obamacare will raise costs--and everybody knows it
Give President Obama credit for persistence. And stubbornness. And lack of imagination. He declared again last week that his health care plan "will slow the growth of health care costs for our families and our businesses and our government." And this historic achievement will be accompanied by a dazzling array of new medical benefits that everyone will receive--guaranteed by law. Okay, you've heard this before. But that's the president's story, and he's sticking to it.
The question is, why? Does he think we're stupid? His argument has failed to persuade a sizeable majority of the American people precisely because they're not stupid. They understand the laws of addition and subtraction. When you offer more--much, much more in this case--of a good, it's going to cost more. Somebody has to pay for it. Yet Obama says we'll all be paying less, and that includes businesses and government.
If he could actually pull off this feat, he would indeed be the One we've been waiting for. But he can't. This is apparent whenever Obama explains where the "savings" will come from. They're from eliminating "hundreds of billions of dollars" in waste, fraud, and abuse (WFA) in the health care system. Surely, he knows better. Everyone in Washington recognizes these savings are imaginary. They're offered with a wink. They never happen. President Reagan promised to slash WFA in the 1980s. The result: zilch. Where Reagan failed, Obama is not likely to succeed.
Obama may be unaware, but there are three programs--in Maine, Massachusetts, and Tennessee--currently testing his idea of get-more-pay-less. The evidence is already in: Expanded health care coverage costs more, an awful lot more. There are no known exceptions.
The test cases mirror Obamacare in one way or another. In 2003, Maine decided to cover the uninsured by expanding the state's Medicaid program and creating a government-run "public option" to provide health insurance with subsidized premiums. Controls on hospital and doctor costs would lead to reduced premiums and savings for everyone, without tax increases, or so it was claimed. Five years later, "the system that was supposed to save money has cost taxpayers $155 million and is still rising," the Wall Street Journal reported. Meanwhile, Medicaid enrollment has doubled to 22 percent of the state's population, and access to the public plan has been capped.
In Massachusetts, "universal" coverage was enacted in 2006 along with a requirement that everyone be insured or pay a fine. (By 2009, the fine was up to $1,068.) Again, the claim was made--a claim Obama repeats--that costs would decline once everyone was covered. Today, 97 percent of Massachusetts citizens are covered, the highest rate in the country. But costs have soared to the point the New York Times characterized them as "runaway." Spending on the state's health insurance program has risen by 42 percent. A major cause shouldn't have surprised anyone: The newly insured have flooded doctors' offices for medical care paid for by others. Now Governor Deval Patrick, a close ally of Obama, wants to impose cost controls.
The Tennessee experiment began in 1994 with one thought in mind: curbing the rise in health care costs. TennCare was established to cover everyone either on Medicaid or unable to obtain insurance. Rather than bend downward, the cost curve has steeply climbed. In a decade, spending surged from $2.5 billion to $8 billion. To cope with this, the state is cutting the TennCare rolls and reducing benefits. The program still consumes a higher share of the state budget than any Medicaid program in the country.
More here
Baucus’s insurance bill is a dose of bad medicine
AFTER MONTHS of work, Senate Finance Chairman Max Baucus has come up with a health bill that pleases neither Republicans nor many Democrats, but insurers must be smiling broadly.
It’s no surprise that his bill includes no public sector insurance plan. Instead, the only competition that giant insurers face will come from tiny co-operatives - and even then, to qualify for federal funding, they must be fledglings. Established co-ops will not qualify for help. Thus, private insurers can count on controlling the marketplace as millions of new customers who don’t have job-based coverage are required by law to come their way, tax subsidies in hand.
But what is shocking is that under the Baucus plan, a 50-year-old single parent could wind up paying far more for health insurance than a 28-year-old single adult who earns twice her salary. The Baucus bill won’t let insurers hike premiums because a customer suffers from a pre-existing condition. But it lets insurers charge older Americas five times as much as younger customers.
In a July letter to House leaders, the trade group America’s Health Insurance Plans called for the 5 to 1 ratio, saying anything less than that would force many young people to pay more to “heavily subsidize the naturally higher health care costs of older individuals.’’ House Democrats refused. The House bill, like Massachusetts, says that insurers can charge older adults no more than twice what they bill younger ones.
The Baucus legislation also imposes a penalty on single-parenthood. If you live alone with one child, you will be asked to shell out 80 percent more than a childless adult.
Of course it makes sense that coverage for a mother and child would cost more than the premium for a single person. But since children typically use much less health care than adults, 80 percent is a steep surcharge for single-parenthood - especially since a couple with children would pay only 50 percent more than a childless couple.
The Baucus bill also punishes smokers, adding 50 percent to their premiums. No doubt many would argue that this is only fair. But the vast majority of adults who smoke are poor. Many will qualify for full subsidies; others will be eligible for partial subsidies to help them pay for their premiums.
So who will pay 50 percent more for their health care? You, the taxpayer. If the smoker receives a subsidy, the 50 percent surcharge isn’t likely to induce him to stop. This rule seems designed primarily to funnel more taxpayer dollars to private sector insurers.
Single parents also tend to cling to the lower rungs of the income ladder. Many will qualify for at least a partial, if not a full subsidy. Who lays out the extra 80 percent? That’s right - you and I.
Finally, if under the Baucus bill, insurers can charge middle-income 50-somethings five times as much as even the most affluent 20-somethings, a great many of those older customers are going to need fat subsidies, sending more tax dollars to Aetna.
Granted, premiums are capped at 13 percent of income if you earn somewhere between 300 percent and 400 percent of the federal poverty level. But this means a 56-year old couple with joint income of $58,000 could wind up paying premiums of more than $7,500 - plus out-of-pocket expenses. Couples earning more than 300 percent of poverty ($43,710 in 2009) don’t qualify for subsidies.
Under the more generous House bill, couples earning up to 400 percent of poverty (or $58,280) would be eligible for federal help. Tax increases for the top 1.5 percent of earners would help fund the subsidies. By contrast, under the Baucus plan, middle-class and upper-middle class Americans who buy insurance but don’t qualify for subsidies would help foot the bill for those who do.
The irony is that in the end, neither conservatives nor progressives are backing the Baucus proposal. The senator’s goal was bipartisan reform. But he has failed to achieve that. Instead, by eliminating a public option that might have set a benchmark for high quality, affordable care and by offering stingy subsidies that exclude many middle-income families, he has watered down reform without pleasing either side of the aisle.
SOURCE
Healthcare reform is more corporate welfare
by Ron Paul
Last Wednesday the nation was riveted to the President’s speech on healthcare reform before Congress. While the President’s concern for the uninsured is no doubt sincere, his plan amounts to a magnanimous gift to the health insurance industry, despite any implications to the contrary.
For decades the insurance industry has been lobbying for mandated coverage for everyone. Imagine if the cell phone industry or the cable TV industry received such a gift from government? If government were to fine individuals simply for not buying a corporation’s product, it would be an incredible and completely unfair boon to that industry, at the expense of freedom and the free market. Yet this is what the current healthcare reform plans intend to do for the very powerful health insurance industry.
The stipulation that pre-existing conditions would have to be covered seems a small price to pay for increasing their client pool to 100f the American people. A big red flag, however, is that they would also have immunity from lawsuits, should they fail to actually cover what they are supposedly required to cover, so these requirements on them are probably meaningless. Mandates on all citizens to be customers of theirs, however, are enforceable with fines and taxes.
Insurance providers seem to have successfully equated health insurance with health care but this is a relatively new concept. There were doctors and medicine long before there was health insurance. Health insurance is not a bad thing, but it is not the only conceivable way to get health care. Instead, we seem to still rely on the creativity and competence of politicians to solve problems, which always somehow seem to be tied in with which lobby is the strongest in Washington.
It is sad to think of the many creative, free market solutions that government prohibits with all its interference. What if instead of joining a health insurance plan, you could buy a membership directly from a hospital or doctor? What if a doctor wanted to have a cash-only practice, or make house calls, or determine his or her own patient load, or otherwise practice medicine outside the constraints of the current bureaucratic system? Alternative healthcare delivery models will be at an even stronger competitive disadvantage if families are forced to buy into the insurance model. And yet, the reforms are sold to us as increasing competition.
What if just once Washington got out of the way and allowed the ingenuity of the American people to come up with a whole spectrum of alternatives to our broken system? Then the free market, not lobbyists and politicians, would decide which models work and which did not.
Unfortunately, the most broken aspect of our system is that Washington sees the need to act on every problem in society, rather than staying out of the way, or getting out of the way. The only tools the government has are force and favors. These are tools that many unscrupulous and lazy corporations would like to wield to their own advantage, rather than simply providing a better product that people will willingly buy. It seems the health insurance industry will get more of those advantages very soon.
SOURCE
High Cost Of Care
Medicare: As Democrats try to remake the health care system in the face of bitter opposition, the federal public option for the elderly is preparing to cut benefits. This should be part of the debate, but of course it's not.
Supporters of the health care revision tell us that its $1 trillion price tag won't add a dime to the national deficits. But the reality is, any program that expands Washington's reach into health care will cost far more than the rosy projections we're hearing. History shows that the bureaucracy always spends far more on programs than the Beltway experts say it will.
One program that has spun wildly out of control is Medicare, enshrined as an entitlement in 1965. Actuaries projected its cost for 1990 at $10 billion. Yet actual outlays were $107 billion. Now the program is spending more than it is taking in through the payroll tax that funds it, leaving Washington with only two options: ration Medicare or raise taxes.
Don't make the mistake of thinking that brilliant minds in Washington will figure out a way to avoid rationing before it becomes necessary. Those heads are busy looking for places to slash now. Medicare, for instance, is considering cutting $1.4 billion in benefits beginning on Jan. 1, 2010. If the new schedule is adopted, the reductions will be in fees paid to cardiologists and oncologists.
At the same time that fees for heart and cancer physicians will be trimmed by 10%, fees paid to family doctors will be boosted by 8% and reimbursements paid to nurses will rise 7%. The administration believes that moving the fees toward primary care will be a boost for preventive care.
There are two points to take away from this mostly ignored news. One, any scheme passed by this Congress and signed into law will cost taxpayers dearly. Two, the government will have to ration care because it cannot possibly pay for a nation of 305 million demanding its "free" medical care.
If the rationing is adopted, it will have a direct effect on patients, particularly those who are suffering from two of the most serious illnesses. Heart and cancer specialists, who will be expected to accept Medicare reimbursements that are less than some procedures cost, are already reporting that they will either close their practices or limit care. Some will simply stop treating Medicare patients.
Anyone who believes Washington can improve health care by increasing its involvement is not thinking clearly. Its solutions tend to create bigger problems. Yes, a government takeover may improve care for a small segment of the population. But it will be far worse for everyone else.
SOURCE
President Obama insists that requiring Americans to get health insurance does not amount to a tax increase. In a testy exchange on ABC's "This Week," broadcast Sunday, Obama rejected the assertion that forcing people to obtain coverage would violate his campaign pledge against raising taxes on middle-class Americans. "For us to say you have to take responsibility to get health insurance is absolutely not a tax increase," Obama said in response to persistent questioning, later adding: "Nobody considers that a tax increase."
A proposal going before the Senate Finance Committee this week includes the mandate for health coverage. Obama has praised the plan in general, and indicated in the interview conducted Friday that he could back the coverage mandate. He noted that consumers currently pay higher health insurance premiums due to the costs run up by hospitals and other facilities providing care to uninsured people.
Those unable to afford health insurance should get government help, Obama said, but others who can afford coverage but choose not to get it should face coverage requirements similar to those for auto insurance. "What it's saying is ... that we're not going to have other people carrying your burdens for you any more than the fact that right now everybody in America, just about, has to get auto insurance," he said. "Nobody considers that a tax increase. People say to themselves, that is a fair way to make sure that, if you hit my car, that I'm not covering all the costs."
Asked again about critics calling the requirement to pay for health insurance a tax increase, Obama said: "My critics say everything is a tax increase."
On another aspect of his desired health care reform, Obama said cutting billions of dollars in government subsidies for Medicare Advantage would not reduce essential coverage for senior citizens in that program. The government cites the proposed subsidy cut for Medicare Advantage -- an enhanced program within Medicare -- as an example of how it can reduce health care spending while expanding coverage to millions of uninsured Americans.
Republican opponents say cutting Medicare costs will reduce benefits for senior citizens, a claim Obama has denied as misinformation. When pressed on that issue in the interview, Obama said Medicare Advantage provided essentially the same level of medical care as regular Medicare while costing the government much more due to the subsidies.
Insurance companies were "overcharging" for the service, Obama said, insisting that the change would mean senior citizens will get the same level of coverage at a lower cost to the government. "Now, they package these things in ways that, in some cases, may make it more convenient for some consumers, but they're overcharging massively for it," Obama said. "There's no competitive bidding under the process."
He said people currently signed up for Medicare Advantage would still get regular Medicare coverage "and the same level of benefits, but they may not be having their insurer get a 14 percent premium." "And will the insurers squawk? You bet," Obama said, rejecting claims that those enrolled in Medicare Advantage would be left with substandard benefits. "These folks are going to be able to get Medicare that is just as good, provides the same benefits, but we're not subsidizing them for $18 billion a year."
Republican response to Obama on Sunday called the president's promises of expanded health coverage at lower costs too good to be true. "It's just not believable," said Michael Steele, the Republican National Committee chairman, on the CBS program "Face the Nation." No matter what Obama says, Steele added, "Taxes are going to go up for the middle class because they have to."
Sen. Lindsey Graham, R-South Carolina, said on the NBC program "Meet the Press" that Obama "is selling something that people quite frankly are not buying." "This is not about tone -- this is about policy," Graham said.
Also appearing on the show, House Minority Leader John Boehner, R-Ohio, said health care reform as proposed by Obama and the Democrats was dead in Congress. "At some point when these big government plans fail -- and it will, the Congress will not pass it -- it's really time for the president to hit the reset button," Boehner said.
For his part, Obama offered a different perspective on the Republican position, telling Univision in an interview broadcast Sunday that Republicans -- for political reasons -- "are just not going to support anything."
SOURCE
There’s no free health care
Obamacare will raise costs--and everybody knows it
Give President Obama credit for persistence. And stubbornness. And lack of imagination. He declared again last week that his health care plan "will slow the growth of health care costs for our families and our businesses and our government." And this historic achievement will be accompanied by a dazzling array of new medical benefits that everyone will receive--guaranteed by law. Okay, you've heard this before. But that's the president's story, and he's sticking to it.
The question is, why? Does he think we're stupid? His argument has failed to persuade a sizeable majority of the American people precisely because they're not stupid. They understand the laws of addition and subtraction. When you offer more--much, much more in this case--of a good, it's going to cost more. Somebody has to pay for it. Yet Obama says we'll all be paying less, and that includes businesses and government.
If he could actually pull off this feat, he would indeed be the One we've been waiting for. But he can't. This is apparent whenever Obama explains where the "savings" will come from. They're from eliminating "hundreds of billions of dollars" in waste, fraud, and abuse (WFA) in the health care system. Surely, he knows better. Everyone in Washington recognizes these savings are imaginary. They're offered with a wink. They never happen. President Reagan promised to slash WFA in the 1980s. The result: zilch. Where Reagan failed, Obama is not likely to succeed.
Obama may be unaware, but there are three programs--in Maine, Massachusetts, and Tennessee--currently testing his idea of get-more-pay-less. The evidence is already in: Expanded health care coverage costs more, an awful lot more. There are no known exceptions.
The test cases mirror Obamacare in one way or another. In 2003, Maine decided to cover the uninsured by expanding the state's Medicaid program and creating a government-run "public option" to provide health insurance with subsidized premiums. Controls on hospital and doctor costs would lead to reduced premiums and savings for everyone, without tax increases, or so it was claimed. Five years later, "the system that was supposed to save money has cost taxpayers $155 million and is still rising," the Wall Street Journal reported. Meanwhile, Medicaid enrollment has doubled to 22 percent of the state's population, and access to the public plan has been capped.
In Massachusetts, "universal" coverage was enacted in 2006 along with a requirement that everyone be insured or pay a fine. (By 2009, the fine was up to $1,068.) Again, the claim was made--a claim Obama repeats--that costs would decline once everyone was covered. Today, 97 percent of Massachusetts citizens are covered, the highest rate in the country. But costs have soared to the point the New York Times characterized them as "runaway." Spending on the state's health insurance program has risen by 42 percent. A major cause shouldn't have surprised anyone: The newly insured have flooded doctors' offices for medical care paid for by others. Now Governor Deval Patrick, a close ally of Obama, wants to impose cost controls.
The Tennessee experiment began in 1994 with one thought in mind: curbing the rise in health care costs. TennCare was established to cover everyone either on Medicaid or unable to obtain insurance. Rather than bend downward, the cost curve has steeply climbed. In a decade, spending surged from $2.5 billion to $8 billion. To cope with this, the state is cutting the TennCare rolls and reducing benefits. The program still consumes a higher share of the state budget than any Medicaid program in the country.
More here
Baucus’s insurance bill is a dose of bad medicine
AFTER MONTHS of work, Senate Finance Chairman Max Baucus has come up with a health bill that pleases neither Republicans nor many Democrats, but insurers must be smiling broadly.
It’s no surprise that his bill includes no public sector insurance plan. Instead, the only competition that giant insurers face will come from tiny co-operatives - and even then, to qualify for federal funding, they must be fledglings. Established co-ops will not qualify for help. Thus, private insurers can count on controlling the marketplace as millions of new customers who don’t have job-based coverage are required by law to come their way, tax subsidies in hand.
But what is shocking is that under the Baucus plan, a 50-year-old single parent could wind up paying far more for health insurance than a 28-year-old single adult who earns twice her salary. The Baucus bill won’t let insurers hike premiums because a customer suffers from a pre-existing condition. But it lets insurers charge older Americas five times as much as younger customers.
In a July letter to House leaders, the trade group America’s Health Insurance Plans called for the 5 to 1 ratio, saying anything less than that would force many young people to pay more to “heavily subsidize the naturally higher health care costs of older individuals.’’ House Democrats refused. The House bill, like Massachusetts, says that insurers can charge older adults no more than twice what they bill younger ones.
The Baucus legislation also imposes a penalty on single-parenthood. If you live alone with one child, you will be asked to shell out 80 percent more than a childless adult.
Of course it makes sense that coverage for a mother and child would cost more than the premium for a single person. But since children typically use much less health care than adults, 80 percent is a steep surcharge for single-parenthood - especially since a couple with children would pay only 50 percent more than a childless couple.
The Baucus bill also punishes smokers, adding 50 percent to their premiums. No doubt many would argue that this is only fair. But the vast majority of adults who smoke are poor. Many will qualify for full subsidies; others will be eligible for partial subsidies to help them pay for their premiums.
So who will pay 50 percent more for their health care? You, the taxpayer. If the smoker receives a subsidy, the 50 percent surcharge isn’t likely to induce him to stop. This rule seems designed primarily to funnel more taxpayer dollars to private sector insurers.
Single parents also tend to cling to the lower rungs of the income ladder. Many will qualify for at least a partial, if not a full subsidy. Who lays out the extra 80 percent? That’s right - you and I.
Finally, if under the Baucus bill, insurers can charge middle-income 50-somethings five times as much as even the most affluent 20-somethings, a great many of those older customers are going to need fat subsidies, sending more tax dollars to Aetna.
Granted, premiums are capped at 13 percent of income if you earn somewhere between 300 percent and 400 percent of the federal poverty level. But this means a 56-year old couple with joint income of $58,000 could wind up paying premiums of more than $7,500 - plus out-of-pocket expenses. Couples earning more than 300 percent of poverty ($43,710 in 2009) don’t qualify for subsidies.
Under the more generous House bill, couples earning up to 400 percent of poverty (or $58,280) would be eligible for federal help. Tax increases for the top 1.5 percent of earners would help fund the subsidies. By contrast, under the Baucus plan, middle-class and upper-middle class Americans who buy insurance but don’t qualify for subsidies would help foot the bill for those who do.
The irony is that in the end, neither conservatives nor progressives are backing the Baucus proposal. The senator’s goal was bipartisan reform. But he has failed to achieve that. Instead, by eliminating a public option that might have set a benchmark for high quality, affordable care and by offering stingy subsidies that exclude many middle-income families, he has watered down reform without pleasing either side of the aisle.
SOURCE
Healthcare reform is more corporate welfare
by Ron Paul
Last Wednesday the nation was riveted to the President’s speech on healthcare reform before Congress. While the President’s concern for the uninsured is no doubt sincere, his plan amounts to a magnanimous gift to the health insurance industry, despite any implications to the contrary.
For decades the insurance industry has been lobbying for mandated coverage for everyone. Imagine if the cell phone industry or the cable TV industry received such a gift from government? If government were to fine individuals simply for not buying a corporation’s product, it would be an incredible and completely unfair boon to that industry, at the expense of freedom and the free market. Yet this is what the current healthcare reform plans intend to do for the very powerful health insurance industry.
The stipulation that pre-existing conditions would have to be covered seems a small price to pay for increasing their client pool to 100f the American people. A big red flag, however, is that they would also have immunity from lawsuits, should they fail to actually cover what they are supposedly required to cover, so these requirements on them are probably meaningless. Mandates on all citizens to be customers of theirs, however, are enforceable with fines and taxes.
Insurance providers seem to have successfully equated health insurance with health care but this is a relatively new concept. There were doctors and medicine long before there was health insurance. Health insurance is not a bad thing, but it is not the only conceivable way to get health care. Instead, we seem to still rely on the creativity and competence of politicians to solve problems, which always somehow seem to be tied in with which lobby is the strongest in Washington.
It is sad to think of the many creative, free market solutions that government prohibits with all its interference. What if instead of joining a health insurance plan, you could buy a membership directly from a hospital or doctor? What if a doctor wanted to have a cash-only practice, or make house calls, or determine his or her own patient load, or otherwise practice medicine outside the constraints of the current bureaucratic system? Alternative healthcare delivery models will be at an even stronger competitive disadvantage if families are forced to buy into the insurance model. And yet, the reforms are sold to us as increasing competition.
What if just once Washington got out of the way and allowed the ingenuity of the American people to come up with a whole spectrum of alternatives to our broken system? Then the free market, not lobbyists and politicians, would decide which models work and which did not.
Unfortunately, the most broken aspect of our system is that Washington sees the need to act on every problem in society, rather than staying out of the way, or getting out of the way. The only tools the government has are force and favors. These are tools that many unscrupulous and lazy corporations would like to wield to their own advantage, rather than simply providing a better product that people will willingly buy. It seems the health insurance industry will get more of those advantages very soon.
SOURCE
High Cost Of Care
Medicare: As Democrats try to remake the health care system in the face of bitter opposition, the federal public option for the elderly is preparing to cut benefits. This should be part of the debate, but of course it's not.
Supporters of the health care revision tell us that its $1 trillion price tag won't add a dime to the national deficits. But the reality is, any program that expands Washington's reach into health care will cost far more than the rosy projections we're hearing. History shows that the bureaucracy always spends far more on programs than the Beltway experts say it will.
One program that has spun wildly out of control is Medicare, enshrined as an entitlement in 1965. Actuaries projected its cost for 1990 at $10 billion. Yet actual outlays were $107 billion. Now the program is spending more than it is taking in through the payroll tax that funds it, leaving Washington with only two options: ration Medicare or raise taxes.
Don't make the mistake of thinking that brilliant minds in Washington will figure out a way to avoid rationing before it becomes necessary. Those heads are busy looking for places to slash now. Medicare, for instance, is considering cutting $1.4 billion in benefits beginning on Jan. 1, 2010. If the new schedule is adopted, the reductions will be in fees paid to cardiologists and oncologists.
At the same time that fees for heart and cancer physicians will be trimmed by 10%, fees paid to family doctors will be boosted by 8% and reimbursements paid to nurses will rise 7%. The administration believes that moving the fees toward primary care will be a boost for preventive care.
There are two points to take away from this mostly ignored news. One, any scheme passed by this Congress and signed into law will cost taxpayers dearly. Two, the government will have to ration care because it cannot possibly pay for a nation of 305 million demanding its "free" medical care.
If the rationing is adopted, it will have a direct effect on patients, particularly those who are suffering from two of the most serious illnesses. Heart and cancer specialists, who will be expected to accept Medicare reimbursements that are less than some procedures cost, are already reporting that they will either close their practices or limit care. Some will simply stop treating Medicare patients.
Anyone who believes Washington can improve health care by increasing its involvement is not thinking clearly. Its solutions tend to create bigger problems. Yes, a government takeover may improve care for a small segment of the population. But it will be far worse for everyone else.
SOURCE
Monday, September 21, 2009
Senior British politician chooses private hospital rather than the NHS
NICK CLEGG, the Liberal Democrat leader, last night admitted he had paid for private healthcare partly because of his frustration at NHS waiting times.
Clegg, who said he had occasionally “coughed up” so one of his sons could see medical specialists quickly, becomes the first political leader to break the Westminster taboo about going private. “I understand the sensitivity but I feel fervently that I am a dad before I am a politician,” said the Lib Dem leader in an interview with The Sunday Times.
Clegg’s admission contrasts with the position of Gordon Brown, who has always used the NHS for his two sons, one of whom has cystic fibrosis. Similarly, David Cameron, the Conservative leader, has praised the way the NHS treated his disabled son Ivan, who died earlier this year. However, other members of the Tory front bench have refused to say whether they pay for medical insurance.
Clegg, 42, who is married to a high-flying Spanish lawyer and has three young sons, said his family did not have private health cover. But he added: “If you ask, has there been an occasion where we have paid for a consultation, then the answer is yes.” Asked why he had opted out of the NHS, he said: “Because we were very keen to see a particular consultant for a particular problem very quickly.” He refused to elaborate on the details of the medical problems concerned. “As far as my children’s health or education is concerned, I am simply not going to hold them hostage to make political points,” he said.
Speaking on the eve of the Lib Dem annual conference in Bournemouth, he claimed both Labour and the Conservatives were ducking serious discussion on the future of healthcare. “Why on earth is the NHS as centralised as it is? Why is there layer upon layer of centralised bureaucracy?” he said. He asserted that while the NHS had areas of excellence, there were also serious failings. “Mental health, for example, is a Cinderella service,” he said.
SOURCE
Health reformers targeting 'enemies'
Protest events tightly scripted. Civility not envisaged
The plan for a series of grass-roots demonstrations Tuesday to promote President Obama's health care agenda calls for tightly scripted events and an "escalation" of efforts against "enemies" of reform. Organizers insist there is no comparison to rowdy summer town hall meetings and recent "tea party" protests that have challenged White House policies.
But Health Care for America Now (HCAN), which is backed by a coalition of labor unions and liberal groups including ACORN and MoveOn.org, organized the protests to target insurance companies and drafted the plan, which describes the demonstrations as part of its "insurance enemies project."
The document, a copy of which was obtained by The Washington Times, details specific talking points, tactics, props and strategies to stage the protests. It lists goals that include action that "mobilizes our base by animating existing anger about private insurers."
The HCAN field plan dictates that each protest will include a minimum of 30 participants, target only health care insurers CIGNA, WellPoint and United Health Care and showcase what it calls "victims," or people who have either lost insurance, can't afford it or were denied coverage because of pre-existing medical conditions. "We built a campaign to win health care reform and that is exactly what we are working on," said HCAN national spokeswoman Jacki Schechner, who authenticated the documents. But she asserted: "There is nothing top-down about this."
The field plan says the protests should attract media coverage that "creates villains or enemies that serve as a contrast with our side; validates the need for affordability and the public health insurance option; [and] forces the other side to respond."
David Palombi, senior vice president of corporate communications for WellPoint, said the "enemies project" is counterproductive to the debate and will do nothing to expand access, reduce costs or improve the quality of health care in the United States. "It is extraordinarily disappointing that it comes at a time when [House Speaker Nancy Pelosi] and others are calling for a civil discussion." Mrs. Pelosi, California Democrat, became emotional at a news conference Thursday when she expressed fear that the harsh rhetoric of the debate would lead to violence.
More here
Values voters poke fun at health reform
2,000 gather for D.C. summit
Minnesota Republican Gov. Tim Pawlenty, once considered a moderate by some social conservatives, was the headliner at the Values Voters Summit in Washington on Friday evening, quoting from the Bible and bringing the nearly 2,000 social and religious conservatives to their feet. "We need to be sure we are a force for wise values, not just wisecracks," Mr. Pawlenty told the activists from 49 states. "We need to humbly ask God to bless the United States," said the two-term governor, who had announced more than three months ago he would not seek a third term. He has been traveling the country looking very much like a potential presidential nomination seeker.
Poking fun at President Obama's health care plan, Tony Perkins opened the summit Friday morning by quipping that he fears the plan will produce a system with the empathy of the Internal Revenue Service and the efficiency of the Federal Emergency Management Administration. Mr. Perkins, Family Research Council president, got the expected laughter and applause from the nearly 2,000 religious and social activists gathered at the Omni Shoreham Hotel for a good but godly time.
Rep. Mike Pence, Indiana Republican, took the podium to toss out a few one-liners before settling down to criticize his own party for what he thinks are its unprincipled excesses of the past. "On Election Day last year, only 22 percent of Americans described themselves as liberal, but our nation went forward to elect the most liberal one-party government in American history," he said. "So, what happened? Well, some blame the war in Iraq. Some blame Republican scandals. Well, I think the real scandal in Washington, D.C., was runaway federal spending under Republican control."
The religious-social right has never been about fire and brimstone but about moral behavior by government and citizens. Legalized abortion and same-sex marriages rank at the top of the movement's must-stop agenda.
The next speaker was former Arkansas Gov. Mike Huckabee, who proceeded to rock the house with humor. Dismissing the health care "reform" approach of Mr. Obama and the Democratic Congress, Mr. Huckabee compared the "real" health problem to "an NFL game on Sunday [with] 22 people down on the field desperately in need of rest and 70,000 in the stands desperately in need of exercise." "There is America's health care problem right there," he said.
Mr. Huckabee, who ran second to Arizona Sen. John McCain in the Republican presidential nomination contest last year, has been an increasingly important figure in the religious-social right movement that bemoans what former Education Secretary William J. Bennett has called the "coarsening of American culture." Now a Fox News talk-show host, Mr. Huckabee let fly with such zingers aimed at Mr. Obama as "The audacity of hope has become the audacity of hypocrisy," and America is being trivialized and demeaned into "land czars, clunker cars and Hollywood stars."
Mr. Huckabee, who complained about the unequal footing financially between him and opponent Mitt Romney in the 2008 presidential nomination contest, took a swipe at the former Massachusetts governor who enacted statewide health care reform before leaving office. "A couple of states have already tried government-run medicine: Tennessee and Massachusetts. Both plans went bankrupt," Mr. Huckabee said. "The only thing inexpensive is $50 for an abortion in Massachusetts. No thanks."
As for Mr. Obama's claim that his health care reform will not increase the federal debt or deficit because it will offset new costs by "squeezing $500 billion out of the Medicare program. If he can do it now, why hasn't he already done it?"
SOURCE
More Cowbell
We wrote about the original "more cowbell" here. Lately, the phrase has come to denote the Obama administration's efforts to promote the Democrats' health care plan (whatever it is). Personal appeals by the President are the "cowbell." Today Michelle Obama got into the act, proclaiming that the current health care system "crushes women":
I really don't understand this. Under Obamacare, will someone other than mothers (or fathers) arrange checkups for their kids? Take care of family illnesses? Make sure the kids are taking their medicine and get follow-up care if they need it? Is there really anything like this in any of the Democrats' proposals? If mothers (and fathers) don't arrange their kids' checkups, who will? Someone else's mother or father, apparently. No doubt they'll care more and do a better job.
The Obama administration seems to be bringing a whole new meaning to the phrase "nanny state."
SOURCE (See the original for links)
Separating 'He Lied' From The 'Elides'
You lie? No. Barack Obama doesn't lie. He's too subtle for that. He . . . well, you judge.
Herewith three examples within a single speech — the now-famous Obama-Wilson "you lie" address to Congress on health care — of Obama's relationship with truth:
1. "I will not sign (a plan)," he solemnly pledged, "if it adds one dime to the deficit, now or in the future. Period."
Wonderful. The president seems serious, veto-ready, determined to hold the line. Until, notes Harvard economist Greg Mankiw, you get to Obama's very next sentence: "And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize."
This apparent strengthening of the pledge brilliantly and deceptively undermines it. What Obama suggests is that his plan will require mandatory spending cuts if the current rosy projections prove false. But there's absolutely nothing automatic about such cuts. Every Congress is sovereign.
Nothing enacted today will force a future Congress or a future president to make any cuts in any spending, mandatory or not.
Just look at the supposedly automatic Medicare cuts contained in the Sustainable Growth Rate formula enacted to constrain out-of-control Medicare spending. Every year since 2003, Congress has waived the cuts.
Mankiw puts the Obama bait-and-switch in plain language. "Translation: I promise to fix the problem. And if I do not fix the problem now, I will fix it later, or some future president will, after I am long gone. I promise he will. Absolutely, positively, I am committed to that future president fixing the problem. You can count on it. Would I lie to you?"
2. And then there's the famous contretemps about health insurance for illegal immigrants. Obama said they would not be insured. Well, all four committee-passed bills in Congress allow illegal immigrants to take part in the proposed Health Insurance Exchange.
But more importantly, the problem is that laws are not self-enforcing. If they were, we'd have no illegal immigrants because, as I understand it, it's illegal to enter the United States illegally. We have laws against burglary, too. But we also provide for cops and jails on the assumption that most burglars don't voluntarily turn themselves in.
When Republicans proposed requiring proof of citizenship, the Democrats twice voted that down in committee. Indeed, after Rep. Joe Wilson's "You lie!" shout-out, the Senate Finance Committee revisited the language of its bill to prevent illegal immigrants from getting any federal benefits. Why would the Finance Committee fix a nonexistent problem?
3. Obama said he would largely solve the insoluble cost problem of ObamaCare by eliminating "hundreds of billions of dollars in waste and fraud" from Medicare.
That's not a lie. That's not even deception. That's just an insult to our intelligence. Waste, fraud and abuse — Meg Greenfield once called this phrase "the dread big three" — as the all-purpose piggy bank for budget savings has been a joke since Jimmy Carter first used it in 1977.
Moreover, if half a trillion is waiting to be squeezed painlessly out of Medicare, why wait for health care reform? If, as Obama repeatedly insists, Medicare overspending is breaking the budget, why hasn't he gotten started on the painless billions in "waste and fraud" savings?
Obama doesn't lie. He merely elides, gliding from one dubious assertion to another. This has been the story throughout his whole health care crusade. Its original premise was that our current financial crisis was rooted in neglect of three things — energy, education and health care.
That transparent attempt to exploit Emanuel's Law — a crisis is a terrible thing to waste — failed for health care because no one is stupid enough to believe that the 2008 financial collapse was caused by a lack of universal health care.
So on to the next gambit: selling health care reform as a cure for the deficit. When that was exploded by the Congressional Budget Office's demonstration of staggering ObamaCare deficits, Obama tried a new tack: selling his plan as revenue-neutral insurance reform — until the revenue neutrality is exposed as phony future cuts and chimerical waste and fraud.
Obama doesn't lie. He implies, he misdirects, he misleads — so fluidly and incessantly that he risks transmuting eloquence into mere slickness.
Slickness wasn't fatal to "Slick Willie" Clinton because he possessed a winning, near irresistible charm. Obama's persona is more cool, distant, imperial.
The charming scoundrel can get away with endless deception; the righteous redeemer cannot.
SOURCE
NICK CLEGG, the Liberal Democrat leader, last night admitted he had paid for private healthcare partly because of his frustration at NHS waiting times.
Clegg, who said he had occasionally “coughed up” so one of his sons could see medical specialists quickly, becomes the first political leader to break the Westminster taboo about going private. “I understand the sensitivity but I feel fervently that I am a dad before I am a politician,” said the Lib Dem leader in an interview with The Sunday Times.
Clegg’s admission contrasts with the position of Gordon Brown, who has always used the NHS for his two sons, one of whom has cystic fibrosis. Similarly, David Cameron, the Conservative leader, has praised the way the NHS treated his disabled son Ivan, who died earlier this year. However, other members of the Tory front bench have refused to say whether they pay for medical insurance.
Clegg, 42, who is married to a high-flying Spanish lawyer and has three young sons, said his family did not have private health cover. But he added: “If you ask, has there been an occasion where we have paid for a consultation, then the answer is yes.” Asked why he had opted out of the NHS, he said: “Because we were very keen to see a particular consultant for a particular problem very quickly.” He refused to elaborate on the details of the medical problems concerned. “As far as my children’s health or education is concerned, I am simply not going to hold them hostage to make political points,” he said.
Speaking on the eve of the Lib Dem annual conference in Bournemouth, he claimed both Labour and the Conservatives were ducking serious discussion on the future of healthcare. “Why on earth is the NHS as centralised as it is? Why is there layer upon layer of centralised bureaucracy?” he said. He asserted that while the NHS had areas of excellence, there were also serious failings. “Mental health, for example, is a Cinderella service,” he said.
SOURCE
Health reformers targeting 'enemies'
Protest events tightly scripted. Civility not envisaged
The plan for a series of grass-roots demonstrations Tuesday to promote President Obama's health care agenda calls for tightly scripted events and an "escalation" of efforts against "enemies" of reform. Organizers insist there is no comparison to rowdy summer town hall meetings and recent "tea party" protests that have challenged White House policies.
But Health Care for America Now (HCAN), which is backed by a coalition of labor unions and liberal groups including ACORN and MoveOn.org, organized the protests to target insurance companies and drafted the plan, which describes the demonstrations as part of its "insurance enemies project."
The document, a copy of which was obtained by The Washington Times, details specific talking points, tactics, props and strategies to stage the protests. It lists goals that include action that "mobilizes our base by animating existing anger about private insurers."
The HCAN field plan dictates that each protest will include a minimum of 30 participants, target only health care insurers CIGNA, WellPoint and United Health Care and showcase what it calls "victims," or people who have either lost insurance, can't afford it or were denied coverage because of pre-existing medical conditions. "We built a campaign to win health care reform and that is exactly what we are working on," said HCAN national spokeswoman Jacki Schechner, who authenticated the documents. But she asserted: "There is nothing top-down about this."
The field plan says the protests should attract media coverage that "creates villains or enemies that serve as a contrast with our side; validates the need for affordability and the public health insurance option; [and] forces the other side to respond."
David Palombi, senior vice president of corporate communications for WellPoint, said the "enemies project" is counterproductive to the debate and will do nothing to expand access, reduce costs or improve the quality of health care in the United States. "It is extraordinarily disappointing that it comes at a time when [House Speaker Nancy Pelosi] and others are calling for a civil discussion." Mrs. Pelosi, California Democrat, became emotional at a news conference Thursday when she expressed fear that the harsh rhetoric of the debate would lead to violence.
More here
Values voters poke fun at health reform
2,000 gather for D.C. summit
Minnesota Republican Gov. Tim Pawlenty, once considered a moderate by some social conservatives, was the headliner at the Values Voters Summit in Washington on Friday evening, quoting from the Bible and bringing the nearly 2,000 social and religious conservatives to their feet. "We need to be sure we are a force for wise values, not just wisecracks," Mr. Pawlenty told the activists from 49 states. "We need to humbly ask God to bless the United States," said the two-term governor, who had announced more than three months ago he would not seek a third term. He has been traveling the country looking very much like a potential presidential nomination seeker.
Poking fun at President Obama's health care plan, Tony Perkins opened the summit Friday morning by quipping that he fears the plan will produce a system with the empathy of the Internal Revenue Service and the efficiency of the Federal Emergency Management Administration. Mr. Perkins, Family Research Council president, got the expected laughter and applause from the nearly 2,000 religious and social activists gathered at the Omni Shoreham Hotel for a good but godly time.
Rep. Mike Pence, Indiana Republican, took the podium to toss out a few one-liners before settling down to criticize his own party for what he thinks are its unprincipled excesses of the past. "On Election Day last year, only 22 percent of Americans described themselves as liberal, but our nation went forward to elect the most liberal one-party government in American history," he said. "So, what happened? Well, some blame the war in Iraq. Some blame Republican scandals. Well, I think the real scandal in Washington, D.C., was runaway federal spending under Republican control."
The religious-social right has never been about fire and brimstone but about moral behavior by government and citizens. Legalized abortion and same-sex marriages rank at the top of the movement's must-stop agenda.
The next speaker was former Arkansas Gov. Mike Huckabee, who proceeded to rock the house with humor. Dismissing the health care "reform" approach of Mr. Obama and the Democratic Congress, Mr. Huckabee compared the "real" health problem to "an NFL game on Sunday [with] 22 people down on the field desperately in need of rest and 70,000 in the stands desperately in need of exercise." "There is America's health care problem right there," he said.
Mr. Huckabee, who ran second to Arizona Sen. John McCain in the Republican presidential nomination contest last year, has been an increasingly important figure in the religious-social right movement that bemoans what former Education Secretary William J. Bennett has called the "coarsening of American culture." Now a Fox News talk-show host, Mr. Huckabee let fly with such zingers aimed at Mr. Obama as "The audacity of hope has become the audacity of hypocrisy," and America is being trivialized and demeaned into "land czars, clunker cars and Hollywood stars."
Mr. Huckabee, who complained about the unequal footing financially between him and opponent Mitt Romney in the 2008 presidential nomination contest, took a swipe at the former Massachusetts governor who enacted statewide health care reform before leaving office. "A couple of states have already tried government-run medicine: Tennessee and Massachusetts. Both plans went bankrupt," Mr. Huckabee said. "The only thing inexpensive is $50 for an abortion in Massachusetts. No thanks."
As for Mr. Obama's claim that his health care reform will not increase the federal debt or deficit because it will offset new costs by "squeezing $500 billion out of the Medicare program. If he can do it now, why hasn't he already done it?"
SOURCE
More Cowbell
We wrote about the original "more cowbell" here. Lately, the phrase has come to denote the Obama administration's efforts to promote the Democrats' health care plan (whatever it is). Personal appeals by the President are the "cowbell." Today Michelle Obama got into the act, proclaiming that the current health care system "crushes women":
First lady Michelle Obama sought support for the administration's health-care plans from family advocacy groups and health-care professionals, saying the treatment of women under the current system is "unacceptable." ...
Michelle Obama said women are being "crushed by the current structure of our health care" because they often are responsible for taking care of family illnesses, arranging checkups and monitoring follow-up care.
"Women are the ones to do it," she said to an audience of 140 people, including representatives from groups such as the Women's Chamber of Commerce and the National Council of Negro Women. "Mothers are the ones that do it. And many women find themselves doing the same thing for their spouses."
I really don't understand this. Under Obamacare, will someone other than mothers (or fathers) arrange checkups for their kids? Take care of family illnesses? Make sure the kids are taking their medicine and get follow-up care if they need it? Is there really anything like this in any of the Democrats' proposals? If mothers (and fathers) don't arrange their kids' checkups, who will? Someone else's mother or father, apparently. No doubt they'll care more and do a better job.
The Obama administration seems to be bringing a whole new meaning to the phrase "nanny state."
SOURCE (See the original for links)
Separating 'He Lied' From The 'Elides'
You lie? No. Barack Obama doesn't lie. He's too subtle for that. He . . . well, you judge.
Herewith three examples within a single speech — the now-famous Obama-Wilson "you lie" address to Congress on health care — of Obama's relationship with truth:
1. "I will not sign (a plan)," he solemnly pledged, "if it adds one dime to the deficit, now or in the future. Period."
Wonderful. The president seems serious, veto-ready, determined to hold the line. Until, notes Harvard economist Greg Mankiw, you get to Obama's very next sentence: "And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize."
This apparent strengthening of the pledge brilliantly and deceptively undermines it. What Obama suggests is that his plan will require mandatory spending cuts if the current rosy projections prove false. But there's absolutely nothing automatic about such cuts. Every Congress is sovereign.
Nothing enacted today will force a future Congress or a future president to make any cuts in any spending, mandatory or not.
Just look at the supposedly automatic Medicare cuts contained in the Sustainable Growth Rate formula enacted to constrain out-of-control Medicare spending. Every year since 2003, Congress has waived the cuts.
Mankiw puts the Obama bait-and-switch in plain language. "Translation: I promise to fix the problem. And if I do not fix the problem now, I will fix it later, or some future president will, after I am long gone. I promise he will. Absolutely, positively, I am committed to that future president fixing the problem. You can count on it. Would I lie to you?"
2. And then there's the famous contretemps about health insurance for illegal immigrants. Obama said they would not be insured. Well, all four committee-passed bills in Congress allow illegal immigrants to take part in the proposed Health Insurance Exchange.
But more importantly, the problem is that laws are not self-enforcing. If they were, we'd have no illegal immigrants because, as I understand it, it's illegal to enter the United States illegally. We have laws against burglary, too. But we also provide for cops and jails on the assumption that most burglars don't voluntarily turn themselves in.
When Republicans proposed requiring proof of citizenship, the Democrats twice voted that down in committee. Indeed, after Rep. Joe Wilson's "You lie!" shout-out, the Senate Finance Committee revisited the language of its bill to prevent illegal immigrants from getting any federal benefits. Why would the Finance Committee fix a nonexistent problem?
3. Obama said he would largely solve the insoluble cost problem of ObamaCare by eliminating "hundreds of billions of dollars in waste and fraud" from Medicare.
That's not a lie. That's not even deception. That's just an insult to our intelligence. Waste, fraud and abuse — Meg Greenfield once called this phrase "the dread big three" — as the all-purpose piggy bank for budget savings has been a joke since Jimmy Carter first used it in 1977.
Moreover, if half a trillion is waiting to be squeezed painlessly out of Medicare, why wait for health care reform? If, as Obama repeatedly insists, Medicare overspending is breaking the budget, why hasn't he gotten started on the painless billions in "waste and fraud" savings?
Obama doesn't lie. He merely elides, gliding from one dubious assertion to another. This has been the story throughout his whole health care crusade. Its original premise was that our current financial crisis was rooted in neglect of three things — energy, education and health care.
That transparent attempt to exploit Emanuel's Law — a crisis is a terrible thing to waste — failed for health care because no one is stupid enough to believe that the 2008 financial collapse was caused by a lack of universal health care.
So on to the next gambit: selling health care reform as a cure for the deficit. When that was exploded by the Congressional Budget Office's demonstration of staggering ObamaCare deficits, Obama tried a new tack: selling his plan as revenue-neutral insurance reform — until the revenue neutrality is exposed as phony future cuts and chimerical waste and fraud.
Obama doesn't lie. He implies, he misdirects, he misleads — so fluidly and incessantly that he risks transmuting eloquence into mere slickness.
Slickness wasn't fatal to "Slick Willie" Clinton because he possessed a winning, near irresistible charm. Obama's persona is more cool, distant, imperial.
The charming scoundrel can get away with endless deception; the righteous redeemer cannot.
SOURCE
Sunday, September 20, 2009
Bungle after bungle kills woman in British public hospital
Woman bleeds to death after doctor accidentally punctures jugular while inserting a drip - and no blood is available for transfusion
A young woman died in hospital after waiting almost two hours for a blood transfusion that could have saved her. Sally Thompson, 20, bled to death after a doctor accidentally punctured her jugular vein during a bungled procedure. Despite an urgent request to the blood bank at Manchester Royal Infirmary, she died one hour and 45 minutes later, before any arrived.
Speaking after her inquest, her father John, 62, said she would still be alive if the blood had been available sooner. The retired farmer said: 'This hospital is supposed to be the cornerstone of the NHS in Manchester, but they couldn't get any blood for two hours. 'We have never had any answers about why it took so long. I feel very let down by the hospital.'
Coroner Nigel Meadows said the inability to supply the blood was a 'significant failure' and he would write to hospital bosses. If a patient needs a transfusion, blood is tested first by type and then further tests, known as crossmatching, are performed to check antibodies in the blood. But in an emergency when there is no time for crossmatching, blood of the same type as the patient's - in Miss Thompson's case O-negative, one of the most common types - can be given. The inquest was told that doctors did eventually request non-crossmatched blood, but by then it was too late.
Miss Thompson, an administration assistant for Rochdale Council, had suffered from a rare blood disorder, hemophagocytic lymphohistiocytosis (HLH), since she was eight. The condition caused her immune system to fail and doctors said she would eventually need a bone marrow transplant.
On August 22, 2005, she collapsed at home in Middleton, Manchester, and was admitted to the Royal Infirmary. Doctors stabilised her, but two days later she had a series of fits and was transferred to intensive care. The following evening, and with the fits still going on, doctors decided to start her on a course of chemotherapy. They decided to insert a tube called a central venous catheter into her jugular vein to administer the chemotherapy drugs directly into her bloodstream.
Dr Jaydeep Mandal, a critical care specialist registrar, who no longer works at the hospital, used a technique known as 'landmark' to find the blood vessel. But when the tube was inserted, it caused internal bleeding.
The inquest heard that the landmark technique, which involves mapping out the features of the neck to find the vein, was contrary to guidelines, which recommend using an ultrasound scan to find the vein. Ultrasound equipment was available.
However, Dr Mandal had used the landmark technique 300 times and consulted colleagues before it was agreed that it should be used on Miss Thompson, the inquest was told.
Her father said: 'It punctured Sally's vein and, unbeknown to them, she was bleeding into her chest cavity for almost an hour. 'When they did find out they sent an order down for blood but the bank said they were having trouble finding any crossmatched blood because of her disorder.'
Miss Thompson died before any blood arrived after having a heart attack caused by the internal bleeding.
Coroner Mr Meadows, who recorded a narrative verdict, said he would ask hospital bosses to review the procedure relating to central venous catheters. 'No crossmatched or uncrossmatched O-negative blood was supplied, despite it being requested during the resuscitation, and this was a significant failure,' Mr Meadows said. 'Blood salvage was organised but not initiated until towards the very end of attempts to resuscitate the deceased.'
A hospital spokesman said it had reviewed procedures concerning CVCs and was investigating why no blood was ever supplied for a transfusion.
SOURCE
Government Medicine vs. the Elderly
Rarely has the Atlantic seemed as wide as when America’s health-care debate provoked a near unanimous response from British politicians boasting of the superiority of their country’s National Health Service. Prime Minister Gordon Brown used Twitter to tell the world that the NHS can mean the difference between life and death. His wife added, “we love the NHS.” Opposition leader David Cameron tweeted back that his plans to outspend Labour showed the Conservatives were more committed to the NHS than Labour.
This outbreak of NHS jingoism was brought to an abrupt halt by the Patients Association, an independent charity. In a report, the association presented a catalogue of end-of-life cases that demonstrated, in its words, "a consistent pattern of shocking standards of care." It provided details of what it described as "appalling treatment," which could be found across the NHS.
A few days later, a group of senior doctors and health-care experts wrote to a national newspaper expressing their concern about the Liverpool Care Pathway, a palliative program being rolled out across the NHS involving the withdrawal of fluids and nourishment for patients thought to be dying. Noting that in 2007-08, 16.5% of deaths in the U.K. came after "terminal sedation," their letter concluded with the chilling observation that experienced doctors know that sometimes "when all but essential drugs are stopped, 'dying' patients get better" if they are allowed to.
The usual justification for socialized health care is to provide access to quality health care for the poor and disadvantaged. But this function can be more efficiently performed through the benefits system and the payment of refundable tax credits.
The real justification for socialized medicine is left unstated: Because health-care resources are assumed to be fixed, those resources should be prioritized for those who can benefit most from medical treatment. Thus the NHS acts as Britain's national triage service, deciding who is most likely to respond best to treatment and allocating health care accordingly.
It should therefore come as no surprise that the NHS is institutionally ageist. The elderly have fewer years left to them; why then should they get health-care resources that would benefit a younger person more? An analysis by a senior U.K.-based health-care expert earlier this decade found that in the U.S. health-care spending per capita goes up steeply for the elderly, while the U.K. didn't show the same pattern. The U.K.'s pattern of health-care spending by age had more in common with the former Soviet bloc.
A scarcity assumption similar to the British mentality underlies President Barack Obama's proposed health-care overhaul. "We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it," Mr. Obama claimed in his address to Congress last Wednesday, a situation that, he said, threatened America's economic competitiveness.
This assertion is seldom challenged. Yet what makes health care different from spending on, say, information technology —or any category of consumer service —such that spending on health care is uniquely bad for the American economy? Distortions like malpractice suits that lead to higher costs or the absence of consumer price consciousness do result in a misallocation of resources. That should be an argument for tackling those distortions. But if high health-care spending otherwise reflects the preferences of millions of consumers, why the fuss?
The case for ObamaCare, as with the NHS, rests on what might be termed the "lump of health care" fallacy. But in a market-based system triggering one person's contractual rights to health care does not invalidate someone else's health policy. Instead, increased demand for health care incentivizes new drugs, new therapies and better ways of delivering health care. Government-administered systems are so slow and clumsy that they turn the lump of health-care fallacy into a reality.
According to the 2002 Wanless report, used by Tony Blair's government to justify a large tax hike to fund the higher spending, the NHS is late to adopt and slow to diffuse new technology. Still, NHS spending more than doubled to £103 billion in 2009-10 from £40 billion in 1999-2000, equivalent to an average growth rate of over 7% a year after inflation.
In 1965, economist (and future Nobel laureate) James Buchanan observed of the 17-year old NHS that "hospital facilities are overcrowded, and long delays in securing treatment, save for strictly emergency cases, are universally noted." Forty-four years later, matters are little improved. The Wanless report found that of the five countries it looked at, the U.S. was the only one to be both an early adopter and rapid diffuser of new medical techniques. It is the world's principal engine driving medical advance. If the U.S. gets health-care reform wrong, the rest of the world will suffer too.
SOURCE
Obamacare will hit workers in the pocket
If U.S. health reform efforts lead to higher costs for employers, employees may end up bearing the brunt, according to a new survey. Employers will not absorb higher costs, choosing instead either to reduce benefits, lower salaries or cut jobs, the survey from professional services firm Towers Perrin said on Thursday. Eighty-seven percent of employers said they were very likely or likely to cut benefits if reform leads to higher costs. Only 11 percent said they would accept lower profits. "They simply don't have money and margins today to absorb additional healthcare costs," said Dave Osterndorf, chief health actuary at Towers Perrin.
Should reform reduce benefit costs to the companies, 78 percent they were very likely or likely to retain the savings in the business.
The survey of more than 430 human resource executives at medium and large businesses taken in July was designed to gauge opinions on reform as legislative efforts were heating up.
Congress is weighing bills that would overhaul the healthcare system, which is President Barack Obama's top legislative priority. Proposals that might drive up employer costs include those that would force employers to expand their coverage, such as to part-time workers, or those that would allow healthy workers to find coverage elsewhere, leaving employers to pay for sicker, more expensive employees, Osterndorf said.
Although the ultimate outcome of reform efforts remains uncertain, nearly one in four companies in the survey are already rethinking changes in light of possible reforms. Of all the goals of health reform, cost containment was listed most frequently as an absolutely critical or high priority among the businesses in the survey, which ranged in size from roughly 1,500 to 100,000 workers.
But, Osterndorf said, employers believe that issues such as expanding access to coverage and reforming certain insurance practices have received more attention. "Employers are saying, 'These are important social issues that are being addressed, but they don't necessarily hit on the issues that we're facing as employers,'" Osterndorf said.
Of the healthcare proposals, 53 percent of employers believe research on effectiveness of treatments will help their business by influencing the quality of care.
Employers had varying responses to how they would react to proposals mandating they offer coverage to meet certain minimum standards or pay a penalty -- called "pay-or-play" mandates. Thirty-seven percent of employers would provide company-sponsored coverage that substantially exceeds the standard. But 29 percent said they would end company-sponsored health coverage and pay the assessment if the per-employee costs to the government were much lower than current costs.
SOURCE
Rationing By Any Other Name...
We critics of ObamaCare may have been doing ourselves a bit of a disservice over the past few months by focusing on health care “rationing.”
Yes, “rationing” best describes some of the most disconcerting effects of government run health care, and it strikes a chord with the general public. But it is rarely used by our duplicitous opponents, leaving the door open for them to argue that we are just raising a general alarm over nothing.
But rationing does not have to be called such to be rationing. So, perhaps, we should shift our focus away from language that we prefer and toward illuminating language used by our opponents when, in cloaked words, they discuss what we all know is nothing more (and unfortunately, nothing less) than cold and calculated government rationing.
Ezekiel Emanuel heads the Federal Council of Comparative Effectiveness Research, whose job it is, we are told, to save the government money. The GLG Group observes that, “The Commonwealth Fund…has estimated that establishing a Center for Comparative Effectiveness Research could save up to $634 billion between 2010 and 2020…” And just how would it do this?
Well, in sum total, “effectiveness” in this context is merely another term for rationing. Emanuel makes it clear that the “effectiveness” of a new drug, device or procedure is not measured by whether it works to heal a patient and save lives, but by whether it is effective relative to its cost. A drug, for instance, that adds half a year of life on average to cancer patients, but costs the Obama government $50,000 cost would not receive government backing. It’s all a matter of a cold and heartless cost-benefit analysis.
Astute readers may notice that in real life, Ezekiel Emanuel now actually heads an organization that has essentially the same function as his envisioned Institute for Technology and Outcomes Assessment, which we discussed last week. From this we could glean that the word “outcomes” is another buzz word used for rationing. Only those health services whose “outcomes” justify their costs are worth Big Government’s time and money. So, in short, under Obamacare, you and your loved ones are reduced to mere dollar figures
Other words occur when members of the Obama administration, or the President himself, talk about eliminating “waste” and “inefficiency” as Obama did last week and on July 22: “We also want to create an independent group of doctors and medical experts who are empowered to eliminate waste and inefficiency in Medicare on an annual basis.”
Contrary to White House denials to the effect that this board, “will not be authorized to propose or implement Medicare changes that ration care or affect benefits, eligibility or beneficiary access to care,” the CBO has recommended that the Independent Medicare Advisory Council (IMAC) have exactly those powers in order to “improve the efficiency of the health care system.” And improving “efficiency” again means weighing costs over benefits in ways that produce rationed care.
The fact is, as Gertrude Stein opined, “A rose by any other name is still a rose.” And government “rationing” by any other name is still a death warrant for the elderly and infirm.
SOURCE
Woman bleeds to death after doctor accidentally punctures jugular while inserting a drip - and no blood is available for transfusion
A young woman died in hospital after waiting almost two hours for a blood transfusion that could have saved her. Sally Thompson, 20, bled to death after a doctor accidentally punctured her jugular vein during a bungled procedure. Despite an urgent request to the blood bank at Manchester Royal Infirmary, she died one hour and 45 minutes later, before any arrived.
Speaking after her inquest, her father John, 62, said she would still be alive if the blood had been available sooner. The retired farmer said: 'This hospital is supposed to be the cornerstone of the NHS in Manchester, but they couldn't get any blood for two hours. 'We have never had any answers about why it took so long. I feel very let down by the hospital.'
Coroner Nigel Meadows said the inability to supply the blood was a 'significant failure' and he would write to hospital bosses. If a patient needs a transfusion, blood is tested first by type and then further tests, known as crossmatching, are performed to check antibodies in the blood. But in an emergency when there is no time for crossmatching, blood of the same type as the patient's - in Miss Thompson's case O-negative, one of the most common types - can be given. The inquest was told that doctors did eventually request non-crossmatched blood, but by then it was too late.
Miss Thompson, an administration assistant for Rochdale Council, had suffered from a rare blood disorder, hemophagocytic lymphohistiocytosis (HLH), since she was eight. The condition caused her immune system to fail and doctors said she would eventually need a bone marrow transplant.
On August 22, 2005, she collapsed at home in Middleton, Manchester, and was admitted to the Royal Infirmary. Doctors stabilised her, but two days later she had a series of fits and was transferred to intensive care. The following evening, and with the fits still going on, doctors decided to start her on a course of chemotherapy. They decided to insert a tube called a central venous catheter into her jugular vein to administer the chemotherapy drugs directly into her bloodstream.
Dr Jaydeep Mandal, a critical care specialist registrar, who no longer works at the hospital, used a technique known as 'landmark' to find the blood vessel. But when the tube was inserted, it caused internal bleeding.
The inquest heard that the landmark technique, which involves mapping out the features of the neck to find the vein, was contrary to guidelines, which recommend using an ultrasound scan to find the vein. Ultrasound equipment was available.
However, Dr Mandal had used the landmark technique 300 times and consulted colleagues before it was agreed that it should be used on Miss Thompson, the inquest was told.
Her father said: 'It punctured Sally's vein and, unbeknown to them, she was bleeding into her chest cavity for almost an hour. 'When they did find out they sent an order down for blood but the bank said they were having trouble finding any crossmatched blood because of her disorder.'
Miss Thompson died before any blood arrived after having a heart attack caused by the internal bleeding.
Coroner Mr Meadows, who recorded a narrative verdict, said he would ask hospital bosses to review the procedure relating to central venous catheters. 'No crossmatched or uncrossmatched O-negative blood was supplied, despite it being requested during the resuscitation, and this was a significant failure,' Mr Meadows said. 'Blood salvage was organised but not initiated until towards the very end of attempts to resuscitate the deceased.'
A hospital spokesman said it had reviewed procedures concerning CVCs and was investigating why no blood was ever supplied for a transfusion.
SOURCE
Government Medicine vs. the Elderly
Rarely has the Atlantic seemed as wide as when America’s health-care debate provoked a near unanimous response from British politicians boasting of the superiority of their country’s National Health Service. Prime Minister Gordon Brown used Twitter to tell the world that the NHS can mean the difference between life and death. His wife added, “we love the NHS.” Opposition leader David Cameron tweeted back that his plans to outspend Labour showed the Conservatives were more committed to the NHS than Labour.
This outbreak of NHS jingoism was brought to an abrupt halt by the Patients Association, an independent charity. In a report, the association presented a catalogue of end-of-life cases that demonstrated, in its words, "a consistent pattern of shocking standards of care." It provided details of what it described as "appalling treatment," which could be found across the NHS.
A few days later, a group of senior doctors and health-care experts wrote to a national newspaper expressing their concern about the Liverpool Care Pathway, a palliative program being rolled out across the NHS involving the withdrawal of fluids and nourishment for patients thought to be dying. Noting that in 2007-08, 16.5% of deaths in the U.K. came after "terminal sedation," their letter concluded with the chilling observation that experienced doctors know that sometimes "when all but essential drugs are stopped, 'dying' patients get better" if they are allowed to.
The usual justification for socialized health care is to provide access to quality health care for the poor and disadvantaged. But this function can be more efficiently performed through the benefits system and the payment of refundable tax credits.
The real justification for socialized medicine is left unstated: Because health-care resources are assumed to be fixed, those resources should be prioritized for those who can benefit most from medical treatment. Thus the NHS acts as Britain's national triage service, deciding who is most likely to respond best to treatment and allocating health care accordingly.
It should therefore come as no surprise that the NHS is institutionally ageist. The elderly have fewer years left to them; why then should they get health-care resources that would benefit a younger person more? An analysis by a senior U.K.-based health-care expert earlier this decade found that in the U.S. health-care spending per capita goes up steeply for the elderly, while the U.K. didn't show the same pattern. The U.K.'s pattern of health-care spending by age had more in common with the former Soviet bloc.
A scarcity assumption similar to the British mentality underlies President Barack Obama's proposed health-care overhaul. "We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it," Mr. Obama claimed in his address to Congress last Wednesday, a situation that, he said, threatened America's economic competitiveness.
This assertion is seldom challenged. Yet what makes health care different from spending on, say, information technology —or any category of consumer service —such that spending on health care is uniquely bad for the American economy? Distortions like malpractice suits that lead to higher costs or the absence of consumer price consciousness do result in a misallocation of resources. That should be an argument for tackling those distortions. But if high health-care spending otherwise reflects the preferences of millions of consumers, why the fuss?
The case for ObamaCare, as with the NHS, rests on what might be termed the "lump of health care" fallacy. But in a market-based system triggering one person's contractual rights to health care does not invalidate someone else's health policy. Instead, increased demand for health care incentivizes new drugs, new therapies and better ways of delivering health care. Government-administered systems are so slow and clumsy that they turn the lump of health-care fallacy into a reality.
According to the 2002 Wanless report, used by Tony Blair's government to justify a large tax hike to fund the higher spending, the NHS is late to adopt and slow to diffuse new technology. Still, NHS spending more than doubled to £103 billion in 2009-10 from £40 billion in 1999-2000, equivalent to an average growth rate of over 7% a year after inflation.
In 1965, economist (and future Nobel laureate) James Buchanan observed of the 17-year old NHS that "hospital facilities are overcrowded, and long delays in securing treatment, save for strictly emergency cases, are universally noted." Forty-four years later, matters are little improved. The Wanless report found that of the five countries it looked at, the U.S. was the only one to be both an early adopter and rapid diffuser of new medical techniques. It is the world's principal engine driving medical advance. If the U.S. gets health-care reform wrong, the rest of the world will suffer too.
SOURCE
Obamacare will hit workers in the pocket
If U.S. health reform efforts lead to higher costs for employers, employees may end up bearing the brunt, according to a new survey. Employers will not absorb higher costs, choosing instead either to reduce benefits, lower salaries or cut jobs, the survey from professional services firm Towers Perrin said on Thursday. Eighty-seven percent of employers said they were very likely or likely to cut benefits if reform leads to higher costs. Only 11 percent said they would accept lower profits. "They simply don't have money and margins today to absorb additional healthcare costs," said Dave Osterndorf, chief health actuary at Towers Perrin.
Should reform reduce benefit costs to the companies, 78 percent they were very likely or likely to retain the savings in the business.
The survey of more than 430 human resource executives at medium and large businesses taken in July was designed to gauge opinions on reform as legislative efforts were heating up.
Congress is weighing bills that would overhaul the healthcare system, which is President Barack Obama's top legislative priority. Proposals that might drive up employer costs include those that would force employers to expand their coverage, such as to part-time workers, or those that would allow healthy workers to find coverage elsewhere, leaving employers to pay for sicker, more expensive employees, Osterndorf said.
Although the ultimate outcome of reform efforts remains uncertain, nearly one in four companies in the survey are already rethinking changes in light of possible reforms. Of all the goals of health reform, cost containment was listed most frequently as an absolutely critical or high priority among the businesses in the survey, which ranged in size from roughly 1,500 to 100,000 workers.
But, Osterndorf said, employers believe that issues such as expanding access to coverage and reforming certain insurance practices have received more attention. "Employers are saying, 'These are important social issues that are being addressed, but they don't necessarily hit on the issues that we're facing as employers,'" Osterndorf said.
Of the healthcare proposals, 53 percent of employers believe research on effectiveness of treatments will help their business by influencing the quality of care.
Employers had varying responses to how they would react to proposals mandating they offer coverage to meet certain minimum standards or pay a penalty -- called "pay-or-play" mandates. Thirty-seven percent of employers would provide company-sponsored coverage that substantially exceeds the standard. But 29 percent said they would end company-sponsored health coverage and pay the assessment if the per-employee costs to the government were much lower than current costs.
SOURCE
Rationing By Any Other Name...
We critics of ObamaCare may have been doing ourselves a bit of a disservice over the past few months by focusing on health care “rationing.”
Yes, “rationing” best describes some of the most disconcerting effects of government run health care, and it strikes a chord with the general public. But it is rarely used by our duplicitous opponents, leaving the door open for them to argue that we are just raising a general alarm over nothing.
But rationing does not have to be called such to be rationing. So, perhaps, we should shift our focus away from language that we prefer and toward illuminating language used by our opponents when, in cloaked words, they discuss what we all know is nothing more (and unfortunately, nothing less) than cold and calculated government rationing.
Ezekiel Emanuel heads the Federal Council of Comparative Effectiveness Research, whose job it is, we are told, to save the government money. The GLG Group observes that, “The Commonwealth Fund…has estimated that establishing a Center for Comparative Effectiveness Research could save up to $634 billion between 2010 and 2020…” And just how would it do this?
Well, in sum total, “effectiveness” in this context is merely another term for rationing. Emanuel makes it clear that the “effectiveness” of a new drug, device or procedure is not measured by whether it works to heal a patient and save lives, but by whether it is effective relative to its cost. A drug, for instance, that adds half a year of life on average to cancer patients, but costs the Obama government $50,000 cost would not receive government backing. It’s all a matter of a cold and heartless cost-benefit analysis.
Astute readers may notice that in real life, Ezekiel Emanuel now actually heads an organization that has essentially the same function as his envisioned Institute for Technology and Outcomes Assessment, which we discussed last week. From this we could glean that the word “outcomes” is another buzz word used for rationing. Only those health services whose “outcomes” justify their costs are worth Big Government’s time and money. So, in short, under Obamacare, you and your loved ones are reduced to mere dollar figures
Other words occur when members of the Obama administration, or the President himself, talk about eliminating “waste” and “inefficiency” as Obama did last week and on July 22: “We also want to create an independent group of doctors and medical experts who are empowered to eliminate waste and inefficiency in Medicare on an annual basis.”
Contrary to White House denials to the effect that this board, “will not be authorized to propose or implement Medicare changes that ration care or affect benefits, eligibility or beneficiary access to care,” the CBO has recommended that the Independent Medicare Advisory Council (IMAC) have exactly those powers in order to “improve the efficiency of the health care system.” And improving “efficiency” again means weighing costs over benefits in ways that produce rationed care.
The fact is, as Gertrude Stein opined, “A rose by any other name is still a rose.” And government “rationing” by any other name is still a death warrant for the elderly and infirm.
SOURCE
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