Thursday, September 30, 2004


"The official inquiry into incompetent gynaecologist Richard Neale has called for reform of the way doctors are recruited and employed by the NHS. Neale was struck off in 2000 after being found guilty of serious professional misconduct. A General Medical Council hearing concluded he botched operations on 12 women. In total more than 250 women said they had been damaged by Neale. The inquiry calls for a new body to oversee the employment of doctors

It also says that checks should be made on all doctors appointed from overseas as standard. The report also says the complaints procedure at Friarage Hospital was poor. Patients were not actively encouraged to follow up their initial complaints, and were given little or no help with how to navigate the system. "Generally speaking we have found that the climate in which Richard Neale operated did not lend itself to full and objective examination of what was going wrong with the doctor-patient relationship. His attitude to some patients and some colleagues was arrogant, dismissive and overbearing; it stifled complaints by patients and criticisms by colleagues alike."

Neale was over-confident, and over-reached himself in performing certain clinical practices, the report finds. He also deliberately allowed his employers to be misled on a number of occasions, including failing to disclose the fact that he had been struck off in Canada. However, the report says that adequate checks on his clinical ability were not carried out. "Vulnerable patients, such as many of those treated by Richard Neale, deserve better," the report says....

The official inquiry, ordered by the government, was boycotted by many of his alleged victims because it was not held in public.....

In a statement, the GMC apologised for the way it had handled the Neale case in the 1980s. "We cannot defend the GMC procedures that 15 years ago failed by allowing him to practise in this country despite his record in Canada".

More here.

Wednesday, September 29, 2004


And a culture of carelessness kills

"A critic of declining standards in the National Health Service died after being given a large overdose of iron by a hospital doctor who did not read the instructions on the drug's label properly. Carys Pugh, 63, a former president of a patients' association in Wales, was taken to casualty at the Royal Glamorgan Hospital after the blunder turned her skin brown and "saturated" her liver with iron.

While she fought for survival in hospital for seven weeks, Mrs Pugh suffered a heart attack and contracted deep vein thrombosis in both legs, a chest infection and then E.coli. Finally, she suffered a second heart attack that killed her.

When her daughter, Hawys Pugh, complained to the hospital authorities about what had gone wrong she was told that the doctor who had carried out the routine infusion for suspected anaemia had found the instructions difficult to decipher and that he had only read half of them. "They told me that because the text was in two columns instead of one, the doctor just read the section on how much to give, but didn't bother reading the rest which said over what duration it should be given," Miss Pugh said. "Instead, he just put the entire dose into her system in one go. They suggested it was the manufacturer's fault and said they would be contacting them."

The officials dismissed Miss Pugh's concerns that the overdose had caused her mother's initial heart attack and refused to name the doctor concerned, insisting that the trust had a "no blame" culture.

Miss Pugh said last week: "Basically, they admitted that it had been a mistake and an accident due to a failure to read the instructions, but denied it was negligence, which I find ridiculous." Miss Pugh said that the way that her mother, who was the head of the Mid Glamorgan Valley's patients' association in the 1990s and a staunch critic of the NHS's failures, had been treated was "a disgrace".

More here.


For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.


Tuesday, September 28, 2004

How eight states destroyed their individual insurance markets: "Since February of this year, "Health Care News" has featured a series of monthly case studies documenting how community rating and guaranteed issue mandates have destroyed the individual health insurance markets in eight states. These mandates are not merely poorly crafted laws: They represent fundamentally bankrupt ideas in what should be a voluntary, consumer-driven insurance marketplace."


For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.


Monday, September 27, 2004

Bureaucratizing private medicine: "In the late 1970s, the Supreme Court decided the antitrust laws should apply to 'professionals' such as lawyers and physicians. In 1993, lawyers at the FTC and the DOJ's Antitrust Division made up a set of rules governing how physicians and other health care providers should run their businesses. To avoid antitrust charges, independent physicians had to organize their practices according to a government-approved economic model. Experimentation or deviation from this model would subject doctors to criminal price-fixing charges on top of potential treble-damage civil lawsuits."


"The United States spends more on health care than any country on earth -- nearly 15 percent of its overall economy. That's nearly a half again as much as other countries and on a per capita basis, no one else is even close. Yet if one looks at the performance of our health care system, we're clearly not getting what we pay for. "USA Today" last week published a list of the top 50 countries in terms of life expectancy. The United States ranked third from the bottom. That's right. We're number 48. This year, Americans can expect an average life span of 77.4 years, nearly four years behind the Japanese... "

A quick look at the Centers for Disease Control website at health disparities in the United States gives a few clues about why our health care system performs so poorly despite outlandish costs. While the overall U.S. life expectancy rate is 77 years, the rate for blacks is about 72 years with black males at a Third World-level of 68 years...... It's not middle-class moms in suburban hospitals losing babies. It's poor mothers without prenatal care. It's teenagers who hide their pregnancies, deliver low birth weight babies and have few support systems to help them care for their newborns.....

In this election season, by all means let's have a debate about how to provide health insurance to the 43 million Americans without it. But let's also talk about who in this society suffers from ill health, why they suffer and what can be done about the social and economic disparities that lead to ill health. It will take more than universal insurance coverage to tackle those issues.

More here.


For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.


Sunday, September 26, 2004


"The blue-grey colour on Lynette Jeffrey's foot grew "like a wave on the beach", intermittently receding, only to creep higher up her ankle each time. The 50-year-old sat up in a Liverpool Hospital bed and watched in horror as gangrene enveloped her left leg. A doctor told her that she would die within 24 hours if it was not amputated.

Mrs Jeffrey is suing the South West Sydney Area Health Service, and three doctors, for more than $750,000 in the NSW Supreme Court, claiming they failed to warn her of risks from an angiogram she had in August 1997.

"They pushed me up from the bed and my foot was blue, bluey grey ... and then it was a lighter grey," Mrs Jeffrey told the court yesterday. The tragic irony was that Mrs Jeffrey, a diabetic, woke up hours later without her left leg in the same amputee ward where only three months earlier she was told that she would lose her right leg because of circulatory problems and the presence of gangrene on her right foot.

Mrs Jeffrey, who has since moved from Bossley Park in Sydney to her hometown of Ulverstone in northern Tasmania, refused the amputation, and still has her right leg. "I told him [the doctor] straight away that that was not going to happen to me," she said.

However, the diagnostic test she underwent then - an angiogram - had resulted in severe blood clotting in her left leg, after an artery wall in her groin was ruptured with a catheter. The hospital did not deny this happened, but claimed it warned Mrs Jeffrey it was a common complication, the court heard".

["a common complication" !!!!!]

More here.


For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.


Saturday, September 25, 2004

Good doctors destroyed by power-mad bureaucrats: "It's uncomfortable to hear Dr. Frank Fisher speak. His eyes are usually glassed over, seemingly on the verge of tears. ... As he talks, you get the impression that he's just a small dose of bad news away from shattering into a thousand pieces. And with good reason. Fisher, a Harvard-trained physician, once specialized in the treatment of chronic pain. He served a predominantly rural and poor population in California. About 5-10 percent of his 3,000 clients were pain patients, victims of illnesses like cancer, steep falls or car accidents. A little more than five years ago, California Attorney General Bill Lockyer initiated a high-profile campaign against pain doctors who prescribe high doses of opioids -- drugs such as Oxycontin, Vicodin and codeine. Lockyer made Frank Fisher his example."


Leftist promises won't help

"Labor's promise to inject $1 billion into public hospitals has drawn a mixed response from public hospital groups and the nation's most influential doctors' organisation. While public hospitals welcomed the plan as a necessary boost to a system under strain, the Australian Medical Association said the policy was based on "wrong assumptions about relieving the pressure on hospital emergency departments".....

The AMA - which earlier yesterday expressed "outrage" at "the gross misrepresentation" of doctors in Labor's television advertisements depicting an auction for a doctor's consultation - said it was not the co-ordinated policy that was needed. It was a shortage of hospital beds, not a shortage of general practitioner services, that was causing queues at public hospitals, the AMA vice president, Mukesh Haikerwal, said.....

The Australian Healthcare Association, representing about 500 public hospitals, said the Labor plan was "a great start" but it was disappointed it did not specifically tackle the need for more public hospital beds. "The declining bed numbers is the major reason for 'bed block' in hospital emergency departments, resulting in patients spending too long on trolleys waiting for admission," the association's executive director, Prue Power, said....

But the Australian Private Hospitals Association said the Labor focus was "too narrow" and ignored the private hospitals where most surgery was performed".

More here.


For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.


Friday, September 24, 2004


This poor b***** didn't even get to see a doctor for 4 months. Now he has to wait for over 2 more years

"A Penticton man has placed a personal ad offering to pay for a better spot on a knee-replacement waiting list. "Anyone who is looking at a knee or hip replacement is looking at two to 2 1/2 years," said notary public Bill Binfet, who needs both knees replaced. Binfet has had knee trouble since last October, when he was referred by his family doctor to orthopedic surgeon Dr. Justin Naude of Penticton. "He never saw me until February," said Binfet, who suffers from arthritis so bad, he now has bone grinding on bone

He said he's 290th on Naude's surgical waiting list. "Medical studies have shown that once the disease has gone beyond six months, the patient's health starts to deteriorate," he said. "You end up on more drugs, more physio, and then you go to a cane, and then you go to a wheelchair and then you go to bed." Binfet will not reveal how much he's willing to offer for a higher place on the waiting list or how many calls he's received as a result of an ad placed in the Penticton Herald. In July, his pain medication dosage was increased. "As things get worse, then I won't be able to work," he said

Binfet said it would cost $45,000 US per knee to have the surgery done in Bellingham, Wash. "I can't afford it," he said. Asked whether he thinks it's ethical to buy a better place on the list, Binfet responded, "If ICBC and the WCB (Workers' Compensation Board) can do it, why can't I?" The Canada Health Act requires there be equitable access to care, said Linda Mueller, public affairs officer with the Ministry of Health Services in Victoria, Tuesday. But under the Canada Health Act, certain organizations are excluded from the requirements of the act, she said. ICBC is not one of them, but the WCB, RCMP and the Canadian Forces are.... "

More here

Without socialized medicine, he would probably have had insurance.... He has been conned.


For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.


Thursday, September 23, 2004


That the guy is black had nothing to do with it, of course. Just a small excerpt of the full story below:

"State Department of Health regulators expressed increasing alarm in recent years about a South King County physician who was charged this week with rape - calling him a "bad doctor" as early as 1999 - but allowed him to keep working. The state suspended Dr. Charles Momah's license a year ago, after a rape accusation, but had already logged several unrelated complaints about the obstetrician-gynecologist.

Doctors, nurses, hospital administrators and state investigators questioned Momah's medical skills and practices. Investigators generated dozens of reports detailing Momah's behavior: yelling at patients and nurses, ignoring pages and making suspect medical decisions. Complaints began in 1998. Since then, 50 patients have reported Momah to the state and 47 women have sued - most since the first rape allegation. The Department of Health is pursuing 18 separate disciplinary charges against Momah and investigating 29 more complaints, said Donn Moyer, department spokesman....

Prosecutors say other sex-related charges weren't filed because a three-year statute of limitations had passed.

Moyer acknowledged that the state could have acted more quickly against Momah for questionable professional and medical conduct. It is unlikely that any disciplinary action by the state before the rape allegation would have resulted in Momah immediately losing his license, Moyer said. "I'm not going to candy-coat it," he said. "I'm not going to hide this from you - there is culpability on our part."

... the first complaint against Momah - alleging a variety of unprofessional acts - wasn't filed by the state's Medical Quality Assurance Commission until June 2003, two months before the rape allegation surfaced and nearly three years after the commission had opened its investigation. The commission licenses doctors and investigates complaints against them.

During the spring and summer of 2001, state investigators generated more than 30 Momah-related memos. Several dealt with complaints that he was frequently unavailable when emergencies arose at the hospitals where he practiced - Auburn Regional Medical Center and Highline Community Hospital in Burien. Both eventually revoked his privileges.

In one instance, in May 2001, nurses repeatedly and desperately paged Momah while one of his surgical patients bled uncontrollably, reports say. A passing orthopedic surgeon and an emergency-room physician stepped in to treat the woman as her blood pressure dropped and doctors pumped six units of blood into her, according to reports of the incident. When Momah finally called in, he told a nurse to call him back "in an hour if there was a change."

Nurses on duty at the time, and later the patient herself, alleged Momah destroyed and altered records about the incident.

State investigators also were concerned that Momah appeared to be performing major abdominal surgeries in his small suite of offices in Federal Way without certification as an outpatient surgical center. They learned about it after Momah brought tubs of "heavy duty" surgical instruments to Highline hospital for sterilization, reports show.

Washington's investigation is not the first Momah has faced. While a doctor in New York, where he began a practice in 1987, he was reprimanded and censured for negligent care. He also was indicted in 1997 on 23 counts of billing fraud, by the New York Attorney General's Medicaid Fraud Control Unit. He was acquitted of the criminal charges, but ordered to pay $500,000 in overbillings in a civil case. He paid $350,000 cash and promised the remainder within a year.....

Washington officials knew about the New York reprimand and fraud cases, state records show. But because New York did not restrict his license, Momah was able to practice medicine in Washington when he moved here in 1993......"

More here

"Regulators" create a sense of security -- but they are chronically negligent so the sense of security is a con. As this story shows, in practice there is no regulation. And how do the regulators get so negligent? Because they never suffer any penalty for it. So only the patients suffer. Without regulators, people would be warier and safer

Wednesday, September 22, 2004


And the nationalized hospitals can't cope

The number of women who are seeking treatment at hospital casualty units after being injured in drunken catfights is rising sharply, consultants warn. Late-night brawls between women who have been binge-drinking are resulting in horrific injuries such as facial wounds caused by "glassing", broken jaws and bleeding scalps, where girls have had their hair pulled out.

Hospital staff, already under pressure from the rising numbers of emergency admissions, say that they are struggling to cope with a "disturbing" increase in the number of intoxicated women requiring treatment. In some areas, the number of admissions has tripled in five years.

Don MacKechnie, the chairman of the British Medical Association's accident and emergency committee and a consultant at Rochdale Infirmary in Lancashire, said that casualty units were being inundated with injured young women, particularly at weekends. "There has certainly been a big increase and some of the fights are really vicious," he said. "It is not just cuts and grazes, but fractured hands as a result of them punching other people, and broken cheekbones."

Amjid Muhammed, a consultant at Calderdale Royal Infirmary in Halifax, West Yorkshire, said that about 45 of the 300 patients seen in accident and emergency over a typical weekend were women wounded in drunken brawls. Five years ago, the typical figure was less than 15. He blamed the three-fold rise on the increasing tendency of groups of young women to binge-drink. "There are women who are intoxicated who are hurting themselves by toppling over or having an accident. Then there are women who are injured in fights. It used to be men but now women are turning up in this state - and even worse than the men in some cases," he said. Mr Muhammed said that one worrying new trend was "glassing" - women hitting other females with glasses or bottles. "That was something we never used to see, but I have seen a few cases recently," he said. "It causes quite serious injuries - a facial glassing can be very nasty."

Mr Muhammed said that drunken women were putting pressure on already stretched A & E departments. "They are adding to the growing numbers of people that are coming in that need to be seen. Every extra patient adds to the queue." The extent of the spiralling workload facing Britain's casualty units was underlined earlier this month by figures from the Department of Health showing that the number of admissions rose by up to a third in some hospitals in the second quarter of this year, compared with the same period last year.

More here

Tuesday, September 21, 2004


"It was a mere coincidence that a nurse was removed from a senior role just days after a public confrontation with the then health minister, Craig Knowles, the state's corruption watchdog has heard.

The former director of nursing at Fairfield Hospital, Elizabeth Graham, told the Independent Commission Against Corruption yesterday that secondment of the nurse, Giselle Simmons, to a senior position at the hospital had simply ended early, and that her return to Macarthur Health was not unusual. Ms Graham denied telling Ms Simmons her career was over because of her confrontation with Mr Knowles.

The inquiry, which is examining whether Mr Knowles bullied and intimidated nurses who were attempting to expose poor patient care, heard that Ms Simmons was acting nursing unit manager at Fairfield Hospital intensive care unit when she attended a UTS nursing workshop on February 14 last year.

After Mr Knowles had addressed the class, she challenged him over the lack of 24-hour critical care coverage at her hospital, telling him "people were not receiving good care and some people were dying". Mr Knowles became aggressive and raised his voice, she told the inquiry on August 19.

Soon after she spoke up at the workshop, Ms Simmons was removed from her senior position at Fairfield Hospital. She alleges Ms Graham told her: "You do not say what you said to the minister of health and get away with it."

However, Ms Graham told ICAC yesterday that the secondment had ended early because the person she was replacing had finished her placement ahead of time. Admitting she had some concerns about Ms Simmons's management style, Ms Graham said she had planned to speak to her about complaints she had received from medical and nursing staff.

But Ms Graham also acknowledged that the concerns Ms Simmons raised about inadequate staffing of the intensive care unit were concerns she too had voiced on many occasions......

Two nurses - Nola Fraser and Sheree Martin - gave evidence to the inquiry last month, saying they felt bullied and intimidated by Mr Knowles's behaviour at a meeting in his Ingleburn office in November 2002 to discuss their concerns about patient care...."

More here

Monday, September 20, 2004

A plan for healthcare

The post below was lifted bodily from "doc Russia"

There is likely to be some talk in politics about healthcare coming up. Ironically, Edwards, who made a career and a fortune out of suing healthcare providers is likely going to advance his own ideas about what I can only assume will be a Universal socialized healthcare system. So, before I start tearing the socialized medicine model to shreds, I am going to offer my own alternative. I often castigate the left for decrying a conservative plan, while failing to offer an alternative, and I will not fall into hypocrisy.

Part I

Professional insurance caps. We must drive out the lottery system from malpractice litigation. If a doctor has erred, hold them accountable, but do not allow for fraudulent and expensive allegations to consume the time and resources of the courts and physicians. It has been my experience that perhaps nothing else is more cost producing for healthcare than litigation. It manifests in a number of ways, beyond the raise in professional liability premiums, which drive away physicians, and force physicians to recoup the loss by seeing more patients in less time, or working longer hours. Neither of these improve the quality of care. It also causes a ripple effect where physicians practice defensive medicine. We run more tests than are reasonable, driving up costs, and detrimentally affecting the patients experience with healthcare. Also, we keep them hospitalized longer in order to completely Cover our Collective hindquarters. This drives up costs further, as well as facilitating hospital acquired diseases and superbugs, both of which require more expensive care than the community acquired diseases.

Part II

Right to refuse. Allow physicians to refuse services except in the most emergent of situations. This means that unless the patient presents with something emergent (lethal in less than 72 hours), hospitals can turn them out, either right from the start, or once a reasonable level of confidence has ruled out an emergent condition. This means that Chest Pain gets serial EKG and enzymes, with a Chest X-ray on top, and if nothing is found, you turf them to their PCP. If they have no PCP, then they had better get one, or pay for their own care starting immediately.

Part III

Make government care shitty. That's right; make it the absolute worst. As it stands medicare and medicaid provide a very high level of care for free to people who would rather spend their money on disposable items than on preventative care. Medicare has become an enabler for bad decision making by not making people accountable for paying their own bills. I know this sounds very harsh, but it is key to citizens taking responsibility for their own health. If we cannot get the private individual to be a proactive agent in their own healthcare, then all the government programs and funding in the world is going to be incredibly undereffective. We do not malevolently downgrade care, but we institute the cheapest programs reasonably possible. This will reduce the taxpayer burden, and impel patients to stay out of the public trough.

Part IV

Make Healthcare providers being reimbursed by medicare/medicaid immune to civil litigation. This will do the following: Patients who are not paying for their care will no longer be able to sue their way to financial independance for care which was provided to them free of charge. Also, it will give the salaries of medicare/medicaid doctors a competitive advantage, and help drive down the cost since the docs will not need such a high salary to maintain their standard of living since they will no longer have to factor in the overhead of professional insurance. Lastly, those less adroit physicians, after being sued enough times will have to seek refuge being a government provider. This will mean that government healthcare will be substandard, and people will try harder to get off of it, and pay for their own bills.

Part V

Allow for wage garnishment starting at the time of service. This will allow hospitals and doctors to recoup losses over time by having amounts deducted from the patients income directly for services rendered in an emergency situation. Also, allow for a healthcare equivalent to Bail. In this way, patients can put up their home or automobile as collateral for their healthcare.

Part VI

Provide for itemized price lists to the patients. It is a small measure, but it will have great results because those things which patients can provide themselves (pillows, blankets, gowns, bandaids) or can buy on the open market are going to bring down the cost of healthcare. Hand in hand with this, we need to allow private vendors to compete in the hospital. Part of the way that the hospital meets their overhead is by overcharging for items that are used. A $1 oxygen mask will be billed to you for $50. Stuff like that. I think that hospitals should get a percentage of the vendors take as kind of a privelage for access to the patients, and that this percentage should be hammered out between the hospital and the vendor, with one important caveat: there must be more than one vendor available for any sort of supplies. Hospitals also can make money from procedures performed. So, I think that there is still plenty of profitability to be had to keep our hospitals running.

Part VII

Allow for open bidding. Allow doctors and hospitals to bid for the care of patients. Also, we should allow for charity hospitals to bid for medicare/medicaid patients.
This seven point plan does have a number of overlaps. It is supposed to. This is because it runs under two basic concepts:

Publicly funded healthcare must be as cheap as is possible. It is there to save those who cannot save themselves, not for those who will not.

Private incentive, mixed with professional pride, will inspire more excellence, efficacy, and efficiency than professional pride alone.

Sunday, September 19, 2004


Is conservatism a "personality disorder"? Most Leftists probably think so.

"The UK government's draft Mental Health Bill is the latest attempt to reform mental health legislation. Two proposals attracted most criticism in 2002, with the recent modifications unlikely to appease critics: plans to allow compulsory community treatment orders, and measures that would allow those with a personality disorder who are considered dangerous to be detained indefinitely, even if they had not committed a crime.

Not surprisingly, such moves have sparked fierce criticism from service users and mental health campaign groups. But many psychiatrists are also hostile to the new Bill. According to the president of the Royal College of Psychiatrists: 'the Bill will extend use of compulsory powers to a wider group of patients than is medically necessary, thus putting pressure on psychiatric services, and infringing human rights.'"

More here

Saturday, September 18, 2004


"Hospitals in metropolitan Sydney are the most pressured in the country, with half of all beds in emergency departments taken up by people who have been waiting more than eight hours to be admitted to a ward, a survey shows. Many hospitals were operating above 95 per cent capacity, the Australasian College for Emergency Medicine warned, because of extensive bed closures across the system. "It is the single most important cause of emergency department overcrowding," said the college's president, Ian Knox.

Australian Medical Association data show a steep drop in the availability of hospital beds, from 5.2 per 1000 people in 1967-68 to less than half that in 2002-03.

The situation was dire all around the country, Dr Knox said, with more than 80 per cent of patients waiting more than eight hours in emergency departments before being admitted to a hospital ward. But the solutions favoured by the state and federal governments, including increasing funding to emergency departments or establishing GP clinics, would do nothing to fix the crisis, he said. "Opening the beds is the first step, but then there needs to be precision bed management at the same time".

Based on a snapshot taken on August 30 of 73 hospitals and 1509 patients across the country, the college found 39 per cent of all emergency beds were taken by patients who had been waiting for an in-patient bed for more than eight hours. In metropolitan Sydney the figure was 52 per cent. The snapshot confirmed data from an identical survey done on May 30. Dr Knox acknowledged there was always a winter peak in emergency department presentations but said the bed crisis was a years-old problem.

"The demand for beds is going up as the population ages, so [governments] really need to look at projected demand and understand there is an increasing requirement of hospital beds," he said. Mass bed closures and the resulting access block from emergency departments to wards started in Sydney but now affected every part of Australia.

More here


Two months to see a doctor????

"Kath Brewster lives on the front line of an ageing society. In Coffs Harbour, her home for 18 years, the septugenarian faces up to two months' wait to see her GP. "He's a good, caring GP, and when I rang a fortnight ago I was told his books were closed for August and September, and to ring back in October," she said.

A report called Older People, NSW, published yesterday, shows elderly people aged 65 and over will outnumber children aged 0-14 for the first time by 2016.....

Already more than 18 per cent of the population on the mid-North Coast is elderly, and Ms Brewster is feeling the pinch. "The biggest issue is health," she said. "There aren't enough doctors or nurses. It's impossible to make a quick appointment with a GP so people are going to hospital emergency departments.".....

However, Gary Moore, director of the NSW Council of Social Service, said the pressure would be on the Government to deliver to areas outside Sydney an acceptable suite of health and community services. "A significant proportion of the elderly population will be low income, especially those living in inland centres such as Kempsey," he said."

More here.

Friday, September 17, 2004


But surveys have to be taken with a grain of salt. I am sure I could produce a survey that gave opposite results if I tried. And this "Institute" is plainly biased to the Left.

"Rising health care costs and shrinking coverage have prompted a significant majority of Americans to support government regulation -- or even universal health care, according to a survey released yesterday. Two-thirds of those surveyed said they supported a health care "guarantee," similar to the Canadian or British systems, according to the survey, which was issued by Results for America, a division of the Civil Society Institute, a Newtown, Mass.-based think tank.

Additionally, 78 percent of Americans advocate government regulation of health care, similar to utilities such as gas and water, the survey found. "What this survey shows is a nation in the grips of a health care crisis," said Civil Society Institute president Pam Solo. "Americans are now prepared to embrace some tough ideas.".....

The Civil Society Institute says it is a nonprofit, independent organization that attempts to focus on social issues such as health care, education and the environment. Solo, is a social activist and grassroots advocate who has focused on issues such as national health care, stem cell research and global warming.....

The survey's results, particularly on the rising cost of health care, have been echoed by other experts and research groups. The Kaiser Family Foundation just announced its findings that health care premiums rose by double digits for the fourth year in a row in 2004. "Health insurance is becoming increasingly unaffordable in our country, especially for small employers," said Kaiser president Drew Altman at a Washington, D.C., news conference last week. "We unfortunately should expect the ranks of the uninsured to continue to pick up."...."

Note: "Other experts" only seem to have echoed them on rising costs -- which is no news anyway

More here.

Thursday, September 16, 2004


Plenty of Canadians will do so -- and no prizes for guessing why: It may be "free" but is it readily available?

"As Canada's premiers haggled into the night over the future of Canada's health-care system, three Montreal doctors announced yesterday they are joining the ranks of those opting out of medicare and will open the province's first private emergency medical clinic next month. The clinic will guarantee speedy service to anyone who can pay out of pocket. The doctors will take care of minor emergencies, like fixing a broken finger and stitching a cut, for a $100 fee.

Quebec Health Minister Philippe Couillard said yesterday that the doctors are free to do as they please, as long as they don't bill the medicare board for their services. Since 2000, 82 Quebec doctors have gone private, no longer billing the Regie de l'assurance-maladie du Quebec for medical services. By comparison, there are 15,267 licensed doctors working within the province's medicare system.

The new private clinic will be far from the standard walk-in 24-hour ER. Patients will have to phone the clinic in advance. If their emergency is deemed too serious, they'll be referred to a hospital. "We will not see more than two or three patients per hour," said Dr. Luc Bessette, who used to work in the ER of St. Luc Hospital. "We don't believe it's possible to give good quality of care if you're not there to listen and to be able to give time to your patients.

The MD-Plus Medical Clinic on Beaumont St., a few blocks south of the Jarry metro station, will open on Oct. 12. It's one of a rising number of private medical facilities that have sprouted across Quebec in the last few years. This week, Cataract MD, a clinic on Rene Levesque Blvd., opened. The two doctors who will be performing cataract surgery privately have also opted out of medicare, as managed by the Regie de l'assurance-maladie du Quebec. That means that the doctors cannot bill the government for medical services, and patients must pay out of pocket....

The MD-Plus clinic will offer a number of services, including checkups and regular follow-up family medical care. The clinic will also be using the resources of a private lab and an adjacent radiology clinic for magnetic resonance imaging. Among the minor emergencies that doctors will take care of are fixing broken fingers, stitching a deep cut, removing a foreign object from an eye and diagnosing abdominal pain.

Bessette said he believes there's a market for his clinic, predicting that up to 3,000 patients will visit it by next year. "If you're talking about minor emergency conditions, if people wait five or six hours in the emergency room and are self-employed and cannot work for five or six hours, it's worth much more than $100 for a medical fee," he said. "For a lot of people, there is a huge cost in waiting in our system. That cost will be relieved from their shoulders. They will make the calculation that it's much cheaper to wait for a medical consultation if they get rapid access to care."

Bessette said he opted out of medicare because the system isn't working. "My colleagues and I decided that we could not criticize the system and be frustrated by it, and still work within it in good conscience."

More here


Note this story (excerpt):

For G.M., the nation's largest private purchaser of health services and of drugs from Viagra to Lipitor, the projected cost of providing health care benefits to current and future retirees .... is a staggering $63 billion.

While soaring medical costs are an issue for all employers in the United States, for older domestic manufacturers the nation's health care system is a competitive double whammy. That is particularly true for G.M., the world's largest - but far from the most profitable - automaker.

G.M. covers the health care costs of 1.1 million Americans, or close to half a percent of the total population, though fewer than 200,000 are active workers while the rest are retirees, children or spouses. Not only are such costs escalating rapidly, but G.M.'s rivals, based in Japan and Germany, have virtually no retirees from their newer operations in the United States and, at home, the expenses are largely assumed by taxpayers through nationalized health care systems"

You get the drift? The NYT is trying to drum up support for nationalized medicine by getting you to feel sorry for GM! The audacity of it all is rather breathtaking. Where to start? I suppose the first thing I should mention is the elephant in the bedroom: The Japanese manufacturers in Japan have a similar problem! They too have a lifetime obligation to their employees. So if they can hack it without government support, why can't GM?

The next point is the irony of anyone on the Left pretending to feel sorry for GM. Maybe I missed something, but isn't GM the great capitalist ogre that all good comrades want to see dead? Or do they really believe that what is good for GM is good for the USA? There would have to be a zillion Leftists who have furiously denied it!

The third point is that businesses who make bad decisions have to take the consequences of that. If every bad decision made by business got a bailout from the taxpayer, the nation would be broke in a week. GM clearly made unwise healthcare deals with its unions so it is just going to have to pay for those decisions.

And even if GM went broke over it (which nobody is suggesting), there would still be enough assets to pay for the healthcare obligations it contracted for.

Wednesday, September 15, 2004


Legal hazards are a big problem in all systems of medicine

If real life played out like a Hollywood action flick, in which good conquers evil all in a couple of hours, there might be a happy ending in the battle over how to cure the nation's medical malpractice woes. After all, each side in the presidential campaign has fixed on a convenient villain.

On Monday, President Bush blamed "junk lawsuits" for driving up the cost of medicine and "running good docs out of practice." Bush pointed to rich trial lawyers as the culprits - and alluded to the fact that one of them is the Democratic vice presidential nominee. In fact, John Edwards made millions suing doctors.

The Bush campaign says frivolous lawsuits and huge jury verdicts drive up premiums for malpractice insurance, which doctors must purchase, raising health care costs for everyone. It proposes limits on certain types of damages as a cure. Edwards, the Democratic point man on the issue, opposes such caps, and blames rising health costs on insurance and drug companies, which, he charges, are Bush's allies....

Democrats - Edwards in particular - enjoy huge financial support from trial lawyers, who oppose caps on damages. Attorneys lavished $9.9 million on Edwards' race for the 2004 Democratic presidential nomination, according to the Center for Responsive Politics, a non-partisan campaign-finance watchdog. Republicans favor limiting damages for "pain and suffering," which are granted by juries on top of payments for actual harm. That position is backed by health providers and insurers, who have given the 2004 Bush campaign $9.5 million, according to the center.

Caps on damages may do some good. In large states that have such limits, malpractice premiums have increased less than those have in states without caps, according to a 2003 survey by Medical Liability Monitor, a newsletter that tracks malpractice trends.

The current system fails to spur health care providers to "identify, compensate (for) and reduce errors" because they fear lawsuits, according to a study released in 2002 by the Institute of Medicine, a federal advisory group. It estimated that medical errors result in more than 44,000 deaths a year. A new study by HealthGrades, a health care rating organization, said errors caused 195,000 deaths, on average, in 2000, 2001 and 2002.

Physicians often perform extra costly tests to protect themselves from suits filed by patients alleging that a medical problem was missed. The price tag? More than $60 billion a year, according to the U.S. Department of Health and Human Services.

Fears of lawsuits and high insurance premiums are forcing some physicians to quit, move to states where premiums are more stable, or limit services. One in seven obstetrician/gynecologists have stopped delivering babies, according to a survey this summer by the American College of Obstetricians and Gynecologists.

More here

Australia's largest State -- New South Wales -- now has a $300,000 cap on personal injury awards, which should go a long way to overcoming the legal hazards of medicine there

Tuesday, September 14, 2004


The bureaucratic FDA as a huge obstacle to medical care. The battle to save a sick baby:

"It became clear that his heart wouldn't hold up over time and that he would need a transplant, Rosenthal said.

But infant heart transplants are hard to come by and the wait can be a long one. Of the three babies who've received transplants at Packard, the wait has ranged from 10 to 200 days, Rosenthal said. So he and his colleagues began looking at options to keep Miles alive until a heart small enough for the 15-pound infant might come through.

None of the heart pumps available in this country is small enough to serve an infant population. So Miles' doctors looked to a device known as the Berlin Heart, named for its city of origin, which has been used in 50 to 100 children worldwide. Getting it here -- and in short order -- was something else again.

It required a special evening meeting of the Institutional Review Board, which oversees research involving human subjects at Stanford, and special dispensation from the U.S. Food and Drug Administration to bring it into the country. And it took a massive organizational effort at Packard to ensure everything was in place -- from skilled nursing care to customs release forms to the proper electrical adaptors for the device, Rosenthal said".

Monday, September 13, 2004


Esther Pacione needs a family doctor. At age 56 she is afflicted with severe ataxia, a neurological condition that causes her acute pain, choking and loss of consciousness. The walls of her home are scuffed from the times she fell and hit her head.

Her regular doctor suffered a stroke a year ago, and all the local doctors she has contacted say they cannot take new patients, so now Ms. Pacione goes to a walk-in clinic whenever she has an emergency. At the clinic, she waits hours and sees a different doctor and no one there is familiar with her medical history and what drugs she has been taking.

Ms. Pacione, a retired bookkeeper, said she would like to be at the table when Prime Minister Paul Martin meets with the provincial premiers on Monday for a three-day televised meeting to find ways to alleviate the lengthening waits for basic care in Canada. "If you are not bleeding all over the place, you are put on the back burner," Ms. Pacione said, "unless of course you have money or know somebody."

The publicly financed health insurance system remains a prideful jewel for most Canadians, who see it as an expression of communal caring for the less fortunate and a striking contrast to an American health care system that leaves 45 million people uninsured. But polls indicate that public confidence in the system is eroding, although politicians remain reticent to urge increasing privatization of services.....

But medical professionals and local officials say a major reason it may not be easy to address the problem of slow access to treatment is because doctors who do preliminary diagnostic work, refer patients to specialists and monitor the care of chronically ill people are less and less available - especially in small towns and rural areas.....

Ms. Pacione's predicament is surprisingly common even in this upper-middle-class community on the north shore of Lake Ontario that seems to have everything going for it: immaculate lawns, a yacht marina, a downtown graced by vintage Victorian architecture and quaint parks and fruit markets....

Whitby officials estimate that 22,000 people here have no doctor at all, forcing them to go to emergency rooms at overcrowded local hospitals to wait in line for up to four hours simply to refill a prescription, get a doctor's note for an employer or care for their flu symptoms. "It's like winning the lottery to get in and see the doctor," Mayor Marcel Brunelle said. "This is a very wealthy country. What happened to bring the situation to this point?"....

Mayor Brunelle formed a task force in June to recruit young doctors by introducing them to real estate agents and giving them advice on how to start new practices, and the town government is considering building a municipal clinic. The town of Peterborough is offering large monetary incentives and a grab bag of perks, including memberships at the Y.M.C.A. and cable television. Other municipalities offer moving expenses and the inside track on real estate next to golf courses.

But experts say those efforts may not be enough. "If the current trends continue we can anticipate a crisis," warned Joseph D'Cruz, a University of Toronto business school professor who specializes in health care. "People will actually find it impossible to get general medical services in their towns."

More here.

Thursday, September 09, 2004


"The speed with which President Clinton received quadruple bypass surgery provides an important lesson in health care reform that voters should keep in mind this election season.....

When government makes medical care "free," people demand medical care without regard to cost. Governments can't keep up with the excess demand and therefore must find some way of allocating care amid shortage conditions. Most choose to make patients wait.

According to Nadeem Esmail and Michael Walker of Canada's Fraser Institute, the median wait for an appointment with a cardiologist in Canada's single-payer health care system was 3.4 weeks in 2003. The wait for urgent bypass surgery was another 2.1 weeks on top of that, while the wait for elective bypass surgery was an additional 10.7 weeks. Canadian doctors reported a "reasonable" wait would be 0.9 and 6.1 weeks, respectively. Great Britain and New Zealand have even longer waiting times for bypass surgery.

Esmail and Walker cite studies confirming that longer waits for heart surgery result in a higher risk of heart attack and death. In fact, they report American hospitals act as a "safety valve" for Canadian patients who face life-threatening shortages: "The government of British Columbia contracted Washington State hospitals to perform some 200 operations in 1989 following public dismay over the 6-month waiting list for cardiac bypass surgery in the province... A California heart-surgery centre has even advertised its services in a Vancouver newspaper."

Had America had followed his lead ten years ago, President Clinton might not have been able to get his diagnosis and surgery appointment so quickly. Instead of waiting overnight for an appointment with a cardiologist, he might have had to wait the 3.4 weeks Canadians do. Instead of waiting three days for quadruple bypass surgery, he might have had to wait over two weeks. Instead of receiving care from what Senator Clinton called "one of the great hospitals in the world," President Clinton might be looking for a safety valve.

Since the Clinton health plan was defeated, untold patients have been aided because America's health care system, whatever its faults, was not subjected to the shortages and waiting lines that plague other nations".

More here

Socialists block desperately-needed tort reform: "Health care costs are going through the roof, and one of the major culprits is the proliferation of lawsuits that tangle the system. Hospitals face huge legal costs every day in defending themselves from frivolous lawsuits. These lawsuits also bring astronomical insurance premiums as hospitals attempt to protect themselves from continuous legal wrangling and exorbitant monetary fees that juries are awarding. It is estimated that legal fees alone add more than $200 billion a year to our health care system, which eventually gets passed on to patients through co-payments and insurance premiums. The Republicans, who are pushing to get this situation under control through tort reform, have proposed a series of rules and guidelines that would financially define the limits on malpractice and discourage frivolous lawsuits. These efforts have been repeatedly blocked by Democrats in the U.S. Senate."

Monday, September 06, 2004


Theodore Dalrymple notes with alarm the way white males are being driven away from the medical profession in Britain and replaced by "overseas trained" doctors. He is tactful enough not to quote what "overseas trained" doctors can be like (see here for a very sanitized account of it) but it is another good reason not to get sick in Britain. A few excerpts:

"The medical profession used to be the preserve, give or take an interloper or two, of the white middle class male.... Not for very much longer. White males, despite being 43 per cent of the population, comprise only 26 per cent of medical students.

Irrespective of whether it matters, what accounts for the forthcoming decline in the numerical, and no doubt intellectual, predominance of white males in the British medical profession?

There are two possible explanations, which are not mutually incompatible. The first is the decline in academic performance, relative to other groups, of young white males. If places in medical schools are allocated strictly according to examination results, then any such decline would be reflected in their numbers in the student body....

There is also the possibility that medicine as a profession is a less attractive career than it once was. Certainly, the number of applications for each place at medical school is falling, which would suggest that such is the case. Clever, diligent white males, who once might have become doctors, prefer to do something else. The relative loss of white males is actually a sign of the decreasing prestige of medicine as a career.....

Not only are the financial rewards of medicine declining compared with other jobs, but the risks for doctors are growing ever greater. The public is litigious; the regulatory bodies are ever more bureaucratically intrusive and demanding; even the Crown Prosecution Service is adding its mite by insisting on prosecuting doctors more frequently than ever before for criminal negligence. Above all, doctors are increasingly beholden to bureaucrats, who are often their intellectual and moral inferiors.

While our doctors drop out, of course, doctors from poor foreign countries drop in. This is our ethical foreign policy.

Sunday, September 05, 2004

Nit-picking regulation that takes years! "The Food and Drug Administration on Tuesday approved a device designed to prevent strokes by clearing blocked carotid arteries, the main blood vessel leading to the brain. While similar metal mesh tubes, known as stents, are used in other arteries, it was the FDA's first approval of such a device for neck arteries."

How socialist ideas kill AIDS victims: "One of the main points of contention in the subtle "you're-too-stupid-to-spend-your-own-money" argument being waged against America, is the US insistence that the patents on AIDS drugs be respected, especially when the money buying these drugs is American in origin. Indeed, France's President, Jacque Chirac, called such US action "tantamount to Blackmail".... There can be no doubt that invalidating drug company patents will make drugs cheaper and more available throughout much of the impoverished world. But it will also insure that the drugs we have today will be the drugs we have for a long time to come. What will be the motivation for companies to invest hundreds of millions of dollars to develop new drugs, just to have them stolen in the name of crisis? .... I suspect that many drug companies have already reduced their AIDS research substantially, solely because of the unstable, politically charged environment that has been created around the disease by those that see it as their personal domain."

There is a good history of the American medical system here and the perverse, government-driven incentives that drive up its costs. A complex story so I will not endeavour to excerpt anything from it.