Thursday, January 12, 2006


Rising health care costs, already threatening many basic industries, now consume 16 percent of the nation's economic output -- the highest proportion ever, the government said yesterday in its latest calculation. The nation's health care bill continued to grow substantially faster than inflation and wages, increasing by almost 8 percent in 2004, the most recent year with near-final numbers. Spending for physicians and hospitals shot up considerably faster than in recent years, while drug costs grew at a slower rate than over the past decade.

Even as health care costs continue to escalate, however, many Americans -- especially minorities and the poor -- still do not receive high-quality care, according to two other federal reports yesterday. The quality of health care is improving slowly and some racial disparities are narrowing, the reports found, but gaps persist and Hispanics appear to be falling even further behind. "We can do better," Health and Human Services Secretary Mike Leavitt said at a Washington conference on racial and ethnic disparities in health care. "Disparities and inequities still exist. Outcomes vary. Treatments are not received equally."

Political, medical and economic leaders and experts have long warned that health care cost trends will gradually overwhelm the economy, and many companies now complain that employee and retiree health costs are making them less competitive. Yesterday's report added new reasons to worry. The overall cost of health care -- everything from hospital and doctor bills to the cost of pharmaceuticals, medical equipment, insurance and nursing home and home-health care -- doubled from 1993 to 2004, said the report from the Centers for Medicare and Medicaid Services. In 2004, the nation spent almost $140 billion more for health care than the year before. In 1997, health care accounted for 13.6 percent of the gross domestic product.

"Americans rejected the tougher restrictions of managed care in the late 1990s, and yet they want all the latest advances in medical technology," said Drew Altman, president of the nonpartisan Kaiser Family Foundation, which researches health issues. "Since government regulation of prices and services is not in the cards, the inevitable result is higher costs."

The health care increase of 7.9 percent in 2004 was almost three times the overall national inflation rate, which was 2.7 percent. The average hourly wage for workers in private companies was essentially unchanged that year, according to the U.S. Department of Labor. After a sharp jump in health care costs earlier in the decade, the health inflation rate appears to be plateauing, officials added. The best news involved spending on pharmaceutical drugs, which increased by less than 10 percent for the first time in more than a decade.

More here

Lurching from one bungle to another

The Queensland Government was considering changes to its procedures for recruiting overseas-trained doctors in a bid to alleviate an acute staff shortage. Queensland Health has admitted facing a serious shortage of doctors and a cut in services when doctors' public hospital contracts run out on January 16. Hospitals were bracing for staff shortages caused by the retirement or resignation of doctors, as well as junior doctors moving to other departments or hospitals and staff taking leave.

The Queensland Medical Board raised concerns about the length of time it took to assess medical graduates, saying Queensland Health should space out its recruitment dates throughout the year to avoid a bottleneck of applications every January. Health Minister Stephen Robertson today said he would consider the suggestion. "In terms of our recruitment of overseas-trained doctors, if we can stagger that throughout the year then that may provide some improved workforce planning benefits which is something that I want to explore," Mr Robertson said.

Meanwhile, opposition health spokesman Bruce Flegg said an imminent reduction of emergency services at Caboolture, north of Brisbane, because of the doctor shortage would place more pressure on other southeast Queensland hospitals. The emergency department will feature just one junior doctor on night duty instead of the usual four. "It will overstretch the ambulance system, it will overstretch hospitals because they will have to provide retrieval teams to accompany these critically ill patients," Dr Flegg said on ABC radio. "The hospitals to which they are being transferred are themselves already under great strain and in no position to take extra critically ill patients."

However, Mr Robertson said Brisbane hospitals already regularly accept critically ill patients from Caboolture, playing down concerns they would not be able to cope with extra transfers. "The advice that I've received is that this is traditionally a quiet time of the year so hospitals ... don't have the level of demand coming through their doors as we see at other times of year so we have that benefit," Mr Robertson said.



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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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