This Cure Is Free!: A Shadeggelic health-care plan
The Republican Congress can't seem to touch health care without making America sick. While Health Savings Accounts are a recent plus, the long-feared Medicare drug benefit premiered January 1 to widespread panic. Seniors are confused and frustrated, while fiscal conservatives stand aghast as tax dollars fly from the Treasury like bats fleeing a cave.
Congress can redeem itself with a simple and cost-free cure rather than an elaborate and expensive complication. The Health Care Choice Act, sponsored by Rep. John Shadegg (R., Ariz.) and Sen. Jim DeMint (R., S.C.), would let American consumers purchase health insurance across state lines, just as they now may shop coast to coast for mortgages.
Shadegg-DeMint would let insurers licensed in one state sell to individuals in the other 49. As such, Congress would use its constitutionally enumerated powers to liberate interstate commerce and transform 50 separate, closed markets for medical coverage into one open, national market for health insurance.
"Two-thirds of the uninsured have incomes below 200 percent of the federal poverty level, and most cite unaffordability as the top reason for why they are uninsured," said Shadegg, who hopes to succeed Rep. Tom DeLay as House majority leader. "Until consumers can purchase their health care like their auto, homeowners, or life insurance, we won't reform health care; we will only re-regulate it."
"Just as Delaware became a magnet for banking, some states will become magnets for health insurance," predicts Dr. David Gratzer, a physician and Manhattan Institute senior fellow, and one of this idea's earliest proponents. "People seem to understand intuitively that it doesn't matter whether their checks come from Delaware or New York or California. Likewise, the issues around health insurance are cost and availability rather than state of origin."
Location matters. A health policy for a single Pennsylvanian costs roughly $1,500 annually. Cross the Delaware into New Jersey, as George Washington did in 1776, and a similar health plan costs about $4,000, thanks to government regulations. "When doctors worsen a patient's condition, we call it an iatrogenic ailment," Dr. Gratzer notes. "We lack an equivalent term for when politicians aggravate a problem."
By mandating benefits, legislators have swelled the standing army of the uninsured. As Victoria Craig Bunce and J. P. Wieske explained in their January 2005 report for the Council for Affordable Health Insurance: "Mandating benefits is like saying to someone in the market for a new car, if you can't afford a Lexus loaded with options, you have to walk." Making every health policy cover acupuncturists, marriage therapists, or in vitro fertilization, as some states do, looks less compassionate when such adornments drive the humble from the market. CAHI estimates that state mandates can hike insurance prices 20 to 45 percent.
"Guaranteed issue" rules, which let people wait until they ail to purchase coverage, also boost prices. Ditto "community rating." It slaps the same government-controlled price on insurance for everyone - young or old, fit or fat - in a given jurisdiction. This is as idiotic as charging 16-year-old boys and 60-year-old widows the same amount for auto insurance.
Economics aside, Dr. Gratzer praises Shadegg-DeMint's clinical potential. "The more people who are covered the better," he says. "That means fewer people hesitate to get tests or follow up with physicians. Eventually, that will lead to a healthier population."
Critics argue that letting consumers shop for health insurance will launch a dreaded "race to the bottom" as Americans buy inexpensive plans from unscrupulous insurers in unregulated states. But which states, precisely, let health insurers operate like numbers rackets? Of course, consumers could avoid questionable plans in clueless jurisdictions by patronizing reputable, sensibly supervised providers.
So, what will this cost? Nothing. Unlike nearly every action by this Republican Congress, this legislation expends no tax dollars. Your wallet is safe. For now.
Democrats routinely complain that 45 million Americans lack health insurance. Many are between jobs, young, or more prosperous, and decide to forgo insurance. Still, Democrats correctly call this a serious concern for many Americans. The Shadegg-DeMint proposal could be a key solution to this problem. Democrats should embrace this Republican idea. If they rather would deny the uninsured an expanding array of lower-cost health-coverage options, let them stand up this election year and say so.
Source
AMAZING! GOVERNMENT FINDS THAT CUTTING THE NUMBER OF HOSPITAL BEDS CREATES BED SHORTAGES
It takes a government to need years to find that out
Health bureaucrats have been ordered to open every available hospital bed as the State Government struggles to overcome the "access block" problem choking emergency departments. The order has come with an admission by Premier Peter Beattie that planners were wrong to downsize major hospitals during redevelopments in the 1990s. Mr Beattie returned from his three-week annual holiday yesterday to issue a 10-point plan to combat statewide doctor shortages in the short term....
It commits $3 million to find ways to ease "access block", whereby the lack of available beds or medical treatment prevents patients from being moved out of emergency departments. "In addition, this week every hospital in Queensland will be instructed by the director-general to investigate how many beds it can open to assist with solving 'access block' across the Queensland health system," the plan says.
Mr Beattie said there was "capacity in the existing hospitals" to open more beds, but admitted his and previous governments had erred in reducing the number of beds in major hospitals. The Opposition said the Government eliminated about 600 beds when it redeveloped the Princess Alexandra and the Royal Brisbane hospitals as part of its capital works agenda in the late 1990s. At the time, the Government said fewer beds would be needed because future health care models would allow more day surgery and extra-mural treatment.
But Mr Beattie yesterday said the patient care model used to determine bed numbers then was wrong. "I think there were major flaws in the model . . . and the advice that we're now getting 15 years later is different to what it was 15 years ago. And I think we should be upfront about that."
More here
There is a joke just up on Wicked Thoughts that readers here may find amusing.
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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?
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, January 24, 2006
Monday, January 23, 2006
Choice on the sickbed
New Labour's new Patient Choice initiative suggests it doesn't know the meaning of the c-word
You may be part of the 80 per cent of the British public who didn't know this, but as of 1 January this year we Brits have the right to choose between at least four hospitals for non-emergency treatment.
Under health secretary Patricia Hewitt's Patient Choice initiative, which she modestly describes as a 'revolution', you will no longer have to put up with treatment at your run-down, resources-challenged local hospital - you can choose a different run-down, resources-challenged hospital in your Strategic Local Authority instead. The only problem is, a Mori poll carried out for the Department of Health found that of 1,276 people surveyed 41 per cent knew 'nothing at all' about the new policy and 39 per cent said they knew 'just a little'. Only four per cent said they knew a 'great deal'. And given that the NHS is one of the biggest employers in Europe, that four per cent may well be its own staff.
Welcome to Britain 2006, where a 'revolution' can occur without anybody noticing and where you can have apparently brilliant brand new choices without even knowing it; where the government's idea of overhauling the NHS is to let us pick between hospitals rather than to rethink the hospitals themselves. Nothing better captures the government's degraded view of choice than the 'empowering patients' debate. Under New Labour choice has come to mean, not active citizens making decisions about big issues, but sick people deciding whether they want their injections or stitches from Dr Patel or Dr Jones in hospital A or B (or C or D, to be fair). It says a lot about the government's view of citizens that it only seems able to conceive of us as choice-makers when we're dilapidated, and temporarily removed from public life to get something fixed.
Government ministers present choice-in-health as something that patients are crying out for and which they are graciously providing. According to Hewitt, 'Every survey shows people want more choice and control over healthcare. We found the majority welcome being offered a choice and use that choice.' In truth, patient choice is an entirely top-down initiative; it's a political invention. How many people do you know who when they get sick think to themselves: Right, I must flick through the catalogues and go on a tour of hospitals in and around my area to find out which has the best resources and doctors? When we're ill we want to be made un-ill as quickly as possible, preferably in a local hospital that does things competently. For most people, hospital treatment is a technical thing rather than a life-changing choice: we want to be made better so that we can get on with the important things in life.
Indeed, choice in healthcare is something of a misnomer. Most of us are not in a position to make serious choices about the treatment we receive because we don't know enough. As Barry Schwartz, author of The Paradox of Choice, argues, 'individuals are not in a position to accept responsibility for their medical treatment' because we generally do not know 'the ins and outs' of such matters. It is precisely when we're sick or injured that we are most willing to absolve ourselves of decision-making and hand our bodies over to the experts. We trust doctors to choose what treatment we need because they know better than us. One satire website summed up the absurdity of too much choice in healthcare with the headline 'New NHS reform allows patients to choose own diagnoses..'
Something that we could take responsibility for is rethinking how the NHS is run - but if this isn't really a personal choice over treatment then neither is it a political debate about healthcare. 'Patient choice' never refers to making choices about how public healthcare is organised and distributed; instead it's limited to choosing between different hospitals within an already-defined healthcare system. Indeed, the government's emphasis on patient choice seems designed to avoid having any kind of proper debate. By making choice of hospitals the priority Hewitt and co are really saying: 'Yes, we know some local hospitals are crap. But there isn't much we can do about it, so from now on you can choose a different hospital instead.' Giving us more choice over which hospital to have our kidney op in is another way of limiting the debate about hospitals and healthcare more broadly. Instead of having a say in how the healthcare system might be reshaped, we're given leeway to wander around the current healthcare system a bit more than we could before.
Hewitt's revolution really amounts to a choice between venues. We will receive much the same treatment for the same ailment, but in one of four buildings of our choice. This is choice in the consumerist rather than the political sense. Our medical treatment is necessarily a set course of action, and it seems that political decision-making about the NHS is off the agenda, so our choice is only over where that action should take place. Like consumers in the supermarket we can pick already-made products off the shelf; how those products got to be made and put on the shelves is something for other people to concern themselves with, apparently. I prefer the late social theorist C Wright Mills' definition of choice: 'Freedom is not merely the opportunity to do as one pleases; neither is it merely the opportunity to choose between set alternatives. Freedom is, first of all, the chance to formulate the available choices, to argue over them - and then, the opportunity to choose.'
Hewitt's Patient Choice initiative is really an attempt to tart up the NHS with some positive-sounding words (or 'Hooray Words' as Jamie Whyte calls them in his book A Load of Blair). Bereft of ideas for how to improve the NHS the government simply plays around with its presentation. This could end up making things worse by increasing the bureaucracy. As one doctor said when asked for his response to the choice revolution: 'At the present time we're still, to be honest, pretty short of doctors, nurses and other health professionals to run a high-quality 21st-century health service.' (5) Maybe the government should put its thinking cap on about those problems instead of giving us bogus choices we never asked for in the first place.
Source
***************************
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?
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.
***************************
New Labour's new Patient Choice initiative suggests it doesn't know the meaning of the c-word
You may be part of the 80 per cent of the British public who didn't know this, but as of 1 January this year we Brits have the right to choose between at least four hospitals for non-emergency treatment.
Under health secretary Patricia Hewitt's Patient Choice initiative, which she modestly describes as a 'revolution', you will no longer have to put up with treatment at your run-down, resources-challenged local hospital - you can choose a different run-down, resources-challenged hospital in your Strategic Local Authority instead. The only problem is, a Mori poll carried out for the Department of Health found that of 1,276 people surveyed 41 per cent knew 'nothing at all' about the new policy and 39 per cent said they knew 'just a little'. Only four per cent said they knew a 'great deal'. And given that the NHS is one of the biggest employers in Europe, that four per cent may well be its own staff.
Welcome to Britain 2006, where a 'revolution' can occur without anybody noticing and where you can have apparently brilliant brand new choices without even knowing it; where the government's idea of overhauling the NHS is to let us pick between hospitals rather than to rethink the hospitals themselves. Nothing better captures the government's degraded view of choice than the 'empowering patients' debate. Under New Labour choice has come to mean, not active citizens making decisions about big issues, but sick people deciding whether they want their injections or stitches from Dr Patel or Dr Jones in hospital A or B (or C or D, to be fair). It says a lot about the government's view of citizens that it only seems able to conceive of us as choice-makers when we're dilapidated, and temporarily removed from public life to get something fixed.
Government ministers present choice-in-health as something that patients are crying out for and which they are graciously providing. According to Hewitt, 'Every survey shows people want more choice and control over healthcare. We found the majority welcome being offered a choice and use that choice.' In truth, patient choice is an entirely top-down initiative; it's a political invention. How many people do you know who when they get sick think to themselves: Right, I must flick through the catalogues and go on a tour of hospitals in and around my area to find out which has the best resources and doctors? When we're ill we want to be made un-ill as quickly as possible, preferably in a local hospital that does things competently. For most people, hospital treatment is a technical thing rather than a life-changing choice: we want to be made better so that we can get on with the important things in life.
Indeed, choice in healthcare is something of a misnomer. Most of us are not in a position to make serious choices about the treatment we receive because we don't know enough. As Barry Schwartz, author of The Paradox of Choice, argues, 'individuals are not in a position to accept responsibility for their medical treatment' because we generally do not know 'the ins and outs' of such matters. It is precisely when we're sick or injured that we are most willing to absolve ourselves of decision-making and hand our bodies over to the experts. We trust doctors to choose what treatment we need because they know better than us. One satire website summed up the absurdity of too much choice in healthcare with the headline 'New NHS reform allows patients to choose own diagnoses..'
Something that we could take responsibility for is rethinking how the NHS is run - but if this isn't really a personal choice over treatment then neither is it a political debate about healthcare. 'Patient choice' never refers to making choices about how public healthcare is organised and distributed; instead it's limited to choosing between different hospitals within an already-defined healthcare system. Indeed, the government's emphasis on patient choice seems designed to avoid having any kind of proper debate. By making choice of hospitals the priority Hewitt and co are really saying: 'Yes, we know some local hospitals are crap. But there isn't much we can do about it, so from now on you can choose a different hospital instead.' Giving us more choice over which hospital to have our kidney op in is another way of limiting the debate about hospitals and healthcare more broadly. Instead of having a say in how the healthcare system might be reshaped, we're given leeway to wander around the current healthcare system a bit more than we could before.
Hewitt's revolution really amounts to a choice between venues. We will receive much the same treatment for the same ailment, but in one of four buildings of our choice. This is choice in the consumerist rather than the political sense. Our medical treatment is necessarily a set course of action, and it seems that political decision-making about the NHS is off the agenda, so our choice is only over where that action should take place. Like consumers in the supermarket we can pick already-made products off the shelf; how those products got to be made and put on the shelves is something for other people to concern themselves with, apparently. I prefer the late social theorist C Wright Mills' definition of choice: 'Freedom is not merely the opportunity to do as one pleases; neither is it merely the opportunity to choose between set alternatives. Freedom is, first of all, the chance to formulate the available choices, to argue over them - and then, the opportunity to choose.'
Hewitt's Patient Choice initiative is really an attempt to tart up the NHS with some positive-sounding words (or 'Hooray Words' as Jamie Whyte calls them in his book A Load of Blair). Bereft of ideas for how to improve the NHS the government simply plays around with its presentation. This could end up making things worse by increasing the bureaucracy. As one doctor said when asked for his response to the choice revolution: 'At the present time we're still, to be honest, pretty short of doctors, nurses and other health professionals to run a high-quality 21st-century health service.' (5) Maybe the government should put its thinking cap on about those problems instead of giving us bogus choices we never asked for in the first place.
Source
***************************
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?
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, January 22, 2006
HOW SOCIALIZED MEDICINE HELPS THE POOR
Australia's public hospitals show the way
Surgeons are being prevented from performing operations on poor people in public hospitals because of budget constraints, the Royal Australian College of Surgeons said yesterday. The college made the claim when rejecting Productivity Commission proposals which would overhaul medical training and pass some doctor roles to nurses and other health workers. The commission said the health system was inefficient and needed to be restructured to ease shortages in the medical workforce.
The Australian Physiotherapy Association yesterday backed the commission's report. But Royal Australian College of Surgeons president Russell Stitz said the recommendations would do nothing to deliver extra health workers. "The report does not address the real problems of inadequate funding, duplication, excessive bureaucracy and poor utilisation of current resources," Dr Stitz said. "Insufficient funding means too few operations can be performed and too few training places are available to train enough surgeons of the future. "Surgeons currently working within the public system are prevented from operating on needy patients just to balance budgets."
Dr Stitz said the health system was archaic and impractical. He also said that it would be indefensible to continue to operate under the "current chaos". "Tasks cannot be simply reassigned to other professional groups," Dr Stitz said. "There are insufficient numbers of workers throughout the health system."
More here
THE FDA REGULATES CHERRY PIES
They're better busybodies than they are drug regulators
The bakery business wants U.S. regulators to stop picking on cherry pies. Cherry pies are the only frozen fruit pies that must meet quality standards set by the Food and Drug Administration. Other fruit pies -- including apples, blueberries and peaches -- are exempt. The FDA created the rule more than 30 years ago. At least 25% of the pie by weight must contain cherries, and no more than 15% of the cherries can be blemished. No one recalls why cherries were singled out. "We likely issued the one standard because we were petitioned to," FDA spokesman Michael Herndon says.
Bakers aren't worried: frozen cherry pie sales reached $22.9 million last year, up 5.7% from 2004, says Information Resources Inc. Bakers say they pack their pies with more cherries than required. Sara Lee Corp. says the fruit makes up between 29% and 43% of its cherry pies. Still, the American Bakers Association is asking the FDA to drop the requirement, but they don't expect a quick answer. An identical plea in 1997 "just fizzled," says Lee Sanders of the bakers association. The FDA says it receives thousands of petitions a year, and it sets no deadline to respond to queries.
Source
***************************
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?
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.
***************************
Australia's public hospitals show the way
Surgeons are being prevented from performing operations on poor people in public hospitals because of budget constraints, the Royal Australian College of Surgeons said yesterday. The college made the claim when rejecting Productivity Commission proposals which would overhaul medical training and pass some doctor roles to nurses and other health workers. The commission said the health system was inefficient and needed to be restructured to ease shortages in the medical workforce.
The Australian Physiotherapy Association yesterday backed the commission's report. But Royal Australian College of Surgeons president Russell Stitz said the recommendations would do nothing to deliver extra health workers. "The report does not address the real problems of inadequate funding, duplication, excessive bureaucracy and poor utilisation of current resources," Dr Stitz said. "Insufficient funding means too few operations can be performed and too few training places are available to train enough surgeons of the future. "Surgeons currently working within the public system are prevented from operating on needy patients just to balance budgets."
Dr Stitz said the health system was archaic and impractical. He also said that it would be indefensible to continue to operate under the "current chaos". "Tasks cannot be simply reassigned to other professional groups," Dr Stitz said. "There are insufficient numbers of workers throughout the health system."
More here
THE FDA REGULATES CHERRY PIES
They're better busybodies than they are drug regulators
The bakery business wants U.S. regulators to stop picking on cherry pies. Cherry pies are the only frozen fruit pies that must meet quality standards set by the Food and Drug Administration. Other fruit pies -- including apples, blueberries and peaches -- are exempt. The FDA created the rule more than 30 years ago. At least 25% of the pie by weight must contain cherries, and no more than 15% of the cherries can be blemished. No one recalls why cherries were singled out. "We likely issued the one standard because we were petitioned to," FDA spokesman Michael Herndon says.
Bakers aren't worried: frozen cherry pie sales reached $22.9 million last year, up 5.7% from 2004, says Information Resources Inc. Bakers say they pack their pies with more cherries than required. Sara Lee Corp. says the fruit makes up between 29% and 43% of its cherry pies. Still, the American Bakers Association is asking the FDA to drop the requirement, but they don't expect a quick answer. An identical plea in 1997 "just fizzled," says Lee Sanders of the bakers association. The FDA says it receives thousands of petitions a year, and it sets no deadline to respond to queries.
Source
***************************
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?
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, January 21, 2006
THE METASTATIC GROWTH OF AN AMERICAN SOCIALIZED MEDICINE SYSTEM
Barry L. Stanton appears at ease in his spacious new office as he discusses key issues at the Prince George's County Correctional Center in Upper Marlboro. But Mr. Stanton, director of the county Department of Corrections for the past nine years, tenses as he bemoans the jail's rising medical costs for inmates. "People get better medical care in jail than I get at home," he says from behind his desk in the jail's new $8 million annex. "If you pick up the phone and you say, 'I am sick' ... they say, 'If it is not an emergency, I will see you tomorrow,'" he says. "Here, [inmates] want to be on sick call right way."
He has seen the Prince George's detention center's average cost per inmate rise from about $83 per day in 2003 to nearly $100 per day last year, while more and more inmates crowd the jail's spaces. Mr. Stanton is not alone in his concerns. Most detention centers in the metro area are dealing with increasing medical costs -- which are covered by taxpayer funds -- and overcrowding, reflecting a national trend.
At the D.C. Jail, inmates routinely are double-bunked in cells designed for one person in most of the 30-year-old facility's housing units. The jail -- one of the oldest detention centers in the region -- can adequately house 2,164 inmates a month, according to a consultant's recommendation in 2004. However, the jail usually houses more than 2,500 inmates a month and sometimes holds as many as 3,555 a month, according to D.C. corrections officials. Most inmates are pretrial defendants awaiting hearings, and their numbers fluctuate as the courts handle their cases. Many inmates also are awaiting transfer to federal prisons, and the remainder are serving sentences.
According to statistics from the U.S. Justice Department and the American Correctional Association, the D.C. Jail's average cost per inmate rose from about $65 per day in 2003 to about $78 per day in 2004. D.C. officials estimate the cost rose to about $86 last year. "I would definitely agree that the cost has risen," says S. Redwood York Jr., who has served as the interim director of the D.C. Department of Corrections since February. "And it is probably a factor of having higher support costs in medical, food service and other inmate needs, combined with the increased population."
City officials attribute the rising costs in part to the jail's exhaustive health screenings, which include voluntary testing for AIDS and tuberculosis. City law requires that the screenings be provided to all inmates, regardless of whether they have been convicted or are being held for trial. Repeat offenders and suspects must be provided with repeat treatments by the jail's more than 140 medical staffers, who work alongside the facility's 687 guards. "We are hoping that someone will understand that we cannot go on doing what we are doing," says Dr. Malek Malekghasemi, the D.C. Jail's associate medical director. "You cannot tell people 'no' because ... inmates have a constitutional right to health care."
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. 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?
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.
***************************
Barry L. Stanton appears at ease in his spacious new office as he discusses key issues at the Prince George's County Correctional Center in Upper Marlboro. But Mr. Stanton, director of the county Department of Corrections for the past nine years, tenses as he bemoans the jail's rising medical costs for inmates. "People get better medical care in jail than I get at home," he says from behind his desk in the jail's new $8 million annex. "If you pick up the phone and you say, 'I am sick' ... they say, 'If it is not an emergency, I will see you tomorrow,'" he says. "Here, [inmates] want to be on sick call right way."
He has seen the Prince George's detention center's average cost per inmate rise from about $83 per day in 2003 to nearly $100 per day last year, while more and more inmates crowd the jail's spaces. Mr. Stanton is not alone in his concerns. Most detention centers in the metro area are dealing with increasing medical costs -- which are covered by taxpayer funds -- and overcrowding, reflecting a national trend.
At the D.C. Jail, inmates routinely are double-bunked in cells designed for one person in most of the 30-year-old facility's housing units. The jail -- one of the oldest detention centers in the region -- can adequately house 2,164 inmates a month, according to a consultant's recommendation in 2004. However, the jail usually houses more than 2,500 inmates a month and sometimes holds as many as 3,555 a month, according to D.C. corrections officials. Most inmates are pretrial defendants awaiting hearings, and their numbers fluctuate as the courts handle their cases. Many inmates also are awaiting transfer to federal prisons, and the remainder are serving sentences.
According to statistics from the U.S. Justice Department and the American Correctional Association, the D.C. Jail's average cost per inmate rose from about $65 per day in 2003 to about $78 per day in 2004. D.C. officials estimate the cost rose to about $86 last year. "I would definitely agree that the cost has risen," says S. Redwood York Jr., who has served as the interim director of the D.C. Department of Corrections since February. "And it is probably a factor of having higher support costs in medical, food service and other inmate needs, combined with the increased population."
City officials attribute the rising costs in part to the jail's exhaustive health screenings, which include voluntary testing for AIDS and tuberculosis. City law requires that the screenings be provided to all inmates, regardless of whether they have been convicted or are being held for trial. Repeat offenders and suspects must be provided with repeat treatments by the jail's more than 140 medical staffers, who work alongside the facility's 687 guards. "We are hoping that someone will understand that we cannot go on doing what we are doing," says Dr. Malek Malekghasemi, the D.C. Jail's associate medical director. "You cannot tell people 'no' because ... inmates have a constitutional right to health care."
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. 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?
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, January 20, 2006
GERMAN PUBLIC HEALTH SYSTEM FALLING APART
If Germany sacked just 1% of its bureaucrats, it could afford to pay its doctors a heap more
Thousands of German doctors threatened yesterday to desert Europe’s most modern health system and work in Britain, rather than put up with declining wages and longer hours. The doctors, many wearing operating masks, marched through the centre of Berlin to besiege the Health Ministry in the first big demonstration against Angela Merkel’s coalition Government. Hospitals worked at half strength and about 50,000 doctors’ surgeries across the country were closed.
“It’s no longer bearable,” Andreas Dahmen, a 31-year-old orthopaedic surgeon, said. “I earn €2,800 [£1,920] a month here after taxes. I’m moving to England where I can earn double that amount for much less work.” In Britain, he said, he could expect to earn £3,000 a month after tax, with the promise of bonuses bringing his earnings to £4,500. The hip specialist was speaking in a sea of placards held aloft by his colleagues, announcing: “England, we’re on our way!” and “If you want to see a German doctor, come to England!”. A third of all German doctors now earn less than €2,000 (£1,373) a month after tax. Junior doctors are using cheap airlines to fly to Britain on a Thursday night, working as a locum for the weekend, and returning on Monday morning. They earn up to £2,000 — the equivalent of a month’s salary. “Recruitment agencies are already trawling our country, hunting for up to 10,000 doctors,” Jürgen-Dietrich Hoppe, the chairman of the German Doctors Association, said. “And I’m sure they’ll get them — English working conditions are so much better.”
Under NHS’s Out of Hours scheme, health trusts can fly in foreign doctors to relieve British GPs who do not want to work in the evenings and at weekends. There is also a desperate shortage in Britain of doctors in areas such as radiology and diagnostics.
The German doctors stopped work yesterday because of government reforms that seek to restrain them from prescribing expensive medicines, cap the individual budgets of surgeries and force hospital administrators to make widespread use of unpaid overtime. Medical staff worked more than €2 billion worth of unpaid overtime in German hospitals last year, and further reforms planned by the Government will put even more strain on them. Another measure would financially penalise doctors who administer costly drugs.
There are 4,127 German doctors registered in Britain, which has become their European destination of choice, ahead of Switzerland and Scandinavia. Some spend their summer holidays in Britain working as locums, others do so for about a year. Far more are weekend commuters and are drawn from across the medical spectrum. “We’re thinking of setting up a mobile anaesthetic unit,” Christof Kouidis, a demonstrator, said. “Working in Britain for a week could cover our practice costs in Germany for the rest of the month.”
The influx of British patients to Germany trying to avoid NHS queues for hip replacements has encouraged German doctors to cross the Channel. Stefan Krukenberg, from Hanover, is planning to replace hip joints in Britain on a freelance basis. “I get €65 for preparing an artificial hip joint — that’s for at least two hours work. Now I’m seriously considering going to Britain on a Friday, preparing three or four hip replacements a day over the weekend and effectively doubling my monthly income.” The only way he would be able to break even under the new tight German costing rules is by preparing 1,000 hip prostheses a month. “And that’s impossible. What we’re doing at the moment amounts in financial terms to a mere hobby. We have to earn the money to live somewhere else.”
The paradox of the German medical crisis is that doctors are now abandoning rural and eastern areas to work abroad, leaving many active but underfunded surgeries in decline. The German Doctors Association estimates that 32,000 surgeries are on the brink of bankruptcy. “We are soon going to have a real shortage of doctors,” Uwe Gremmler, a cardiologist from Peine, said. “Older doctors are taking earlier retirement because it has become impossible to make a living. The younger doctors are moving to Britain and, at the same time, as Germans live longer, there are more and more patients to be treated. The Government should act now before we all disappear to England.”
Source
THE BRITISH ARE CUTTING PUBLIC HOSPITAL SEVICES TOO
The spiralling cash crisis in the NHS has already forced two thirds of hospitals to close wards and will soon start directly affecting patient care, health chiefs give warning today. A survey of 117 chief executives of NHS trusts reveals the depth of concern among healthcare professionals about the destabilising impact of wide-ranging government reforms. Three quarters of them say that growing financial pressures brought on by primary and acute care restructuring will affect patient treatment. Almost half of hospital trust managers said that building and refurbishment projects were being delayed, while many trusts were also having to make staff redundant and to introduce recruitment freezes.
The Times understands that the Prime Minister is to order a shake-up of ministers and top civil servants, such is the concern in Downing Street about perceived NHS disarray. It follows six years of unprecedented rises in NHS funding. Mr Blair wants a new junior minister to fend off criticism of the Government’s faltering reform programme and to sell NHS modernisation both to the public and Labour MPs. The health service is braced for even starker financial shortfalls from 2008, when the current round of annual funding increases will stop. The poll of trust executives, conducted by Health Service Journal, comes as nursing leaders also give a bleak warning of massive NHS deficits. Their research suggests that health service debts in England will hit £1.2 billion this year, putting up to 4,000 jobs at risk.
The new minister, who will be charged with promoting the reform agenda in the media, is expected to be imposed on the Department of Health in a reshuffle due within days. The jobs of Jane Kennedy, the Minister for quality and patient safety, and Rosie Winterton, the Minister for health services, are both at risk. The Times understands that a number of senior bureaucrats will also be moved in an attempt to speed up the pace of delivery. It is hoped that the MP will be a more effective deputy to Patricia Hewitt, the Health Secretary, who has struggled to explain the benefits of reforms and had to revise plans to reform primary care trusts.
The uncertainty surrounding unforeseen knock-on effects of the Government’s reforms emerged when ministers decided to review the £1.2 billion redevelopment of Barts and the Royal London hospitals. The last-minute decision, taken after more than six years of project planning, prompted 1,000 doctors to write to The Times earlier this week. They gave warning of the serious impact on cancer and cardiac services for London if the project was downscaled.
Evidence of serious financial problems is supported by 75 per cent of hospital chief executives who said that patient care would be affected by cash shortfalls. The warning comes despite assurances from Ms Hewitt that any cuts should only affect administration. The Royal College of Nursing (RCN), which has been tracking the level of deficits and the impact on staff and services during 2005, confirmed that patient services and treatments were now being disrupted. It found that cost-cutting measures — including freezing job vacancies and use of agency staff — were now having a “direct and detrimental” effect on patients, with operations cancelled, appointments postponed and beds closed. According to documents obtained under the Freedom of Information Act, a total of 81 NHS trusts in financial difficulties have been investigated by KPMG, the acountant. This is far more than the Department of Health acknowledged when it announced the “turnaround teams” of accountants before Christmas. It said that 50 trusts with financial problems would be visited.
The disclosure, and the full list of trusts visited, was obtained by Accountancy Age. They include 20 out of the total of 28 strategic health authorities, 29 primary care trusts, and 33 hospital trusts. A Department of Health spokeswoman last night defended the NHS reform programme. She said that the RCN’s predictions were “back of-an-envelope calculations”, adding that the “turnaround teams” would help to address financial problems centred on a small number of trusts
Source
***************************
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?
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.
***************************
If Germany sacked just 1% of its bureaucrats, it could afford to pay its doctors a heap more
Thousands of German doctors threatened yesterday to desert Europe’s most modern health system and work in Britain, rather than put up with declining wages and longer hours. The doctors, many wearing operating masks, marched through the centre of Berlin to besiege the Health Ministry in the first big demonstration against Angela Merkel’s coalition Government. Hospitals worked at half strength and about 50,000 doctors’ surgeries across the country were closed.
“It’s no longer bearable,” Andreas Dahmen, a 31-year-old orthopaedic surgeon, said. “I earn €2,800 [£1,920] a month here after taxes. I’m moving to England where I can earn double that amount for much less work.” In Britain, he said, he could expect to earn £3,000 a month after tax, with the promise of bonuses bringing his earnings to £4,500. The hip specialist was speaking in a sea of placards held aloft by his colleagues, announcing: “England, we’re on our way!” and “If you want to see a German doctor, come to England!”. A third of all German doctors now earn less than €2,000 (£1,373) a month after tax. Junior doctors are using cheap airlines to fly to Britain on a Thursday night, working as a locum for the weekend, and returning on Monday morning. They earn up to £2,000 — the equivalent of a month’s salary. “Recruitment agencies are already trawling our country, hunting for up to 10,000 doctors,” Jürgen-Dietrich Hoppe, the chairman of the German Doctors Association, said. “And I’m sure they’ll get them — English working conditions are so much better.”
Under NHS’s Out of Hours scheme, health trusts can fly in foreign doctors to relieve British GPs who do not want to work in the evenings and at weekends. There is also a desperate shortage in Britain of doctors in areas such as radiology and diagnostics.
The German doctors stopped work yesterday because of government reforms that seek to restrain them from prescribing expensive medicines, cap the individual budgets of surgeries and force hospital administrators to make widespread use of unpaid overtime. Medical staff worked more than €2 billion worth of unpaid overtime in German hospitals last year, and further reforms planned by the Government will put even more strain on them. Another measure would financially penalise doctors who administer costly drugs.
There are 4,127 German doctors registered in Britain, which has become their European destination of choice, ahead of Switzerland and Scandinavia. Some spend their summer holidays in Britain working as locums, others do so for about a year. Far more are weekend commuters and are drawn from across the medical spectrum. “We’re thinking of setting up a mobile anaesthetic unit,” Christof Kouidis, a demonstrator, said. “Working in Britain for a week could cover our practice costs in Germany for the rest of the month.”
The influx of British patients to Germany trying to avoid NHS queues for hip replacements has encouraged German doctors to cross the Channel. Stefan Krukenberg, from Hanover, is planning to replace hip joints in Britain on a freelance basis. “I get €65 for preparing an artificial hip joint — that’s for at least two hours work. Now I’m seriously considering going to Britain on a Friday, preparing three or four hip replacements a day over the weekend and effectively doubling my monthly income.” The only way he would be able to break even under the new tight German costing rules is by preparing 1,000 hip prostheses a month. “And that’s impossible. What we’re doing at the moment amounts in financial terms to a mere hobby. We have to earn the money to live somewhere else.”
The paradox of the German medical crisis is that doctors are now abandoning rural and eastern areas to work abroad, leaving many active but underfunded surgeries in decline. The German Doctors Association estimates that 32,000 surgeries are on the brink of bankruptcy. “We are soon going to have a real shortage of doctors,” Uwe Gremmler, a cardiologist from Peine, said. “Older doctors are taking earlier retirement because it has become impossible to make a living. The younger doctors are moving to Britain and, at the same time, as Germans live longer, there are more and more patients to be treated. The Government should act now before we all disappear to England.”
Source
THE BRITISH ARE CUTTING PUBLIC HOSPITAL SEVICES TOO
The spiralling cash crisis in the NHS has already forced two thirds of hospitals to close wards and will soon start directly affecting patient care, health chiefs give warning today. A survey of 117 chief executives of NHS trusts reveals the depth of concern among healthcare professionals about the destabilising impact of wide-ranging government reforms. Three quarters of them say that growing financial pressures brought on by primary and acute care restructuring will affect patient treatment. Almost half of hospital trust managers said that building and refurbishment projects were being delayed, while many trusts were also having to make staff redundant and to introduce recruitment freezes.
The Times understands that the Prime Minister is to order a shake-up of ministers and top civil servants, such is the concern in Downing Street about perceived NHS disarray. It follows six years of unprecedented rises in NHS funding. Mr Blair wants a new junior minister to fend off criticism of the Government’s faltering reform programme and to sell NHS modernisation both to the public and Labour MPs. The health service is braced for even starker financial shortfalls from 2008, when the current round of annual funding increases will stop. The poll of trust executives, conducted by Health Service Journal, comes as nursing leaders also give a bleak warning of massive NHS deficits. Their research suggests that health service debts in England will hit £1.2 billion this year, putting up to 4,000 jobs at risk.
The new minister, who will be charged with promoting the reform agenda in the media, is expected to be imposed on the Department of Health in a reshuffle due within days. The jobs of Jane Kennedy, the Minister for quality and patient safety, and Rosie Winterton, the Minister for health services, are both at risk. The Times understands that a number of senior bureaucrats will also be moved in an attempt to speed up the pace of delivery. It is hoped that the MP will be a more effective deputy to Patricia Hewitt, the Health Secretary, who has struggled to explain the benefits of reforms and had to revise plans to reform primary care trusts.
The uncertainty surrounding unforeseen knock-on effects of the Government’s reforms emerged when ministers decided to review the £1.2 billion redevelopment of Barts and the Royal London hospitals. The last-minute decision, taken after more than six years of project planning, prompted 1,000 doctors to write to The Times earlier this week. They gave warning of the serious impact on cancer and cardiac services for London if the project was downscaled.
Evidence of serious financial problems is supported by 75 per cent of hospital chief executives who said that patient care would be affected by cash shortfalls. The warning comes despite assurances from Ms Hewitt that any cuts should only affect administration. The Royal College of Nursing (RCN), which has been tracking the level of deficits and the impact on staff and services during 2005, confirmed that patient services and treatments were now being disrupted. It found that cost-cutting measures — including freezing job vacancies and use of agency staff — were now having a “direct and detrimental” effect on patients, with operations cancelled, appointments postponed and beds closed. According to documents obtained under the Freedom of Information Act, a total of 81 NHS trusts in financial difficulties have been investigated by KPMG, the acountant. This is far more than the Department of Health acknowledged when it announced the “turnaround teams” of accountants before Christmas. It said that 50 trusts with financial problems would be visited.
The disclosure, and the full list of trusts visited, was obtained by Accountancy Age. They include 20 out of the total of 28 strategic health authorities, 29 primary care trusts, and 33 hospital trusts. A Department of Health spokeswoman last night defended the NHS reform programme. She said that the RCN’s predictions were “back of-an-envelope calculations”, adding that the “turnaround teams” would help to address financial problems centred on a small number of trusts
Source
***************************
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?
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.
***************************
Thursday, January 19, 2006
SCOTTISH HOSPITALS SOCK THE VISITORS
When you have been told that your government will look after you, it is a shock to find that it doesn't
The astronomical cost of charges imposed on relatives and friends comforting their sick loved ones in hospital has been laid bare by The Scotsman. Visitors to Scotland's hospitals face a postcode lottery of parking fees. Families also face exorbitant costs contacting their relatives in hospitals using private telephone lines that charge up to 49p per minute for incoming calls, more than the cost of phoning Australia on standard land lines. Charges for patients watching TV add to the overall burden, which can reach £55 a week or more. Families and friends of the most seriously ill on extended hospital stays are having to pay hundreds of pounds to comfort their loved ones.
Colin Craig, whose partner Elaine McFadden was a patient at the Royal Infirmary in Edinburgh from April 2003 to March 2004, when she was battling pancreatitis, racked up £1,600 in parking fees. Widower Henry Robertson paid out £600 over seven months while visiting his dying wife at the same hospital.
The survey of charges highlighted by The Scotsman prompted cancer charities and unions to condemn the practice as immoral, while opposition politicians called on hospitals to review their systems. Ministers have forbidden any health board from using car parking to make a profit, but private companies are subject to no such controls. The most costly parking is at the Private Finance Initiative-built Royal Infirmary, Edinburgh (RIE), where visitors are charged £10 for more than six hours' parking. The car park is managed by Meteor Car Parks for Consort, the firm that built the hospital and runs facilities. The Western General in Edinburgh also charges £7 for more than four hours, while St John's Hospital in Livingston charges £1 per day. At Glasgow Royal Infirmary, where private firm Apcoa runs the car park for owners Impregilo, visitors are charged £1 per hour between 8am and 6pm and a maximum of £1.80 for staying overnight....
However, the Scottish Executive said guidelines issued to health boards should prevent anyone visiting hospital regularly being charged and Lothian Health Board said parking is offered free of charge to relatives, where attendance at hospital relates to trauma or a bereavement. It also offers reduced fees for those visiting hospital on a regular basis over a prolonged period of time.
However, Margaret Watt, chairwoman of the Patients' Association Scotland, said these concessions were unknown to most families and, as a consequence, they were paying out. "It is morally wrong that they are taxing the people who are visiting people who are ill, perhaps seriously," she said. Elspeth Atkinson, Macmillan Cancer Relief director for Scotland, said the experience of being in hospital was stressful enough without having to worry about the extra costs of parking, television or telephone. "Travel costs are the biggest financial burden on people with cancer and that's why Macmillan is calling on the Executive and all health boards in Scotland to ensure that cancer patients do not have to pay for hospital parking," Ms Atkinson said....
Unions representing health workers in Glasgow and Edinburgh have consistently complained about the costs of parking, although the Executive recommends sufficient car parking space and concessionary car parking rates should be available. Apart from the ten named hospitals, all others provide parking for free. However, patients are also being charged to contact patients by phone in many hospitals. Eight hospitals in Scotland have a system installed which is run by the Patientline firm: Crosshouse Hospital in Kilmarnock, Ayr Hospital, Dumfries and Galloway Royal Infirmary, Aberdeen Royal Infirmary, Monklands hospital in Airdrie, Edinburgh Royal Infirmary, Raigmore Hospital in Inverness and Glasgow Royal Infirmary. The firm charges £3.50 a day for watching television, although under-16s get free access, while it is half price for OAPs and long-stay patients. Patients can use the phone for the same cost as a payphone but incoming calls are 39p per minute off peak or 49p per minute at peak times. Phoning Australia from home during the day costs just under 22p a minute.
More here
Feds pressure bureaucrat-heavy Queensland public health system
The Caboolture Hospital fiasco could cost Queensland $67 million in health funding, after the Federal Government yesterday ordered an investigation into possible breaches of the Medicare Agreement. Acting Federal Health Minister Julie Bishop said she was "extremely concerned" about the closure of emergency services at the hospital and the decision to send patients away to see GPs instead.
The State Government yesterday announced it was a step closer to restoring full services at Caboolture, with an agreement for three senior staff from the Mater Hospital in Brisbane to reopen the emergency department on Friday. It had been closed since Monday because of a doctor shortage.
But even as it solved the Caboolture problem, the Government was handed another as Ms Bishop asked her department to investigate the affair. Under the Australian Health Care Agreement, patients who present for treatment at the emergency department of a public hospital must be treated. The hospital is allowed to suggest other "clinically appropriate" service providers "but must provide free treatment if the patient chooses to be treated at the hospital". This agreement also stipulates that "hospital employees will not direct patients . . . towards a particular choice". The contingency plan enacted by the [Queensland] Government to cover the doctor shortage involves less-serious patients being advised to see their GP. Ms Bishop said the referral of more-serious Caboolture patients to Redcliffe and Brisbane may also breach Queensland's commitment to provide "equitable access to public hospital services regardless of geography".
She said the agreement provided for a "compliance payment" which would amount to around $67 million if Queensland failed to meet its obligations. "We're extremely concerned that the Queensland Government appears to be breaching its responsibilities under the Australian Health Care Agreement," Ms Bishop said. "We've provided very substantial funding - $8 billion over five years - and, clearly, this should be used to better maintain the public health system."
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. 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?
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.
***************************
When you have been told that your government will look after you, it is a shock to find that it doesn't
The astronomical cost of charges imposed on relatives and friends comforting their sick loved ones in hospital has been laid bare by The Scotsman. Visitors to Scotland's hospitals face a postcode lottery of parking fees. Families also face exorbitant costs contacting their relatives in hospitals using private telephone lines that charge up to 49p per minute for incoming calls, more than the cost of phoning Australia on standard land lines. Charges for patients watching TV add to the overall burden, which can reach £55 a week or more. Families and friends of the most seriously ill on extended hospital stays are having to pay hundreds of pounds to comfort their loved ones.
Colin Craig, whose partner Elaine McFadden was a patient at the Royal Infirmary in Edinburgh from April 2003 to March 2004, when she was battling pancreatitis, racked up £1,600 in parking fees. Widower Henry Robertson paid out £600 over seven months while visiting his dying wife at the same hospital.
The survey of charges highlighted by The Scotsman prompted cancer charities and unions to condemn the practice as immoral, while opposition politicians called on hospitals to review their systems. Ministers have forbidden any health board from using car parking to make a profit, but private companies are subject to no such controls. The most costly parking is at the Private Finance Initiative-built Royal Infirmary, Edinburgh (RIE), where visitors are charged £10 for more than six hours' parking. The car park is managed by Meteor Car Parks for Consort, the firm that built the hospital and runs facilities. The Western General in Edinburgh also charges £7 for more than four hours, while St John's Hospital in Livingston charges £1 per day. At Glasgow Royal Infirmary, where private firm Apcoa runs the car park for owners Impregilo, visitors are charged £1 per hour between 8am and 6pm and a maximum of £1.80 for staying overnight....
However, the Scottish Executive said guidelines issued to health boards should prevent anyone visiting hospital regularly being charged and Lothian Health Board said parking is offered free of charge to relatives, where attendance at hospital relates to trauma or a bereavement. It also offers reduced fees for those visiting hospital on a regular basis over a prolonged period of time.
However, Margaret Watt, chairwoman of the Patients' Association Scotland, said these concessions were unknown to most families and, as a consequence, they were paying out. "It is morally wrong that they are taxing the people who are visiting people who are ill, perhaps seriously," she said. Elspeth Atkinson, Macmillan Cancer Relief director for Scotland, said the experience of being in hospital was stressful enough without having to worry about the extra costs of parking, television or telephone. "Travel costs are the biggest financial burden on people with cancer and that's why Macmillan is calling on the Executive and all health boards in Scotland to ensure that cancer patients do not have to pay for hospital parking," Ms Atkinson said....
Unions representing health workers in Glasgow and Edinburgh have consistently complained about the costs of parking, although the Executive recommends sufficient car parking space and concessionary car parking rates should be available. Apart from the ten named hospitals, all others provide parking for free. However, patients are also being charged to contact patients by phone in many hospitals. Eight hospitals in Scotland have a system installed which is run by the Patientline firm: Crosshouse Hospital in Kilmarnock, Ayr Hospital, Dumfries and Galloway Royal Infirmary, Aberdeen Royal Infirmary, Monklands hospital in Airdrie, Edinburgh Royal Infirmary, Raigmore Hospital in Inverness and Glasgow Royal Infirmary. The firm charges £3.50 a day for watching television, although under-16s get free access, while it is half price for OAPs and long-stay patients. Patients can use the phone for the same cost as a payphone but incoming calls are 39p per minute off peak or 49p per minute at peak times. Phoning Australia from home during the day costs just under 22p a minute.
More here
Feds pressure bureaucrat-heavy Queensland public health system
The Caboolture Hospital fiasco could cost Queensland $67 million in health funding, after the Federal Government yesterday ordered an investigation into possible breaches of the Medicare Agreement. Acting Federal Health Minister Julie Bishop said she was "extremely concerned" about the closure of emergency services at the hospital and the decision to send patients away to see GPs instead.
The State Government yesterday announced it was a step closer to restoring full services at Caboolture, with an agreement for three senior staff from the Mater Hospital in Brisbane to reopen the emergency department on Friday. It had been closed since Monday because of a doctor shortage.
But even as it solved the Caboolture problem, the Government was handed another as Ms Bishop asked her department to investigate the affair. Under the Australian Health Care Agreement, patients who present for treatment at the emergency department of a public hospital must be treated. The hospital is allowed to suggest other "clinically appropriate" service providers "but must provide free treatment if the patient chooses to be treated at the hospital". This agreement also stipulates that "hospital employees will not direct patients . . . towards a particular choice". The contingency plan enacted by the [Queensland] Government to cover the doctor shortage involves less-serious patients being advised to see their GP. Ms Bishop said the referral of more-serious Caboolture patients to Redcliffe and Brisbane may also breach Queensland's commitment to provide "equitable access to public hospital services regardless of geography".
She said the agreement provided for a "compliance payment" which would amount to around $67 million if Queensland failed to meet its obligations. "We're extremely concerned that the Queensland Government appears to be breaching its responsibilities under the Australian Health Care Agreement," Ms Bishop said. "We've provided very substantial funding - $8 billion over five years - and, clearly, this should be used to better maintain the public health system."
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. 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?
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.
***************************
Wednesday, January 18, 2006
DO-GOODER DRUG LEGISLATION CREATES HUGE MUDDLE INSTEAD
And the private insurance fund contributors get lumbered with paying for the problems the legislators and bureaucrats created
With tens of thousands of people unable to get medicines promised by Medicare, the Bush administration has told insurers that they must provide a 30-day supply of any drug that a beneficiary was previously taking, and it said that poor people must not be charged more than $5 for a covered drug. The actions came after several states declared public health emergencies, and many states announced that they would step in to pay for prescriptions that should have been covered by the federal Medicare program.
Republicans have joined Democrats in asserting that the federal government botched the beginning of the prescription drug program, which started on Jan. 1. People who had signed up for coverage found that they were not on the government's list of subscribers. Insurers said they had no way to identify poor people entitled to extra help with their drug costs. Pharmacists spent hours on the telephone trying to reach insurance companies that administer the drug benefit under contract to Medicare. Many of the problems involve low-income people entitled to both Medicare and Medicaid.
In a directive sent to all Medicare drug plans over the weekend, the Bush administration said they "must take immediate steps" to ensure that low-income beneficiaries were not charged more than $2 for a generic drug and $5 for a brand-name drug. In addition, it said insurers must cover a 30-day emergency supply of drugs that beneficiaries were taking prior to the start of the new program.
In an interview yesterday, Dr. Mark B. McClellan, administrator of the federal Centers for Medicare and Medicaid Services, said that "several hundred thousand beneficiaries who switched plans" in December may have had difficulty filling prescriptions in the last two weeks. In California, officials estimate that 200,000 of the state's 1.1 million low-income Medicare beneficiaries had trouble getting their medications. Despite these problems, Dr. McClellan said, Medicare is now covering one million prescriptions a day. With the latest corrective actions, he said, "all beneficiaries should be able to get their prescriptions filled."
In the past, such predictions proved to be premature. New problems appeared as old ones were solved, and some insurers were slow to carry out federal instructions. Since the program began on Jan. 1, many low-income people have left pharmacies empty-handed after being told they would have to pay co-payments of $100, $250 or more. About 20 states, including California, Illinois, Ohio, Pennsylvania and all of New England, have announced that they will help low-income people by paying drug claims that should have been paid by the federal Medicare program. "The new federal program is too complicated for many people to understand, and the implementation of the new program by the federal government has been awful," said Gov. Tim Pawlenty of Minnesota, a Republican. On Saturday, he signed an emergency executive order making the state a "payer of last resort" for the out-of-pocket drug costs.
The Bush administration said it was rushing to provide insurers with correct information about the extra subsidies available to low-income people enrolled in their plans. "We sent files to all plans providing complete information on dual-eligible beneficiaries" entitled to both Medicare and Medicaid, Dr. McClellan said. "The plans now have all the information in one place." The new drug benefit is the most significant expansion of Medicare since creation of the program in 1965.
More here
Ordeal for woman injured just outside a large public hospital
A one-minute trip to hospital became a 44-minute ordeal for a woman suffering serious head and chest injuries, as the human cost of the Caboolture hospital emergency department closure was revealed yesterday. On the first day of the Beattie Government's contingency plan for Caboolture, a fatal accident just 250m from the hospital's entrance resulted in a lengthy ambulance trip to Redcliffe for a 50-year old female patient. And it forced a 77-year-old with more serious injuries to wait for more than an hour to be airlifted to Brisbane. A 97-year-old female passenger, who had been receiving treatment at the hospital, died in the accident.
After weeks of denials, the State Government admitted yesterday that emergency services at Caboolture were effectively closed as a result of a statewide doctor shortage. The Caboolture Hospital's emergency department was closed from 6am yesterday because of a lack of staff. The fatal accident at the entrance to the hospital happened at 3.45pm after a white Holden Barina hatchback, in which the three women were travelling, and a white Holden Rodeo collided. The 97-year-old woman, who died in the crash, had been receiving treatment at the hospital. The 50-year-old female driver of the Barina was transported by ambulance to Redcliffe Hospital. The 77-year-old seriously injured passenger in the Barina was airlifted to Royal Brisbane Hospital.
Last night The Courier-Mail was advised it took an ambulance 44 minutes to transport the injured female driver to Redcliffe. But it is believed the woman, suffering from head injuries, broken ribs, and chest injuries, requires a high-dependency bed not available at Redcliffe Hospital, and will have to be transferred to either the Royal Brisbane or Princess Alexandra Hospital.
Australian Medical Association Queensland president Dr Steve Hambleton said he was advised a doctor from the Caboolture Hospital assisted paramedics at the accident. "A tragedy like this drives home the importance of quality services in large communities that are growing fast," Dr Hambleton said. "It may well have been that these people would have needed air transport anyway. "It just highlights how unpredictable our lives are, and the need for quality services." Dr Hambleton said the Queensland Government now had no choice but to "fix" the problems with its public hospitals.
Opposition Leader Lawrence Springborg described the car accident victims as "the tragic human face of government spin". Late yesterday, Acting Premier Anna Bligh announced a temporary deal made with the Mater Hospital to provide doctors so the emergency department could be reopened in coming days. Health Minister Stephen Robertson insisted the two patients injured outside Caboolture Hospital had received appropriate care despite the closure. He said the woman transported to Redcliffe had received immediate attention from paramedics, and the person airlifted to Brisbane would not have been treated in Caboolture because of the nature and extent of her injuries.
But Caboolture's former emergency department director Sylvia Andrew-Starkey said the woman "would have been stabilised at Caboolture" if the department had been operational....
Mr Robertson yesterday admitted the Caboolture Emergency Department "is, in fact, closed" after claiming since late last year it would remain open and services would simply be scaled back. He said five people had presented at the hospital yesterday. Three had been told to go to a GP, despite Mr Robertson's claim earlier this month that "no one's going to be turned away". Despite previously insisting that the department would be staffed by a senior doctor during the day and a junior doctor at night, Mr Robertson admitted there had been no emergency doctor present to see the other two patients.
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. 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?
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.
***************************
And the private insurance fund contributors get lumbered with paying for the problems the legislators and bureaucrats created
With tens of thousands of people unable to get medicines promised by Medicare, the Bush administration has told insurers that they must provide a 30-day supply of any drug that a beneficiary was previously taking, and it said that poor people must not be charged more than $5 for a covered drug. The actions came after several states declared public health emergencies, and many states announced that they would step in to pay for prescriptions that should have been covered by the federal Medicare program.
Republicans have joined Democrats in asserting that the federal government botched the beginning of the prescription drug program, which started on Jan. 1. People who had signed up for coverage found that they were not on the government's list of subscribers. Insurers said they had no way to identify poor people entitled to extra help with their drug costs. Pharmacists spent hours on the telephone trying to reach insurance companies that administer the drug benefit under contract to Medicare. Many of the problems involve low-income people entitled to both Medicare and Medicaid.
In a directive sent to all Medicare drug plans over the weekend, the Bush administration said they "must take immediate steps" to ensure that low-income beneficiaries were not charged more than $2 for a generic drug and $5 for a brand-name drug. In addition, it said insurers must cover a 30-day emergency supply of drugs that beneficiaries were taking prior to the start of the new program.
In an interview yesterday, Dr. Mark B. McClellan, administrator of the federal Centers for Medicare and Medicaid Services, said that "several hundred thousand beneficiaries who switched plans" in December may have had difficulty filling prescriptions in the last two weeks. In California, officials estimate that 200,000 of the state's 1.1 million low-income Medicare beneficiaries had trouble getting their medications. Despite these problems, Dr. McClellan said, Medicare is now covering one million prescriptions a day. With the latest corrective actions, he said, "all beneficiaries should be able to get their prescriptions filled."
In the past, such predictions proved to be premature. New problems appeared as old ones were solved, and some insurers were slow to carry out federal instructions. Since the program began on Jan. 1, many low-income people have left pharmacies empty-handed after being told they would have to pay co-payments of $100, $250 or more. About 20 states, including California, Illinois, Ohio, Pennsylvania and all of New England, have announced that they will help low-income people by paying drug claims that should have been paid by the federal Medicare program. "The new federal program is too complicated for many people to understand, and the implementation of the new program by the federal government has been awful," said Gov. Tim Pawlenty of Minnesota, a Republican. On Saturday, he signed an emergency executive order making the state a "payer of last resort" for the out-of-pocket drug costs.
The Bush administration said it was rushing to provide insurers with correct information about the extra subsidies available to low-income people enrolled in their plans. "We sent files to all plans providing complete information on dual-eligible beneficiaries" entitled to both Medicare and Medicaid, Dr. McClellan said. "The plans now have all the information in one place." The new drug benefit is the most significant expansion of Medicare since creation of the program in 1965.
More here
Ordeal for woman injured just outside a large public hospital
A one-minute trip to hospital became a 44-minute ordeal for a woman suffering serious head and chest injuries, as the human cost of the Caboolture hospital emergency department closure was revealed yesterday. On the first day of the Beattie Government's contingency plan for Caboolture, a fatal accident just 250m from the hospital's entrance resulted in a lengthy ambulance trip to Redcliffe for a 50-year old female patient. And it forced a 77-year-old with more serious injuries to wait for more than an hour to be airlifted to Brisbane. A 97-year-old female passenger, who had been receiving treatment at the hospital, died in the accident.
After weeks of denials, the State Government admitted yesterday that emergency services at Caboolture were effectively closed as a result of a statewide doctor shortage. The Caboolture Hospital's emergency department was closed from 6am yesterday because of a lack of staff. The fatal accident at the entrance to the hospital happened at 3.45pm after a white Holden Barina hatchback, in which the three women were travelling, and a white Holden Rodeo collided. The 97-year-old woman, who died in the crash, had been receiving treatment at the hospital. The 50-year-old female driver of the Barina was transported by ambulance to Redcliffe Hospital. The 77-year-old seriously injured passenger in the Barina was airlifted to Royal Brisbane Hospital.
Last night The Courier-Mail was advised it took an ambulance 44 minutes to transport the injured female driver to Redcliffe. But it is believed the woman, suffering from head injuries, broken ribs, and chest injuries, requires a high-dependency bed not available at Redcliffe Hospital, and will have to be transferred to either the Royal Brisbane or Princess Alexandra Hospital.
Australian Medical Association Queensland president Dr Steve Hambleton said he was advised a doctor from the Caboolture Hospital assisted paramedics at the accident. "A tragedy like this drives home the importance of quality services in large communities that are growing fast," Dr Hambleton said. "It may well have been that these people would have needed air transport anyway. "It just highlights how unpredictable our lives are, and the need for quality services." Dr Hambleton said the Queensland Government now had no choice but to "fix" the problems with its public hospitals.
Opposition Leader Lawrence Springborg described the car accident victims as "the tragic human face of government spin". Late yesterday, Acting Premier Anna Bligh announced a temporary deal made with the Mater Hospital to provide doctors so the emergency department could be reopened in coming days. Health Minister Stephen Robertson insisted the two patients injured outside Caboolture Hospital had received appropriate care despite the closure. He said the woman transported to Redcliffe had received immediate attention from paramedics, and the person airlifted to Brisbane would not have been treated in Caboolture because of the nature and extent of her injuries.
But Caboolture's former emergency department director Sylvia Andrew-Starkey said the woman "would have been stabilised at Caboolture" if the department had been operational....
Mr Robertson yesterday admitted the Caboolture Emergency Department "is, in fact, closed" after claiming since late last year it would remain open and services would simply be scaled back. He said five people had presented at the hospital yesterday. Three had been told to go to a GP, despite Mr Robertson's claim earlier this month that "no one's going to be turned away". Despite previously insisting that the department would be staffed by a senior doctor during the day and a junior doctor at night, Mr Robertson admitted there had been no emergency doctor present to see the other two patients.
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. 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?
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, January 17, 2006
THE STRANGE PRIORITIES OF THE BRITISH NHS
Post lifted from NHS Blogdoctor -- written by a British GP. He notes some of the things that the NHS will NOT pay for
Post lifted from NHS Blogdoctor -- written by a British GP. He notes some of the things that the NHS will NOT pay for
The Ritz Hotel, London. "Free at the point of entry".
Reported in the Times today, the sad case of John Pilley, currently a long term guest of Her Majesty in Holloway Prison. He is serving life imprisonment for kidnapping and attempted murder. Those of you who are alert will have noticed that John is in a female prison. Has there been a mistake?
John thought so. The mistake being that he was not a "he" but a she. Not to worry, though, the good old NHS stepped in, and at a cost of some œ15,000 he had a sex change operation and so was, appropriately enough, moved from a male prison to a female prison. Anyway, she doesn't like it there, or maybe she was a bit hasty, because she now thinks she was wrong and is really "he".
So the good old NHS is going to put her back to status quo. Dr Crippen does not know how much that will cost. Phalloplasty is somewhat more technically challenging than vaginoplasty. To put that in simple terms, it is cheaper to chop a willy off than it is to it put back on again.
Dr Crippen currently has three patients with angina waiting to have a CABG. Last year he had four, but one died. And he has two female patients in their late thirties who have blocked fallopian tubes and cannot afford to pay for IVF. And then there is the fifteen year old girl who had her ears pierced not once but four times, and ended up with a seriously damaged ear lobe. Silly girl, but she is a teenager. Dr Crippen referred her for plastic surgery. They will not do it. This sort of Surgery is "not available on the NHS". And this month, and every month, Dr Crippen writes out prescriptions for hundreds of pounds worth of groceries for fit people who have coeliac disease. And then the heavy smokers, who spend œ100 a week on cigarettes, demand NHS prescriptions for nicotine patches. And I cannot get radiotherapy within a reasonable length of time for patients with lung cancer. Last year, one of them died before she had even seen the radiotherapist. And some of my breast cancer patients are not on the optimum treatment. My old English teacher said I should not begin a sentence with "and". I have just done it seven times in succession. The list is endless.
Where am I headed? Some get too much, many get too little. The NHS is under-resourced of course. We all know that. But it is grossly abused by some patents who, frankly, are taking the piss. I know that is rude. Sorry. I can't think of a better way to convey the precise nuance of meaning I wish to acheive.
The only way to solve this is to put a charge on the front end. I have said it before. I am saying it again, and I will keep on saying it. The last time I said it I got over two hundred e-mails from people, most of whom remain wedded to this nonsense of "free at the point of entry."
The NHS is only "free at the point of entry" when it is not closed. It is closed to infertile women. It is closed to middle aged men who need urgent cardiac surgery. It is closed to teenage girls with scarred ears. It is closed to some women who want breast cancer medication.
At least it is fair, you may say. It is the same for everyone. No it is not. Full healthcare is not available for the poor. But the hospital door swings open if you turn up with a wallet full of cash. Go privately, (or be a prime minister) and you get anything you want.
It is like the "The Ritz" hotel. That is free at the point of entry too. But see how far you get without your wallet.
In the meantime, the taxpayers who are reading this article can only hope that JanesoontobeJohnagain Pilley finally settles on an acceptable gender.
How many more goes shall we allow her/him?
John Pilley story from The Times
The downward spiral in the Queensland public hospital system continues
Emergency services at Ipswich and Maryborough hospitals are facing similar problems to Caboolture Hospital's accident and emergency department, which is closed from today due to doctor shortages. Both hospitals have been forced to divert medical staff from other areas to prop up understaffed accident and emergency departments, Queensland Health has confirmed. The department yesterday warned there was "potentially an increased wait for non-urgent matters" at both hospitals. "Queensland Health is exhausting every avenue to find solutions to addressing the staffing shortages," a spokesman said yesterday.
Although triage nurses will be on duty today at Caboolture Hospital, patients will be diverted to Redcliffe Hospital. Queensland Health is urging people to call triple-0 in the case of urgent matters and its hotline - 1300 557 514 - for non-urgent matters. Health Minister Stephen Robertson has insisted the reduction in services is a downgrade, but this was cast into doubt yesterday by Caboolture Hospital acting emergency department director Chris Johnstone. In an interview on ABC Radio, Dr Johnstone said "the emergency department at Caboolture Hospital will be closed". "In other words, there will be no doctors available to provide any medical service," he said.
Opposition health spokesman Bruce Flegg said Queensland Health staff had been threatened with disciplinary action just for using the word "closure". "The situation at the Ipswich Hospital is in a critical state, and locals in yet another huge Queensland community face the prospect of being forced to travel to the Princess Alexandra Hospital in Brisbane," Dr Flegg said.
More here
Severe danger to kids from the Queensland public hospital meltdown
"When three-year-old Zachary began swelling in front of Bronny Chetham's eyes last year, the terrified mother rushed her son to the emergency ward at Caboolture Hospital. He was playing with an egg he had broken open. It took only seconds for a severe allergic reaction to take hold. "When he turned around his eyes were swollen shut, his feet and hands were all swelling," she said. "By the time I got him into the shower, he had a rash from head to toe . . . and I raced him to the hospital." In the worst-case scenario, Mrs Chetham said her son would have suffered an anaphylactic fit, which could have led to death if they had been unable to access medical help immediately. So having the Caboolture Hospital's emergency department only five minutes away has always been a source of comfort to her.
But today, with the closure of the department, that comfort has been replaced by fear. With three children under the age of four suffering from allergies and asthma, Mrs Chetham said she was "terrified" by the prospect. Over the past couple of years she has rushed her children to the emergency department more than half a dozen times. The family, who place their eggs on top of the fridge and go to extreme lengths to keep Zachary out of danger, are now looking to move to Brisbane or to Redcliffe".
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. 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?
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, January 16, 2006
Fixing Medicaid one state at a time
Sometimes it seems the motto in Congress should be, "Don't just do something, stand there!" Lawmakers debated a flurry of measures throughout December, but ended up punting many issues into 2006. That includes Medicaid reform.Luckily, two states decided not to wait for Washington to do something. Florida and South Carolina are both proposing reforms of their own Medicaid programs.
Most states recognize they can't afford their current Medicaid programs. Over the long haul, spiraling Medicaid costs will eventually squeeze out spending on other priorities - such as education, transportation and homeland security.
In Florida, for example, 24 percent of the state's 2005 budget went to Medicaid. South Carolina's Medicaid program is expected to demand 24 percent of the state's budget by 2010. So both states are using existing waiver authority to test new approaches for Medicaid.
The specifics of each plan are different, but that's really the point. Both states aim to use different methods to make the Medicaid program more patient-centered rather than system-centered. They intend to introduce choice for beneficiaries, competition among providers and insurers and stability to the program. Similar principles are already found in the highly popular Federal Employees' Health Benefits Program, the system that provides health coverage to federal workers and members of Congress.
Choice is always good for consumers, in health care as in retail sales. Medicaid enrollees would be better off if they could select a plan that best suits their needs instead of depending on a one-size-fits-all system that leaves much to be desired. Choice will spur competition, as insurance plans and other providers of services will have to compete for enrollees based on value. By trusting in the free-market forces of choice and competition, states will reap the benefits of greater stability in the program.
To accomplish these goals, Florida and South Carolina want to establish a fair and equitable financing system based on individual needs and costs. Enrollees would be able to apply their Medicaid contribution to the plan they choose. The states also would focus on enhancing and improving coverage options. o promote choice and competition, these states allow for flexibility in benefit structure. That sounds complex, but it really means allowing insurers and provider groups to design packages that enrollees actually want. Some plans may focus on diabetes while others may focus on pediatric care. In the end, most patients will probably get a plan that addresses their specific concerns. Finally, these states will invest in educating Medicaid patients so they can make smart choices about their own health. Enrollees will be given the tools and information they need to make informed decisions about their health care and their health care services.
These states aren't the only ones looking for change. Governors from across the country and political spectrum stress the need for Medicaid reform. This puts them - Democrats and Republicans alike - at odds with many of their party's elected officials in Washington, who seem to want to maintain the failing status quo. Gov. Mark Warner, Virginia Democrat, and Gov. Mike Huckabee, Arkansas Republican tried to set Congress straight. As former and current heads of the National Governors Association, respectively, they testified about the need for change and supported the House of Representatives in its efforts to give more control over Medicaid to the states.
The urgency for change in Medicaid is evident to those at the state level who are dealing with the program on a pragmatic level. Reform efforts like those in Florida and South Carolina are only the start. As with welfare reform, it appears that the states - not Washington - will lead the way to reform.
State governments, unlike Congress, are required to balance their budgets every year. They know they can't afford to just stand there and let an unreformed Medicaid program gobble up an ever-growing share of their budgets year after year. So while Congress dithers along with deficit spending, the real reform action is in states like Florida and South Carolina, where leaders are working to save and improve Medicaid.
Source
Staff shortage shuts emergency ward at a major Australian public hospital
An unbelievably incompetent health bureaucracy -- despite (or because of) the fact that they have got 3 times as many paper-shufflers as medical staff
The emergency ward of a major Queensland hospital will shut on Monday - probably for months - because of a doctor shortage. The Caboolture Hospital emergency ward was to be closed amid community fear and anger, Liberal health spokesman Dr Bruce Flegg said. "This community has been treated appallingly, they still haven't had any official word from the Government on what they are supposed to do in an emergency," he said. "People in Caboolture want an emergency department in Caboolture, they don't want to be told they've got to go a long distance to an already overcrowded hospital." It was only a matter of time until someone dies because of the closure, he said.
A health spokesman said this would be the only emergency ward closure in Queensland and no one would be turned away if they presented at Caboolture Hospital in a serious condition. "If you have a life threatening emergency, ring 000, if you've got non life threatening situations, we have set up a 1300 number where you will get an experienced emergency department nurse who will advise you about where to go for the most appropriate treatment. "About 60 per cent of people who turn up to the emergency department of a hospital are there for minor conditions that could be treated by their local GP."
The spokesman said the small number of bulk billing doctors in the area meant patients would need to travel to the next closest hospital - in Redcliffe - to receive free medical attention, for which they would receive a "patient travel subsidy scheme reimbursement". The Queensland Ambulance Service also would provide extra services to transport patients between Caboolture and Redcliffe hospitals, he said. The spokesman said the Caboolture emergency ward may be reopened in a couple of months and blamed the doctor shortage on medicos not wanting to work in Caboolture.
The Australian Medical Association has urged the Queensland Government to further improve the pay and conditions of the state's doctors, despite a pay rise awarded to senior doctors late last year.
Source
***************************
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?
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.
***************************
Sometimes it seems the motto in Congress should be, "Don't just do something, stand there!" Lawmakers debated a flurry of measures throughout December, but ended up punting many issues into 2006. That includes Medicaid reform.Luckily, two states decided not to wait for Washington to do something. Florida and South Carolina are both proposing reforms of their own Medicaid programs.
Most states recognize they can't afford their current Medicaid programs. Over the long haul, spiraling Medicaid costs will eventually squeeze out spending on other priorities - such as education, transportation and homeland security.
In Florida, for example, 24 percent of the state's 2005 budget went to Medicaid. South Carolina's Medicaid program is expected to demand 24 percent of the state's budget by 2010. So both states are using existing waiver authority to test new approaches for Medicaid.
The specifics of each plan are different, but that's really the point. Both states aim to use different methods to make the Medicaid program more patient-centered rather than system-centered. They intend to introduce choice for beneficiaries, competition among providers and insurers and stability to the program. Similar principles are already found in the highly popular Federal Employees' Health Benefits Program, the system that provides health coverage to federal workers and members of Congress.
Choice is always good for consumers, in health care as in retail sales. Medicaid enrollees would be better off if they could select a plan that best suits their needs instead of depending on a one-size-fits-all system that leaves much to be desired. Choice will spur competition, as insurance plans and other providers of services will have to compete for enrollees based on value. By trusting in the free-market forces of choice and competition, states will reap the benefits of greater stability in the program.
To accomplish these goals, Florida and South Carolina want to establish a fair and equitable financing system based on individual needs and costs. Enrollees would be able to apply their Medicaid contribution to the plan they choose. The states also would focus on enhancing and improving coverage options. o promote choice and competition, these states allow for flexibility in benefit structure. That sounds complex, but it really means allowing insurers and provider groups to design packages that enrollees actually want. Some plans may focus on diabetes while others may focus on pediatric care. In the end, most patients will probably get a plan that addresses their specific concerns. Finally, these states will invest in educating Medicaid patients so they can make smart choices about their own health. Enrollees will be given the tools and information they need to make informed decisions about their health care and their health care services.
These states aren't the only ones looking for change. Governors from across the country and political spectrum stress the need for Medicaid reform. This puts them - Democrats and Republicans alike - at odds with many of their party's elected officials in Washington, who seem to want to maintain the failing status quo. Gov. Mark Warner, Virginia Democrat, and Gov. Mike Huckabee, Arkansas Republican tried to set Congress straight. As former and current heads of the National Governors Association, respectively, they testified about the need for change and supported the House of Representatives in its efforts to give more control over Medicaid to the states.
The urgency for change in Medicaid is evident to those at the state level who are dealing with the program on a pragmatic level. Reform efforts like those in Florida and South Carolina are only the start. As with welfare reform, it appears that the states - not Washington - will lead the way to reform.
State governments, unlike Congress, are required to balance their budgets every year. They know they can't afford to just stand there and let an unreformed Medicaid program gobble up an ever-growing share of their budgets year after year. So while Congress dithers along with deficit spending, the real reform action is in states like Florida and South Carolina, where leaders are working to save and improve Medicaid.
Source
Staff shortage shuts emergency ward at a major Australian public hospital
An unbelievably incompetent health bureaucracy -- despite (or because of) the fact that they have got 3 times as many paper-shufflers as medical staff
The emergency ward of a major Queensland hospital will shut on Monday - probably for months - because of a doctor shortage. The Caboolture Hospital emergency ward was to be closed amid community fear and anger, Liberal health spokesman Dr Bruce Flegg said. "This community has been treated appallingly, they still haven't had any official word from the Government on what they are supposed to do in an emergency," he said. "People in Caboolture want an emergency department in Caboolture, they don't want to be told they've got to go a long distance to an already overcrowded hospital." It was only a matter of time until someone dies because of the closure, he said.
A health spokesman said this would be the only emergency ward closure in Queensland and no one would be turned away if they presented at Caboolture Hospital in a serious condition. "If you have a life threatening emergency, ring 000, if you've got non life threatening situations, we have set up a 1300 number where you will get an experienced emergency department nurse who will advise you about where to go for the most appropriate treatment. "About 60 per cent of people who turn up to the emergency department of a hospital are there for minor conditions that could be treated by their local GP."
The spokesman said the small number of bulk billing doctors in the area meant patients would need to travel to the next closest hospital - in Redcliffe - to receive free medical attention, for which they would receive a "patient travel subsidy scheme reimbursement". The Queensland Ambulance Service also would provide extra services to transport patients between Caboolture and Redcliffe hospitals, he said. The spokesman said the Caboolture emergency ward may be reopened in a couple of months and blamed the doctor shortage on medicos not wanting to work in Caboolture.
The Australian Medical Association has urged the Queensland Government to further improve the pay and conditions of the state's doctors, despite a pay rise awarded to senior doctors late last year.
Source
***************************
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?
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, January 15, 2006
FEEBLE ATTEMPT TO UNBLOCK THE FDA BARRIERS TO NEW DRUGS
Saying "No" to everything would of course be the ideal bureaucratic strategy. There lieth safety for the bureaucrats! They can't quite go that far but they do their best
Drugmakers may be able to hone in on their most promising compounds more quickly under relaxed U.S. guidelines for human testing that apply more modern scientific techniques and ease manufacturing requirements. The Food and Drug Administration guidelines, released yesterday, let companies make microscopic amounts of compounds and give them to less than a dozen people before animal studies are complete. Researchers would then use imaging tests to track the drugs' effects before undertaking larger and longer human studies.
The move is designed to overcome one of the most formidable hurdles in drug development: taking promising compounds from the laboratory to successful human studies.
The FDA approved 20 new breakthrough drugs in 2005, the second-lowest number in more than a decade. While the revolution in human-genome research created insights into the biology underlying disease, the advances haven't been exploited to simplify and speed drug testing. Drug development "is expensive and too often uses technologies of the last century to evaluate cutting-edge, 21st century treatments," FDA acting director Andrew von Eschenbach said in a conference call. The rules enable researchers to "more rapidly establish whether a new compound truly has a clinical benefit for people."
Nine of 10 experimental drugs that begin full-scale human studies ultimately fail, Health and Human Services Secretary Mike Leavitt said in a statement. The initiative is designed to improve those odds. Companies are bringing fewer breakthrough drugs to pharmacy shelves, while their spending on research and development skyrockets.
Source
GOVERNMENT REGULATION DOES NOT WORK ANYWAY
It sure did not in this case. An approved drug was actually very harmful
A drug commonly used to prevent pregnant women from going into labour too early actually has the opposite effect, a trial has shown. The antibiotic metronidazole is given to about one in every 200 women to treat a condition called bacterial vaginosis. This is linked to pre-term delivery, so the assumption has been that treating it reduces the risks of having a baby too early. A new trial supported by Tommy's, the baby charity, suggests that this is mistaken. [A charity had to put them right!]
The trial identified 900 women over a period of 4+ years who were believed to be at risk of early delivery. At 23 to 24 weeks' gestation, the women were given a week's course of either the drug or a placebo. In the placebo group, 39 per cent of the women went on to have pre-term babies. But in the drug group, 62 per cent did, Andrew Shennan and colleagues report in the British Journal of Obstetrics and Gynaecology.
In Britain about one in 20 pregnant women is screened for bacterial vaginosis, and one in 10 of the tests records a positive result. That means that one in 200 pregnant women is BV-positive and at high-risk of having a pre-term baby. Given that there are about 700,000 births each year in Britain, Tommy's estimates that 1,000 babies may be being born prematurely every year because of the drug.
Metronidazole has been used for years after studies in the 1980s suggested that it was beneficial. "There is no doubt that bacterial vaginosis is associated with pre-term birth," Professor Sherman said. "It is not really an infection, but an excess growth of certain bacteria in the vagina that may in fact be normal for some women. Getting rid of this by using metronidazole may not be helpful because it allows other bacteria in." It is also possible, the team suggests, that dying bacteria may result in an inflammatory response that increases the risk of premature labour.
Professor Shennan said that the drug also increased the risks of seriously early births, which frequently produced babies that would later suffer severe abnormalities. "Clinicians and high-risk pregnant women should be aware of this research so that we can avoid the escalation of pre-term birth and save more babies' lives."
Source
***************************
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?
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.
***************************
Saying "No" to everything would of course be the ideal bureaucratic strategy. There lieth safety for the bureaucrats! They can't quite go that far but they do their best
Drugmakers may be able to hone in on their most promising compounds more quickly under relaxed U.S. guidelines for human testing that apply more modern scientific techniques and ease manufacturing requirements. The Food and Drug Administration guidelines, released yesterday, let companies make microscopic amounts of compounds and give them to less than a dozen people before animal studies are complete. Researchers would then use imaging tests to track the drugs' effects before undertaking larger and longer human studies.
The move is designed to overcome one of the most formidable hurdles in drug development: taking promising compounds from the laboratory to successful human studies.
The FDA approved 20 new breakthrough drugs in 2005, the second-lowest number in more than a decade. While the revolution in human-genome research created insights into the biology underlying disease, the advances haven't been exploited to simplify and speed drug testing. Drug development "is expensive and too often uses technologies of the last century to evaluate cutting-edge, 21st century treatments," FDA acting director Andrew von Eschenbach said in a conference call. The rules enable researchers to "more rapidly establish whether a new compound truly has a clinical benefit for people."
Nine of 10 experimental drugs that begin full-scale human studies ultimately fail, Health and Human Services Secretary Mike Leavitt said in a statement. The initiative is designed to improve those odds. Companies are bringing fewer breakthrough drugs to pharmacy shelves, while their spending on research and development skyrockets.
Source
GOVERNMENT REGULATION DOES NOT WORK ANYWAY
It sure did not in this case. An approved drug was actually very harmful
A drug commonly used to prevent pregnant women from going into labour too early actually has the opposite effect, a trial has shown. The antibiotic metronidazole is given to about one in every 200 women to treat a condition called bacterial vaginosis. This is linked to pre-term delivery, so the assumption has been that treating it reduces the risks of having a baby too early. A new trial supported by Tommy's, the baby charity, suggests that this is mistaken. [A charity had to put them right!]
The trial identified 900 women over a period of 4+ years who were believed to be at risk of early delivery. At 23 to 24 weeks' gestation, the women were given a week's course of either the drug or a placebo. In the placebo group, 39 per cent of the women went on to have pre-term babies. But in the drug group, 62 per cent did, Andrew Shennan and colleagues report in the British Journal of Obstetrics and Gynaecology.
In Britain about one in 20 pregnant women is screened for bacterial vaginosis, and one in 10 of the tests records a positive result. That means that one in 200 pregnant women is BV-positive and at high-risk of having a pre-term baby. Given that there are about 700,000 births each year in Britain, Tommy's estimates that 1,000 babies may be being born prematurely every year because of the drug.
Metronidazole has been used for years after studies in the 1980s suggested that it was beneficial. "There is no doubt that bacterial vaginosis is associated with pre-term birth," Professor Sherman said. "It is not really an infection, but an excess growth of certain bacteria in the vagina that may in fact be normal for some women. Getting rid of this by using metronidazole may not be helpful because it allows other bacteria in." It is also possible, the team suggests, that dying bacteria may result in an inflammatory response that increases the risk of premature labour.
Professor Shennan said that the drug also increased the risks of seriously early births, which frequently produced babies that would later suffer severe abnormalities. "Clinicians and high-risk pregnant women should be aware of this research so that we can avoid the escalation of pre-term birth and save more babies' lives."
Source
***************************
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?
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, January 14, 2006
BRITISH NHS JUST GOES ROUND IN CIRCLES
The Government's latest NHS reforms have been savaged by a Commons select committee, which describes them as ill-judged and unlikely to improve healthcare. The risks of the changes are high and there is little evidence that the costs will be outweighed by the benefits, says the Helath Select Committee in an attack on changes to primary care trusts (PCTs) that were introduced in July. "The cycle of perpetual change is ill-judged and not conducive to the successful provision and improvement of health services," the committee's report concludes. "Major restructuring should only be undertaken if there is an overwhelming argument in its favour; in this case there is not."
The report addresses changes to PCTs that were announced in a circular to the NHS by its chief executive, Sir Nigel Crisp. The trusts, established in 2002, were given the task of commissioning NHS services: identifying what patients needed, planning how this should be provided, allocating resources and buying operations in hospitals. There are 302 PCTs, which the new policy plans to cut to 100 or fewer. Sir Nigel's letter also said that the trusts should stop providing services themselves, such as community nurses, and that commissioning should be done by GP practices - a throwback to GP fundholding under the Conservatives.
At the time, analysts were shocked by the scale of the changes and the abrupt abandonment of the trusts as the driving force of the NHS. One reason for the changes was a promise made during the election campaign to save 250 million pounds by cutting bureaucracy. The changes were "clumsy and cavalier", the select committee said, and six months later it was still not clear what the policy actually was. Staff morale had fallen, and there was a risk of the fragmentation of community services, it said. The committee found that it took an average of 18 months for organisations to "recover" after restructuring. That is the time it takes to bring performance back to its previous level. "Thus, just as the benefits of PCTs are about to be realised, the Government has decided to restructure them." Instead, ministers should have allowed the trusts "to develop organically, and adopt a managed approach to sharing best practice in commissioning". They added: "This would avoid the hugely disruptive and costly impact of another root-and-branch reform of the NHS."
Sir Nigel's letter had allowed for just 11 weeks to put together complex proposals, starting as many people went on holiday. This was "insufficient and flawed", the committee said. "As a result patients, local people, NHS staff, other NHS organisations, MPs, councillors and other key stakeholders have been unable to contribute meaningfully to the process." The irony was that, at the very moment Sir Nigel's letter appeared, Patricia Hewitt, the Health Secretary, was beginning what she claimed to be the largest consultation by the NHS to work out the future of care outside hospitals. Yet the results were largely anticipated, or negated, by the changes introduced by Sir Nigel, making a mockery of the whole expensive exercise.
Ms Hewitt has since told the Commons that district nurses, health visitors and other staff who work in the community would continue to be employed by the trusts, unless a decision were made locally by them. But this has failed to mollify the committee. It says: "The department must more carefully consider the impact of its proposals on its staff, which are its most valuable asset. Major changes to the NHS have large costs and should not be embarked upon lightly." It is not even clear that the changes will save 250 million pounds. "It is worth noting that only three years ago, when they were created, the Government thought PCTs good value for money," the report says.
Kevin Barron, chairman of the committee, said: "It is clear that there are lessons to be learnt. In particular, the Government must ensure that, in future, consultation on restructuring is fully inclusive right from the beginning of the process."
Ms Hewitt denied that the reform was "change for change's sake". She said: "We aim to create stronger and more effective PCTs which can secure the best possible health and healthcare, for all patients. We are responding to local wishes in many parts of the country to merge PCTs. These changes were well signalled, for example through the commitment in May 2005 to save o250 million from streamlining. "All the changes that are being made in the NHS are designed to achieve even better NHS services for patients. That is the goal and the test of everything that we do."
Source
Update:
I have just received from NHS Doctor the following comment on the above article:
"The merry-go-round of politically “inspired” changes in the NHS is absolutely bewildering for those of us working within it. The restructuring of the PCTs, and in particular the re-introducing of what used to be called “fund-holding” (Thatcher) but is now going to be called “commissioning” (Blair) is causing confusion all round, from administrators to doctors. We have recently been told we have a “choice matrix” of hospitals we can now refer to, but have received no information as yet as to the referral mechanisms. We are being buried in expensive gobble-de-gook".
***************************
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?
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.
***************************
The Government's latest NHS reforms have been savaged by a Commons select committee, which describes them as ill-judged and unlikely to improve healthcare. The risks of the changes are high and there is little evidence that the costs will be outweighed by the benefits, says the Helath Select Committee in an attack on changes to primary care trusts (PCTs) that were introduced in July. "The cycle of perpetual change is ill-judged and not conducive to the successful provision and improvement of health services," the committee's report concludes. "Major restructuring should only be undertaken if there is an overwhelming argument in its favour; in this case there is not."
The report addresses changes to PCTs that were announced in a circular to the NHS by its chief executive, Sir Nigel Crisp. The trusts, established in 2002, were given the task of commissioning NHS services: identifying what patients needed, planning how this should be provided, allocating resources and buying operations in hospitals. There are 302 PCTs, which the new policy plans to cut to 100 or fewer. Sir Nigel's letter also said that the trusts should stop providing services themselves, such as community nurses, and that commissioning should be done by GP practices - a throwback to GP fundholding under the Conservatives.
At the time, analysts were shocked by the scale of the changes and the abrupt abandonment of the trusts as the driving force of the NHS. One reason for the changes was a promise made during the election campaign to save 250 million pounds by cutting bureaucracy. The changes were "clumsy and cavalier", the select committee said, and six months later it was still not clear what the policy actually was. Staff morale had fallen, and there was a risk of the fragmentation of community services, it said. The committee found that it took an average of 18 months for organisations to "recover" after restructuring. That is the time it takes to bring performance back to its previous level. "Thus, just as the benefits of PCTs are about to be realised, the Government has decided to restructure them." Instead, ministers should have allowed the trusts "to develop organically, and adopt a managed approach to sharing best practice in commissioning". They added: "This would avoid the hugely disruptive and costly impact of another root-and-branch reform of the NHS."
Sir Nigel's letter had allowed for just 11 weeks to put together complex proposals, starting as many people went on holiday. This was "insufficient and flawed", the committee said. "As a result patients, local people, NHS staff, other NHS organisations, MPs, councillors and other key stakeholders have been unable to contribute meaningfully to the process." The irony was that, at the very moment Sir Nigel's letter appeared, Patricia Hewitt, the Health Secretary, was beginning what she claimed to be the largest consultation by the NHS to work out the future of care outside hospitals. Yet the results were largely anticipated, or negated, by the changes introduced by Sir Nigel, making a mockery of the whole expensive exercise.
Ms Hewitt has since told the Commons that district nurses, health visitors and other staff who work in the community would continue to be employed by the trusts, unless a decision were made locally by them. But this has failed to mollify the committee. It says: "The department must more carefully consider the impact of its proposals on its staff, which are its most valuable asset. Major changes to the NHS have large costs and should not be embarked upon lightly." It is not even clear that the changes will save 250 million pounds. "It is worth noting that only three years ago, when they were created, the Government thought PCTs good value for money," the report says.
Kevin Barron, chairman of the committee, said: "It is clear that there are lessons to be learnt. In particular, the Government must ensure that, in future, consultation on restructuring is fully inclusive right from the beginning of the process."
Ms Hewitt denied that the reform was "change for change's sake". She said: "We aim to create stronger and more effective PCTs which can secure the best possible health and healthcare, for all patients. We are responding to local wishes in many parts of the country to merge PCTs. These changes were well signalled, for example through the commitment in May 2005 to save o250 million from streamlining. "All the changes that are being made in the NHS are designed to achieve even better NHS services for patients. That is the goal and the test of everything that we do."
Source
Update:
I have just received from NHS Doctor the following comment on the above article:
"The merry-go-round of politically “inspired” changes in the NHS is absolutely bewildering for those of us working within it. The restructuring of the PCTs, and in particular the re-introducing of what used to be called “fund-holding” (Thatcher) but is now going to be called “commissioning” (Blair) is causing confusion all round, from administrators to doctors. We have recently been told we have a “choice matrix” of hospitals we can now refer to, but have received no information as yet as to the referral mechanisms. We are being buried in expensive gobble-de-gook".
***************************
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?
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, January 13, 2006
THERE ARE SOME THINGS THE BRITISH NATIONAL HEALTH CAN AFFORD
Despite vast financial deficits
A prisoner who had a sex change operation to become a woman is to undergo further surgery to become a man again.
John Pilley, currently known as Jane Anne, is in Holloway women's jail in North London. The prisoner made legal history in 1999 when he became the first inmate in England and Wales to be granted permission for a sex change operation. He is understood to have undergone the gender reassignment operation on the NHS in 2001 at an estimated cost of 15,000 pounds.
Pilley, 54, was moved from Gartree Prison, in Leicestershire, where he was serving life for attempted murder and kidnapping a female taxi driver, to Holloway, but after living in the female jail has decided to become a man again. He is waiting to have his second operation on the NHS, then will be transferred to a male prison.
Christine Burns, of Press for Change, a pressure group for transsexual rights, said: "Although it is not unheard of, it is very rare indeed for people to have regrets and want to change back." The surgery would be similar to that used for female-to-male transsexuals, she said.
Pilley underwent seven years of hormone treatment, after which he won the right to have a sex change operation. He was initially refused permission by the Prison Service to have the operation, but the service dropped its opposition after taking legal advice. He was allowed to wear women's clothing in his cell at night but wore men's clothes during the day. The Prison Service has refused to comment on the case
Source
Queensland Aged-care muddle
The article below does not even mention the vast bureaucratic maze that aged-care providers have to navigate in order to operate
A Queensland nursing home will employ overseas nurses to overcome a staffing crisis caused by a statewide shortage of up to 500 aged care nurses. The 60-bed facility at Yeppoon, which has tried for nine months to attract enough staff to open, yesterday received approval to hire four nurses from South Africa. [How big-hearted of the government!]
As well as the need to hire overseas staff, there are concerns Brisbane has an acute shortage of aged care beds. Aged care consultant Stan Manning said calculations based on State Government planning data showed another 7000 beds were needed. He said about 2000 places were needed on the southside, including some centres which were approved but had not yet opened, and a shortfall of 5000 beds on the northside. Mr Manning, the former head of Sydney's Wesley Mission, said it was taking longer for the elderly in Brisbane to find a place. "Most (northside) facilities have closed their waiting lists because they are now so long," he said. "It is taking people waiting for beds anywhere up to two to three years for a place to become available and be offered to them. "There is no doubt there is a problem because of the shortage of nursing staff right across Australia, but the situation is going to get dramatically worse. "Between now and 2021, there is going to be a 300 per cent increase in the number of people over the age of 80." .....
The staffing crisis has largely been blamed on the widening gap between what general and aged-care nurses are paid, a difference that has more than doubled in the past three years. The Federal Government boosted aged care funding last year but has been criticised for not ensuring the money was used to increase wages of aged care nurses, who are now paid on average $191.83 less than their hospital counterparts.
Despite that, however, Mr Gilkes said the shortage of aged care staff was not the biggest issue facing the aged health care industry. "To be honest, the biggest issue is actually finding land," he said. "You can't build a residential facility on an acre block. You need a reasonable tract of land, so that is the biggest issue in southeast Queensland." Queensland's 498 residential aged care homes care for 28,629 residents.
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. 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?
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.
***************************
Despite vast financial deficits
A prisoner who had a sex change operation to become a woman is to undergo further surgery to become a man again.
John Pilley, currently known as Jane Anne, is in Holloway women's jail in North London. The prisoner made legal history in 1999 when he became the first inmate in England and Wales to be granted permission for a sex change operation. He is understood to have undergone the gender reassignment operation on the NHS in 2001 at an estimated cost of 15,000 pounds.
Pilley, 54, was moved from Gartree Prison, in Leicestershire, where he was serving life for attempted murder and kidnapping a female taxi driver, to Holloway, but after living in the female jail has decided to become a man again. He is waiting to have his second operation on the NHS, then will be transferred to a male prison.
Christine Burns, of Press for Change, a pressure group for transsexual rights, said: "Although it is not unheard of, it is very rare indeed for people to have regrets and want to change back." The surgery would be similar to that used for female-to-male transsexuals, she said.
Pilley underwent seven years of hormone treatment, after which he won the right to have a sex change operation. He was initially refused permission by the Prison Service to have the operation, but the service dropped its opposition after taking legal advice. He was allowed to wear women's clothing in his cell at night but wore men's clothes during the day. The Prison Service has refused to comment on the case
Source
Queensland Aged-care muddle
The article below does not even mention the vast bureaucratic maze that aged-care providers have to navigate in order to operate
A Queensland nursing home will employ overseas nurses to overcome a staffing crisis caused by a statewide shortage of up to 500 aged care nurses. The 60-bed facility at Yeppoon, which has tried for nine months to attract enough staff to open, yesterday received approval to hire four nurses from South Africa. [How big-hearted of the government!]
As well as the need to hire overseas staff, there are concerns Brisbane has an acute shortage of aged care beds. Aged care consultant Stan Manning said calculations based on State Government planning data showed another 7000 beds were needed. He said about 2000 places were needed on the southside, including some centres which were approved but had not yet opened, and a shortfall of 5000 beds on the northside. Mr Manning, the former head of Sydney's Wesley Mission, said it was taking longer for the elderly in Brisbane to find a place. "Most (northside) facilities have closed their waiting lists because they are now so long," he said. "It is taking people waiting for beds anywhere up to two to three years for a place to become available and be offered to them. "There is no doubt there is a problem because of the shortage of nursing staff right across Australia, but the situation is going to get dramatically worse. "Between now and 2021, there is going to be a 300 per cent increase in the number of people over the age of 80." .....
The staffing crisis has largely been blamed on the widening gap between what general and aged-care nurses are paid, a difference that has more than doubled in the past three years. The Federal Government boosted aged care funding last year but has been criticised for not ensuring the money was used to increase wages of aged care nurses, who are now paid on average $191.83 less than their hospital counterparts.
Despite that, however, Mr Gilkes said the shortage of aged care staff was not the biggest issue facing the aged health care industry. "To be honest, the biggest issue is actually finding land," he said. "You can't build a residential facility on an acre block. You need a reasonable tract of land, so that is the biggest issue in southeast Queensland." Queensland's 498 residential aged care homes care for 28,629 residents.
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. 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?
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.
***************************
Thursday, January 12, 2006
AS GOVERNMENT INTERFERENCE GETS MORE PERVASIVE.....
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.
Source
***************************
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?
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.
***************************
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.
Source
***************************
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?
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.
***************************
Wednesday, January 11, 2006
A health bureaucracy that seems unable to do anything right
Queensland's hospital crisis has deepened, with the State Government accused of trying to shift the blame for the looming doctor shortage on to the Medical Board of Queensland. With emergency wards across the state under threat of closure as early as Monday, an urgent meeting will be held today on how to fast-track doctor job applications. Health Minister Stephen Robertson yesterday ordered the medical board to speed up its processing of medical accreditation to bring hundreds of new doctors into the system.
But the independent medical board hit back, accusing Mr Robertson's department of dumping more than 150 incomplete doctor applications on the board last Thursday. Opposition health spokesman Bruce Flegg said the Government had attempted to shift the blame for its own failings. When existing employment contracts expire on Monday, emergency departments around the state face staff shortages and some elective surgery may need to be postponed.
Representatives of the Australian College of Emergency Medicine yesterday met acting health director-general Terry Mehan to raise concerns about the impact of doctor shortages. They warned only three hospitals - the Princess Alexandra, Gold Coast and Townsville - had filled all their emergency department staff allocations. They also claimed their warnings about doctor shortages had been disregarded for months, and concerns about Caboolture Hospital - where the shortages are expected to be most severe - were still being ignored.
Mr Robertson yesterday revealed he had ordered the medical board to be more "efficient, prompt and welcoming" in its processing of applications for registration. In a letter to board executive officer Jim O'Dempsey last month, Mr Robertson said delays in processing registrations were hindering the Queensland Health recruitment campaign. The Minister also demanded reports on how many applications had been delayed, and how an additional $3.7 million in funding allocated as part of the health reform process had been spent. Mr Robertson told The Courier-Mail the more stringent checks introduced in the wake of the Jayant Patel scandal in Bundaberg had created delays, but said there should be "no diminution of the standards that we have put in place" in fast-tracking the registrations.
Mr O'Dempsey accepted there had been some delays in registering doctors, "but this is necessary to ensure that doctors who are registered aren't frauds". He said Queensland Health had provided its "priority list" for registrations only last week - less than two weeks before the January 16 deadline - and many of the applications were incomplete. Of the 220 doctors identified, 91 had not supplied sufficient information and 68 had not lodged applications at all.
Mr Robertson said he had not been told of any problems with the quality of information being supplied to the board by his department. "The medical board haven't given the courtesy of alerting me to that particular issue, if in fact it did occur," he said.
Source
***************************
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?
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.
***************************
Queensland's hospital crisis has deepened, with the State Government accused of trying to shift the blame for the looming doctor shortage on to the Medical Board of Queensland. With emergency wards across the state under threat of closure as early as Monday, an urgent meeting will be held today on how to fast-track doctor job applications. Health Minister Stephen Robertson yesterday ordered the medical board to speed up its processing of medical accreditation to bring hundreds of new doctors into the system.
But the independent medical board hit back, accusing Mr Robertson's department of dumping more than 150 incomplete doctor applications on the board last Thursday. Opposition health spokesman Bruce Flegg said the Government had attempted to shift the blame for its own failings. When existing employment contracts expire on Monday, emergency departments around the state face staff shortages and some elective surgery may need to be postponed.
Representatives of the Australian College of Emergency Medicine yesterday met acting health director-general Terry Mehan to raise concerns about the impact of doctor shortages. They warned only three hospitals - the Princess Alexandra, Gold Coast and Townsville - had filled all their emergency department staff allocations. They also claimed their warnings about doctor shortages had been disregarded for months, and concerns about Caboolture Hospital - where the shortages are expected to be most severe - were still being ignored.
Mr Robertson yesterday revealed he had ordered the medical board to be more "efficient, prompt and welcoming" in its processing of applications for registration. In a letter to board executive officer Jim O'Dempsey last month, Mr Robertson said delays in processing registrations were hindering the Queensland Health recruitment campaign. The Minister also demanded reports on how many applications had been delayed, and how an additional $3.7 million in funding allocated as part of the health reform process had been spent. Mr Robertson told The Courier-Mail the more stringent checks introduced in the wake of the Jayant Patel scandal in Bundaberg had created delays, but said there should be "no diminution of the standards that we have put in place" in fast-tracking the registrations.
Mr O'Dempsey accepted there had been some delays in registering doctors, "but this is necessary to ensure that doctors who are registered aren't frauds". He said Queensland Health had provided its "priority list" for registrations only last week - less than two weeks before the January 16 deadline - and many of the applications were incomplete. Of the 220 doctors identified, 91 had not supplied sufficient information and 68 had not lodged applications at all.
Mr Robertson said he had not been told of any problems with the quality of information being supplied to the board by his department. "The medical board haven't given the courtesy of alerting me to that particular issue, if in fact it did occur," he said.
Source
***************************
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?
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, January 10, 2006
Spin doctor numbers surge
Queensland Health has been accused of being more interested in spin doctors than real doctors after a major expansion in its public relations staff in recent years. Figures provided to Parliament show the department has increased the size of its public relations and media management staff three times faster than it expanded its medical workforce. But the Government has defended the PR staff, saying they keep local communities informed of what's happening at their hospitals.
Health Minister Stephen Robertson told Parliament the number of full-time public relations and communications staff employed by the department grew from 32.05 in 2001-02 to 46.62 in December last year - an increase of more than 45 per cent. By contrast, annual reports tabled to Parliament show the medical workforce grew by just 14.43 per cent between 2001-02 and last year.
The number of nurses employed by Queensland Health grew by just 3.87 per cent over the four years, and the number of specialists retained as visiting medical officers actually fell by 17.7 per cent. The total health workforce expanded by 6.8 per cent over the period.
The cost of paying Queensland Health's PR professionals is this year expected to top $3 million for the first time on record, with a total wages bill of around $12 million since 2001-02. The department is now advertising a $100,000-per-year position for a director of public affairs in its corporate office. Mr Robertson said most of the PR staff were hospital-based information officers, and the number of public affairs staff in Queensland Health's head office had actually fallen from 20 to 14 as part of the health system reform process.
Liberal leader Bob Quinn, who asked Mr Robertson to provide the figures, said the results showed the Government's obsession with influencing public opinion on health rather than actually fixing the system. "What these trends show is that the Beattie Labor Government is more interested in protecting its own political hide than it is the health of Queenslanders," Mr Quinn said.
Source
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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?
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.
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Queensland Health has been accused of being more interested in spin doctors than real doctors after a major expansion in its public relations staff in recent years. Figures provided to Parliament show the department has increased the size of its public relations and media management staff three times faster than it expanded its medical workforce. But the Government has defended the PR staff, saying they keep local communities informed of what's happening at their hospitals.
Health Minister Stephen Robertson told Parliament the number of full-time public relations and communications staff employed by the department grew from 32.05 in 2001-02 to 46.62 in December last year - an increase of more than 45 per cent. By contrast, annual reports tabled to Parliament show the medical workforce grew by just 14.43 per cent between 2001-02 and last year.
The number of nurses employed by Queensland Health grew by just 3.87 per cent over the four years, and the number of specialists retained as visiting medical officers actually fell by 17.7 per cent. The total health workforce expanded by 6.8 per cent over the period.
The cost of paying Queensland Health's PR professionals is this year expected to top $3 million for the first time on record, with a total wages bill of around $12 million since 2001-02. The department is now advertising a $100,000-per-year position for a director of public affairs in its corporate office. Mr Robertson said most of the PR staff were hospital-based information officers, and the number of public affairs staff in Queensland Health's head office had actually fallen from 20 to 14 as part of the health system reform process.
Liberal leader Bob Quinn, who asked Mr Robertson to provide the figures, said the results showed the Government's obsession with influencing public opinion on health rather than actually fixing the system. "What these trends show is that the Beattie Labor Government is more interested in protecting its own political hide than it is the health of Queenslanders," Mr Quinn said.
Source
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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?
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.
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Monday, January 09, 2006
CALIFORNIA'S EXTENSIVE HEALTH CARE FOR FREE-RIDERS
In our hopelessly PC world, we aren't supposed to talk about illegal immigrants. But let's be bad and do it anyway. This proposal diverts most of the $2.1 billion tax to emergency-room care and to health coverage for children -- two services that, in California, provide outsized assistance to illegal immigrants...
California already pours vast sums into free health insurance for children. We are probably the most generous state, offering Healthy Families and other programs to families who need not even be poor. You can earn around $50,000 and get Healthy Families coverage as good as a private plan, and you don't need to be in the state legally. John Graham, director of health-care studies for the fiscally conservative Pacific Research Institute in San Francisco, tells me: "If your child hasn't got health care in California, you are a negligent parent. There are 900,000 children who qualify for Health Families and other programs. ... They are eligible, but still not enrolled due to parents' inattentiveness, laziness, or the feeling that the kids are healthy so they don't give a hoot." Smokers should take the hit for this? Graham, who will soon release a study of California insurance, says "The number of children not insured, who are not eligible, is probably very, very close to zero in California. We don't have a crisis of coverage here. We have a crisis of parents not taking appropriate parental action."
The other sneak feature of the proposed $2.1 billion tax is its intent to spend vast sums on ER care -- a staggering $902 million each year. As Graham notes, "If this were a rational tax, it would go to programs on smoking cessation and curing lung cancer. But it is not rational. The overuse of emergency rooms in California -- the use of the system is highly biased toward illegal immigrants and not toward smokers."
Illegal immigrants badly overuse ERs instead of tapping into often-free health-care clinics or finding a family doctor. Their behavior cries out for reform, not encouragement. California should spend dough to educate immigrant families to stop using costly ERs as a replacement for the family doctor. Again, we are not supposed to talk like this. But if the misuse of the ER system ended, we'd quickly discover that taxpayers are pouring more than enough into California ER care, and people with true emergencies would be far better served.
More here
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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?
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.
***************************
In our hopelessly PC world, we aren't supposed to talk about illegal immigrants. But let's be bad and do it anyway. This proposal diverts most of the $2.1 billion tax to emergency-room care and to health coverage for children -- two services that, in California, provide outsized assistance to illegal immigrants...
California already pours vast sums into free health insurance for children. We are probably the most generous state, offering Healthy Families and other programs to families who need not even be poor. You can earn around $50,000 and get Healthy Families coverage as good as a private plan, and you don't need to be in the state legally. John Graham, director of health-care studies for the fiscally conservative Pacific Research Institute in San Francisco, tells me: "If your child hasn't got health care in California, you are a negligent parent. There are 900,000 children who qualify for Health Families and other programs. ... They are eligible, but still not enrolled due to parents' inattentiveness, laziness, or the feeling that the kids are healthy so they don't give a hoot." Smokers should take the hit for this? Graham, who will soon release a study of California insurance, says "The number of children not insured, who are not eligible, is probably very, very close to zero in California. We don't have a crisis of coverage here. We have a crisis of parents not taking appropriate parental action."
The other sneak feature of the proposed $2.1 billion tax is its intent to spend vast sums on ER care -- a staggering $902 million each year. As Graham notes, "If this were a rational tax, it would go to programs on smoking cessation and curing lung cancer. But it is not rational. The overuse of emergency rooms in California -- the use of the system is highly biased toward illegal immigrants and not toward smokers."
Illegal immigrants badly overuse ERs instead of tapping into often-free health-care clinics or finding a family doctor. Their behavior cries out for reform, not encouragement. California should spend dough to educate immigrant families to stop using costly ERs as a replacement for the family doctor. Again, we are not supposed to talk like this. But if the misuse of the ER system ended, we'd quickly discover that taxpayers are pouring more than enough into California ER care, and people with true emergencies would be far better served.
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. 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?
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, January 08, 2006
Viruses to blame for palsy in babies
Doctors sued for delivering babies with cerebral palsy may have been wrongly accused of medical negligence, with new research showing a virus in the womb, rather than oxygen starvation, is to blame in most cases.
The findings raise the prospect of a vaccination to cut the rate of cerebral palsy but also have the potential to slash the estimated $100 million a year that is paid out in medical negligence settlements. About 600 Australian babies are born each year with the debilitating brain and motor disorder, which has traditionally been attributed to birth asphyxia - a lack of oxygen caused by improper delivery.
However, a study of 443 Australian children with cerebral palsy and 883 babies without the condition has found that exposure to viruses before and directly after birth can trigger the disorder, which can affect movement, sight, hearing, perception and learning.
Alastair Maclennan, leader of the South Australian Cerebral Palsy Research Group, which published the work in the British Medical Journal, said the findings proved that cases of cerebral palsy should not be dealt with by courts. "Judgments are made in total ignorance," he said. "(Cerebral palsy) is very rarely due to birth asphyxia." Professor Maclennan, an obstetrician and gynaecologist based at the University of Adelaide, criticised "rogue expert witnesses" for swaying courts. "It's always possible to find hired-gun expert witnesses, usually retired, who say that if they'd delivered the baby a half-hour earlier, there would be no cerebral palsy."
The strongest link to cerebral palsy was found with herpes group B viruses, which include varicella zoster, the virus responsible for chicken pox and shingles. The risk of the condition almost doubled with exposure to these viruses. In Australia, medical negligence cases brought when babies are born with cerebral palsy cost more than $100 million a year. One such case in 2001 attracted the nation's biggest medical negligence payout of $14.2million. NSW woman Calandre Simpson was awarded the payout after she sued obstetrician Robert Diamond for a botched forceps delivery. Her payment, reduced to $11 million on appeal, revealed the vulnerability of the medical insurance industry. Months later, her medical indemnity provider, United Medical Protection, went into provisional liquidation.
Professor Maclennan said the fear of lawsuits was driving obstetricians out of the field and forcing maternity ward closures. Australian Medical Association medical indemnity chairman Andrew Pesce said: "Hopefully, as more and more evidence like this stacks up, fewer doctors will be successfully sued for negligence in cerebral palsy cases."
Source
***************************
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?
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.
***************************
Doctors sued for delivering babies with cerebral palsy may have been wrongly accused of medical negligence, with new research showing a virus in the womb, rather than oxygen starvation, is to blame in most cases.
The findings raise the prospect of a vaccination to cut the rate of cerebral palsy but also have the potential to slash the estimated $100 million a year that is paid out in medical negligence settlements. About 600 Australian babies are born each year with the debilitating brain and motor disorder, which has traditionally been attributed to birth asphyxia - a lack of oxygen caused by improper delivery.
However, a study of 443 Australian children with cerebral palsy and 883 babies without the condition has found that exposure to viruses before and directly after birth can trigger the disorder, which can affect movement, sight, hearing, perception and learning.
Alastair Maclennan, leader of the South Australian Cerebral Palsy Research Group, which published the work in the British Medical Journal, said the findings proved that cases of cerebral palsy should not be dealt with by courts. "Judgments are made in total ignorance," he said. "(Cerebral palsy) is very rarely due to birth asphyxia." Professor Maclennan, an obstetrician and gynaecologist based at the University of Adelaide, criticised "rogue expert witnesses" for swaying courts. "It's always possible to find hired-gun expert witnesses, usually retired, who say that if they'd delivered the baby a half-hour earlier, there would be no cerebral palsy."
The strongest link to cerebral palsy was found with herpes group B viruses, which include varicella zoster, the virus responsible for chicken pox and shingles. The risk of the condition almost doubled with exposure to these viruses. In Australia, medical negligence cases brought when babies are born with cerebral palsy cost more than $100 million a year. One such case in 2001 attracted the nation's biggest medical negligence payout of $14.2million. NSW woman Calandre Simpson was awarded the payout after she sued obstetrician Robert Diamond for a botched forceps delivery. Her payment, reduced to $11 million on appeal, revealed the vulnerability of the medical insurance industry. Months later, her medical indemnity provider, United Medical Protection, went into provisional liquidation.
Professor Maclennan said the fear of lawsuits was driving obstetricians out of the field and forcing maternity ward closures. Australian Medical Association medical indemnity chairman Andrew Pesce said: "Hopefully, as more and more evidence like this stacks up, fewer doctors will be successfully sued for negligence in cerebral palsy cases."
Source
***************************
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?
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.
***************************
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