British parents have 90 days to raise £250,000 for cancer treatment to save son
That's socialized medicine at work for you. Big talk, very limited action. No funds even to save a kid's life. And how odd that the best treatment is in America!
The parents of Jamie Inglis, 4, have been told his only hope is expensive treatment in the US which is only available privately and has to be administered within three months of the end of his chemotherapy. Jamie has been diagnosed with an aggressive form of the childhood cancer neuroblastoma, which began with a tumour on his kidney and spread to the rest of his body.
He has had eight sessions of chemotherapy and went through a seven-hour operation to remove the infected kidney, but his cancer is so virulent he is still expected to relapse, which could kill him. However, a new treatment developed in America could help save him. Doctors say it must be administered within 90 days to reduce his chances of relapsing.
Jamie's father John, 37, an environmental health officer for the Royal Medical Corps, was due to be posted to Afghanistan until he and wife Vicky, 34, a teacher, received the news about their young son in April. He said: "After his final treatment yesterday he has a 90 day window to receive the antibody. Children who have received it so far have shown a rapid improvement and it greatly reduces the chance of a relapse. "His body is so fragile after all the chemotherapy and surgery that a relapse would probably be fatal for him."
Recalling Jamie's diagnosis, he said: "One of the many problems with this form of cancer is the symptoms are so subtle. We noticed Jamie would sweat in the night and seemed tired but he didn't seem too serious until he was taken ill at nursery. "He was taken to his GP who referred him to hospital and we were told he had this rare and aggressive form of cancer. You feel like you have been stabbed in the chest. Just a few days earlier he had been happy and playing at his friend's birthday party. "You just want to curl up in a ball and hope it all goes away. He started chemotherapy within a week and has had regular monthly bouts of chemotherapy since he was diagnosed, as well as having one of his kidneys removed."
The antibody treatment is only available at a cancer hospital in New York and, because it is so new, it is expensive only available privately.
Mr Inglis said: "Hopefully in a few years time this treatment will be far more readily available and much cheaper to children like Jamie suffering from neuroblastoma. But that's obviously too late for him." The family, who also have a five-month-old daughter called Poppy, live near Düsseldorf in Germany, where John has been working.
John added: "Jamie is in good spirits and always has been. The one thing that has kept us going is the fact that he is always smiling. He earned the nickname Prince Charming from the nurses at the hospital, he's so cheery and belligerent. "The military community have been fantastic but we need to raise this £250,000. It's a lot of money but we have to do it, anything to give Jamie a better chance of life."
Increase in diabetes patients having limbs amputated
The increase in amputations has almost doubled over a 10 year period with up to 100 patients a week losing a leg to complications of the disease. The number of people diagnosed with type-two diabetes the type caused by obesity - has increased greatly in the past decade, which could partly explain the findings, according to researchers. But doctors believe that with better care up to 80 per cent of amputations could be avoided.
Major amputations, above the ankle joint, have risen by 43 per cent and the average age of those having above-ankle amputations fell from 71 to 69 years, which followed the pattern of more people being diagnosed younger.
Dr Eszter Vamos, from Londons Imperial College, who led the study, said they had expected to see long-term complications of diabetes rising because the number of people diagnosed with the condition had increased. "But at the same time there is very strong evidence that you can prevent up to 80 per cent of the amputations.
Along with complications such as heart attacks and strokes, people with diabetes are far more likely to develop foot problems, including ulcers, which can become infected and lead to gangrene. Researchers believe that better checks by doctors and awareness of symptoms by patients could reduce the need for amputation.
The findings in the journal Diabetes Research and Clinical Practice - highlight the importance of frequent foot checks and getting control of blood sugar levels, blood pressure and cholesterol."
Diabetes UK said more early diagnosis was needed, as diabetes could go undetected for more than 10 years and most people already had complications when they were diagnosed. The charity also said too many people with diabetes are walking barefoot around their houses. It warned that diabetes sufferers are at risk of damage to their feet caused by them being numb, a complication of the disease. Damage can lead to foot ulcers and slow- healing wounds which, if they become infected, can result in amputation. Podiatrists recommend that people with diabetes should always wear slippers around the home to reduce the risk of foot injuries.
Caroline Butler, care adviser at Diabetes UK, said: "It's appalling that thousands of people with diabetes in the UK undergo lower limb amputations every year. We want to help reduce that number by getting people with diabetes to wear suitable slippers at home.
Rasmussen's health-care polling results since Senate Majority Leader Harry Reid orchestrated the Christmas Eve vote are full of undeniably bad news for Democrats. In roughly ascending order of bad news (if one is a Democrat)...
Likely voters oppose Obamacare by more than the (18-point) margin by which Ronald Reagan beat Walter Mondale: 58 percent to 39 percent.
There are far more likely voters who "strongly" oppose Obamacare (46 percent) than there are likely voters who support it even "somewhat" (39 percent).
Only 24 percent of likely voters think that the quality of health care would get better under Obamacare, while 54 percent think it would get worse -- a gap of 30 percent.
Only 13 percent of likely voters think that the cost of health would go down under Obamacare, while 63 percent think it would rise -- a gap of 50 percent.
Seniors oppose Obamacare by more than 2 to 1: 63 percent to 31 percent.
And the worst news of all for Democrats...
Independents oppose Obamacare by the head-turning tally of 66 percent to 28 percent.
Lest Democrats try to console themselves with the thought that perhaps Rasmussen has got it wrong, CNN's latest poll, from just a few days before the Christmas Eve vote, showed Americans opposing Obamacare by a similar tally: 56 percent to 42 percent.
In light of these numbers -- and in light of the extreme difficulty that the Democrats had in squeezing a bill tailor-made for the House through the House, and one tailor-made for the Senate through the Senate -- anyone who thinks that either the passage or the subsequent implementation of Obamacare is anything remotely resembling inevitable, is forgetting that Tocqueville's book wasn't called Monarchy in America.
New reasons emerge almost daily as to why Obamacare can and must be defeated.
1. The American people oppose Obamacare by almost 2 to 1 in the latest CNN poll. Other polls show lopsided opposition to passing either the Senate or House health-care bill.
Public opinion is against the bill because of its obscene costs in higher taxes, burdensome debt, anti-freedom mandates, rationing, and reduced care for seniors. The American people have awakened to the fact that Obamacare is transformational legislation that will drag us against popular will into European-style Socialism.
2. The Democrats' double-counting of Obamacare's financial benefits has been exposed as a colossal lie. Harry Reid told the Senate that his bill strengthens our future by both "cutting our towering national deficit by as much as $1.3 trillion over the next 20 years" AND "strengthening Medicare and extending its life by nearly a decade."
The Congressional Budget Office (CBO) refuted that assertion. CBO said the claim that Obamacare would provide these benefits simultaneously "would essentially double-count a large share of those savings and thus overstate the improvement in the government's fiscal position."
3. Obamacare is unconstitutional because of its mandate that all individuals must carry "approved" health insurance, and all businesses must give health insurance to their employees whether or not the company can afford it. "Universal" coverage will be enforced by the Internal Revenue Service with power to punish those who don't have such a plan.
Constitutional lawyers point out that the Commerce Clause does not give Congress the authority to force Americans to buy health insurance as a condition of living in our country because personal health insurance is not "commerce." The CBO wrote that "a mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action"; the Supreme Court has never upheld any requirement that an individual must participate in economic activity.
4. Since the Senate bill imposes sharp limits on health-insurance companies' ability to raise fees or exclude coverage, it likely will force many of them out of business. Obamacare is unconstitutional because it violates the Bill of Rights protections against takings without just compensation and deprivation of property without due process of law.
5. Other Obamacare provisions blatantly legislate racial and other forms of discrimination. The U.S. Commission on Civil Rights sent two letters to the President and congressional leaders warning about the obnoxious requirements for racist and sexist quotas.
The Senate bill requires that "priority" for federal grants be given to institutions offering "preferential" admissions to minorities (race, national origin, sex, sexual orientation, and religion). Institutions training social workers, psychologists, psychiatrists, behavioral pediatricians, psychiatric nurses, and counselors will be ineligible for federal grants unless they enroll "individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations."
6. Obama's claim that "everybody" will now be covered creates few winners but lots of losers. Universal health insurance will be achieved by forcing young people to pay the additional costs (insurance for the youngest third of the population would rise by 35 percent), and by restricting and rationing care for the elderly.
7. According to Robert Samuelson in the Washington Post, the "wild card is immigration." From 1999 to 2008, 60 percent of the increase in the uninsured occurred among Hispanics, and Obama's refusal to close our borders will make this problem more costly every year.
8. Obamacare gives Medicare bureaucrats the power to ration health care by forcing doctors to prescribe cheaper medical devices and drugs. In the recent case of Hays v. Sebelius, the court ruled that Medicare doesn't have the right to make this rule, but Obamacare takes jurisdiction away from the courts to hear any appeal from decisions of the new Medicare Commission.
The "stick" applied to primary-care doctors is imposing financial penalties if they refer too many patients to specialists. The "carrot" is financial rewards to doctors who give up small practices and consolidate into larger medical groups or become salaried employees of hospitals or other large institutions.
9. The Senate bill contains at least a dozen of what can be described as bribes. Senator Mary Landrieu received a $300 million increase in Medicaid funding for her state (known as the Second Louisiana Purchase), and a $100 million bribe to Senator Ben Nelson gives Nebraska a permanent exemption from the costs of Medicaid expansion.
10. The Senate bill even has a four-page section artfully written to enable ACORN to get federal health-care grants. This section describes grant recipients as "community and consumer-focused nonprofit groups" having "existing relationships ... with uninsured and underinsured consumers."
It seems inevitable that the government will grab the remains of “private” medical care, so I will look at our medical futures. One development will be the implementation of the infamous “death panels” that socialists swear are a figment of the imaginations of paranoid persons like Sarah Palin.
For example, I received emails from the religious left-wing organization “Sojourners,” which declared that Palin was lying when she made the comment last August 7 in her Facebook page that declared:
The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.
In the ensuing firestorm, the New York Times called it a “false rumor,” and the “fact checkers” at the Politifact website named her statement the “Lie of the Year.” Kate Snow of ABC News said the claim was “shocking” and “inflammatory.”
Neither the House nor the Senate bills use the phrase “death panels,” but that is not surprising. None of the other countries that have socialist care actually have committees with that name. However, the “death panel” mentality certainly exists, and it exists precisely because socialist medical care exists not for care of individuals, but rather to enforce larger egalitarian political goals.
Ironically, the New York Times provides the “smoking gun” to the egalitarian mentality that leads to the “death panels” route. The paper last year carried a story about a British woman, Debbie Hirst, who suffered from cancer, but could not receive the medications she needed because the National Health Service declared them too costly.
Hirst decided to raise the money herself by selling her house, but the government said that if she did that, then it would not pay for any of her care:
Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.
Patients “cannot, in one episode of treatment, be treated on the N.H.S. and then allowed, as part of the same episode and the same treatment, to pay money for more drugs,” the health secretary, Alan Johnson, told Parliament.
“That way lies the end of the founding principles of the N.H.S.,” Mr. Johnson said.
In other words, unless one can justify one’s treatment under larger socialist purposes, then the government will be happy to let someone die, for enforced egalitarianism trumps actual care. This is not something new. Writing in the November 1993 Freeman, Dr. Jane Orient noted that government medical “cost containment” is another term for denying care:
The global budgeters “contain costs”—ration health care by denying those things that you do need insurance to pay for: heart surgery, radiation treatments for cancer, hip replacements, things like that. Out of “compassion,” reformers may open another exit: the one that leads to the cemetery. Do you think it’s accidental that euthanasia and “universal access” are on the agenda at the same time?
Thomas Sowell is correct. Entrepreneurs lower real costs by finding ways to create more goods and using fewer resources. Governments “lower” costs via raw force or denying medical care, and if a person offers to pay for the care, well, that defeats the real purpose of socialism. Yet, we are told that private entrepreneurship in medical care is evil and medical socialism is good. People who accept such things as being true also will endorse the presence of “death panels,” even while denying that the panels exist.
In the spirit of the Christmas season, let me offer up the following analogy for why health care reform, as envisioned by congressional Democrats, won't work.
Imagine that you're a child and you wake up on Christmas morning. Instead of that bike you wanted, there's a note under the tree saying that a lot of kids want bikes and the elves' workshop is backlogged for years. Don't worry -- you're guaranteed to get a bike, but Santa says that unfortunately he can't tell you where or when you might finally get that bike you're owed. Here's the part where my festive analogy breaks down: If you don't get that bike soon, you might die.
That's the problem with Democrats' health care legislation in a nutshell. It promises coverage for millions of Americans, but a government IOU is a far cry from seeing a doctor when you need one. And yet, the Senate health care legislation promises to expand Medicaid coverage to those making up to 133 percent of the federal poverty level. Do that would make 11 million more Americans dependent on a program that's already broken. The government can't compel doctors to treat Medicaid patients at fixed rates they dictate, at least not yet.
The policy outcome is Econ 101: Price controls always result in scarcity. Over half of all specialists in many major metropolitan areas are refusing to take on new Medicaid patients, according to a 2009 survey by Merritt Hawkins and Associates on physician wait times. "Medicaid is not widely accepted in most markets surveyed, in at least some of the medical specialties reviewed, and, in some cases, all of them," according to the survey.
The practical consequences of the government printing more health care IOUs than doctors can handle are horrifying. The Baltimore Sun recently reported that state auditors found 250 people out of the 17,000 people listed on the state's Medicaid waiting list are deceased. Other states have similarly outsized Medicaid backlogs of people desperate for medical care.
The worst part is that Democrats lean heavily on Medicaid as cost control mechanism in their health care legislation, even though they know it doesn't provide adequate care.
While hashing out the Senate's health care legislation, Democrats rejected a Republican amendment to increase Medicaid reimbursement rates to the same level as Medicare. It didn't pass. Democrats fought with a Republican president over expanding the State Children's Health Insurance Program (SCHIP) just a few years ago.
But Sen. Jay Rockefeller, D-W.V., a multi-millionaire oil scion, axed expanding SCHIP in favor of putting kids in Medicaid, cutting the price tag on the current legislation. The SCHIP program utilizes private insurance and costs more, but that also means there are many more doctors willing to treat kids with SCHIP coverage.
This is the same reason why the Democrats are gutting $122 billion out of the popular Medicare Advantage program. Medicare Advantage allows for private insurance through Medicare, and consequently it's more expensive. In 2003, there were 5.3 million Americans enrolled in Medicare Advantage. As of 2009, there were 10.2 million Americans enrolled in Medicare advantage -- including more than one-in-three Medicare recipients in New York and California. Why the explosion of people enrolled in Medicare advantage? More doctors take private insurance with better reimbursement rates. A 2008 report by the Medicare Payment Advisory Commission found 29 percent of Medicare patients have trouble finding a primary physician.
Health care for all Americans is a noble goal, but adding 11 million more Americans to an overtaxed Medicaid system is not the way to do it. For far too many Americans, the prospect of getting good health care through the government insurance is a lot like Santa Claus. It doesn't exist.
Lots of patients come out of British hospitals with malnutrition but more than £50 million spent on bids to improve hospital food has been wasted, according to a recent report
Researchers said 17 separate government initiatives since 2000 had resulted in no discernable improvement in the quality of meals served to patients and a change in the law was needed. Alex Jackson, from the Good Food for our Money campaign which published the report, said the initiatives had been a missed opportunity. He said: "The Government has led us into an expensive ground hog day to improve hospital food and seems incapable of learning from past mistakes.
"One billion meals are served by public sector institutions every year, paid for by taxpayers' money. This huge amount of food provides a unique opportunity to improve health and encourage more sustainable farming. Yet the Government has failed to seize this opportunity, and continues to spend our money on issuing weak voluntary schemes and yet more 'guidance' to public sector caterers, who are given no incentive to take action."
The authors of the report, called A Decade of Hospital Food Failure, want to see the introduction of legal standards guaranteeing the quality of the food and its environmental benefits.
Among the schemes criticised was the £40 million Better Hospital Food Initiative which was launched in 2001, headed by former Masterchef host Loyd Grossman, before being scrapped five years later. It set a target for all hospitals to introduce at least three new meals from its menu, but figures from the Hospital Caterers Association found after five years a quarter of NHS trusts had failed to introduce a single dish.
The report also quoted researchers from Bournemouth University who tested the quality of food in hospitals earlier this year and found patients were often left "undernourished and hungry" and would be better fed in prison.
The Good Food for our Money campaign is organised by Sustain, a charity that campaigns for better food, whose members include Christian Aid, Friends of the Earth and the Wholesome Food Association.
NHS fraud investigations cost three times more than they recover
A fraud squad dedicated to detecting those cheating the National Health Service has cost three times as much money as it recovered, new figures have revealed. Over the last three years, the budget of the NHS Counter Fraud unit was £32.4 million, while the squad recovered £10.1 million. The figures, contained in a Parliamentary written answer obtained by the Liberal Democrats, also show that fewer than 200 convictions were secured.
Norman Lamb, the party’s health spokesman, said that the unit was failing to deliver value for money. He added: “Tackling fraud and ensuring that every penny spent by the NHS can be accounted for is a vital task. There must be serious question marks over whether this unit is working effectively. “It is clear from these figures that the current approach isn’t working.
The NHS needs to work more closely with the police to tackle fraud at a local level and ensure that every penny possible goes to frontline services. “These figures raise serious questions about whether a dedicated NHS Counter Fraud Unit is the best way to tackle this complex issue. We need an urgent review of how fraud is investigated.”
Fraud is estimated to cost the NHS £115 million a year.
Surprise: NYT Discovers Spending Money on Frail Elderly Not Always Useless
After a year of front-page stories pushing not so subtly for reductions in “costly” end of life care for the old and “frail” (as a precursor for the kind of universal health care the editors favor) reporter Reed Abelson looked at the other side of the debate in a December 23 front-page piece from Los Angeles, an entry in the paper’s new “Months to Live“ series: “U.C.L.A. Medical Center at Heart of End-of-Life Debate.”
The Ronald Reagan U.C.L.A. Medical Center, one of the nation’s most highly regarded academic hospitals, has earned a reputation as a place where doctors will go to virtually any length and expense to try to save a patient’s life.
“If you come into this hospital, we’re not going to let you die,” said Dr. David T. Feinberg, the hospital system’s chief executive.
Yet that ethos has made the medical center a prime target for critics in the Obama administration and elsewhere who talk about how much money the nation wastes on needless tests and futile procedures. They like to note that U.C.L.A. is perennially near the top of widely cited data, compiled by researchers at Dartmouth, ranking medical centers that spend the most on end-of-life care but seem to have no better results than hospitals spending much less.
Listening to the critics, Dr. J. Thomas Rosenthal, the chief medical officer of the U.C.L.A. Health System, says his hospital has started re-examining its high-intensity approach to medicine. But the more U.C.L.A.’s doctors study the issue, the more they recognize a difficult truth: It can be hard, sometimes impossible, to know which critically ill patients will benefit and which will not.
That distinction tends to get lost in the Dartmouth end-of-life analysis, which considers only the costs of treating patients who have died. Remarkably, it pays no attention to the ones who survive.
Take the case of Salah Putrus, who at age 71 had a long history of heart failure. After repeated visits to his local hospital near Burbank, Calif., Mr. Putrus was referred to U.C.L.A. this year to be evaluated for a heart transplant. Some other medical centers might have considered Mr. Putrus too old for the surgery. But U.C.L.A.’s attitude was “let’s see what we can do for him,” said his physician there, Dr. Tamara Horwich.
Indeed, Mr. Putrus recalled, Dr. Horwich and her colleagues “did every test.” They changed his medicines to reduce the amount of water he was retaining. They even removed some teeth that could be a potential source of infection. His condition improved so much that more than six months later, Mr. Putrus has remained out of the hospital and is no longer considered in active need of a transplant.
One certainly doesn't see admissions like this in the Times very often:
Indeed, U.C.L.A. and five other big California medical centers recently published their own research results with a striking conclusion: for heart failure patients, the hospitals that spend the most seem to save the most lives
Over the Christmas holiday lull, I saw one commenter support Obamacare on the purely utilitarian grounds that the government should do that which benefits the most people. I almost spit out my eggnog. Obamacare will actually harm most people to benefit the minority by reducing the level of medical care we now receive so that the minority can get greater access. I am not saying that is wrong–protecting minorities is usually a very worthy endeavor. But that statement just wasn’t true. For better or worse, the point of Obamacare is to provide less health care for more people, not better health care or more affordable health care.
None other than the liberal columnist Bob Herbert sees it and complains that union members will be hurt by that agenda in today’s New York Times. He writes against taxing so-called “Cadillac” insurance policies–most of which are enjoyed by union members, and reveals an important truth. From his column:
The bill that passed the Senate with such fanfare on Christmas Eve would impose a confiscatory 40 percent excise tax on so-called Cadillac health plans, which are popularly viewed as over-the-top plans held only by the very wealthy. In fact, it’s a tax that in a few years will hammer millions of middle-class policyholders, forcing them to scale back their access to medical care. Which is exactly what the tax is designed to do.
Precisely. And that “cost cutting” agenda is the law’s primarily thrust–which is why the expensive for whom to care will find themselves rationed out.
Moreover, since another primary purpose of the bill is to grant the government greater power over all our lives to promote the cultural agendas of the Left, Obamacare exacerbates the cuts to come by expanding the meaning of health care to encompass non medical things, like paying counselors visit the homes of families with small children. When the health care financing system pays for non health care services, it will mean, by definition, there will be less money to pay for the delivery of true medicine.
Why the Personal Mandate to Buy Health Insurance Is Unprecedented and Unconstitutional
Some excerpts from an extensive legal analysis of the interstate commerce clause and the Supreme Court's most expansive precedents
Executive Summary
A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States. An individual mandate would have two features that, in combination, would make it unique. First, it would impose a duty on individuals as members of society. Second, it would require people to purchase a specific service that would be heavily regulated by the federal government.[1]
This statement from a 1994 Congressional Budget Office Memorandum remains true today. Yet, all of the leading House and Senate health-care reform bills being debated in Congress require Americans to either secure or purchase health insurance with a particular threshold of coverage, estimated by CBO to cost up to $15,000 per year for a typical family.[2] This personal mandate to enter into a contract with a private health insurance company is enforced through civil and criminal tax penalties in section 501 of the House bill[3] and with a freestanding mandate and equally questionable civil tax penalties in sections 501 and 513 of the pending Senate bill.[4]
The purpose of this compulsory contract, coupled with the arbitrary price ratios and controls, is to require many people to buy artificially high-priced policies to subsidize coverage for others as well as an industry saddled with other government costs and regulations. Congress lawfully could enact a general tax to pay for these subsidies or it could create a tax credit for those who buy health insurance, but that would require Congress to "pay for" or budget for the subsidies in a conventional manner. The sponsors of the current bills are attempting, through the personal mandate, to keep the transfers entirely off budget or--through the gimmick of unconstitutional taxes or penalties they dub "shared responsibility payments"--make these transfers appear to be revenue-enhancing.
This "personal responsibility" provision of the legislation, more accurately known as the "individual mandate" because it commands all individuals to enter into a contractual relationship with a private insurance company, takes congressional power and control to a striking new level. Its defenders have struggled to justify the mandate by analogizing it to existing federal laws and court decisions, but their efforts do not withstand serious scrutiny. An individual mandate to enter into a contract with or buy a particular product from a private party, with tax penalties to enforce it, is unprecedented-- not just in scope but in kind--and unconstitutional as a matter of first principles and under any reasonable reading of judicial precedents.
Congress has a responsibility, pursuant to the oath of all Senators and Representatives, to determine the constitutionality of its own actions independently of how the Supreme Court has previously ruled or may rule in the future. But it is very unlikely that the Court would extend current constitutional doctrines, or devise new ones, to uphold this new and unprecedented claim of federal power.
Constitutional Overview
In reaction to states that were enacting trade barriers and violating the rights of their citizens, those who drafted and ratified the U.S. Constitution were determined both to constrain the powers of states and, at the same time, limit the power of Congress. They designed an ingenious system of checks and balances that divides state and federal authority in the hope of preventing any one government from exerting too much control over a free people.[5] To that end, the Constitution creates a national government with a legislature of limited and enumerated powers. Article I allocates to Congress "[a]ll legislative powers herein granted,"[6] which means that some legislative powers remain beyond Congress's reach. The Constitution's Necessary and Proper Clause similarly grants Congress the power "[t]o make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States, or in any department or officer thereof."[7]
The Supreme Court recognized and affirmed this fundamental principle from the earliest days of the republic, as Chief Justice Marshall famously observed: "The powers of the legislature are defined and limited; and that those limits may not be mistaken, or forgotten, the constitution is written."[8] And in his canonical opinion interpreting the Necessary and Proper Clause, Chief Justice Marshall insisted that "should Congress, under the pretext of executing its powers, pass laws for the accomplishment of objects not entrusted to the [national] government; it would become the painful duty of this tribunal, should a case requiring such a decision come before it, to say that such an act was not the law of the land."[9]
Nowhere in the Constitution is Congress given the power to mandate that an individual enter into a contract with a private party or purchase a good or service and, as this paper will explain, no decision or present doctrine of the Supreme Court justifies such a claim of power. Therefore, because this claim of power by Congress would literally be without precedent, it could only be upheld if the Supreme Court is willing to create a new constitutional doctrine. This memorandum explains why the two powers cited by supporters of this bill--the power of Congress to regulate interstate commerce and the power of Congress to tax--do not justify an individual mandate, even under the most expansive readings given these powers by the Supreme Court. In particular, this paper addresses four topics that have not yet been given adequate consideration by Congress and most, if not all, of the commentators:
First, most arguments, either favoring or opposing the individual mandate, do not discuss the Supreme Court's "class of activities" test, which it has applied in every relevant Commerce Clause case. This paper addresses this oversight and argues that, despite the broad congressional power to regulate interstate commerce, the individual mandate provision fails this test and is unlikely to survive the Court's review.
Second, this paper addresses the common, but mistaken, suggestion that a universal federal mandate to obtain health insurance is no different than a state requiring its licensed automobile drivers to have liability insurance for their injuries to others.
Third, this paper analyzes claims arising under the Taxing Clause. A preliminary review raises serious questions about the constitutionality of using the taxing power in this manner.
And finally, this paper explains why it is highly unlikely that the Supreme Court would break new constitutional ground to save this unpopular personal mandate.....
Conclusion
In theory, the proposed mandate for individuals to purchase health insurance could be severed from the rest of the 2,000-plus-page "reform" bill. The legislation's key sponsors, however, have made it clear that the mandate is an integral, indeed "essential," part of the bill.[54] After all, the revenues paid by conscripted citizens to the insurance companies are needed to compensate for the increased costs imposed upon these companies and the health care industry by the myriad regulations of this bill.
The very reason why an unpopular health insurance mandate has been included in these bills shows why, if it is held unconstitutional, the remainder of the scheme will prove politically and economically disastrous. Members need only recall how the Supreme Court's decision in Buckley v. Valeo--which invalidated caps on campaign spending as unconstitutional, while leaving the rest of the scheme intact--has created 30 plus years of incoherent and pernicious regulations of campaign financing and the need for repeated "reforms." Only this time, the public is aligned against a scheme that will require repeated unpopular votes, especially to raise taxes to compensate for the absence of the health insurance mandate.
These political considerations are beyond the scope of this paper, and the expertise of its authors. But Senators and Representatives need to know that, despite what they have been told, the health insurance mandate is highly vulnerable to challenge because it is, in truth, unconstitutional. And political considerations aside, each legislator owes a duty to uphold the Constitution.
It seems to be aiming to treat donations as part of what the government pays to hospitals -- so that it can reduce what it actually pays. So donations to a particular hospital will no longer benefit it and might as well not be made. Very socialist but incredibly stupid
Hundreds of millions of pounds of charity donations to hospitals are to be “nationalised” under an NHS accounting change, which critics say will make it easier to slash health budgets. Ministers are imposing new rules on NHS charities requiring all donations — including those to specialist children and cancer units, local fundraising campaigns, teaching hospitals and local community trusts — to be listed on a hospital’s balance sheet.
The Charities Commission says that this is “wholly inappropriate” because combining the trust and charity accounts will jeopardise the charity’s autonomy and discourage donations. About £330 million was given to 300 NHS charities in the year to June 2008, and they control an estimated £2 billion of assets. A spokeswoman for the Commission said: “The Charity Commission does not agree with the interpretation of the accounting rules in the Department of Health letter to NHS bodies. We are currently engaging with the Department on this matter.”
Charities also fear that the change, due to come into effect in April, will be used as a smokescreen to hide cuts in health spending, with ministers reducing funds for organisations such as children’s hospitals that have successful charitable arms. Jenny Willott, a Cabinet Office spokeswoman for the Liberal Democrats, said: “This could lead to hundreds of millions of pounds of charitable donations being effectively nationalised under the NHS. “The Government has no right to get its hands on any charitable NHS funds. People make donations on the understanding that it is up to charities to decide how to spend it, not ministers.”
A source at a leading hospital said that the rule change appeared entirely unreasonable and risked creating unnecessary budgetary pressures and distorted disparities between hospitals with different levels of fundraising ability.
Ministers were banned from counting charitable donations towards the central NHS budget under the original legislation that created the NHS in 1948. But this looks set to be reversed after the Treasury agreed to implement International Accounting Standard (IAS) 27. Now all NHS Trusts whose trustees have the “power to control” their charitable arm look likely to be forced to consolidate both sets of accounts in one. Estimates of the number of NHS charities affected vary between 30 and 300 organisations.
A Department of Health spokesman said: “The accounting rule does not change the fact that the deployment of all the monies donated remain the responsibility of the trustees.” The spokeswoman denied that the change would stop NHS charities from claiming Gift Aid.
The massive accounting blunder that should sink U.S. healthcare reform
Yesterday, David discussed the CBO's miscalculation regarding the Senate health care bill. Democrats had been insisting that bill somehow cut the deficit and strengthened Medicare, but as it turns out the CBO had to clarify that the savings of the bill were being double counted. The "savings" the bill produces either have to be applied toward the Medicare trust fund or they have to be put toward the cost of the legislation to make it reduce the deficit by $132 billion over the next ten years. (That's assuming you buy into the shady accounting tricks used to score the bill.) Megan McArdle has a typically astute blog post up discussing the implications all of this. Megan even observes that as recently as Saturday, President Obama was trumpeting the bill's twin achievements of deficit reduction and strengthening Medicare. However, Megan didn't quote Obama in full -- fortunately The American Spectator's Phil Klein did. The entirety of Obama's remarks in the immediate aftermath of Senate Democrats securing finally securing 60 votes to pass their health care bill are worth pondering:
"This bill with strengthen Medicare and extend the life of the program. Because it’s paid for and gets rid of waste and inefficiency in our health care system this will be the largest deficit reduction plan in over a decade. In fact, we just learned from the Congressional Budget Office that this bill will reduce our deficit by $132 billion over the first decade of the program, and more than one trillion dollars in the decade after that."
Well, we now know that whether it was an innocent mistake or fiscal prestidigtation, one of these claims is simply not true. Which is all the more reason you don't railroad an unpopular bill through in the middle of the night, as this episode proves conclusively that the Senate can't be trusted not to make mistakes involving literally hundreds of billions of dollars.
But the bottom line is that this is a massive, massive blunder and the President and the Senate Democrats need to come clean about it. They sold the American people, or tried to anyway, on specific promises regarding deficit reduction and preserving Medicare. Now they can't be sure of either of those promises. And Joe Taxpayer should probably be scared has heck about what else they've overlooked regarding the consequences of health care legislation.
If the President and Senate Democrats are serious about their repeated promises to produce health care reform that saves money in the long-term, then they're going to have to scrap what they've got and go back to the drawing board. But nothing in the way that health care legislation has been handled so far suggests that Democrats are hoping for anything other than a short-term, ego-driven legislative victory.
Like Mushrooms, Health Care 'Reform' Flourishes in the Dark
In a key scene in Frank Capra's 1939 film "Mr. Smith Goes to Washington," appointed senator (and unwitting pawn in a corruption scheme) Jefferson Smith, played by Jimmy Stewart, suggests to a colleague that perhaps it would be a good idea to read bills before voting on them. "The bills?" responds an incredulous Senator Paine, played by Claude Rains. "These bills are put together by legal minds after long study. I can't understand half of them myself, and I used to be a lawyer." Forget it, he tells Smith. "When the time comes, I'll advise you how to vote."
Never has art so closely mirrored life as with the mammoth 2,100-page health care bill passed by the Senate. "The result makes no sense whatsoever -- not to conservatives, not to liberals, not to anyone," accurately concludes the Weekly Standard. "Rather than reform a system that everyone agrees is a failure, it will subsidize that system and compel participation in it."
Many who have long touted health care reform are turning up their noses at the final product. Michael Bloomberg, New York's independent mayor, told "Meet the Press" over the weekend: "I have asked congressperson after congressperson. Not one can explain to me what's in the bill, even in the House version. Certainly not in the other version. And so for them to vote on a bill that they don't understand whatsoever, really, you've got to question how -- what kind of government we have."
Mr. Bloomberg added that his own reading of the Senate bill led him to conclude that it would blow a hole in the New York State budget and force closure of perhaps 100 health clinics.
It's no wonder Congress and the White House are so determined to hide their handiwork from the public while the House and Senate versions are "reconciled." President Obama has said the negotiations will take place in the West Wing and he will be actively involved. But when ABC's Jake Tapper asked White House Press Secretary Robert Gibbs about the president's campaign pledge to "have the [health care] negotiations televised on C-SPAN," Mr. Gibbs dodged the question and took refuge in his talking points, insisting that voters already "have a pretty good sense of who is battling on behalf of thousands of lobbyists that are trying to protect drugs profits and insurance profits, and who's fighting on behalf of middle-class Americans."
In other words, no one in the White House wants the public to be looking on as this Frankenstein monster is finally stitched together.
Enacting health-care legislation in the face of overwhelming public disapproval may cost the party its chance of forging a sustainable majority
Barack Obama emerged from his meeting with Senate Democrats this week to claim Congress was on the "precipice" of something historic. Believe him. The president is demanding his party unilaterally enact one of the most unpopular and complex pieces of social legislation in history. In the process, he may be sacrificing Democrats' chances at creating a sustainable majority.
Slowly, slowly, the Democratic health agenda is turning into a political suicide pact. Congressional members have been dragged along by momentum, by threat, by bribe, but mostly by the White House's siren song that it would be worse to not pass a bill than it would be to pass one. If that ever were true, it is not today.
Public opinion on ObamaCare is at a low ebb. This week's NBC-WSJ poll: A mere 32% of Americans think it a "good" idea. The Washington Post: Only 35% of independents support it—down 10 points in a month. Resurgent Republic recently queried Americans over the age of 55, aka Those Most Likely to Vote In a Midterm Election. Sixty-one percent believe ObamaCare will increase their health costs; 68% believe it will increase the deficit; 76% believe it will raise their taxes.
Democrats also have managed to alienate the liberal base to which they were catering. The death of the public option and Medicare buy-in this week sent Howard Dean to thundering "kill the bill." A week from now, the current polls might look good.
Yet it is in individual states where the disconnect between the White House's soothing words and the ugly political reality is most stark. While Democrats are under fire for the economy and spending, it is health care that has voters thinking it's time for political change.
Consider North Dakota. A recent Zogby poll showed 28% (you read that right) of state voters support "reform." A full 40% said they'd be less likely to vote for Democratic Sen. Byron Dorgan next year if he supports a bill. In a theoretical matchup with Republican Gov. John Hoeven (who has yet to announce), Mr. Hoeven wins 55% to 36%. Mr. Dorgan has been in the Senate 17 years; he won his last election with 68% of the vote. This should not be happening.
In Arkansas, 32% support this health-care legislation. Sen. Blanche Lincoln, also running next year, trails challengers by more than 50 points among the 56% of voters who strongly disapprove of the health plan. Senate Majority Leader Harry Reid, the public face of health reform, can barely break 38% approval in Nevada. In Colorado, where 55% of voters oppose a health bill, appointed Democratic Sen. Michael Bennet told CNN he'd vote for a bill even if it "cost him his job." Give the freshman credit for honesty.
Nor is this a red state/swing state phenomenon. In deep-blue Delaware, 46% oppose the health plan. Democrats pounded Delaware GOP Rep. Mike Castle, running for Senate, for voting against the House bill. That vote has in fact kept Mr. Castle leading his expected opponent, Beau Biden, the vice president's son. Chris Dodd helped author the Senate health bill and is up for re-election next year. He is arguably the Senate's most politically vulnerable Democrat.
Don't trust the polls? In the past weeks, four well known House Democrats announced they will not run for re-election. All are longtime incumbents; one, Tennessee's respected John Tanner, co-founded the Blue Dog coalition. These folks have seen the political handwriting on the wall.
Democrats have also been pulled by another White House promise: That once Americans witness reform, they will turn around. Yet even supporters know this ugly bill will not "fix" health care. The problems will remain—with more in addition—and Democrats will own them. Meanwhile, the backlash against the pending health-care legislation is seeping out to hamper Democrats' broader agenda. Pew this week published a poll in which it marveled (fretted?) over the "extent to which the public has moved in a conservative direction on a range of issues" since President Obama took office.
So why the stubborn insistence on passing health reform? Think big. The liberal wing of the party—the Barney Franks, the David Obeys—are focused beyond November 2010, to the long-term political prize. They want a health-care program that inevitably leads to a value-added tax and a permanent welfare state. Big government then becomes fact, and another Ronald Reagan becomes impossible. See Continental Europe.
The entitlement crazes of the 1930s and 1960s also caused a backlash, but liberal Democrats know the programs of those periods survived. They are more than happy to sacrifice a few Blue Dogs, a Blanche Lincoln, a Michael Bennet, if they can expand government so that in the long run it benefits the party of government.
What's extraordinary is that more Democrats have not wised up to the fact that they are being used as pawns in this larger liberal game. Maybe Mr. Obama will see a bump in the polls if health care passes; maybe not. What is certain is that this vote is becoming one that many in his party will not survive.
House backers of public insurance option may yield
Two House Democrats who favor a government insurance plan, a central element of health care legislation passed in their chamber, acknowledged Sunday it might have to be sacrificed as negotiators work out a final agreement with the Senate. Rep. James Clyburn of South Carolina, the No. 3 Democrat in the House and one who had appealed to President Barack Obama not to yield on the public plan, set out conditions for yielding himself. Asked during rounds on the Sunday news shows whether he could vote for a final bill that does not embrace a public plan, Clyburn said: "Yes, sir, I can."
Clyburn added: "We want a public option to do basically three things: Create more choice for insurers, create more competition for insurance companies, and to contain costs. So if we can come up with a process by which these three things can be done, then I'm all for it. Whether or not we label it a public option or not is of no consequence."
While insisting "it's not dead," Rep. Chris Van Hollen of Maryland said he recognizes realities in the Senate, where Democrats had to scrape up every vote from their side even to pass a bill without a government plan to compete in the private insurance marketplace. "Before the House was to give up the public option, we would want to be persuaded that there are other mechanisms in whatever bill comes out that will keep down premiums," said Van Hollen, appearing to sketch out a bottom line without a government plan necessarily included. "We've got to make sure that the final product is affordable."
Sen. Robert Menendez, D-N.J., underscored the divisions Democrats will need to bridge when negotiators from the House and Senate meet next month to reconcile the two bills. He said there will need to be more give on the House side than the Senate, which took weeks to find the 60 votes needed for passage. "If we are going to have a final law, it will look a lot more like the Senate version than the House version," Menendez asserted.
The Senate's Christmas Eve achievement brought the nation closer than it's been for generations to a new order in health insurance, one that would eventually require nearly all Americans to get coverage, help many pay for it and restrict onerous insurance company practices such as denying coverage to people with pre-existing sickness. But nothing will change for anyone until the House and Senate can settle on common legislation, pass it and send it to Obama to sign.
The high stakes have both parties hoping they can find a few converts from the other side. Nearly every Republican in Congress has opposed the measures. "If some of the Republicans would come forward with suggestions - offer a vote or two, or three or four - to take away the need to have every last one of the 60 Democrats, you'd have a much better bill in accordance with the tradition of the Congress, especially the Senate, on bipartisanship," said Democratic Sen. Arlen Specter of Pennsylvania, himself a party switcher.
Republican Sen. Jim DeMint of South Carolina voiced similar hope, to opposite ends - "a few Democrats to stand up in the House that maybe didn't before and help us stop this thing." DeMint, Van Hollen, Menendez and Specter spoke on "Fox News Sunday." Clyburn was on CBS'"Face the Nation" and CNN's "State of the Union."
British Conservative leader meets NHS privatisation campaigners
David Cameron has met a health care pressure group that advocates full privatisation of the National Health Service - a meeting that could infuriate doctors and nurses. The Conservative leader held an hour of talks with the leader of the group Nurses For Reform (NFR) in his private office in the Commons two weeks ago.
His decision to meet the radical group, which calls the NHS a "dystopian, Soviet-style calamity", will be seen as foolhardy after the painstaking efforts he has made to reassure voters that the NHS is safe in Tory hands. The meeting risks reigniting the row which exploded four months ago when Mr Cameron was forced to distance himself from a leading Tory MEP who suggested that the NHS was a "mistake". The Tory leader's meeting with the leader of the group, Helen Evans, is revealed on her internet blog where she claims she was invited by him to present the group's ideas.
Among others, she says, these included "the view that the state should not own or have any of its agents manage hospitals." In comments which could embarrass Mr Cameron she says: "If he becomes Prime Minister I have no doubt NFR will meet with him and his policy team again. But whatever happens, he can rest assured that NFR will remain very much on the outside of his – and any other party political – tent. We will remain dangerous and continue to think the unthinkable."
A spokeswoman for Mr Cameron said: “David Cameron meets with lots of people of different views but his commitment to the NHS is clear and it should be an NHS that is free at the point of delivery.” However the meeting is bound to be exploited by Labour ministers in the run-up to the election. Nurses For Reform, by its own admission, is the most extreme pressure group calling for NHS privatisation in Britain.
On its website it denounces the NHS as a "Soviet" organisation which must be dismantled. "The idea that state can do it all, on its own – for everyone – is dead," it says. "Sixty years on from the inception of the NHS, British patients, voters and politicians are rightly moving away from the calamity of fully nationalised health care." Britain is a society "that is fast turning against the dystopian realities of unsustainable Soviet-style medicine."
It says a hugely slimmed down NHS should remain only as a "last resort" provider for those who cannot afford private health care. The vast majority of people would get care through insurance schemes or simply pay themselves. It also calls for controversial "top-up" care to be brought in now, so that people currently using the NHS can pay extra to get better treatment, drugs and services if they have the money.
The group, which describes itself as a "pan-European network of nurses" dedicated to health care reform across the world, says the government should "recast" the NHS as "simply a funder of last resort alongside an insurance and self-funder based market."
Dr Evans, a senior nurse with more than 20 years experience in the NHS, is now a health policy consultant with Farsight Strategic Political Intelligence Ltd, which describes itself as Britain's leading predictive public affairs consultancy in health policy. She also works with right wing, free market organisations such as the Centre for the New Europe, the Institute of Economic Affairs and the Libertarian Alliance.
In August Mr Cameron was forced to distance himself from the Conservative MEP Dan Hannan after he said the NHS "hasn't worked, it's made people iller". Although he did not discipline the MEP, Mr Cameron said: "I don't agree with Daniel Hannan. The Conservative party stands full square behind the NHS ... We back it, we are going to expand it, we have ring-fenced it and said that it will get more money under a Conservative government, and it is our No 1 mission to improve it."
Australia: Elective surgery wait shows that government hospitals are still not coping with many medical needs
And that's despite the fact that 40% of Australians have private insurance and go to private hospitals
ALMOST 200 Queenslanders have been waiting more than five years to have elective surgery. The 183 patients have conditions classified as "non-urgent" but under Queensland Health guidelines should still have had their operations within 12 months. Another 310 people have been languishing on the waiting list for up to two years, despite having more serious illnesses or injuries that should have put them in an operating theatre within 90 days.
However, the figures – revealed in an answer to an Opposition question on notice to the Government – have improved significantly in the past year. Twelve months ago, almost 400 Queenslanders had been waiting more than five years for surgery. The release of the figures comes as Health Minister Paul Lucas prepares to unveil a new initiative to tackle the so-called long-waits for elective surgery.
Opposition health spokesman Mark McArdle said yesterday the State Government needed to go back to the drawing board to address the problem. "No Queenslander should be waiting any longer than the recommended time for elective surgery, particularly these 310 category two patients who have waited more than 90 days even though some of them have quite serious conditions," Mr McArdle said.
Mr Lucas said hospitals performed 115,000 elective surgery operations each year, so it was a small percentage that waited longer than the recommended times, but agreed it was "not acceptable". "Frankly it should be 0 per cent. It is simply not acceptable to have people waiting more than five years for surgery, even if it is the non-urgent type," he said. "By this time next year, I want that figure reduced to zero." Mr Lucas remains tight-lipped on his plan to tackle long waits but earlier this month took time out to meet surgeons.
One of the options believed to be under consideration is turning the Royal Children's Hospital at Herston into an elective surgery centre once the new children's hospital opens in 2014. The move would help ensure elective surgeries went ahead.
According to the figures, 310 category two patients who should have their surgery within 90 days have been waiting between one and two years for surgery, 83 have waited up to three years and 21 for four years.
Obamacare is the fast-track to a permanent left-of-center political culture
By Mark Steyn
Last week, during a bit of banter on Fox News, my colleague Jonah Goldberg reminded me of something I’d all but forgotten. Last September, during his address to Congress on health care, Barack Obama declared: “I am not the first President to take up this cause, but I am determined to be the last.” Dream on. The monstrous mountain of toxic pustules sprouting from greasy boils metastasizing from malign carbuncles that passed the Senate on Christmas Eve is not the last word in “health” “care,” but the first. It ensures that this is all we’ll be talking about, now and forever.
Government can’t just annex “one-sixth of the U.S. economy” (i.e., the equivalent of annexing the entire British or French economy, or annexing the entire Indian economy twice over) and then just say: “Okay, what’s next? On to cap-and-trade . . . ” Nations that governmentalize health care soon find themselves talking about little else.
In Canada, once the wait times for MRIs and hip surgery start creeping up over two years, the government distracts the citizenry with a Royal Commission appointed to study possible “reforms” which reports back a couple of years later usually with recommendations to “strengthen” the government’s “commitment” to every Canadian’s “right” to health care by renaming the Department of Health the Department of Health Services and abolishing the Agency of Health Administration and replacing it with a new Agency of Administrative Health Operations which would report to a reformed Council of Health Policy Administrative Coordination to be supervised by a streamlined Public Health Operations & Administration Assessment Bureau. This package of “reforms” would cost a mere 12.3 gazillion dollars and usually keeps the lid on the pot until the wait times for MRIs start creeping up over three years.
The other alternative is what the British did earlier this year: They created an exciting new “Patient’s Bill of Rights,” promising every Briton the “right” to hospital treatment within 18 weeks. Believe it or not, that distant deadline shimmering woozily in the languid desert haze can be oddly reassuring if you’ve ever visited a Scottish emergency room on a holiday weekend. And, if the four-and-a-half months go by and you still haven’t been treated, you get your (tax) money back? Ah, no. But there is a free helpline you can call which will give you continuously updated estimates on which month your operation has been rescheduled for. I mention these not as a preview of the horrors to come, but because I’ve come to the bleak conclusion that U.S.-style “health” “reform” is going to be far worse.
We were told we had to do it because of the however many millions of uninsured, yet this bill will leave some 25 million Americans uninsured. On the other hand, millions of young fit healthy Americans in their first jobs who currently take the entirely reasonable view that they do not require health insurance at this stage in their lives will be forced to pay for coverage they neither want nor need. On the other other hand, those Americans who’ve done the boring responsible grown-up thing and have health plans Harry Reid determines to be excessively “generous” will be subject to punitive taxes up to 40 percent. On the other other other hand, if you’re the member of a union which enjoys privileged relations with Commissar Reid you’ll be exempt from that 40 percent shakedown. On the other other other other hand, if you’re already enjoying government health care, well, you’re 83 years old and, let’s face it, it’s hardly worth us giving you that surgery for the minimal contribution you make to society, so in the cause of extending government health care to millions of people who don’t currently get it we’re going to ration it for those currently entitled to it.
Looking at the millions of Americans it leaves uninsured, and the millions it leaves with worse treatment and reduced access, and the millions it makes pay significantly more for their current health care, one can only marvel at Harry Reid’s genius: government health care turns out to be all government and no health care. Adding up the zillions of new taxes and bureaucracies and regulations it imposes on the citizenry, one might almost think that was the only point of the exercise.
That’s why I believe America’s belated embrace of government health care is going to be far more expensive and disastrous than the Euro-Canadian models. Whatever one’s philosophical objection to the Canadian health system, it is, broadly, fair: Unless you’re a cabinet minister or a bigtime hockey player, you’ll enjoy the same equality of crappiness and universal lack of access that everybody else does. But, even before it’s up-and-running, Pelosi-Reid-Obamacare is an impenetrable thicket of contradictory boondoggles, shameless payoffs, and arbitrary shakedowns.
That’s why Nebraska’s grotesque zombie senator Ben Nelson is the perfect poster boy for the new arrangements, and not just another so-called Blue Dog Democrat spayed into compliance by a massive cash injection. There is no reason on earth why Nebraska should be the only state in this Union to have every dime of its increased Medicare tab picked up by the 49 others. So either that privilege will be extended to all, or to favored others, or its asymmetry will be balanced by other precisely targeted lollipops hither and yon. Whatever happens, it’s a dagger at the heart of American federalism, just as the bill’s magisterial proclamation that the Independent Medicare Advisory Board can only be abolished by a two-thirds vote of the Senate strikes at one of the most basic principles of a free society — that no parliament can bind its successors.
These details are obnoxious not merely in and of themselves but because they tell us the truth about where we’re headed: Think of the way almost every Big Government project bursts its bodice and winds up bigger and more bloated than its creators allegedly foresaw. In this instance, the stays come pre-loosened, and studded with loopholes. Because the Democrat operators — the Nancy Pelosis and Barney Franks — know that what matters is to get something, anything across the river, and then burn the bridge behind you.
My Republican friends often seem to miss the point in this debate: The so-called “public option” is not Page 3,079, Section (f), Clause VII. The entire bill is a public option — because that’s where it leads, remorselessly. The so-called “death panel” is not Page 2,721, Paragraph 19, Sub-section (d), but again the entire bill — because it inserts the power of the state between you and your doctor, and in effect assumes jurisdiction over your body. As the savvier Dems have always known, once you’ve crossed the Rubicon, you can endlessly re-reform your health reform until the end of time, and all the stuff you didn’t get this go-round will fall into place, and very quickly.
As I’ve been saying for over a year now, “health care” is the fast-track to a permanent left-of-center political culture. The unlovely Democrats on public display in the week before Christmas may seem like just a bunch of jelly-spined opportunists, grubby wardheelers and rapacious kleptocrats, but the smarter ones are showing great strategic clarity. Alas for the rest of us, Euro-style government on a Harry Reid/Chris Dodd/Ben Nelson scale will lead to ruin.
Health Care, Barack Obama, and the U.S. Constitution
In the aftermath of the Senate’s passage of an Obamacare bill, Attorney’s General from multiple states have begun to announce that they are launching investigations into the legality, and constitutionality of the Senate legislation. Chief among their concerns is the possibility that that the bill places Americans outside the state of Nebraska at a significant disadvantage, financially and otherwise, to residents of the state of Nebraska.
South Carolina Attorney General Henry McMaster, along with the Attorneys General in the states of Washington, Michigan, Texas, Colorado, Alabama and North Dakota – have joined forces to consider, among other things, if the Obamacare bill in the U.S. Senate violates the 10th Amendment of the U.S. Constitution. The 10th Amendment stipulates that powers not granted to the national government nor prohibited to the states by the constitution of the United States , are reserved to the states or the people.
As such, the 10th Amendment may pose constitutional challenges to the Obamacare bill itself. Does the constitution grant to the federal government the “power” to provide healthcare? More curiously, does the constitution grant to the federal government the “power” to mandate that people buy anything - including health insurance (the Senate version of the healthcare reform legislation stipulates both)?
Additionally, state Attorneys General should also be concerned about Obamacare for another reason: it could be in violation of the “equal protection” clause of the Fourteenth Amendment.
Concerns over the Fourteenth Amendment appear to be present (this is based on what we know of the legislation, which, because of Pelosi and Reid’s secretiveness, is not a lot) in the portion of the Obamacare bill that grants special (and expensive) privileges to residents of the state of Nebraska. In the Senate’s Obamacare bill, the state of Nebraska is afforded special financial advantages from the federal government - to the tune of hundreds of millions of dollars every year – for the funding of Medicaid. The reason this provision appears in a Senate healthcare bill, as many readers of this column are aware, is because the bill could not be passed without the vote of Democratic Senator Ben Nelson of Nebraska .
Obamacare is strongly opposed by roughly two-thirds of American voters. And according to a survey published less than two weeks ago by the Tarrance Group polling firm, sixty-seven percent of Nebraskans oppose Obamacare, while ninety percent of Nebraskans are happy with the heatlhcare they currently receive and don’t want it to change.
Additionally, the Senate Obamacare bill is vague, at best, as to when and where it funds abortion procedures – and Nebraskans overwhelmingly find the aborting of unborn children to be abhorrent. And for all these reasons, Senator Ben Nelson had every reason to vote against the Obamacare bill.
So, given Senator Nelson’s incentives to oppose the Obamacare bill, Senate Majority Leader Harry Reid crafted a special deal to incentivize Nelson to vote in favor of the bill. The “incentives” included special economic incentives for the state of Nebraska , incentivizes that people in the other 49 states don’t receive.
Using the law to single-out certain individuals, or certain groups of individuals, and impart to them either special privileges or penalties that don’t apply to other Americans, is, well – Un-American. And it may very well prove to be un-constitutional in court.
Residents in the other forty-nine states pay taxes according to the same federal taxation structure as do Americans in Nebraska. Furthermore, in as much as we are U.S. citizens, we are all deserving of the same “protections” under the law to which Nebraskans are subject.
But the Senate Obamacare bill sets aside Nebraskans, and makes a special privileged class of them. If this bill becomes law, Nebraskans will be entitled to subsidies from the federal government that those of us who belong in the category called “non-Nebraskans” are not.
This disregard for the U.S. Constitution and matters of “equal protection” do not begin and end with Senator Ben Nelson. Earlier this winter, Senator Mary Landrieu (D-Louisiana) was asked a simple question by reporter Nicholas Ballasy of CNSNews.Com: “What part of the Constitution do you think gives Congress the authority to mandate that individuals have to purchase health insurance?”
In response, Senator Landrieu (who, much like Senator Nelson of Nebraska did, essentially “sold” her vote in the Senate despite opposition to Obamacare in her home state of Louisiana) replied “we’re very lucky as members of the Senate to have constitutional lawyers on our staff, so I’ll let them answer that.”
Yes, of course – “the lawyers clean up all details” as American poet (and “classic rock” star) Don Henley once lamented about his country. The fact is, however, that Senator Landrieu couldn’t answer the question if she tried.
But just like the legal profession itself, our current President and Congress have little regard for the U.S. Constitution, and for the rights of the human individual. Just as it is with the practice of law, the process of “law making” revolves around “leverage” – what can one individual or group force another individual or group to do? What does it take to accomplish what we, the politicians, want to accomplish?
Will any more among the 535 elite Americans in Congress dare to raise any constitutional concerns about this? And how about the Attorneys General of the other 43 states? Does the Constitution matter any more?
Pro-Life Democrat Predicts Senate Health Care Bill Will ‘Go Down in Flames’ in House, Unless Changes Made
The Senate health care bill is dead on arrival in the House of Representatives unless major changes are made, including removal of special “carve outs” for Medicaid funding for certain states and inclusion of language barring taxpayer-funded health plans that cover abortions, Rep. Bart Stupak (D-Mich.) told CNSNews.com on Tuesday.
Faced with the possibility that House Democratic leaders and the White House will try to force the U.S. House to accept “as is” the health care bill that the Senate is poised to pass on Christmas Eve, the pro-life Democrat said the Senate bill differs too much from the version passed by the House to be accepted. “If they expect the House to accept the Senate bill, it’s going to go down in flames,” Stupak told CNSNews.com in an interview.
CNSNews.com asked Stupak: “Are you prepared to vote for a bill that looks more like the Senate bill – and Senator Nelson’s language on abortion – than the House bill, with your language?” “No, absolutely not,” said the Democratic congressman, whose district encompasses all of Michigan’s Upper Peninsula and roughly one-quarter of the territory in the remainder of Michigan.
“The Senate bill will not receive support in the House,” Stupak said. “If they tell us we have to take that bill without changes, it will not survive the House. Regardless of the abortion language, there are just too many objectionable items in there that at least I see, and in talking with maybe a half-dozen other members, they sort of see the same thing.”
Stupak, like many in Congress, takes strong exception to the fact that, under the Senate plan, certain states would receive special “carve outs” for increased funding for Medicare/Medicaid. “That’s not what it’s all about,” he said. “This is about health care, this is providing health care for all Americans – it’s not to see who can strike the best deal for their state. This is the wrong piece of legislation to try to do carve outs, or get an exception for your state and the rest of the country is supposed to pick up the tab. That’s not what health care is all about. That’s not the policy, that’s not the principle behind the bill.
In exchange for their votes for the Senate bill, Sen. Ben Nelson (D-Neb.) reportedly obtained $100 million in additional Medicaid benefits for Nebraska and Sen. Mary Landrieu (D-La.) obtained $300 million in additional aid for Louisiana. In addition, Sen. Bill Nelson (D-Fla.) managed to obtain a carve-out for 800,000 Floridians, who will keep their Medicare Advantage plans, while those in other parts of the country are slated to lose their Medicare Advantage plans under the bill’s targeted cuts.
Stupak was incensed at the special deals. “All the rest of us that live in states that did not receive that exception, why would we [be] inclined to give Nebraska or Florida or Louisiana a special break underneath the bill and expect the rest of us to pay for it?”
Beyond the carve-outs, Stupak pointed out that seniors “take some cuts in the Senate bill that are not found in the House bill [that] members are not going to accept” -- and that the bill would tax people who have “decent” health insurance programs. “Aren’t you really going to force more people off health insurance?” Stupak said.
He added: “If you just take a look at my three main constituencies – Right to Life, labor unions, and senior citizens – the Senate bill is contrary to all their interests,” Stupak said. “I’d have no real desire to vote for this bill the way its being outlined in the media," he said. "I know the bill’s not finalized yet, but if that holds true, if they expect the House to accept the Senate bill, it’s going to go down in flames.”
Stupak, who succeeded last month in getting 64 House Democrats to join him in attaching his pro-life amendment to the House version of the health care bill, also firmly rejected language in the Senate bill regarding abortion. The “Stupak amendment,” as his provision is known, would prohibit the federal government from allocating taxpayer money to pay for any part of any health insurance plan that covers abortion except in cases of rape, incest, or when the life of the mother is in danger.
But the abortion language in the Senate bill secured by Sen. Ben Nelson (D-Neb.), which attempts to segregate taxpayer money from paying for health plans that provide abortion, does not contain an outright ban on taxpayer money going to fund abortion. Stupak, however, added: “Even if they fixed the abortion language, if it’s the Senate language, I have to vote for – I’m not voting for it.”
Spending on NHS bureaucracy has risen by 50 per cent in just four years, according to "heartbreaking" government figures. The increases include a 43 per cent rise in the costs of managers, while spending on clerical staff rose by 78 per cent at Primary Care Trusts (PCTs), which decide how NHS funds should be used. Meanwhile, their expenditure on management consultants and temporary staff more than doubled. Patients' groups accused the Government of wasting "ludicrous and heartbreaking" sums expanding an army of administrators while starving the frontline of resources.
In 2006, ministers promised to cut NHS administration costs by halving the total number of PCTs - the organisations which decide which treatments and medications are funded - from 303 to 150. In fact, Department of Health figures show that in the four years ending last year, the total amount spent on administration went from £1.43 billion to £2.14 billion - a rise of 49.5 per cent. The statistics, which cover the period from 2004 to 2008, show that the total spent on managers went from £566 million to £808 million, a rise of 43 per cent. Spending on other administrative staff increased by 78 per cent, from £606 million to £1.07 billion.
As the total number of organisations shrunk, the new larger bodies spent more hiring temporary staff and consultants, according to an analysis of the DoH figures by the Conservatives. In total, PCT spending on outside agencies rose from £53 million to £139 million - an increase of 162 per cent.
Katherine Murphy, from the Patients Association, said too often the millions spent on NHS bureaucracy did little to help patients, while the systems they set up left too many worse off. "These sorts of sums are ludicrous - and especially so given the heartbreaking stories we hear all too often about patients who have been denied their most basic needs," Mrs Murphy said. "This Labour Government has said an awful lot about putting the patient at the centre of services, but what we find is that the current system puts more and more layers between the patient and their doctor and nurse, and leaves vulnerable people fighting against a system of targets."
Andrew Lansley, the shadow health secretary, accused Labour of "pouring" huge amounts of taxpayers' money into the NHS while failing to ensure value for money. Highlighting figures published earlier this year, showing that the number of NHS managers is increasing at three times the rate of nurses, Mr Lansley said: "This Government has created a bloated NHS bureaucracy which is overloaded with Government targets. I am determined that under a Conservative government all of this would change."
In October, the Conservatives promised to cut total spending on administration by PCTs, strategic health authorities and dozens of NHS quangos by one third, from £4.5 billion to £3 billion, within four years.
Earlier this month, Labour said it would cut NHS "management costs" - a more narrow category than administration - by 30 per cent. A spokesman for the Department of Health said significant investment in the NHS had brought the shortest waiting times for patients since records began, but that it was for local organisations to decide how money was spent. He added: “To drive services forward, the NHS needs strong management - but efficiency is crucial, so we have set a clear goal of reducing management costs in strategic health authorities and PCTs by 30 per cent over the next 4 years.”
The Sunday Telegraph's campaign, Heal our Hospitals, has received 5,200 signatures backing its calls for a review of hospital targets to make sure they work to improve quality of care. The campaign has uncovered major pay rises for NHS chief executives who presided over hospitals exposed as having some of the worst death rates in Britain.
As US legislators continue to advance the largest expansion of government control over health care in the US, many Americans may need some comic relief. Although such massive consolidation of federal control over health care is by no means a laughing matter, the following 2-minute clip from a popular BBC Documentary Series “Yes, Minister” illustrates the ridiculousness of the efforts.
This not an entirely trivial story contrived for political satire; in fact, even early this year, the 2009 opening to an NHS hospital was canceled until “early 2010” for among other items not being able to “[control] the heat of the floor in some parts of the hospital.” In 2008, a survey by the (British) Health Care Commission found that roughly 11 million hospital meals were simply wasted. Moreover, the Taxpayers’ Alliance in England, find that “misguided directive[s]” lead to a “total waste of NHS resources”, and most importantly, divert global health care resources “at a time when people are struggling to get life-saving operations and medication”.
While the US healthcare system is not (yet) the socialized health care system of the British NHS, Obamacare does continue a massive transfer of regulatory power in the health care and health insurance markets to the federal government. In the attempt to bring more equity into the US health care system by granting the federal government even greater power, even an advanced socialized health care system faces great concerns of inequality. This is highlighted best by Steve Webb, MP and Liberal Democrat Shadow Health Secretary, stating of the NHS that “health inequalities still run deeply through our society. People still face an unfair postcode lottery in accessing health services across the country, which bears little relation to need. Health needs around the country would be best met by democratic community bodies giving local people a direct say in the services they need.”
This underscores the gravity of the current health reform debate in the US where the federal government has progressively consolidated regulatory and financing power in health care for the last 30 years. Rather than moving more towards a decentralized system that many in Britain now want (and polls have shown US voters want) US legislators want to centralize more of the power in Washington.
10 Really Nasty Surprises For The American People In The Health Care Reform Bill
Most Americans who support the health care reform bills currently being rammed through Congress believe that this process will result in Americans receiving universal health care that is cheaper, more efficient and that gives all of us more choices. But that is not the case at all. Rather, Americans will soon have much fewer health choices which are much less efficient and for which they will end up paying much more for. In fact, there are a ton of really nasty surprises for the American people in the health care reform bill. The following are 10 of the nastiest of the surprises....
#1) All Americans will be forced to buy health insurance. If you don't like the new system, that is too bad for you. If you don't pay up, you will be heavily fined and you could ultimately end up in prison. There will simply be no escape from participating in this health care system until you die.
#2) Americans will have basically two places from which to get health coverage - either their workplaces or from "insurance exchanges" set up by the government. If you are not employed, you will have one choice.
#3) Americans will have much fewer health plan choices under the new system. The new "insurance exchanges" that the government is setting up will offer four health plan templates that have been mandated by the government. Each plan will contain health benefits that have been specifically dictated by government agencies. You will be forced to pay for the benefits contained in these plans whether you need them or not. So if you will never need substance abuse treatment or prescription drug coverage that is too bad - you will be forced to pay for them.
#4) Americans will be eligible for a federal subsidy to help them buy health insurance, but only if they earn less than 400 percent of the poverty level ($88,200 for a family of four). However, an individual will only be eligible for a subsidy if their employer does not offer health coverage and if that individual purchases a "government-approved" plan from a "government-approved" insurance exchange.
#5) The Congressional Budget Office estimates that a family insurance plan for a typical family of four will cost approximately $15,000 per year when the health care bill comes into full effect in 2016. How do you think most American families will react to that?
#6) The Congressional Budget Office also says that the coverage provisions in the Senate bill will cost the U.S. government $200 billion annually by 2019 and that these costs will grow by 8 percent per year. Considering the fact that the U.S. government is already drowning in red ink, where in the world will all of that money come from?
#7) American workers will be hit with nasty new taxes under the new system, including a .9 percent Medicare payroll tax increase that the Senate bill would implement.
#8) There is also a 40 percent tax on "Cadillac" health plans in the Senate version of the bill. That tax is not indexed to inflation, which means that eventually every health plan will be subject to the tax.
#9) Even if your current health plan is "grandfathered" in, your current health insurance company will be required to meet new federal mandates that will dramatically increase the cost for any health plan it offers you right now. Guess who the health insurance companies will pass those costs on to?
#10) Senator Harry Reid has inserted some really wicked provisions in the Senate version of the health care bill that will make it virtually impossible to repeal the Obamacare bill once it is adopted. So the reality is that once it is voted in, the American people will be stuck with it forever.
It is almost incomprehensible that the Congress of the United States has just passed bills in both houses that will annually cut $500,000,000,000 (one-half a Trillion dollars) from the cost to extend the lives (longevity) of America’s senior citizens. The Republicans stood firm in their opposition to these bills but the Democrats claimed that their majorities were created by the public’s mandate in November 2008 to “change” health care to include the small minority of the uninsured.
The Democrats took a financial crisis – a deep recession – as an opportunity they couldn’t pass up to grow their political power and increase the size of government at the expense of the free market and the private sector. The medical profession had expanded the life span of the Average America from 62 to over 80 in just 75 short years. The eventual cuts the Democrats have proposed will stop that progress and the life span of the average American will start dropping.
All this is being done to seniors because keeping seniors alive has become too costly. In order for Democrats to pay for the enormous takeover of 1/6th of the private sector economy they have to cut expenses. They decided seniors in the last years of life were their best bet to finance their plan of “social justice” for a small number of Americans now relying on free emergency care to save their life.
Democrats reasoned why not kill seniors when they become too costly – they are living too long now anyway. They said let’s expand health care to the point where we Democrats can dictate who and when old people are deemed worthy of life saving procedures - in that way, we can ration and withhold expensive procedures from those who don’t have long to live thus financing our enormous medical bureaucracy.
It is true that half of the cost of Medicare is spent in the last years of life. That became a reality when Americans adopted Medicare. The cost of surgeries, medicines and hospitalization that have increased longevity have been costly. Under new healthcare these costs will be trimmed and earlier deaths assured.
This change to politician-controlled healthcare is just another dagger in the heart of the liberty and freedom of choice that built the greatest economy the world and the best medical care on the planet. From now on Americans will have to ask their government for permission to live. What a sad state of affairs. Our Founders must be turning over in their graves.
This is what a society gets when they stop making money, increasing overall wealth using the principles and freedom under capitalism and start concentrating on redistributing the wealth using the principles of socialism and collectivism. Under socialism wealth is consumed and eventually disappears. Under capitalism wealth is created and freedom and liberty deliver prosperity.
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Nanny State Gone Wild: Defining Dependency Up
by Michelle Malkin
The greatest gifts you can give your children can't be boxed and bowed. Consider the timeless gift of self-sufficiency -- a stubborn thirst to leave the nest, make it on your own and live as a free-willed adult. It's a concept that Big Nanny Democrats are sabotaging at every legislative turn.
Several times during the sneaky debate on the government health care takeover bill this past Sunday, Democrats hailed a provision requiring insurance plans that cover dependents to provide benefits to children up to age 26. Democratic Sens. Ben Cardin and Tom Harkin both specifically championed the unfunded mandate in their floor statements.
This manifestation of the Nanny State is especially galling given the massive levels of generational theft the Democratic majority has presided over this past year. If they truly cared about the physical and financial well-being of young Americans, they'd stop piling on expensive regulations that simply put affordable health insurance out of their reach.
I propose a new symbol for the Democrats. Out: donkey. In: a giant adult pacifier.
I can tell you what most fiscally responsible parents are thinking when they hear the feds "taking care" of everyone else's adult "children" by confiscating their tax dollars and forcing private companies to comply: You've got to be kidding me. Yes, Virginia, there are still some of us left who believe our children shouldn't depend on a government-manufactured umbilical cord as they approach their third decade on earth.
Nonetheless, there are now an estimated 20 states that have already passed legislation requiring insurers to cover adult children. The slacker mandates cover "kids" ranging in age from 24 to 31. And it's these government health care mandates that are driving up the cost of insurance.
Health policy researcher Nathan Benefield of the Commonwealth Foundation reported that in New Jersey, Nanny State peddlers claimed the adult kiddie protection law would help 100,000 uninsured young adults. "Yet in two years, only 6 percent of that estimate has been realized. The primary reason -- health insurance is still too expensive."
Wisconsin has experienced similar results. "Whenever you insure somebody whom you didn't insure before there's some additional risk," insurance expert James Mueller told the Milwaukee Sentinel Journal. Mueller points to the premium increases that have followed coverage mandates on employer-sponsored plans. "The problem with all these good ideas is there's funding necessary," Mueller said. In Wisconsin, not only are adult children covered, but also the children of those "children" if they live in single-parent homes.
As he rammed through this mandate and the mountain of other government regulations buried in Demcare, Senate Majority Leader Harry Reid promised on Sunday: "We are reshaping the nation. That's what we want to do."
Indeed, this defining dependency up phenomenon is part of the larger push for single-payer-by-proxy. The other universal health care Trojan horse signed into law this year -- the expansion of SCHIP (the State Children's Health Insurance Program) -- welcomed more non-"children" into the government insurance fold.
Both political parties have advocated federal waivers to use SCHIP funds for adults, including parents of Medicaid/SCHIP children, caretaker relatives, legal guardians and childless adults. According to the General Accounting Office, SCHIP-funded expenditures on adults nationwide "totaled about $674 million in 2006." J.P. Wieske of the Council for Affordable Health Insurance notes that the bennies provide an incentive for parents to drop their private coverage in order to take advantage of free or discounted health insurance for their children. "It has become a program for the middle class at the expense of the poor."
This is the engine that will power the Demcare architects' most naked, radical ambitions: "Health care as an inalienable right," as Sen. Harkin put it. How? By breeding a massive permanent culture of dependency and bottomless debt in the name of the "children" from birth through quarter-life -- and beyond.
Scrooge came early on Christmas Eve this year -- and he looks strangely like Senate Majority Leader Harry Reid. Instead of "bah humbug," he delivered the U.S. Senate's version of "health care reform" -- the most expensive legislation ever passed by the Congress of the United States and the greatest expansion of government power in our nation's history. Now that's some Christmas present -- and a different way of celebrating the birth of Jesus Christ.
If the Democratic majorities in the House and Senate succeed in cobbling together a final bill after the new year begins, every American taxpayer will take a hit in the pocketbook, and every Tiny Tim in the next generation can look forward to government-rationed medical care. According to those who purport to speak for him, President Barack Obama is celebrating this "historic event," and they aren't talking about the Nativity two millenniums ago.
For reasons apparently obscure to Obama and Reid and House Speaker Nancy Pelosi, most Americans don't seem to be as pleased at their Christmas gift as those who gave it. Perhaps that's because "We the People" see the Senate's $848 billion stocking stuffer has a price tag that would choke a reindeer.
Actually, that's just the down payment. According to the Congressional Budget Office, the first decade of the Senate's bill would cost $2.5 trillion. Even the Magi couldn't imagine a gift this precious.
Those who voted for "Change!" last year may find that's all they have left in their pockets. Administration actuaries estimate that both the House and Senate bills would accelerate growing costs for medical care. The CBO calculates that annual health care premiums for middle-income Americans would go up by $300 for individuals and more than $2,000 for families. And just in case you didn't notice, not getting health insurance is no longer an option. Higher costs may not have been on your Christmas list, but the O-Team in Washington wants you to have them anyway.
Overwhelmingly, Americans have been telling pollsters for more than a year that what they really wanted this Christmas (and the rest of the year, as well) were "jobs" and "job security." Apparently, the elves at the White House and on Capitol Hill weren't listening. Instead, they want to give us a $400 billion tax increase, new mandates on employers and higher fees for prescription drugs and medical devices. None of this would stimulate private-sector job growth.
But not to worry. "Hark! The Herald Angels Sing"; there may be new jobs -- at the Office of Personnel Management. In the Senate version of this Christmas Carol, up to 10 million Americans would lose their employer-sponsored health coverage. The individual health insurance plans for millions more would be nonexistent soon. To "ensure these Americans will never be denied coverage," OPM would set up a whole new bureaucracy to administer a government-run "insurance exchange." Though OPM is the federal agency responsible for granting security clearances -- and hopeless backlogs are commonplace -- we should be encouraged that it would do better at "managing" our health insurance. Take an aspirin, and call OPM in the morning.
The O-Team is confident that shortly after we ring in the new year, the House and Senate health care bills will be melded into one giant gift that keeps on giving -- to the federal government. There are some "fine points" to work out, such as how many of our tax dollars can really be spent on abortions and how deep the cuts in Medicare coverage for seniors will be and how much more "the wealthiest Americans" will pay. But those are just "minor details" that we are assured can be "worked out in the spirit of the season." We all should remember that "it's the thought that counts."
According to Reid, the "hard work" is done. The "exhausted" members of Congress are now home on "winter recess." Mr. Obama and his family are on their "Hawaiian holiday." Notably, the word "Christmas" is rarely, if ever, used in our government.
But that proscription isn't as pervasive as some would like. Though the majority of our elected officials call their health care bills a "gift" -- yet dare not speak the word "Christmas" -- there are others who know the true spirit of this holiday. Right now, more than 250,000 soldiers, sailors, airmen, guardsmen and Marines are deployed far from home -- a good number in harm's way. Those who wear our nation's uniform and their loved ones embody what giving, self-sacrifice and Christmas are really all about.
British parliamentarian Warns America of Government Healthcare Horrors
Member of European Parliament Daniel Hannan warned Americans of the dangers of government-run healthcare on the Friday edition of the “Glenn Beck Program." Hannan, a Conservative who represents Southeast England in the European Parliament, said of the British National Health Service (NHS), “The most striking thing about it is that you are very often sent to the back of the queue.”
Beck noted the lengthy waiting times for care under Britain’s socialist National Health Service (NHS). These figures were provided by the BBC on May 27, 2009:
*cataract surgery – 8 months
*hip replacement – 11 months
*knee replacement – 12 months
*slipped disc – 5 months
*hernia repair – 5 months
Although to be fair, Hannan said, the NHS provides “not so bad” care with children but “the worst thing to be is elderly under a system like ours.” Said Hannan:
I could tell you horror stories about elderly people left starving in wards, and the amazing thing is, why do we put up with it? The reason we put up with it for so long is because it has become such a huge system. It’s got such an enormous bureaucracy based around it. We have 1.4 million people employed by the National Health Service.
The NHS is the third largest employer on the planet after the Red Army in Communist China and the Indian national railways. “Most of those 1.4 million people are administrators,” Hannan said.
And the existence of that huge electoral bloc makes it impossible to get rid of the system, Hannan said.
If Americans bring in universal healthcare, they should disabuse themselves of the notion that they can somehow come back and change the system a few years from now, Hannan said.
Facing the camera, Beck said, “America, you cannot let this thing pass. You cannot let any of this structure in…now you understand why this is going to change the face of America and it’ll do it forever.”
Hannan also spoke in Washington, D.C. last week. The title of his speech at the Heritage Foundation was “Putting the Government in Charge: Why America Should Avoid Europe’s Mistakes.”
US President Barack Obama has praised the passage of his signature health care Bill through the Senate as historic and landmark, saying "real, meaningful" reform was incredibly close to becoming a reality.
The Senate voted 60-39 in an early morning session in favor of the controversial legislation, despite continuing opposition from many American voters concerned it will end up costing them more in taxes.
Now that both the House of Representatives and Senate have finished their votes the two chambers must reconcile their starkly different Bills in the New Year before sending the final version for Mr Obama to sign into law.
The President acknowledged the battle was not over: "With passage of reform Bills in both the House and the Senate we are now finally poised to deliver on the promise of real, meaningful health insurance reform," he said. "Our challenge then is to finish the job."
That may not be straightforward. Senator John Barrasso told Fox News the $871bn healthcare overhaul meant it would "ultimately be harder to see a doctor and healthcare costs will go up". He urged voters to lobby their politicians over the holiday season. "The American people do not support this. This is not over," he said.
The $871bn bill will allow 31 million additional Americans to buy health insurance through subsidies and newly-created exchanges for individuals and small businesses. Among other measures, it taxes certain high-value plans, and mandates that most citizens must carry health coverage or pay a penalty.
Importantly it will also prevent insurance companies denying cover to customers with preexisting health conditions.
Senate Majority leader Harry Reid (D-NV), who shepherded the Bill though the chamber, said after the vote: "This is a victory for the American people. We've affirmed that the ability to live a healthy life is a right not a privilege for a selected few. This vote brings us one step closer to bringing Senator Ted Kennedy's dream to reality."
But the health care overhaul remains unpopular with American voters on both sides of the aisle, according to recent polls. Some Democrat activists say liberal lawmakers conceded too much ground in the struggle for 60 votes, while Republicans almost universally criticise the legislation as a new, unfunded entitlement program.
Republicans vow to stop health reform despite passage through Senate
THE historic Senate passage of a health reform bill has bitterly divided the US political landscape, with Democrats gleeful but defiant Republicans warning the battle is far from over. All 58 Democratic senators and two independents voted in favour after months of tortuous debate to pass the sweeping reforms. But Republicans unanimously rejected the measure, denying the majority any hoped-for claims of bipartisanship. Conservatives had sought to kill the bill or at least delay the battle well into 2010, when mid-term elections will make it more difficult for centrist Democrats to support the overhaul that bears a heavy pricetag of nearly $1 trillion over 10 years.
Republican leaders were quick to seize on the economic hardships of average Americans, saying the United States cannot afford the reforms in the midst of a painful recession tagged with double-digit unemployment. Warning “this fight isn't over,” Senate Minority Leader Mitch McConnell vowed to work with his colleagues to “stop this bill from becoming law.”
They will have ample opportunity to do so, as senators must now work with their counterparts in the House of Representatives to merge their widely different versions before President Barack Obama can sign his top domestic priority into law.
The mood turned ugly earlier this year when angry audiences shouted down and targeted politicians at townhall meetings across the country. A political firestorm erupted over allegations the plan would frame a bureaucratic “death panel” to make end-of-life choices, while Republicans denounced Democratic horse trading to round up all 60 votes necessary to avoid parliamentary delaying tactics.
With all 435 House seats and at least 36 Senate seats up for grabs in 2010, Republicans are keen to seize on liberal infighting to dictate the terms of the debate and take back power from the Democrats. And many Democrats fear they could be living through a repeat of former president Bill Clinton's unsuccessful healthcare reform drive, which never even came to a vote in Congress and severely wounded his first-term administration. “Every step of this long process has been an enormous undertaking,” Senate Majority Leader Harry Reid said.
But jubilant Democrats sought to bank on their major achievement in coming closer to extending health coverage to some 31 million of the 36 million Americans who lack insurance after decades of successive failures by seven presidents and multiple congresses. Many invoked Senator Edward Kennedy, the storied liberal “lion of the Senate” who made health reform the cause of his life before he died in August after losing a battle to brain cancer. “With Senator Ted Kennedy's booming voice in our ears - with his passion in our hearts - we say, as he said: The work goes on, the cause endures,” Reid said.
As Democrats scramble to get a final bill to the president's desk early next year, much of the contentious debate centres on providing a government-backed “public option” to compete with private insurers. The measure was stripped from the Senate bill but remains in the House version. Another hot-button item is the House bill's tougher restrictions on federal funds subsidizing abortions: while pro-choice lawmakers denounce the limits, centrist Democrats say they will doom the legislation without them.
House Republican Minority Leader John Boehner blasted the “2733-page government takeover of health care,” calling the process “a disgrace to our country.”
Republican National Committee Chairman Michael Steele was equally unforgiving. “This Christmas, the Democrats and President Obama have given America the one gift that keeps on taking,” he said.
But lawmakers got some comic relief from the ferocious debate during the Christmas Eve vote, when an exhausted Senate Reid initially voted “no” against his own bill in the heat of the moment. As the chamber erupted in laughter, he quickly corrected himself to a “yes” vote, as Senate rules allow.
Scrooge came early on Christmas Eve this year -- and he looks strangely like Senate Majority Leader Harry Reid. Instead of "bah humbug," he delivered the U.S. Senate's version of "health care reform" -- the most expensive legislation ever passed by the Congress of the United States and the greatest expansion of government power in our nation's history. Now that's some Christmas present -- and a different way of celebrating the birth of Jesus Christ.
If the Democratic majorities in the House and Senate succeed in cobbling together a final bill after the new year begins, every American taxpayer will take a hit in the pocketbook, and every Tiny Tim in the next generation can look forward to government-rationed medical care. According to those who purport to speak for him, President Barack Obama is celebrating this "historic event," and they aren't talking about the Nativity two millenniums ago.
For reasons apparently obscure to Obama and Reid and House Speaker Nancy Pelosi, most Americans don't seem to be as pleased at their Christmas gift as those who gave it. Perhaps that's because "We the People" see the Senate's $848 billion stocking stuffer has a price tag that would choke a reindeer.
Actually, that's just the down payment. According to the Congressional Budget Office, the first decade of the Senate's bill would cost $2.5 trillion. Even the Magi couldn't imagine a gift this precious.
Those who voted for "Change!" last year may find that's all they have left in their pockets. Administration actuaries estimate that both the House and Senate bills would accelerate growing costs for medical care. The CBO calculates that annual health care premiums for middle-income Americans would go up by $300 for individuals and more than $2,000 for families. And just in case you didn't notice, not getting health insurance is no longer an option. Higher costs may not have been on your Christmas list, but the O-Team in Washington wants you to have them anyway.
Overwhelmingly, Americans have been telling pollsters for more than a year that what they really wanted this Christmas (and the rest of the year, as well) were "jobs" and "job security." Apparently, the elves at the White House and on Capitol Hill weren't listening. Instead, they want to give us a $400 billion tax increase, new mandates on employers and higher fees for prescription drugs and medical devices. None of this would stimulate private-sector job growth.
But not to worry. "Hark! The Herald Angels Sing"; there may be new jobs -- at the Office of Personnel Management. In the Senate version of this Christmas Carol, up to 10 million Americans would lose their employer-sponsored health coverage. The individual health insurance plans for millions more would be nonexistent soon. To "ensure these Americans will never be denied coverage," OPM would set up a whole new bureaucracy to administer a government-run "insurance exchange." Though OPM is the federal agency responsible for granting security clearances -- and hopeless backlogs are commonplace -- we should be encouraged that it would do better at "managing" our health insurance. Take an aspirin, and call OPM in the morning.
The O-Team is confident that shortly after we ring in the new year, the House and Senate health care bills will be melded into one giant gift that keeps on giving -- to the federal government. There are some "fine points" to work out, such as how many of our tax dollars can really be spent on abortions and how deep the cuts in Medicare coverage for seniors will be and how much more "the wealthiest Americans" will pay. But those are just "minor details" that we are assured can be "worked out in the spirit of the season." We all should remember that "it's the thought that counts."
According to Reid, the "hard work" is done. The "exhausted" members of Congress are now home on "winter recess." Mr. Obama and his family are on their "Hawaiian holiday." Notably, the word "Christmas" is rarely, if ever, used in our government.
But that proscription isn't as pervasive as some would like. Though the majority of our elected officials call their health care bills a "gift" -- yet dare not speak the word "Christmas" -- there are others who know the true spirit of this holiday. Right now, more than 250,000 soldiers, sailors, airmen, guardsmen and Marines are deployed far from home -- a good number in harm's way. Those who wear our nation's uniform and their loved ones embody what giving, self-sacrifice and Christmas are really all about.
Notwithstanding some minor tinkering, the U.S. Senate has now passed the government takeover of healthcare. And despite the fact that it may not contain all of the far left's extreme demands, it is almost impossible to overstate the nefarious effect of what has emerged.
As Barack Obama has rightly intoned, even as now written, without the "public option," the measure embodies the single most massive government entitlement program since social security. One-sixth of the economy will be summarily placed in the hands of federal bureaucrats. And the greatest health care system in the history of the world will be torn asunder.
Yet, as horrifying as all of that may be, it is just the beginning. Because like the Pale Rider of biblical prophecy, "hell will follow after it."
The Democrats have already made clear that the current bill is just the opening salvo of their all-out assault on every aspect of private health care. As Tom Harkin (D-IA) has said, "What we are buying here is a modest home, not a mansion. But, we can build additions as we go along … In the future, amending it and changing it isn't going to be as tough as passing it in the first place. We amend Medicare and Social Security all the time …That's what we will do in health care."
As Harkin and others have also made clear, a binding public option is inevitable. Full funding of abortions is simply a matter of some minor tinkering. And then, once the new law has inserted the federal government into every aspect of health care, a sprawling new "Department of Health" will be created, empowered to control who receives which medical procedure and – even more chilling – who does not.
And even that doesn't begin to address the full scope of the bill's malevolent intent. More than anything else, the government health care takeover is a sinister political move to insulate the Democrats in power for decades to come.
If the Democrats are allowed to implement their strategy of using the current bill as a foothold to gain a stranglehold, they will then use their newfound power to "redistribute the health" in order to establish a middle-class dependency on bureaucratic dictates and federal subsidies.
As the popular leftwing website TPM recently observed in its editorial "The Death of Conservatism": "[The bill] will re-legitimize middle-class dependence for 'security' on government spending and regulation. It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government."
So, how do conservatives and/or Republicans fight back against this blatant power grab? They have two alternatives left.
First, the Republicans in both the Senate and the House must use any means necessary to prevent the bill's final passage. That may require the most expensive, extensive political ad campaign in TV history. It may also require the most aggressive – and, to some, acrimonious – public attacks in political history. And it will most certainly require the deftest parliamentary machinations in congressional history. In fact, it will likely require all three.
Then, should the bill pass anyway, political activists at the grassroots level must extract an Election Day toll on Senate and House members in marginal seats that will make wayward politicians shudder for decades to come. Even waiting until 2012 will be too late; the Democrat strategy of control and subsidize will already be too far advanced. The electoral pogrom must begin immediately.
The Senate has now passed the government takeover of health care over the objections of the vast majority of Americans. All that remains to be determined is whose hell "will follow after it."
Putting Government in the Hands of Bureaucrats and "Experts"
The suspense is over and it is inevitable that the monstrous medical care bill will become law. There is no way to sanitize this thing, period. It is the ultimate “Progressivist” legacy. Paul Krugman, perhaps the most visible “Progressive” today, supports this bill because it vastly expands the scope of the state in our lives. Like most “Progressives,” Krugman believes many things about a state controlled by people he supports. Among the “Progressive” beliefs are:
* “Experts” should decide what is best for everyone;
* The executive branch of government must employ “experts” who can make rules for everyone else;
* Governmental executives (i.e., President of the United States) should not be impeded by legislators, most of whom are not “experts,” and who fail to have the interests of everyone in mind, unlike the “experts” of the executive branch;
* Therefore, the legislative branches of government should defer to the executive branch, provided the “right kind of people” are in the executive’s chair.
Few people actually know everything that exists in this long and convoluted bill. However, that is unimportant, for in the end, the executive branch and its bureaucracies, not Congress, will interpret what the bill contains.
Most people still have the civics book ideas in their heads regarding law and the three branches of government. Americans are taught from grammar school on that the federal government has three branches: Congress, the Executive Branch, and the Federal Courts. According to the civics lessons, Congress makes the laws, the Executive Branch carries out the laws, and the Federal Courts interpret the laws.
That “model” of government disappeared even before the Progressive Era gripped the country a century ago, but it gained in strength during the Great Depression. “Progressives” such as Theodore Roosevelt and Herbert Croly, believed that people had become so advanced through “science” that they no longer needed to be subjected to the messy and (to them) “chaotic” processes of private markets and legislative debate. The “experts” already knew what needed to be done, and anything done by legislatures and markets to delay the directives of the “experts” should be swept away.
Thus, Krugman can write the following, which is fully consistent with the Progressive ethos: "Now consider what lies ahead. We need fundamental financial reform. We need to deal with climate change. We need to deal with our long-run budget deficit. What are the chances that we can do all that — or, I’m tempted to say, any of it — if doing anything requires 60 votes in a deeply polarized Senate?"
Translation: We need government action, not legislative debate. The legislative branch just gets in the way of what we need. (I do find it curious that a person who had advocated the most irresponsible spending in the history of the country now says we must “deal” with the “long-run budget deficit.” What he really means, of course, is that we have to raise taxes through the roof.)
Krugman need not fear, however, for the Obama administration really did not need this bill to take over medical care. Remember the 2009 GM/Chrysler bailouts? They came entirely through the executive branch, while in 1980, Congress had to pass legislation to aid Chrysler. In other words, the financial and regulatory role of Congress has shrunk massively even in the past 30 years.
Likewise, the EPA recently re-interpreted (with permission from the U.S. Supreme Court) the 1990 Clean Air Act Amendments to include carbon dioxide as a “dangerous pollutant.” The original law had no such language, but the EPA simply identified a new pollutant, and it legally can impose “solutions.”
In the end, the bill will be whatever the White House wants it to be. The ultimate legacy of “Progressivism” is that political debate no longer matters. The medical bill was bad legislation and everyone knew it, which was why the political tension was so great. However, now that Congress has given it permission to determine our medical futures, the Obama administration will waste no time imposing oppressive and costly new rules upon us, even if they are not contained in the actual bill Congress passed.
When legerdemain is used to pass an unpopular bill
It's time to blow the whistle on two erroneous statements that opponents and proponents of the health care legislation being jammed through Congress have been making. Republicans have been saying that never before has Congress passed such an unpopular bill with such important ramifications by such a narrow majority. Barack Obama has been saying that passage of the bill will mean that the health care issue will be settled once and for all.
The Republicans and Obama are both wrong. But perhaps they can be forgiven because the precedent for Congress passing an unpopular bill is an old one, and the issue it addressed has long been settled, though not by the legislation in question. That legislation was the Kansas-Nebraska Act of 1854. Its lead sponsor was Stephen A. Douglas, at 41 in his eighth year as senator from Illinois, the most dynamic leader of a Democratic Party that had won the previous presidential election by 254 electoral votes to 42.
Douglas' legislative prowess far exceeded that of current Senate Majority Leader Harry Reid. To hold together his 60 Senate Democrats, Reid simply dispensed favors -- eternal Medicaid financing for Ben Nelson's Nebraska, a hospital grant for Chris Dodd's Connecticut, more rural health money for Byron Dorgan's North Dakota and Montana's Max Baucus. Douglas did something far more difficult. He got the Senate to pass a bill some of whose provisions were supported by half of the Senate plus Douglas and some of which were supported by the other half plus Douglas. After passage, Douglas spent a day getting drunk -- a consolation unavailable to the teetotaling Reid.
The issue that Douglas said the Kansas-Nebraska Act would settle forever was slavery in the territories. His bill repealed the 34-year-old Missouri Compromise prohibiting slavery in territories north of Arkansas and substituted popular sovereignty -- territory residents could vote slavery up or down.
We cannot say with assurance that the Kansas-Nebraska Act was unpopular; Dr. Gallup didn't start polling until 81 years later. But the results of the next election were pretty convincing. The Republican Party was suddenly created to oppose the Kansas-Nebraska Act, and the 1854-55 elections transformed the Democrats' 159-71 majority to a 108-83 Republican margin. Democrats didn't win a majority of House seats for the next 20 years.
On the health care bill, there can be little doubt about public opinion. Quinnipiac, polling just after the Senate voted cloture, found Americans opposed by a 53 percent to 36 percent margin. Polls suggest that Democrats may suffer as much carnage in the 2010 elections as they did in 1854.
Nor did the Kansas-Nebraska Act settle the issue it addressed. Pro-slavery and anti-slavery settlers fought it out in "bleeding Kansas," and Douglas felt obliged to break with the Democratic administration and disown election stealing by the pro-slavery side. The issue roused a former congressman named Abraham Lincoln to re-enter politics, and he beat Douglas in the popular vote (but not in the legislature) in 1858 and then was elected president in 1860.
A health care bill like the Senate's is unlikely to settle all health care issues either, though the ensuing political struggles will stop somewhere short of civil war. "We aren't done talking about health care," writes Atlantic blogger (and Obama voter) Megan McArdle. "We haven't even really started. Our budget problems are as big as ever, and we just used up both political capital, and some of our stock of tax increases and spending cuts, to pay for something else."
The Senate bill contains provisions that are likely to be revisited. Its language channeling federal and consumer dollars to abortion coverage is opposed, according to Quinnipiac, by a 72 percent to 23 percent margin. Its provision establishing an Independent Medicare Advisory Board and stating that it cannot be abolished except by a two-thirds vote of the Senate is of dubious constitutionality, and even if upheld in a court of law may not pass muster in the court of public opinion. Since when has Congress passed laws that cannot be repealed?
Kansas-Nebraska was an attempt to settle a fundamental issue by legislative legerdemain and political trickery. The Democrats' health care bills are an attempt to settle a fundamental issue by partisan maneuver and cash-for-cloture. As Stephen Douglas learned, such tactics can work for a while, but the country -- and the Democratic Party -- can end up paying a heavy price.
CBO: Real 10-Year Cost of Senate Bill Still $2.5 Trillion
The Congressional Budget Office's score is in for the final Senate health bill, and it's amazing how little Americans would get for so much.
The Democrats are irresponsibly and disingenuously claiming that the bill would cost $871 billion over 10 years. But that's not what the CBO says. Rather, the CBO says that $871 billion would be the costs from 2010 to 2019 for expansions in insurance coverage alone. But less than 2 percent of those "10-year costs" would kick in before the fifth year of that span. In its real first 10 years (2014 to 2023), the CBO says that the bill would cost $1.8 trillion -- for insurance coverage expansions alone. Other parts of the bill would cost approximately $700 billion more, bringing the bill's full 10-year tab to approximately $2.5 trillion -- according to the CBO.
In those real first 10 years (2014 to 2023), Americans would have to pay over $1 trillion in additional taxes, over $1 trillion would be siphoned out of Medicare (over $200 billion out of Medicare Advantage alone) and spent on Obamacare, and deficits would rise by over $200 billion. They would rise, that is, unless Congress follows through on the bill's pledge to cut doctors' payments under Medicare by 21 percent next year and never raise them back up -- which would reduce doctors' enthusiasm for seeing Medicare patients dramatically.
And what would Americans get in return for this staggering sum? Well, the CBO says that health care premiums would rise, and the Chief Actuary at the Centers for Medicare and Medicaid Services says that the percentage of the Gross Domestic Product spent on health care would rise from 17 percent today to 21 percent by the end of 2019. Nationwide health care costs would be $234 billion higher than under current law. How's that for "reform"?
Even MoveOn.org says that the bill is "a massive giveaway" to private insurance companies. The CBO estimates that, from 2015-25, private insurers would receive $1.0 trillion in subsidies from the American taxpayer -- the insurers' apparent price for giving up their freedom and being controlled by the government. Congress would mandate that Americans buy the insurers' product and would redirect massive sums of taxpayer money to make that mandate more feasible. So, if insurance companies are your idea of a worthy object of philanthropy, then Obamacare is for you.
And this is the bill that Ben Nelson has decided to support?
One hopes that Nebraska voters -- and all other voters in other states who have sent Democrats to Washington -- are making a list and checking it twice, keeping track of votes on Obamacare.
As Harry Reid keeps senators in session rather than letting them go home to be with their families and celebrate Christmas, it's important to remember that this bill would not go into effect in any meaningful way until more than an Olympiad from now. Thus, it is the American voters -- and not the current Democratic Congress or the current president -- who will ultimately decide its fate. Providing reminders to representatives in both chambers of that in the coming days will be crucial to beating back the onslaught of proposed legislation that, even if it passes the Senate, would at least have to passed again by the House and would likely have to go back through both chambers in compromised form.
Australian psychiatric hospital: Moronic official "wisdom"
Keep psych ward knives in drawers after fatal stabbings, says chief psychiatrist. THAT should be a big help! (NOT). It's often said that the psychiatrists are nearly as mad as the patients and this seems rather a good example of that
AN inquiry into the stabbing deaths of two patients at a Melbourne psychiatric hospital has come up with seven recommendations, including a requirement that knife sets be kept in drawers.
Last month two patients at the Thomas Embling Hospital - Raymond Splatt and Paul Notas - were stabbed to death. Fellow patient Peko Lakovski is facing two counts of murder.
Victoria's Chief Psychiatrist Dr Ruth Vine conducted an inquiry into the deaths, aided by a team of interstate experts with forensic clinical experience. Dr Vine said the government has accepted all seven recommendations and said the inquiry found that there was a ``very high threshold" of safety at the Thomas Embling.
The inquiry recommended that the hospital find a way for night staff, who may not deal directly with inmates, to come into contact with patients so they can assess their mental state and stability.
It also recommended that the hospital remove boxed knife sets from benches and put them into drawers. It said that while Jardine Unit patients were expected to cook and clean for themselves, ``the immediate and visible availability of implements that could be used as weapons should be minimised".
Other recommendations included the regular monitoring of relationships between the residents, getting more feedback on patients from their family and carers and documenting any early relapses of illness. "It is still the case that there has never been a serious incident committed by a patient on leave or following release from Thomas Embling Hospital," Dr Vine said. "The community can feel confident that Thomas Embling Hospital is well managed." [Two patients murdered and it is "well managed"!!??]
Australia: Ill people hit by cuts to government health funding
Hitting businesses just ends up hitting the little guy in the end -- as business passes on its increased costs in the form of price rises
THOUSANDS of private hospital patients are being forced to pay gap fees running into hundreds of dollars because of a dispute over price increases between the big health funds and Australia's largest pathology company. The stand-off over a 30 per cent fee increase that Sonic is requiring from members of the second biggest health fund, Bupa Australia, is set to worsen next week when the dispute spreads to Medibank Private. The industry giant estimates some patients could be up to $500 out of pocket after a hospital stay. "We're extremely concerned that Sonic are forcing private health insurance members to pay excessive costs for pathology services, which in the worst-case scenario can be up to several hundred dollars," the managing director of Bupa, Richard Bowden, said. Mr Bowden said the fees demanded by Sonic were up to twice the level set by the Medicare benefits schedule.
Sonic's demand for an increase of more than 30 per cent on current contracted rates was "clearly unaffordable and unreasonable" and was well above prices negotiated with other pathology providers. The breakdown in negotiations has meant that since November 1, Bupa no longer has a contract for no-gap arrangements with Sonic, exposing patients to big surprise bills.
Medibank members will be in the same position once its contract with Sonic expires on December 31. The two funds account for about 200,000 private hospital patients a year.
The Federal Government's 8 per cent cut to Medicare payments for pathology has contributed to Sonic's demand for a big rise from health funds to cover reduced government cover and rising costs, but the Health Minister, Nicola Roxon, refused to comment yesterday. "This is a commercial matter between Sonic and the health funds so it's not something we can comment on," a spokeswoman for Ms Roxon said.
The chief executive of Sonic, Colin Goldschmidt, stood by the fee rises, saying they followed years of inadequate payments from Medicare [government insurer], which reimburses 75 per cent of the official schedule fee, and Medibank [private insurer], which had covered part of the remaining costs. The rises were required to restore viability of many hospital pathology laboratories, which he said were running at a loss. Several other funds had accepted Sonic's terms. "Patients are free to change funds. We believe we cannot go on with the same fee structure we have had with Bupa and Medibank," Dr Goldschmidt said. He dismissed as "scurrilous" the Medibank claim that people could be $500 out of pocket.
The Bupa and Medibank members, who account for more than half of the 10 million Australians covered by health insurance, are the latest group to be exposed to surging gap costs. The Government's cut to Medicare rebates for cataract operations is leaving many patients with $300 gap bills.
The health funds have warned that the pathology rise, which would add millions of dollars to health insurance costs, would feed into premium rises currently before the Health Department.
Carol Bennett, the executive director of the Consumers Health Forum, said her organisation was concerned by the growing trend of pathology companies "to maximise their profits at the expense of vulnerable consumers who are often hit with large and unexpected pathology bills". "This is an industry that has enjoyed above average profits for many years now," Ms Bennett said. "No government can continue to drain taxpayers' money to fund ever-increasing pathology costs without proper checks and balances."
British Emergency Room patient has to wait 32 DAYS as NHS target time is exposed as a sham
Labour's A&E waiting-time target was exposed as a sham last night after it was revealed hospitals were fiddling the figures. No one is supposed to wait more than four hours in hospital casualty departments before being treated - but patients are waiting far longer and one was not treated for 32 days.
Evidence collected by the Tories shows that hospitals often put patients in curtained-off 'emergency assessment units' - where they are still waiting but do not count towards the A&E target because they are technically no longer on the ward. People are waiting an average of 17 hours in these units. Emergency units are mixed-sex and often do not contain proper beds: just trolleys. Critics say they are being used as dumping grounds so hospitals can 'stop the clock' and hit the admissions target.
The Tories have pledged to scrap Whitehall targets, but fear that this will lead to a return to long waiting times. While no one in the NHS waits for more than 18 weeks for treatment; under the Conservatives waits of 18 months were not uncommon.
Conservative health spokesman Andrew Lansley said: 'Labour complacently claim that they have abolished long waits for patients being admitted to hospitals, but these figures show that all they have really done is fiddle the figures. 'The reality is that in some cases, patients are being left in often inappropriate wards for days and weeks at a time. It is unacceptable and has to change. 'Labour's insistence on forcing doctors to focus on ticking boxes ahead of looking after patients means that more time is spent on devising elaborate schemes to satisfy the bureaucrats rather than making sure unwell patients get better. 'We need to get back to the drawing board and once again put patients at the heart of the NHS, not Labour's targets.'
The Tories used the Freedom of Information Act to find that in one case, a patient was kept for 32 days in an admissions unit at the Royal Bournemouth and Christchurch hospitals NHS foundation trust. The trust declined to say why the wait lasted so long.
Other patients are shunted off the four-hour target clock by being moved to medical assessment units, which always have beds but are still usually mixed-sex. Average waits here are even longer, at 22 hours. One patient was held in one of these units for 24 days. The Tories say the scandals are occurring because the number of hospital beds have been slashed over recent years.
Health minister Gillian Merron said: 'The reality is that the overwhelming majority of patients are seen in A&E within three hours, well within the four-hour standard and a major improvement from 12 years ago. 'The figures presented are misleading and have been deliberately combined with those of assessment units - where patients who need further observation or investigation before a diagnosis can be made are treated.
British Coroner furious after a grandmother dies in 'burning agony' following NHS injection blunder
A grandmother died after 'gross failures' by NHS doctors who injected her lungs with a chemical that was ten times the recommended strength, a coroner ruled today. Rosemary McFarlane, 64, spent ten days in 'burning agony' after receiving the lethal dose during what should have been a routine procedure. The caustic chemical, phosphate buffered saline, burned the inside of her lungs.
The hospital's usual supplier had run out of the PBS fluid and a pharmacy was asked to provide the solution. It was bought over the internet by a junior pharmacist, who mistook '10x' on the label to mean ten bottles of the liquid rather than its super-strength concentration, an inquest heard. At that strength it is used for preserving tissue samples in laboratories and is unlicensed for use on the living.
Coroner Aiden Cotter launched a stinging attack on staff at Heartlands Hospital, in Birmingham. Addressing the workers at Birmingham Coroner's Court, he said: 'I have dealt with far too many deaths from NHS hospitals in recent years. 'We hold out our arms and trust medical professionals to inject things into us and the thought some people do not check something that could kill us is appalling. 'You hold our lives in your hands every day when you are at work when people need to act professionally. Too many people are unprofessional.' He added: 'There are many people working in the NHS who are hard working and professional, but there are a significant number who are not. 'The failures made by the doctors and the pharmacy team are gross failures. I consider they have sufficient causal connection to the death of Mrs McFarlane.' He recorded a narrative verdict with neglect as a contributing factor.
Mrs McFarlane, a mother of four and grandmother of five, from Kingshurst, Birmingham, was admitted to the hospital with pulmonary fibrosis, a lung condition which affected her breathing, on August 12 last year. The housewife's illness was serious but not life-threatening when medics decided to conduct a routine bronchoscopy to investigate the problem by pumping fluid into the lungs. It was then removed along with lung tissue samples to be sent for analysis.
A nurse administered the solution after asking the physician, Dr Aden Mansur, if it was 'OK'. Dr Mansur told the inquest: 'This was used as a mere replacement, I was not aware there are different strengths. 'I was under the impression there was only one bottle of PBS to be used.' He said he did not see '10x' on the front of the bottle and would not have known its meaning.
Mrs McFarlane's daughter Ann Marie Tranter said: 'The pain was so bad that she was crying with agony and she told us that it felt like her chest was burning.'
Senate Sets Up Requirement for Super-Majority to Ever Repeal Obamacare
The Senate Democrats declare a super-majority of senators will be needed to overrule any regulation imposed by the Death Panels
If ever the people of the United States rise up and fight over passage of Obamacare, Harry Reid must be remembered as the man who sacrificed the dignity of his office for a few pieces of silver. The rules of fair play that have kept the basic integrity of the Republic alive have died with Harry Reid. Reid has slipped in a provision into the health care legislation prohibiting future Congresses from changing any regulations imposed on Americans by the Independent Medicare [note: originally referred to as "medical"] Advisory Boards, which are commonly called the “Death Panels.”
It was Reid leading the Democrats who ignored 200 years of Senate precedents to rule that Senator Sanders could withdraw his amendment while it was being read. It was Reid leading the Democrats who has determined again and again over the past few days that hundreds of years of accumulated Senate parliamentary rulings have no bearing on the health care vote. On December 21, 2009, however, Harry Reid sold out the Republic in toto.
Upon examination of Senator Harry Reid’s amendment to the health care legislation, Senators discovered section 3403. That section changes the rules of the United States Senate. To change the rules of the United States Senate, there must be sixty-seven votes.
Section 3403 of Senator Harry Reid’s amendment requires that “it shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.” The good news is that this only applies to one section of the Obamacare legislation. The bad news is that it applies to regulations imposed on doctors and patients by the Independent Medicare Advisory Boards a/k/a the Death Panels.
Section 3403 of Senator Reid’s legislation also states, “Notwithstanding rule XV of the Standing Rules of the Senate, a committee amendment described in subparagraph (A) may include matter not within the jurisdiction of the Committee on Finance if that matter is relevant to a proposal contained in the bill submitted under subsection (c)(3).” In short, it sets up a rule to ignore another Senate rule.
Senator Jim DeMint confronted the Democrats over Reid’s language. In the past, the Senate Parliamentarian has repeatedly determined that any legislation that also changes the internal standing rules of the Senate must have a two-thirds vote to pass because to change Senate rules, a two-thirds vote is required. Today, the Senate President, acting on the advice of the Senate Parliamentarian, ruled that these rules changes are actually just procedural changes and, despite what the actual words of the legislation say, are not rules changes. Therefore, a two-thirds vote is not needed in contravention to longstanding Senate precedent.
How is that constitutional? It is just like the filibuster. Only 51 votes are needed to pass the amendments, but internally, the Senate is deciding that it will not consider certain business. The Supreme Court is quite clear that it won’t meddle with the internal operations of the House and Senate. To get around the prohibition on considering amendments to that particular subsection of the health care legislation, the Senate must get two-thirds of the Senate to agree to waive the rule. In other words, it will take a super-majority of the people the citizens of our Republican elected to overrule a regulation imposed by a group of faceless bureaucrats and bean counters.
Here is the transcript of the exchange between Jim DeMint and the Senate President:
DEMINT: But, Mr. President, as the chair has confirmed, Rule 22, paragraph 2, of the standing rules of the Senate, states that on a measure or motion to amend the Senate rules, the necessary affirmative vote shall be two-thirds of the senators present and voting. Let me go to the bill before us, because buried deep within the over 2,000 pages of this bill, we find a rather substantial change to the standing rules of the Senate. It is section 3403 and it begins on page 1,000 of the Reid substitute. . . . These provisions not only amend certain rules, they waive certain rules and create entirely new rules out of whole cloth.”
The Senate President disagreed and said it was a change in procedure, not a change in rules, therefore the Senate precedent that a two-thirds vote is required to change the rules of the Senate does not apply. Senator DeMint responded:
DEMINT: and so the language you see in this bill that specifically refers to a change in a rule is not a rule change, it’s a procedure change?
THE PRESIDING OFFICER: that is correct.
DEMINT: then I guess our rules mean nothing, do they, if they can redefine them. thank you. and I do yield back.
THE PRESIDING OFFICER: the senate stands adjourned until 7:00 a.m. tomorrow.
That’s right. When confronted with the facts, the Senate Democrats ran for cover. The Senate Democrats are ignoring the constitution, the law, and their own rules to pass Obamacare.
Senate Set To Pass Medical Overhaul, But Hurdles Remain
Senate Democrats have achieved a major victory in the health care overhaul, yet major differences over abortion and the public plan option remain between the Senate and House. Just after 1 a.m. Monday, Majority Leader Harry Reid got the 60 votes he needed to end debate on the Senate health care bill. "The Senate took another historic step toward our goal of delivering access to quality, affordable health care to all Americans," he said.
Final passage of the bill requires 51 votes and is all but guaranteed. The vote is expected Thursday. The Senate and House bills then go to a conference committee in which House and Senate negotiators will try to iron out the differences in the two bills. "There are serious differences between the two, and not the kind that can be easily put aside by saying, 'This is such an historic moment, let's get health care done,'" said Michael Cannon, director of health policy studies at the libertarian Cato Institute.
What makes the process more difficult is that some liberals are unhappy with what the Senate produced. "Speaking as a progressive voice in this debate, the House bill is superior to the Senate bill in almost every respect," said Roger Hickey, co-director of the liberal Campaign for America's Future. "We'd prefer to see the major shortcomings in the Senate bill rectified."
Sen. Ben Nelson, D-Neb., threatened to vote against ending debate until he struck a deal with Sen. Bob Casey, D-Pa., over abortion language. Under the compromise, government premium subsidies are segregated from private money so that no taxpayer dollars pay for abortion. Further, every state will have the option of banning insurance plans that provide abortion coverage from their insurance exchanges.
Rep. Bart Stupak, D-Mich., called the compromise "unacceptable in a number of ways." Stupak succeeded in adding an amendment to the health bill with tougher language that prevents any federal dollars from going to pay for any part of any plan that covers abortion. He did suggest that there was room for a compromise with the Senate.
The House bill passed 220-215, leaving little margin for error. Forty-one Democrats who voted for Stupak's amendment also voted for the House bill, including Stupak. "I would certainly prefer Stupak over the Senate," said Rep. Jason Altmire, D-Pa. "But the only thing that will get me to vote against the bill is if it were to add to the deficit."
Altmire, a member of the moderate-conservative Blue Dog Caucus, voted against the House bill, but might change his mind. "The Senate bill is a much better bill on cost containment," he said. "I would be much more favorable toward that bill if it were the final product."
Some liberals thought the Senate abortion part went too far. "The language included in the Senate's manager's amendment still raises many questions. I am concerned that it appears to go beyond current law," Rep. Rosa DeLauro, D-Conn., said in a written statement. "I look forward to working toward a satisfactory resolution in the conference between the House and Senate."
"It will be a very long and contentious conference, given the fact that it has taken this long to pass separate bills in both the House and Senate over issues that are now at odds such as abortion, the public plan, and the financing source," said James Capretta, a senior fellow at the conservative Ethics & Public Policy Center.
The House bill contains a public plan that will negotiate rates with providers. It was the product of intraparty fighting between moderate Democrats who prefer no public option and liberals who want one base on Medicare rates. The Senate couldn't resolve such conflicts, so the Senate bill has no public plan.
Rep. Lynn Woolsey, D-Calif., co-chairwoman of the House Progressive Caucus, has called the Senate bill a giveaway to private insurance companies. "It does not have a public option to control costs," she said in a news report. "By providing low-cost competition, the public option would have forced insurers to rein in the spiraling costs of premiums."
The Progressive Caucus has 81 members, all of whom voted for the House bill. Some observers think it won't be a crippling issue. "It's an ideological fixation that the left has," Cannon said. "They'll be upset, but they'll suck it up and vote for something without the public option."
The one Senate member of the Progressive Caucus, Bernie Sanders, I-Vt., threatened to vote against the Senate bill unless it included a public plan. He relented when Reid agreed to include an additional $10 billion for community health centers.
Even some on the left think the politics in the Senate will cause House liberals to fold. "I don't want to admit that it's impossible to get a public plan," said one prominent liberal activist who spoke on condition of anonymity. "I've been fighting and will continue to fight for a public option. But in order for a bill to get 60 votes in the Senate, it will be very difficult if a public option is in the bill."
Barack Obama's quest for historic health care legislation has turned into a parody of leadership. We usually associate presidential leadership with the pursuit of goals that, though initially unpopular, serve America's long-term interests. Obama has reversed this. He's championing increasingly unpopular legislation that threatens the country's long-term interests. "This isn't about me," he likes to say, "I have great health insurance." But of course, it is about him: about the legacy he covets as the president who achieved "universal" health insurance. He'll be disappointed.
Even if Congress passes legislation -- a good bet -- the finished product will fall far short of Obama's extravagant promises. It will not cover everyone. It will not control costs. It will worsen the budget outlook. It will lead to higher taxes. It will disrupt how, or whether, companies provide insurance for their workers. As the real-life (as opposed to rhetorical) consequences unfold, they will rebut Obama's claim that he has "solved" the health care problem. His reputation will suffer.
It already has. Despite Obama's eloquence and command of the airwaves, public suspicions are rising. In April, 57 percent of Americans approved of his "handling of health care" and 29 percent disapproved, reports The Washington Post-ABC News poll; in the latest survey, 44 percent approved and 53 percent disapproved. About half worried that their care would deteriorate and that health costs would rise.
These fears are well-grounded. The various health care proposals represent atrocious legislation. To be sure, they would provide insurance to 30 million or more Americans by 2019. People would enjoy more security. But even these gains must be qualified. Some of the newly insured will get healthier, but how many and by how much is unclear. The uninsured now receive 50 percent to 70 percent as much care as the insured. The administration argues that today's system has massive waste. If so, greater participation in the waste by the newly insured may not make them much better off.
The remaining uninsured may also exceed estimates. Under the Senate bill, they would total 24 million in 2019, reckons Richard Foster, chief actuary of the Centers for Medicare & Medicaid Services. But a wild card is immigration. From 1999 to 2008, about 60 percent of the increase in the uninsured occurred among Hispanics. That was related to immigrants and their children (many American born). Most illegal immigrants aren't covered by Obama's proposal. If we don't curb immigration of the poor and unskilled -- people who can't afford insurance -- Obama's program will be less effective and more expensive than estimated. Hardly anyone mentions immigrants' impact, because it seems insensitive.
Meanwhile, the health care proposals would impose massive costs. Remember: The country already faces huge increases in federal spending and taxes or deficits because an aging population will receive more Social Security and Medicare. Projections made by the Congressional Budget Office in 2007 suggested federal spending might rise almost 50 percent by 2030 as a share of the economy (gross domestic product). Since that estimate, the recession and massive deficits have further bloated the national debt.
Obama's plan might add almost another $1 trillion in spending over a decade -- and more later. Even if this is fully covered, as Obama contends, by higher taxes and cuts in Medicare reimbursements, these revenues could have been used to cut the existing deficits. But the odds are that the new spending isn't fully covered, because Congress might reverse some Medicare reductions before they take effect. Projected savings seem "unrealistic," says Foster. Similarly, the legislation creates a voluntary long-term care insurance program that's supposedly paid by private premiums. Foster calls it "unsustainable," suggesting a need for big federal subsidies.
Obama's overhaul would also change how private firms insure workers. Perhaps 18 million workers could lose coverage and 16 million gain it, as companies adapt to new regulations and subsidies, estimates The Lewin Group, a consulting firm. Private insurers argue that premiums in the individual and small group markets, where many workers would end up, might rise an extra 25 percent to 50 percent over a decade. The administration and the Congressional Budget Office disagree. The dispute underlines the bills' immense uncertainties. As for cost control, even generous estimates have health spending growing faster than the economy. Changing that is the first imperative of sensible policy.
So Obama's plan amounts to this: partial coverage of the uninsured; modest improvements (possibly) in their health; sizable budgetary costs worsening a bleak outlook; significant, unpredictable changes in insurance markets; weak spending control. This is a bad bargain. Benefits are overstated, costs understated. This legislation is a monstrosity; the country would be worse for its passage. What it's become is an exercise in political symbolism: Obama's self-indulgent crusade to seize the liberal holy grail of "universal coverage." What it's not is leadership.
Legislating Discrimination - One more reason to oppose Obamacare
What’s the worst bill ever seriously considered for passage by the U.S. Congress? Certainly both the House health-reform bill and Sen. Harry Reid’s health bill are leading contenders.
Both proposals are obscenely expensive. Both limit our freedom to choose our families’ health care. And both would legislate racial and other forms of discrimination — making them not only unconstitutional, but immoral, counterproductive, and dangerous.
Within the last three months, the U.S. Commission on Civil Rights has twice sent letters to the president and the leaders of the House and Senate warning them of discriminatory provisions in both bills. But those warnings have been ignored, and the problems remain.
Take Reid’s bill. It directs the secretary of health and human services to award federal grants worth billions of dollars to educational institutions that train medical-service providers. However, “priority” for federal dollars is to be given only to those institutions offering “preferential” admissions to underrepresented minorities (according to race, national origin, sex, sexual orientation, and religion, depending on which section of the bill you look at). Thus, schools will be unable to compete for essential federal funding unless they adopt admission policies that intentionally and deliberately discriminate. It guarantees the institution of racist and sexist quotas sanctioned and encouraged by the federal government in what Linda Chavez of the Center for Equal Opportunity correctly calls “a new racial spoils system.”
The bill also declares that institutions training social workers, psychologists, psychiatrists, behavioral pediatricians, psychiatric nurses, and counselors will be ineligible for federal grants unless they discriminate. According to Section 756, these programs must enroll “individuals and groups from different racial, ethnic, cultural, geographic, religious, linguistic, and class backgrounds, and different genders and sexual orientations” and demonstrate “knowledge and understanding of the concerns of the[se] individuals and groups.” If the schools fail to abide by these requirements, they will be liable for “liquidated damages.”
The Senate bill even creates a federally funded and administered medical school called the United States Public Health Services Track to “grant appropriate advanced degrees.” Priority in admissions is to be given to “students from rural communities and underrepresented minorities.” (“Underrepresented minorities” is liberal code for “Asians need not apply.”)
Naturally, other sections of the bill require lots of data collection regarding race, ethnicity, sex, and so on. Those data will be used to implement quotas of all kinds and put providers at risk of being sued. For example, the data will help trial lawyers pursue “disparate impact” cases against physicians and hospitals — even if the differing health outcomes of patients have nothing to do with actual discriminatory treatment by providers. One provision even requires the secretary of health and human services to consult with “representatives of racial and ethnic minorities” about the content of promotional labels or print ads for drugs. Racial politics is poised to trump scientific accuracy in drug labeling.
In general, the bill reflects two articles of faith prevalent on the left: (1) that discrimination is perfectly acceptable when practiced in favor of certain minority groups; and (2) that racial disparities in health outcomes arise because doctors and patients don’t have the same racial or ethnic or cultural background. The latter is, of course, nonsense. As the Civil Rights Commission said succinctly, the assumption that “racial health disparities are caused by a shortage of medical professionals of particular races misdiagnose[s] the problem and may well exacerbate it.”
Ethnic and racial disparities in health outcomes are caused by a variety of factors, including minorities’ greater dependence on Medicaid, the federal-state health program for the poor, which is notorious for providing poor-quality care. For blacks, disparities also emerge because, in the words of the Civil Rights Commission, “as a population, black patients use different doctors, clinics and hospitals than white patients.” Unfortunately, “the doctors who treat black patients . . . are less likely to be highly credentialed.” One study found that “blacks tend to live in parts of the country that have a disproportionate share of low-quality providers.” At those hospitals, “both whites and blacks tend to receive low-quality care, but since blacks are overrepresented in such areas, the quality of the hospital will cause an overstatement of the role that race plays.”
In, sum, the kind of care you get — and your individual health outcome — is determined by your doctor’s skill, not by his race or “cultural sensitivity.” Unfortunately, the Democrats’ health-care legislation will force medical institutions to hire based on race and sex, not qualifications, and to lower their admission standards, which will lead to even more “low-quality” doctors. Medical students admitted based on lower qualifications generally perform more poorly on licensing exams.
Race-based admissions end up endangering patients — such as those treated by Patrick Chavis, one of whom bled to death due to Chavis’s medical malpractice. Chavis was the black applicant admitted to the University of California at Davis Medical School even though he had much weaker academic qualifications than Allan Bakke, a white applicant who was rejected from the school and subsequently was the plaintiff in a famous Supreme Court case. Chavis eventually lost his medical license because of his gross negligence, incompetence, and “inability to perform some of the most basic duties required of a physician.”
Instead of helping ensure all Americans access to high-quality medical care, Harry Reid’s bill seems intent on populating the medical community with more bad physicians like Patrick Chavis. The bill’s discriminatory provisions are both unconstitutional and immoral. Over time, they will erode the quality of patient care. That’s no way to “reform” our health system.
Obamacare Slaps $15,000 Annual Fee on Middle Class Families
The Congressional Budget Office's analysis of the final Senate health care bill indicates it would slap a mandatory annual fee of about $15,000 on middle-class families that earn an annual income greater than 400 percent of the federal poverty level ($88,200 for a family of four) and are not provided with health insurance by their employer.
On Dec. 19, the CBO sent a letter to Senate Majority Leader Harry Reid, D-Nev., analyzing the fiscal impact of the bill the Senate is poised to vote on before Christmas. The CBO analysis cites five basic facts about the bill that acting together would deal a devastating financial blow to many middle-class families if the bill is enacted and enforced as written. Here are these facts:
Fact 1: You will be forced to buy health insurance.
Page 1 of the CBO's letter to Reid says, "Among other things, the legislation would establish a mandate for most legal residents of the United States to obtain health insurance"
Fact 2: You will be eligible for a federal subsidy to help you buy health insurance, but only if you earn less than 400 percent of the poverty level ($88,200 for a family of four), your employer does not offer you coverage and you purchase a government-approved plan in a government-regulated insurance exchange.
Page 7 of the CBO's letter to Reid says: "The bill also would establish new insurance exchanges and would subsidize the purchase of health insurance through those exchanges for individuals and families with income between 133 percent and 400 percent of the federal poverty level. ... As a rule, full-time workers who were offered coverage from their employer would not be eligible to obtain subsidies via the exchanges."
Fact 3: Your employer will not be required to offer you coverage, and will face a maximum fine of $750 per worker per year if it does not.
Page 7 of the CBO letter to Reid says: "In general, firms with more than 50 workers that did not offer coverage would have to pay a penalty of $750 for each full-time worker if any of their workers obtained subsidized coverage through the insurance exchanges; that dollar amount would be indexed."
Fact 4: Your insurance provider will face new federal mandates that will increase its cost for any plan it offers you.
Page 7 of the CBO's letter to Reid says, "Policies purchased through the exchanges (or directly from insurers) would have to meet several requirements: In particular, insurers would have to accept all applicants, could not limit coverage for pre-existing medical conditions, and could not vary premiums to reflect differences in enrollees' health."
Fact 5: Your family insurance plan -- if your employer drops your coverage and you are forced to buy it on your own -- will cost about $15,000 per year when the legislation is in full force in 2016.
Page 19 of the CBO letter to Reid says the average premiums for insurance plans under the final version of the bill should be "quite similar" to the estimates the CBO and Joint Committee on Taxation made in a Nov. 30 letter to Sen. Evan Bayh, D-Ind.: "Although CBO and JCT have not updated the estimates provided in that letter, the effects on premiums of the legislation incorporating the manager's amendment would probably be quite similar." Page 6 of the CBO's letter to Bayh said: "Average premiums per policy in the nongroup market in 2016 would be roughly $5,800 for single policies and $15,200 for family policies under the proposal."
The Senate health care bill gives employers two powerful incentives to stop offering health insurance coverage to their workers. First, if an employer does offer coverage, its lower-wage workers will lose the federal insurance subsidy they would otherwise get. Secondly, if an employer does not offer coverage, the $750-per-worker fine it faces will be far less than the premiums it would pay if it did offer coverage.
Where does this leave a mom and dad with two children and an annual income greater than $88,200? It leaves them without employer-based health insurance and facing a federally mandated $15,000-per-year insurance bill.
If this legislation is not stopped now, there will surely be a popular rebellion when the insurance mandate hits in five years.
When that happens, the liberals will not say: We made a mistake. We never should have forced families out of their employer-based health insurance and required them to purchase a $15,000 policy. They will say: We told you so. We cannot trust these greedy insurance companies. We need a single-payer system so the government can provide everyone with health care. Just like they did in the Soviet Union.
President Obama’s vision of near universal healthcare took a big step closer to reality yesterday when his plans secured a watertight majority in the Senate. With Washington covered in 2ft of snow and some senators flown in on government jets to make sure they were there for the 1am roll call, all 58 Democrats and the chamber’s two independents held together to deliver the 60 votes needed to cut off Republican efforts to block the Bill.
The vote, which followed a frenzy of last-minute compromises to win over the last Democratic moderate, clears the way for a Senate Bill to win passage in a vote scheduled for 7pm on Christmas Eve. A final piece of legislation — the centrepiece of Mr Obama’s domestic agenda — is likely to reach his desk next month.
Republicans, who voted unanimously against the package, decried the $871 billion (£540 billion) ten-year Bill as a hastily crafted, fatally flawed partisan monstrosity that would raise taxes, increase healthcare costs and explode the already record budget deficit. Mitch McConnell, the senior Senate Republican, called it a mess and a “blind call to make history”.
Yet after a century in which many US presidents have talked about universal health coverage — and with some, including the Republican Richard Nixon and Democratic Bill Clinton trying and failing — Mr Obama will rightly be able to claim that he has achieved something no other US president has managed.
The White House and Democratic leaders conceded that the Bill was far from perfect, but argued that failure to pass some form of sweeping legislation would have consigned efforts to reform the health insurance industry to the political wilderness, possibly for at least another generation. Tom Harkin, a Senate liberal who had to swallow significant concessions to moderates, called his backing of the Bill “the defining vote of my career”.
Watching from the chamber’s gallery was Victoria Kennedy, the widow of Edward Kennedy — a staunch liberal who campaigned for health reform during his career. Hours before the vote she argued in a piece written for The Washington Post that her husband would have voted for the Bill because “he said that it was better to get half a loaf than no loaf at all, especially with so many lives at stake”.
Obstacles remain, but yesterday’s vote was seen as the critical hurdle Mr Obama needed to clear to see a final piece of legislation emerge. If passed on Christmas Eve the Senate Bill will need to be merged, or reconciled, with a version passed by the House last month, and there remain significant differences between the two.
Unlike the $1 trillion House Bill, the Senate version contains no government-run health insurance programme, known as the “public option”. Liberals have seen this as a crucial test for any legislation because they claim that it is needed to provide competition to keep the costs of private insurers down. Harry Reid, the Democratic Senate leader, dropped the public option to win over Joe Lieberman, the former Democrat turned independent, and the final Democratic holdout, Ben Nelson of Nebraska.
Mr Nelson also won restrictions on the use of federal money for abortions, and an extraordinary financial gift to his home state. Unlike every other US state, Nebraska will no longer have to share the cost with central government of providing Medicaid, the medical assistance programme for low income Americans — a concession condemned by Republicans as a blatant bribe. Because Mr Reid has no room for manoeuvre — one defection would doom the Bill — the Senate version is expected largely to prevail during negotiations with the House.
Under the legislation, an additional 30 million Americans, who are currently uninsured, would receive coverage. The Bill will require nearly all Americans to obtain health insurance, or face a financial penalty for failing to do so. About half of those would be helped to do so by an expansion of Medicaid.
Small businesses would receive tax breaks to help them to provide coverage to employees. Big companies would face financial penalties for failing to do so. Insurance companies would no longer be able to decline coverage to people with pre-existing conditions.
To pay for the reform, the Bill would impose an array of taxes and fees, including tax rises for individuals earning more than $200,000 and couples earning more than $250,000. The most expensive health insurance coverage, known as “Cadillac plans”, will be taxed heavily. The Bill would also slash government spending on Medicare, the government subsidy programme for the elderly.
A year into the Obama era, the left claims triumph (but they admit the policies stink)
By JAMES TARANTO
Well, they did it. Through a combination of intimidation and bribery (using our money, of course), the Democrats who run the Senate achieved cloture on their version of ObamaCare. The 60-40 vote was strictly along party lines, and it took place at 1:08 a.m. Monday, a time when any decent person is either home in bed or out at a bar.
So, a big triumph for the left, right? More than 64 years after President Truman proposed it, "universal health care" is finally on the verge, or at least the precipice, of becoming reality.
Only there's one problem: Many on the left admit that by their own lights, ObamaCare is bad policy. Here's a fascinating exchange from PBS's "Bill Moyers Journal" Friday. Moyers is interviewing the liberal-left economist Robert Kuttner and the liberal-left journalist Matt Taibbi. Both agree that the bill is very bad, but Kuttner wants Congress to enact it anyway:
Kuttner: Well, it's so far from what I think is necessary that I don't think it's a it's a good bill. But I think if it goes down, just because of the optics of the situation and the way the Republicans have framed this as a make-or-break moment for President Obama, it will make it easier for the Republicans to take control of Congress in 2010. It will make Obama even more gun-shy about promoting reform. It will create even more political paralysis. It will embolden the Republicans to block what this president is trying to do, some of which is good, at every turn. So I would hold my nose and vote for it. . . .
Moyers: Aren't you saying that in order to save the Democratic president and the Democratic Party in 2010 and 2012 you have to have a really rotten health insurance bill?
Kuttner: Well, when you come down to one pivotal moment where a bill is before Congress and the administration has staked the entire presidency on this bill and you're a progressive Democrat are you going to vote for it or not? Let me put it this way, if I were literally in the position that Joe Lieberman is in and it was up to me to determine whether this bill live or die, I would hold my nose and vote for it even though I have been a fierce critic of the path this administration has taken. . . .
The Democrats are really between a rock and a hard place here, because if it loses, there's one set of ways the Republicans gain. If it wins, there could be another set of ways that the Republicans gain. And this is all because of the deal that our friend, Rahm Emanuel struck back in the spring of passing a bill that's a pro-industry bill that doesn't really get at the structural problems. . . .
But now we're down to a moment of final passage. And maybe my views are very ambivalent. But I would still vote for it because I think the defeat would be absolutely crushing in terms of the way the press played it, in terms of the way it would give encouragement to the far right in this country that we can block this guy if we just fight hard enough, if we just demagogue it.
Taibbi: But couldn't that defeat turn into--that crushing defeat, couldn't that be good for the Democrats? Couldn't it teach them a lesson that, you know, maybe they have to pursue a different course in the future?
Kuttner: Well, you're younger than I am.
There is little doubt that the attitude Kuttner expresses is shared by some senators who voted "yes" at 1:08 a.m. Sunday--all of whom, by the way, also are older than Taibbi. The cynicism is breathtaking: The Kuttner caucus is willing to subject a sixth of the nation's economy, and the lives of millions, to an admittedly awful legislative scheme, on the basis of the dubious assumption that it will help their party politically in the short term, and also to spite "the far right in this country."
Senator Joe Lieberman should be ashamed of himself. He said he would not support a “public option.” But he did. He knows he did—and he’s hoping the American people don’t. Of course, to listen to the press coverage of Senate Majority Leader Harry Reid’s manager amendment, one would think that taxpayer-subsidized, government-run health care was no longer a part of the proposal. For example, reports TalkingPointsMemo.com, “The public option is dead. Its successors are dead.” Oh, really.
Then, how is it that, so conspicuously in the Congressional Budget Office’s (CBO) cost estimate, there lays some $871 billion in taxpayer subsidies from insurance coverage provisions? Is this some kind of sick joke? Do Harry Reid and Barack Obama really think they can spend a trillion dollars over ten years on government-run health care—and then convince taxpayers that they are not doing so, simply by rhetorical tomfoolery and sleight of hand?
Does it really matter if the taxpayer subsidies are funneled through insurance “exchanges” rather than monolithic bureaucracies? Did the public-private model serve Fannie Mae and Freddie Mac any better when they finally went bankrupt last year in the midst of the financial crisis?
The answers to these questions are obvious enough. Whether through single-payer, co-ops, insurance “exchanges” or the like, taxpayers are going to be on the hook for a trillion dollars. As if the problem with the “public option” was a marketing difficulty to be surmounted by changing the name.
The numbers don’t lie, although they tend to be understated. For example, the CBO writes that the net cost “reflects a gross total of $871 billion in subsidies provided through the exchanges, increased net outlays for Medicaid and the Children’s Health Insurance Program (CHIP), and tax credits for small employers; [but] those costs are partly offset by $149 billion in revenues from the excise tax on high-premium insurance plans and $108 billion in net savings from other sources.”
And so, the CBO concludes, the cost of increasing subsidized health care is only $614 billion. How do they come to that conclusion? By including the $149 billion in revenues and $108 billion in “savings” in the same table labeled “net changes in the deficit from insurance coverage provisions.”
Which is simply duplicitous. To discover the hidden cost of the insurance provisions, one has to read the following footnote to that controversial table: “Includes excise tax on high-premium insurance plans.” Really, the excise tax should have been included in the table clearly labeled, “net changes in the deficit from other provisions affecting revenues.” And, as a result, that table should have read that the bill increases taxes by $413 billion, not $264 billion.
The high jinks do not stop there, however. The estimate claims that the bill “would yield a net reduction in federal deficits of $132 billion over the 2010-2019 period.” That is accurate, of course, only if one assumes the impossible that the $483 billion in proposed cuts to Medicare ever occur. By far the most unpopular provision has been the inevitable rationing of care away from seniors that would occur under the Congressional Democrat proposal.
Of course, the only purpose of the phony “cuts” is to obtain a better score from CBO. The “cuts” are restored in concurrent legislation called the “doc-fix”. The result? The new “public option” will spend some $350 billion more than it takes in through revenues in its first ten years alone. And, the subsidized care provided through the exchanges will still create a state-run monopoly in the health insurance market, drive up premiums, muscle individuals out of their privately-provided care, deplete the public treasury, and once bankrupt, result in the rationing of medical treatment away from the American people, especially seniors.
All of the goals of the Democrat-sponsored plan—reducing costs, slashing the deficit, expanding coverage, etc.—all fail, raising the question: Why? The only reason is that the stated goals are a ruse. And the real goal is ideological: to move America to a socialized single-payer health system that will cost trillions—one way or another.
Senator Joe Lieberman had but one chance to stop this madness in the final cloture vote early this morning. If he had meant what he said that he did not support a “public option,” surely he would have agreed that $871 billion in taxpayer subsidies for health insurance is quite public. Instead, he voted along party lines in the monumental 60-40 vote. Changing the name and funneling the taxpayer dough through “exchanges” will not hide the facts—or his shame.
The lust to score a political win on health care is making Tiger Woods look like a saint. Congressional Democrats are willing to throw all common sense overboard in their frenzy for a conquest. Of all the desperate ideas in the current health care proposals before Congress, the absolute worst is the "Medicare buy-in" slipped in by Harry Reid at the last minute.
This has long been a dream of the left: Expand Medicaid to ever-higher income levels and Medicare to ever-lower age groups, and pretty soon the two populations will meet in the middle. Voila! Single Payer Nirvana!
There are a few problems with this idea, however, starting with its effects on the health care system, on patients, and on the federal budget and the country as a whole. In a recent report, Richard Foster, chief actuary for the federal government, concluded 20 percent of all U.S. hospitals and nursing homes could go out of business under the reform proposals-even before the Medicare buy-in was proposed. Medicare and Medicaid already don't pay these facilities enough to cover their costs.
According to the actuarial consulting firm Milliman, Medicare pays hospitals $34.8 billion less than their costs and physicians $14.1 billion less than what it costs to provide services. Medicaid underpays hospitals $16 billion and doctors $23.7 billion. The only way doctors and hospitals can absorb such underpayments is by overcharging people with private insurance $89 billion a year.
Even before the Medicare buy-in proposal, the health reforms were going to cut Medicare spending by $50 billion a year, making it even harder for providers to stay in business. The Medicare buy-in makes this problem much worse by removing a large portion of the privately insured population that currently subsidizes Medicare and Medicaid, putting them into a program that pays far less than it costs. Moreover, this is a population of high users of health care services, so their impact on costs will be even greater.
The effect on health care services will be profound. Many more providers will go out of business or stop seeing people on Medicare, which will make access to services much more difficult. In addition to decreased access to health care services, it is not clear that the millions of new Medicare users will save any money or get improved health insurance. The population of ages 55-64 is the segment most likely to be insured today. According to the Census Bureau only about 12 percent of this age group is uninsured, compared to about 26 percent of people aged 25 to 34, 18.5 percent of those aged 35 to 44 and 15.6 percent of people aged 45 to 54.
Regarding quality, Medicare wouldn't even qualify as "creditable coverage" under the current proposals. The core program doesn't cover prescription drugs or preventive care, and it has no limit on out-of-pocket spending. People who signed up for Medicare would have to buy a supplemental policy to cover the gaps.
Finally, Medicare is already headed for bankruptcy. The federal government reports it will be spending more money than it takes in by 2017, and that is before most of the Baby Boom generation becomes eligible. The system is on the hook for $89 trillion in spending, and not a penny of that is actually funded. Extending Medicare is madness piled on top of insanity. And all of this is just to give the Congressional Democrats and President Barac k Obama a political "win" to hang on the wall.
As the U.S. Senate works feverishly to further distort the marketplace and deprive Americans of even more of what remains of their liberty by “overhauling” the health care industry, I offer you these excerpts from a December 16th article run by CBS News:
“Obama repeated his demand for action, telling ABC News ‘the federal government will go bankrupt’ if the health care bill fails. He said Medicare and Medicaid are on an ‘unsustainable’ path if no action is taken.
“To make matters more complicated, the Senate stumbled into health care gridlock after a Republican senator forced the clerk to read aloud a 767-page amendment.
“GOP Sen. Tom Coburn of Oklahoma had sought approval to require that any amendment considered by the Senate must be offered 72 hours in advance and with a full cost report.
“When he was rebuffed by Democratic Sen. Max Baucus of Montana, Coburn invoked his right to require that an amendment by another Democrat be read aloud. That sent the Senate into limbo, since the amendment by Vermont Independent Bernie Sanders was 767 pages long. It called for guaranteeing coverage to all through a public program similar to Medicare.
“Sanders withdrew his amendment some three hours later, after 139 pages had been read, with a broadside at Republicans. Pounding the lectern on his desk, his voice rising, he accused Republicans of trying to shut down the legislative process. ‘That is an outrage,” Sanders said. ‘People can have honest disagreements, but in this moment of crisis it is wrong to bring the United States government to a halt.’”
To Obama I would say that the federal government is not “going” bankrupt – it already is. The amount of federal debt is irresolvable, unpayable, and entirely beyond repair. What is even more outrageous about this statement is that Medicare, Medicaid, and so-called Social Security overall have been unsustainable for decades. What do you expect from a socialist system modeled after Otto von Bismarck’s 19th century Prussia? But Obama’s solution is pouring more money into the mouth of the monster, and further impinging upon individual choice – not necessarily health care provider, but whether one chooses to purchase health care or not. In Obama’s collectivist universe – along with most of his fellow statists – it’s okay, in terms of bureaucratically sanctioned progressive escalation of force, to ultimately kill people who choose to resist mandatory health care. Sick indeed.
Health care reform isn’t about making sure people are healthy. It never was. Like all actions of government, it is a justification for further control and enslavement of a population. It’s about non-productive fat cats living high off the hog at the expense of the politically unconnected working class. It’s about simple ruthless domination. It’s a cynical, insidious power play. If politicians and bureaucrats were truly concerned about people’s well-being (other than their own, of course), they’d resign their posts, find jobs that are actually useful and beneficial, and put government out of business forever.
This is where I need to address Vermont’s Bernie Sanders, a self-proclaimed and proud socialist directly: “’…in this moment of crisis it is wrong to bring the United States government to a halt.’”
No, Sanders, you just don’t get it. That is precisely what we need, and soon, and permanently. And since at least the time of Gustave de Molinari, market anarchism has been there, waiting only to point out the near-infinite ways in which that is possible.
Does anyone remember the TV show "Supermarket Sweep"? Contestants would compete with one another by careening through a supermarket and grabbing as many products as they could toss into a basket. The winner was the shopper whose cart carried the biggest price tag when the bell sounded.
It's a fitting image for the way Nancy Pelosi and Harry Reid have handled the most important domestic issue of the decade. They've raced down the health policy aisles, sweeping items off the shelves and into their legislative carts, heedless of nutritional value, taste, or cost. As items dropped out on the hairpin turns, others were shoved into the spaces. Harry Reid inserted the Medicare "buy-in" at the 11th hour and just as quickly withdrew it under pressure. No organizing principle has governed the contents of their baskets (Pelosi added and jettisoned abortion coverage), just an urgent imperative to pass something. And now, as the clock winds down, they are declaring, as a journalistic cheerleader at the Washington Post put it, "a legislative feat of epic proportions."
Actually, it was the sloppiest and most slapdash legislative process ever to accompany a major bill. The 383-page manager's amendment, making changes to the Senate bill, was released on the morning of the cloture vote. Secrecy marked Reid's handling of the bill throughout. Not only Republicans, but Democrats, too, were kept from studying the legislation. Payoffs to wavering Sens. Lieberman, Landrieu, and Nelson, on the other hand, were blatant.
The Democratic leaders of the House and Senate, in concert with the White House, have bullied, bribed, and rushed their members to vote on this legislation so that the deed could be done before constituents -- who oppose it forcefully -- could confront their representatives face-to-face over the Christmas break.
The Democrats have endured bruising internecine conflicts and risked the loss of between 20 and 40 seats in 2010 (Pelosi's estimate) for this. And what have they achieved? Their goal -- a single-payer system or a glide path to one -- remains as distant as ever. Instead, they have produced (or will, after the conference committee) an enormous new $2.5 trillion octopus of federal regulation that will increase premiums, contribute to medical cost inflation, reduce quality and choice of care, and deeply politicize an aspect of life that most Americans regard as sacrosanct. Additionally, and most alarmingly, it will aggravate the already crushing debt we are accumulating.
President Obama has betrayed every ringing promise he made about this reform. People will not be able to keep their health plans if they are happy with them. The federal government will determine which plans pass muster. As for not adding one dime to the federal deficit? Risible. The "savings" in the Senate bill consist of cuts to Medicare, not increased competition or more efficient delivery of services. And while CBO has scored the bill as reducing the deficit, CBO must abide by the assumptions Congress presents. It cannot say what we know from history to be the truth: Congress will not make cuts in Medicare. Besides, every entitlement ever enacted has wound up costing orders of magnitude more than the estimates at passage. That's why the Medicare and Social Security unfunded liability is currently $107 trillion, according to a 2009 trustees' report. The Reid bill will add at least 15 million new beneficiaries to Medicaid, accelerating that program's budget-busting momentum.
The president also promised that no one earning less than $250,000 would pay higher taxes. But under both the Senate and House bills, people who do not purchase health insurance will be slapped with an excise tax (2.5 percent of adjusted gross income under Pelosicare, and $750 or 2 percent of income, whichever is larger, under Reidcare).
The Democrats have not achieved their goal of completely lassoing one-sixth of the economy, but their mammoth legislation (the House and Senate bills both top 2,000 pages) will apply heavy-handed regulation that will further gum up a system already choking on bureaucracy. Americans will be forced to buy health insurance. Insurance companies will be forbidden to price their services according to actuarial tables. And no aspect of medical care will be free of political interference. (One section of the Senate bill reinstates coverage for DXA scans because two senators insisted upon it. Another requires breastfeeding breaks in the workplace.)
The Democrats will create, among others, the following new bureaus: The Grant Program for Health Insurance Cooperatives, the Telehealth Advisory Committee, the Community Based Medical Home Pilot Program, the Center for Comparative Effectiveness Research, and the Qualified Health Benefits Plan Ombudsman. In short, Democrats have done the maximum amount of damage to our system that they could manage under the circumstances.
Dying man, 80, is denied care at home as British health chiefs say he's not ill enough for help
But the light of publicity seems to be working, as usual. Too bad if you can't get a major newspaper to campaign for you, though
An 80-year-old man with a terminal disease that has left him immobile and with swallowing difficulties has been denied NHS funding for care at home. Health bosses say Brian Stroud is not ill enough to qualify. The ruling left his 77-year-old wife Eileen, who is herself frail and on crutches, to look after him. The couple have paid £16,000 for extra care in the last six months but their daughter Debbie Hill, 46, says the physical and financial strain is proving too much. They are also struggling with the bureaucracy involved in appealing against the decision.
The Strouds, of Hollandon-Sea, Essex, have been living a nightmare since Mr Stroud was diagnosed with the terminal disease PSP (progressive supranuclear palsy) three years ago. It is a rare and incurable degenerative brain disorder, whose victims included actor Dudley Moore. They applied for NHS Continuing Healthcare funding eight months ago but have been turned down twice by North East Essex Primary Care Trust.
Mrs Hill said: 'All the health service staff who have seen my father say he qualifies for funding but we've been told his needs are only 'moderate'. He can't use his left side, he's virtually immobile and in a wheelchair, he's doubly incontinent and cannot lift his head. 'Swallowing has got more difficult, so has communicating. It seems incredible that he's been turned down. 'It's all about money - and we're disgusted that the PCT chief executive got a three per cent bonus last year for achieving financial targets'.
The Daily Mail's Dignity for the Elderly campaign has repeatedly highlighted the unfairness of the means test system when families need nursing care for conditions such as Alzheimer's. Department of Health criteria on who qualifies for help are subject to interpretation by individual NHS trusts. Many people are denied funding by primary care trusts - which have to foot the bill - because their disease does not automatically make them eligible. Campaigners say requests are unlawfully rejected or mired in the appeal system for months or years.
Mrs Hill, a mother of two, said last night: 'We want justice for dad and mum, and for everyone else in this situation. 'They've been married 52 years, they're devoted to each other, but when they need the NHS it's not there for them.'
Jane Hardy, chief executive of the PSP Association, said refusal of NHS funding was becoming more common. She said there were around 1,250 sufferers diagnosed with this 'absolutely dreadful disease' at any one time. She said: 'It's made more terrible because people with PSP know what's happening to them. 'They are trapped in a broken body, unable to communicate and knowing it's only going to get worse. 'We need a system that's not left to local officials, who often have every incentive to reject applications.'
NHS North East Essex said last night that it will soon be making a new assessment of Mr Stroud's condition as his needs have ' potentially increased'.
British women with signs of breast cancer wait months as Labour government breaks manifesto pledge
Women with signs of breast cancer are waiting months for a diagnosis amid the failure of one of Labour's key manifesto pledges, the Government's cancer tsar has admitted. All patients with symptoms of the disease should be seen by a specialist within two weeks of visiting their GP, following a promise made before the last election. Labour said the NHS would meet the pledge by 2008 – a deadline it later extended to the end of this month.
Now the Government's cancer tsar Prof Mike Richards has disclosed that the health service is about to miss that target, with thousands of worried women waiting weeks and sometimes even months to see a hospital specialist. In an interview with The Sunday Telegraph, he also indicated that figures which will document widespread failings to meet the target are unlikely to be published before a general election.
Charities said last night that they were "deeply concerned" that thousands of women are routinely being left in an anxious limbo, waiting to find out if they have cancer, with delays that could worsen their prognosis and threaten lives. Experts also expressed fury that Labour might not be held to account for failure to meet its high profile pledge.
In 2000, the Government introduced a maximum 2-week waiting limit for those cases where GPs suspected breast cancer. However, research found that family doctors were unable to accurately identify such cases. One study found higher rates of cancer among women whose referrals had not been fast-tracked; latest figures on newly diagnosed breast cancer sufferers show half had not been given an urgent referral.
The newer target, drawn up as part of the 2005 manifesto, means that by the end of this month, all women who see their GP about any kind of "breast symptom" should be seen by a specialist within 2 weeks. Prof Richards admitted the deadline -already postponed from 2008 – will not be hit. "The feedback I am getting is that across the country as a whole we haven't made sufficient progress," he said.
The Department of Health's national cancer director said he was "hopeful" that the commitment would be achieved six months after its deadline. "I am confident we will hit the target but I am not confident we will get there by the date we said," he said.
In a report for the NHS, Prof Richards described "significant concerns" about the NHS' efforts to reduce waiting times for women with symptoms of breast cancer. He told The Sunday Telegraph: "We know that this is a very anxious time for women. If they are being referred to a specialist because of breast symptoms they are going to worry."
Latest quarterly figures show that of more than 9,000 women diagnosed with breast cancer, almost half had not been given an urgent referral by their GP. While data was not yet available to show just how long such women were waiting, "most" would be referred within six to eight weeks of seeing their GP, as part of a wider NHS target which means all treatment should happen within 18 weeks of referral, Prof Richards said. He said shortages of staff in hospitals who could carry out tests such as mammograms were one of the main obstacles to reducing waiting times.
Prof Richards said not all symptoms of breast cancer were easy to recognise. While most women and their doctors recognised a single breast lump as a possible indication of cancer, general lumpiness, and other symptoms including blood and discharge, were less clear indicators.
Many young women worried unduly about breast cancer, while older women tended to dismiss their fears, experts said. Breast cancer is now Britain's most common cancer. Of around 45,000 cases of breast cancer diagnosed each year, more than three quarters involve woman aged 50 or over.
Prof Richards said that although official monitoring of the two week target will start on January 1st, he did not expect to publish figures until May – meaning the extent of the failure on a manifesto pledge is likely to be hidden until after a general election.
Last night Jeremy Hughes, chief executive of charity Breakthrough Breast Cancer, expressed concern about the delays for women and anger about the notion that Labour could go into the next election without being held accountable for a previous manifesto pledge. He said: "We think this is a major concern. It is five years since [then health secretary] John Reid said before the last election that all women would be seen within two weeks of referral, not just those designated as urgent." "Women are being left with enormous anxiety and stress, as well as at increased risk, for those who turn out to have cancer. Once you have gone to see your GP, and they have said you are being referred to a breast cancer clinic, it just isn't something you can forget about for five or six weeks".
The charity is furious that data detailing failure against the target might not be published until after a general election. Mr Hughes said: "We are really concerned about the lack of data on this; we just don't think its acceptable to go into an election without this information".
Dr Jane Maher, Chief Medical Officer at Macmillan Cancer Support, said: "When breast cancer presents and it is not a lump, GPs can find it difficult to assess, so it is really important that all women are sent to a specialist quickly." She said it was equally important that women, especially the elderly, with the highest risk of breast cancer, went to see their GPs if they had concerns about changes to their breasts.
Anna Beckingham, aged 40, from Norwich, visited her GP practice three times because of concerns about a pea-sized lump and pains in her right breast. The mother of two was first told that the changes were "probably hormonal," and related to recent breast feeding. Discharge was dismissed as likely to be caused by an infection. On a third visit, to a different doctor at the practice, she was given a "non-urgent" referral to hospital, but it was not until March 2007 – 14 months after she first saw her GP – that she was finally diagnosed with cancer. By then, she had no option but to have a full mastectomy, to remove a growth which was now five centimetres in diameter, followed by reconstruction surgery.
Mrs Beckingham, who trained as a physiotherapist, fears many women who see their GP about symptoms of breast cancer are brushed away. "I kept saying to the doctors, I really do think this is breast cancer, but every time, they were dismissive. I am quite a confident woman and I know something about medicine so I was prepared to stand up for myself – if I had given up, I think I would be dead by now."
The Fight Over Fascist ObamaCare Is Only Just Beginning
Senate Majority Leader Harry Reid (D-Nev.), who may be unaware that he is currently enjoying his final term in the U.S. Senate, claims to have the 60 votes he needs to muscle ObamaCare through his chamber. God help us if he does.
The current iteration of ObamaCare is classic Mussolini-style Fascism (i.e. corporatism). It forces Americans at gunpoint to purchase health insurance, a requirement never before imposed on the American people. The big insurance companies and the federal government have combined to subject the public to this tyrannical mandate that Americans overwhelmingly oppose. This is the economic essence of Fascism. Shame on them on all.
Nonetheless, William Kristol of the Weekly Standard offers some words of encouragement to the patriotic Americans who still believe in limited government.
Keep fighting on health care. Fight for the next few days in the Senate. Fight the conference report in January in the Senate and the House. Start trying to repeal the worst parts of the bill the moment it passes, if it does.
After all, never before has so unpopular a piece of major legislation been jammed through on a party-line vote. This week, Rasmussen showed 57% of voters nationwide saying that it would be better to pass no health care reform bill this year instead of passing the plan currently being considered by Congress, with only 34% favoring passing that bill. 54% of Americans now believe they will be worse off if reform passes, while just 25% believe they'll be better off. Making the 2010 elections a referendum on health care should work--if Republicans don't let up in the debate over the next year.
Indeed ObamaCare may be the Democrats' undoing. They are betting it all on their healthcare plan, which won't kick in for years to come. A public backlash before then could halt the program in its tracks and kill it, leading to a Bastille Day-like slaughter at the polls for the Democratic powers that be.
Of course, it would be better to abort this monstrosity while in the womb, but the beauty of politics is that the fight is never really over. There will be more battles to come.
As Kristol writes, "Fight on with respect to health care. Fight on other fronts. And recruit new fighters. In a word: Fight. "
So the Democrats have reached a "compromise" and ObamaCare is going to pass. So what's it going to cost the taxpayers and what are we going to get out of it? Simple enough questions. But try to find the straight answers to that and you'll feel like the proverbial tiger chasing his tail.
Here's the Congressional Budget Office's "scoring" of the bill: click here if you have the nerve to do so. But we'll make it simple. Jeffrey Anderson, in the Weekly Standard has done the math for us. Here's a capsule of what he found:
The bottomline cost will be $2.5 TRILLION. This according to the CBO. The numbers the Democrats are throwing out are correct but they don't include everything. Bottom line: $2.5 TRILLION.
And remember, We are already out of money; with annual deficits over a TRILLION dollars a year. This bill will add $210 billion to that deficit and even more if Congress does as it has done with other entitlement programs in the past.
"And what would Americans get in return for this staggering sum? Well, the CBO says that health care premiums would rise, and the Chief Actuary at the Centers for Medicare and Medicaid Services says that the percentage of the Gross Domestic Product spent on health care would rise from 17 percent today to 21 percent by the end of 2019. Nationwide health care costs would be $234 billion higher than under current law. How's that for "reform"?"
And while the Weekly Standard does not say it, you can mark our words: health insurance premiums will go UP. Count on it.
And what about those big, nasty insurance companies? They get a $1 TRILLION windfall.
A bill so reckless that it has to be rammed through on a partisan vote on Christmas eve
And tidings of comfort and joy from Harry Reid too. The Senate Majority Leader has decided that the last few days before Christmas are the opportune moment for a narrow majority of Democrats to stuff ObamaCare through the Senate to meet an arbitrary White House deadline. Barring some extraordinary reversal, it now seems as if they have the 60 votes they need to jump off this cliff, with one-seventh of the economy in tow.
Mr. Obama promised a new era of transparent good government, yet on Saturday morning Mr. Reid threw out the 2,100-page bill that the world's greatest deliberative body spent just 17 days debating and replaced it with a new "manager's amendment" that was stapled together in covert partisan negotiations. Democrats are barely even bothering to pretend to care what's in it, not that any Senator had the chance to digest it in the 38 hours before the first cloture vote at 1 a.m. this morning. After procedural motions that allow for no amendments, the final vote could come at 9 p.m. on December 24.
Even in World War I there was a Christmas truce.
The rushed, secretive way that a bill this destructive and unpopular is being forced on the country shows that "reform" has devolved into the raw exercise of political power for the single purpose of permanently expanding the American entitlement state. An increasing roll of leaders in health care and business are looking on aghast at a bill that is so large and convoluted that no one can truly understand it, as Finance Chairman Max Baucus admitted on the floor last week. The only goal is to ram it into law while the political window is still open, and clean up the mess later.
• Health costs. From the outset, the White House's core claim was that reform would reduce health costs for individuals and businesses, and they're sticking to that story. "Anyone who says otherwise simply hasn't read the bills," Mr. Obama said over the weekend. This is so utterly disingenuous that we doubt the President really believes it.
The best and most rigorous cost analysis was recently released by the insurer WellPoint, which mined its actuarial data in various regional markets to model the Senate bill. WellPoint found that a healthy 25-year-old in Milwaukee buying coverage on the individual market will see his costs rise by 178%. A small business based in Richmond with eight employees in average health will see a 23% increase. Insurance costs for a 40-year-old family with two kids living in Indianapolis will pay 106% more. And on and on.
These increases are solely the result of ObamaCare—above and far beyond the status quo—because its strict restrictions on underwriting and risk-pooling would distort insurance markets. All but a handful of states have rejected regulations like "community rating" because they encourage younger and healthier buyers to wait until they need expensive care, increasing costs for everyone. Benefits and pricing will now be determined by politics.
As for the White House's line about cutting costs by eliminating supposed "waste," even Victor Fuchs, an eminent economist generally supportive of ObamaCare, warned last week that these political theories are overly simplistic. "The oft-heard promise 'we will find out what works and what does not' scarcely does justice to the complexity of medical practice," the Stanford professor wrote.
• Steep declines in choice and quality. This is all of a piece with the hubris of an Administration that thinks it can substitute government planning for market forces in determining where the $33 trillion the U.S. will spend on medicine over the next decade should go.
This centralized system means above all fewer choices; what works for the political class must work for everyone. With formerly private insurers converted into public utilities, for instance, they'll inevitably be banned from selling products like health savings accounts that encourage more cost-conscious decisions.
Unnoticed by the press corps, the Congressional Budget Office argued recently that the Senate bill would so "substantially reduce flexibility in terms of the types, prices, and number of private sellers of health insurance" that companies like WellPoint might need to "be considered part of the federal budget."
With so large a chunk of the economy and medical practice itself in Washington's hands, quality will decline. Ultimately, "our capacity to innovate and develop new therapies would suffer most of all," as Harvard Medical School Dean Jeffrey Flier recently wrote in our pages. Take the $2 billion annual tax—rising to $3 billion in 2018—that will be leveled against medical device makers, among the most innovative U.S. industries. Democrats believe that more advanced health technologies like MRI machines and drug-coated stents are driving costs too high, though patients and their physicians might disagree.
"The Senate isn't hearing those of us who are closest to the patient and work in the system every day," Brent Eastman, the chairman of the American College of Surgeons, said in a statement for his organization and 18 other speciality societies opposing ObamaCare. For no other reason than ideological animus, doctor-owned hospitals will face harsh new limits on their growth and who they're allowed to treat. Physician Hospitals of America says that ObamaCare will "destroy over 200 of America's best and safest hospitals."
• Blowing up the federal fisc. Even though Medicare's unfunded liabilities are already about 2.6 times larger than the entire U.S. economy in 2008, Democrats are crowing that ObamaCare will cost "only" $871 billion over the next decade while fantastically reducing the deficit by $132 billion, according to CBO.
Yet some 98% of the total cost comes after 2014—remind us why there must absolutely be a vote this week—and most of the taxes start in 2010. That includes the payroll tax increase for individuals earning more than $200,000 that rose to 0.9 from 0.5 percentage points in Mr. Reid's final machinations. Job creation, here we come.
Other deceptions include a new entitlement for long-term care that starts collecting premiums tomorrow but doesn't start paying benefits until late in the decade. But the worst is not accounting for a formula that automatically slashes Medicare payments to doctors by 21.5% next year and deeper after that. Everyone knows the payment cuts won't happen but they remain in the bill to make the cost look lower. The American Medical Association's priority was eliminating this "sustainable growth rate" but all they got in return for their year of ObamaCare cheerleading was a two-month patch snuck into the defense bill that passed over the weekend.
The truth is that no one really knows how much ObamaCare will cost because its assumptions on paper are so unrealistic. To hide the cost increases created by other parts of the bill and transfer them onto the federal balance sheet, the Senate sets up government-run "exchanges" that will subsidize insurance for those earning up to 400% of the poverty level, or $96,000 for a family of four in 2016. Supposedly they would only be offered to those whose employers don't provide insurance or work for small businesses.
As Eugene Steuerle of the left-leaning Urban Institute points out, this system would treat two workers with the same total compensation—whatever the mix of cash wages and benefits—very differently. Under the Senate bill, someone who earned $42,000 would get $5,749 from the current tax exclusion for employer-sponsored coverage but $12,750 in the exchange. A worker making $60,000 would get $8,310 in the exchanges but only $3,758 in the current system.
For this reason Mr. Steuerle concludes that the Senate bill is not just a new health system but also "a new welfare and tax system" that will warp the labor market. Given the incentives of these two-tier subsidies, employers with large numbers of lower-wage workers like Wal-Mart may well convert them into "contractors" or do more outsourcing. As more and more people flood into "free" health care, taxpayer costs will explode.
• Political intimidation. The experts who have pointed out such complications have been ignored or dismissed as "ideologues" by the White House. Those parts of the health-care industry that couldn't be bribed outright, like Big Pharma, were coerced into acceding to this agenda. The White House was able to, er, persuade the likes of the AMA and the hospital lobbies because the federal government will control 55% of total U.S. health spending under ObamaCare, according to the Administration's own Medicare actuaries.
Others got hush money, namely Nebraska's Ben Nelson. Even liberal Governors have been howling for months about ObamaCare's unfunded spending mandates: Other budget priorities like education will be crowded out when about 21% of the U.S. population is on Medicaid, the joint state-federal program intended for the poor. Nebraska Governor Dave Heineman calculates that ObamaCare will result in $2.5 billion in new costs for his state that "will be passed on to citizens through direct or indirect taxes and fees," as he put it in a letter to his state's junior Senator.
So in addition to abortion restrictions, Mr. Nelson won the concession that Congress will pay for 100% of Nebraska Medicaid expansions into perpetuity. His capitulation ought to cost him his political career, but more to the point, what about the other states that don't have a Senator who's the 60th vote for ObamaCare?
"After a nearly century-long struggle we are on the cusp of making health-care reform a reality in the United States of America," Mr. Obama said on Saturday. He's forced to claim the mandate of "history" because he can't claim the mandate of voters. Some 51% of the public is now opposed, according to National Journal's composite of all health polling. The more people know about ObamaCare, the more unpopular it becomes.
The tragedy is that Mr. Obama inherited a consensus that the health-care status quo needs serious reform, and a popular President might have crafted a durable compromise that blended the best ideas from both parties. A more honest and more thoughtful approach might have even done some good. But as Mr. Obama suggested, the Democratic old guard sees this plan as the culmination of 20th-century liberalism.
So instead we have this vast expansion of federal control. Never in our memory has so unpopular a bill been on the verge of passing Congress, never has social and economic legislation of this magnitude been forced through on a purely partisan vote, and never has a party exhibited more sheer political willfulness that is reckless even for Washington or had more warning about the consequences of its actions.
These 60 Democrats are creating a future of epic increases in spending, taxes and command-and-control regulation, in which bureaucracy trumps innovation and transfer payments are more important than private investment and individual decisions. In short, the Obama Democrats have chosen change nobody believes in—outside of themselves—and when it passes America will be paying for it for decades to come.
The White House, Democrats, and MoveOn liberals are spreading health care sob stories to sell a government takeover. But there’s one health care policy nightmare you won’t hear the Obamas hyping. It’s a tale of poor, minority patient-dumping in Chicago — with First Lady Michelle Obama’s fingerprints all over it.
Both Republican Sen. Charles Grassley of Iowa and Democrat Rep. Bobby Rush of Chicago have raised red flags about the outsourcing program, run by the University of Chicago Medical Center. The hospital has non-profit status and receives lucrative tax breaks in exchange for providing charity care. Yet, it spent a measly $10 million on charity care for the poor in fiscal 2007 when Mrs. Obama was employed there—1.3 percent of its total hospital expenses, according to an analysis performed for The Washington Post by the non-partisan Center for Tax and Budget Accountability. The figure is below the 2.1 percent average for nonprofit hospitals in surrounding Cook County.
Rep. Rush called for a House investigation last week in response to months of patient-dumping complaints, noting: “Congress has a duty to expend its power to mitigate and prevent this despicable practice from continuing in centers that receive federal funds.”
Don’t expect the president to support a probe. While a top executive at the hospital, Mrs. Obama helped engineer the plan to offload low-income patients with non-urgent health needs. Under the Orwellian banner of an “Urban Health Initiative,” Mrs. Obama sold the scheme to outsource low-income care to other facilities as a way to “dramatically improve health care for thousands of South Side residents.” The program guaranteed “free” shuttle rides to and from the outside clinics.
In truth, it was old-fashioned cost-cutting and favor-trading repackaged as minority aid. Clearing out the poor freed up room for insured (i.e., more lucrative) patients. If a Republican had proposed the very same program and recruited black civic leaders to front it, Michelle Obama and her grievance-mongering friends would be screaming “RAAAAAAAAACISM!” at the top of their lungs.
Joe Stephens of the Washington Post wrote: “To ensure community support, Michelle Obama and others in late 2006 recommended that the hospital hire the firm of David Axelrod, who a few months later became the chief strategist for Barack Obama’s presidential campaign. Axelrod’s firm recommended an aggressive promotional effort modeled on a political campaign—appoint a campaign manager, conduct focus groups, target messages to specific constituencies, then recruit religious leaders and other third-party ‘validators.’ They, in turn, would write and submit opinion pieces to Chicago publications.”
Some health care experts saw through Mrs. Obama and her public relations man, David Axelrod—yes, the same David Axelrod who is now Mr. Obama’s senior adviser at the White House. The University of Chicago Medical Center hired Axelrod’s public relations firm, ASK Public Strategies, to promote Mrs. Obama’s Urban Health Initiative. Axelrod had the blessing of Chicago political guru Valerie Jarrett – now White House senior adviser.
Axelrod’s great contribution: Re-branding! His firm recommended re-naming the initiative after “[i]nternal and external respondents expressed the opinion that the word ‘urban’ is code for ‘black’ or ‘black and poor’….Based on the research, consideration should be given to re-branding the initiative.” Axelrod and the Obama campaign refused to disclose how much his firm received for its genius re-branding services.
In February 2009, outrage in the Obamas’ community exploded after a young boy covered by Medicaid was turned away from the University of Chicago Medical Center. Dontae Adams’ mother, Angela, had sought emergency treatment for him after a pit bull tore off his upper lip. Mrs. Obama’s hospital gave the boy a tetanus shot, antibiotics, and Tylenol and shoved him out the door. The mother and son took an hour-long bus ride to another hospital for surgery.
I’ll guarantee you this: You’ll never see the Adams family featured at an Obama policy summit or seated next to the First Lady at a joint session of Congress to illustrate the failures of the health care system.
Following the Adams incident, the American College of Emergency Physicians (ACEP) blasted Mrs. Obama and Mr. Axelrod’s grand plan. The group released a statement expressing “grave concerns that the University of Chicago’s policy toward emergency patients is dangerously close to ‘patient dumping,’ a practice made illegal by the Emergency Medical Labor and Treatment Act (EMTALA)” – signed by President Reagan, by the way – “and reflected an effort to ‘cherry pick’ wealthy patients over poor.”
Rewarding political cronies at the expense of the poor while posing as guardians of the downtrodden? Welcome to Obamacare.
Thousands of British patients 'could be denied lung cancer drug by Nice'
Thousands of patients could be denied a lung cancer medication after the Government’s drugs rationing body decided it was too expensive for the NHS. The drug, called Alimta or pemetrexed, has already been passed for use in the health service as a first line treatment. But in draft guidance the National Institute for Health and Clinical Excellence (Nice) said that the evidence was that the drug was too costly to use a maintenance therapy, to try to prolong the time that patients stay in remission. The drug prolongs life for an average of around five months, but costs around £51,000 annually.
Nice said that it was “disappointed” to have to turn down the drug, which could be used by an estimated 2,000 patients a year. But it said that the information it had been given about the drug’s effectiveness and benefits by its manufacturers did not justify its use. Dr Carole Longson, from Nice, said: “We are disappointed not to have been able to recommend the drug as a maintenance treatment as well. “The committee felt that there were many uncertainties in the data and analysis provided by the manufacturer. “These uncertainties led the committee to conclude that, on current evidence, the cost of the drug related to the benefits it brings means that pemetrexed would not be a good use of NHS money. “The next step in the NICE process is for the manufacturer to consider the Committee’s comments and respond to its concerns.” The organisation is not expected to make a final decision about the use of the drug until next year.
Lilly, the pharmaceutical company which makes the drug, said that it was hopeful that it could change the decision and said that they were pleased that Nice had already accepted that the drug was an end of life medication, to which the body is required to look upon more favourably than other drugs. A spokesman for Lilly said: “We are pleased that within this preliminary guidance, NICE has found that Alimta fits within the end of life criteria. “We believe that the cost of Alimta related to its benefits is a good use of NHS resources and we look forward to participating in the ongoing NICE appraisal process during the consultation phase and providing additional information to further demonstrate the significant benefit that Alimta brings to patients."
Doctors and nurses at one of the country's top children's hospitals have been asked to help clean wards in their free time, according to the British Medical Association. Staff, including consultants and managers at Alder Hey Children's Hospital in Liverpool, were reportedly asked to do the work outside normal working hours. It is thought the suggestion was made to ensure the hospital impressed inspectors from the Care Quality Commission (CQC) who visited Alder Hey. They had previously criticised the hospital's hygiene standards in April.
Unions criticised the move and said cleanliness should be sufficiently resourced without seeking volunteers. Dr Jaswinder Bamrah, of the British Medical Association, said: "Doctors and nurses have been asked to volunteer to clean the hospital and I just do not think it is right. "They are over-using a highly skilled workforce to do what they are not trained to do. "They need to look at the issue of who is paid to do the cleaning and sort it out. "This step takes doctors and nurses away from patient care - the time spent cleaning would be better spent providing care for patients.
"This has been an ongoing problem for Alder Hey and it is very important to make sure the hospital is cleaned properly by those paid to do it - otherwise all sorts of problems car arise, like MRSA or C difficile spreading."
Paul Summers, Unison's regional organiser, said although it was a voluntary request some employees felt pressure to comply. "It was not compulsory but I have heard some people did feel bullied into helping out," he said. "I understand some staff were offered time in lieu if they did volunteer, but this isn't really the point. "There should be enough cleaning staff employed to do this job. "It raises questions about cleaning standards and about current cleaning staff levels."
Louise Shepherd, chief executive at Alder Hey Children's NHS Foundation Trust said CQC inspectors were impressed by the way staff rallied round after the unannounced visit. She said: "We believe, along with all our staff, that maintaining high standards of cleanliness in a healthcare environment is everyone's responsibility and have very much welcomed those many staff who have volunteered from every service and department to support this initiative. "Throughout this campaign, our patients have remained our top priority and we are confident that patient care has at no time been compromised. Indeed, we have received huge support from our parents and families for this initiative.
"We would also like to reiterate that this campaign was categorically not a response to inadequate levels of resources available. Indeed, Alder Hey has increased resources put in to hygiene yet again during the last year and the entire Organisation is committed to ensuring cleanliness remains a top priority at all times.
"Finally, we were delighted to receive glowing feedback about the high standards of cleanliness and hygiene achieved across the trust from the Care Quality Commission Inspection Team who visited our trust unannounced yesterday. "They were particularly complimentary about the initiative undertaken by staff and felt it was an exemplary demonstration of the passion and commitment they have to maintaining the highest standards of care and keeping our children safe at all times."
Barack Obama's health reform set to pass Senate after abortion deal
President Barack Obama's goal of health care reform received a key boost when Senate Democrat leaders said they had secured the key 60th vote needed to pass legislation. The Senate bill is now expected to be put to a vote before Christmas, despite Republican delaying tactics. Democrats from the Senate and the House of Representatives will then still have to hammer out major differences between their two versions of health reform before a final bill can be delivered to Mr Obama.
The president has made health reform his domestic policy priority and White House aides welcomed reports that there were now 60 supporters for a compromise deal in the Senate. Mr Obama devoted his weekend radio and Internet address to the issue he campaigned on in 2008. "Now - for the first time - there is a clear majority in the Senate that's willing to stand up to the insurance lobby and embrace lasting health insurance reforms that have eluded us for generations," he said.
The breakthrough came when Sen Ben Nelson, a socially conservative Democrat, told his party colleagues that he was willing to accept new wording that restricted federal funding for abortion. It also emerged that he had secured extra federal funding for health programmes in his home state of Nebraska after days of negotiations. His support appeared to give Senate leader Harry Reid the 60 votes required in the 100-seat chamber to overcome the threat of a Republican filibuster.
He was confident that his party's liberal wing would back the legislation, despite the absence of a government-run insurance scheme and other concessions made to Mr Nelson and Joe Lieberman, an Independent whose support the Democrats required. Mr Nelson made clear that he would vote against a final bill if the more liberal provisions in the House version are incorporated into the final merged legislation.
But for now, Democrats were celebrating the likely passage of a bill that will extend cover to 31 million uninsured Americans and restrict the scope for insurance companies to turn down patients for pre-existing conditions or hike their fees.
The legislation was being read in full on the floor of the Senate on Saturday at the insistence of Republican leaders. A first procedural vote is expected for the highly unusual time of 1am on Monday, paving the way for a full vote by Christmas Eve. Republicans accused their counterparts of trying to force through a bad bill with unprecedented voting times in the days before Christmas.
"This bill is a legislative train wreck of historic proportions," Senate Republican leader Mitch McConnell of Kentucky said. He said it includes cuts to the federal Medicare health care programme for the elderly, home health care and hospices as well as "massive tax increases" at a time of double-digit unemployment.
The Obama White House and its congressional allies have tried all year to push their various bills through to passage by truncating the time between introduction and a decisive vote to the bare minimum. They figure the only way to get something passed is to minimize public review and scrutiny of whatever their latest idea is to engineer American health care from Washington, D.C.
To date, that tactic hasn’t worked out so well. In July, House Democrats tried to unveil a bill on the 14th for a planned vote on the 31st. A firestorm erupted, however, pushing back the vote into November. In the Senate, meanwhile, a series of self-imposed deadlines have been missed as Democratic pronouncements of inevitability have bumped up against the reality of steadfast and growing public opposition.
Nonetheless, Senate Majority Leader Harry Reid is running the same play again today, and very possibly with different results. He unveiled the latest version of his reform legislation this morning, filled to the brim with outrageous payoffs to buy the votes of holdout Senators. Virtually no one else has seen the bill before today, much less had a chance to give it the scrutiny it deserves. And certainly the public has not had a chance to weigh in. No matter. Senator Reid has simultaneously set in motion the procedures necessary to force a vote on his new health-care plan in a matter of hours, not weeks.
And yet, despite the unprecedented effort to short-circuit public review and input, it is likely that this latest version of the Reid plan will be just as unpopular as the previous one, and for many of the same basic reasons.
According to the Congressional Budget Office (CBO), the amended Reid plan would reduce the federal budget deficit by $132 billion over the period 2010 to 2019, but that is a mirage.
For starters, as CBO notes, the bill presumes that Medicare fees for physician services will get cut by more than 20 percent in 2011, and then stay at the reduced level indefinitely. There is strong bipartisan opposition to such cuts. Fixing that problem alone will cost more than $200 billion over a decade, pushing the Reid plan from the black and into a deep red.
Then there are the numerous budget gimmicks and implausible spending reductions. The plan’s taxes and spending cuts kick in right away, while the entitlement expansion doesn’t start in earnest until 2014, and even then the real spending doesn’t begin until 2015. According to CBO, from 2010 to 2014, the bill would cut the federal budget deficit by $124 billion. From that point on, it’s essentially deficit neutral — but that’s only because of unrealistic assumptions about tax and Medicare savings provisions. By 2019, the entitlement expansions to cover more people with insurance will cost nearly $200 billion per year, and grow every year thereafter at a rate of 8 percent. CBO says that, on paper, the tax increases and Medicare cuts will more than keep up, but, in reality, they won’t. The so-called tax on high cost insurance plans applies to policies with premiums exceeding certain thresholds (for instance, $23,000 for family coverage). But those thresholds would be indexed at rates that are less than health-care inflation — forever. And so, over time, more and more plans, and their enrollees, would bump up against it until virtually the entire U.S. population is enrolled in insurance that is considered “high cost.”
Similarly, the Medicare cuts assume that hospitals, nursing homes, home health agencies and others can survive with a permanent annual cut in their payment rates for presumed productivity gains. Medicare’s chief actuary has already signaled that this reduction could push one in five hospitals into insolvency, thus forcing them out of the Medicare program.
What’s more, the benefit promises are sure to expand well beyond what CBO has assumed. There are 127 million people living in households with incomes between 100 and 400 percent of the federal poverty line, but CBO assumes that only 18 million of them will get the new subsidized insurance under the Reid plan by 2015 because of rules that make most workers ineligible for assistance. But, if enacted, employers would find ways to push more workers into subsidized arrangements, and Congress would loosen the rules to make more people eligible. Costs would grow much faster than CBO currently projects. In addition, the Reid plan continues to include a new entitlement program for long-term care that every actuary who has looked at it says is a financial disaster waiting to happen. If passed, it would only be a matter of time before another federal bailout would be necessary.
It is now plain as day that the Reid plan has evolved into nothing more than a massive entitlement expansion, which subsidizes more people into an unreformed system with soaring costs. Several Senate Democrats claim to be strong fiscal conservatives. Their votes on the Reid legislation will provide conclusive evidence whether that’s true or not.
Americans overwhelmingly like their health care and their health insurance. While Americans reject ObamaCare, the President and Congress insist on driving it through. Most Americans, up to 85 percent, already have health insurance and are satisfied with it. Lacking health insurance is different from lacking health care -- which, by law, emergency rooms must supply. Millions go without health insurance by choice and not due to lack of resources. Deduct from the number without insurance those who have access to it via entitlement programs, those temporarily without it while between jobs, those here illegally and those who could go on their parents' insurance plans by paying affordable amounts -- and you're down to 10 million to 15 million people without health insurance for longer than a year. This represents 5 percent of Americans.
To address this, the President and the Democrats are this close to a complete government takeover of health care. And a takeover it is. Assuming some kind of plan reaches the President's desk, it will -- at minimum -- force all Americans to purchase health insurance or pay fines or worse. It will force nearly all employers to provide health insurance or pay fines. It will tell health insurers that they must accept applicants with pre-existing illnesses and restrict their ability to "discriminate" based on factors like sex and age.
Incredibly, the President and Congress tell us that our economic recovery hinges on "health care reform" and that they can achieve it -- providing millions of people with health insurance estimated to cost a trillion dollars in the first decade -- while simultaneously reducing the deficit. The plan anticipates cutting hundreds of billions from the popular Medicare programs, whose beneficiaries vote in numbers greater than any other age group. Doctors and hospitals already complain that Medicare reimbursements fall short of costs, let alone profits. Good luck with that.
"Health care reform" achieves its deficit-reducing magic by collecting taxes in the early years -- building up money -- while paying out very little. Only after the first four years does money go out. It also forces states to pick up part of the tab. So, voila, it actually reduces the deficit -- at least in the first decade.
Then what? The Congressional Budget Office -- in cost estimates full of caveats, conditions and on-the-one-hands -- says that it could/might/may reduce the deficit in the second and third decades, too. Again, this assumes continued cuts in doctor and hospital reimbursements.
Despite the White House photo op of docs in their white frocks, most physicians oppose ObamaCare. They resent further government supervision and control over their practice. A poll commissioned by Investor's Business Daily found that 65 percent "oppose" ObamaCare and that 45 percent would consider taking early retirement or leaving their practice if the bill went through. Given the broad opposition -- most Americans, most doctors and seniors in fear of cuts in Medicare -- why do it?
First, the Democrats -- now in control of all three branches of government -- have convinced themselves that they face a political price if they fail. ObamaCare supporters, based on bogus assumptions and inflated numbers, argue that many, if not most, bankruptcy filings are due to health care bills. If, as President Obama asserts, "reforming" health care and economic prosperity go hand in hand, how can they abandon it?
Second, while a large majority of Republicans and most independents oppose these "reforms," Democrats overwhelming support them. They consider health care and health insurance a right -- never mind the Constitution or the price tag -- and think "the rich" should bear the costs. Congresspersons fear an electorate upset at a failure "to deliver" a victory over the evil, money-grubbing insurance companies.
Third, many believe in good faith that this is the "right thing to do." This breathtakingly ignores the mountain of evidence that government command-and-control health care reduces quality, reduces innovation and inevitably leads to rationing. The president of the Canadian Medical Association says Canada's system -- a single-payer kind, favored by President Obama -- is "imploding." She calls for more competition.
Critics of America's health care system say that citizens in other countries enjoy longer life expectancies. But after adjusting for homicides, increased infant mortality due to teen pregnancies and low birth weights, obesity and other behavioral factors, the discrepancy disappears. Compare American medical outcomes against those of other countries. Our system produces the world's best results for cancer patients who go into medical care at the same time similarly situated patients enter their countries' care. Our pharmaceutical companies lead the world in coming up with new life-extending and -enhancing drugs, a record at risk given new controls and taxes under the guise of "reform."
When the ObamaCare bill comes due -- when the deficit explodes and the costs are "controlled" through government-directed rationing -- supporters, including President Obama, will long have departed Washington, leaving others to deal with the mess. In the meantime, bend over and cough. Or else.
Can the US Constitution force Americans to have medical insurance?
One of the proposals in the restructuring of medical insurance in the USA is to force all adults to buy medical insurance. This calls for an analysis of the moral and legal basis for such force.
By natural moral law, as expressed by the universal ethic (http://www.progress.org/fold54.htm), each human being is a self-owner, with the single moral obligation to avoid harming others. The absence of insurance does not harm others. A person without insurance in effect becomes self-insured. If he requires medical services, he has a moral obligation to pay for them. There is generally also a legal obligation to pay for such services.
Thus an uninsured person who obtains emergency medical services can properly be required to pay for the services. If does not have the funds at the time, he should be required to pay the debt in the future. If he is poor and penniless, he is most likely receiving or eligible for assistance. It is therefore not only morally wrong to force people to obtain insurance, but also there is no sound financial reason to force everyone to have medical coverage.
Now let’s consider whether the U.S. Constitution authorizes Congress to force Americans to have medical insurance. The question was posed to the Speaker of the U.S. House of Representatives, and she refused to answer it. Presumably she believes that this is not a serious question because of the belief that the U.S. Constitution authorizes Congress to apply force on U.S. citizens without any restriction.
In other words, in the view of many such welfare-statists, there is no restriction on the use of force by the U.S. government on U.S. citizens and residents. Regarding the rights and liberties of Americans, they may as well tear up the Constitution and just put in a note, “anything goes.”
Tyrants who are in favor of making U.S. citizens slaves of the government argue that drivers are required to obtain liability insurance, and thus the same applies to medical insurance. But the federal government does not require drivers’ insurance within the states. The states do so because drivers travel on governmental roads, and as the agent providing the road, the state may enact rules of the road, and a driver agrees to the rules when he obtains a license. But no license is required just to be a human being.
The view that general welfare or interstate commerce authorize the U.S. federal government to use any force whatsoever on U.S. citizens is contrary to legal logic. The Constitution states that Congress only has the powers specifically allocated to it by the Constitution. The Tenth Amendment makes it clear that all other powers are left to the states. The Ninth Amendment recognizes that there are moral and common-law rights that exist prior to and apart from the U.S. Constitution, and that such rights shall not be denied by Congress, thus making natural moral rights also Constitutional rights.
A principle of legal logic is that the authorization of power in one section of a constitution does not cancel out constraints of power in other sections. Thus the authorization to levy legislation for commerce among the states does not void free speech or the security of property. Commerce may be regulated only within the constraints specified by the other sections.
In 1994, the Congressional Budget Office issued a memorandum titled, “The Budgetary Treatment of an Individual Mandate to Buy Health Insurance.” It stated, “The imposition of an individual mandate, or a combination of an individual and an employer mandate, would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States.”
If the requirement to buy insurance becomes law, it will be brought to the Supreme Court, which will then have to decide whether to shred what remains of the spirit of the Constitution, limited government. Congressional personae may anticipate this and do a clever run-around. They may provide funds to the states on the condition that the states make insurance mandatory. Or, Congress could just levy a tax that would pay for universal coverage.
In effect, the requirement to pay for medical insurance is a tax. But it is a tax on personhood rather than on a privilege or an activity or on property. Such a direct tax is Unconstitutional unless it is apportioned according to state population. If some folks are getting angry about the coming medical legislation, it is because such mandates are what is destroying the spirit of American liberty. Moreover, forcing Americans to buy insurance shifts more power from consumers to the very insurance firms that are being blamed for coverage that is both expensive and deficient. Consumer sovereignty is the power to not buy, and that will be lost.
Another Creative Way To Pretend A Public Mandate Is Constitutional
This one's from Sen. Blanche Lincoln (D-Ark.). The Constitution “charges Congress with the health and well-being of the people," according to Lincoln.
Unfortunately, as CNS News points out, "the words 'health' and 'well-being' do not appear anywhere in the Constitution."
Congress' own Budget Office has determined that the U.S. has never required Americans to buy any good or service. But the Supreme Court still might rule the mandate to purchase insurance as constitutional. National Journal's Stuart Taylor Jr. explains why: "It's true that the proposed mandate, like much else that congress has done since the New Deal, would extend federal powers far beyond anything envisioned by the Framers. The commerce clause, in particular, was not intended to allow Congress to regulate activities that were neither interstate nor commercial. But the need to govern an ever-more interconnected nation, in which once-local activities such as health care have become critical components of the national economy, has spawned a long line of precedents expanding the commerce power, especially since the justices began upholding New Deal programs in 1937.
As Taylor points out, whether those precedents are justified is an entirely separate matter.
Woman wins £1m compensation after British NHS doctors misdiagnose back condition
Nicola Dalby, a woman who was left disabled after doctors misdiagnosed her spinal condition, has won a £1m out-of-court settlement. Miss Dalby said she had agreed a million-pound settlement with two local GPs and Barking, Havering and Redbridge NHS Trust. The 43 year-old former coffee shop manager from Harold Wood, Essex, needs crutches to walk and suffers from clawed hands after doctors took nine months to diagnose and treat compressed nerves in her spinal cord. She has been warned that she will become wheelchair-bound over the next few years because of the delay in providing her with treatment.
MIss Dalby first saw doctors in October 2002 when she started suffering tingling fingers and dragging feet. But GPs diagnosed carpal tunnel syndrome - a relatively common condition involving compressed nerves at the wrist ~ and referred her to an orthopaedic surgeon at hospital. The surgeon said she needed to see a neurologist urgently but procedural failures by the hospital meant she was not seen until July 2003. Miss Dalby finally had surgery nine months after her first visit to her GP but her condition had already seriously deteriorated.
"The NHS needs to look at the errors in my case and ensure that they learn from this," she said. "I wouldn't want anyone else to go through what I have had to." Medical experts believe that had she been operated on before May 2003 she would be much better today.
Auriana Griffiths, a clinical negligence specialist for lawyers Irwin Mitchell, who represented Miss Dalby, said: "We are pleased that this result will at least offer Nicola the resources to adapt her home and maintain a reasonable quality of life with the long-term care she needs."
Dr Tim Woodman, director of medicine for NHS Havering, said: "Since 2003, GPs have been operating to a new contract which enables us to take a closer look at the quality of care they provide. "From 2011, all GPs will have to undergo a vigorous revalidation to stay in practice. "NHS Havering are putting measures in place to support this process, which includes ensuring that GPs keep their skills up-to-date and learn from any untoward incidents."
A spokesman for Barking, Havering and Redbridge NHS Trust said: "The trust is pleased the claim has settled and that Ms Dalby has sufficient funds to pay for her future needs. "The trust would like to assure Ms Dalby that it continues to work hard to ensure the quality of its healthcare services improves and would again like to take this opportunity to wish her, and her family, all the best for the future."
British health officials 'paid almost £1.7m in bonuses despite NHS facing millions of pounds in cuts'
Department of Health civil servants have been paid almost £1.7m in bonuses this year despite the NHS facing millions of pounds in cuts, figures show. Almost 200 staff shared in the payouts, with the highest totalling £27,500 and the average £8,000. The figures, revealed in a written parliamentary answer, also show that over the last five years hundreds of health bureaucrats have benefited from bonuses totalling almost £7.7 million.
Opposition parties described the amounts as “staggering” while millions of families struggle to make ends meet during a recession. The revelation comes just weeks after a damning report, by Dr Foster Intelligence, suggested that thousands of patients could have died needlessly at seven hospitals with extremely high death rates over the last five years.
The NHS has already committed to making £20 billion of efficiency savings over the next four years. Earlier this month ministers announced plans to cancel parts of the NHS IT scheme in a move to save £600 million, while the health service has also has been told to cut management costs by almost a third in coming years. Hospitals are also facing a four-year long squeeze on their funding. The Government plans to freeze the income they receive per procedure, in effect a real terms cut.
Norman Lamb, the Liberal Democrat Health spokesman, said: “This is a staggering amount of money to be paid in bonuses this year. “While families across the country are struggling to make ends meet, ministers are paying out bonuses to senior civil servants that are equivalent to some people’s annual income. “It’s hardly surprising that the public finances are in such a mess with such apparent profligate use of taxpayer’s money.” He called on ministers to conduct a review of when to was appropriate to award bonuses during a recession.
The largest bonus given to a single official over the last five years was £49,000, paid out last year, the figures also show. The amount paid in bonuses this year so far is almost double that in 2005/06, when £961,843 was shared between 181 staff. Earlier this year a report commissioned by the Department of Health by McKinsey, the management consultancy firm, found that a tenth of health service jobs would need to be cut within five years to meet planned £20bn efficiency savings. However, ministers immediately disowned the report and insisted that they had no plans to implement its findings.
A spokesman for the Department of Health said that bonuses were rigorously assessed. He added: "Senior civil servants have a vital role in the success of the NHS and social care. "Their leadership, supporting clinical colleagues, has been vital to the NHS's strong performance in recent years: finances are under control, patients are experiencing the shortest waiting times on record and hospital infections have decreased significantly. "Our ambitious plans for putting quality at the heart of everything the NHS and social care does, require the best possible leadership."
The signature bill of Barack Obama's first year - health reform that curbs costs and picks up 30 million uninsured people - is looking sick. The likelihood of a US Senate vote before Christmas is fading, amid stalling tactics by the Republicans and objections from liberal Democrats. A delay over the Christmas break could be extremely dangerous as senators will return home to their states, facing an increasingly worried public. But it would also be a crushing blow to the President, who desperately needs a win.
Two new polls show that support for Mr Obama's health care reform is ebbing in the face of a barrage of negative advertising from interest groups. A Wall Street Journal poll found that only 32 per cent of Americans think it a ''good'' idea. A Washington Post poll found that only 35 per cent of independents support it, down 10 points in a month.
There is also pressure on the Administration from progressives who are bitterly disappointed that the Senate version has stripped out a public insurance option in favour of private subsidised care, and curtailed plans to expand Medicare, a government-funded program for seniors. This week former presidential candidate and medical practitioner, Howard Dean, called on Democrats to walk away from the latest proposal saying it did not achieve the reforms promised and amounted to the ''insurance companies' dream''.
The latest salvo came on Thursday from the head of the powerful Service Employees International Union, Andy Stern, who criticised the decision to sacrifice the public option and Medicare expansion.
There were also rumblings on the right of the Democrats. One conservative senator, Ben Nelson of Nebraska, who unsuccessfully proposed an amendment on abortion, was threatening to vote against the bill. Majority Leader Harry Reid needs all 58 Democrats and the two independents to vote to end debate and prevent a Republican filibuster. He has limited senators to 10 minutes each to speak on the bill, but time is running out. When the acting speaker, Democrat Al Franken, tried to impose the 10-minute rule on independent Joe Lieberman, Republican John McCain saw red. Debate had not been cut off in this way in the 27 years he had been in the Senate, he said.
Democrats are now looking at a possible vote at 7pm on Christmas Eve - but even that might be ambitious.
Left Wing Objects To Health Care Bill As Insurer Sellout
While Majority Leader Harry Reid pushes to clear a Senate health bill by Christmas, his leftist allies are grumbling that the compromise plan is a lump of coal. On Thursday, Reid was laying out plans to approve the measure by Dec. 25. Yet he will need 60 votes to end debate and some key senators still seem unsure, if not opposed. Senate Republicans have also had some success at slowing down the legislative machinery.
But the bill's biggest threat now may be coming from progressive pundits. Howard Dean, former head of the Democratic National Committee and 2004 presidential candidate, on Tuesday said the Senate health care bill was a "dream bill" for health insurers and was "not worth passing." Dean seemed to be responding to Reid's decision to strip the Medicare "buy in" from the bill, an attempted compromise on the public option. That failed to win over Sen. Joe Lieberman, I-Conn. So Reid gave up on both options. That apparently secured Lieberman's support but triggered a revolt on his left flank.
Dean's comments may have given cover to Sen. Bernie Sanders, I-Vt., to say he couldn't support the bill without a public option. Speaking with Fox News' Neil Cavuto, the socialist Sanders said, "I have indicated both to the White House and the Democratic leadership that my vote is not secure at this point." Later in the day, his spokesman told IBD that Sanders "hasn't decided how he will vote. He's not happy with the bill, but is still working with Senate leadership and the White House to improve the still-evolving bill language." That followed Sen. Roland Burris, D-Ill., who on Monday reiterated his threat to block the bill without a public option.
Dean continued his opposition Thursday with an op-ed in the Washington Post, stating, "If I were a senator, I would not vote for the current health care bill." This, in turn, appears to have inspired an insurrection among progressives. At the Huffington Post, liberal pundit David Sirota called Dean a "genuine hero" for opposing "the Lieberman-gutted" health bill. Markos Moulitsas, who runs the influential leftist blog Daily Kos, wrote, "Time to kill this monstrosity coming out of the Senate."
The White House hit back at Dean again on Thursday. Press Secretary Robert Gibbs responded, "I think he is wrong. I think the American people think he is wrong. If this is such a great thing for the insurance companies, why are they spending hundreds and millions of dollars every day to attack it?"
But Dean keeps winning allies. Wednesday evening, MSNBC TV host Keith Olbermann said, "Howard Dean is right, and the White House's reaction to him has been incendiary, short-sighted and inaccurate."
Big Labor piled on. Richard Trumka, president of the AFL-CIO, said in a press release that a Senate bill without a public option was inadequate because "it bends toward the insurance industry, the Senate bill will not check costs in the short term, and its financing asks working people and the country to pay the price, even as benefits are cut."
Andy Stern, head of the Service Employees International Union, wrote in a letter to fellow union members, "The public option is declared impossible. Americans cannot purchase Medicare at an earlier age. The health insurance reform effort we have needed for a century is at risk." But while Stern opposes the current Senate proposal, he urged senators to pass it, with the hopes that it can be improved in the House-Senate conference.
Trumka's point about "working people" paying the price alludes to labor's objections to the Senate bill's 45% tax on high-cost health plans. That will impact many union members who enjoy very generous benefits.
If the leftist and unions grass-roots come out against the Senate health bill, it raises serious questions as to whether Democratic lawmakers will want any bill. The political calculus has been that voting for an unpopular bill will still help drive out the liberal base next November. But that doesn't add up if the leftist Netroots and unions are hostile....
Senators are still waiting for the final cost estimate from the Congressional Budget Office.
Following Analysis of ABC News Health Care Advertising, Group Says ABC News Should Worry Less About Its Anchors and More About Its Integrity
ABC News should focus less on the retirement of Charlie Gibson and his replacement by Diane Sawyer and more on integrity, says the National Center for Public Policy Research, which just completed an advertising review of ABC's nightly World News.
The multi-month review, using data collected by executive director David Almasi and analyzed by policy analyst Matt Patterson, was conducted after ABC allowed President Obama to pitch his health care proposal in a special edition of ABC's Primetime hosted by Gibson and Sawyer in June. Obama was given additional airtime to pitch his health care agenda that evening on Nightline. That night, ABC News refused to allow the conservative group Conservatives for Patients Rights to purchase paid advertising to put forth an alternative perspective.
In the 98 days of ABC World News advertising logged by Almasi and analyzed by Patterson, the broadcast featured 1,102 commercials, 597 of which were placed by member companies of the Pharmaceutical Research and Manufacturers of America (PhRMA) trade association, representing 54.17 percent of total commercials aired. PhRMA very aggressively supports President Obama's health care agenda.
"It's clear that World News relies on the members of PhRMA to sponsor it," said Almasi. "Ford and Proctor and Gamble are reliable sponsors, but the overwhelming amount of paid ads were for drugs pushed by the members of this very powerful and very political trade association. Ad after ad on World News comes from members of the drug lobby group PhRMA. It's almost laughable how many ads they run each day. If they were to stop, it would seem doubtful the broadcasts could continue."
Says Patterson, "ABC News seems to have a significant financial stake in the success of ObamaCare. Should we be surprised that they hand over an hour to Obama to promote his plan, while shutting out opposing views?"
"There was not one day in which the members of PhRMA were not major advertisers on World News," continued Almasi. "It's hard to believe that the producers of the program don't have this on their minds when they are selecting the issues they cover. CBS burned off the series Swingtown two summers ago because the network found advertisers weren't interested... NBC cancelled Southland before the second season even aired because of concerns the show... would be unacceptable to advertisers. The concerns of advertisers do drive content. With so many PhRMA members sponsoring World News, it would be hard not to think that people at the network are always mindful of who is paying their bills. PhRMA makes no bones about its support for ObamaCare, and PhRMA's member companies appear to be the lifeblood of ABC's flagship World News program."
Patterson recalls that White House Communications Director Anita Dunn attacked the legitimacy of Fox News in October and White House Senior Advisor David Axelrod said of Fox's news programming, "it's really not news." Patterson notes that the White House has shown no similar concern for objectivity at ABC: "ABC appears willing to turn over large chunks of its news programming to a politician, if that politician is backed by companies representing more than half of their advertisements. And for the president, it seems it's OK for a news organization to support a point of view - so long as it's his."
Patients 'still suffering at crisis hit British hospital'
Patients are still suffering unnecessarily at a hospital criticised six months ago for poor standards that contributed to hundreds of deaths, according to a new report. At least one patient has died because of similar problems since, the review suggests. Health watchdogs also found that Stafford Hospital, run by Mid-Staffordshire NHS Trust, was still suffering staff shortages.
In March a damning investigation found that up to 1,200 people had died because of the poor standards of care at the hospital. Regulators found overstretched nurses who turned off vital pieces of equipment because they did not know how to use them and reception staff expected to judge the seriousness of the conditions of patients arriving at A&E.
The latest report, by the Care Quality Commission, found that improvements were being made but that the changes needed to happen faster. In one case the commission found that a “serious untoward incident” on an ward where concerns had been raised about staffing levels led to a patient’s death. The hospital closed the 12-bed Clinical Decision Unit (CDU) soon after the death.
But the CQC warned that there were still staff shortages across the hospital. Relying heavily on bank or agency nurses could also have a negative impact on patient care, the report states.
Too many patients are still being sent unnecessarily to casualty when they could be dealt with in other parts of the hospital, inspectors also found. In one case a patient with heart failure who was already in the outpatients department was sent to A&E instead of straight to see a specialist when he developed breathlessness.
The report also found that patients were being seen by senior doctors sooner but that there were still problems contacting consultants during night shifts.
Andrea Gordon, regional director for CQC in the West Midlands, said: "On CQC's six month follow up review we found that while some progress had been made against the trust's action plan, more still needs to be done. "Permanent staffing levels remain a concern and this must improve. “Although there had been some change, there was still a shortfall in permanent nursing staff and the trust was still using bank and agency staff to supplement numbers. “We are aware that the trust is working to address these issues but there is still some way to go.”
Antony Sumara, the chief executive of Mid-Staffordshire Trust, said: “We know that there is more to do and that this needs to be delivered more quickly. Staff at our hospitals are as committed as I am, to making changes for the benefit of our patients.”
Last month the CQC warned that hundreds of patients had died needlessly at another hospital, Basildon University Hospital, because of poor care.
Katherine Murphy, director of the Patients Association, said: "This is a Trust under unbelievable levels of pressure to improve and it still can't get the basics right every time or ensure it has enough staff. "That should be worrying for all of us. "The local community don't want improvement over a few months or 6 months or a year, they want it straight away. "They are the ones that suffer if things aren't put right."
It would be a lot cheaper for them to do their job properly in the first place but that doesn't enter a bureaucratic mind. It's not their money that they are wasting
The number of negligence cases being brought against the NHS is rising at 11 per cent a year. Lawyers representing patients in clinical negligence claims frequently take more money from the NHS than their clients receive in damages. The rise of no-win, no-fee actions against the health service has been blamed for a sharp increase in the proportion of payouts ending up in the pockets of the claimants’ lawyers.
Law firms representing patients made more than £100 million last year from successful claims concluded against the NHS. Their costs, at rates of up to £400 an hour, were more than double those for lawyers representing the health service. “Success” fees charged by lawyers working on a no-win, no-fee basis — which cover their risk of losing some cases — can double the cost, according to the NHS Litigation Authority (NHSLA).
Figures released by the authority, which handles all clinical negligence claims, show that legal fees accounted for almost half the £312 million damages claims closed last year. Patients’ legal costs exceeded the damages that they received in more than one in five cases. According to the authority, the number of cases being brought against the health service is rising at 11 per cent annually, with more than 6,700 cases expected for this financial year.
The cost to the NHS is accelerating at a similar rate. The authority’s annual report says that payouts, including both completed cases and continuing payments, will pass £800 million this year — a 60 per cent rise on five years ago. When settlements relating to staff injuries are included, the total is even higher.
A review of civil litigation costs, which is due to report next month, is expected to address the way no-win, no-fee costs can spiral. Submissions to the review, seen by The Times, describe how this problem has grown in recent years because of success fees and insurance premiums taken out by lawyers to protect against losing the case. Since 2000, both have been recoverable from the NHS.
Christine Tomkins, chief executive of the Medical Defence Union, which provides medico-legal support to health professionals, said that analysis of their cases had shown that the average damages was just under £10,000. Claimant costs, including legal fees, success fees and insurance premiums, had been calculated at an average of more than £20,000.
Dr Tomkins said that cases and costs should be more closely managed, with a cap on fees, adding that the no-win, no-fee cases were being “cherry-picked because they were winnable”. She said: “There needs to be much closer attention to costs being accrued by claimants’ solicitors. We are often not aware of a case until we are contacted and we immediately think: ‘We must settle.’ But we can then discover that there have already been weeks of costs accrued.”
Among contested claims highlighted in the NHSLA annual report was the case of six male cancer patients who had banked semen samples with a hospital trust for possible future use. The samples thawed and became unviable. In another case a child born with congenital rubella syndrome, “due to admitted NHS negligence”, is receiving care costing £130,000 a year.
The Conservatives, who identified some of the disparities in legal costs and damages, said that there were cases where lawyers were getting ten times as much as patients. They calculated that over the past five years, almost £700 million in NHS funds has been spent on fees to lawyers dealing with clinical negligence claims. Mark Simmonds, the Conservative health spokesman, said: “Taxpayers will be rightly angry that hundreds of millions of pounds of their money is being paid out for mistakes in the NHS and that in many cases lawyers get their hands on more of the compensation money than the patients.”
Stephen Walker, chief executive of the NHSLA, described the claimant costs as “seriously disproportionate”. He said: “These law firms are not doing anything dishonest or illegal, they are just playing the system.”
A Department of Health spokesman said that litigation costs were a concern across government and were the reason for the current review, adding: “The vast majority of the millions of people treated by the NHS every year experience good quality, safe and effective care. However, if patients do not receive the treatment they should and mistakes are made, it is right that they are compensated and have access to legal representation.”
The New York Times' Nicholas Kristof recently wrote a column about John Brodniak of Oregon, who developed a cavernous hemangioma, causing him great pain as blood leaks into his brain. According to Kristof, Brodniak can't get medical help because we don't have universal health care. Senators who vote against ObamaCare, Kristof said, are morally equivalent to someone who would walk past a man "writhing in pain on the sidewalk."
In another article in the Times, William Yardley wrote about Melvin Tsosies -- also of Oregon -- who ended up with $200,000 in medical bills after having a heart attack. As of March 2008, Yardley reported, Tsosies was waiting to find out if he would win the Oregon lottery for health insurance. But with 600,000 uninsured state residents and a "universal" health care program with only enough money to pay for about 24,000 of them, Tsosies is more likely to win a Powerball lottery.
How can this be happening? Oregon already has "universal health care"! (Probably just a coincidence, but isn't Oregon also the only state with physician-assisted suicide?)
Once again forgetting about the existence of the Internet, the Times neglects to mention its own erstwhile enthusiasm for Oregon's universal health care plan, introduced back in 1990. Back then, the Times published an editorial titled "Oregon's Brave Medical Experiment," hailing this technocratic monstrosity as an example of "hardheaded compassion" designed to make "health coverage available to many more families." Ron Wyden -- then a congressman from Oregon, now a U.S. senator at the forefront of pushing "universal health care" onto the nation -- said: "This is a strong dramatic step toward universal access of health care." He predicted, "[T]his is going to be copied everywhere."
No wonder Wyden is such an ardent proponent of national health care -- it will force states that didn't adopt these idiotic universal health care schemes to bail out the ones that did.
Liberals cite medical horror stories from the very states they once cheered for enacting universal health care in order to argue for a national health care plan that will wreck the entire nation's medical care the same way liberal states already wrecked their own medical care. Only Democrats could propose fixing one Bernie Madoff-style scam with an even bigger Bernie Madoff-style scam. Maybe when national universal health care fails, we'll be able to go international. Then interplanetary -- then interstellar! Why should I pay for my gall bladder surgery when some Venusian could?
Eighty-five percent of Americans are happy with their health care, but Democrats have a plan to make it worse for more money. As a bonus, national health care will add trillions of dollars to the national debt, and your insurance rates will skyrocket.
Democrats are being utterly disingenuous to say that you won't have to leave your current plan under national health care. Maybe, but it won't be your choice: Your employer will be making that decision for you. Recall that one of the big selling points of national health care is that it is supposed to reduce costs for American businesses. The only way national health care will make American companies "more competitive" is if they dump their employees into the public health care system. It's so weird! We expected X number of people to show up for health care and instead 75X showed up! Yeah, just like every other government program in the history of the world.
Ten years from now, we'll be talking about cost overruns of $6 trillion -- but by then, national health care will be an untouchable "third rail" of politics, just as Medicare is now. (Ironically, injuries sustained from actually touching the third rail won't be covered under ObamaCare.)
As with Medicare, voters will be terrified to go back to even the wisp of a free market system we have now, afraid that they'll never be able to get health insurance without the government providing it. Having been dragged unwillingly into the government plan, how will a 58-year-old be able to leave the public system and get insurance on the free market?
Speaking of which, how many of you are planning to retire on your Social Security benefits? Just you there, with the shopping cart full of cans?
The only solution will be for the government to keep running up gigantic deficits and raising taxes on "the rich," which, in turn, will stifle job creation and economic growth in a phenomenon known to economists as "the Carter years."
In addition to forcing Americans into dealing with surly government workers in order to obtain medical care, sooner or later, there's no free lunch. (And if government X-rays are anything like the photos the DMV takes for your license, count me out. I don't want my lungs looking like they had a bad hair day.)
Even if national health care puts the screws to doctors and pharmaceutical companies by reimbursing them below cost -- so all future doctors will soon resemble DMV employees and no new drugs will ever be invented -- the government is still going to have to cut services and pay for the system with massive tax hikes. Which is exactly what happened with Oregon's "Brave Medical Experiment."
It has been shown that the so-called "public option" for low-premium health insurance is sure to significantly crowd out, and perhaps even eliminate, the private provision of health insurance. Thanks to Senator Joseph Lieberman's courageous stand, it appears that the public option will not be a part of any bill that passes the Senate. Unfortunately, HR 3962 includes regulations that will destroy the ability of private firms to provide marketable insurance, with or without a public option.
To understand the devastation that will be wrought by this bill, one must understand how health insurance functions on a free market to transfer individuals' financial risk to large "risk pools" with less variation across time. Consumers who are risk averse pay "premiums" to insurers each month for the removal of that risk, and in turn insurers assign their clients to different pools according to their risk of large claims.
An Already-Regulated Industry
Insurance companies have already been strictly limited in their ability to assign individuals to different risk pools and charge them varying premiums. By forcing high-risk and low-risk groups into the same pool, existing regulations increase premiums for low-risk consumers and decrease premiums for high-risk consumers. This is nothing more than a coerced subsidy to the less healthy, and it drives low-risk consumers away from purchasing health insurance. This is why the majority of the uninsured are not poor and dying, but in fact healthy young people who are at almost no risk of unanticipated healthcare costs.
To cope with their inability to partition along risk levels, profit-seeking insurance companies must cut costs by excluding the highest-risk patients from insurance. In a free market, these individuals would be offered insurance at a higher premium aligned with their high risk of major claims. In human terms, this leads to the exclusion of people with preexisting conditions and those with significant claims on past insurance plans. Once again, we see how leftist economic policy harms the very class of society that its supporters desire to help.
Obamacare is a Welfare Program
Not oblivious to the exclusion of these unfortunate citizens, on page 95 of the bill, House Democrats have proposed to completely outlaw the exclusion of any customer on any of the following grounds: "health status, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, disability, or source of injury (including conditions arising out of acts of domestic violence) or any similar factors."
Thus, it will become illegal to refuse to insure any consumer on any grounds, including evidence of insurability. In addition to being unable to exclude future enrollees, insurers will be prevented by page 29 from legally dropping any consumers from their plans on any grounds other than "clear and convincing evidence of fraud."
The effect on the structure of insurance is obvious; this new law will turn health insurance into a legally-enforced entitlement program, and the new entitlement will be used by those who are too costly to be insured under the current restrictions on risk-pool partitioning. Again, it is important to remember that these patients would have the option to buy insurance on a free market, but that their plans would carry premiums that actually reflect their personal health risk.
While risk-pool separation is considerably limited by national and state regulations, the little separation that is allowed would still be able to mitigate the heavy costs of forcing insurers to cover literally every customer who wishes to buy insurance. While the high-risk individuals would not pay as much in premiums as they would on a free market, insurance companies would still be able to use slightly lower premiums to attract low-risk customers.
However, this inequality in premiums is offensive to politicians hell-bent on equality. Therefore, in the very next page of the bill, House Democrats propose to outlaw all variations in premiums except according to geographical area, age group, and whether the plan in question covers an individual or a family.
These provisions will be catastrophic to the insurance market. The bill only allows for premium variation across age by a ratio of two to one between the highest and lowest premiums. In real terms, elderly patients who cost several times as much to insure can only be charged twice as much as 20-somethings who often go entire years without claims. That this is a subsidy for the elderly hardly needs to be explicitly stated.
The bill leaves the determination of the maximum difference between individual and family plans at the discretion of the "health choices" commissioner, who is likely to find himself bombarded with visits and letters from family-centered lobbying organizations seeking subsidized health insurance paid for by singles and nonparents. This rent seeking will inevitably end up in subsidies handed out according to political objectives, whether the goal is to attract more young, single voters or more parents of children.
Turning any transaction into a subsidy both induces the subsidized class to enter the transaction and induces the subsidizing class to attempt to avoid it. In this case, it means that an even greater number of young and healthy individuals (and, most likely, nonparents) will drop their increasingly expensive insurance plans and attempt to prepare for healthcare risks on their own. This terrible result of coercive price-fixing decreases the benefit of the subsidy to high-risk consumers and decreases the ability of the insurance companies to control and reduce average payouts.
Democrats are aware of this effect of their policy, and have legislated accordingly. Pages 296–300 amend federal tax law to create a new tax on all citizens who fail to purchase health insurance. Depriving these individuals of the ability to opt out of the new, undifferentiated insurance pool is an atrocious affront to individual choice, and requires the threat of imprisonment. This new tax will help achieve the statistical goal of universal coverage, but it will do so at an incredible cost to the income and liberty of the relatively young and healthy, most of whom, ironically, voted for Obama and Democratic congressional candidates.
Soaring Costs
Not only will high-risk individuals who are now forced out of the market by regulation be legally entitled to purchase the bill's minimum standard of coverage, but both these excluded consumers and those who are now in high-risk pools will have financial incentives to buy higher levels of insurance. Facing new, subsidized prices, high-risk individuals will purchase plans with lower deductibles. Paying for a higher percentage of the price of more claims will massively increase the cost of insuring the new general pool of clients.
One of the only remaining ways for insurers to cut their costs, then, is to limit the amount that individuals are able to receive in claims. Indeed, insurance companies already use lifetime claims limits to cope with risk-partition laws and deliver lower-price packages to low-risk consumers. Predictably, page 50 of the House bill prohibits insurance companies from imposing any such limits on lifetime benefits.
Outlawing lifetime limits guarantees that all consumers will have the incentive to undergo drastically more treatments in their lifetimes, because the bill ensures that they will not be moved into a higher premium group until they enter a different age group or move to a different area. For the already-subsidized elderly, this creates incentives to undergo many more life-extending treatments in the final year of their lives. Such treatments are several times more expensive than general care for other elderly patients.
Astute readers will correctly object that while the Democrats' healthcare proposal will drastically increase the costs facing every insurance provider, the bill also requires all individuals to buy the minimum package of insurance, or to enroll in the public option. Especially because in the current discussion we are ignoring the effects of the public option, it is possible to argue that if there were no public option this bill would actually be a boon to private insurers, who are virtually guaranteed that every American will buy their plans. To survive this bill, then, insurance companies will simply increase the premiums of the packages that are forced onto every citizen.
This would indeed be true, were it not for further regulations effectively barring premium increases. Page 31 of the bill would require insurance companies to "submit a justification" for any projected future increase in premiums for any group to the secretary of Health and Human Services as well as state-level authorities.
The secretary of HHS and the state "health czars" would then annually review and approve or deny any increase in premiums. In various sections of the bill, the health choices commissioner is given power to determine the cost-accounting and other ratings methods that will determine whether a price increase is "justified" in the eyes of the DHHS Secretary.
Public officials operating under a Congressional mandate to achieve universal coverage are hardly likely to approve price increases, even though that means slowly bankrupting private insurers. Even if they are not made to "compete with" and be strangled by a public option that consumers have already funded with their tax dollars, private insurers will be absolutely ruined by restrictions on their ability to control and separate costs and to increase prices to account for their ever-rising costs.
Conclusion
While a public option would certainly hasten the death of the private-insurance market in America, it is not a necessary means to that end. By destroying the economic structure of insurance, House Resolution 3962 would convert an already-overregulated industry into a pseudo-private welfare program. Even without a public option, insurance companies would be kept from controlling costs or adjusting their prices. The inevitable result will be the complete dissolution of the private health-insurance market.
A Return to Slavery One Progressive Step at a Time
Let’s just call it what it is, as one of my favorite economists Walter E. Williams writes in a recent Town Hall column: “There is absolutely no moral case, much less constitutional case, for Congress forcibly using one American to serve the purposes of another American, a practice that differs only in degree from slavery, which we all should find morally offensive.”
If you strip the health-care debate of it’s sugar coated political buzz words such as mandate and public option, aren’t we really talking about just another case where the government has decided to force you to labor for the benefit of someone else? At the rate we are going, how long will it be before you’ll be spending more of your time working for others rather than yourself. Isn’t that so very altruistic of you!
If the Health Care Police (HCP), I assume they would be the ones in charge of enforcing the governments health care mandate, knocked on your door every other Monday morning and forced your college educated 22 year old daughter to work all day picking up trash on the side of the highway you’d be horrified. You’d want some answers! What dastardly criminal act could she have committed to deserve such a punishment, keeping her out of work all day and thereby depriving her of 10% of her income?
They don’t do that in America, you say. Well, not quite yet anyway, but they will soon if the Democrats have their way with health care. She will be forced by the government to spend an equivalent amount of her earnings to purchase something she had decided not to. Is this not also a practice that differs only in degrees?
As a parent, wouldn’t you want to talk to the prosecutor to know what crime your daughter had committed that merited a fine that was upwards of 10% of her income? Shouldn’t there be some kind of a trial to find her guilty before punishment is meted out, even if it is only a show trial like the one KSM is entitled to? Won’t you be mortified to learn she has committed the most heinous of acts imaginable in our new Progressive Society? That’s right she is guilty of working for an employer who does not provide health insurance, and has failed to purchase a government approved insurance policy on her own. Oh, the shame of it!
Your representatives in Congress are spinning a yarn that goes like this: legions of hospitalized young adults without medical insurance are the cause of the explosion in health insurance premiums. This in an attempt to justify a morally bankrupt and unconstitutional taking of private property. Their remedy? Mandate (a pretty word that means to force) that all citizens must buy health insurance. That’s what they would like you to believe, but that is not what the facts tell us.
The fact is that they are bullying healthy young people into to subsidizing health care premiums for those in poor health who have medical insurance, those with preexisting conditions who have been denied health insurance coverage and those who are not financially able to purchase health insurance. The Progressive bullies in Congress always pick on the politically weak in society, in this case it happens to be young people, it’s not like they are reliable voters anyway, and their perennial favorites, “The Rich” who will pay the freight to provide an insurance subsidy for the politically favored classes.
Will health insurance reform really be the rallying cry Progressives use to justify re-instituting a modern day version of Slavery in America?
British government hospitals 'are wrong to ban flowers as a health threat'
Hospitals that ban flowers in an attempt to stop infections spreading are actually slowing patients' recovery, researchers have found. They say visitors bringing bouquets to wards do not increase the spread of germs and help speed a patient's return to health. In fact, the biggest hazard posed by flowers could be nurses' irritation at having to change the water.
A growing number of hospitals have introduced 'no flower' policies, with Southend University Hospital bringing in a blanket ban this summer despite protests. Bosses said patients were in favour because of the potential health and safety risk to bedside electrical life support equipment as well as fears over the spread of germs.
But research in the British Medical Journal says the risks have been overplayed. There is no record of an outbreak of infection in a hospital being traced to bacteria found in flower water, according to Giskin Day and Naiome Carter from Imperial College London. Vases might tip over, they admit, but the risk is no greater than that posed by crockery containing food and drink.
The researchers say studies show flowers have immediate and long-term beneficial effects on emotional reactions, mood and memory. One trial found that patients in rooms with plants and flowers needed significantly less pain relief after surgery. They also had lower blood pressure readings, lower rates of pain, anxiety and fatigue and more positive feelings than those who were in flower-less wards.
However, hospitals continue to impose bans on the wards despite the absence of any ruling from the Department of Health.
The study also found evidence of contrasting attitudes to flowers on private and NHS wards, after questioning patients and staff at two London hospitals, the Royal Brompton and the Chelsea & Westminster. Private nurses appeared much keener on flowers than those from the public sector.
Charge nurse Dermot Richards-Scully at the Royal Brompton said: 'I hate them [flowers].' 'My staff don't have time to change stagnant water, spillage is responsible for slips, trips and falls, and they cause hay fever.'
But sister Susan Bunce, in charge of the Sir Reginald Wilson ward for private patients at the same hospital, welcomes them. 'Maintaining flowers doesn't take up any nursing time and they have a positive effect on patients,' she said.
The BMJ article concluded: 'Although flowers can undoubtedly be a time-consuming nuisance, the giving and receiving of flowers is a culturally important transaction.' It recommends bedside lockers be designed to cut the chances of spillage from vases.
Britain: Need urgent help? Dial 111, but you may have to pay
An admission that existing services are failing -- after 60 years to get them right
An 'urgent care' phone number will be set up for sick patients to ease pressure on ambulances, despite fears it could cause confusion and even delay life-saving treatments. Health minister Mike O'Brien will tomorrow outline plans for the phone line - 111 - for those who need treatment but not enough to warrant a 999 call.
It would mean patients deciding whether to call 999, 111, NHS Direct or their GP.
Dr Hamish Meldrum, chairman of the British Medical Association, said: 'We would want to be assured that what is being proposed really does simplify things for patients rather than adding to the confusion as to which part of the NHS they should be going to for care. 'We would certainly not want to see a situation where patients are so confused that genuine life-threatening emergencies are missed.'
Patients may even have to pay to ring the service. Ministers have suggested either a 10p flat fee, or up to 5p a minute - ignoring concerns that poorer patients and pensioners may be put off by the charge.
The Department of Health quotes polling which reveals most patients would be happy to pay a small fee. The 111 number is designed for people who need 'urgent advice, care, treatment and diagnosis'.
The number, which would be piloted from spring 2010 would be staffed, like NHS Direct, with a mixture of call centre workers and clinicians. The Department of Health would not comment last night.
Australia: Impaled woman has long wait for government ambulance
"Ambulance Victoria (AV) will make sure you receive the best possible care", they say. Tell that to the woman below
A WOMAN was impaled on a steel fence for an agonising 47 minutes waiting for an ambulance. The 34-year-old received no pain relief while her body was supported by volunteer emergency services workers during the ordeal at Yarrawonga, in Victoria's north.
Ambulance Victoria has launched an investigation into the delay. It was contacted at 9.42pm on Tuesday and told Kim Broadbent had been impaled through the groin in a fall. A crew did not arrive until 10.29pm. There was no paramedic available in the border town that night and sources said a graduate officer was refused permission to attend.
A crew was sent from Wangaratta, 55km away, but was not cleared to travel over the speed limit or with lights and sirens. By then, Ms Broadbent had spent more than 47 minutes seriously injured, lapsing in and out of consciousness. There is widespread disgust in Yarrawonga at the delay.
Ms Broadbent travelled to Melbourne by air ambulance with a section of fence still lodged inside her. She did not arrive at The Alfred hospital until about three hours after the first call. She was stable last night.
Her mother, Heather Broadbent, attended the scene and said those waiting for the ambulance were supporting her daughter and afraid to move her for fear of doing more damage. Mrs Broadbent said Wangaratta seemed too far away for an emergency job in Yarrawonga.
AV regional general manager Garry Cook said all parts of the case were being examined. Ambulance Employees Australia acting general secretary Phil Cavanagh said the review needed to address a key point: "Yarrawonga had no ambulance. Why?"
Dem Pols Must Ask: Will Yes Health Vote Hurt Them In 2010?
Congressional Democrats face a quandary going into the 2010 midterms. Pass a sweeping health plan that's increasingly unpopular, or do nothing and watch the liberal base stay home election night. Late Monday, Senate Majority Leader Harry Reid, D-Nev., seemed to move Joe Lieberman, I-Conn., closer to supporting the Senate health bill by dropping the Medicare buy-in for those age 55-64. Lieberman now says he is "ready to vote for health care reform." That could provide a boost to sagging morale among Democrats.
That seems to leave Sen. Ben Nelson, D-Neb., who has concerns over abortion funding, as the last holdout to Democrats getting 60 votes to override a GOP filibuster. It's not clear how he's leaning. Several other centrists have let Lieberman and Nelson take the heat for blocking the bill. But they may raise objections now that the bill is close to reality — and if they think they can win concessions.
Many opponents of the bill still think a health bill will pass. "The Democrats are going to do whatever it takes to get this health care bill," said Robert Broadus, who is running for Congress in 2010 as a Republican in Maryland's liberal 4th District, held by Democrat Donna Edwards. Broadus was participating in a "Code Red: Senate Rally" put together by groups in the tea party movement. About 2,000 protestors showed up Tuesday outside the Senate office buildings.
But not all protesters thought the Democrats would succeed. Eileen Hunkins of Virginia said, "I don't think they will pass a health care bill. It's not a health care bill. It's a bill to kill people."
The most recent CNN poll found 61% of respondents opposed the Senate health bill, with 39% in support. A new poll released Monday by Public Policy Polling, a Democratic firm, showed Republicans at 42% and Democrats 44% on a generic 2010 House ballot. In the previous PPP poll the GOP was down by eight points.
"That's the rub for the majority. They are in a bind," said J. Mark Wrighton, associate dean and professor of political science at Southern Mississippi University. "Polling data show that independents are moving toward the GOP. And there is some letdown among the Democratic voters as their high hopes have been dashed on issues like health care."
Leonard Steinhorn, professor of communication at American University, disagrees. "Conventional wisdom 11 months before an election needs to be taken with a grain of salt," he said. "Right now, independents are people who are motivated by a strong sense that Washington doesn't get stuff done. If health care reform is successful and is played as a triumph of the legislative process, it could help the Democrats."
As the Democrats inexorably slog toward the finish line, lugging and wrenching their malformed health care bill, the most passionate debate has been on contentious issues like abortion, the public option, and Medicare cuts. Yet the overriding danger of the Senate bill and its House counterpart is the massive government bureaucracies that will emerge as the legislation takes effect.
The Democrats' colossal experiment threatens to unleash forces that will ultimately overwhelm the doctor-patient relationship, ration our health care, and stifle innovation and excellence in the medical field. A massive government bureaucracy soon acquires a life of its own, with dominion over its constituency that no politician dares attempt to rein in.
Perhaps the greatest expansion of power will be in the Department of Health and Human Services. The Secretary of HHS will become the monarch of the health care kingdom. The Washington Examiner said the Senate health bill contains the word "secretary" 2,500 times, and that "[t]he legislation lists 1,697 times where the Secretary of Health and Human Services is given the authority to create, determine or define things in the bill."
In a massive power shift, the Secretary of HHS would take over insurance regulation from the states and would define qualified plans, what they cover, what they should cost, and whom should be covered. Competition and choice, the president's favorite buzz words, will disappear as HHS becomes the focal point of central planning for health care.
A second epicenter in the new health care infrastructure will be the IRS, which is poised to assume a powerful role in rulings, collections, and enforcement of health care mandates and taxes. There is a provision in the Senate bill for a reporting requirement similar to the current W-2. It would require, in Section 1502, the name, address, tax ID number, dates insured, and plan qualification, among other things. An expanded IRS is likely to become even more intrusive, dispelling any remaining illusions of a compassionate government-run program.
Embedded in the legislation in section 3403 is the Independent Medicare Advisory Board, one of 118 new boards, commissions, and programs making up a third power center that will have immense control over life and death. This board, with fifteen members appointed by the president, would have extraordinary powers, not subject to judicial review, to dictate what is covered and thus what treatments, drugs, and procedures patients can get. The bill's wording says the purpose of the board is to "reduce the per capita rate of growth in Medicare spending," a simple but chilling statement. With a set budget, the board would become a rationing commission in a "radical change for U.S. health care," as the Wall Street Journal describes it:
... the various health bills stipulate that Congress will arbitrarily decide how much to spend on health care for seniors every year-and then invest an unelected board with extraordinary powers to dictate what is covered ...
The core problem with government-run health care is that it doesn't make decisions in the best interests of patients, but in the best interests of government.
The Senate bill contains a labyrinth of regulations defining the operation of the Medicare Advisory Board -- "target growth rate," "implementation year," "inflationary payment update," "direct subsidy payments," "base beneficiary percentage"...and on and on. The language even includes a note prohibiting "any recommendation to ration health care." Yet as the Journal points out, the hard budget-cap rules mean there "is only so much money to be divvied up for care."
The bill's green eye-shade language may be numbing, but its long-term effect on health care will be devastating, as physician discretion is displaced by government fiat. The mention of "death panels" by Sarah Palin sent the Democrat left over the edge in denying, disparaging, and demonizing, perhaps because that is precisely the effect of what is in the bill.
A fourth empire is the expanded burden of unfunded Medicaid mandates on the states. A massive Medicaid increase will initially be federally subsidized, but after five years, it will be shifted back to the states. The House bill increases Medicaid up to 150% of the poverty level, and the Senate bill increases it up to 133%. Dick Morris summarizes the impact on his web site:
... in California ... the already fiscally beleaguered state would have to increase its Medicaid spending on poor people by 50%, at least an extra $2 billion a year and perhaps more...
In many Southern states, the Medicaid program only covers a portion of those living below the poverty level ... In Arkansas and Louisiana, where swing Senators Pryor, Lincoln, and Landrieu come from, the cost could exceed $1 billion for each state each year.
The question now is whether the governors of the fifty states, particularly the Democrats, are going to sit idly by and let their budgets be destroyed by the health care bill.
Offloading some of the increased insurance cost to the states by adding to the Medicaid rolls further disguises the real cost of the legislation. The American Spectator quotes Sen. Lamar Alexander (R-Tenn.): "There's an air of unreality here. ... The language is, 'we'll shift it back to the states' as if the states had the money or a printing press. But this isn't just a little increase. This is a bankrupting increase for most states."
A fifth enormous burden of a perversely different sort is the rampant Medicare fraud that stands to expand in a Medicare-for-all health system. The federal government has had forty years to figure out how to control Medicare fraud, but it is still pervasive. A Washington Times article quotes an Inspector General saying his office "finds fraud everywhere it looks." The Times quotes another source saying "3 percent to 10 percent of the $800 billion spent on Medicare and Medicaid each year 'is lost to waste, fraud and abuse.'" A recent CNN headline tells the story: "Organized crime's new target: Medicare."
So we have the HHS, the IRS, the Medicare Advisory Commission, expanded Medicaid, and expanded turf for Medicare and Medicaid fraud, each a leviathan of big government excess in its own right.
The Republicans are correct in strongly challenging the Democrats on topical issues, but there are larger forces at work that will have staggering implications on our future as the juggernaut of big government consumes all in its path.
I planned to write on a different subject, but after reading an editorial in Saturday’s New York Times, I decided to continue the subject of my last column on medical costs. The editorial not only contains more nonsense from the “Newspaper of Record,” but also demonstrates how the mainstream print media actively participates in something akin to releasing a dispatch from Orwell’s “Ministry of Truth.”
In urging Congress to pass medical “reform,” the Times claims that this country can “afford” this multitrillion-dollar monstrosity because it ultimately will “cut costs,” lower the federal deficit, and make “affordable medical care available to all: "Over the next two decades, the pending bills would actually reduce deficits by a small amount and reforms in how medical care is delivered and paid for — begun now on a small scale — could significantly reduce future deficits."
My response is simple: How do we know this legislation will accomplish these things? From what I can tell, the Times says we know it because, well, the legislation declares it to be so. In other words, we are supposed to take Congress and the White House at their word because, after all, they allegedly have our best interests at heart, just as Congress and the White House claimed that the Iraq war would be done on the cheap (paid mostly through oil exports from Iraq, something that did not exactly work as planned).
However, the editorial claims that there are real-live portions of the bill that should result in the supposed federal budget savings: "Electronic medical records could eliminate redundant tests; standardized forms and automated claims processing could save hundreds of billions of dollars; “effectiveness” research would help doctors avoid costly treatments that don’t work; various pilot projects devised to foster better coordination of care and a shift away from fee-for-service toward fixed payments for a year’s worth of a patient’s care all show some promise."
In the next paragraph the editorialist admits: "These reforms are mostly untested. And the C.B.O. is properly cautious when it says that it does not see much if any savings for the government during the next decade, in part because of upfront costs and in part because no one knows what will work."
Let me get this straight. The Times is urging us in the name of “cost reduction” to accept a huge new government expense that will affect us all in ways we cannot imagine because the regime in power declares that it will cut costs. It must be so because, well, it must be so.
The mind boggles at this logic. According to those who want government-run medical care (actually, most of medical care today already is run by the government one way or another), profit-seeking medical-insurance, drug, and private-care firms deliberately are driving up their costs in order to become more profitable. If that were true it would be the first time that profitability in a market system was positively related to firms’ artificially raising their own costs.
Indeed, as economists such as Ludwig von Mises and Murray Rothbard clearly demonstrated, firms earn profits by cutting costs, being resourceful, and creating goods and services that consumers want to purchase. The notion that companies become profitable through high production costs turns economic logic on its head.
For example, we have seen prices fall in the production and sale of computers and personal electronics in some of the freest markets on the planet. However, if these firms had adopted a production plan akin to what the Times demands for medical care, we would be paying a fortune for inferior electronic goods and there would be a “cost crisis” in that industry.
Sheldon Richman recently wrote about the “perverse incentives” that government has created in modern medical care, and he said that free markets in health care would better serve people than what we have now. Granted, he is using real economic logic, something that the political classes and their media allies have rejected as politically unsuitable. The rest of us will pay dearly for that arrogance.
When it comes to health care reform, the White House and its allies on Capitol Hill seem to live in an alternate universe.
The White House Council of Economic Advisers just released a report arguing that the reforms before Congress would reduce the growth in health costs, cut the federal budget deficits and produce thousands of dollars in benefits for the average family. The problem is that just a few days earlier a report from the president's own chief health care actuary concluded that the bill the Senate is considering would actually increase U.S. health spending by $234 billion over the next 10 years and hurt seniors' access to care. But then, reformers have generally had trouble telling fact from fiction. Among the biggest whoppers:
* Health care reform will reduce your insurance premiums. According to the Congressional Budget Office, the Senate bill does little or nothing to reduce insurance premiums. Even if the bill passes, premiums will roughly double by 2016, and keep rising after that. But for millions of Americans, the Senate bill will actually make things worse. According to the CBO, the bill would actually increase insurance premiums by 10 to 13 percent for Americans who don't receive insurance from their employers and buy their own insurance. These increases are over and above any increases that would occur if we did nothing.
* Middle-class taxes won't be raised. The Senate bill raises at least 15 new or increased taxes totaling more than $493 billion. While some, like the increase in the payroll tax, would primarily hit the wealthy, many would fall solidly on the middle class. For example, the bill includes a 40 percent excise tax on so-called "Cadillac" insurance plans, that is, insurance that is more generous than the government thinks it should be. According to the CBO, roughly 19 percent of workers would initially find their plans subject to the tax. However, because the tax threshold is set to increase at a rate slower than medical inflation, as time goes by more and more middle-class workers will be hit by it.
Middle-class taxpayers would be taxed in other ways as well. The Senate bill would require everyone to buy a government-designed insurance plan, even if it were more expensive than their current policy. Failure to comply brings a penalty of up to $6,750 for a family of four. If the government took money directly from you, then turned around and gave it to an insurance company, everyone would agree that you've been taxed. How is that any different from the government mandating that you pay the insurer directly?
* You can keep your current insurance. The Senate bill contains an individual mandate, that is, a requirement that every American must purchase health insurance. But not just any health insurance will satisfy that mandate. To qualify, a plan would have to meet certain government-defined standards. Those standards may be more expensive than your current plan, may include benefits you don't want and may even have benefits you are morally opposed to. As noted above, failure to comply brings a penalty of up to $6,750 for a family of four.
* It will only cost $848 billion. It is true that the CBO officially scored the bill as costing $848 billion. But much of the spending is back-loaded. The bill doesn't start spending until 2014, and only costs $9 billion that year. By 2019, the annual cost hits $196 billion. The minority staff of the Senate Budget Committee reports the cost is closer to $2.5 trillion over 10 years once all budget gimmicks are factored out. If you include costs shifted to individuals, businesses and state governments, the price tag could top $6 trillion.
* It will reduce the budget deficit. The CBO does say that the bill would reduce the deficit by $130 billion over the next 10 years (which is less than the deficit the government ran last month alone). However, even that tiny savings depends on budget gimmicks and the willingness of future Congresses to make huge cuts in Medicare spending. In fact, the CBO makes it clear that it will be "difficult" to achieve the predicted savings.
"Facts," John Adams said, "are stubborn things." As the health care reform debate goes forward, it's worth keeping some of these facts in mind.
British hospital accused of 'gross negligence' after 10-year-old boy dies
A hospital has been accused by a coroner of "gross negligence" after a 10-year-old boy died following a seven hour wait for an ambulance
Kieran Howard, from Fordcombe, Kent, was taken to three hospitals after emergency staff failed to diagnose the severity of his condition, Southwark Coroner's Court heard. Doctors were aware there was potentially a problem with the child's brain, but the boy sill had to wait 12 hours to receive a scan which would have allowed a diagnosis and meant life-saving surgery could have gone ahead.
Kieran suffered the burst tumour after sneezing at his home on the morning of Saturday March 28 last year. Paramedics did not spot he was suffering from a neurological problem, so took him Pembury Hospital, the nearest to his home. Kieran was moved to the children's intensive care ward where he suffered an "epileptic-like" fit before his condition worsened and he was sedated.
Southwark Coroner's Court heard that doctors treating the schoolboy should have checked his pupils with a torch every 15 minutes, but this was not done.
Coroner Dr Fiona Wilcox said there was a "four hour window of opportunity" after the boy's eyes had become fixed and dilated to perform surgery which likely would have saved his life. She described the Pembury doctors failures to check his eyes as "gross negligence" and "neglect".
Medics at the hospital called the South Thames Retrieval Service, which shuttles seriously ill children between hospitals, over an hour after Kieran arrived requesting he be moved to London for a brain scan. The STRS was supposed to arrive within two hours, but later warned there could be further delays of up to four hours.
The coroner said that the hospital should either have taken the him to the nearby Kent and Sussex Hospital for a brain scan or reduced his sedation to see how responsive he was. But neither of these were done which Dr Wilcox said may have contributed to the boy's death.
Kieran eventually arrived at St Thomas's Hospital in London where he received a scan at 1am the following morning, before being moved again to King's College Hospital where he received unsuccessful surgery at 4am. He died on April 2 at the hospital.
Dr Wilcox recorded a death by natural causes contributed to by neglect, saying: "What killed Kieran could have been prevented by prompt neurological assessment and treatment – and that is what did not happen."
Outside the coroner' court, Kieran's mother Vanessa said: "After 20 months of fighting to get answers we have finally been vindicated – our son's death was preventable. "We hope that all those who made mistakes may now begin to acknowledge them to stop something like this happening again."
Dr Wilson Bolsover, of Maidstone and Tunbridge Wells NHS Trust, which includes Pembury Hospital, apologised on behalf of the trust "for not doing our level best" in caring for Kieran and said "every lesson that can be learnt, will be learnt." "We accept the coroner's findings fully and have already made significant improvements," he said. [Like what??]
Britain spends half of what it reasonably could on medicines
Britain spends less on medicines than similar countries making it the 'poor man of Europe', a report has said
Britain spends less than half that of Greece, Portugal and Spain on medicines, the report from the Association of British Pharmaceutical Industry, the trade association for companies making prescription drugs said. As a proportion of gross domestic product Britain spends one per cent on medicines, compared with 2.32 per cent in Greece, 2.17 per cent in Portugal and two per cent in France. Britain also pays the lowest price for drugs out of any European country.
David Fisher, commercial director of the ABPI, said: “What we are talking about here is the breakthrough medicines which make huge differences to people’s lives. Prices in the UK are less than in any other comparative European country, yet the UK Government, via NICE, continues to tell patients we can’t afford new medicines. "I think patients, many of whom have paid into the healthcare pot for many years, should be asking hard questions about why they are not being allowed to get their investment back.” He added: “Spending by GDP provides an indication of what is affordable. No matter what measure you use, the UK is the poor man of Europe. Patients in the UK deserve better.”
However other experts said Britain was using the spending power of the NHS to get better value for money on medicines and makes greater use of generic drugs instead of more expensive branded ones.
There has been criticism of the National Institute for health and Clinical Excellence (Nice) which evaluates the cost effectiveness of medicines as some drugs which can prolong the lives of cancer patients or ease symptoms of Alzheimer's disease have been turned down. Nice, however, does not consider the NHS budget on its deliberations or whether the drugs are affordable, it only looks at whether the drug delivers enough extra benefit to justify the extra cost over standard treatments.
A spokeswoman for the Department of Health said: "These figures need to be treated with caution as the fall in value of the pound between 2004-2008 accounts for much of the change of the position of the UK relative to other countries over this period."
Mixed sex wards to be abolished in Britain next year
More promises. Talk is cheap
Mixed sex wards in NHS hospitals will finally be abolished next year, ministers have said - 13 years after Labour's first pledge to end the degrading practice. Men and women sleeping next to each other in hospitals has proved one of the most difficult issues in the NHS for the Labour government. Despite repeated pledges to end mixed sex wards in the 1997 and 2001 election manifestos, earlier this year one in seven trusts admitted they still used old-style Nightingale wards sleeping rows of both men and women. In total 85 per cent of trusts said they had some form of mixed sex sleeping areas, washing facilities or toilets.
Now ministers have claimed that £100m of investment will mean all trusts will provide single sex sleeping areas by June next year or face fines. Only patients needing very specialist or emergency treatment will be allowed to be admitted to a mixed sex area but their privacy and dignity must still be maintained, the report from the Department of Health said.
A lack of privacy and dignity is one of the most common complaints made to the NHS and is especially upsetting for vulnerable and elderly patients, critics pointed out.
Katherine Murphy, Director of the Patients Association said: "After all the announcements on mixed sex wards since 1997 when the original pledge was made, we are still waiting for the only announcement patients are interested in - that they have abolished this undignified practice. We look forward to hearing that in June next year."
In November 1996 Tony Blair asked if it was 'beyond the collective wit' of the government to eliminate mixed sex wards. The Labour election manifesto in 1997 said: "We will work towards the elimination of mixed sex wards," and in 2001 the manifesto went further saying: "Mixed sex wards will be abolished." However in November 2006 then Health Secretary Patricia Hewitt said there was 'more work' to be done to 'eliminate mixed sex accommodation wherever possible'.
The change in terminology was to reflect that 'wards' could contain both sexes but that each sleeping area with partitions, known as 'bays' should be single sex. In January 2008 then junior health minister Lord Darzi told the Lords that always separating the sexes was 'an aspiration that cannot be met'. In April 2008 then Health Secretary Alan Johnson told the Royal College of Nursing Conference that he hoped that 'by next year' the 'frayed-at-the-edges' manifesto commitment would be met.
In January this year Mr Johnson announced that trusts not providing single sex accommodation would face financial consequences in April 2010. Now Ann Keen, health minster has released an interim report saying the NHS is on target to deliver the pledge. The report, Delivering same-sex accommodation – the story so far, said that sleeping in same-sex bays or wards and having access to same-sex lavatories and bathrooms facilities is now the everyday experience of the overwhelming majority of NHS patients, at every stage in their journey through care.....
Shadow Health Secretary Andrew Lansley said: “Time and again we have heard Labour Ministers boast about how they are within touching distance of abolishing mixed sex wards. But sadly, the reality for thousands of patients is that they still have to suffer the indignity of sharing a room with members of the other sex when they are trying to recover in hospital. “If we are going to get rid of mixed sex wards once and for all we need to focus on building more single rooms in NHS hospitals. But instead Labour have focused on buying thousands of extra curtains. This is simply not good enough."
In a blow to the bill grinding through the Senate, Howard Dean bluntly called for the bill to be killed in a pre-recorded interview set to air later this afternoon, denouncing it as “the collapse of health care reform in the United States Senate,” the reporter who conducted the interview tells me.
Dean said the removal of the Medicare buy-in made the bill not worth supporting, and urged Dem leaders to start over with the process of reconciliation in the interview, which is set to air at 5:50 PM today on Vermont Public Radio, political reporter Bob Kinzel confirms to me.
The gauntlet from Dean — whose voice on health care is well respsected among liberals — will energize those on the left who are mobilizing against the bill, and make it tougher for liberals to embrace the emerging proposal. In an excerpt Kinzel gave me, Dean says: “This is essentially the collapse of health care reform in the United States Senate. Honestly the best thing to do right now is kill the Senate bill, go back to the House, start the reconciliation process, where you only need 51 votes and it would be a much simpler bill.”
Kinzel added that Dean essentially said that if Democratic leaders cave into Joe Lieberman right now they’ll be left with a bill that’s not worth supporting.
Dean had previously endorsed the Medicare buy-in compromise without a public option, saying that the key question should be whether the bill contains enough “real reform” to be worthy of progressives’ support. Dean has apparently concluded that the “real reform” has been removed at Lieberman’s behest — which won’t make it easier for liberals to swallow the emerging compromise.
Update: The full interview is now up at Vermont Public Radio.
Fifty-six percent (56%) of U.S. voters now oppose the health care plan proposed by President Obama and congressional Democrats. That’s the highest level of opposition found - reached three times before - in six months of polling. The latest Rasmussen Reports national telephone survey finds that just 40% of voters favor the health care plan.
Perhaps more significantly, 46% now Strongly Oppose the plan, compared to 19% who Strongly Favor it.
Overall support for the health care plan fell to 38%, its lowest point ever, just before Thanksgiving. This is the fourth straight week with support at 41% or less. With the exception of a few days following nationally televised presidential appeals for the legislation, the number of voters opposed to the plan has always exceeded the number who favor it.
“The most significant detail in the data is that 63% of senior citizens oppose the plan, including 52% who strongly oppose it,” says Scott Rasmussen, president of Rasmussen Reports. “Seniors are significant in this debate both because they use the health care system more than anyone else and because they vote more than younger voters.”
Democrats, whose legislators control both the House and Senate, continue to be the big supporters of the health care plan. Seventy-one percent (71%) of those in the president’s party favor it. Eighty-one percent (81%) of Republicans and 69% of voters not affiliated with either party oppose the plan.
But again the emotion is on the side of the opponents: Thirty-eight percent (38%) of Democrats strongly support the plan, but 74% of GOP voters and 57% of unaffiliateds strongly oppose it.
Only 21% of voters say the quality of health care in the country will get better if the plan passes. Fifty-four percent (54%) say quality will get worse, while 18% expect it to stay about the same.
Fifty-seven percent (57%) say health care costs will go up if the plan passes. Seventeen percent (17%) say costs will go down, as the authors of the plan contend. Twenty percent (20%) say health care costs will remain about the same if the legislation becomes law.
Liberals swallow another health compromise in Senate
In a last-ditch attempt to come up with the 60 votes needed to pass health care legislation this year, Senate Democrats appeared ready to dump plans to expand Medicare, with leaders telling their liberal faction to accept a stripped-down proposal because it is better than passing nothing at all. Sen. Joe Lieberman, I-Conn., who is opposed to the provision to allow people as young as 55 to enroll in Medicare, told reporters after a 90-minute caucus meeting that Democratic leaders are likely to remove it. Lieberman said Senate Democratic leaders did not give him "an explicit assurance" that it will not be in the bill, but he added, "let's just say I'm encouraged by the direction things are going in."
Majority Leader Harry Reid, of Nevada, refused to answer questions after the meeting, but other Democratic leaders signaled that liberals are being asked to accept a bill that falls fall short of their original proposal, which at one point included a large, government-run health insurance program. "It's a lot easier to envision the legislation you want than to pass the legislation you need," said Sen. Chris Dodd, D-Conn., chairman of the Health, Education, Labor and Pensions Committee.
When the meeting ended, several liberal Democrats wearing grim expressions, brushed past waiting reporters, refusing to talk. But a few did speak, and justified their support by pointing to the bill's proposal to expand Medicaid to non-elderly adults earning up to 133 percent of the poverty level, which will expand government health care coverage to millions of people.
Sen. Jay Rockefeller, D-W.Va., said he told colleagues in the meeting that he believed it was wrong for anyone to hold up passage of the bill, which also proposes a national insurance plan similar to the one offered to federal workers. "How could I not vote for the bill?" Rockefeller said. "I have to consider who is looking to me for results and what can I give to them. This makes it easy for me to vote for it."
Sen. Paul Kirk, D-Mass., also seemed ready to accept the compromise. In the closed-door meeting, he called for everyone else to go along too, invoking the name of his predecessor, the late Sen. Edward Kennedy, and his desire to pass health care reform. "If some of the things I wanted in the bill aren't in the bill, the pluses offer so many more benefits," Kirk said after the meeting.
While the Medicare expansion idea is all but dead, it could somehow be revived if the Congressional Budget Office calculates a more rosy outlook on its cost than many are expecting. Rockefeller said Reid told the caucus he expects the CBO analysis of both the Medicare buy-in and the national health insurance plan to be ready on Tuesday.
In the meantime, Reid is counting votes. It was not clear to anyone on Monday whether he has 60. "That's something nobody can answer," Rockefeller said.
Midwives in meltdown: A former NHS worker reveals how understaffed maternity wards are sinking into chaos
What the British midwife reports below is dreadful but there is often great neglect in Australian public hospitals too. For that reason, when my stepdaughter was going to have her first baby recently, I sent her to a large private maternity hospital nearby, where she got excellent attention and resort-style accommodation. She was admitted on Friday, had the baby on Saturday and kept in until Wednesday morning to make sure that there were no problems: Nearly it used to be and most unlike the public hospital rush these days. I was there a few hours after the birth and found not a distressed mother but a "happy little Vegemite", as we say in Australia. A picture of the happy mother and day-old baby here. Contrast that with the story below. Government medical care is a disaster -- JR
Clutching her husband's hand and with agony and exhaustion etched on her face, a young woman struggled into a room in the maternity unit where I worked. She was in the early stages of labour with her first baby, she was terrified, in excruciating pain and desperate for any crumb of support. Helpless beside her, her overnight bag in his hand, her poor husband looked equally traumatised.
My heart went out to them. But I knew there was little I could do. With five other pregnant women to care for at the same time, all with hugely different and complex problems, I was rushed off my feet and didn't have the time to look after her properly, to allay her fears or to hear about how she wanted the birth to unfold.
I longed to sit with this poor young woman, calm her and remind her gently to breathe deeply through each contraction. Just half an hour of my time could have made all the difference. Instead, I put on my cheeriest smile and followed hospital procedure. 'Would you like a painkiller?' I asked. Ten hours later, after she had been drugged to the eyeballs to dull the pain, I heard she'd given birth. Her baby was healthy, but I knew I'd let her down.
As I watched her being wheeled into the ward, I felt eaten up with guilt. She'd effectively been ignored from the moment she turned up until the moment she gave birth. Plonked on an antenatal ward until her time came, with no one to reassure her during what was most likely the most terrifying moment of her life. No woman should have to give birth in these conditions - let alone in a modern hospital with professional staff at hand.
Welcome to the modern NHS maternity ward. A world of shoddy practice, poor hygiene standards and a shocking disregard for patients' individual needs.
When I read about newly qualified midwife Theresa Naish, who hanged herself in January after a premature baby died on her shift, I couldn't help wondering if she, too, was a victim of the over-worked and under-resourced labour wards I have experienced. Her father Thomas told the inquest into her death: 'Like all NHS staff, she was over-worked, doing too many hours in a department that was understaffed.' Although the child had little chance of survival, poor Theresa spent weeks torturing herself that she was to blame, before killing herself.
I don't want to alarm people for, of course, the vast majority of babies are born healthy and safe, but I think it's time we admit what is happening in our hospitals. Driven by targets and mired in red tape, our NHS maternity wards are becoming baby-producing factories where mothers' needs come very low on the agenda. The quicker midwives turn out babies, the more successful everyone tells us that we are. We might as well be producing sausages. It's utter madness.
I started working as a midwife in Basildon in 1995. I left to work as an independent midwife in January last year because I simply could not bear to let any more women down.
During a typical 12-hour shift, I could be the sole midwife in charge of six women in the antenatal ward - some in early labour - or one of two qualified midwives running a postnatal ward with up to 32 women. If I was in the delivery unit, I would assist in the births of up to three babies a shift.
Obviously, if there was a crisis during a woman's labour - such as a sudden need for an emergency Caesarean - there was always a surgical team on call, and there would be an anaesthetist available to administer epidurals and so on. But in terms of the normal care through labour, that was all down to the midwives. Although we were under huge stress even back in 1995, current cutbacks mean fewer and fewer midwives are caring for more and more women. No wonder new mothers are encouraged to leave hospital just hours after giving birth.
When I started in the mid-Nineties, there were 35,000 midwives working in Britain. A year or two ago, that number had fallen to 25,000, more than half of whom were part-time.
So, how bad did it get? Take one typical day I remember a few years ago. I found myself with up to six patients to look after at once and no back-up. From the moment I stepped into the admissions ward, the area was crammed with women clamouring for attention. Two women were in early labour. I longed to reassure them. But my stress levels rocketed when I saw the dramas that lay ahead.
One young woman, expecting her second baby in three months, had arrived in an ambulance with high blood pressure. She had been sent by her GP, who feared that her life and her baby's were in danger. High blood pressure is often a symptom of pre-eclampsia - one of the most serious risks facing a pregnant woman and one of the most difficult to detect. Terrified she was going to lose her baby, or die, or both, she was frightened. I tried to reassure her.
All the while, half my brain was on the screams of the two women in early labour a few doors away. Did they need more pain relief? When would they need to go into the delivery suite? I had to check my new patient's blood pressure every 15 minutes as well as taking blood samples to be sent for analysis to see exactly what the problem was. It was a race against time because if her blood pressure carried on rising I'd have to ensure she was whisked off for emergency surgery.
As I ran between her bed and the two women in early labour, I barely had time to greet another patient. She was in floods of tears. Her baby was due in a month. He had stopped moving and she was convinced he was dead. Strapping her up to a monitor to check the baby's heartbeat, I tried to calm her. But I didn't even have time to offer her a cup of tea before rushing to another new arrival.
She'd arrived in an ambulance after her waters broke while she was out shopping. The baby wasn't due for another week. Again, her unborn baby had to be urgently monitored.
I was frantically checking my watch to ensure I remembered my patient with high blood pressure when a young woman, hair matted with sweat and eyes wild with fear, staggered towards me. 'I can't take any more,' she said, gripping my hand. 'You've got to help me.' She'd been in labour for five hours and the pain was excruciating. I knew she'd be happier in a delivery room - which is more comfortable and has better specialist equipment - rather than a bed on the ward, but my heart sank. There was no room. I felt sick with guilt as I led her back to her bed. She was in agony, but she'd have to wait.
It was an hour before she was wheeled into the labour room. And in between nursing, I had to write up notes on each patient. There were days when I barely had time to go to the toilet.
In the 13 years since I joined the NHS, conditions have deteriorated. Starting from the moment they arrive through the hospital doors, birth plans tucked neatly in their overnight bags, women are being betrayed. There is reams of evidence to prove that a woman's labour is likely to be shorter and she runs less chance of needing medical intervention if she feels calm and relaxed in the early stages. It's not rocket science. Yet because midwives don't have time to sit with women in early labour for more than a few minutes at most, we are encouraged to do the next best thing. We offer them strong painkilling drugs such as pethidine or diamorphine - which is a form of heroin. Drugs keep the mother nice and quiet which, of course, suits staff. But they also likely to make her and her unborn baby terribly sleepy.
Although these drugs can sometimes increase contractions, they all too often slow them down. The end result at the woman will need more drugs, not fewer, and labour will take longer. But, of course, we don't explain of that as we dole out our pain killers. Besides, on a busy ward, what's the alternative?
Once a woman is in full labour, you'd thought we'd put her needs first. But I'm embarrassed to admit that, all too often, we were not allowed to. Most hospitals rigidly enforce the rule that, once in labour, a woman's canal must dilate at the rate of 1cm an hour. If that isn't happening, midwives are encouraged to tell the her that her baby may be getting in distress - even if that isn't the case. Terrified and exhausted by a haze of drugs, the woman agrees to anything which is offered. In practice, this means we give her extra drugs to intensify the contractions and so speed the arrival of the child.
Her pain levels increase and she'll need an epidural injection in her spine to numb the pain around her groin. It's a vicious circle. I felt terribly mean persuading women to go along with it. I knew I wasn't always acting in their best interests. But what could I do?
It's a joke to say women have choices over how they give birth. The truth is - thanks to the drive to cut costs and improve efficiency - births are turning into conveyer-belt productions. Women dream of having a natural birth and there is often no medical reason why they can't. Instead, they leave the delivery room with a healthy baby, but feeling like a failure because they have used drugs. Some are on such heavy drugs they don't remember giving birth at all. It's heartbreaking.
I also get very angry when I hear NHS authorities extolling the virtues of breastfeeding. According to the NHS website, it's the 'best start in life'. I couldn't agree more. But the truth is that breastfeeding rates are plummeting in the hospitals I've worked in. The reason is simple. Midwives don't have the time to spend helping mothers to feed properly. And without that vital support in the early days, women give up. With three women arriving on a ward at any one time, and three ready to leave, how could I possibly sit for an hour and help a new mother? It's physically impossible, particularly as we are encouraged to rush women home as soon as they are on their feet.
It's to save money, but it does at least reduce the risk of the new mums and their babies picking up an infection. It's no news that hospitals are often dirty. By the time I left, I was almost inured to the filth around me. With so many women and too little time, it was impossible to keep the wards spotless. I regularly found myself wiping off blood which had been missed by the cleaners in their rush.
It's a huge relief to have left the NHS. As an independent midwife in Northwich, Cheshire, I am finally able to help women the way they deserve. Calm, supported and not rushed, my mothers give birth in six to seven hours. In the units where I worked, the average labour was ten to 14 hours.
I feel guilty about the women I let down as an NHS midwife. Weak and in pain, they don't have the knowledge or strength to stand up for themselves. Instead, they end up being patronised by doctors and bullied by midwives into taking drugs they don't want.
But what makes me most sad and angry is that those hospital staff - everyone from managers down - are taking advantage of women when they are at their most vulnerable.
Girl, two, died 24 hours after NHS hospital doctors said she 'had no illness'
Lazy government doctors again. Diagnostic tests? Who's heard of them?
A girl of two died of suspected swine flu the day after hospital doctors allegedly told her parents she had no illness and sent her home. Michelle Fernando, two, began showing symptoms a week after her mother was diagnosed with the virus in November. Her worried father took her to hospital but said medics sent them home, telling him to give the little girl Calpol and water.
The next day Michelle stopped breathing and died. In a tragic twist of fate, it was the day ministers announced that under-fives would be vaccinated against swine flu.
Her mother Uthpala, 27, who lives with husband Rashid and their son Marlon, four, in Bristol, said Michelle would still be alive if she had not been sent home. 'We trusted the doctors but we don't any more,' she said yesterday. 'When Rashid took her to hospital, the doctors told him she had no illness. 'Even when my husband explained I had swine flu, they didn't take it seriously.'
Michelle was taken to Bristol Children's Hospital after she stopped eating and was very weak. Her parents claim doctors did not carry out a blood test or X-ray before sending her home, where her condition worsened.
Her parents were due to receive a report today, which will reveal if swine flu killed her. They have made an official complaint. Health chiefs in Bristol said an inquiry has started.
Doctors are to be formally tested on their knowledge of medicines before they graduate amid concerns about poor prescribing practises.
The British Pharmacological Society (BPS) is developing a national prescribing assessment alongside a website where students can practise their skills, including “dragging and dropping” the right drug doses on to virtual patients.
The BPS believes that current training in prescribing is “piecemeal” and more needs to be done to ensure standards are high. In some cases doctors had filled out a hospital prescription care just a handful of times during their entire medical degree — before taking on roles that could require them to write 50 prescriptions a day.
It comes after a study commissioned by the General Medical Council (GMC), published earlier this month, found doctors rely heavily on pharmacists and nurses to correct their mistakes with medicines. More experienced staff act as a “safety net” to help catch errors before they reach patients, it revealed.
The report said a lack of “safety culture” within the NHS is causing some errors, which occur in around one in 10 hospital prescription orders.
But the study found no evidence that junior doctors made more mistakes than doctors who had been in their jobs far longer.
The BPS welcomed that report but said there needed to be far more focus on ensuring medical students are properly educated.
Professor Simon Maxwell, chairman of the BPS prescribing committee, said prescribing was the “core business of the NHS” and the evidence of a problem with its quality was “now overwhelming”. He said about half of all spending outside of staff costs went on medicines and mistakes were a major reason behind why patients sought compensation from the NHS.
“We recognise that the majority of prescriptions are appropriate, safe and effective [but] the evidence is now unequivocal that there are problems,” he said.
“One of the concerns the BPS has is that there is somewhat of a culture of acceptance that medication errors happen but they are stopped by the good actions of nurses and pharmacists.”
He said the NHS could do a lot better and that such an error rate would not be acceptable in industries such as aviation.
There was a lack of skills training for students despite the fact education was “critical” to driving down the error rate, he said. After “years of indifference and even denial”, the corner may now be turned, he said. “I think everybody accepts that standards of prescribing in the NHS should and can be improved.”
Dr Jeffrey Aronson, president of the BPS, said doctors were dealing with more and more complex drugs and more complicated treatments. As people age, they tend to suffer a range of problems and more medications are prescribed, increasing the potential for negative interactions between drugs, he added.
Australia: Loads of money for hospital computers but nothing more for patients?
This is obscene for two reasons: 1). The huge waiting lists for treatment in most hospitals. The money should be spent on more doctors and nurses; 2). The British experience suggests that the money will be completely wasted anyway. The Brits have just given up on their computter system after spending 12 BILLION pounds on it
A BROAD coalition of health professionals believes it made progress in its quest for $6.3 billion in federal funding at the government's massive broadband conference in Sydney last week. The Coalition for e-Health's hopes have been buoyed by strong indications it has support from Kevin Rudd, Health and Ageing Minister Nicola Roxon and Communications Minister Stephen Conroy.
Michael Legg, president of the Health Informatics Society, which convenes the CeH, said the group had been asked to hang tight. Professor Legg said the group had been strongly encouraged by comments made by Department of Health and Ageing deputy secretary Jane Halton at the conference that indicated the department was behind the group. "That's the first time that I've really heard anybody at that level in the department declaring their position with respect to it, which means, I think, that that they do have strong political support," Professor Legg said.
The group has been in limbo since June, when the federal government accepted a report issued by the National Health and Hospitals Reform Commission that found e-health was critical to improving Australian healthcare. The report convinced the government to recognise e-health as a critical component of its health reform policy.
The Business Council of Australia issued a strategy paper last month that suggested Australia could cut $27.8bn from its national medical bill over eight years if $6.3bn were invested in e-health systems over five years. [What utter bull!]
The Prime Minister was expected to provide feedback on the strategy after last week's meeting of the Council Of Australian Governments. CeH wrote to Mr Rudd urging him to move swiftly to accept the findings of the strategy paper. It said in the letter the government had not made its position clear on e-health and asked Mr Rudd to take a stronger leadership position to ensure stronger cohesion between state and federal health jurisdictions. "We ask you as Prime Minister to lead the way," the group wrote.
"This is a nation-building exercise that requires clear vision and strong leadership. To date, your government, while supportive, has not articulated a clear position and commitment. Without this, all jurisdictions will struggle to move ahead . . . We also believe this is a great opportunity to chart a new course; to give the broader health community something to aspire to and work toward, and that this is an essential step towards providing a health system fit for the 21st century." But Professor Legg said Mr Rudd had declined to provide the feedback on the basis the issue was too complex.
The government has isolated health as one of the five key policy areas to be entwined with its $4bn plan to build a super-fast national broadband network. Delivering his opening address to the Realising our Broadband Future conference on Thursday, Mr Rudd said the NBN went beyond communications policy. "In other words, our national broadband policy is not about communications policy," Mr Rudd said. "It is about health policy, education policy, transport policy and the whole way that governments meet the needs of our people."
Labor has given e-health a prominent place in its health reform strategy, but the Prime Minister's positive mood did not carry over to discussion sessions on e-health later in the day. There, frustration was strong over an apparent lack of political leadership backing the vision. In one session Ms Halton faced strongly worded commentary from health professionals on a range of issues. Some bemoaned regulations that prevented them charging for health services supplied electronically. Others were concerned that the e-health agenda was too closely tied to the NBN and urged the government to take "the low-hanging fruit" by supporting health services that were possible with existing broadband connections.
Privately, others expressed concerns that ongoing political conflict over medicine services between the federal government and states and territories was holding back e-health.
However, Professor Legg took up one of the main barriers to e-health services -- the lack of unique healthcare identifiers linking individuals to healthcare records. As discussions were taking place at the conference on Thursday, the federal government released draft legislation to assign such identifiers to providers and patients. [A national ID card by the back door?] That was expected to overcome security and accuracy problems with medical records.
Some questioned the timing of the legislation but Professor Legg said it was a logical progression from the Council of Australian Governments meeting. "The government was moving as fast as governments do," he said.
Senate health bill goes into sudden-death overtime
On Thursday, it will have been 132 days since Congress broke President Obama's August deadline for a final version of his health care plan. That will be exactly twice as long as the time the president gave lawmakers to get the job done when he set the deadline back on June 2. Old political hands knew better than to take Obama seriously when he called for his national health plan to be completed before Congress left for its August recess on Aug. 7. But as he said, it's setting deadlines that's important, not meeting them.
Deadlines, Obama explained, help end the "hand-wringing" that dominated Washington before his arrival. Even if the clock ran out on his plan this summer, he had created some much-needed pressure. "Now, if there are no deadlines, nothing gets done in this town. If somebody comes to me and says, it's basically done; it's going to spill over by a few days or a week -- you know, that's different," was how Obama put it to Jim Lehrer in mid-July.
It's actually been 18 weeks and three days since the Senate left for its August break, and Majority Leader Harry Reid's caucus is in a state of greater disunity now than when Obama was shrugging off missing a deadline because the agreement was imminent. Except for a few bubbles of optimism when Democrats quit talking about the details of health care and focused on how sweet it would be to score such a big win over Republicans, we've seen the Super Bowl of hand-wringing in Washington.
There has not been meaningful debate or useful discussion, but rather the same baloney being sliced in different ways. There is still no consensus on how to expand coverage or how to pay for it, which are the same problems that existed when Obama first called for action in his Feb. 23 address to a joint session of Congress -- 294 days ago.
A plan so sweeping, so expensive and so unpopular has simply proved more than the Senate can handle, especially when Obama has steadfastly refused to be as specific about what he wants in the bill as when he wants it passed.
The House blithely approved a whopper of a health plan. But as Democrats in swing districts announce their retirements and the party keeps slipping in the polls, Nancy Pelosi seems caught in a political kamikaze mission.
After the August deadline was broken in the Senate, Reid and the White House whipped through a series of new deadlines, including Columbus Day and Thanksgiving. Each one was said to be valuable in terms of focusing debate, but all ultimately proved useless. The White House has lately taken to saying that the real deadline was the end of the year all along. This would allow Obama to herald the plan in his State of the Union speech next month, at which time we're told that he intends to cast himself as a budget hawk.
But to strike that unlikely pose, Obama needs the Senate to finish with health care before Christmas. But the yuletide deadline is now slipping as lawmakers await a cost estimate on a new version of the bill.
If Majority Leader Harry Reid had the 60 votes needed to break a filibuster, he could start the process on a final vote today and be headed back to Las Vegas on Dec. 21 as a big winner. But the votes aren't there, and starting the process now would result in a stinging defeat.
Reid was jazzed last week when 10 senators he selected to negotiate a new plan agreed that the thing to do was ditch the idea of a government-run insurance program -- the heart of the Obama plan -- and just expand Medicare. That would be as if the contractor struggling with the roof on your new house suggested that he tear down what he'd already built and just set up a trailer for you.
And Medicare wouldn't even be a double-wide model. It is tens of trillions of dollars in the red, and doctors and hospitals are already fleeing its measly payments and bureaucratic snarls.
It seemed inevitable that the Democratic supermajority would eventually get something passed on health care, if only through an utter indifference to quality. But this process has been grinding on so long to so little effect that if the CBO pans the idea of expanding Medicare, Obama may find that time is really up for his plan.
Anonymous Senate Aide X: Obamacare Going To January. Less Than 50% Chance Of Passage
By John Hawkins
Despite the Democratic attempts to paint the health care bill as an inevitability, the signs of life for the bill are looking ever more faint.
The bill is extremely unpopular and the poll numbers seem to be getting worse for it by the week. Moreover, Harry Reid is having an extremely difficult time getting to 60 votes and his attempt to replace the public option by expanding Medicare seemed like a desperation move. Yet and still, Lieberman and Nelson shot the idea down almost as soon as it was proposed, leaving Reid with no easy option to get a bill passed and a Christmas break coming up where Democratic senators are sure to get an earful from angry constituents who oppose the bill.
So with that in mind, I decided to turn to some of my sources in the Senate to see what they had to say. What follows is an edited transcript of a conversation I had with Senate Aide X, one of my most trusted sources. What you're about to read is probably representative of the behind-the-scenes thinking of Republicans in the Senate and of course, this is being posted with that person's permission:
John: Hey, if this latest Medicare/healthcare bill goes down in flames, will Reid go for reconciliation? Also, I assume if this fails, we're into January, right?
Senate Aide X: Yes, January and I doubt if they'll go for reconciliation.
John: Why do you doubt reconciliation? I ask because I am thinking it won't get 60.
Senate Aide X: I just haven't heard any talk of it.
John: Do you think it will get 60? I am thinking, no.
Senate Aide X: I don't doubt the Dems may do anything to pass it, so I'm not ready to declare it dead.
John: But still, it's looking grim right?
Senate Aide X: They are in much worse shape now than a week ago. If the bill dies this week, it will be because Dems just let it crumble through infighting and the Tea Party/American people standing up in August and demanding through weeks of recent phone calls and protests that it be stopped.
John: If it were to pass somehow, do you think it could die going through ping pong, back and forth between the House?
Senate Aide X: No! Pelosi will rubber stamp whatever the Senate passes.
John: So, you think all these demands from the Left about the public option and the Blue Dogs saying they have to have the Stupak Amendment in there are all for show?
Senate Aide X: No, the left-roots passion is real, but if you are Obama, Reid, and Pelosi, you know this is a one shot deal. This moment won't happen again soon and it's better to cut any deal you can to socialize health care as much as you can now. Take the win, go for more later.
John: One last thing: Chances of passing a health care bill? Give me a percentage.
Senate Aide X: Less than 50% now
John: Thanks for your time. Have a good night.
Long story short, folks, the fight isn't over by a longshot. Reid is still working to get something passed that Pelosi can slam through the House. Moreover, if that doesn't work, Reid may still try reconciliation. But, the odds are slowly but surely turning in our favor. Keep up the good work and we may be able to stop the Democrats from slashing Medicare, raising premiums, raising taxes, funding abortion with our tax dollars, rationing care, and ruining the quality of our health care system.
Leukaemia sufferers in England will be denied potentially life-saving drugs freely available in Scotland. The proposal to ban English patients from getting the medication on the NHS has been branded 'stupid and heartless'.
Doctors and campaigners say the Government rationing body's measures will worsen the postcode lottery, with patients north of the border able to get dasatinib and nilotinib that could add years to their lives.
The preliminary guidance from the National Institute for Health and Clinical Excellence affects patients with chronic myeloid leukaemia. Although the drugs cost £30,000 a year, only a maximum of 300 patients a year are likely to need them. They have failed to respond to treatment with another drug, called Glivec, or become resistant to it.
Professor John Goldman, a specialist at Hammersmith Hospital, in West London, said it was 'a stupid and unjustified decision'. Calling for a rethink, Tony Gavin, of Leukaemia CARE, said: 'Nice's decision is very bad news because there is no acceptable alternative.'
Professor Peter Littlejohns, of NICE, said the evidence presented was 'extremely poor' and the costly drugs were not 'an appropriate use of resources'.
Gamma Knife: a life-and-death lottery for British brain tumour patients
Too many British brain tumour patients are denied state-of-the-art treament that could extend their lives by years
Sally-Anne Wright, a sales manager who lives with her husband and two daughters in Redhill, Surrey, knew something was seriously wrong when she woke up one morning in March to find she had lost all feeling on the right side of her face. "I couldn't feel my nose run, taste anything on the right side of my mouth, or even feel the earring in my right ear," she recalls.
Sally-Anne, 48, went straight to her GP, and was referred to a local ear, nose and throat specialist. "I have medical insurance through my work, so I was able to have a private CAT scan," she says. "A week later, I was told that I had a golf-ball-sized tumour in the middle of my brain. It was a benign, slow-growing meningioma and was pressing on the trigeminal nerve, which controls sensation in the face, and this was what had caused the numbness.
"The tumour was deep, and I was told that removing it surgically would damage healthy tissue. Surgery could also cause terrible complications, such as epilepsy and loss of function on my right side. Instead, my neurosurgeon recommended a non-invasive treatment called Gamma Knife."
Sally-Anne had never heard of Gamma Knife, but she did some research on the internet and discovered that it was a state-of-the art procedure, also known as stereotactic radio-surgery, which uses a single dose of highly focused radiation, designed to destroy only the tumour and leave the surrounding healthy tissue undamaged. It can be used to treat brain tumours (often secondaries which have spread from primary breast cancers, for examople), and conditions such as arteriovenous malformation, a problem affecting the blood vessels in the brain.
Sally-Anne decided it was her best option. "My job involves a lot of driving and if I'd undergone surgery, it could have taken a year to recuperate." In October, she was treated at the BMI Thornbury Hospital in Sheffield, which has a 92 per cent success rate in using a Gamma Knife on this type of tumour.
The procedure was carried out by Mr Andras Kemeny, a pioneer of the treatment, and involved a special frame being attached by pins to the skull under local anaesthetic. The Gamma Knife itself is a semicircular, helmet-like structure containing around 200 sources of radioactive cobalt.
An MRI scan performed while the frame is attached serves as a "road map" for immobilising the patient's head in the helmet. Although each beam causes no damage to the tissue en route, when they all meet at the target, the resulting dose destroys the tumour. The one-off treatment lasts about an hour and most patients leave hospital with only minor side-effects such as a headache.
Sally-Anne's operation was a success, and she went home the next day. "I felt a bit tired and headachy and my face was slightly swollen, but within hours I felt perfectly well and I was driving three days later. I have regular checks, but Mr Kemeny says that it's unlikely to cause any more problems. It's great to come through this unscathed."
Sally-Anne is one of the lucky ones. Though Gamma Knife technology is not new (it was developed in 1967 and has been refined and improved ever since), access to this treatment is limited. There are five Gamma Knife centres in the UK: one at the Leeds General Infirmary, two in Sheffield, at the Royal Hallamshire and BMI Thornbury hospitals, and two in London, at the Cromwell and St Bart's. They are used to treat about 1,500 people each year. However, many cancer specialists, including Professor Christer Lindquist at the Cromwell Hopspital in London and Mr Andras Keneny at the Hallamshire and BMI Thornbury hospitals in Sheffield, believe that thousands more patients are being denied treatment, which could save or extend their lives, because of a shortage of knives and stringent NHS criteria determining who gets access to it.
All Gamma Knife treatment must be approved by a patient's local Primary Care Trust, and the criteria by which PCTs decide who will be approved for funding is set by one of 10 Specialised Commissioning Groups covering different areas of the country. Some take a harder line than others. Patients in Devon are far more likely to be approved than those in parts of Derbyshire and Yorkshire. Some people refused treatment on the NHS, choose to pay for the £17,000-plus cost, often incurring large debts, rather than undergoing surgery.
The only alternative is Whole Brain Radio-Therapy (WBRT), a treatment most often used on large tumours. WBRT involves delivering daily doses of radiation over three weeks. It is far less precise than Gamma Knife and can cause sickness and hair loss. It also damages normal cells along with cancerous ones, and may cause severe side-effects, such as dementia and loss of movement.
Although a single Gamma Knife treatment costs considerably more than the estimated £1,500 for a three-week course of WBRT, most neurosurgeons acknowledge that the enhanced quality of life and savings on nursing care more than compensate for the expense. "Gamma Knife treatments are highly effective," says Prof Lindquist. "It is more like surgery than Whole Brain Radio-Therapy and is very focused on the tumour.
"Some of our breast-cancer patients can live many years if their secondaries elsewhere are well controlled, but if we don't treat the brain tumours the patients often die within months. Our longest surviving patient has kept going for 19 years after treatment for melanoma (skin cancer). Another Gamma Knife patient with breast cancer has survived 10 years, despite being given six months to live in 1999 when 10 brain tumours were discovered. "With the incidence of cancer on the rise, we certainly need more Gamma Knives; probably double the five we have at the moment."
But funding is not the only issue, according to a Specialised Services Commissioner, who asked to remain anonymous. "Cost is not a major factor," he says. "We have nationally agreed criteria governing who should get the treatment. All people who are suitable, and meet the criteria, are routinely funded and receive their treatment. The apparent differences in treatment provision are down to individual Specialised Commissioning Groups. Work has been in progress for some time, co-ordinated at a national level, to consider any new evidence that has emerged since those criteria were introduced, and if necessary the specifications will be revised, probably within the next few months."
Despite this hint at a change of heart, Sally-Anne's surgeon, Mr Kemeny, remains frustrated at the bureaucracy involved in getting the NHS to pay for treatment. "Each PCT comes up with its own set of rules, based on finance, justified by their reading of the medical literature. If you have two brain metastases and live in Derbyshire, you cannot have Gamma Knife on the NHS, even if it is your only option, because all else has been tried, whereas you may have four treated if you are referred from London or the South West. It is a total lottery.
"More Gamma Knives would not help if we are not allowed to treat those patients who are suitable. In spite of a positive assessment by all the doctors involved, one has to fill in endless, different forms for each patient, jumping through hoops, trying to prove "exceptionality" when the treatment is standard around the world," he says. "It is incredibly sad to see a young woman with small children denied the opportunity of living another few years with good quality of life when, without this treatment, the alternative is death."
Eileen O'Grady, 68, from Bolton, felt almost suicidal after suffering from trigeminal neuralgia (severe pain in her face) for nearly a decade. "It was excruciating" she said. "l couldn't chew, walk or even touch my face. Drugs had no effect, and I wasn't suitable for surgery. In July, my neurosurgeon recommended Gamma Knife treatment on the NHS at the Royal Hallamshire Hospital in Sheffield. It took just half an hour and I came home at once. I can't believe the difference: no pain for the first time in years, and I haven't had a tablet since coming out of hospital. Everyone says I look totally different because I've got my life back."
Jane, 42, a housewife from Nottingham, who requested anonymity to protect her children, was diagnosed with breast cancer eight years ago. She had two sons under four years old. She developed a brain tumour in 2005, which was treated with Whole Brain Radio-Therapy and removed surgically, which has left her with memory loss. Another small brain tumour appeared two years later and, in September 2008, Jane was referred for Gamma Knife treatment, and was the first patient to be treated by Mr Andras Kemeny at the BMI Thornbury in Sheffield.
"It was amazing," she said. "It took just half an hour and was quite painless. I've had two scans since and there's been no recurrence. I'm now 42 and to still be here eight years after that first diagnosis is fantastic. My sons are now 10 and 12. Each year is a milestone I never thought I'd see. At the time, it broke my heart to see the boys asleep in bed. I was terrified I wouldn't be around for their next birthday. We have medical insurance, but it seems so wrong that, with this amazing facility available, the recommending committees don't let specialists treat more people who would benefit like me."
You sometimes wonder if they are human beings. They are about as subtle as a punch in the head. Paperwork trumps people. And they are not backing down. The only people they don't bother are the crooks
EMINENT doctors - including prominent pro-RAH crusader Jim Katsaros - have been threatened with suspension unless they prove they are qualified. The demand for proof comes as the Health Department belatedly moves to ensure doctors employed in the public system are qualified. The move comes in the wake of the Queensland scandal in which former Bundaberg Hospital surgeon Dr Jayant Patel faces three charges of manslaughter and two of grievous bodily harm, as well as 387 claims for compensation. [All of which happened years ago]
SA Health Minister John Hill declined to answer whether he could guarantee every doctor in the health system was qualified. Public hospital specialists have been sent letters demanding they produce a certified copy of their primary medical degree, certified copy of post-graduate qualifications and a copy of their curriculum vitae. Surgeons with decades of service have baulked at the demand that they dismantle their framed medical degrees, firmly attached to their office walls, to show bureaucrats they are qualified.
Dr Katsaros, the RAH's head of plastic and reconstructive surgery, has written back objecting to the "wasteful and time-consuming" demand, and invited officials to view his degrees in his office where they are "framed and glued to a wall". During the week he was given a curt written warning by RAH general manager Lindsay Gough saying he would be suspended unless he produced the documents within two weeks. [Bluff! He would be in deep do-do if he fired essential medical staff]
Dr Katsaros, who has worked at the RAH since 1968 and is chairman of the Save the RAH committee, said it was "bureaucracy gone mad". "You have bureaucrats sitting in their ivory towers, who never come into hospital wards to see what happens with patients, trying to justify their existence," he said. "We have patients lying in corridors, waiting lists that have blown out, medical staff juggling the workload and these turkeys come up with this blunderbuss approach to belatedly see if the people they have employed are actually doctors. "We work our butts off in the public system because we care about patients and we want to teach the younger generation coming through, and while we are dealing with the reality of health care the bureaucrats want me to dismantle my degrees off my wall to show I really am a doctor."
Director of ear, nose and throat surgery at the RAH, Dr Suren Krishnan - who has been employed at the hospital since 1982 and is a past president of the Australian and New Zealand Head and Neck Society - is similarly livid. "Some patients are waiting 12 months to see me here - I am too busy looking after patients to deal with over-the-top big brother policies of the Health Department," he said. "When someone applies for a job there should be a duty of care to present their Medical Board credentials - surely they can check that by computer or a phone call rather than a bureaucrat demanding we bring in our degrees. "It shows how divorced they are from the coalface of patient care; we're dealing with waiting lists that are out of control and our focus is on patient care. "Then we get this officious letter that has offended quite a number of doctors."
In response to questions from the Sunday Mail , Mr Hill's office provided a statement saying all doctors appointed to specialist positions across SA public hospitals were now required to produce original certificates for their basic and specialist qualifications in the wake of the Patel scandal. "This credentialling reflects national standards, and health systems across Australia are adopting these more rigorous checks," the statement said. "The tighter checks are aimed at protecting the community, and ensuring that doctors are properly credentialled to provide surgery in SA hospitals."
SA Chief Medical Officer Professor Paddy Phillips said the new policy was fundamental to ensuring people working as doctors had relevant qualifications. "It is mandatory for all medical staff employed within SA Health; it is the foundation of safety and quality in our hospitals," he said.
ObamaCare Starts to Show Cracks, Update: Lieberman Tell Reid to his Face: Nyet
The New York Times is reporting:
“In a surprise setback for Democratic leaders, Senator Joseph I. Lieberman, independent of Connecticut, said on Sunday that he would vote against the health care legislation in its current form.”
And on the issue of abortion, the New York Times was equally shocked by Senator Nelson:
“On a separate issue, Mr. Reid tried over the weekend to concoct a compromise on abortion that would induce Senator Ben Nelson, Democrat of Nebraska, to vote for the bill. Mr. Nelson opposes abortion. Any provision that satisfies him risks alienating supporters of abortion rights.”
Meanwhile, this just in from the Huffington Post, Senator Lieberman told Senator Reid to his face this morning that he will vote against the Reid vapor deal:
“Senator Joseph Lieberman (I-Conn.) informed Senate Majority Leader Harry Reid (D-Nev.) in a face-to-face meeting on Sunday that he will vote against a health care bill that includes a public option or a provision that would expand Medicare, a Democrat Senate aide tells the Huffington Post.
The two Senators had a discussion in Reid’s office shortly after Lieberman appeared on CBS’s Face the Nation Sunday morning. The Connecticut Independent discussed with Reid some of his concerns about the legislation, elaborating on issues he had raised during the show. According to the source, who was briefed on the exchange, Lieberman punctuated the discussion by telling the majority leader directly that he would vote against the bill if the Medicare buy-in and public option provisions remained in it.”
Here is what Senator Lieberman and Senator Nelson said on Face the Nation, via the Weekly Standard:
“On Face The Nation, Sens. Joe Lieberman and Ben Nelson made it pretty clear they weren’t inclined to support the Reid “compromise” featuring a Medicare buy-in. Nelson said he thought such a buy-in is a bad idea, and Lieberman noted that on “the so-called Medicare buy-in — the opposition to it has been growing as the week has gone on. Though I don’t know exactly what’s in it, from what I hear I certainly would have a hard time voting for it because it has some of the same infirmities that the public option did.”
From Robert Costa, in the Corner:
“All of the king’s horses and all of the king’s men may not be able to put 60 together again,” says [Senator] Alexander, in reference to the (barely) 60 votes Reid got last month to bring his bill to the floor. “With two weeks until Christmas, Democrats find themselves in the awkward position of trying to pass a 2,000-page bill — a bill which most of them admit they don’t know much about.”
“Alexander cites the new report from the chief actuary for the Centers for Medicare and Medicaid Services (CMS) as a potential death blow to Reid’s cause. The CMS, a division of the Department of Health and Human Services, says that if Reid’s bill became law, America would spend $234 billion more on health care over the next decade.
“Add the CMS report to the Mayo Clinic’s devastating letter against the expansion of Medicare, as well as the opposition of the American Medical Association and hospitals to Reid’s Medicare idea, and it’s clear that the more people find out about this, the less they like it,” says Alexander. “I’m not ready to make a prediction (on whether it will fail), but things aren’t looking good for the majority leader.”
Given Senator Bill Nelson’s (D-Fla) statement on FOX News that the Reid Vapor Deal is a “non-starter,” and the fact that Senator Snowe has said she does not support it, and Senator Lieberman never has supported it, and the only public statements he has made have been to cast doubt about the idea’s viability; and that Senator Nelson has now publicly stated that he cannot vote to end the filibuster if the abortion restrictions he supports are not in the bill — it appears that the ObamaCare implosion is imminent.
ObamaCare is a political failure. Its political failure will lead to its legislative failure. It is just a matter of when.
A Hundred Billion Here, A Hundred Billion There...
The New York Times reported today that the Democrats “hit a rough patch Friday in their push for sweeping health care legislation” when “a top Medicare official” declared that their proposal would raise, not lower, health care costs.
The Medicare official ... said that total national health spending would increase slightly as a result of the Senate bill, put together by the majority leader, Harry Reid, Democrat of Nevada. President Obama has repeatedly said that one of his top goals is to slow the growth of health costs.
Richard S. Foster, the chief actuary of the federal Centers for Medicare and Medicaid Services, said Friday that under Mr. Reid’s bill national health spending from 2010 to 2019 would total $35.5 trillion. That is $234 billion, or 0.7 percent, more than the amount projected under current law, he added.
So, in the Times’s telling $234 billion is only a slight increase. How much additional spending, I wonder, is required for the Times to regard an increase as un-slight.
Half of NHS hospitals 'will have to significantly reduce MRSA rates next year'
Half of all hospitals in England will have to significantly reduce MRSA rates next year as part of a crackdown on the potentially deadly superbug. They have been told bring rates down to the national average or reduce the number of case by 20 per cent, whichever has the greater impact.
Ministers are trying to tackle the worst performing hospitals, after successfully halving the overall number of cases across the country.
A report earlier this year from the National Audit Office showed that while rates of the hospital-acquired infections are falling across the country MRSA cases were actually rising in one in 10 hospital trusts.
A spokesman for the Department of Health confirmed that hospitals would not face penalties for missing the target. However, he added, hospitals would continue have their infection rate figures published on the NHS Choices website and could see patients choose to go elsewhere if they consistently had a large numbers of MRSA cases.
Frustrated surgeons walk out of chaotic West Australian public hospital
ONE THIRD of the general surgery team at WA's biggest hospital are so disgruntled they have either quit or are poised to resign, frustrated medicos revealed last night. One senior surgeon, who quit her job at Sir Charles Gairdner Hospital late last month, said she was being forced to compromise care because she felt pressured to "push patients" out the door as quickly as possible.
Senior surgeons, a number of whom have detailed a litany of concerns to The Sunday Times, said they are fed up with management, compromised patient care and unreasonable workloads. The surgeon who quit last month said her resignation from SCGH was one of "many fires burning in the department". She said the departures could be as many as eight - equal to a third of the hospital's general surgery team. "At least seven other surgeons have either left or are in the process of resigning and won't be around after December," the specialist surgeon said. "We're all high-calibre people. You're talking a big-time walkout."
She added: "There is so much pressure to push through patients just for the numbers that you're not being allowed to give the appropriate time to communicate and assist them to the level that they should be." Most of the departing medicos have found new jobs, either in other public hospitals or in the private sector.
Another surgeon said budget cuts were forcing doctors to cancel important surgery. The surgeon, who is planning to quit SCGH within months, said staff who complained were bullied by management. Another doctor, who said he went on leave and would not be returning to the hospital, alleged SCGH was recruiting overseas doctors and forcing them to work unfair hours. "The heads of department are hoping to get rid of local people and get overseas doctors because they're more vulnerable," he said. "They don't know the health system or the area and a lot of them are on special work visas."
Australian Medical Association state president Gary Geelhoed said doctors were finding it increasingly frustrating to work in the public hospitals. "We know that the hospitals are under pressure and it's getting more difficult," he said. "People are finding it harder to work within the public system."
The Sunday Times revealed in July that senior heart doctors at SCGH were locked in a bitter dispute after one doctor, John Alvarez, claimed two of his colleagues weren't qualified. SCGH suspended one of the doctors, Jaffar Shehatha, from duty pending an investigation into 18 of his patient files. The Health Department also launched an investigation into Dr Alveraz, over allegations of misconduct.
Opposition health spokesman Roger Cook called for an inquiry into the ongoing unrest among surgical staff at SCGH. "There is an emerging picture of disquiet at SCGH among the surgeons," Mr Cook said. "We need to make sure we're supporting our professional doctors and nurses as much as possible."
A spokeswoman for the hospital confirmed that three part-time surgeons would be leaving. "The timing of the departures is purely coincidental, and we are unaware of any other planned resignations in the near future," she said. "The hospital has not received a formal complaint from any of these surgeons." She said the hospital was looking to recruit two extra full-time general surgeons as soon as possible.
The Founding Fathers created a Republic, but 60 Senators are poised to take it away. With the pending disaster of the passage in the Senate of a bill nationalizing one sixth of the U.S. economy and our entire healthcare system at a cost of over $2.5 trillion, we are faced with a crucial question: are the Republican senators using every means at their disposal to stop this looming, tyrannical abuse of power? Unfortunately, the answer appears to be “no.”
The Senate, unlike the House of Representatives, has parliamentary rules and procedures that give the minority the ability to stall legislation. In fact, unlike the House, the minority have the ability to virtually paralyze the Senate. Doing so is not something we would want or expect for every bad bill that comes through Congress, but the proposed healthcare legislation is probably the worst piece of legislation ever considered by the United States Congress. It is the most intrusive, most damaging, most costly, most dangerous bill to the economic and personal freedom and liberty of individual Americans that Congress has ever considered. If there is any bill that deserves being stopped by shutting down the Senate, it is this one.
There are a whole series of parliamentary maneuvers that could be used by Republican senators to stop this bill. There is a hard backstop to the current process (Christmas). The Republicans’ goal should be to prevent Reid from passing the bill before that time. If he goes past Christmas and is forced to adjourn or recess, the momentum will shift in favor of those opposing the bill. How could this be done?
To start with, they should stop constantly agreeing to “unanimous consent” requests from the Democrats. Senate Republicans, to date, have allowed Democrats, by unanimous consent, to process 10 amendments. The amendments that have been accepted – Democrat amendments – did not make the over 2000-page atrocity any better. The Republican strategy of trying to pass their own “message” amendments carries no message unless you consider “no strategy to kill the bill” a message. There are no amendments that could possibly make this bill a palatable piece of legislation – and any amendments the Republicans get passed that supposedly make the bill “better” may just make it easier for the Democrats to get final passage. If the Republicans want the news media to cover what they are doing to educate the American people even further about the atrociousness of this bill, they have to create drama on the floor of the Senate. And the only way to do that is through an all-out fight with no holds barred. They need to look like Braveheart, fighting to the end to save freedom. Because, in fact, it is our very freedom and liberty that is at stake.
The most powerful words in the Senate are “I object.” Senate Republicans should have been shouting those two words on the Senate floor early and often from the moment this bill was considered, instead of the complete silence we have heard – other than to constantly agree to conduct business through unanimous consent. Here are just a few ways those words can (and should) be used in a very effective way:
The rules of the Senate require that a quorum be present to transact business. A quorum is 51 Senators. In most instances, outside of roll call votes, there are no more than 4 Senators on the Senate floor. If a Republican Senator suggested the absence of a quorum, Democrats could not transact business on the bill. It is a common courtesy to allow the quorum call to be dispensed with, without requiring 51 members to show up on the Senate floor (to get 51 Senators to appear without a roll call vote is very time consuming). When the Democrats ask unanimous consent that the quorum call be dispensed with, the Republican should immediately shout “I object.”
In 1988, when the Democrats were attempting to pass campaign finance reform, and Republicans refused to help them make a quorum, it took 53 hours for the quorum call to be dispensed with. If at any moment at least 50 Democrats are not on the floor, a Republican Senator could again suggest the absence of a quorum and start the process over again, causing huge delays in the legislative process being able to move forward.
No amendment can automatically or without substantial delay receive a roll call vote without every member of the Senate agreeing. Again, the Senate generally operates on collegial courtesy, but a $2.5 trillion courtesy is too much. Once an amendment is pending, it only takes one Senator to step in front of this freight train. If a Senator objects to ending debate on the amendment or having the amendment set aside, the majority must file cloture on the amendment. First cloture has to ripen and it cannot ripen until the next day’s session of the Senate, so that kills a day of the majority’s time. Assuming 60 Senators vote in favor of ending debate, the Senate is then required to spend 30 hours of its session time before voting on final passage for the amendment. Suffice it to say, if the Republicans had continuously objected from the start, the ten amendments they allowed the majority to process would have taken more days than Harry Reid has on the Senate calendar.
Senators have an obligation to protect the Constitution and the budget and points of order can be raised on both. Many constitutional scholars have pointed out that numerous bill provisions, particularly the individual mandate, are unconstitutional. Under the Senate’s rules, constitutional points of order are debatable. The Republicans should be constantly bringing up constitutional points of order, one after another, on every questionable provision. Reid would presumably be forced to file cloture on the points of order and another three days could be burned up on each one.
The healthcare bill violates § 425(a)(2) of the Budget Act, which prohibits consideration of any legislation that contains an unfunded intergovernmental mandate in excess of $69 million per year. If the point of order is raised and sustained, a simple majority may vote to waive the point of order. But the waiver is debatable and thus would presumably require 60 votes to cloture the motion to waive. This would require them to produce 60 votes at a time when they do not have their deal wrapped up yet, once again burning up three days.
On every vote, including on constantly raised points of order, the Republicans should be objecting that the vote total is incomplete – the Democratic Chair will rule that it is complete and the Republicans then appeal and once again force a vote, delaying the process again and again.
The Republicans should be offering one amendment after another on all of their favorite issues such as guns, abortion, elimination of the death tax, ending the TARP program, and gay marriage in the District of Columbia. Nothing connotes trench warfare like non-germane amendments on hot-button social issues. When you look back at all of the great filibusters of past decades, they almost always involved non-germane, explosive amendments on contentious social and other issues. Republicans should be offering hundreds of such amendments on every topic and using the rules to force votes on every single one. And the Republicans should be forcing the reading of the bill and every single amendment, not consenting to waiving that requirement.
Some might argue that Republicans should not look “obstructionist.” But they are wrong – the vast majority of Americans don’t like this bill and don’t want it to pass. The Tea Party movement was the upheaval of millions of ordinary Americans who are scared and angry about the out-of-control growth of the federal government, federal spending, and the national debt. They want to see the Republicans obstructing passage of this bill and if they think the Republicans are not fighting with every tool they have at their disposal, then any advantage that the Republicans think they will get in next year’s elections from such a bill being passed will evaporate. Conservatives will mount challenges to what they see as weak Republicans, just like what happened in New York’s special congressional race, helping Democrats eek out wins. And other conservative will stay home (like they did in 2008) rather than support GOP incumbents who did not fight.
The view coming out of the Senate of the Republicans has the appearance of business-as-usual – colloquies, speeches, and unanimous consent agreements. It does not convey the sense of urgency that should come with an issue of this magnitude and it does not provide any assurance to the public, including most especially the conservative base that is the heart of the Republican Party, that Republican Senators are willing to do everything it takes to stop this bill. If they don’t starting acting forcefully quickly and immediately, not only will they allow the country’s future to be unalterably damaged, they will be hastening the end to their own careers in the elections coming down the road faster than they can imagine.
Finally, I often hear that Senators express frustration when we dare to tell them how to fight, and that their frequent refrain is “you just don’t understand how the Senate works.” Actually some of us understand better than they do how it should work (whether they agree with every particular parliamentary tactic described or not), and the current frustration they feel with us will be nothing like what they may feel if they don’t stop this bill at all costs and act to preserve our Republic.
Do Democrats Really Believe Most Americans Want To Embarrass Obama?
Last night Sen. Sheldon Whitehouse (D, RI) asserted on the Senate floor that opposition to the Democrats’ health care reform “is about creating a political defeat for the president of the United States,” that it has “nothing to do with health care, entirely about creating a defeat for this new president....”
Also yesterday, reports Real Clear Politics, a new CNN poll found “61% opposed to the health care plan currently working its way through the Senate. Only 36% approve of the legislation.”
I wonder: does Sen Whitehouse believe that the opposition of 61% of “adult Americans” to the Democrats’ plan is based entirely on a desire to embarrass the president, that it has “nothing to do with health care”?
Hmm. So, we have one party opposing and the other party supporting something that 61% of adults oppose. Since politicians opposing something that most people oppose hardly requires a hidden, conspiratorial explanation, isn’t it more likely that it is the supporting party’s support that “has nothing to do with health care” but is based instead on a desire to prevent a defeat for their party and president?
As I have written about in a previous article entitled "Stop the Swine Whine," the public health establishment has used the current swine flu hysteria to try to impose mandatory vaccination laws under the guise of a health crisis. Fortunately, these proposed laws, with the exception of New York's short-lived mandatory health care worker vaccination mandate, have yet to come to fruition. In the case of New York some courageous doctors and nurses filed suit against the dictatorial law and were successful in getting the state government to back down.
While the constitutional crisis that this represented has been temporarily averted, a dangerous precedent has been set. It may be that in the coming months and years that these same government officials will not so easily relent. It may be as soon as the next flu season or the passage of the Obamacare health bill that our medical rights are lost forever.
We may have been granted a temporary reprieve from forced medical treatments this time around, but have we been spared from the government? As usual, the answer is "no". While the government may not be forcing a medicine down our throats or corralling uncooperative people in camps, what they are doing should send shivers down our collective spine. They are creating lists of dissidents and "terrorists". These lists contain detailed information on individuals. And, if ever the laws were changed to permit more coercive action instead of passive data collection then the government would already have the names of the supposed "enemies of the state" on hand.
What evidence of these government lists exists? Most people are aware of the government "no-fly" list, which now includes more than a million possible "terrorist" individuals. Additionally, there are government agencies such as the Department of Homeland Security (DHS) that are creating lists of supposed "domestic terrorists" including Ron Paul supporters, constitutionalists, Federal Reserve skeptics, military veterans, and many more as detailed in the Missouri Information Analysis Center (MIAC) and DHS rightwing extremism reports. More recently, the Obama Whitehouse has created its own enemies list composed of individuals that are opponents to Obama's socialist agenda.
There is also a group of people that range from the upper middle class to the wealthy that are frequently portrayed as "economic terrorists" by the IRS and the media. These people are often depicted as evil, selfish individuals that only acquired their living by parasitically draining it from the public. While there are indeed some individuals that fit this depiction, the vast majority are hard-working, innovative individuals who have accumulated wealth by their own efforts. Unfortunately, the media likes to lump these common Americans in with the likes of Bernie Madoff, who swindled investors out of billions of dollars, thus further engendering the false stereotype of wealthy people as being synonymous with corrupt greedy hucksters. This media and government propaganda garners increased support for forced confiscation of wealth as long as Robin Hood's (or rather the Federal Government's) loot is redistributed to those that have been supposedly wronged. Thus the government bribes one group of people, through promised welfare, unemployment, and medical benefits, to support increased IRS efforts to rob the savings from another smaller, but wealthier, group of Americans.
Although most of you are probably familiar with some of these government lists, many are not aware of the latest and potentially most dangerous data collection effort. Not only is the government seeking to monitor foreign, domestic, and economic terrorists but you can now add medical dissidents to the list. These dissidents include people that don't take the prescribed government treatments, physicians who don't follow the government protocols, and those that openly oppose any government medical measure. Traditionally, these medical dissidents could be found among the lists of conscientious objectors who refused to vaccinate their children as a prerequisite for public school enrollment. But the conscientious objectors are only the beginning.
Unbeknownst to most people that have received the H1N1 flu vaccine, they not only got a painful shot in the arm but also may have suffered a shot to their liberty. For example, as part of getting the vaccination in Texas, people are provided information about the H1N1 swine flu from the Texas Department of State Health Services (DSHS). While the information in the packet all seems innocent the catch comes at the end when patients are required to sign a consent to have their name entered into a government database for at least five years, if not forever.
The reason for this extraordinary period of retention seems to be that the H1N1 flu epidemic has been termed a disaster. In fact, the consent section starts with the title "Consent for retention of Disaster-Related Information and Release of Information to Authorized Entities." Furthermore, as part of the consent patients agree to grant "retention of my (or my child's) disaster-related information by DSHS beyond the 5 year retention period." This information will be stored in "the states central immunization registry ('ImmTrac')" and used for "coordinating communicable disease prevention and control efforts."
The "disaster" justification for encroaching upon our constitutional rights is nothing new. What is new is that this "disaster" has now been exposed as at most over-blown and at worst a fraud. While many experts were predicting up to hundreds of thousands of deaths in both the UK and the U.S., the reality has been that only a few hundred have unfortunately succumbed to the "swine" flu. In addition, over the past few weeks there has been a dramatic decrease in the number of swine flu cases. It is likely that this "disaster" may be already over. Unfortunately, for the poor unsuspecting public the end of their liberty has only just begun.
What will the government do with all this information?
Because this virus has been relatively mild and vaccine compliance has been so low, the government is not likely to gain much epidemiological information. However, despite the fact that the government will glean very little information about the effects of the vaccine, this will not prevent it from monitoring those that are vaccine compliant and vaccine non-compliant. It is this list of vaccine non-compliant people that I fear will be the focus of future government pandemic vaccine intervention.
Unfortunately, the story doesn't stop with vaccinations. Ever since the federal government began to tie reimbursement rates of hospitals with preventative medicine or "best practice" measures has come the potential for non-compliance lists of unheard proportions. It all started with Medicare mandating that hospitals "voluntarily" push pneumococcal, tetanus, and flu vaccinations on their patients or else face financial penalties. It didn't matter if the patient came in for a broken leg, he or she would have a vaccine pushed in their face largely because of the threat of federal financial disincentives. Now the Federal government is beginning to push best practice measures in other areas. These areas include government mandates about supposedly evidence-based best treatment protocols for conditions such as heart attacks, strokes, pneumonia, heart failure, and many others. If hospitals and doctors don't follow the protocol, they face the prospect of future blacklisting and financial hardship from federal regulators and auditors.
If that isn't scary enough, soon these measures will affect your local primary care physician as they face the prospect of having their treatments and compliance/non-compliance to protocols for diabetes, heart failure, hypertension, and many other conditions monitored by federal auditors. In anticipation of this many large physician groups and hospital organizations are already putting this monitoring in place on their own physicians in order to help them be good little obedient physicians so that they will be prepared when the eventual mandates from government arrives.
What has made this sort of control possible is the advent of electronic medical records (EMR). With most EMR systems it is possible to data mine and extract patient non-compliance/compliance and monitor physician adherence to best-practice protocols for many conditions and preventative measures. For example, it is possible for these systems to monitor what percentage of a physician's patients are getting colonoscopies, flu vaccines, mammograms, etc. and with the percentage comes a list of compliant and non-compliant individuals. It is with these lists that non-compliant individuals are beginning to be hounded on a never-ending basis to comply or else. This is because physicians fear economic and even possible professional retribution from state medical boards and the government if their numbers aren't high enough.
The only saving grace right now is that the entire system is highly fragmented due to the large number of EMR systems. However, if a single-payer system becomes the dominant medical system under the current health care reform proposed by the Obama administration then it would be much easier for federal government to gather and monitor this information. It may be that soon both physicians and patients are put in medical straight-jackets where all the treatments are prescribed in advance and physicians become nothing more than desk-clerks, even more so than they already are. That is why it may be that the Obama administration is pushing EMR and why Medicare has threatened to start decreasing physician reimbursement for physicians that are not using these systems. It may have more to do with making sure that future government rationing, treatment protocols, physician compliance, and patient compliance can be strictly monitored than improving the quality of medical care.
Think that this kind monitoring could never happen in America? Well, you would be wrong. In January of 2006, New York City became the first city to require certain diabetes blood tests to be sent to the public health department where patient and physician compliance to diabetes treatment protocols are monitored. If the numbers are not good enough both the patient and physician are liable to be sent a report.
It is not too late to become anxiously engaged in fighting for your health care freedom. Just be aware that the next time you decide to be non-compliant to the treatment protocol that you may unwittingly have become part of a non-compliant list. As a member of the non-compliant list, physicians will be forced to continue to nag you on a seemingly never-ending basis until you become compliant. This is because they don't want their name to be published as a bad physician for not getting enough patients to comply nor do they want their livelihood and certification taken away.
If we are unsuccessful in turning the tide then this system of protocols, electronic medical records, and a single-payer system will inevitably be put in place. Your only hope may be to insist that your physician uses paper and not plastic.
Patients with a crippling gut condition 'could be made ill under British government plans to remove their drugs'
Something for Americans to look forward to under Obamacare
The National Institute for Health and Clinical Excellence (Nice) wants to restrict how long patients are given the drugs, which stabilise their illness and have been credited with allowing many to live a normal life. Under new proposals patients with Inflammatory Bowel Diseases (IBD), which includes Crohn's disease, will be guaranteed the treatment for just one year. They will only receive the drugs again if their condition worsens.
At the moment many patients are given the drugs permanently, to prevent relapses in their illness. But Nice insists that the drugs are too costly for the benefits that they provide to continue to prescribe them indefinitely. The new proposals come only a year after Nice sparked outrage by proposing to stop prescribing the drugs entirely if a patient’s condition appeared to stabilise, without even guaranteeing a year of treatment.
Michael Addelman, from Manchester, whose seven-year-old son Jake currently takes one of the drugs involved, Infliximab, said that to remove his son’s medication would “cruel”. “It would be immeasurably cruel to force somebody back into this hellish life,” he said. “The prospect of my son going back to a life of intense pain is extremely worrying.”
Richard Driscoll, chief executive of the National Association for Colitis and Crohn's Disease (NACC), said that the proposals were “madness”. He said: “We really don’t think the NICE Committee understands what this will actually mean for patients’ lives. “The treatment that has been keeping (patients) well and able to lead a near normal and productive life at college, or in work or in caring for their family will suddenly stop. “For many, their symptoms will then start to recur, interrupting work, education and family life. “They will be attending hospital again for assessment and treatment, and this will continue until they get ill enough to ‘requalify’ for the treatment.”
He added: “Just imagine how it would feel for a university student whose treatment has enabled them to complete their course, only to find that it is to stop a couple of months before their final exams – this is madness. “And is it really more efficient and cost-effective for the health service to have someone getting steadily more ill and needing a series of appointments and tests or even admission to hospital compared to having them on a planned programme of care that keeps them well?”
The two drugs involved are Infliximab, which Nice estimates costs £12,500 a year to prescribe, and Adalimumab, which costs £10,000 a year.
There are an estimated 250,000 sufferers of IBD in Britain. Symptoms often include severe weight loss, because the disease makes it difficult for patients to eat. Other signs can be extreme pain, diarrhoea, vomiting, and associated diseases like arthritis.
A spokesman for Nice said: "In making their provisional recommendations, the appraisal committee was unable to recommend adalimumab and infliximab in people with severe active Crohn’s disease for continuous treatment after 12 months due to a lack of long-term data and insufficient evidence identifying a patient group at high risk of relapse. "A further course of treatment with adalimumab or infliximab for another 12 months was recommended as an option for people whose disease relapses”.
Civil servant Sarah Stitt, 36, went to her GP complaining of chronic earache and was given antibiotics for her pain. But another infection causing meningitis was missed despite further medical examinations - and spread to attack her brain. Mrs Stitt, mother to two sons, died from the brain virus just four weeks after first going to her doctor.
Ear specialist witness Desmond Nunez told the inquest: "Some things could have been done, it might have made a difference."
Mrs Stitt began suffering earache in January 2007. She visited her GP, spoke to an out-of-hours healthcare worker and went to hospital as she struggled to cope with the pain. Doctors diagnosed an infection and prescribed antibiotics and eardrops. But the inquest heard a second "extremely rare" infection called masked mastoiditis was missed before developing into meningitis.
Her husband, Sean, then took her to the Royal Gwent Hospital in Newport, South Wales where she died. Gwent coroner David Bowen yesterday recorded a narrative verdict, saying diagnosing the second infection would have pointed towards meningitis. He added: "Mrs Stitt wasn't a lady who easily complained. She had a very high pain threshold."
Speaking outside court, Mr Stitt, 40, of Magor, Gwent, said: "Sarah was so friendly, loving and generous. "I can't believe no-one spotted she was seriously ill until it was too late. "She was in extreme pain. The doctors failed to recognise the symptoms and just treated her for an ear infection."
Mr Stitt added: "I'm glad the coroner recognised there was a missed opportunity to save Sarah's life. "My family and I will have to live with the consequences of that missed opportunity for the rest of our lives. "I've lost a loving wife and my children have lost a devoted mother who can't be replaced. "Harry doesn't even remember his mum - he was only three when she died. Joseph still finds it painful."
A spokesman for Aneurin Bevan Local Health Board, which runs the Royal Gwent Hospital, said: "We fully accept the coroner's verdict in this tragic case. "There are lessons to be learned in respect of clinical management of such cases and appropriate action has already been taken." [Like what?]
Hospitals face a four year long squeeze on their funding with the announcement that ministers will freeze the income they receive for procedures, in effect a real terms cut. Ministers insisted that the move would increase efficiency within the NHS. But health experts warned that the freeze, coupled with a goal to reduce management costs by almost a third, could mean cuts.
Ministers have committed to a freeze next year, but have said that there will be a “maximum” increase of naught per cent for the three years after that – suggesting that the payment rate, or tariff as it is known, might actually be cut.
Mr Burnham, the Health Secretary, insisted that the move would improve productivity within the health service, as he published a roadmap for the NHS for the next five years. He said: “There is no doubt and getting away from it, (this) is challenging, it is tough and let’s be honest about that. “But there is time to plan. “There are lots of things that we can do to spend money better and more wisely in the NHS.”
But health experts warned that the plan could lead to cuts which affect patients. Dr Jennifer Dixon, director of the Nuffield Trust, the health policy charity, said: ‘The scale of the challenge will be intense. “Without significant increases in productivity – the likes of which have not been achieved in the past – the health service will inevitably face real terms cuts in its budgets from 2011 onwards.”
The document also lays out plans for family doctors to be asked to make one per cent efficiency savings across the board. Hospitals’ incomes will also be linked to patient satisfaction for the first time. The NHS has previously set a target to make between £15 and £20 billion of efficiency savings by 2014.
Sarching for an acceptable alternative to the controversial "public option," Senate Democrats on Tuesday night adopted three bad ideas instead. Having tried and discarded the "robust" public option, the opt-in and opt-out approaches, co-ops and the "trigger," Senate Majority Leader Harry Reid proposed a program similar to the Federal Employees Health Benefit Program, which covers government workers, including Congress members. Reid's plan would also expand Medicare and Medicaid.
The FEHBP offers a variety of private insurance plans under a program managed by the US Office of Personnel Management. Each year, OPM uses the federal procurement process to solicit bids from insurance firms to be one of the plans offered. Premiums can vary, but participating plans operate under stringent rules.
Moderates like Connecticut Sen. Joe Lieberman like the FEHBP model because the insurance plans are private rather than government entities. Liberals like Sen. Charles Schumer like it because it is government-regulated and managed.
In using the FEHBP as a model, however, Democrats have chosen an insurance plan whose costs are rising faster than average. FEHBP premiums are expected to rise 7.9 percent this year and 8.8 percent in 2010. By comparison, private-insurance premiums will rise on average by 5.5 to 6.2 percent annually in the next few years, the Congressional Budget Office predicts. In fact, FEHBP premiums are rising so fast that nearly 100,000 federal employees (who pay 30 percent of their plans' premiums) have opted out of the program.
FEHBP members are also finding their choices reduced. Next year, 32 insurance plans will either drop out of the program or reduce their participation. Some 61,000 workers will lose their current coverage.
Moreover, the government can't simply allow non-government workers to buy into the FEHBP. According to the Robert Woods Johnson Foundation, such an approach would result in substantial "adverse selection" — that is, new enrollees would be much sicker than the current pool of workers, driving premiums higher for current plan participants. A similar proposal in Tennessee several years ago nearly destroyed the state-employee health system.
So the plan would authorize a parallel program replicating the FEHBP. But former OPM director Linda Springer doubts that the agency has the "capacity, the staff or the mission" to manage the new program, saying, "ultimately, it would break the system."
And an independent FEHBP-like system ultimately also would suffer from the same adverse selection, making its premiums unaffordable for most Americans without government subsidies. So even this "nonpublic" public option would wind up being a drain on taxpayers.
But the expansion of Medicare and Medicaid are even worse ideas.
Medicare is now $50 trillion to $100 trillion (yes, that's trillion with a "T") in debt, depending on which accounting measure you use. But Democrats now want to allow individuals age 55 to 65 to be able to "buy in" to the program.
The plan initially calls for enrollees to pay actuarially valid premiums if they elect to participate in the program. But history suggests that such funding mandates are likely to fade over time. Medicare Part B was originally supposed to support 50 percent of its costs through premiums. Premiums now pay for less than 25 percent of the program's cost.
Plus, Medicare under-reimburses doctors, especially in rural areas. Thus, expanding Medicare enrollment would threaten the viability of rural hospitals and other providers and also result in more cost-shifting, driving up private insurance premiums.
Democrats may also raise Medicaid eligibility to 150 percent of the poverty level — even though that program is one of the biggest threats to the solvency of the federal and state governments' budgets.
Medicaid now costs more than $330 billion a year, a cost that grows at a rate of about 10.7 percent annually. The program spends money by the bushel, yet reimburses providers even worse than Medicare. The Medicare Payment Advisory Commission says only 69.5 percent of doctors are willing to accept new Medicaid patients. So Medicaid patients have a tough time finding adequate primary care. The number of Medicaid beneficiaries who use emergency-department services for non-emergency care is higher than the rate for any other payer group, including the uninsured.
It's easy to understand why Senate liberals would support this "compromise": It expands government health-care programs and further squeezes private insurance. But why would self-professed moderates sign on to a proposal that raises costs, results in higher insurance premiums and provides a lower quality of care?
The Democrats' Assault On Seniors: Wrecking Medicare To Save Obamacare
by Hugh Hewitt
In an interview on my radio show Wednesday, Arizona Senator Jon Kyl underscored the fact that Senate Democrats do not have the 60 votes they need to pass Obamacare, and that reports about the inevitability of Obamcare passing are part of the Democrat's strategy. (The transcript of the interview is here.) Kyl asserted that Harry Reid routinely announces, and then the MSM echoes, statements about the inevitability of the bill's passing, but then reality catches up.
This is happening again today as the premature reports of an agreement to expand Medicare to those 55 and older are exposed as more puff talk from a disappointed and reeling left that has seen its dream of a public plan take some serious blows in the past few days. David Drucker's and Emily Pierce's report in Roll Call (subscription required) conveys the difficulty facing Reid:
Democratic Senators involved in crafting what Majority Leader Harry Reid (D-Nev.) described as a “broad agreement” on health care policy appear to be at odds over both the policy proscriptions and the notion that they had even reached such a deal.
Though Reid announced late Tuesday that negotiations among a group of 10 liberal and moderate Democratic Senators had largely resolved the intraparty standoff over the public insurance option, participants in the group said their “agreement” had been mischaracterized and that they agreed only to send the proposal to the Congressional Budget Office for a cost estimate, saying more information was necessary before making any firm decisions.
Seniors especially have to hope that the new deal falls apart as it represents a savaging of Medicare. The Obama-Pelosi-Reid assault on Medicare has three parts now.
First, Obamacare proposes to loot Medicare of about a half trillion dollars in benefits. Obamacare enthusiasts dismiss the devastating impacts to Medicare Advantage enrollees as necessary to rebalance the system, but the loss of benefits to those senior citizens will be huge. So too will the cutbacks for hospitals treating the elderly if the bill passes.
Second, Medicare payroll taxes are raised in the Senate bill, but that massive flow of new revenue isn't going to secure the financial future of Medicare, but to instead pay for new entitlements, thus crowding out a source of future funding for Medicare when it hits the rocks in a very few years.
And now, third, Democrats are proposing the expansion of the nearly insolvent Medicare program to millions of new enrollees 55 and older. This enormous mistake will not only quickly drain the program of its remaining resources, it will accelerate the trend of doctors heading into concierge practices, abandoning the low-paying Medicare patients for the much more equitable payments provided by the dwindling number of privately covered patients.
All of the versions of Obamacare are radical assaults on seniors, but the latest version is a recipe for disaster for Medicare, and seniors know it. The seniors' political punishment of all Democrats will come in 47 weeks, but right now they have to act to alert the few Democrats on the fence that voting for this reckless scheme is political suicide.
Here are the five steps that everyone should take, but especially those already or soon to be covered by Medicare.
Readers should also take a moment to review the Democrats' plan on the debt limit --lifting it by nearly $2 trillion!-- which is every bit as reckless as their gamesmanship with Medicare. This is another transparent political trick, one that will further undermine the dollar and lock in future inflation that will destroy the savings of seniors that are in fixed investments.
Two days ago, Rupert Murdoch wrote in the Wall Street Journal about the failures and future of journalism. The very first thing that journalists must do to have their enterprises survive, Murdoch wrote, is to "give people the news that they want."
This doesn't mean the lowest common denominator of news such as sensational tabloid stories, but it most certainly does mean news about how readers' lives are going to be impacted by what D.C. does. Right now I am devoting most of every show to Obamacare because the audience is huge and very dialed in to how the Democrats' massive scheme will change their health care and thus the arc of their lives. Incredibly, MSM is not covering this aspect of the story --is not talking to seniors or doctors or hospital execs. Instead the Beltway-Manhattan media elite is covering Obamacare like a game of whether or not Harry Reid can get to 60 votes. Not surprisingly Reid announces he is going to win and the MSM scurries off to report that Reid is on the verge of winning. Almost nothing is being written about what the proposed deal will do to seniors' health care, just as the impact on the dollar of the massive hike in the debt ceiling is also largely unreported.
If Obamacare was fully and fairly explained, it would have been dead long ago, and the opinion polling shows that despite the best efforts of MSM to ignore the realities of the bill, it is deeply unpopular in the country and is triggering a massive blowback for Democrats, as it should.
Never have so many reporters produced so little in the way of accurate meaningful coverage of so important a bill. Perhaps they are simply not up to the complexity of the story, but the failure of MSM to get the story straight or the facts right or even to ask moderately difficult questions of so-called Democratic centrists like Indiana Senator Evan Bayh and Pennsylvania Senator Bob Casey is remarkable.
New media will continue to report the reality of the Democrats' assault on older Americans, and all the AARP propaganda and MSM misdirection will not obscure the growing recognition that Obamacare is a massive bait-and-switch that is not going to help Americans get better medical care but will instead hasten the collapse of Medicare and the arrival of rationing.
Ronald Brownstein of The Atlantic is the only mainstream reporter I am aware of who glimpses what the debate over health care economics should be about.
Last month he wrote, “To save costs, Democrats mostly want to change the incentives for providers. Republicans mostly want to change the incentives for patients by shifting toward a model where insurance covers only catastrophic expenses and people pay for more routine care from tax-favored health savings accounts. In essence, the Republican view is that the best way to hold down long-term costs is to directly expose patients to more of them. Few Democrats accept that logic though and it has little influence on either chamber’s legislation.”
Brownstein gives the Republicans too much credit, but my focus is on the contending ideas, not who may or may not hold them. The economic issue is incentives (no slight intended toward the moral issue), and the choice is between having government micromanage incentives and letting the free market’s natural incentives work.
If we have to sum up the problem of the American health care system in a single phrase, it would be: perverse incentives. Tax and other government policies make it look smart for each individual to do socially stupid things, such as abandoning cost-consciousness under the influence of apparently low-cost comprehensive coverage and having “insurance” for uninsurable things like pregnancy, abortion, contraception, well-baby care, physical and dental exams, eyeglasses, and more. Few if any people would find it worth the price to buy such “insurance” in a free market since the premium would include the cost of the future services plus administrative overhead. I find it hard to believe that companies would offer policies with such coverage, since the actions giving rise to the “need” for the services are largely discretionary. (A lot of other coverage we are used to, such as for diseases brought on bad habits, might also become extinct.)
Yet government policies that make employer-based coverage preferable to independently purchased coverage induce us to do things we would not do in the absence of those policies. The system hides the true costs, encourages consumption, and turns active consumers into passive patients. We end up paying higher (though hidden) prices than we would find in a free market. That’s why the current system has so many bad features, which people have erroneously blamed on the marketplace.
Spending Too Much
As a result of the constellation of perverse incentives, Americans spend more than other populations on “health care.” And because the incentives are perverse we may safely say that we on the whole pay too much. How much is hard to say. Surely one reason our medical bill is so high is that we are a rich society and there are many new and valuable services to buy that were unavailable even ten years ago. But that does not exhaust the explanation for why we pay so much or why the price of “health care” rises faster than the price the average product. We have been taken for a ride. From the perspective of the average person’s well being, the system is irrational. But it is not irrational from the perspective of those making money off it, or of the politicians who benefit one way or another.
So we have an incentive problem. What do we do about it? The dominant view in Washington is, as Brownstein notes, that provider incentives must be changed. That’s why there is so much talk about abolishing traditional fee-for-service and going to a system where doctors are rewarded for the quality not the quantity of care. That’s also why there are plans for new commissions that will issue advisories—and perhaps ukases—regarding “best practice.”
In other words, the prevailing thinking is that doctors ought to be induced or ordered to practice medicine they way politically anointed “experts” think they should practice it. Consumers would still be passive observers, and those who wanted a different form of practice would be out of luck.
The problem with this is not that fee-for-service is sacred. Maybe it’s as bad as the planners say. The point is that the best provider-incentive arrangement(s) will be the outcome of a competitive—not bureaucratic—process. Competition is a discovery process, F. A. Hayek taught. Doctors, health economists, and bureaucrats sitting around a conference table in front of a whiteboard and PowerPoint presentation may agree unanimously that some new arrangement is optimal. But we really can’t know if it is as good as they think until it’s tried out in a competitive environment with real people. However, if bureaucrats impose their scheme and it comes a cropper, we’ll all suffer. Bureaucracies are slow to admit mistakes.
Consumer Incentives
That brings us to the other way to change incentives: on the consumer side. People choose differently depending on whether they face the full costs of their actions or, instead, artificially depressed (and therefore shifted) costs. If public policies make services look cheaper than they are to those lucky enough to have comprehensive coverage and encourage overconsumption and cost-obliviousness, then it stands to reason that abolishing those policies would bring down real prices and introduce consumer responsibility. We don’t need government to create incentives to lower costs. It just needs to back off and let the market work. “Back off” is shorthand for a long list of repeals, including the protectionist regulatory regime for the insurance industry and medical profession, and subsidized consumption through Medicare and Medicaid.
The common impulse for “health care reform” is entirely honorable. It is distressing to know that so many people are vulnerable to bankruptcy-threatening medical bills or to raw deals from State-cartelized insurance companies. Who wouldn’t change that if he could? The question is: Which approach has a better chance of changing it? Centralized bureaucratic decision-making by self-serving politicians and their “private sector” patrons? Or decentralized, cooperative, entrepreneurial efforts to satisfy cost-conscious, freely choosing consumers?
It’s time we junked the intolerable system we have, rejected further state control, and tried freedom.
Health Reform Deal Greeted Cautiously By Moderate Dems
A deal to unite Senate Democrats behind their health plan seems to be creating its own divisions. Liberals agreed to drop demands for a government-run insurer. In return, the bill would let people ages 55-64 "buy in" to Medicare and let small firms and individuals get private, nonprofit insurance, much like that available under the Federal Employees Health Benefits Program (FEHBP).
Majority Leader Harry Reid, D-Nev., said the deal "has something that we think should satisfy everybody." But the lack of specifics, especially about the Medicare buy-in, is raising concerns.
"Until we see the details about it, it's hard to really react," said Ron Pollack, executive director at Families USA, a liberal health care group. "The Medicare buy-in could be helpful, but whether it is more helpful than people going into the exchange, especially those who are eligible for subsidies, is hard to determine."
One prominent senator said he was worried about the impact on his home state as well as the overall budget impact. "My initial reaction to this was the state I represent," said Senate Budget Committee Chairman Kent Conrad, D-N.D. "An additional cohort on Medicare means Medicare rates of reimbursement, and my state is third or second lowest in Medicare reimbursement. I'm also concerned about Medicare solvency, and that's why I need to see the Congressional Budget Office analysis before making a final decision."
When asked if higher Medicare reimbursement rates for North Dakota would win him over to the plan, he replied: "It would make it more palatable, but I want to make it clear, while my first obligation is my state, I've also got a broader obligation. Even if they fixed rates for my state, if the CBO analysis came back that this would have an adverse effect on the solvency of Medicare, I'd still have to resist it."
Sen. Joe Lieberman, I-Conn., who had strongly opposed a public option, said in a statement that he would reserve judgment until he learns more about the impact on Medicare's solvency.
Robert Zirkelbach, a spokesman for America's Health Insurance Plans, an industry group, said the plan "would add millions of people to a Medicare program that the trustees say will start running a deficit in the near future." According to the Medicare Trustees, the hospital portion of Medicare will begin running a deficit in 2017. Medicare has a present-value unfunded liability of $13 trillion over the next 75 years.
The public option you have when you are not having a public option
Only in the nation's capitol could people pushing Obamacare keep a straight face while claiming that a new health insurance operation to be run by the same government agency that manages the federal bureaucracy is actually a private program. Senate Majority Leader Harry Reid, hoping to mollify the liberal wing of his party, insists that it's still a "public option," but everybody else on the Democratic side seems to think the public option has been replaced by this new "private" option. Thus, Reuters News Agency reported that "Democratic Senate sources said the substitute would create a non-profit plan operated by private insurers but administered by the Office of Personnel Management, which supervises health coverage for federal workers." The OPM runs the Federal Employee Health Benefits Program, but that is only part of its duties in managing the federal government's 2 million-plus career civil service workers.
Call it what they will, Reid and his fellow Obamacrats are still doing what they've been doing for months, seeking 60 Senate votes for a trillion-dollar federal takeover of the nation's health care system. First, it was the banking and automotive industries disappearing into Leviathan's gaping maw; now the health care industry, accounting for one-sixth of the private economy, is about to become a ward of the government, too. If they succeed, Reid and the Obamacrats will turn the day-to-day operation of the world's best health care system over to the same bumbling cast of characters who managed the TARP bailout for pinstriped thieves on Wall Street, the mortgage foreclosure crisis birthed by ACORN's government-backed banking industry blackmail, and the Cash-for-Clunkers debacle. Sleep tight tonight, America, because Barack, Harry and Nancy are taking good care of you.
If the claim that government-run health insurance can be a "private" program is patently absurd, this latest Senate Obamacare deal actually includes something even more bizarre. Millions more Americans are to be made eligible for Medicare, which is supposed to be cut by $500 billion to pay for this Rube Goldberg contraption. Go figure. As it is, Medicare is the federal government's biggest entitlement program and the one closest to bankruptcy. According to the latest Medicare Trustees Report, the program has a $36 trillion unfunded liability that is certain to explode in 2011 when the first of the baby boomers retire and begin drawing benefits. Try as Reid and the Obamacrats might, there is no getting away from this cold, hard fact: The government has for decades promised Medicare benefits it cannot pay for without either raising taxes or cutting benefits promised under other government programs. When private corporations promise benefits they can't deliver, it's called "fraud" and company executives go to jail. When Washington politicians do the same thing, it's called "health care reform."
Senate Democrats on Wednesday largely embraced a compromise that dropped a "public option" from health-care legislation, setting aside their concerns about aspects of the consensus plan in the hopes that the deal hatched by negotiators would serve as a rallying point in their push for the passage of reforms.
Industry groups representing doctors and hospitals attacked one of the alternatives in the deal, designed to take the place of a proposed government-run insurance program, in the hours after Senate leaders announced it Tuesday night. They argued that a plan by liberal Democrats to allow uninsured individuals as young as 55 to buy into Medicare would be financially untenable and would jeopardize access to health-care services for millions of Americans.
But even Democrats who were not thrilled with the buy-in program applauded the deal's central component: replacing the public option with two national private insurance policies under the oversight of the Office of Personnel Management, the agency that administers health benefits for federal employees. "If there's 60 senators who can reach agreement, I'm for it," said Finance Committee Chairman Max Baucus (D-Mont.), a chief sponsor of the bill, who represents the kind of rural state that industry groups said would be harmed by a Medicare buy-in. "Sometimes you've got to do a little bit on the liberal end and a little bit on the moderate end to reach agreement. And that's what's going on."
Earlier Wednesday, President Obama gave the compromise a major boost, praising Senate Democrats for producing "a creative new framework" to provide coverage to uninsured Americans without relying on a public option, an idea that has long divided Democrats and threatened final passage.
"I support this effort, especially since it's aimed at increasing choice and competition and lowering cost," Obama said at a health-care event near the White House, where he was joined by a handful of Senate Democrats. "So I want to thank all of you for sticking with it, for all those late nights, all the long weekends that you guys have put in. With so much at stake, this is well worth all of our efforts."
Senate Majority Leader Harry M. Reid (D-Nev.) announced the compromise Tuesday night after overseeing days of negotiations between moderate and liberal Democrats over the last sticking points preventing all 60 members of his caucus from supporting the legislation.
Reid was expected to include the new insurance program and the expansion of Medicare eligibility in the "manager's amendment" of last-minute changes to the $848 billion bill that he submitted Wednesday night to the Congressional Budget Office. But Democratic aides said the Medicare provision could still be dropped or altered before the measure advances to the floor. That could happen as soon as next week, assuming Reid can answer remaining questions. Democrats hope to keep the legislation on track for final passage before Christmas.
Lawmakers remained wary of the objections of hospital and doctor groups, which have considerable influence on Capitol Hill. The groups believe their members could be the big losers under the proposal to allow people as young as 55 to buy into Medicare, because the program pays providers at much lower rates than private insurers, and because older Americans are the greatest consumers of health-care services.
Hospital representatives said the idea also would violate a deal they reached with the White House this year to give up $155 billion in Medicare payments over the next decade. The concession helped to lower the cost of a health-care package that promised hospitals a pool of at least 30 million newly insured customers.
"Such a policy will further negatively impact hospitals, after we have already agreed to contribute the maximum level of sustainable reductions that community hospitals can reasonably endure," the Federation of American Hospitals said in an e-mail to its members. The American Hospital Association urged the 5,000 facilities and 37,000 individuals in its membership to lobby senators "to reject expansion of Medicare."
American Medical Association President J. James Rohack warned Wednesday on his blog that expanding Medicare would jeopardize access to physician services not only for near-retirees, but for millions of people older than 65 who already are covered by the federal plan.
A Medicare buy-in program would "adversely impact American society by putting people into a government program that is going broke with the combination of Baby Boomers entering in 2012 as they turn 65," Rohack wrote. "We would add millions of more patients to a program where it is difficult for a new enrollee to get an appointment with a physician."
Republicans and their business allies strongly criticized the Senate bill, portraying it as a threat to jobs. The National Federation of Independent Business, a small-business association, released a statement opposing the legislation as an inadequate response to rising costs. Sen. Mike Enzi (R-Wyo.), who helped to negotiate an earlier version of the Senate bill, called the revised measure "a job landslide" that would bury employers "under an avalanche of new regulations."
Although Democratic senators expressed confidence that the bill will pass, they professed to know few details about the public-option deal, kept under wraps by Reid while the CBO analyzes the cost. "I don't know what the deal is," Sen. Bill Nelson (Fla.) said as he emerged Wednesday night from a Democratic caucus meeting. "But I think at the end of the day that we'll have 60 votes."
One question as of late Wednesday was whether a "trigger" mechanism would be included in the Office of Personnel Management program, creating a public option if the private plans were unable to provide affordable coverage. That is a crucial distinction for Sen. Joseph I. Lieberman (Conn.), an independent member of the Democratic caucus, who has ruled out supporting a public option in any form.
Lieberman said he has heard different variations of the OPM idea and remains unclear on the status of the trigger. But he warned: "If there's a trigger, I can't support it."
Despite lingering concerns, key uncommitted Democrats -- including Lieberman -- appeared to be warming to the legislation. Speaking at a news conference in which she announced a package of small-business amendments, Sen. Mary Landrieu (La.) declined to endorse the bill but spoke favorably of the public-option alternatives, describing both the OPM plans and the Medicare buy-in program as potentially beneficial.
Sen. Blanche Lincoln (Ark.) said she liked the OPM idea but sounded less certain about expanding Medicare. "You might find that other products offered in the exchange might be less costly," she said. "Medicare is a pretty good plan. So it might be expensive."
If Congress manages to pass a health-insurance bill in the next few weeks, it will undoubtedly require every person to have medical coverage or pay a fine. If someone’s employer doesn’t offer a policy, he will be obligated to buy one for himself no matter how expensive. (Subsidies will be available to lower- and middle-income people.)
Coverage is not likely to be cheap because the bill that President Obama signs will also undoubtedly mandate that “basic” coverage contain far more than coverage for bankruptcy-threatening catastrophic illness. It will also include a large variety of elective and preventive services that are actually inappropriate for insurance, since they are discretionary. The day of high-deductible, low-cost insurance will be gone. Congress and the president will decree that you must have Cadillac coverage even if a Ford suits your needs and your budget better.
Everyone who believes he lives in a free country should be asking himself, By what authority do the Congress and the president force me to buy insurance?
That this question is hardly discussed is an ominous sign. The public discussion about so-called health-care reform has focused almost entirely on whether the government should compete with private insurers through a “public option.” Abortion financing and the impact on the budget deficit have also gotten their share of attention.
But nearly everyone takes for granted the government’s authority to force us to buy medical insurance. How does that square with the traditional American belief that government should leave you alone unless you commit a crime against person or property? Where does compulsory health insurance fit into that principle?
I imagine that most people think that the government doesn’t even need specific grounds to exert that power. If a majority of Congress and the president in their wisdom think we need insurance, then they can compel us to buy it — or so the implicit reasoning seems to go.
But that shouldn’t be good enough for a country whose founding document speaks of inalienable rights to life, liberty, and the pursuit of happiness, not to mention the right of revolution.
Even the Congressional Budget Office calls the mandate “unprecedented,” adding, “The government has never required people to buy any good or service as a condition of lawful residence in the United States.”
So why aren’t we all asking, “By what authority?” Senate Majority Leader Harry Reid’s 2,074-page bill tries to answer that question. It states that health insurance is interstate commerce, which Congress has the power to regulate under the Constitution’s Commerce Clause. The first question that should arise is that even if you grant that government may regulate interstate commerce, what does forcing consumers to buy insurance have to do with regulation? The bill states that the mandate is necessary because the insurance market won’t work effectively without it. And why not? Because the same bill also compels insurance companies to cover everyone essentially at the same price regardless of health status. If the sick and the healthy must be charged the same premium and healthy people choose to opt out of insurance, then premiums to the remaining sick policyholders will be higher than otherwise. Therefore, the healthy must be forbidden to opt out. Hence the mandate.
Notice the circularity: The mandate is necessary to protect the insurance market from the high premiums caused by the bill containing the mandate. And by what authority are insurers compelled to cover everyone at the same price? The Commerce Clause, of course. However you construe that clause, it is twisted logic for the government to burden interstate commerce through price controls, then impose a mandate on consumers to fix the problems the burden created. (By the way, if health insurance is interstate commerce, why does the federal government stop insurers from selling across state lines?)
Government intervention begets more intervention. When politicians forbid insurers to charge customers according to risk, that is not real insurance. It’s welfare, requiring forced participation by those who would opt out if free to do so. Congress and Obama are about to violate the rights of Americans in an attempt to avoid the mess they know they are about to make. But they forgot something: Free societies don’t have mandates.
Does Regulation Lower Costs? A Personal Experience
For many years I have struggled to breathe through my nose, and decided to do something about it, given that the condition helps cause sleep apnea. The experience of having this condition “fixed” has taught me both about the wonders of modern medical care as well as the idiocy of the medical/government bureaucracy. Unfortunately, the latter slowly is destroying the former.
I won’t describe the procedure, except to say that the local anesthetic was effective, and I have a high pain tolerance. Furthermore, I was surprised that this invasive operation resulted in quick results, making me the beneficiary of something that was medically impossible not long ago.
The procedure itself was good, but the administration of the operation was lacking because it was much more costly than it needed to be. The activity took place in the same-day surgery center at our community’s brand-new hospital, and while the center was impressive, it was not medically necessary for me to be there.
The doctor and I often discuss the economics of medicine and the government policies that are driving the system into ruin, and our encounter that week provided more opportunity for conversation. After he finished and I was leaving, he dropped a small bombshell: He told me that he just as easily and efficiently could have performed this small operation in his office for $250, much less than what my insurance company will be paying for the same procedure.
Obviously, someone will wonder why an insurance company would demand practices that raise its costs. Insurance companies, after all, are private firms that allegedly are trying to make a profit, and why they would impose unnecessary costs on themselves should be a mystery.
It is not hard to solve this paradox, however. The insurance process we have today would not exist in a free market for medical care. Just because a firm providing a service is a profit-seeking corporation does not mean it is engaged in free enterprise.
First and most important, the present system came about because of a quirk in tax policy during World War II. Because of government wage and price controls, companies could not compete for workers by offering better wages, but they could offer benefits such as “health insurance,” a relatively new product that was not taxed as income. Thus health insurance became employer-based, a situation that became institutionalized in the postwar years.
Second, while early insurance tended to provide protection against catastrophic events, the entire apparatus took another turn after Congress enacted Medicare in 1965. This tax-funded plan paid a large percentage of medical costs for senior citizens, and it poured a lot of new money into the medical system. Although doctors at first were leery of this program, they found soon that if they billed it, the government would pay.
At the same time, American labor unions began to demand greater pension and medical benefits, and U.S. companies gave in, creating a huge time bomb that fully exploded when General Motors and Chrysler went bankrupt earlier this year (only to be bailed out by taxpayers who now have alleged ownership of these white elephants). At the time of their bankruptcies, the largest single cost these companies faced was the medical bills of union employees.
What does that have to do with the unnecessary costs for my own operation? Over the years, as the federal and state governments have increased their intrusions into health care, driving up costs, health insurers have become little more than regulated utilities that operate just like other risk-averse bureaucracies, and regulated bureaucracies tend to demand medical procedures that supposedly are safe. Hang the costs.
I must admit that I was tempted to pay the $250 and get the job done in the doctor’s office, as a matter of principle. Unfortunately, after having paid monthly premiums well in excess of that amount, the incentive was for me to get the higher-cost procedure, since I was not paying directly for it. Welcome to “cost containment,” government style.
Newborn baby died after staff at 'chaotic' British government hospital ruled out caesarean
A newborn baby died after receiving 'chaotic' care at an understaffed maternity unit, an inquest heard yesterday. Ebony McCall died shortly after she was born after medical staff failed to spot her erratic heartbeat, it was alleged.
Her mother, Amanda McCall, 18, had been admitted in severe pain to the Milton Keynes General Hospital's maternity unit the day before she gave birth.
Doctors missed two chances to save Ebony's life at the hospital - which was criticised earlier this year for blunders which led to the death of another baby. Miss McCall and her parents had asked for an emergency surgical delivery because of the pain she was in, but doctors ruled against it. Then they failed to spot Ebony's erratic heartbeat and so did not order an emergency caesarean.
Staff were overstretched as 12 mothers gave birth at the unit that night - and only four midwives were on duty, the court heard. Miss McCall was only given a caesarean section after her mother Breda became so concerned about the heart monitor reading that she pressed a panic button. Ebony was born at 3.21am on May 9 this year weighing 7lbs 4oz. She died at 3.54am from lack of oxygen.
Miss McCall was 40 weeks pregnant when she was admitted to the hospital with abdominal pain, the inquest in Milton Keynes heard. After her admission she, her mother and her father Terry, a police sergeant, begged doctors for a caesarean because of the pain. Midwife Tamara Jackson agreed as Miss McCall's state was 'distressing for the baby'. But doctors decided it was not strictly medically necessary, the inquest heard.
After the baby was born, only to die shortly after, Miss McCall's mother confronted Dr Nandini Gupta in the delivery room. Glenna Murray, a senior nurse, recalled: 'She kissed the baby and told the baby it wasn't her [the baby's] fault. She then asked Dr Gupta why didn't she have a caesarean section when she asked for it. 'Dr Gupta said she had spoken to her consultant colleagues and said there was no indication for caesarean section at that time.'
Paul Wood, a consultant obstetrician, reviewed notes of the labour as an expert witness. He said Miss McCall should have been 'the highest priority' due to her health problems including a faulty heart valve, only one working kidney and curvature of the spine. Mr Wood said Miss McCall should have had a midwife by her at all times and one-to-one care would 'probably' have saved Ebony's life.
By 10.30pm, Miss McCall was diagnosed as in labour and 'she was rolling in pain'. Mr Wood said: 'At that point, due to the pressures on the maternity unit, the management of labour from there on was somewhat chaotic.'
An official report earlier this year criticised the hospital for low staffing levels which led to the death of another baby, Romy Feast, in 2007.
Simple test shows whether cancer drug will work - but NHS does not use it
British cancer patients are missing out on the latest and best drugs because the NHS lacks the capacity to exploit them, one of the country’s most senior medical scientists has told The Times.
The introduction of a new generation of powerful cancer therapies is being held up by poor access to critical genetic tests, according to Sir John Bell, Regius Professor of Medicine at Oxford University and President of the Academy of Medical Sciences. The new medicines, such as Iressa (gefitinib) for lung cancer and Erbitux (cetuximab) for colorectal cancer, can be highly effective, but against tumours only with a particular genetic profile. DNA tests are needed before they can be prescribed.
While several of these drugs are licensed in Britain, they are rarely used by the NHS because there is no system for commissioning the genetic tests, Sir John said. The science and technology were “ready to rock’n’ roll” and it was time for ministers to “get with the programme”.
“Genomic medicine is going to change the way we use drugs and that’s already starting with cancer,” he said. “We’re increasingly able to define cancer by its molecular pathology rather than its site of origin, and to prescribe drugs accordingly. That’s taking us from drugs that are effective in 10 per cent of patients, to drugs that work in 80 to 90 per cent of the population with a particular genetic type. “The big question is where is the NHS in all of this. Mostly, it is unprepared. It doesn’t have the testing capacity. With all these drugs coming through, you would imagine that all the clinical genetics labs would be ready to offer the tests they require. None is.”
Sir John’s criticisms come six months after a House of Lords inquiry found that the NHS was not ready to take advantage of genetic advances in healthcare. He said that scientific developments since the report was published had made action more urgent.
Iressa was licensed this summer after trials showed impressive results against lung cancers that carry a mutation in a gene called EGFR. As it does not work against tumours without that mutation, a test is required before it is used.
Another example is Erbitux, which can be effective against bowel and head and neck tumours but fails to work when a gene called KRAS is mutated. A test for the gene costs about £150. Erbitux is approved by the National Institute for Health and Clinical excellence, though Iressa will not be appraised until next year.
Glivec (imatinib), which has transformed chronic myeloid leukaemia from an incurable to a treatable disease, has been found to work against gastrointestinal stromal tumours with a particular genetic profile. Early trials of a drug made by the company Plexxikon have also suggested marked effects against malignant melanomas with a certain mutation in the BRAF gene.
These discoveries run counter to ministers’ claims that the benefits of genomic medicine lie in the future, Sir John said. “The past six months have proven that to be so wrong. We are running into this now. All the big centres in the US have got this sort of molecular profiling in place, but it doesn’t happen here. Come on guys, let’s get with the programme.
“There are some very talented people in the NHS, but it needs to get powered up. We are so in a position to do this. We’ve got the technology base and the scientific underpinning to do this, we’re ready to rock’n’ roll. The real problem is it runs into the sand because the commissioning isn’t right, or because of lack of willingness to accept the unknown.”
Sir John’s criticisms were supported by Peter Johnson, chief clinician for Cancer Research UK. “The provision of testing is fragmentary. There are some private labs doing it, there are some research laboratories doing it, and there are some NHS pathology departments doing it. But it isn’t at the moment subject to any overarching plan or co-ordination, which means that although it can be done, it’s more difficult than it needs to be. As is often the case, moving from research to routine practice is proving awkward. “There is definitely a need for a concerted programme to put in place testing for the things we know about, and to get ready for things we haven’t yet discovered but are about to,” he said.
The Department of Health said: “Our response to the House of Lords report on genomic medicine will address this. We know that the ability to develop sophisticated diagnostic approaches, and use them well, is central to achieving ever better outcomes for patients.”
Pregnant mum and bub fall down ancient lift shaft at hospital
EIGHT weeks' pregnant and with her toddler daughter in her arms, Shavaun Nemere could do nothing but scream as she plunged down a Kingaroy Hospital elevator shaft after its doors malfunctioned. The screams continued as they lay seriously injured at the bottom of the shaft, with a young staffer coming to their rescue before the lift could descend and crush them.
Shavaun, 17, and daughter Izabella, 14 months, face more surgery for the horrific injuries sustained in the accident six weeks ago. They have made almost daily trips to hospitals in Toowoomba, Brisbane and Caboolture from their Benarkin home in the South Burnett to be treated for multiple fractures and gashes so bad they needed plastic surgery. Shavaun is still too distressed to talk about what happened.
Her mother Julie Nemere has spoken for the first time about the ordeal because she wants the hospital's 68-year-old elevator to be replaced. "The hospital has been asking for a new lift for years but their requests have fallen on deaf ears," she said.
Ms Nemere said her daughter was visiting a sick relative at the hospital and decided to go up a floor to make an antenatal appointment. With Izabella in her arms, she opened the exterior polished doors to the elevator and then pushed back the inside metal security doors and stepped forward - into space.
Desperately trying to protect Izabella, she fell 1.6m to the bottom of the lift shaft landing on her left hip, arm and cheek, while the little girl hit the concrete floor with her face. A staff member heard their screams and jumped down the shaft handing the baby up to a doctor and rescuing Shavaun.
Both were airlifted to Brisbane where Shavaun was treated for multiple fractures to her left arm, shock, concussion and amnesia. Izabella's badly gashed face needed stitches and plastic surgery. If the injuries had been a few millimetres higher, she could have lost an eye. Ms Nemere said there had also been bleeding complications with Shavaun's pregnancy and doctors were still monitoring a small haematoma behind her uterus.
The executive director of the Darling Downs-West Moreton Health Service District, Ray Chandler, said the lift had been tested by engineers and was safe and fully operational. "It undergoes a service check every month," he said. [A very cursory check, obviously]
TEARS and anger have followed a coroner's finding that no one was to blame for the death of a Mareeba mother-of-five twice turned away in pain from her local hospital. Coroner Kevin Priestly yesterday said Mareeba Hospital did not have the staff or equipment to save Sharon Con Goo, who died of bacterial septicemia in January 2007. But he cleared its doctors of any negligence, finding it was unlikely they could have done anything to save her life.
Relatives reacted angrily yesterday after Mr Priestly found there was "no missed opportunity for medical intervention that would have affected the outcome" of Ms Con Goo’s case. Ms Con Goo was not admitted to the hospital on January 7 nor January 9 after presenting on both dates with serious pain caused by a septic leg. On one occasion she was sent home with Panadol to ease her suffering. [No missed ipportunity???] She returned to the hospital on January 10 and was transferred to Cairns Base Hospital, where she died on January 11.
During the inquest in August, Mareeba Hospital doctor Asif Majeed said he offered to admit Ms Con Goo during her second visit, but she refused. But her husband, Andrew Con Goo, testified that his wife was not given the option of being admitted, despite having her bags packed to stay overnight.
Ms Con Goo's mother, Faye Rigg, broke down outside court yesterday, telling reporters that her daughter was in such a poor state of health, family members had to carry her to the hospital. She said she was upset at the verdict, labelling it ""bulls---''.
Mr Priestly said he reviewed a range of expert medical opinions to conclude it was unlikely Mareeba Hospital staff could have prevented Ms Con Goo`s death. But he also found the hospital was "not properly equipped with the resources or medical professionals required''.
Former Tablelands MP Rosa Lee Long, who attended the inquest, said yesterday's findings should prove worrying for people who rely on Mareeba Hospital. "She packed her bags to be admitted, and what did they do? They turned her away,'' Ms Lee Long said. "Everyone should be frightened, everyone should be concerned.''
KEVIN Rudd's promise to build 35 GP super clinics across the nation appears to be in tatters, with only one completed centre in operation after two years of Labor government. The Australian can reveal that despite the Prime Minister's claims that six more centres are partially complete, at least two are offering little more than conventional GP services. And one centre claimed by Health Minister Nicola Roxon as a partially functioning GP super clinic -- in Darwin -- is in fact being fully funded by the Northern Territory government.
Mr Rudd campaigned for the 2007 election promising to spend $275 million on super clinics -- medical one-stop shops in areas struggling with inadequate medical services. The centres were to offer after-hours general practitioners, specialists, mental health services, chronic disease management, allied health practitioners and training for medical students and trainee specialists.
Yesterday, as the opposition savaged the scheme as a politicised con, Mr Rudd refused to answer questions from The Australian as to whether the scheme was on target and exactly how many clinics he expected to deliver by the end of his three-year term. Instead, the Prime Minister, who was criticised earlier this week by health sector groups for taking too long to deliver promised reform to the health system, blamed the Howard government for being negligent on health.
Last month, Ms Roxon told parliament the GP super clinic program was being well received, with the nation's first super clinic -- at Ballan, in Victoria -- already operating and another six offering "early services".
Inquiries by The Australian yesterday revealed that at least two of the partially complete super clinics -- at Palmerston in Darwin and at Woongarrah in NSW -- were offering simple GP services. The Palmerston facility was offering after-hours, bulk-billed GP consultations. Local mayor Robert Macleod said he was pleased with the extra services. But the super clinic is not due to begin operating until March next year.
Despite Ms Roxon claiming the Palmerston facility as evidence of the success of the program, Health Department officials told a Senate budget estimates committee earlier this year that it was funded by the Northern Territory government and was not a super clinic. The Woongarrah clinic also offers limited services and the super clinic is not due to open for a year.
The opening of the Ballan super clinic has resulted in the previous two GPs being increased to three and the addition of four-day-a-week dental services as well as a range of allied health services. Ballan Bush Nursing spokesman Glenn Rowbotham told The Australian the GPs did not operate out of hours but that one was on-call for emergencies.
Opposition health spokesman Peter Dutton said the government had used the scheme to curry favour in marginal electorates but had failed to deliver. "Mr Rudd was tricky during the election campaign by not putting a deadline on the provision of these clinics," Mr Dutton said. "But most people would have expected they would have been delivered in the first term of government."
Australian Medical Association national president Andrew Pesce said he did not know whether the scheme was running behind schedule because the government had never consulted his organisation at any stage of the program. Dr Pesce said the AMA had always argued it was wiser and more cost-effective to offer grants to existing medical practices to broaden their services rather than building a new system "from the ground up".
Earlier this week, The Australian sent written questions to Mr Rudd asking why the six GP super clinics were operating only partially and whether he would explain the hold-up. His spokesman responded with a written statement that ignored these questions. However, the spokesman said "several more" clinics would begin operating within the next 12 months. "Some GP super clinics have begun providing services while their full infrastructure is being completed in order to allow them to provide a wider range of services," the spokesman said. "The procedures for delivering many of these clinics involves tender processes."
Senate kills off Obama plans for major healthcare reforms
So Americans will still get a vast expansion of bureaucracy -- for what?
BARACK Obama's ambitious plan for a government-run health insurance scheme to cover millions of uninsured Americans was killed off last night, after a deal in the US Senate to abandon it. Legislation to reform US healthcare is expected to be passed, but it will be a much scaled-down version that sees private insurance companies still in charge.
The dumping of a government-run health scheme to compete with private companies from legislation being considered by the Senate is a serious blow to the US President after he had rated reform of health his No 1 domestic priority.
While disappointed, the White House is expected to play down the impact of removing a proposed scheme that is common to almost all developed countries but has provoked heated debate across the US. Mr Obama will argue that many people previously denied health cover will gain access for the first time under the compromise deal, even if the numbers fall far short of the national scheme he had in mind.
Under last night's deal, negotiated by Democrat Senate majority leader Harry Reid when it was clear an impasse involving senators from his and Mr Obama's party could not be resolved, a proposed government-run scheme will be replaced by a series of national insurance policies administered by private companies. These private insurance policies are to be negotiated on behalf of members by the Office of Personnel Management, the Washington authority in charge of overseeing health insurance for many federal public servants.
In one concession to widening public healthcare, the Medicare scheme that provides government-supported insurance to the over-65s age group would be expanded to allow people as young as 55 to sign up.
Last night's abandonment of government-run insurance will rile many senators on the Left of the Democratic Party who had said they would vote against legislation if it was removed. They are still likely to vent their anger at the deal over the next week, claiming the compromise is weak because it will offer no meaningful competition to the private firms. But their apparent willingness to accept the compromise is a recognition of the political reality that independent senator Joe Lieberman and up to four conservative Democrats would not budge from opposition to the government proposal because of concerns about costs and a watering-down of services.
Republicans have opposed the Democrats' health legislation as a bloc, meaning the votes of all Democrats and two independents were needed to pass legislation.
A bill with a strong government-run insurance scheme was passed in the House of Representatives last month with much fanfare, and Mr Obama made a last-ditch attempt on Sunday to persuade Democrat senators to accept a full-scale reform of health when he paid a rare visit to Capitol Hill.
After last night's compromise, the house will have to review its legislation and remove the government insurance plan so any final bill for the President to sign into law is consistent. House Speaker Nancy Pelosi is likely to raise strong objections.
The model likely to be approved by congress after all the haggling will fall far short of public health schemes operating in Australia, Britain, Canada and most European countries. It will leave many millions of Americans who cannot afford coverage without insurance reliant on hospital emergency rooms for care.
There is a huge middle-class marriage penalty hidden in the House and Senate health care bills. The penalty becomes evident by evaluating questions like the following:
* How much would two single people, each making $30,000 per year, pay for private health insurance if the Pelosi bill was in effect now? The answer is $1,320 per year for both individuals combined (based on the premium limits and subsidies outlined on the charts on p. 3).
* But how much would they pay for the same level of insurance under the Pelosi bill if they were to marry? Their combined cost would then be about $12,000 a year (the estimated cost for private insurance).
This extraordinary penalty people will pay, should they marry, extends all the way from a two-person combined income of $58,280 to $86,640, a spread of $28,360. A large number of people fall within this spread. As premiums for private insurance escalate, as expected, the marriage penalty will become substantially larger.
Once the income of Americans exceeds 400% of the Federal Poverty Level, there are no limits on the premiums they can be charged, and their premiums are no longer subsidized. The poverty level is much higher for two people living unmarried as compared to the same two people being married. That is why citizens in many cases will pay far more for insurance if they are married. Why should married people be subjected to financial discrimination?
The Senate bill also creates a marriage penalty, in this case by imposing a new tax on individuals who make $200,000 annually but it also applies to married couples making $250,000 each year. This marriage tax on the affluent, however, is just the tip of the marriage penalty iceberg in the Senate bill.
The Senate bill stipulates that two unmarried people, 52 years of age, with private insurance and a combined income of $60,000, $30,000 each, will pay a combined cost of $2,483 for medical insurance. Should they marry, however, they will pay a combined cost of $11,666 for insurance—a penalty of $9,183 for getting married (based on tables at: http://healthreform.kff.org/SubsidyCalculator.aspx).
This substantial marriage penalty applies to persons on individual insurance, but, as the Heritage Foundation’s Bob Moffit said, “if an employer has a health care benefits package that is 12 to 13 percent of payroll, and they can solve their problem by paying an 8 percent payroll tax [into the Exchange], I think they’re going to do it,” (New York Times, 9-30-09).
And Howard Dean said that, “Small businesses with payrolls of less than half a million dollars don’t have to buy health insurance anymore for any of their employees.”(FNS, 11-29-09).
Businesses will shed their employees and health care dollars into the Exchange, but the dollars that are paid back out will be directed only to those who make less than 400% of the Federal Poverty Level. Those above the Poverty Level will receive none of their previous insurance benefits from businesses. For that reason the new system is income redistribution on steroids.
“Household” is defined in both bills as including those who can be claimed as dependents for federal income tax purposes thereby clarifying that adults can avoid the marriage penalty by living together unmarried. The new system provides a huge incentive for doing so.
The bills additionally contain De Facto salary caps. How much would a married couple pay for private insurance under the House bill if their income was $58,000 per year? The answer is $2,088. But what if their income increased by $1,000? Their annual premium would then be about $12,000. The economic penalty for going off the subsidized system is so severe that it will be difficult for people to increase their earnings beyond 400% of Poverty Level. The Senate bill works essentially the same way.
Senior citizens and small businesses have already been identified as big losers in the health care bills. Married citizens in the middle class need to be added to the list.
Britain has some of the worst health outcomes in Europe
Heart and cancer survival rates among worst in developed world
British health care is little better than that of former Communist countries, which spend a fraction of the billions poured into the NHS. A survey published yesterday by the Organisation for Economic Cooperation and Development sees Britain languishing with the Czech Republic and Poland in international league tables on health.
The OECD - which represents developed Western countries, some former Soviet nations, Mexico, Japan and South Korea - compared healthcare standards among its 30 members and found that we lag even further behind the wealthiest nations, such as France, Sweden and Germany. The figures showed:
* British cancer and heart attack victims are more likely to die than almost anywhere in the developed world;
* Asthma and diabetes patients are more than three times as likely to end up in hospital as their neighbours in Germany;
* Life expectancy in Britain - 79 years and six months for a man - is far worse than in France, where men expect to live until 81. The deficit is similar for women.
Britain performed only marginally better than former Communist states whose governments spend only half as much on healthcare.
Last night critics seized on the league table as an indictment of Labour's failure to improve the Health Service over 12 years - despite tripling NHS spending to more than £100billion a year. But ministers insisted the figures were out of date and that significant improvements have occurred since.
Among the OECD's most worrying findings were Britain's five-year survival rates for cancer between 2002 and 2007. A shortage of cancer specialists and the lack of access to life-saving drugs is thought to be behind our poor showing.
On the positive side, the survey shows British healthcare is much more equitable than most other countries. Just 9 per cent of low income homes say they have unmet care needs, compared to 52 per cent in the U.S. and 24 per cent in Germany.
Britain also has more nurses than many countries. There are ten nurses for every 1,000 people here. That's higher than the OECD average of 9.6 and the French figure of 7.7.
But the picture of cancer survival in this country remains bleak. The survey found that in Britain, a woman diagnosed with breast cancer had a 78.5 per cent likelihood of being alive five years later. But in France, the figure was 82.6 per cent, in Sweden 86.1 per cent and in the U.S., 90.5 per cent.
The situation is even worse for those with bowel cancer. In these cases, Britain was the second worst country of the 30 member states.
Much of the blame for Britain's poor showing is attributed to the fact that patients and GPs fail to spot cancer signs early enough. A lack of access to life-saving cancer drugs, a shortage of specialists, and a lack of MRI scanners are also factors. The report found that in Britain there are 8.2 scanners per million people: much lower than the OECD average of 11. There are also far fewer doctors in Britain: 2.5 per 1,000 population, compared to 3.4 in France.
The survey also found that British heart attack patients were more likely to die in hospital than others in the Western world. In 2007, 6.3 per cent had died within 30 days of admission - compared to 4.9 per cent across the OECD, and 2.9 per cent in Denmark. Britain also performed poorly on keeping asthma and diabetes sufferers out of hospital - reflecting badly on the quality of GPs.
In Britain, 75 out of 100,000 people ended up in hospital with asthma in 2007. In France the figure was 43 and in Germany, just 21.
The report found that Britain spends more than the average OECD nation on healthcare: just short of $3,000 (£1,850) per head of population. This compares to $1,626 (£1,000) in the Czech Republic, where cancer survival rates are almost as good. However, the OECD acknowledged that healthcare had improved over the past decade.
Last night Health Secretary Andy Burnham said the data showed 'the enormous progress' that had been made.
A midwife was found hanged after a hospital failed to tell her she was not to blame for a baby's death, an inquest heard yesterday. Theresa Naish, 28, feared she would be struck off because she had failed to tell doctors that the premature baby had had a balloon placed in his throat during his mother's pregnancy to help his lungs develop.
A colleague had been in charge of the baby boy but had gone to lunch leaving Miss Naish, who had just started her shift, to provide cover. The balloon would have prevented the child from breathing. But the baby's health was so poor he would not have survived anyway, Croydon Coroner's Court heard.
Following the incident, distraught Miss Naish went on two weeks' leave, which had been booked previously. During her time off the hospital cancelled two overtime shifts she had been scheduled to work.
The inquest heard she received a series of voicemails asking her to come in to meet hospital managers, but they failed to say she was not facing suspension and was not responsible for the death of the boy.
Her father Thomas Naish criticised the hospital during the hearing for not giving her any reassurance. 'Theresa was just sent home and her shifts were cancelled,' he said. 'There is no umbrella of care within the NHS for the people who work within it - the people who do the caring.'
Miss Naish's sister Cherry, 25, told the inquest: 'The effect this whole thing had on her was that she went home thinking, "They are going to disbar me".'
A couple of days before Miss Naish was due back to work at King's College Hospital in South London colleagues became concerned that they had not heard from her. Senior midwife Linda Sherratt had arranged to have a meeting with her. But Miss Naish did not turn up and suddenly stopped answering her phone. Police forced their way into her flat in Upper Norwood, South London, in the early hours of January 28 where they found her hanging in the bathroom.
The final two internet searches on her laptop had been for 'disbarred midwives' and 'ten ways to commit suicide'. Pathologists believe she probably died three or four days earlier.
Miss Naish had been registered as a midwife for a year and had graduated a few weeks before her death.
In cases where unborn babies' lungs are not developing properly, a technique has been developed where a small balloon is inserted into the throat. Since the placenta provides the oxygen for the foetus in the womb, the balloon does not interfere with foetal breathing. But before birth the balloon must be removed in order for the baby to be able to breathe after birth.
Mrs Sherratt told the court: 'She did amazingly well to get the mother to the labour ward as quickly as she did. 'We discovered that the baby would have stood a very, very minute chance of survival anyway because his condition was so bad, even if the balloon had been taken out. 'Theresa may have felt she contributed to his death by not passing on crucial information. 'I was in charge of the investigation into the incident. My first concern was for Theresa. 'There were all sorts of rumours going around but it was never the case that she would be suspended. 'The really very sad thing about this whole business is that I never got a chance to speak to her.'
At the time of her death, Miss Naish was one and a half times the drink drive limit. Coroner Dr Roy Palmer found that this was enough to give him 'a tiny bit of doubt' about whether Miss Naish intended to kill herself. He recorded an open verdict.
Outside court Miss Naish's father said: 'I have spoken to lots of women Theresa cared for and delivered babies for, and they have all said she was incredible. 'She joined the St John's Ambulance when she was 14. All she ever wanted to do was look after people.'
How can breast surgeon who botched 19 operation still work for the NHS?
A breast cancer surgeon is still allowed to work for the NHS despite botching operations which led to £700,000 in compensation being paid to 19 women. Many of the patients have suffered agony, disfigurement, trauma and been haunted by flashbacks of surgery. One cancer victim who has had three additional operations because of complications said the surgeon had ruined her life and another was shocked when she sold her bras during an examination 'like a dodgy market trader'.
Consultant surgeon Puvaneswary Markandoo was suspended on full pay after 35 women, aged between 30 and 65, came forward to complain about problems after operations. In total, 29 proceeded with compensation claims against the surgeon's employer, the Barnsley Hospital NHS Foundation Trust. The trust has paid out £678,245 to 19 women, at an average settlement of £35,697 each. Health chiefs admitted negligence in a vast majority of the payout cases. Six claims are outstanding.
But much to the astonishment of her patients, the 62-year-old surgeon has been allowed by the General Medical Council to continue to work for the NHS, although she is banned from private work. Last year the GMC found her to be deficient in 11 areas of her job including basic surgery and working within laws and regulations.
The authorities decided she could work for an NHS hospital under conditions including supervision and retraining. Miss Markandoo had been suspended from her £122,000 job for three years and has now left Barnsley Hospital. The Malaysian-born surgeon, who qualified as a doctor 32 years ago, has moved to London. She has done unpaid 'administrative' work at one London hospital but it is not known if she has been carrying out any clinical work.
One patient to receive compensation was Mary Jolly, 57, a grandmother from Barnsley. She had a mastectomy after getting breast cancer which was followed by reconstructive surgery and an implant. Her problems began after a breast reduction on the healthy breast carried out by Miss Markandoo. She suffered constant pain and 'oozing' from the wound. Several further operations followed but she still has pain. The mother-of-three said: 'Like all those other women I put 100 per cent trust in her and she betrayed that trust.
'I wish I had never set eyes on her and I find it unbelievable that she can still work in the health service after what she has done.' 'I realised at some point that there was something odd about her. 'Once when I went for an examination she brought two bras out of her drawer and asked if I wanted to buy them. Doctors just don't do that. She seemed then like some dodgy market trader. 'The doctors won't to do any more surgery on me any more to try and put things right because I am diabetic and I don't heal well so I just have to live the situation as it is.'
A spokesman for the hospital trust said: 'Once the trust identified a problem with treatment provided by Miss Markandoo to patients in the Barnsley breast clinic it took the proactive step of setting up an advice line for all those patients possibly affected. 'The trust has worked hard with its insurers and legal advisers to ensure that these matters have been dealt with as quickly and reasonably as possible.'
How low can they go? The desperate Democratic peddlers of a government health care takeover have proclaimed an insurance "holocaust in America" (Fla. Democratic Rep. Alan Grayson), lambasted conservative health care town hall protesters as "political terrorists" (Indiana Democratic Rep. Baron Hill), sent SEIU thugs to demonstrate outside Democratic Sen. Joe Lieberman's private residence, and derided senior citizens questioning President Obama's fuzzy math savings claims (California Democratic Rep. Pete Stark: "I wouldn't dignify you by peeing on your leg. It wouldn't be worth wasting the urine.") Now, Senate Majority Leader Harry Reid is leading them deeper into demagogic mire.
This week, Reid pummeled opponents with the worn-out race card. Following in the mucky footsteps of former President Jimmy Carter (who blamed GOP Rep. Joe Wilson's objections to Obama's policy deceptions on a "racism inclination") and Jesse Jackson ("You can't vote against health care and call yourself a black man"), Reid likened Republicans who object to socialized medicine to slave masters, enemies of women's suffrage and Bull Connor.
Reid's rhetorical aim was worse than the unhinged Minnesota protester who threw tomatoes at Sarah Palin during a book signing and hit a police officer instead. Splat.
Mustering up as much indignation as his taut face could exhibit, Reid lectured those standing in the way of Demcare: "When this country belatedly recognized the wrongs of slavery, there were those who dug in their heels and said, 'Slow down. It's too early. Things aren't bad enough.'
"When women spoke up for the right to speak up, they wanted to vote, some insisted, 'Slow down. There will be a better day to do t
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