The Left wants a Health Care System like Britain’s NHS despite the NHS having Crippling Deficits

Posted by PITHOCRATES - April 19th, 2014

Week in Review

Obamacare is not going well.  The say it is.  But it isn’t.  The White House can all of a sudden give us a number like 8 million enrollees when they said earlier they couldn’t tell until the insurance companies tell them.  And the other big question is this.  Are these enrollees?  Including all people who enrolled whether they paid or not?  Or are these only the people who paid?  Or are most of these people enrolling in Medicaid?  Those who won’t ever pay?  If that 8 million aren’t paying customers Obamacare is doomed.

So the financial foundation of Obamacare is likely very perilous.  Where the sick and poor are probably signing up more than the healthy with money.  And the delay of the employer mandate to sometime after the midterm election takes a bad financial foundation and makes it worse.  For they can’t keep delaying the funding parts until after elections.  Because someone has to pay for all of the subsidies.  As well as the high cost of the old and sick.  Which alone may bankrupt Obamacare (see Labour considers raising national insurance to fix £30bn NHS ‘black hole’ by Toby Helm posted 4/19/2014 on the guardian).

Radical plans to increase national insurance contributions to plug a looming £30bn a year “black hole” in NHS funding and pay the spiralling costs of care for the elderly are being examined by Labour’s policy review.

The Observer has learnt that the idea is among options being considered to ensure NHS and care costs can be met under a future Labour government, without it having to impose crippling cuts on other services in successive budgets.

Senior party figures have confirmed that a scheme advanced by the former Labour minister Frank Field – under which funds from increased NI would be paid into a sealed-off fund for health and care costs – is being examined, though no decisions have been taken.

Recent figures based on data from NHS England and the Nuffield Trust and produced by the Commons library suggest that NHS costs alone will go from £95bn a year now to more than £130bn a year by 2020.

Some have suggested that they designed Obamacare to fail.  So they can get what they really want.  Single-payer.  Or national health care.  Like they have in Britain with their National Health Service (NHS).  Which is running an enormous deficit.  Based on the above numbers it currently is 31.6% (£30bn/£95bn).  Which is just unsustainable.  But this is what an aging population will do.  When you have more people leaving the workforce consuming health care benefits paid for by fewer people entering the workforce.  Which should be a huge warning for the United States.  Because they have an aging population, too.

At the current exchange rate that £30 billion comes to $50.37 billion.  Is this what the US can expect?  No.  Because they have five-times the population Britain has.  So their deficit will be approximately five-times as big.  Or $251.85 billion.  That’s a quarter of a trillion dollar shortfall PER YEAR.  At least.  And $2.52 trillion over a decade.  So unless the Americans can somehow make their people less sick so they won’t consume health care resources the deficit alone for Obamacare will be more than twice the original CBO projection for the total cost over 10 years.  Which means the Americans will have to do what the British must do.  Increase taxes.  Charge for some health care services in addition to these higher taxes.  Or impose crippling cuts to services.  Hello rationing.  And longer wait times.

This is the absolute worst time to impose a single-payer/national health care system.  Just as the baby boom generation fills our health care system in their retirement.  It might have worked if we had kept having babies the way we did before birth control and abortion slashed the birthrate.  But we didn’t.  And now we have a baby bust generation stuck footing the bill for a baby boom generation.  Fewer paying for more.  And the only way to make that work is with confiscatory tax rates.  Or death panels.  Because you have to raise revenue.  Or cut costs.  There is just no other option.  Or people can work longer, pay out of pocket for routine, expected expenses and buy real insurance to protect themselves from catastrophic, unexpected medical expenses.  Which is actually another option.  And probably the only one that will work.


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Aging Populations and State-Provided Health Care will Stress State Systems to Collapse

Posted by PITHOCRATES - June 16th, 2013

Week in Review

When people provided their own health care and retirement nest eggs it didn’t matter if the population was aging or getting younger.  For each person planned to take care of him or herself.  But when the government took over health care and retirement nest eggs the age of the population began to matter.  For when the state provides these benefits they have to pay for them via taxes.  And if the population is aging that is a big problem.  Because more people are leaving the workforce and consuming health care and pension benefits than there are entering the workforce to pay for them.

Which means the government has to increase tax rates on those paying for these benefits.  And when people are living longer into retirement it really throws a wrench into the state’s plans.  For it is requiring a level of taxation that simply isn’t possible.  And this is exactly what the baby boom generation is doing to advanced welfare states throughout the world.  It’s causing greater governmental expenditures.  Resulting in larger budget deficits.  And financial crises (see Our aging population set to put a heavy toll on our systems, and we’re not ready by Simon Kent and Shawn Jeffords posted 6/14/2013 on the Toronto Sun).

The first baby boomers began turning 65 in 2012, and by 2036, one out of every four of our neighbours will be elderly…

“We don’t have a health care system in Canada, we have an acute care system,” [Sharon] Carstairs [former senator and was the first woman to lead an opposition party in Canada] after becoming Manitoba’s Liberal leader in the ’80stold QMI Agency.

The very sick are cared for well but we don’t do a good job of keeping others at home and out hospitals and high-cost facilities.

“We’re using acute care hospital beds to hold thousands of Canadians who should be in long-term care or home care,” she says…

Canada has a “little bit of breathing space” for preparations to cope with aging boomers, but not much, suggests University of Toronto professor emeritus David Foot, one of the country’s most respected demographers.

“We need to get this right to prepare for that boomer onslaught,” Foot says. “We can have an excellent system if we choose to.”

Zero hour is 2027.

“The first boomer born in 1947 reaches 80 in 2027,” Foot says.

That’s when the critical mass, the largest bulge of the baby boom, approaches 80 and will require the most care of their lives…

Canada needs to train gerontologists, therapists, psychiatrists, palliative care nurses and specialists, replace the workforce of aging nurses and the army of some 3 million volunteers who currently provide the bulk of in-home care to seniors, say experts…

“The sheer number of baby boomers that will be drawing on the system will magnify and put pressures on the systems that has not been felt before,” he says.

Both the United States and Canada have aging populations.  And a baby boomer bulge coming down the pike.  It will make it very difficult in Canada.  And far worse in the United States.  For they have about 9-times the population of Canada.  And will have 9-times the baby boomer bulge.  Making it a very poor time for the state to take over more pension and health care spending obligations.  Which is exactly what the Americans did by passing Obamacare into law.

The United States is already suffering record trillion dollar deficits.  By the time Obamacare pays to train gerontologists, therapists, psychiatrists, palliative care nurses, specialists, etc., and builds nursing homes to handle the baby boomer bulge the deficit will soar even higher.  Unless there really are death panels in Obamacare.  Which may be the only way not to break the fiscal back of the nation.  Well, there’s that.  Or they could let people provide their own health care and retirement nest eggs like they once did.  And then the age of the population would be irrelevant.  For it basically comes down to these two options.  Either we pay for our own health care and retirement.  Or the government will have to figure out how to cut costs.  And how do you do that when the largest cost is caring for the very old and the very sick?  In a word, death panels.  Well, two words, actually.

Welcome to the brave new world of Obamacare.


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Canada does Health Care right even if they do Dental Care Wrong

Posted by PITHOCRATES - March 9th, 2013

Week in Review

Canada does health care right.  They have a single-payer system.  Which is not quite national health care like the National Health Service in Britain.  But it’s the next best thing.  Sort of like Obamacare.  It’s not the national health care the Left wants.  But it’s the next best thing.  And a stepping stone to getting what they want.   So they can do health care right.  Like in Britain.  And like in Canada.  Where they put people before profits.  And everybody has everything they could ever want (see Bite out of dental program will hurt, says dentist posted 3/6/2013 on CBC News Health).

The president of the Newfoundland and Labrador Dental Association says cuts to the adult dental program will cost the province more in the long run.

In a news release Tuesday, the government said it is putting a per person cap of $150 on basic dental services and $750 on denture care, starting on April 1. Dentists will have to get approval from MCP before treating most patients.

“One hundred and fifty dollars is not going to cut it for people that need pain management,” said Dr. Jason Noel.

Valid point.  So why in a country where they do health care right would they do dental care so wrong?

The government set up the Adult Dental Program in January 2012 for people on low incomes, including seniors. At that time, dentists praised the program for its accessibility…

“The program budget was for $6.7 million. In actual fact, it ballooned to something that we never anticipated at all – it was closer to $21 million…”

That’s why.  Because free health care is very expensive.  And government bureaucrats are very bad at making cost projections.  For what government program didn’t exceed government projections?

Just something to think about as Obamacare starts paying the bills.  A potential 213% cost overrun.  Or more.  Because Canada has been doing health care right for a lot longer than the United States.  So if they miss a target by 213% you just know a novice at doing health care right will do a poorer job.  But one thing we’ve learned from the recent sequester debate government doesn’t like cutting spending.  They don’t even like reducing the rate they will increase spending by.

So will the Americans be as responsible as the Canadians in fixing something they screwed up.  Probably not.  Instead they’ll rely on raising taxes.  And when they can raise taxes no more they will resort to rationing, longer wait times and denial of care.  As in those death panels that aren’t technically in Obamacare.  But a government bureaucrat deciding who gets health care and who doesn’t is a death panel.  Even if you don’t call it a death panel.  Something else to think about as Obamacare starts paying the bills.


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Medicare Receipts, Medicare Outlays and the Medicare Deficit

Posted by PITHOCRATES - March 5th, 2013

History 101

The Seller is the Medical Provider and the Customer is the Insurer—not the Patient

Health care prices are out of control because there are no market forces in health care.  Buyers and sellers never meet.  As the consumer of health care services doesn’t pay for them.  And the provider of services neither bills nor collects from the recipient of those services.  Instead billings and payments go through a third party.  The insurer.  Or government.

The buyer is the insurer.  Not the patient.  Who is the recipient of what the buyer pays for.  Because the recipient is not paying the recipient does not care about prices.  Or the number of tests and procedures a doctor orders.  Because if you’re not paying what do you care how much anything costs or how many costly tests or procedures you have?  You don’t.

The seller is the medical provider.  The doctor, hospital, laboratory, nursing home, etc.  Their customer is the insurer.  Who pays their bills.  Not the recipient of their services.  The patient.  Because the patient is not paying medical providers can charge high prices without hurting their patient.  And they can order excessive tests and procedures without hurting their patient.  Financially, at least.  Which they often do because medical providers don’t get paid for all the services they provide.  Some people without insurance can’t pay their bills.  And insurers often refuse to pay or discount some of the bills they receive.  Also, the government is always reducing Medicare reimbursements.  Forcing medical providers to be more creative in getting paid for services rendered.

As Medicare Outlays and Receipts grew Further Apart the Medicare Deficit Soared

Medicare began in 1965.  Medical care for people 65 and older.  And like the private health care market there are no market forces in Medicare.  Worse, government bureaucrats run it.  Which throws open the doors to waste and inefficiencies.  And cost overruns.  Because private insurers have bottom lines to meet.  Government bureaucrats don’t.  All they have to do when they do a poor job managing something is to raise taxes.  Which they had to as Medicare ran a deficit in all but one year of its existence (see Table 2.4—COMPOSITION OF SOCIAL INSURANCE AND RETIREMENT RECEIPTS AND OF EXCISE TAXES: 1940–2017 and Table 3.1—OUTLAYS BY SUPERFUNCTION AND FUNCTION: 1940–2017 at FISCAL YEAR 2013 HISTORICAL TABLES BUDGET OF THE U.S. GOVERNMENT).

Medicare Receipts Outlays Deficit 1970-2011

Medicare ran a $912 million surplus in 1974.  We made it zero to keep the Y-axis positive.  The difference in graphs is negligible and unnoticeable at the scale shown.  The right axis shows the Medicare payroll tax rate.  Medicare outlays and receipts are pulled from the above referenced source.  The Medicare deficit is calculated by subtracting Medicare Receipts from Medicare Outlays.  However, for simplicity we show that negative number as a positive value on the graph (the graph shows the magnitude only of the deficit).  The graphs are pretty flat during the Seventies so we drop them off in the following chart.

Medicare Receipts Outlays Deficit 1980-2011

The Medicare tax rate has been holding steady at 2.8% since 1986.  This tax rate has provided a growing rate of Medicare receipts.  But Medicare outlays have grown at a greater rate.  Outlays remained flat for a few years in the Nineties thanks to the Medicare Sustainable Growth Rate (SGR) included in the Balanced Budget Act of 1997.  Which basically discounted doctors’ Medicare billings.  Doctors provide the same services.  Only the government paid them less.  After some fierce opposition this provision (the doc fix) went away.  For it was either that or doctors would leave the Medicare program en masse instead of operating at a loss.  Leaving the government with a lot of seniors without any doctors.  So Medicare outlays resumed their upward growth.  With receipts growing at a lesser rate.  As outlays and receipts grew further apart the Medicare deficit soared.

Obamacare Spending will be out of Control because Medicare Spending is out of Control

The Medicare tax is a flat tax.  Which means the more you earn the more you pay.  Unlike Social Security that has a maximum taxable earnings amount.  The Social Security tax rate is 12.4% of the first $113,700 you earn.  Bringing the FICA tax (Social Security and Medicare) total to 15.3%.  When they passed the Social Security into law they promised that the Social Security tax would never exceed 3% of the first $3,000 you earn.  Just to give you an idea of how horrible the government’s projections were.  They have raised taxes far beyond what they promised and it still isn’t enough.  Medicare is running greater and greater deficits.  So Medicare is in trouble.  And with Obamacare pulling some $700 billion from Medicare things aren’t going to get any better any time soon.

Medicare is national health care.  And the government is running it very poorly.  The Medicare outlays in 2011 were $485.6 billion (or about 13.5% of all 2011 federal outlays).  And that was generated from treating only 12.8% of the population.  How bad will these numbers be if Obamacare evolves into a full-fledged national health care service?  If you divide the 2011 Medicare outlays by 12.8% you get $3.79 trillion.  This amount would be for 100% of the population receiving medical care as if they are 65 or older.  Currently those 65 and older consume about 35% of all health care spending.  So if we multiply $3.79 trillion by 65% (1-35%) we get $2.47 trillion (or about 68.4% of all 2011 federal outlays).  Which adjusts this amount as if everyone receiving health care is under 65.  As the amount of those 65 and over receiving health care will fall under Obamacare thanks to those unofficial death panels.  And they’re going to need those death panels.  Because with the government running Obamacare it will be an abject failure.

A crude guesstimate.  But it’s probably not that far off.  For national health care is very, very expensive.  And as we’ve learned from Medicare, it’s also very, very inefficient.  Because there are no market forces in health care.  Which is why Medicare spending is out of control.  And why Obamacare spending will be out of control.  Requiring massive new taxation.  Rationing.  And cost cutting.  As in death panels.  For letting people die instead of treating them will be the only way to bring down costs.  Unless they force health care providers to work without pay.  Another way to cut costs.  Compel health care providers to work against their will.  For why should anyone profit off the suffering of others?  Which may be the next dictate handed down in Obamacare.


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Rationing of Health Care Resources leaves those with Rare Diseases without Treatment in NHS

Posted by PITHOCRATES - October 21st, 2012

Week in Review

So you think Obamacare care will provide everyone the same level of high quality health care?  Think again.  Or take a look at the UK.  For even though the UK has national health care under the NHS everyone still does not receive equal health care treatment.  Especially those with rare diseases that will be costly to treat (see Patients with rare conditions face postcode lottery by Denis Campbell posted 10/20/2012 on the guardian).

Seriously ill patients with life-threatening rare diseases are being denied vital drugs because of a postcode lottery across the NHS that campaigners say is frustrating and unfair.

New research reveals that patients with a rare condition have much less chance of accessing “orphan” medication if they live in England rather than Scotland or Wales. “Orphan” drugs treat patients with a condition affecting fewer than five in 10,000 people.

While the European Medicines Agency (EMA) has approved 68 drugs for use with patients with rare conditions such as unusual forms of cancer and epilepsy since 2000, the National Institute for Health and Clinical Excellence (Nice) has assessed only 18 of them, recommending that seven become available on the NHS in England and Wales, and another five under certain restrictions…

Nice insisted the low number of such drugs it had examined was due to a lack of referrals from the Department of Health, as it can only assess the cost effectiveness of medications which ministers there ask them to look at.

But the DoH denied patients with rare conditions were missing out and insisted that the absence of a Nice appraisal should not stop them getting what they need. “There is no evidence of a ‘postcode lottery’ in access to these drugs”, said a spokesman.

First of all why do they have a government agency (Nice) even doing this?  One reason.  Costs.  So they must ration their limited health care resources.  For if they just give anyone life-saving medications regardless of costs it will limit what other treatments the NHS can provide.  Costs are real.  Just because you have a national health care system doesn’t make them go away.  Of course, in a national health care system costs take on a whole new meaning.  For they fund health care with tax dollars.  Tax dollars controlled by bureaucrats, not health care professionals.  So instead of a doctor deciding what’s best for the patient (as it is in America until Obamacare fully kicks in) a doctor must balance doing what’s best for the patient with what’s best for the state.  For spending too much money on someone who is just going to die in a short period of time is just not an efficient use of tax dollars.

Yeah, no doubt you’re thinking about that ominous phrase some say they included in Obamacare but they did not call out by name.  Death panels.  Where some government bureaucrat (or a panel of bureaucrats) makes life or death decisions in determining a patient’s care.  Not by consulting with the patient’s doctor but by consulting a table of acceptable health care treatments for someone based on the expected return of that health care investment.  They may not call these death panels but if the expected return on the health care investment does not meet the minimum acceptable return for that investment then the patient doesn’t get that life-sustaining treatment.  And will die.

So what can we expect in the future of Obamacare?  Well, it will probably have something like Nice.  A panel that makes decisions with assumptions and math like this (see Measuring effectiveness and cost effectiveness: the QALY from the Nice website).

Having used the QALY measurement to compare how much someone’s life can be extended and improved, we then consider cost effectiveness – that is, how much the drug or treatment costs per QALY. This is the cost of using the drugs to provide a year of the best quality of life available – it could be one person receiving one QALY, but is more likely to be a number of people receiving a proportion of a QALY – for example 20 people receiving 0.05 of a QALY.

Cost effectiveness is expressed as ‘£ per QALY’.

Each drug is considered on a case-by-case basis. Generally, however, if a treatment costs more than £20,000-30,000 per QALY, then it would not be considered cost effective.

How a QALY is calculated

Patient x has a serious, life-threatening condition.

•If he continues receiving standard treatment he will live for 1 year and his quality of life will be 0.4 (0 or below = worst possible health, 1= best possible health)

•If he receives the new drug he will live for 1 year 3 months (1.25 years), with a quality of life of 0.6.

The new treatment is compared with standard care in terms of the QALYs gained:

•Standard treatment: 1 (year’s extra life) x 0.4 = 0.4 QALY

•New treatment: 1.25 (1 year, 3 months extra life) x 0.6 = 0.75 QALY

Therefore, the new treatment leads to 0.35 additional QALYs (that is: 0.75 -0.4 QALY = 0.35 QALYs).

•The cost of the new drug is assumed to be £10,000, standard treatment costs £3000.

The difference in treatment costs (£7000) is divided by the QALYs gained (0.35) to calculate the cost per QALY. So the new treatment would cost £20,000 per QALY.

During an ABC News’ June 24 special, Questions for the President: Prescription for America, there was the following exchange (see Lungren says Obama would have government require a centenarian to get a pill, not a pacemaker posted 7/28/2009 on PolitiFact):

The exchange began when Sawyer introduced Jane Sturm, who takes care of her mother, Hazel, now 105. When Hazel was 100, Sturm said, the doctor told her she needed a pacemaker. Both mother and daughter said they were game, but an arrhythmia specialist initially said no, before seeing Hazel’s “joy of life” in person.

Sturm asked the president, “Outside the medical criteria for prolonging life for somebody elderly, is there any consideration that can be given for a certain spirit, a certain joy of living, quality of life? Or is it just a medical cutoff at a certain age?”

After joking that he’d like to meet Sturm’s mother and “find out what she’s eating,” the president said, “I don’t think that we can make judgments based on peoples’ spirit. That would be a pretty subjective decision to be making. I think we have to have rules that say that we are going to provide good, quality care for all people…”

Obama continued, “And all we’re suggesting — and we’re not going to solve every difficult problem in terms of end-of-life care. A lot of that is going to have to be, we as a culture and as a society starting to make better decisions within our own families and for ourselves. But what we can do is make sure that at least some of the waste that exists in the system that’s not making anybody’s mom better, that is loading up on additional tests or additional drugs that the evidence shows is not necessarily going to improve care, that at least we can let doctors know and your mom know that, you know what? Maybe this isn’t going to help. Maybe you’re better off not having the surgery, but taking the painkiller. And those kinds of decisions between doctors and patients, and making sure that our incentives are not preventing those good decisions, and that — that doctors and hospitals all are aligned for patient care, that’s something we can achieve.”

This is the kind of information Nice provides.  Cool, calm, bureaucratic number crunching to determine what the proper medical treatment should be.  Balancing those two factors.  What’s best for the patient.  And what’s best for the state.  For spending too much money on someone who is just going to die in a short period of time is just not an efficient use of tax dollars.

So what can you expect from Obamacare when it’s your mother or grandmother in the hospital desperately needing treatment?  Well, the doctor may come out to the waiting room where you’re sitting scared and distraught and say, “I’m sorry.  But the National Health Efficiency Board has calculated your loved one’s quality-adjusted life years.  Or what we in the health biz call QALYs.  Sadly, her treatment would only result in a net gain of 0.18 additional QALYs.  While our guidelines clearly state that this number shall not be less than 0.22 for such an investment of health care resources.  I am truly sorry for your soon to be loss.  So here’s a prescription you can fill on your way out for a pill to manage her pain until she dies.  Thank you and good day.  Next!”

This is the problem when someone else pays your bills.  That someone else has a say in your treatment.  Whether they are called death panels or not.


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NHS closes Emergency Departments to Save Costs while Angering Britons

Posted by PITHOCRATES - October 14th, 2012

Week in Review

Some of the most expensive services in health care are emergency departments.  Or A/E departments in Britain.  For accident and emergency departments.  Because you need a lot of staffing to handle everything from a heart attack to severe trauma from an accident to a difficult pregnancy.  Doctors, nurses, technicians, orderlies, pharmacists, administrative, cleaning, security, etc.  Not to mention the diagnostic equipment.  Medical devices.  Medicine.  Oxygen.  It adds up.  So it’s no surprise that the NHS is looking at A/E closures to cut costs (see 28,619 Mail on Sunday readers write to Government to stop A&E closures… and Ministers still do nothing by Nick Craven and David Rose posted 10/13/2012 on the Daily Mail).

Thousands of you sent in your protests against A&E closures – and this week we delivered two bulging mailbags full of your demands to David Cameron’s doorstep.

Nearly 30,000 Mail on Sunday readers have called for the Government to reverse the policy of downgrading and axeing local casualty departments across England and Wales.

A total of 28,619 protests were lodged – 17,170 coupons, 7,377 emails and 4,072 text messages – all prompted by fears that the policy for big, centralised A&E departments could risk lives as it leads to longer journey times to hospital…

Changes in London could result in a massive 47 per increase in the number of people served by each A&E department.

You ever waited for a long time to see a doctor in a crowded emergency waiting room?  Before Obamacare in America?  It was not uncommon on a busy night to wait for up to 3 hours if you had a non-life-threatening condition.  Now imagine being in that waiting room with 47% more people waiting with you.  Which could easily extend that wait time to 4-5 hours.  Or more.  Which is what will happen as Obamacare mutates into a national health service like they have in Britain.  Which is what the proponents of Obamacare want.  National health care.

At that time even the proponents of Obamacare won’t like Obamacare.  And they, too, will mail in enough complaints to fill two bulging mailbags.  (Based on the US having five times the population of the UK, that would probably be 10 bulging mail bags.)  Because these people will want everything for nothing.  But they won’t understand the cost of everything.  Or why the health service will have to cut costs, increase wait times and ration health care treatment.  And they will.  Because the NHS is.  And they can probably do national health care better than Obamacare ever will.

As as well as travelling longer distances after answering 999 calls, it will have to pick up seriously ill patients who turn up at the so-called ‘urgent  care centres’ which are set to replace A&Es but in reality cannot treat any life-threatening conditions.

At just one of the hospitals where A&E is due to close, Ealing, there is already an urgent care centre which transfers up to 50 patients a day to casualty.

Currently, this is a short journey down a corridor, but if casualty closes, as planned, all the patients will have to be transferred by blue-light ambulance to an A&E somewhere else, probably West Middlesex 20 minutes away, or Northwick Park, 45 minutes away.

To cut costs national health care services have really only one option.  As they cannot tell people to have 10% fewer accidents and health care emergencies.  Which leaves health care overhead.  If you close an emergency department (A/E department) you can save some money.  Close a few and you can save a lot of money.  So they do.  And make people travel further for their health care.  Up to 45 minutes by ambulance.  Perhaps an hour or more by car.  Even longer by train for those non-life-threatening emergencies.

This is the future of health care in America.  Under Obamacare.  And whatever that evolves into.  The NHS had some good years.  Before the British population began aging.  Now the British population is older.  More people are leaving the workforce while fewer are entering to replace them.  And as they leave the workforce they’re consuming more and more health care services.  Causing the cost strains in the NHS.  And the need for those cost savings.

This would be the starting point for the Americans.  They would not have the good years the NHS had.  Because right from the get-go they will be struggling with the costs of an aging population.  Which they will have to tackle right away by cutting costs, increasing wait times and the rationing of health care treatment.  Meaning that when trying to provide everything for everyone they will end up providing only for those some bureaucrat deems worthy of those limited health care resources.  They won’t be called death panels in the new health care law.  But they will be death panels.  Because someone will have to decide who gets those limited health care resources.  And who doesn’t.  Because they just won’t be able to give everything to everyone.  As the proponents of Obamacare think they will be able to.  And they will be none too happy when they learn this unpleasant little fact.


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The NHS does not provide Long-Term Elderly Care just as Obamacare will not provide Long-Term Elderly Care

Posted by PITHOCRATES - September 29th, 2012

Week in Review

The Liberal Democrats in Britain don’t care much for the elderly.  For they are just too costly.  And there are other social programs that are competing for these valuable but limited government funds.  Which can be put to far better use buying votes (see Reforming elderly care is not the biggest priority, says Danny Alexander by Rowena Mason posted 9/25/2012 on The Telegraph).

Reforming elderly care is not the biggest priority and just one of many problems on the “long term horizon”, Danny Alexander, a Treasury minister, has said.

The Liberal Democrat denied reports that the Treasury is “blocking” elderly care reforms but fuelled fears it is being kicked into the long grass.

Mr Alexander said the Coalition will “take forward the Dilnot plans” for an individual cap on costs to stop so many elderly people having to sell their homes to pay for care.

This no doubt comes as a shock to most Americans.  Who thought the National Health Service (NHS) provided all British health care needs.   All the way right up to the grave.  But even in the utopian world of national health care the NHS cannot afford long-term elderly care.  Just as Obamacare will not be able to afford long-term elderly care.  Which the Americans will have to provide for themselves just as the British must provide for themselves.

Not only will Obamacare not provide long-term elderly care it will be rationing out health care to the elderly.  Where some callous bureaucrat will say that someone’s loved one will not qualify for anything other than a pill to manage his or her pain.  The so-called death panels included in Obamacare.  Though not called death panels.  But for all intents and purposes are death panels.  As some callous government bureaucrat will have the power of life or death over you.

However, he stressed there are “lots of other social care pressures” and competing priorities, including the needs of vulnerable people with low incomes.

In other words, British death panels.  That will choose when and where they will spend limited government funds.  And when it comes down to a dying old person versus a younger worker who, if he or she survives, will pay more income taxes, guess who they will spend those limited funds on?

The Chief Secretary to the Treasury was speaking at the Liberal Democrat conference in Brighton, where delegates are pushing for more wealth taxes and a crackdown on tax avoidance.

Mr Alexander said the taxman could raise huge amounts of money by making Britons with offshore accounts “play by the rules”. Recovering cash due from accounts in Lichtenstein alone could raise up to £3 billion, Mr Alexander said.

He also said the Liberal Democrats would like higher taxes on the rich to pay for tax cuts for the poor.

Classic class warfare.  Cut down on tax avoidance so more people can avoid paying taxes at the lower end.  Tax the few so the many don’t have to pay taxes.  And, of course, the many will vote for those who further raise the taxes on the few.  Or put in another way, buying votes.

Of course, this doesn’t help the elderly with their long-term care.  But it will provide more benefits for the masses that will vote for Liberal Democrats.  Just as a good policy of class warfare should do.  Buy votes as efficiently as possible.  For there is only so much money available to buy votes with.  Especially when health care consumes so much of these precious, limited, government funds.


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The British are Discussing the Cost Advantage of Assisted Suicide on the NHS Budget

Posted by PITHOCRATES - September 15th, 2012

Week in Review

During bad economic times nations see their tax revenues fall.  States with large public state benefits are hit especially hard.  And there is no greater and more costly state benefit than national health care.  So it is not surprising that there is talk about battling the rising cost of health care with legalized assisted suicide (see Recession strengthens case against assisted suicide, MPs say by John Bingham posted 9/15/2012 on The Telegraph).

MPS fear that moves to legalise assisted suicide in the midst of the current economic crisis could place frail and vulnerable people under added pressure to end their lives, the first poll of its kind has found…

Strong majorities also feared that changing the law could lead to vulnerable people – including even those with treatable conditions such as depression – feeling under pressure to opt for suicide.

This is the scary side of socialized medicine.  The needs of the many outweigh the needs of the few.  And if the few are costing too much they provide a means for the many to reduce the high cost of health care.

The National Health Service (NHS) is running a deficit.  The UK deficit is in large part due to the NHS.  So you know there are some bureaucrats thinking how much easier things would be if they had a way to remove their largest expense.  Treating sick people.  Especially those who consume a lot of health care benefits over a long period of time.  For one pill or injection is less costly than months of life support that could extend out to years.

The real scary part is once this becomes policy.  For who will make these decisions?  To end life?  Or to allow life to continue?  For the thing about terminal diseases is that they take some time to advance.  People don’t wake up one day in the advanced stages of Alzheimer’s.  It could take up to 10 years or more for Alzheimer’s to claim a life.  So the question is when will that decision be made?  Year 9 of the disease?  Year 8?  Year 7?  Is it a judgment call?  The problem with that is that Alzheimer’s patients have their good days.  And they have their bad days.  If the medical bureaucrats judge them on one of their bad days they could deprive family from a few more months to a year or more of additional time with their loved one.  Who may be a burden to the government.  But is still a loved family member to someone.

People talked about death panels in Obamacare.  Even though Obamacare does not include the phrase ‘death panels’.  But they are there.  For Obamacare has an unelected panel of medical bureaucrats that will be making health care decisions for others.  With the goal of making health care more cost efficient.  And the best way to do that is to reduce the number of high consumers of health care services.  So don’t be surprised when they are having assisted suicide debates in the U.S. Congress.  For Obamacare will cause much larger budget deficits than the NHS has ever caused.  Because the U.S. has five times the population the UK has.  And will have five times the patients the NHS has.


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Floridians in General and Seniors in Particular want to Repeal Obamacare

Posted by PITHOCRATES - July 15th, 2012

Week in Review

The fact that the Supreme Court upheld Obamacare doesn’t change some facts.  People don’t like it.  They don’t want it.  And they want to repeal it.  Especially the seniors (see Poll: Most Floridians disapprove of federal healthcare law, half want it repealed by Alex Leary, Tampa Bay Times, posted 7/12/2012 on The Miami Herald).

A majority of Florida voters oppose the national healthcare law and half want it repealed, a new Miami Herald/Tampa Bay Times/Bay News 9 poll shows two weeks after President Barack Obama’s signature achievement was largely upheld by the U.S. Supreme Court.

Only 43 percent of voters statewide support the Affordable Care Act and 52 percent oppose it, with 5 percent undecided. With the exception of southeast Florida, more voters think the law will make the healthcare system worse.

More voters also favor the state opting out of provisions of the law, something Gov. Rick Scott has already said it would do…

In perhaps the most worrisome sign for Obama and Democrats, only 39 percent of voters 65 years or older support the law. Seniors make up about 30 percent of the overall state’s electorate…

The results mirror surveys in other states and show the same entrenched partisan feelings.

What is even more significant is that seniors are the largest consumers of health care services.  These aren’t ill-informed young adults who want free birth control and abortion on demand.  These are people whose very lives depend on quality health care.  And that’s the problem.  These informed consumers of health care services see Obamacare reducing the quality of their health care.  For they listen to the details.  Unlike healthy people in their twenties who have other pressing issues on their minds.  I refer you back to the part of Obamacare that interests them.  The free birth control and abortion on demand.

When Coke came out with New Coke the consumers of the original Coke did not like the change.  So they brought out Classic Coke.  And eventually dropped New Coke.  Because New Coke was a disaster with the people who consumed the vast majority of Coke.  The Coca Cola Company understood they had to please the people who consumed the vast majority of their product.  So they took actions to please the consumers of Coke.

The reaction of seniors to Obamacare is similar.  For the new health care system doesn’t benefit the largest consumer of health care services.  These seniors.  No.  These seniors will lose the most.  Obamacare will make huge cuts in Medicare spending which will hurt seniors.  Obamacare will reduce doctors’ Medicare reimbursements and cause many of them to drop Medicare patients.  Again, this will hurt seniors.  And Obamacare will prioritize the use of their limited health care resources.  Those who are younger and have more to live for (i.e., who can work longer and pay more taxes) will receive priority over a senior who no longer contributes to tax revenue while consuming enormous amounts of health care resources.  The phrase ‘death panels’ does not appear in the health care law but there will be government bureaucrats determining who will receive health care and who will not.  Which is a terrifying prospect to all seniors and the terminally ill.  As well as the chronically ill.

Coke listened to their consumers because they cherished them as customers.  The problem with Obamacare is that the government looks at the largest consumers of health care as a burden.  And they don’t like them.  As shown by the passage of a health care bill that is so hostile to them.  Seniors often voted Democrat because they benefited from growing government spending.  That spending will continue to grow under Obamacare.  Only they will pay for a lot of it with spending cuts on programs that serve seniors.  So it’s not likely that the seniors will vote Democrat in the 2012 election.  Especially when only 39 percent of voters 65 years or older support Obamacare.  Meaning 61% don’t.  In Florida as well as other states wherever seniors can be found.  No.  They will vote for those who will listen to them as the largest consumers of health care services.  And who don’t plan on fixing whatever problems we have in the health care system by trying to get seniors to die sooner.


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Too Sick or too Old? Sorry, no Health Care for You in the NHS or in Obamacare

Posted by PITHOCRATES - April 8th, 2012

Week in Review

Critics of Obamacare warned that this national health care system would contain death panels.  Too sick or too old?  Sorry, no health care for you.  That’s ridiculous said the supporters of Obamacare.  There was no mention of ‘death panels’ anywhere in the bill.  And there’s probably no mention of death panels in Britain’s National Health Service (NHS).  But elderly patients are left to die all of the time.  Precisely because they are too old (see Sentenced to death for being old: The NHS denies life-saving treatment to the elderly, as one man’s chilling story reveals by John Naish posted 4/6/2012 on the Daily Mail).

When Kenneth Warden was diagnosed with terminal bladder cancer, his hospital consultant sent him home to die, ruling that at 78 he was too old to treat.

Even the palliative surgery or chemotherapy that could have eased his distressing symptoms were declared off-limits because of his age.

His distraught daughter Michele Halligan accepted the sad prognosis but was determined her father would spend his last months in comfort. So she paid for him to seen privately by a second doctor to discover what could be done to ease his symptoms.

Thanks to her tenacity, Kenneth got the drugs and surgery he needed — and as a result his cancer was actually cured. Four years on, he is a sprightly 82-year-old who works out at the gym, drives a sports car and competes in a rowing team…

Sadly, Kenneth’s story is symptomatic of a dreadful truth. According to shocking new research by Macmillan Cancer Support, every year many thousands of older people are routinely denied life-saving NHS treatments because their doctors write them off as too old to treat…

This kind of ‘professional opinion’ appears to be costing more than 14,000 lives each year, thanks to routine discrimination by doctors who assume older patients are too frail for surgery, chemotherapy or radiotherapy. 

This is according to experts at Macmillan Cancer Support, who warned last week that every day up to 40 elderly cancer sufferers are dying needlessly because they are being denied the best treatments. This is particularly true, it says, for patients over the age of 70.

The charity estimates that if the treatment of older patients matched that on offer in the U.S., as many as 14,000 lives could be saved every year…

Last week, the respected health research charity, the King’s Fund, warned that prejudice about older people means they often go without treatment for conditions such as depression, and are not even tested for illnesses such as heart disease.

This is despite huge advances in medical care which mean that patients can now successfully undergo major surgery at ages where they would not previously be expected to survive.

In America, doctors pioneering the field of ‘geriatric surgery’ regularly perform open-heart surgery on people in their 90s…

Last year, research by the National Cancer Intelligence Network found evidence of widespread age-based discrimination in the NHS on women with breast cancer.

Its study of 23,000 sufferers found that 90 per cent of those aged 30 to 50 are offered surgery to remove tumours, compared to 82 per cent of those aged 60 to 70, and 70 per cent of those in their 70s…

So if you’re elderly and you live in America you better get your health care fast.  Before Obamacare kicks in.  And decides you’re too old to treat.  For if they’re doing it in the NHS they’ll be doing it in Obamacare.  Not because they are mean and hate old people.  But simply because of the economics.  Doctors will advise families that there is no money to spend on their loved ones.  But don’t be upset.  It’s nothing personal.  It’s just business.

It is ironic that the American Association of Retired Persons (AARP) supported Obamacare as they are supposed to represent the elderly that pay their membership fees.  Why you ask would they do something like this?  Well, they sell insurance policies to seniors that pay for what Medicare doesn’t cover.  Medigap policies.  And to get AARP onboard with Obamacare the new health care law exempts AARP from pricing formulas restricting the amount of their premiums spent on non-health services.  Allowing them to charge higher premiums than Obamacare allows other insurers to charge.  At least according to The Daily Caller.  So when Obamacare denies seniors life-saving treatments AARP can tell their families not to be upset.  It’s nothing personal.  It’s just business.

Advocates of national health care like to point to the NHS and say that is the model to follow.  And we are now moving in that direction with Obamacare.  Which can mean only one thing.  Death panels will follow.  Even though they are not specifically mentioned in the bill.  Because when it comes down to it health care is a game of numbers.  Accounting decisions.  Especially when the government runs it.  And the only way to control costs is by rationing services.  And what better way to ration services than by simply withholding them from the greatest consumers of those services?  The elderly.  Don’t think it will happen?  Just look at the NHS.  That is our future.  Where health care isn’t about doing what’s right for the patient.  But controlling costs.  But it’s nothing personal.  It’s just business.


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