The National Health Service isn’t what it used to be despite its Constant Veneration

Posted by PITHOCRATES - March 23rd, 2013

Week in Review

Obamacare is unpopular and divisive.  Democrats passed it on purely party lines when they controlled both the House and the Senate.  Something they felt was more important doing than trying to help the economy recover from the worst recession since the Great Depression.  And now we see nothing but new taxes and costly regulations for business.  Causing a hiring freeze.  And a move to push full-time people to part-time because of the onerous cost of compliance.

Obamacare may prove to be the most damaging piece of legislation to ever come from Washington.  And on top of everything else the quality of health care will decline.  As we have learned from our friends in Britain.  Where in their National Health Service it is not uncommon to see long wait-times, rationing and denials of service.  They even have a de facto death panel.   The Liverpool Care Pathway for the Dying Patient.  Basically pulling the plug on those too old and too costly to keep alive.  But yet every time you turn around someone is heaping praise on the NHS.  Despite the train wreck it’s become (see For crying out loud, Archbishop, do we have to drag the NHS into everything? by Damian Thompson posted 3/21/2013 on The Telegraph).

From Archbishop Justin Welby’s sermon: “Slaves were freed, factory acts passed and the NHS and social care established through Christ-liberated courage.”

Sorry if this is out of place, Your Grace, but I can’t help asking: it is now against the law to hold any grand public occasion in Britain without venerating the NHS?

It’s a system of delivering healthcare. There are many worse and, increasingly, many better around the world. Its foundation was a huge achievement, but it is currently so badly administered and employs so many dodgy staff that many people do not feel safe in its hands.

This is the future of Obamacare.  It will be badly administered.  As all national health care programs typically are.  Because it’s the government running it.  And they just don’t have a good track record of running anything.  With this bad administration you will get political appointments to run crucial parts of it.  Instead of qualified health care professionals.  And as the political cronyism grows the staff will become dodgy.  Until one day people won’t feel safe in its hands.

But despite this those in the government will venerate it.  For it is the Holy Grail of government.  Controlling one-sixth of the economy.  Giving it enormous power over the economy.  And enormous power over life itself.  For Obamacare will have its own Liverpool Care Pathway for the Dying Patient.  A board of government bureaucrats making death panel decisions.  To try and stretch those health care dollars to cover as many people as they can.  After, of course, first taking care of those at the top badly administering it.

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Britain raising Retirement Ages to cope with an Exploding and Costly Aging Population

Posted by PITHOCRATES - March 16th, 2013

Week in Review

When the actuaries first crunched the Social Security numbers do you know what they did?  They built a system that would start paying benefits to people who on average were already dead.  That is the retirement age was pretty close to the average life expectancy.  Which meant few people would live long into retirement.  So if you’re collecting taxes from everyone but only have to pay about half of them in retirement (as the other half would already be dead) it wasn’t that hard to keep Social Security solvent.  But then something happened.  We started living longer.  Which the actuaries never thought would happen.  Worse, people were having fewer babies.  So as more people lived longer into retirement there were fewer people entering the workforce to pay the taxes to pay for their long retirement.  Creating an aging population.  Something else the actuaries never thought would happen.

Put it all together and you have a financial mess.  With both Social Security and Medicare projecting to go bankrupt.  But it’s just not in the United States.  It’s everywhere (see Britain ‘woefully’ under-prepared for rising number of elderly people by Juliette Jowit posted 3/13/213 on the guardian).

Britain is “woefully under-prepared” to cope with an expected explosion of older people and ministers need to respond by raising the retirement age and tackle the costs by reviewing pensioner benefits, a House of Lords inquiry concluded.

A special committee of peers blamed successive governments for their failure to tackle policy issues generated by the ageing population, warned that the biggest threats are to already stretched health and social services, and proposed a raft of new policies to help people cope.

Led by Lord Filkin, the group did not put forward a specific timetable for increasing the state pension age – already set to rise from 60 for women and 65 for men, to 66 in 2020 and 68 by 2046 – but the body did cite recommendations made by Lord Turner, chairman of the pensions commission, who had said the threshold could rise to 70 by 2030…

The wide-ranging inquiry heard startling evidence about the scale of the demographic change coming. Between 2010 and 2030 there is expected to be a 50% increase in people aged 65 or older, and a doubling of people aged 85 or older.

The consequences are predicted to be a 50% increase in people with arthritis, coronary disease or strokes, and an 80% rise in people with dementia to nearly two million.

So the British are talking about raising retirement ages.  And means-testing their benefits.  One thing they don’t mention is their Liverpool Care Pathway for the Dying Patient.  To help the dying to die with dignity.  Though many call it a quasi death panel.  To help unburden the NHS with a lot of costly patients.  Helping them to stretch their limited resources to cover more people.  Obamacare includes something similar.  Some bureaucrat will make life and death decisions to determine whether medical care will have an acceptable cost-benefit ratio.  If not, well, there will be something similar to Liverpool Care Pathway for the Dying Patient in Obamacare.  For it will be the only way to cut costs with an aging population.  Unless you force health care workers to work at bargain discount pay rates.  Like they do in Cuba.  And North Korea.

This will be the future of Obamacare.  For it is the present of the NHS.  And we both have aging populations.

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Woman dying from Cystic Fibrosis gets New Life-Saving Lungs from Heavy Smoker and then dies from Lung Cancer

Posted by PITHOCRATES - December 22nd, 2012

Week in Review

There are often very restricting rules to receive a donor organ.  If you’re on the list for a liver you’ll probably get denied that liver if you had one drink in the past month or so.  They do this because a donated organ is a gift.  There are more people waiting for this gift than there are available organs.  So to make sure the organ goes to the most deserving patient they have some strict rules.  Apparently there are no such rules for donors (see Cystic fibrosis woman died with smoker’s donor lungs posted 12/18/2012 on BBC News Essex).

A 27-year-old woman with cystic fibrosis died of cancer after she was given the donor lungs of a smoker.

Jennifer Wederell, of Hawkwell, Essex, died at home in August – 16 months after the transplant at Harefield Hospital in London…

She had been on the waiting list for a lung transplant for 18 months when in April 2011, she was told there had been a match…

She married her fiance David Wederell in September last year, but by February 2012 a malignant mass was found in her lungs.

“The shock immediately turned to anger in so far as all the risks were explained in the hour before her transplant and not once was the fact smoker’s lungs would be used mentioned,” said Mr Grannell.

“Regrettably, the number of lungs available for transplantation would fall by 40% if there was a policy of refusing those which have come from a smoker; waiting lists would increase and many more patients would die without a transplant…”

“Recipients of transplants are immunosuppressed, to stop the body rejecting the organ – this may have encouraged the cancer to grow. But is no one really knows- these are just theories.”

New warnings on cigarette packages in the U.S. include a scary picture of a diseased lung.  To scare you into quitting smoking.  Because while you can improve your health by quitting some damage is irreversible.  Smoking is that bad.  Smokers have an elevated risk of heart disease.  And lung cancer.  Yet they will give a woman with a suppressed immune system a set of lungs from a heavy smoker.  They were clinically healthy.  But as it turns out they had cancer.  Which probably should not surprise anyone as they came from a heavy smoker.

She was not informed that the donor was a heavy smoker.  Had they told her imagine that horrible decision.  Take a chance with cancer.  Or refuse them and take a chance of dying before the next set of lungs become available.

Was this a failure of national health care?  Cold impersonal staff that didn’t bother to inform the patient about the risk of getting a diseased lung?  Did the NHS just make this decision for her?  Because consulting her would just waste time?  They had already wasted an hour explaining all the risks to her an hour before the surgery.  How much more time would they waste if they had to wait for her to make up her mind about taking a chance with lung cancer?

Time.  It’s something they don’t have a lot of in the NHS.  They’re struggling to make their limited resources cover ever more patients as baby boomers fill their hospitals.  All while having to deal with budget cuts due to deficits.  So they are dealing with longer wait times, rationing of services and service denials.  Things are so difficult that some hospitals have put some elderly patients on the Liverpool Care Pathway for the Dying Patient without consulting their family.  Suspending food and liquids so they die.  Ostensibly to free up a bed and end a needless drain of hospital resources on someone who is just taking their sweet time to die.  It’s cold and callous but this is national health care.  And why they may not waste time waiting for patients to decide if they want to reject a potentially diseased lung.

A donated organ is a gift.  But a potentially cancerous organ?  Given to someone with a suppressed immune system?  Perhaps that’s more the product of a cold and calloused bureaucracy than a gift.  Something to look forward to under Obamacare.  Unless Obamacare just prescribes a pill to manage pain.  Sort of their own version of the Liverpool Care Pathway for the Dying Patient.  But with less to do with a patient’s end-of-life dignity and more to do with economic efficiency.

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