The NHS drops Life-Saving Drug as it would lead to more Rationing and longer Wait Times

Posted by PITHOCRATES - April 22nd, 2014

Week in Review

In 1954 almost 35% of all workers belonged to a union.  Since then that number has fallen to about 11.3%.  As the high cost of union contracts chased manufacturing out of the country.  Today the majority of workers belonging to a union work in the public sector.  Where they enter contract negotiations with the taxpayers to secure better pay and benefits than most taxpayers have.  Of course during these negotiations the taxpayers have no say.  As politicians and unions hammer out these contracts.  Unlike trade unions.  Where the people paying the workers actually have a say.

This is another reason why national health care is the Holy Grail for the left.  They want to unionize all those health care workers.  Pay them more.  And deduct union dues from their pay to fund their political activities.  Leaving less money for patient health care.  But they’re okay with that.  But they’re not okay with a pharmaceutical company charging a lot of money for life-saving drugs.  Which, also, leaves less money for patient health care (see Breast cancer drug turned down for NHS use due to high cost by Sarah Boseley posted 4/22/2014 on the guardian).

A Herceptin-style drug that can offer some women with advanced breast cancer nearly six months of extra life has been turned down for use in the NHS because of its high cost.

In draft guidance now open to consultation, the National Institute for Health and Care Excellence (Nice) blames the manufacturers, Roche, who are asking for more than £90,000 per patient, which is far more than any comparable treatment…

“We apply as much flexibility as we can in approving new treatments, but the reality is that given its price and what it offers to patients, it will displace more health benefit which the NHS could achieve in other ways, than it will offer to patients with breast cancer.”

Paying health care providers more will not improve the quality of health care.  Unless health workers are doing a half-assed job now.  Which I don’t believe they are.  But Roche is helping people with death sentences live another six months or so.  That’s a pretty remarkable thing.  If the NHS can’t afford this wonder drug perhaps they should use their own.  Of course they can’t.  Why?  Because they don’t have one.  For they didn’t pour hundreds of millions of dollars in developing this drug and the all those drugs that failed.

Developing a miracle drug is costly.  Money the pharmaceuticals pay up front.  Because their employees don’t work for free.  Which is why these drugs cost so much.  That high price pays for all of the costs that went into this drug.  For all of the drugs that failed.  And provides a return for investors.  Who give these pharmaceutical companies hundreds of millions of dollars up front just in the hope they may develop a miracle drug.  Which is the only way we should invest in these miracle drugs.  Because these investors will only take a chance on a good thing.  Unlike government.  Which has a history of backing the wrong investment time after time.  And pouring good money after bad.

It’s a tough choice to make.  Take health care benefits away from other patients to pay for a miracle drug for those dying from cancer.  Or let people die 6 months or so sooner.  One thing for sure, though, unionizing our health care workers won’t give either of these patients more health care benefits.  It will only leave less money for everything else.  Leading to rationing.  And longer wait times.  Because less money will pay for fewer things.  Making those other things scarcer.  Forcing people to wait longer and pay more for treatment.

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More Budget Cuts increase Wait Times to see Doctor in the National Health Service

Posted by PITHOCRATES - February 23rd, 2014

Week in Review

The problem with national health care is that it is zero-sum when it comes to budgeting.  There is one big pie of funding that they divide throughout the system to pay for all of its parts.  But anyone who has ever paid attention to a budget debate in Washington has seen that there is never enough in the pie.  And no one is ever satisfied with their slice of the pie.  Worse, every department will spend every last cent in their appropriation lest they reduce next year’s appropriation by the amount of any unspent funds in this year’s appropriation.  No matter how wasteful that spending is.  Such as for conferences in Las Vegas.  Or extravagant office parties at home.

Britain’s National Health Service (NHS) is straining under the cost of an aging population.  More people are leaving the workforce than are entering it.  Which means fewer people are paying taxes.  Just as the number of people using the resources of the NHS is growing.  Forcing the NHS to do more with less.  Which has everyone complaining about their chunk of the NHS budget (see ‘Unprecedented’ cuts see GPs warn half of Britain will be unable to get appointments by Charlie Cooper posted 2/23/2014 on The Independent).

More than 34 million people will fail to secure an appointment with their doctor at some point this year, the GP’s professional body has claimed, blaming “unprecedented” cuts to funding for family practices.

The Royal College of General Practitioners said that the profession was “on its knees” and called for GPs to get a larger share of the NHS budget.

However, the Department of Health dismissed their findings – which would imply that more than half the UK population will miss out an appointment this year – as “complete nonsense” and accused the college of “sensationalising” the issue.

General practice has seen its share of the NHS budget – which totalled more than £109bn in England last year – significantly eroded in recent years, from 11 per cent in 2005/06 to 8.5 per cent in 2011/12…

“GPs and practice nurses want to provide high quality care for every single patient who seeks a consultation, and over the last decade we have increased the number of patients we see each year in England by 40m,” she said. “However [we] can’t keep doing more for less…”

“The GP survey showed the vast majority of patients are satisfied with their GP and rated their experience of making an appointment as good,” the spokesperson said, adding that GPs had been given an extra £50m to modernise services and stay open longer.

Whenever you want to see your doctor you need to make an appointment.  In the NHS that could take a few weeks.  Which is driving a lot of people to the A/E (accident and emergency departments).  Because they are sick now.  And don’t want to wait 2 weeks to see a doctor to get an antibiotic for their strep throat.

If you read the comments following the linked article you can get a feeling of what the British people think about the NHS.  And an idea of what Obamacare may lead to.  They love their NHS.  But are exasperated by it.  Some think the doctors are too greedy.  But there isn’t a mad rush to become a doctor to relieve the doctor shortage.  So whatever the pay is it isn’t enough to get people to join the profession.  Which ultimately increases the wait times to see a doctor.

The problem is that aging population.  People who remember a kinder and gentler NHS remember one before the baby boomers retired and overloaded the system.  Who are living longer into retirement.  Consuming more of the NHS’ limited resources than people did before the baby boomers retired.  Had Britain (and every other advanced economy) not reduced its birthrate around the Sixties they would not have this problem now.  But they did.  So they are.  As we will, too.  And every other advanced economy with an aging population will.  Making it a very bad time for national health care.  Yet President Obama and the Democrats have given us Obamacare at precisely this time.  Which is guaranteed to make health care in the United States worse.  If you don’t believe that just read the comments following the linked article.

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Obamacare on the Path to making People wait 4 Hours to see a Doctor like in Canada

Posted by PITHOCRATES - January 25th, 2014

Week in Review

Obamacare so far has been a disaster.  The website is a billion dollar embarrassment for the Obama administration.  The lack of enrollees.  Far more old and sick signing up than young and healthy.  Millions of people losing the health insurance they liked and wanted to keep.  People losing their doctors.  People going to doctors thinking they have health insurance only to find out they don’t.  The health insurers are looking at huge losses unless they get a federal bailout.  Even the credit rating agencies have said the entire health insurance industry is in danger of going belly up because of Obamacare.

Still the Obamacare supporters say everything will be fine.  Just give it time.  Sure, there has been a bump or two during the rollout.  But it’s getting better every day.  While there are some who are saying these problems are all due to the insurance companies.  And that we need to cut them out of the loop.  And go with a single-payer system.  Like they have in Canada.  So we can at last have the same high-quality system they have where everyone has everything they need when they need it regardless of cost.  A health care utopia.  Where if you’re sick it doesn’t matter if you’re rich or poor.  You’ll get to wait the same 4 hours to see a doctor as everyone else in Canada has to wait (see Would you pay to not wait in your doctor’s waiting room? This company is betting on it by Erin Anderssen posted 1/22/2014 on The Globe and Mail).

In your hand, you hold the number 52. The nurse shepherding patients through the walk-in clinic just called 12, which means you can expect to be waiting hours.

What’s your time worth? A Montreal-based company is betting you’d be willing to pay less than the equivalent of a grande latte for your “freedom” from the coughing, sniffling and tedium of a doctor’s waiting room. Chronometriq has created a text service – $3 in Quebec (and the expected cost of $4 in Ontario) – that will buzz you on your phone as your number approaches. The company expects the technology, now in place in 24 clinics in Quebec, to expand to 50 walk-in clinics by spring, including some Ontario locations, pending approval from the provincial health ministry.

Its next stop is hospital emergency rooms, where Canadians endure longer waits than citizens of 11 other OECD countries, according to a study released last year.

But it’s also controversial: After all, the program introduces a questionable user-pay element to Canada’s health care system. (The program is optional – you can still save your pennies and linger in the waiting room.)

As Natalie Mehra, executive director of the Ontario Health Coalition, points out, it won’t do anything to reduce actual wait times in ERs, where according to the international study 31 per cent of Canadian wa[i]ted more than four hours to be seen by a doctor in 2010. (The average among all countries included was 12 per cent.) “It is not improving access to care at all,” Mehra says. “The issue is people waiting too long to get in the door.”

That’s the point, argues Louis Parent, Chronometriq vice-president. “How many years have government said they will tackle wait times. And nothing has changed. We have to face facts.”

Critics of national health care say it will lead to rationing and longer wait times.  As it has in Canada.  Why?  Because government can’t do anything well.  The huge bureaucracy adds costs by adding layers of people between doctors and patients.  To determine what treatment a doctor may provide for his or her patient.  More and more health care dollars pay for the bureaucracy instead of actually treating patients.  While at the same time an aging population is reducing the number of taxpayers while increasing the number of people consuming taxpayer-funded health care services.  Which means health care providers have to do more with less.  They have to carefully ration what they have.  Which leads to longer waiting times as patients wait their turn for those limited health care services.

This is where the left wants to take the American health care system to.  Even as countries around the world are having the same problems Canada has.  Many of which are privatizing parts of their national health care.  Even Canada.  Who is now charging some patients for the privilege of receiving a text to tell them when their 4 hours of waiting are nearly up.  Of course the Canadians are having these problems because they are not as smart as the American left.  Who after never doing it before will know how to do national health care right.  Just look at how well they rolled out Obamacare.

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Health Care Economics

Posted by PITHOCRATES - January 20th, 2014

Economics 101

Because Obamacare Insurance pays for everything Under the Sun it is anything but Insurance

Do you know what the problem is with health care?  Insurance plans that give away free flu shots.  Not that flu shots are bad.  They’re not.  And it’s a good thing for everyone to get one every year at the onset of the flu season.  For it does seem to limit the spread of the flu virus.  It’s because we get a flu shot every year is why insurance shouldn’t pay for it.  Because we know about this expense.  And we can budget for it.  Just like we can budget for our monthly cellular bill.  Which is in most cases more than ten times the cost of one annual flu shot.

When Lloyds of London started selling marine insurance at that coffee shop they were selling insurance.  Not welfare.  Losing a ship at sea caused a huge financial loss.  And shippers wanted to mitigate that risk.  So every shipper paid a SMALL premium to protect against a LARGE loss.  A POTENTIAL sinking and loss of cargo.  Not every ship sank, though.  In fact, most ships did not.  Which is why that little bit from everyone was able to pay the financial loss of the few shippers that lost their ship and cargo.  But that’s all that Lloyd’s of London paid for.  They didn’t pay a dime to shippers whose ships didn’t sink.  No, those shippers paid every cent they incurred (crew, food, rum, etc.) to ship things across those perilous oceans.  Because they could expect those costs.  And they could budget for them.

This is how insurance works.  Which isn’t how our current health insurance system works.  No.  Today people don’t want to pay for anything out-of-pocket.  Not the unexpected catastrophic costs.  Or the EXPECTED small costs that everyone can budget for in their personal lives.  Like an annual flu shot.  Childhood vaccinations.  Annual checkups.  Childbirth.  Etc.  Even the unexpected things that aren’t that expensive.  Like the stitches required when a child falls off of a bike.  Things that would cost less than someone’s monthly cellular bill.  Or things that people can plan and save for.  Like a house.  A car.  Or a child.  Which is why Obamacare insurance is not insurance.  It pays for way too many expected costs that we can budget for.  And because it does it only increases the cost of our health insurance policies.  Which are now anything but insurance.

Free Market Forces and Insurance for Catastrophic Costs will Fix any Problems in our Health Care System

When we pay these things out-of-pocket there are market forces in play.  For a doctor is not going to charge someone they’ve been seeing for years as much as he will charge a faceless insurance company.  Even today some doctors will waive some fees to help some of their long-time patients during a time of financial hardship.  Because there is a relationship between doctor and patient.  And they want to help.  Which is why they sometimes overcharge insurance companies to recover costs they can’t recover in full from other patients.  (Which is why insurance companies are vigilant in denying overbillings).  Especially those things government pays for.  Medicaid.  And Medicare.  Which the government discounts.  Leaving health care providers little choice but to overbill others to pay for what the government does not.

When we pay out-of-pocket doctors can’t charge as much.  Because they need patients.  If they charge too much their patients may find another good doctor that charges a little less.  Perhaps a younger one trying to establish a practice.  These are market forces.  Just like there are everywhere else in the economy.  Even a cancer patient requiring an expensive miracle drug benefits from market forces.  If there was true insurance in our health care system, that is.  Cancer is an unexpected and catastrophic cost.  But not everyone gets cancer.  Just as every ship does not sink.  Everyone would pay a small fee to insure against a financial loss that can result from cancer.  Where that little bit from everyone buying a catastrophic health insurance policy was able to pay the financial loss of the unfortunate few that require cancer treatment.  Even one including a costly miracle drug.  Because only a few from a large pool would incur these financial losses insurers would compete against other insurers for this business.  Just like they do to insure houses.  And ships crossing perilous oceans.

Health care would work better in the free market.  It doesn’t today because government changed that.  Starting with FDR putting a ceiling on wages.  Which forced employers to offer generous benefits to get the best workers to work for them when they couldn’t offer them more pay.  This was the beginning.  Now the health insurance industry is so bastardized that it doesn’t even resemble insurance anymore.  It’s just a massive cost transfer from one group of people to another.  Instead of a pooling of money to insure against financial risk.  For the few unexpected and catastrophic costs we cannot afford or budget for to pay out-of-pocket.

Because our Health Care System is the Most Expensive in the World it is the Best in the World

The American health care system is the finest in the world.  When you have a serious health care issue and you have the wherewithal there’s only one place you’re going for your medical care.  The United States.  And the best costs.  And it’s because it is so costly that people enter into the health care industry to do wonderful things.  Such as pharmaceutical companies.  Who many rail against for charging so much for the miracle drugs only they produce.  It’s a free country.  Anyone could have created that miracle drug.  All they had to do was to spend a boatload of money for years on other drugs that were losers.  Until they finally found one that wasn’t a loser.  That’s all you had to do.  Yet few do it.  Why?

Because creating miracle drugs is an extremely expensive and often futile endeavor.  Which is why we award patents to the few who do.  Which is the only reason they pour hundreds of millions of dollars into research and development and pay massive liability insurance premiums for taking a huge risk to put a drug onto the market that may harm or kill people.  They do this on the CHANCE that they may develop at least one successful drug that will pay for all of the costs incurred to develop this one drug, the costs for the countless drugs that failed AND provide a profit for their investors.  Who took a huge risk in paying their employees over the many years it took to come up with at least one drug that wasn’t a loser.  Their investors do this only because of the CHANCE that this pharmaceutical will develop that miracle drug that everyone wants.  But most don’t.  And investors just lose their investment.  But it’s the only way miracle drugs become available to us.  Because of rich investors who were willing to risk losing huge amounts of money.

This is what the profit incentive gives us.  The best health care system in the world.  Why the countries based on free market capitalism have the finest health care systems in the world.  And why North Korea, Cuba, the former East Germany, the former Soviet Union, Venezuela, etc., have never given us miracle drugs.  There never was an economic incentive throughout the economy to do so.  Like there is in countries with free market capitalism.  Where everyone at every level pursues profits that result overall in a pharmaceutical industry that produces these miracle drugs.

There is an expression that says you get what you pay for.  Our health care system is the most expensive in the world.  And because it is it is the best in the world.  Trying to inhibit the profit incentive for research and development and forcing medical providers to work for less (steeper Medicaid, Medicare and now Obamacare discounts) will change that.  Because you do get what you pay for.  And those who live/have lived in North Korea, Cuba, the former East Germany, the former Soviet Union, Venezuela, etc., can attest to.

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Abject Ignorance of things Economic is Destroying our Health Care System

Posted by PITHOCRATES - January 18th, 2014

Week in Review

The problem in America these days is the mass ignorance of the people.  Thanks to a public school system that does not educate but programs our children to be good Democrat voters.  Higher education taken over by the leftist radicals of the Sixties that forever changed the curriculum to teach our children to distrust capitalism and love government.  When controlled by Democrats, of course.  And people who are for some reason respected for their economic prowess who are absolutely clueless on things economic (see The Daily Show Nails Why Healthcare Will Never Work As A Free Market by Christina Sterbenz posted 1/18/2014 on Business Insider).

Steven Brill, author of Time’s in-depth healthcare analysis “Bitter Pill,” appeared on The Daily Show this week to discuss his opinion of Obamacare.

Brill’s work exploded his career into a love-hate relationship with Obamacare, now leading to a book. Speaking with Jon Stewart, Brill certainly made his criticisms known but we also feel like he pinpointed exactly why healthcare just can’t work as a free market.

Brill told the story of a cancer patient forced to pay $13,700 out-of-pocket, up-front for transfusion of a drug. And that cost only constituted part of a greater $83,000 payment. Brill claims, however, the drug only cost the pharmaceutical company $300.

Stewart came back at Brill with the typical, conservative argument — creating a free market for healthcare where patients pick-and-choose their coverage to create competition and therefore, better options.

“Everyone says, well it’s a marketplace. That guy [the cancer patient] has no choice in buying that drug. His doctor told him, ‘This will save your life. You don’t take it, you’re gonna die,'” Brill responded.

He further argued free markets must host two aspects — a balance between buyers and sellers and secondly, knowledge — neither of which the current U.S. system offers.

“That cancer drug has a patent. That is a monopoly that the government has given the drug company. There is no other drug. That’s the drug,” Brill said.

Jon Stewart is a comedian.  So one can almost forgive his ignorance.  But you’d think a person writing for a publication with the word ‘business’ in its name would actually understand business.  But the author hasn’t a clue.  It’s not her fault.  It’s because of the politicizing of our educational system.  As her dual degrees in journalism and public affairs would have taught her squat about the classical, Austrian or the Chicago school of economics.  Instead filling her head with Keynesian nonsense.  The one economic school embraced by power-hungry governments everywhere that has a proven track record of failure.  For it was Keynesian policies that gave us the Great Depression, the stagflation of the 1970s, the dot-com bubble and recession of the late 1990s/early 2000s and the Great Recession.  Where massive government spending did not pull the economy out of recession but only made things worse.

Why does this pharmaceutical company have a patent?  Or perhaps a better question would be why do we have this one cancer drug?  Why is it that this one pharmaceutical company developed a cancer drug that works that no other pharmaceutical company or government developed?  Because of that patent.  The only reason they poured hundreds of millions of dollars into research and development and paid massive liability insurance premiums for taking a huge risk to put a drug onto the market that may harm or kill people.  They do this on the CHANCE that they may develop at least one successful drug that will pay all of their past costs for this one drug, the costs for the countless drugs that failed AND a profit for their investors.  Who took a huge risk investing, giving this pharmaceutical company the money to pay all of their employees over the years it took to come up with at least one drug that wasn’t a loser.

Does the author of this article work for free?  No.  Of course not.  She has bills.  As we all do.  Even the people working at pharmaceutical companies.  Who don’t work there for free.  Even if the vast majority of their work produces nothing that their employer can sell their employer still pays them.  Thanks to their investors who give them the money to do so until they can actually sell something.  But their investors do this only because of the CHANCE that this pharmaceutical will develop that miracle drug that everyone wants.  A miracle drug that would never come into being if it weren’t for investors who were willing to risk losing huge amounts of money.  Something only rich investors can afford to do.

Health care worked as a free market before General Motors made it an employee benefit thanks to FDR’s ceiling on wages.  Once people stopped paying for what they received all free market forces left the health care system.  And costs began to rise.  This whole “healthcare just can’t work as a free market” is a product of the dumbing down of our educational system.  One that produces people who don’t know the difference between insurance and health care.  Insurance protects our assets against a catastrophic and UNEXPECTED loss.  Like when Lloyds of London started selling marine insurance at that coffee shop.  Every shipper paid a small premium to protect against a POTENTIAL sinking and loss of cargo.  A POTENTIAL financial loss.  Not every ship sank, though.  In fact, most ships did not.  Which is why that little bit from everyone was able to pay the financial loss of the few that did.  For the ships that didn’t sink the shippers paid every other cost they incurred to ship things across those perilous oceans.

This is how insurance works.  Which isn’t how our current health insurance works.  Where people don’t expect to pay for anything out-of-pocket.  Not the unexpected catastrophic costs.  Or the EXPECTED small costs that everyone can budget for in their personal lives.  Childhood vaccinations, annual checkups, flu shots, childbirth, etc.  Even the unexpected things that have a low cost.  Like the stitches required when a child falls off of a bike.  Things that would cost less than someone’s annual cellular costs.  Or things that people can plan and save for (like a house, a car or a child).  When we pay these things out-of-pocket there are market forces in play.  For a doctor is not going to charge someone they’ve been seeing for years as much as a faceless insurance company.  Even today some doctors will waive some fees to help some of their long-time patients during a time of financial hardship.  Because there is a relationship between doctor and patient.

When we pay out-of-pocket doctors can’t charge as much.  Because they need patients.  If they charge too much their patients may find another good doctor that charges a little less.  Perhaps a younger one trying to establish a practice.  These are market forces.  Just like there are everywhere else in the economy.  Even a cancer patient requiring an expensive wonder drug would contribute to market forces if there was true insurance in our health care system.  Cancer is an unexpected and catastrophic cost.  But not everyone gets cancer.  Everyone would pay a small fee to insure against a financial loss that can result from cancer.  Where that little bit from everyone was able to pay the financial loss of the unfortunate few that receive a cancer diagnosis.  Because only a few from a large pool would incur this financial loss insurers would compete against other insurers for this business.  Just like they do to insure houses.  And ships crossing perilous oceans.

Health care would work better in the free market.  It doesn’t today because government changed that.  Starting with FDR putting a ceiling on wages.  Which forced employers to offer generous benefits to get the best workers to work for them when they couldn’t offer them more pay.  This was the beginning.  Now the health insurance industry is so bastardized that it doesn’t even resemble insurance anymore.  It’s just a massive cost transfer from one group of people to another.  Instead of a pooling of money to insure against financial risk.  For the few unexpected and catastrophic costs we could not afford and budget for to pay out-of-pocket.

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Corporate Politics, Bureaucracy and Obamacare

Posted by PITHOCRATES - September 5th, 2013

Politics 101

(Originally published April 4th, 2013)

You won’t find many Union Workers filling out TPS Reports

In the movie Office Space we see how frustrating it is to work in a big corporation.  The office politics.  The bureaucracy.  The policies and procedures.  The frustration of having to answer to 8 different bosses after making a mistake.   Bumping heads with management at all levels.  And the mind-numbing frustration of getting your paperwork right.

Anyone who has ever worked in an office no doubt had their own TPS report moments.  And dealt with their own Bill Lumbergh.  So we laugh at poor Peter.  For we’ve been there.  And know his frustration.  For there is nothing worse than trying to work through a company’s bureaucracy.  Or dealing with layers of management that often appeared to be working at cross purposes.  And suffering under bad bosses.

Which is the whole purpose of labor unions.  To protect their workers from a business’ management.  And bad bosses.  Because unions say if they don’t management will just abuse their workers.  So unions shield workers from these unfeeling and inefficient bureaucracies.  Who are always introducing new policies and procedures to improve business efficiencies.  Things like TPS reports.  Which unions say only makes things worse for the worker.  So you won’t find many union workers filling out TPS reports.  Just the non-union office workers.

Dealing with a Bureaucrat is like a Grizzled Sergeant with 20 Years Experience reporting to a Junior Officer

Junior officers get no respect.  Comedian George Carlin served in the Air Force.  And said a common joke was to say when someone broke wind, “Captain who?”  They get no respect because they are bureaucrats.  They come out of their officer training with only book-learning.  While enlisted people have been gaining experience and learning how to do things on the job.  Then these junior officers come in with their book-learning.  And start telling these enlisted people how to do their jobs.  Despite these junior officers having never done their jobs.  Or understanding how to do their jobs.  But they will tell these people how to do their jobs better.

This is less of a problem in combat.  As junior officers typically have a short lifespan in combat.  For all the book-learning cannot replace the experience gained in actual combat.  Which is why lieutenants may command units but it is the grizzled sergeants with the combat experience that lead men into battle.  And a smart junior officer will learn everything he can from his senior sergeants.

Small business owners feel the same way about government.  For a lot of small business owners often go into business after working for someone else.  They’re like those grizzled sergeants in the military.  They’ve learned and done pretty much everything in a business.  Then decided to quit and start their own business.  And one of the first things they have to deal with is the mind-numbing bureaucracy of government at all levels.  City, county, state and federal.  A bunch of bureaucrats who never ran a business.  Who have no experience in their field.  And here they are.  Telling them how to run their businesses.  Like a junior officer out of the academy trying to tell a grizzled sergeant with 20 years experience how to do his job.

Under Obamacare Professional Bureaucrats will tell our Doctors how to administer our Health Care

In these complicated times if there is one thing everyone can agree on it’s this.  Bad managers, bosses, and officers are insufferable.  No one likes putting together ‘TPS reports’.  Or being told by 8 different bosses that they did something wrong.  And they sure don’t like people who don’t understand the first thing about their job or business telling them how they should do their job or run their business.  They especially hate people that can cite rules and regulations by chapter and verse who mete out some penalty or fine because they can’t cite those same rules and regulations by chapter and verse.

This will be the world of Obamacare.  And as much as EVERYONE hates these things at their workplace there are some who still want these same clueless bureaucrats and politicians to take over health care.  As if somehow these people who don’t know the first thing about treating sick people can do a better job than the grizzled veterans working in the health care industry.  Who spend more and more time filling out paperwork these days than actually seeing patients.  And the last thing they want is an even more bureaucratic system where they will have to report to 8 different people and agencies to treat a patient.  Where bureaucrats at the Department of Health and Human Services as well as the IRS will have their own coversheets for their ‘TPS reports’.

In the movie The Usual Suspects the character played by Kevin Spacey said, “The greatest trick the devil ever pulled was convincing the world he didn’t exist.”  For if you don’t fear the devil you may live a life more in line with the devil’s wishes.  Making it easier for the devil to get your soul.  Government is a little like that.  For it has a horrible track record of doing anything right.  Even in the finest military in the world the bureaucrat side of the military pays $100 for a $15.00 toilet seat.  And yet the government has tricked so many people into believing they want more government in their lives.  Even though government is nothing but the managers and bosses people hate where they work.  Bureaucrats who tell others how they should do their job by citing rules and regulations by chapter and verse.  But who really don’t know what you do.  Or how you do it.  Now these professional bureaucrats will tell our doctors how to administer our health care.  And God help you if you get sick and put the wrong coversheet on your Obamacare health care services requisition form.  Or leave an important income tax field blank.

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One Fifth of the NHS Budget set aside to pay for Poor Health Care Lawsuits

Posted by PITHOCRATES - July 20th, 2013

Week in Review

Britain’s aging population is playing havoc with the National Health Service (NHS).  More taxpayers are leaving the workforce than are entering it.  Leaving less money to pay for a growing number of retirees who are living longer.  Costs have grown so out of control that they are trying to find £20 billion ($30.54 billion) in efficiency savings over three years.  Perhaps the best way for them to do that would be to just improve the quality of their care (see ‘Jaw-dropping’ rise in NHS claims after scandals by Laura Donnelly posted 7/19/2013 on The Telegraph).

A total of £22.7 billion – nearly one fifth of the health service’s annual budget – has had to be set aside to pay compensation to thousands of people harmed by poor care…

In total, more than 16,000 patients lodged claims during 2012/13, compared with around 13,500 the previous year…

In December, 38 families were offered settlements from Worcestershire Acute Hospitals trust over a series of failings, including the case of a man who starved to death…

The highest individual pay outs are connected to NHS errors which have led to babies becoming brain damaged, with around 100 such cases occurring each year.

A man starved to death?  In a hospital?  How does that happen?  The man must be in a bed.  Nurses and doctors must look at the people occupying these beds.  Is there no chart showing what this patient ate?  And if nothing was written in under what the patient ate shouldn’t that have been a red flag that this patient didn’t eat?

I can understand trying to diagnose some diseases can be difficult.  For some diseases can be devious bastards.  Hiding deep with a patient’s myriad symptoms.  But hunger?

“Hello, random patient.  Bowels okay?”

“I haven’t had a BM in days because no one is feeding me.”

“Not feeding you, eh?  Well, we’d better do something about that?  Let me find your nurse.  She can give me the form to address that.  Then you’ll be right as rain, my good man.  Take care.  And do work on those bowel movements.”

The soothing warmth of red tape in a government bureaucracy.  Just makes you wish Obamacare would hurry up and get here already.

Forms.  Yes, forms.  Beautiful forms.  Filling in blanks.  Filing in triplicate.  The way health care was meant to be.  And the way it will be under Obamacare.

“Hungry?  Not to worry.  I have just the form here.  See?  Here we fill in what you ate.  And here we fill in what you passed.  Beautiful, yes?  And by studying the connection between the two we can fill another 1,000 positions in the health care authority.  Isn’t that wonderful?”

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Doctor Shortages in the NHS force some Hospitals to adopt Banker Hours when treating Stroke Patients

Posted by PITHOCRATES - April 14th, 2013

Week in Review

We hear it all the time how to recognize the early symptoms of a stroke.  Here.  And in the UK.  The sudden headache.  The numbness in an arm or a leg.  The slurred speech.  For if we identified these symptoms early enough we can get to the hospital in time to prevent a massive stroke.  As long as we get there during banker hours (see Mother, 30, suffered massive stroke after being ‘sent home from hospital because a specialist was unavailable’ by Liz Hull posted 4/13/2013 on the Daily Mail).

A young mother suffered a massive stroke after she was wrongly sent home from hospital because there were no specialists on duty over the weekend to assess a brain scan.

Ruth Stanton was aged just 30 when she was admitted to hospital after suffering two mini-strokes over 48 hours.

Doctors carried out two brain scans, but failed to give her a diagnosis because it was a Friday evening and the specialist neurologist was not on site…

Because it was a Friday evening the specialist wasn’t available and, although the scans showed signs of abnormality, medics made the decision to discharge Mrs Stanton, who was told to wait for an out patient’s appointment, instead.

She returned home and went to bed but suffered the stroke in the middle of the night.

A medical expert provided evidence to the couple’s solicitor that prescribing a simple dose of aspirin for Mrs Stanton, now 36, would have prevented it occurring.

We can learn the early warning signs of a stroke but the on-call doctors and nurses in a NHS hospital can’t?  This after she suffered two mini-stokes over a 48-hour period that were in her medical records?  And there were signs of abnormality in two brain scans?  What does it take for someone to call in a specialist?  A flashing neon sign over a patient’s head saying “I’m a having a stroke.  Please call in a specialist.  Help.”  Apparently so.  For they will discharge you on a Friday afternoon and ask you to come back during office hours on Monday otherwise.

There’s a running gag in American television about a busy doctor telling a patient to “take two aspirins and call me in the morning.”  So they don’t have to cancel their evening plans by staying late to see a patient.  Apparently they didn’t give this woman anything.  And asked her to come back sometime after the weekend.  As an outpatient.  Despite having had 2 mini-strokes.  And signs of abnormality in her brain scans.  Is this what we have to look forward to under Obamacare?  Health care resources so stretched that they can’t be bothered to call in a specialist.  Or give a woman about to have a massive stroke a couple of aspirins?

It may very well be.  For Obamacare will take us in the direction of the NHS.  A more top-down managed health care system trying to take care of an aging population.  Where the only way to cut costs will be to force health care providers to work for less.  Leading to the kind of doctor shortages where they ask a patient to come back after the weekend during banking hours when someone will be available to see them.  If they don’t die or suffer a debilitating stroke over the weekend.

Moving in the direction of the NHS may provide health care to more people.  But the quality of that health care will fall so much that there may be more deaths in the long run from substandard care.  More of that fair-share sacrifice President Obama is always talking about.  If people are dying because they don’t have health insurance than some of those who have it need to die, too.  To make things more fair.  Apparently.

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Digital Medical Records have the Medical History Wrong for a Patient in the NHS

Posted by PITHOCRATES - April 13th, 2013

Week in Review

The keystone to Obamacare is digitizing medical records.  To make it easier for any health care professional to access a patient’s record no matter where they are.  Even if they’ve never met the patient before.  One set of records kept online for all to see.  No errors from duplicate copies.  No waiting for hardcopies to arrive.  It’s efficiency.  And accuracy.  Allowing great potential for cost cutting by automating the health care system to mass produce the delivery of health care services.

Patients come in and data-entry clerks encode them into the system.  As they move from station to station the next health care provider just has to pull up the work-order on the patient.  Do their part.  And ship the patient off to the next workstation.  Like an auto assembly plant.  Where they have economies of scale.  Keeping costs down.  This is what digitizing medical records will give us.  Well, that, and this (see Grandmother handcuffed and escorted from GP surgery by police after demanding to see medical notes by Amanda Williams posted 4/8/2013 on the Daily Mail).

A grandmother was handcuffed and led away from her doctor’s surgery by police after a row over her demand to see her medical notes.

Mary Kerswell, 67, asked for a copy of her GP records after she was called in for a urine test for a kidney condition she did not have.

When the mother of two was shown a brief summary of her medical history she was shocked to see that as well as being wrongly listed as having chronic kidney disease, it said she was a heavy smoker with Alzheimer’s.

The incorrect summary of her notes also said the healthy pensioner had undergone a hysterectomy and a double hip replacement.

Obviously there was a data input error somewhere along the way.  An error that no one caught because she was just a digital record in the system.  If there was a doctor-patient relationship like there still is in the United States (for awhile at least) her doctor would have caught that error.  Because he would have known the patient.  And because he would have known the patient he would have known the medical history in the digital medical record was wrong.  Because he treats a person.  Not just process a work-order in the system.

This is national health care.  Fewer health care providers taking care of more patients.  Where patients are just anonymous sick people with a work-order attached.  Allowing doctors to handle greater patient loads with ever more limited health care resources.  Common in all countries with an aging population.  Fewer workers paying income taxes to fund the health care of a greater number of people who have left the workforce.  Just like they have in the United States.  So what’s happening in the NHS will no doubt happen in Obamacare.  Because we both have an aging population.

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If Obamacare will be anything like the NHS first there will be Higher Taxes then there will be Rationing

Posted by PITHOCRATES - April 7th, 2013

Week in Review

There is no such thing as a free lunch.  We’ve all heard this expression.  And we know what it means.  Vendors buy customers lunches to get more business.  And customers know whatever they get ‘free’ from a vendor is included in the price they pay for their products or services.  So nothing is free.  Just other people pay for things you get to enjoy.

A lot of people thought national health care was free health care.  Which is why they want it.  Because they can’t stand paying even the co-pays on the high cost of health care.  But by nationalizing health care those high costs don’t go away.  Because doctors and nurses just don’t start working for free.  No.  We pay for free health care by nickel and diming everyone everywhere we can (see Taxes heat up battle against ‘Obamacare’ by Tom Howell, Jr., posted 4/3/2013 on The Washington Times).

A tax on everything from X-ray machines to oxygen tanks took effect at the beginning of this year — one of about 20 taxes and fees included in President Obama’s health care law — and has emerged as the central battleground in the fight by the law’s opponents to repeal parts of the president’s overhaul…

The device tax is one of several that kicked in this year, along with higher taxes on investment income and an increase in the Medicare payroll tax among households making $250,000 per year. Taxes and restrictions on flexible savings accounts, health savings accounts and health reimbursement arrangements are also starting to bite.

The tax penalty imposed on those who refuse to obtain health coverage will kick in next year, with a minimum penalty for low-income individual taxpayers of $95 in 2014, rising to $325 in 2015 and $695 in 2016. Those with higher incomes will end up paying more because their penalty is based on a percentage of their income — 1 percent in 2014, 2 percent in 2015 and 2.5 percent in 2016 and beyond.

And still looming later this decade is a 40 percent excise tax on high-value “Cadillac” health insurance plans, which will not debut until 2018.

The health care law’s $1 trillion in revenue raisers also includes niche targets, such as a 10 percent assessment on indoor tanning services…

…the health insurance tax, an annual fee that taxes health insurance providers relative to the worth of the insurance premiums they collect each year.

They will tax us every chance they get.  Because ‘free’ health care is more costly than the kind you pay for out of pocket.  Because when it’s ‘free’ you will use it more often.  “If it’s free it’s for me.”  And because the consumption of health care resources will rise so will all of these new taxes as they scramble to find a way to pay for this ‘free’ health care.

A lot of people no doubt draw some comfort in the fact that the rich will pay the majority of these taxes. But all of these taxes will eventually filter down to the average American as businesses raise prices to cover these taxes.  And those “Cadillac” health insurance plans?  They’re just not for rich people.  Very sick people often spend a fortune on these plans to reduce their overall costs of their treatments.  Which means the 40% tax on these plans will make these plans unavailable to them.  Causing great upheaval in their lives as they transition from their private plan and doctors to the state plan and doctors.

Eventually the costs will grow greater than all this new tax revenue.  As it has in the United Kingdom.  Where they have had to turn to cost cutting, consolidation of health care clinics and hospitals, longer travel distances to see a health care provider, longer wait times, rationing and denials of health care treatment.  Because their ‘free’ health care grew so costly with their aging population that they just can’t treat everyone.  Patients sometimes have to wait an hour or more for an ambulance.  And wait another hour or more at the hospital before a bed opens up for them so they can be unloaded from the ambulance.

And then there’s the Liverpool Care Pathway for the Dying Patient.  A quasi death panel.  Basically unplugging a patient to let them die with dignity.  Sometimes without telling the patient’s family about this hospital decision.  Where critics say it’s more about freeing up limited health care resources than about dying with dignity.  Especially with a costly and aging population.

So this is our future with Obamacare.  As the government takes over health care taxes will rise further.  And quality will fall.  As they try and stretch those limited resources to cover more and more patients.  Especially with a costly and aging population.

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