Even with the Bribes Chinese Health Care is Better since Privatization

Posted by PITHOCRATES - April 12th, 2014

Week in Review

China has recently privatized their health care system.  Sort of.  They have private health care providers and a state health insurance that helps pay for it with a small patient ‘co-pay’.  Quality of care did increase.  But health care providers don’t get paid a lot in China.  And turn to other means of compensation that is not without its problems (see ‘Guardian angels’ to protect Chinese doctors from patients by Malcolm Moore posted 4/9/2014 on The Telegraph).

Hospitals in Beijing will recruit 1,500 “guardian angels” to protect their doctors from violent attacks by patients.

In recent years, angry patients have killed a number of Chinese doctors, often citing frustration at how they have been handled by the healthcare system…

Doctors and nurses in hospitals are violently attacked every two weeks on average, the state media said, by patients angry at long waiting times, high medical bills and haughty or uncaring doctors…

The government has promised to root out corruption in the healthcare system, and the Health Ministry said in February it would target patients who bribe doctors for better treatment.

Yes, bribes.  Or hongbao, as it’s called in China.  If you want some decent care in a Chinese hospital you have to slide an envelope with money in it to your health care provider.  Otherwise you’ll only get what the state health insurance will buy you.  Long waiting times, high medical bills (for what the state insurance doesn’t cover—a high deductible, if you will) and haughty or uncaring doctors.  Which tells you how bad the health care system must have been before they privatized it.  For it’s a lot better now than it used to be.

So China made their health care better by privatizing it (although it is still so bad that angry patients who paid good bribes for their loved one’s care are assaulting their doctors and nurses every two weeks on average).  While the United States is going the other way.  Towards more state control.  Pity the Obama administration can’t be more like China when it comes to health care.  And try to improve the quality of health care instead of making it worse.  Which they will likely do as their cost saving measure is simply to pay health care providers less.  Which will likely discourage doctors from entering the system.  Or remaining in the system.  Leading to longer waiting times.  And, perhaps, bribes.  At least from those who want good care for their loved ones.

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Canadian Hospitals suffer from Overcrowding in British Columbia

Posted by PITHOCRATES - March 22nd, 2014

Week in Review

The left likes to say we’re idiots here in the United States.  Because every other advanced economy has national health care.  Of course, every other advanced economy doesn’t have the best health care system in the world.  No.  That honor goes to the United States.  And perhaps NOT having national health care is the reason why we have the best health care system in the world.  For those national health care systems have their problems.  Even the system north of the border the American left yearns to have.  The Canadian single-payer system (see New B.C. seniors advocate to focus on needs of growing elderly population by ROB SHAW posted 3/19/2014 on The Vancouver Sun).

Isobel Mackenzie, a longtime Victoria seniors care administrator, was named Wednesday as the province’s first seniors advocate, more than 16 months after the office was first announced…

There are more than 700,000 seniors in B.C. and that’s expected to double to 1.4 million over the next 20 years…

Mackenzie said she’s not sure if her office will get involved in how hospital overcrowding is affecting seniors care, and sidestepped a reporter’s question at her press conference Wednesday about the case of an elderly man who had spent eight hours waiting in a hospital emergency room…

“Obviously, health care is a priority and home care – giving support to people so they can stay at their home and healthy,” she said.

Logan said the government tried an “experiment” of providing funding to United Way but they’ve been “overloaded with requests.”

All of the advanced economies share something in common.  They all have an aging population.  Thanks to birth control and abortion people in the advanced economies stopped having babies after the Sixties like they used to have.  Which is why the seniors are now the largest growing sector of the population.  We have fewer people entering the workforce to pay the taxes that support a greater number of people leaving the workforce.  And thanks to modern medicine, these people are living long into retirement.  Which is why Canadian hospitals in British Columbia are overcrowded.  Which lead to longer wait times and the rationing of care.  Things common with national health care.  And these things are only going to get worse as their aging populations age further.

This is the future of Obamacare.  For the Affordable Care Act is already proving unaffordable to those who have to pay.  And people are losing the health insurance and the doctors they liked and wanted to keep.  A lot of doctors are opting out of Obamacare.  Leaving fewer in the system to treat a larger number of patients.  Which will, of course, lead to longer wait times and the rationing of care.  Just like in Canada.  And in every other advanced economy with a national health care system.  Which is why the United States is the only advanced economy without a national health care system.  Because Americans don’t want longer wait times and the rationing of care.  And they don’t want the Affordable Care Act.

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Health Care is Expensive because the Government doesn’t pay their Bills in Full

Posted by PITHOCRATES - January 4th, 2014

Week in Review

Health care is expensive.  It’s why we have Obamacare.  To lower the cost of health care.  And give quality health care to everyone.  But why exactly is health care so costly?  And who’s to blame?  Well, let’s take a look at the cost of an appendectomy to get an idea (see Reddit User Posts $55,000 Hospital Bill for Appendectomy by SYDNEY LUPKIN, ABC News, posted 1/1/2014 on Yahoo! News).

When a 20-year-old man got over the pain of having his burst appendix removed in October, he got hit with a hospital bill he wasn’t expecting.

The bill from Sutter General Hospital in Sacramento, Calif., said the total charges were $55,029.31 but that the patient owed only $11,119.23 because his insurance had covered the rest.

Shocked, the patient took to Reddit to post the bill and vent his frustrations.

“I never truly understood how much health care in the U.S. costs until I got appendicitis in October,” he wrote on the social media site. “I’m a 20-year-old guy. Thought other people should see this to get a real idea of how much an unpreventable illness costs in the U.S…”

But the bill was not so unusual, given recent studies that showed how the cost of medical procedures could vary from hospital to hospital, said Timothy McBride, a professor and health policy analyst at Washington University in St. Louis….

Sutter General Hospital spokeswoman Nancy Turner said hospital billing is complicated, and that the hospital has people available to help patients navigate it. She said hospitals often serve many patients who don’t pay at all or don’t pay the actual cost of treatment because they are on Medicare or Medi-Cal, California’s version of Medicaid.

“Sutter Health agrees that an improved billing structure is needed, where published charges are more closely aligned with actual costs,” Turner said. “And a more straightforward pricing system is only possible when reimbursement from government-sponsored patients covers actual costs.”

How much did your television cost?  How much is your cable bill?  How much was your laptop?  Your tablet?  How much was your mobile device?  How much is your cable bill?  How much is your cellular bill?  People know these costs very well.  For they are very discerning shoppers.  And because they are manufacturers and providers bend over backwards to give their customers what they want at the lowest possible price.  This is free market capitalism at work.  Competition for our dollars makes businesses try to give us the highest quality at the lowest price.  But none of this happens in health care.  Because there are no free market forces in health care.

No one knows what their health care costs are.  Because they don’t pay the bill.  So they don’t know.  And they don’t care.  It’s so bad today that most couldn’t shop and pay for the own health care if they tried.  On the rare occasion they pay attention to their bill what do they do?  Blame the hospital for gouging on their bill.  But there is a reason they do this.  And it’s not because they’re greedy.  They do it because it’s the only way they can keep their doors open.  Thanks to the people who don’t pay their bills.  And the government who doesn’t pay all of their bills.  Leaving no choice for health care providers but to over-bill the insurance companies.  Who are the only people paying their bills in full and then some.

Obamacare will only make this worse.  By giving ‘free’ health care to more people.  Health care that the government won’t pay in full.  Which will force the health insurers to raise their premium prices further.  Until it is so expensive that no one will buy it anymore.  The so-called death spiral.  Opening the door for single-payer health care.  And Medicaid-quality health care for everyone.  Well, perhaps not quite Medicaid-quality health care.  With more people in the program wait times and rationing will be greater than they are currently in Medicaid.  So it will be worse than Medicaid.  The worse-quality health care currently available in the United States.

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Obamacare to create Great Doctor Shortages, Long Wait Times and Rationing of Health Care Services

Posted by PITHOCRATES - November 30th, 2013

Week in Review

How did African slavery arrive to the new world?  The New World was vast continents.  And there were just not enough settlers to farm on the scale required.  With a huge shortage of laborers the colonial powers tried enslaving the local population.  But it proved difficult to keep them enslaved.  As they were well familiar with the land.  And the indigenous population.  If they escaped they could disappear into the land and into the indigenous population.  Something an African slave could not do as well.  If at all.  Strangers in a strange land.  Unable to communicate with the indigenous population.  And unable to hide among them.  Who were probably just as hostile to them as they were to the white man taking their land.  Making escape from bondage much more difficult for the African slave than it was for the indigenous slave.  So the African slave proved to be a good fit for the colonial powers.  Allowing them to fill the shortage of labor by forcing the black man into bondage.  To provide their labor against their will to meet the demand of the ruling colonial powers.

Now there is a new demand that the government will struggle to meet (see Lack of Doctors May Worsen as Millions Join Medicaid Rolls by ABBY GOODNOUGH posted 11/28/2013 on The New York Times).

Dr. Ted Mazer is one of the few ear, nose and throat specialists in this region who treat low-income people on Medicaid, so many of his patients travel long distances to see him.

But now, as California’s Medicaid program is preparing for a major expansion under President Obama’s health care law, Dr. Mazer says he cannot accept additional patients under the government insurance program for a simple reason: it does not pay enough…

His view is shared by many doctors around the country. Medicaid for years has struggled with a shortage of doctors willing to accept its low reimbursement rates and red tape, forcing many patients to wait for care, particularly from specialists like Dr. Mazer.

Yet in just five weeks, millions of additional Americans will be covered by the program, many of them older people with an array of health problems. The Congressional Budget Office predicts that nine million people will gain coverage through Medicaid next year alone. In many of the 26 states expanding the program, the newly eligible have been flocking to sign up…

In California, with the nation’s largest Medicaid population, many doctors say they are already overwhelmed and unable to take on more low-income patients. Dr. Hector Flores, a primary care doctor in East Los Angeles whose practice has 26,000 patients, more than a third of whom are on Medicaid, said he could accommodate an additional 1,000 Medicaid patients at most.

“There could easily be 10,000 patients looking for us and we’re just not going to be able to serve them,” said Dr. Flores, who is also chairman of the family medicine department at White Memorial Medical Center in Los Angeles…

The health care law seeks to diminish any access problem by allowing for a two-year increase in the Medicaid payment rate for primary care doctors, set to expire at the end of 2014. The average increase is 73 percent, bringing Medicaid rates to the level of Medicare rates for these doctors.

But states have been slow to put the pay increase into effect, experts say, and because of the delay and the fact that the increase is temporary, fewer doctors than hoped have joined the ranks of those accepting Medicaid patients. “There’s been a lot of confusion and a really slow rollout,” Ms. Folberg said, “which unfortunately mitigated some of the positive effects…”

Dr. Paul Urrea, an ophthalmologist in Monterey Park, said he was skeptical of “blue-sky scenarios” suggesting that all new enrollees would have access to care. “Having been in the trenches with Medi-Cal patients who have serious eye problems,” he said, “I can tell you it’s very, very hard to get them in to see those specialists.”

Dr. Urrea said that when he recently tried to refer a Medicaid patient with a cornea infection to another eye specialist, he was initially informed that the specialist could not see the patient until February. “And this is a potentially blinding condition,” he added.

Travel long distances to see a doctor?  Long wait times?  A shortage of health care providers?  Low reimbursement rates?  Overwhelmed doctors?  A shortage of specialists?  You’d think your were reading about the UK’s National Health Service (NHS).  But this is just what the Affordable Care Act (aka Obamacare) is doing to Medicaid.  Which it will soon do to the rest of the American health care system.

So not only is the Affordable Care Act making health insurance unaffordable it will create doctor shortages that will lead to longer wait times.  Some waits stretching out over two months.  A wait so long that a patient may go blind from a treatable eye infection.  This is national health care.  People succumbing to their diseases as they wait for treatment that is being rationed out.  Which they have to ration as the number of patients far outnumber the number of doctors available to treat these patients.

So this is what Obamacare will do to the American health care system.  Give us longer waiting times.  Rationed care.  And people succumbing to their illnesses because of the long wait to see a doctor.  Funny as the Afford Care Act was to give affordable health insurance to all.  So everyone could live in a utopia where if they were sick they could go to a doctor and have everything covered.  Just pray you’re not one of those who can’t afford to pay the higher premiums and higher deductibles of Obamacare.  Because these people are being dumped into the overcrowded and underfunded states’ Medicaid systems.  Which will only get worse under Obamacare.  Especially with doctors leaving the Medicaid system.  Retiring early.  Or moving into concierge medicine.  Leaving ever fewer health care providers to tend to the swollen Medicaid ranks.

Not a good time to be a doctor.  For you have to be wary of a government that can’t find enough doctors to voluntarily meet the health care demand.  Especially one that has a Senate ‘rubber-stamp’ for its judicial appointments.  Thanks to Harry Reid and the nuclear option.  Changing the rules of the Senate by eliminating the filibuster for judicial appointments.  Which opens the door for a lot of illegal and unconstitutional law.  Such as new health care mandates issued by the executive branch that exceed its constitutional authority.  Which will be challenged.  But once these cases hit these Obama-packed courts you can guess the outcome.  Illegal and unconstitutional mandates will become law.  Which no doubt concern doctors in a health care system that has a doctor shortage and an explosion of new patients.

If a doctor wants to remain a doctor and get paid for his or her services he or she may find new requirements.  Such as mandatory salary caps.  Forced acceptance of Medicaid patients.  With ‘opting out’ made illegal.  Compelling doctors to work against their will.  Now forcing people to work against their will is nothing new.  When Roman taxes rose so high to pay for the bloated Roman state people quit their jobs to avoid paying taxes.  Then the Roman state made that illegal.  Bonding these people to their jobs.  And when they died their children were forced to continue in their place.  Giving Europe feudalism.  Where the masses worked the land against their will.  For the law prevented them from ever leaving the land they or any of their progeny were born on.  Could this happen to the American health care system?  If the state controls the health care industry and the courts, yes.  Which is why it is not a good time to be a doctor.

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Unlike the July Effect the High Inpatient Mortality of the Obamacare Effect will be Year Round

Posted by PITHOCRATES - November 9th, 2013

Week in Review

The Affordable Care Act is making health insurance unaffordable for many.  Especially for those young and healthy who are being whacked open like a cash piñata to pay for the poor, old and sick.  Which is why they are losing their health insurance.  So they must enter the exchanges.  And pay for a lot of insurance coverage they will never use.  Well, to be fare, chances are they will never use any of their insurance with those sky-high deductibles.  Making any doctor visit an out-of-pocket visit.

But that isn’t the only place the Affordable Care Act is shaking down people.  Obamacare is also shaking down doctors.  By cutting their Medicare and Medicaid reimbursements.  Making them take pennies on the dollars.  Making it hard for those in a private practice to pay their staff.  And their bills.  Which isn’t why they went into medicine.  So these doctors are leaving Medicare and Medicaid.  Some are even retiring.  Leaving the profession instead of being beaten up by Obamacare.  So just as Obamacare is giving more free health care to people there will be fewer health care providers.  Which puts a story like this into a new light (see Sicker heart attack patients fare worse in July by C. E. Huggins posted 11/7/2013 on Reuters UK).

Rumor has it the worst time and place to be sick is in a teaching hospital in July, when new doctors-in-training enter the wards and others are promoted. A new study of heart attack patients shows this pattern of worse outcomes known as the “July effect” may indeed be true – but only for the sickest people.

“Patients who are already at high risk of inpatient mortality – because of their age and other (co-existing) diseases – are likely the most to be affected by physician inexperience in July,” Dr. Anupam Jena told Reuters Health in an email. He led the research at Harvard Medical School in Boston…

“Our study is different because it recognizes that the July effect should not be present for all patients, but primarily those patients for whom small clinical errors or relative physician inexperience can substantively impact patient outcomes,” Jena said.

There will be a new name to explain another rise in inpatient mortality.  The Obamacare effect.  Where fewer health care providers will have to do more with less.  Increasing wait times.  Overworked doctors will spend less time with each patient.  And they will make mistakes.  Or miss things they might have caught if they had more time.

So in the future as you sit around with your grandchild on your knee you can talk about the good old days.  Before the Obamacare effect.  When we rushed people to the hospital to make them well.  And most got well.  Unlike after the Obamacare effect.  Which turned the once envied U.S. health care system into the VA hospitals of the Seventies.  Places to avoid like the plague.  Which is why after the Obamacare effect people would rather take their chances with heart attacks and strokes at home.  Instead of going into an Obamacare hospital for near certain death.

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Hinchingbrooke Hospital breaks free from the NHS Bureaucracy and Improves Health Care

Posted by PITHOCRATES - October 13th, 2013

Week in Review

Britain has government-run national health care.  The National Health Service (NHS) provides free health care to all Britons.  And the medical tourists who travel to the country for free health care.  Straining the NHS budget.  At a time when Britain’s aging population is stretching their limited resources thin.  Leading to longer wait times.  Longer travel times as they close local hospitals to consolidate their resources in fewer locations.  And rationing.

Even with their longer wait times, travel times and rationing of services they are still running a deficit in the NHS.  To address these chronic cost overruns they are trying to find £20 billion ($30.54 billion) in efficiency savings over three years.  But there is a beacon of hope for the NHS.  At Hinchingbrooke Hospital (see Set doctors and nurses free to use their common sense – as Hinchingbrooke Hospital does by Charles Moore posted on The Telegraph).

Last month, I visited Hinchingbrooke Hospital, near Huntingdon, the only NHS Trust in the country operated by a private partner…

I spent half a day at Hinchingbrooke, talking to doctors, nurses, administrators and patients, and seeing several wards…

One can visit a large organisation without being aware of big problems. Indeed, one of the great difficulties of the NHS is that internal communications are so bad that people can work well in one area without being aware of utter disaster a few yards away. In the case of Hinchingbrooke, under previous management, maternity was very good while the colorectal unit was shameful. So what follows is not definitive; but I feel I learnt something.

Uniquely in the NHS, Hinchingbrooke’s executive board is dominated by clinical practitioners (doctors and nurses, to you and me). The chief executive is an obstetrician. Only three of the 14 board members have non-clinical backgrounds.

In the only trust that has a private partner doctors and nurses determine how best to treat patients.  Instead of the faceless bureaucracy in the rest of the NHS.  Or what the proponents of Obamacare hope to force onto the American people.

One of the key working methods, borrowed from Toyota, is “Stop the Line”. Anyone in the hospital can stop the line if he or she believes that there might be a “serious untoward incident” or danger to a patient…

A similar, lesser action is a “swarm”. If you are urgently worried about something, you can summon all the relevant people together immediately. Unlike “whistle-blowing”, which is inevitably retrospective and often involves grievance and disloyalty, these ways of acting are instant and preventative. You are encouraged to use them. Someone stops the line in Hinchingbrooke most days.

Nurses work differently from most parts of the NHS. They all wear uniform, even if in managerial roles, and they are encouraged to take part in management without abandoning clinical work…

But what struck me about Hinchingbrooke was not that it was brilliantly original – simply that it was free to act according to common sense. Involve staff in decisions. Make sure that doctors and nurses can run things. Learn from commercial examples of how to improve services. Let the right hand know what the left is doing. Encourage innovation. Don’t “benchmark to the middle”, but to the top. And little things: get A&E nurses to wear identifiable name-badges; get rid of hospital car-park fines. Most of this is simple, but, in the leviathan of the NHS, it is not easy. And at present there are about 2,300 NHS hospitals in the United Kingdom, and only one Hinchingbrooke…

This is far behind the public. As you understand better if you spend a morning in Hinchingbrooke Hospital, the public want health care free at the point of use, but have no ideological prejudice about who delivers it, or how. They rightly judge by results – are they, their spouses, parents, children, well or ill? Are the staff medically competent, efficient and kind? They are not sentimental about the most shocking producer interest ever to have gained power in this country.

The one hospital where things are greatly improving is the one hospital that is moving away from bureaucratic national health care and towards private health care.  Like it once was in the United States.  While President Obama and the Democrats want to move the American health care systems towards the bureaucratic national health care of the NHS.  Where there are longer wait times.  And service rationing.  Well, everywhere in the NHS but Hinchingbrooke Hospital.

Do President Obama and the Democrats care that they will destroy the American health care system?  No.  Because it’s not about health care.  It’s about creating the “most shocking producer interest ever to have gained power in this country.”  Yes, it’s about the power.  Social Security and Medicare made the elderly dependent on government.  Giving the government power over the elderly.  If they can’t raise taxes they just threaten to cut Social Security and Medicare benefits.  National health care, though, makes everyone dependent on government.  Giving the government power over everyone.

Until the day they can no longer maintain that power.  And that day has come in Britain.  Their aging population is breaking the system.  Which is in essence a Ponzi scheme.  The masses in the workforce pay in via taxes.  And the few sick consume health care services at the top of the pyramid.  While a bloated bureaucracy makes sure to take very good care of itself.  But the aging population is shrinking the workforce paying the taxes.  And swelling the number of sick consuming the health care services.  Inverting the pyramid of the Ponzi scheme.  As it will in America thanks to Obamacare.  Because the United States has an aging population, too.

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Canada has Record Number of Doctors but Canadians still have Trouble Finding a Doctor

Posted by PITHOCRATES - September 28th, 2013

Week in Review

Obamacare is coming.  The path to single-payer/national health care.  Which we’ll have once Obamacare kills the private health insurance business.  By forcing insurers to cover so much that they have to raise their premiums beyond what people can afford.  As people stop buying insurance they will have to raise their premiums further still due to fewer people in the insurance pool.  Which, of course, will force more people out of the pool as they simply won’t be able to afford insurance anymore.  Eventually the insurance companies will not be able to insure enough people to remain in business.  Leaving only the government.  And then the left has their single-payer/national health care.

So what will that be like?  Well, we probably won’t be able to keep our doctors.  Like President Obama promised us we could.  No.  Socialized medicine does not encourage people to go through the hell of medical school to become a doctor.  So there will be fewer doctors.  Requiring higher caseloads per doctor.  Prompting many to retire.  And then it will be more like it is in Canada (see Canadian doctor total at record high posted 9/26/2013 on CBC News).

Canada had a record 75,142 doctors last year and they earned $328,000 gross on average, according to two new reports…

But the numbers alone don’t present the full picture. It’s important to ask not just how many doctors are needed, but where are they most needed and in what specialties, said Geoff Ballinger, CIHI’s manager of physician information.

Kristin Speth, 35, of Toronto, has been looking for a regular doctor since she moved from Alberta four years ago. She’s had headaches since childhood and has been going to walk-in clinics but is frustrated with the experience.

She’s tried the provincial service to find a doctor but keeps getting notices saying there are no leads.

“It is extremely frustrating,” said Speth.

“It’s just so hard to find someone who will just stay longer than the one year that I need for my physical. They just don’t stick around or you know, you can’t find anyone who is taking new patients.”

Canada’s population is around 35 million.  So there’s about one doctor per every 468 Canadians.  The US population is around 314 million with about 691,000 doctors (in 2010).  That’s about one doctor per every 454 Americans.  So the Canadians have more doctors per capita than they do in the US.  But currently finding a doctor in the United States is not as difficult as it is in Canada.  Well, until Obamacare, that is.  After which Americans will be as exasperated as their Canadian neighbors.  Because they already have what Obamacare will give us.  Single-payer.  And doctor shortages.  Even though they have more doctors per capita than we do.  But apparently their ‘single-payer’ workloads are so heavy they just can’t—or won’t— take on new patients.   Something to look forward to under Obamacare.

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Obamacare may cause up to 65,000 Needless Deaths based on what’s happening in the NHS

Posted by PITHOCRATES - July 14th, 2013

Week in Review

The problem with national health care is simple economics.  Supply and demand.  Things that cost more are in lower demand.  Things that cost less are in higher demand.  And free things are over consumed.

In Britain they have the NHS.  The National Health Service.  It’s not health insurance.  Like Obamacare is.  It is health care funded by the taxpayers.  What they designed Obamacare to become.  After causing businesses to drop costly mandated health insurance for their employers.  And making it near impossible for private health insurers to remain in the insurance business.  Once they meet these objectives then the government can transform Obamacare more into something like the NHS.  Where people get ‘free’ health care.  Paid for not by private insurance policies.  But from the tax revenue of the federal government.  Where they can over consume all the free health care they can get their hands on.  Such as demanding antibiotics every time they get the sniffles.

Sounds good to some.  Primarily to those who don’t have health insurance.  Because they choose not to pay for it.  Why?  Because it is so expensive.  And it’s so expensive because health insurance is no longer insurance.  Because it covers almost everything.  Instead of just the large, unexpected, catastrophic expenses.  The things insurance used to pay for.  While we paid for checkups and routine doctor visits out of pocket.  So we paid for the little things that we could expect and budget for.  While buying insurance for the things we could not expect or budget for.  And the system worked.  It kept costs under control because we were paying for most of what we were receiving.  Creating a direct relationship between the services we received and the money we spent.  Which introduced market forces into the equation.  But ever since health insurance became an employee benefit there have been fewer and fewer market forces in the equation.  Which has lead to the explosion in health care costs.

Nationalizing health care only removes market force from the equation further.  Which will, of course, raise costs.  As there will be nothing to keep health providers efficient while maintaining high standards of quality.  For if their customers aren’t paying them they don’t have to please their customers with efficiency or high quality care.  They just have to meet the minimum state requirements.  And keep asking the government for more money.  Until the government has no money to give.

And as a large health bureaucracy develops things become more impersonal.  More machine like.  Where patients are units of input.  That have to be processed according to strict bureaucratic guidelines.  Not necessarily what’s best for the patient.  The amount of paperwork rises.  And health care providers spend more time pushing paper than interacting with units of input.  Patients.  People at the hospital must bow to the distant health care authority.  Often following rules and regulations that don’t make sense all of the time.  Frustrating them.  And making them apathetic in their jobs.

Then efficiencies fall.  And costs rise.  Health care providers are forced to do more with less.  Spreading their limited resources over more and more patients.  Unable to provide high quality to everyone they do just the minimum for everyone.  While their apathy turns to indifference to their patients’ wellbeing.  You create an environment like this eventually over time you get this (see ‘Up To 13,000 Needless Deaths’ In NHS Hospitals posted 7/14/2013 on Sky News).

Up to 13,000 people may have died needlessly in NHS hospitals since 2005, according to a report to be published in the coming days…

The report, to be released on Tuesday, will criticise care standards and management failures, fuelling concerns about a problem with the NHS’s culture where whistleblowers are afraid to speak out and regulators often fail to do their job…

Sir Bruce examined not just mortality rates, but measurements including infection levels, the number of patients suffering from preventable and potentially fatal signs of neglect, and the numbers harmed by so-called “never events” such as operations on the wrong part of the body, or surgical instruments left inside a patient.

National health care will eventually poison the greatest assets of the health care system.  Its people.  Taking a good system and making it bad over time.  And you know it’s bad when ‘surgical instruments left inside a patient’ is a metric they track.  Apparently because it happens so often that it is something that they can count.

So take a good look.  This is national health care.  The ultimate destination of Obamacare.  Which will kill some 65,000 people over 8 years (the U.S. has about five times the population of Britain so they will have five times the number of needless deaths).  That comes to about 8,125 a year.  Which isn’t that far below the national homicide rate.  Imagine that.  Raising deaths in our health care system to near the national homicide rate.  That’s what we can expect with Obamacare.  As our health care system struggles to do more with less.  Overwhelming our heath care providers.  And making them grow ever more apathetic.  Just like they have in Britain.

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NHS Doctor Shortage and High Costs of National Health Care reduce Staffing Levels in Hospitals on Weekends

Posted by PITHOCRATES - June 1st, 2013

Week in Review

Health care workers in the National Health Service (NHS) are government workers.  And one thing we know about government workers is that they don’t like working on their time.  They don’t like working after hours during the workweek.  And they especially don’t like working the weekend (see NHS risk of death from elective surgery far greater at end of week, study finds by Denis Campbell posted 5/28/2013 on theguardian).

Patients who have planned surgery near the end of any week or at weekends are at greater risk of dying than those operated on at the start of the week and especially on Mondays, research reveals.

These risks have been rated “very alarming” by patient safety campaigners, and judged unacceptable by the Royal College of Surgeons (RCS).

The findings come as NHS chiefs try to devise ways of ensuring that the health service offers high-quality care across the entire week, in response to a growing body of evidence showing that a shortage of experienced doctors on duty at the weekends heightens the risks of a poor outcome for patients.

It is only common decency.  If these health care workers can do their job in the normal workweek then patients ought to be able to do the same.  Have their surgery and be gone by the weekend.  Because health care workers have lives, too.  And they don’t want to waste it by taking care of burdensome patients on their time.

The study is significant since it is the first to suggest that patients in Britain are more likely to have an “inferior outcome” if they undergo elective surgery later in the week.

Until now concern has focused on high death rates among patients admitted as emergency cases at weekends – dubbed the “weekend effect” – which is often attributed to a lack of consultants on duty on Saturdays and Sundays.

You see, the problem in national health care is that it costs a lot of money.  Especially when you have an aging population.  Where more people leave the workforce than enter it.  Shrinking the tax base.  And these retirees go on to live a long life in retirement.  Instead of dying quickly to save precious health care money.  No, these people live so long that they can have heart attacks, cancer and dementia.  A single patient can have all of these afflictions today.  And that costs a lot of precious health care money.  Which they just don’t have.  So they have to ration what they do have.  To make their limited resources cover more people.  And one way of doing that is short-staffing hospitals on weekends.

[Paul] Aylin [a clinical reader in epidemiology and public health at Imperial College London] said he could not be sure what lay behind the trend. But he said that as the first 48 hours after surgery were critical to patients’ chances of recovery, the poorer care available at weekends – fewer staff, less experienced staff, perhaps less access to diagnostic tools or emergency surgery – was a likely explanation. Those who had surgery on a Friday would stay in hospital over the weekend…

Peter Walsh, CEO of the patient safety group AvMA, said day-dependent differences in the risk of death of as much as 44% were very alarming” and underlined the need to make the NHS a truly seven-day service.

Operating a good service only on weekdays was a completely out of date notion, he said, adding that patients due to have elective surgery on a Friday could ask instead to undergo it earlier in the week…

Sir Bruce Keogh, national medical director of NHS England, said the service was “committed to providing safe care for all patients, regardless of when they receive their treatment”.

Keogh added: “We have established a forum to develop viable financial and clinical options to help our NHS provide more comprehensive services seven days a week. This forum will report back in the autumn.”

Asking people to reschedule their surgeries may help some.  But if everyone does this will they just reduce staffing levels at the end of the week?  Which would kind of make the problem worse.  And it’s not much of an option for people being rushed to the hospital in an ambulance at the end of the workweek.  For those patients to be so inconsiderate as to have their near-death illness or accident at the end of the workweek.  These people will just have to plan their illnesses and accidents better.  Yeah, that may be hard.  But health care resources don’t grow on trees in the NHS.

Financial options?  You know what that means.  Greed.  Making a profit on the sickness of others.  The thing they want to stop in the United States with Obamacare.  And here the British are using it to try and fix their ‘part-time’ NHS.  That prefers not to work weekends.

The proponents of Obamacare see Obamacare as only a temporary layover on the way to single-payer.  Or national health care itself.  Like the NHS.  Where all of our health care workers will be government workers.  And one thing we know about government workers.  They don’t like working on their time.  Not after hours during the workweek.  Or weekends.

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The Swedes reintroduce the Profit Incentive into the Health Care Equation to fix their National Health Care

Posted by PITHOCRATES - May 19th, 2013

Week in Review

Obamacare will transform American health care into a more top-down national health care system.  Because the American left always wanted national health care.  For the power over the economy it will give them.  Not so much for the quality of health care.  For the quality of national health care has not been historically as good as the quality of private health care.  But the left doesn’t care.  Because it’s not about the quality of health care.  It’s about having power over one-sixth of the U.S. economy.

But they tell us it’s about providing high-quality health care to everyone.  Not just for the rich people who can afford it.  Which they can do if they take out the profit incentive from the health care equation.  For that’s what is driving up health care costs.  Greedy doctors and hospitals.  Who are profiting on sick people.  Which is just immoral to those on the left.  No.  The only way to fix health care is by removing the profit incentive from the health care equation.  Like they’ve done in Sweden.  The model of socialism the left so wants to see in the United States (see A hospital case posted 5/18/2013 on The Economist).

SAINT GORAN’S hospital is one of the glories of the Swedish welfare state. It is also a laboratory for applying business principles to the public sector. The hospital is run by a private company, Capio, which in turn is run by a consortium of private-equity funds, including Nordic Capital and Apax Partners. The doctors and nurses are Capio employees, answerable to a boss and a board…

Welcome to health care in post-ideological Sweden. From the patient’s point of view, St Goran’s is no different from any other public hospital. Treatment is free, after a nominal charge which is universal in Sweden…

Staff used to waste precious time looking for defibrillator machines and the like. Then someone suggested marking a spot on the floor with yellow tape and insisting that the machines were always kept there…

St Goran’s is the medical equivalent of a budget airline. There are four to six patients to a room. The decor is institutional. Everything is done to “maximise throughput”. The aim is to give taxpayers value for money. Hospitals should not be in the hotel business, the argument goes…

Spreading efficiency will not be easy, however. Europeans instinctively recoil from private companies making money from health care. British placards protest against modest reforms with pictures of fat cats helping the health minister to disembowel a patient labelled “NHS” (National Health Service). Even in Sweden, the mood has grown more hostile since some private-equity companies were embroiled in scandals at nursing homes…

Private health-care companies have several advantages over public organisations. They have more incentive to make services more efficient, since they typically keep some of the savings. They are better at persuading their employees to adopt new ideas. And they are better at spreading new ideas across borders. Europe should be proud of its public-health services. But if it wants them still to be affordable in the future, it should allow more private companies into the mix.

Hmmm.  The model socialism that the left so admires is using the profit incentive to fix their national health care.  Which means it must have been broken.  Just to show the differences in the way bureaucrats and ‘for profit’ people think consider the tape ‘X’ on the floor to mark the spot where a defibrillator should be stored.  The centralized authority couldn’t make that happen.  The top-down bureaucracy couldn’t figure a way to make people spend less time looking for a defibrillator.  Just something else to look forward to as Obamacare begins to reorganize American health care from the top down.

Maximizing throughput?  That’s a business term.  An alien concept to those in government.  And to their friends in labor unions.  Which will descend on the health care system under Obamacare.  Who will represent health care workers.  Not patients.  And their answer to everything will be more people working fewer hours.  Which will increase the cost of health care.  Just as it increased costs in American manufacturing.  Chasing it out of the country.  So there will be no maximizing throughput under a government/union controlled health care system.  Just more of what the Swedes are trying to get away from by reintroducing the profit incentive into the health care equation.

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