FT219: “Obamacare will give us rationing and long wait times like America’s other national health care: the VA.” —Old Pithy

Posted by PITHOCRATES - April 25th, 2014

Fundamental truth

Our Veterans have been Wounded and Maimed and we thank them for their Service with the VA

Where do the rich and famous go when they go to a hospital?  They can afford the best.  So you will hear hospitals like Cleveland Clinic, Mayo Clinic, Johns Hopkins, Mount Sinai, etc.  The crème de la crème of the best health care system in the world.  But one name you won’t hear?  Any VA hospital.

Rich and famous people have something our veterans don’t.  Choice.  They can choose to go to the crème de la crème of the best health care system in the world.  While our veterans have no choice but to go to the dregs of the best health care system in the world.  Very often the worst place you can go in the United States for health care.

It’s sad, really.  For our veterans have given more than any other American.  They have put themselves in harm’s way.  Had people shoot at them.  Lob hand grenades at them.  Had mortar rounds and artillery rounds land near them.  And had improvised explosive devices (IED) detonate around them.  Our veterans have been wounded and maimed and faced the hell of combat.  And our thanks for their volunteering to do this for us?  The VA.

Our VA Hospitals are so bad because they know our Military will be good Soldiers and Wait

There aren’t a lot of VA hospitals around.  So some veterans have to travel to get to one.  And when they get there they have to wait.  As there are a lot of other veterans in the waiting room with them.  Because there aren’t a lot of VA hospitals around.  But that’s not the only waiting they’re going to do.

If they need surgery or treatment there will be even more waiting.  A lot more waiting.  Because there aren’t a lot of VA hospitals around.  Or a lot of VA health care providers.  Or a lot of VA diagnostic equipment.  Which means they have to ration out health care in our VA hospitals.  And when you ration health care you make people wait longer for treatment.  An alien concept for the rich and famous.  Who get what they want when they want it.  Because they have choice.

Our veterans, on the other hand, continue to be good soldiers, Marines, sailors and airmen.  And wait.  Just like the old military joke to ‘hurry up and wait’.  Where they will get up before dawn to wait on the tarmac for 4 hours to board an aircraft.  So we’ve trained our military personnel well in waiting.  Perhaps this why our VA hospitals are so bad.  Because they know our military will be good soldiers, Marines, sailors and airmen.  And wait.

VA Hospitals are run so poorly that Veterans are dying as they wait for this National Health Care

The sad thing is that some of our veterans are waiting so long that they are dying (see A fatal wait: Veterans languish and die on a VA hospital’s secret list by Scott Bronstein and Drew Griffin posted 4/24/2014 on CNN).  Because rationing leads to longer wait times.  And longer wait times lead to more deaths.  And this is why the VA hospitals (America’s national health care) are the dregs of the best health care system in the world.

The American left wants national health care.  They want VA hospitals for everyone.  Except them, of course.  For they will be going to the hospitals the rich and famous go to.  But it’s VA hospitals for the rest of us.  Where they will ration health care.  Increase wait times.  And provide some of the most inefficient health care service.  Another reason veterans have to wait so long is that the VA still uses paper records.  Like they did before the 1970s.

The left settled for Obamacare.  They wanted national health care but accepted Obamacare as a stepping stone to national health care.  For they think the government can run health care better than the private sector.  Even though they’ve been running the VA for decades without ever modernizing it.  The government runs the VA hospitals so inefficiently that veterans are dying as they wait for this rationed national health care.  But these same people who can’t bring the VA into the 20th century say they can improve the crème de la crème of the best health care system in the world.  But if they do the VA poorly they will do all national health care poorly.  Because the government just can’t do anything well.

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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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Obamacare will Lead to Rationing and Longer Wait Times just like in the NHS

Posted by PITHOCRATES - August 17th, 2013

Week in Review

Britain has a problem with their national health care.  They have an aging population where people are living longer.  And because they are people are having more hospital stays than people were a generation earlier.  As that last decade or so of life requires a lot of medical care.  And this increase in demand for health care is happening at the same time fewer people are entering the workforce to replace the people leaving it.

So you have falling tax revenue at a time of soaring health care expenditures.  So what do you do when you have a demand that is greater than the available resources?  You ration those precious resources.  And cut costs.  By having fewer people handling a greater workload.  Which, of course, increases the waiting times to see a doctor (see GPs predict longer waiting times – survey by Nick Triggle posted 8/16/2013 on BBC News Health).

A Royal College of General Practitioners poll of 206 UK GPs found that more than 70% were forecasting longer waiting times within two years.

Eight in 10 also said they did not have enough resources to provide high-quality care, the survey showed.

A Patients Association report this year suggested that people were already having to wait longer.

Six in 10 of those polled by the royal college said patients in England were waiting longer than the recommended 48 hours…

Chairman Dr Clare Gerada said: “GPs are grappling with a double whammy of spiralling workloads and dwindling resources, and big cracks are starting to appear in the care and services that we can deliver for our patients.

In the NHS 60% of the people have to wait longer than 48 hours to see a doctor.  Unless they go to an accident and emergency department (A/E).  Where they may only have to wait 4 hours or so.  This is national health care.  And this is where Obamacare is trying to take us.  Even Harry Raid admitted this on the PBS program “Nevada Week in Review.”

So this is the future of Obamacare.  As the US has the same problems the UK has.  An aging population with people living longer into retirement.  With fewer people entering the workforce to pay for them.  So the inevitable future of Obamacare is rationing.  And longer waiting times.  Just as it is the reality in the NHS.

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

Posted by PITHOCRATES - October 21st, 2012

Week in Review

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

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

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

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

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

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

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

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

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

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

Cost effectiveness is expressed as ‘£ per QALY’.

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

How a QALY is calculated

Patient x has a serious, life-threatening condition.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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NHS closes Emergency Departments to Save Costs while Angering Britons

Posted by PITHOCRATES - October 14th, 2012

Week in Review

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

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

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

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

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

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

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

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

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

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

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

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

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

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The NHS works to Reduce Post-Caesarean Infections because they’re not Cost-Effective

Posted by PITHOCRATES - August 4th, 2012

Week in Review

Birth by caesarean section is now 25% of all births in the UK.  Reasons being obesity and women waiting until later in life to have their babies.  And now infections from caesareans are on the rise.  And they’re making these women costly patients.  First the childbirth.  Then the infection.  Consuming two rounds of medical treatments for one childbirth.  And that’s just not good for the business of health care (see Caesarean sections result in infections for one in ten patients, study finds by Denis Campbell posted 7/31/2012 on The Guardian).

One in 10 women who have a baby by caesarean section go on to develop an infection around their scar, which causes them pain and discomfort and forces some to go back into hospital to be treated…

While many of the infections following a caesarean are minor, some are so serious that they affect deep tissues or internal organs, including the lining of the womb…

The number of women giving birth by caesarean section has risen sharply, from 9% in 1980 to 25% in 2009-10, partly as a result of increasing maternal obesity and the trend towards later motherhood…

Dr Elizabeth Sheridan, head of healthcare associated infections at the Health Protection Agency, said the study showed that the NHS should make reducing post-caesarean infections a priority. “Given that one in four women deliver their baby by caesarean section, these infections represent a substantial burden. They will impact not only directly on the mother and her family but also are a significant cost in terms of antibiotic use, GP time and midwife care, and every effort should be made to avoid them”, she said.

In America the proponents of a national health care system like to point to people using the emergency room for their health care.  Because emergency rooms can’t deny treatment.  And when these people don’t pay we all end up paying for it.  So we need a national health care system to fix that.  They also like to pick on the ‘greedy’ pharmaceutical companies who make those life saving drugs no one else but them can make.  But they don’t talk about people exceeding their quota of health care services.

In a national health care system funded by the taxpayer medical care transforms into cost management.  For the usual reasons.  An aging population has more people leaving the workforce than entering the workforce.  And those leaving the workforce consume the majority of the health care services.  So you have the demand for health care services increasing (retirees suffering the effects of aging) while the supply is decreasing (fewer people paying taxes to fund health care services).   So there’s rationing.  Doctors talk about excessive antibiotics consumed by patients.  And the need to reduce the amount of time a patient takes up with doctors and midwives (people who provide care during pregnancies and deliver babies).  Because post-caesarean infections are simply not cost-effective.

Obamacare, too, will transform medical care into cost management.  By using mandates to get more people to pay into the system.  And then having medical boards to ration treatment.  Which they will have to do because America has an aging population, too.  And its population is greater than the UK’s population.  About five times greater.  So if the NHS is rationing care Obamacare will ration care.  And they’ll start tracking the amount of antibiotics a patient gets.  As well as how much time they get to spend with doctors and other health care providers.  Because health care is money.  And when you’ve had your fair share that’s it.  No more health care for you.

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

Posted by PITHOCRATES - April 8th, 2012

Week in Review

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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A Glimpse of Obamacare through the Death of a Child in the NHS

Posted by PITHOCRATES - April 8th, 2012

Week in Review

The problem with health care everywhere is twofold.  Our aging populations.  And our longer life spans that allow people to have more illnesses.  So improvements in medicine are compounding the problem.  By allowing people to live longer so they can consume more medical services.  And unlike manufacturing we can’t use new technology to increase efficiencies.  At least not yet.  So the only way to control costs is to spend less.  Treating only those who are sick.  And sending those who are not quickly on their way.  A health care triage system.  Where they quickly weed out the non-sick to make room for the sick.  To make sure they don’t waste their limited funds and services on those who don’t need it. 

It works well on paper.  But it has one serious drawback in practice.  The ‘assembly line’ triage can only catch the glaringly obvious.  Like a missing leg.  Or blood squirting out of a cut artery.  But if everything looks okay on the outside and the standard tests come back negative, doctors can discharge a patient.  Missing something a little more rare and unusual.  Like dehydration and kidney failure in an otherwise healthy child (see Doctors failed to spot toddler’s fatal illness on THREE occasions before he died by Jill Reilly posted 4/6/2012 on the Daily Mail).

A devastated mother is demanding to find out why her young son died after medics sent him home three times in less than two weeks. 

Harry Connolly died of dehydration and acute kidney failure after medics repeatedly failed to diagnose his illness…

Mrs Connolly said: ‘The fact remains that Harry died as a result of dehydration and acute renal failure despite being admitted to hospital twice and attended by an out-of-hours doctor in the space of just five days.

‘He would have survived if he’d remained in hospital from 26 April and fully rehydrated, he would have survived had he been readmitted on 28 April, and would have survived had the out-of-hours doctor referred him to be readmitted on 29 April.

Suppose the doctors admitted a similar child who proved not to be sick.  Taking a bed in pediatrics.  Taking a doctor away from other patients.  Taking nurses away from those more ill.  Taking up time on diagnostic equipment that they could have used on others actually ill.  Perhaps pushing back someone else in line.  Who may die because of the delay.  Then the doctor responsible for admitting a healthy child has to stand before an administrator.  To explain the waste of resources.  The death of a patient they couldn’t save thanks to the waste of said resources.  And the unnecessary expense of all those tests on a healthy child.  Exceeding the department’s budget.

Sadly, these are real concerns for those in the health care industry today.  Especially in national health care systems.  Like Britain’s National Health Service (NHS).  That are bursting at the seams because of the explosion in costs because of that aging population.  And their longer lives.  Taxing available resources so much that doctors have to carefully ration health care services.  To make sure that they are available for the patients who need them most.

This is the world of national health care.  Where you try to take care of everyone.  With resources that can’t save everyone.  Where the rationing of services leaves some to die.  And causes others to die that they could have saved had they only spent a few more moments on their diagnosis.  So if you want a glimpse into the world of Obamacare, here it is.  It will be like the NHS.  Only bigger.  And because it’s bigger it won’t be as good as the NHS.  Which is the problem with health care for everyone.  We don’t have resources to cover everyone in a national system.  Because the bureaucracy to run it will consume so much of the budget.  Requiring some sort of triage system.  Or death panels.  To ration those limited services.  To choose who to save.  And who to send home.  To let nature take its course.

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Elderly Cancer Patients are not Worth the Cost of Health Care they Consume so the Policy of the NHS is to Let them Die

Posted by PITHOCRATES - March 25th, 2012

Week in Review

Proponents of Obamacare attack the profit-oriented private health insurers, medical device and drug manufacturers and hospitals.  Putting profits before people is wrong and shameful they say.  And just plain wrong.  No, the better way is to do like the Canadians.  And the British.  Adopt a health care system that puts people before profits.  Where everyone can smile and enjoy life.  Content in a perfect world where everyone gets whatever health care they need.  Not just the rich who can afford it.  So, with that in mind, let’s take a look at that health care utopia in the United Kingdom.  And see how wonderfully just, kind and generous their health care truly is (see Elderly dying due to ‘despicable age discrimination in NHS’ by Rebecca Smith posted 3/25/2012 on The Telegraph).

A lack of treatment or insufficient treatment is contributing to 14,000 deaths a year in people over the age of 75, Macmillan Cancer Support has found, in what it called an ‘unacceptable act of discrimination’.

Deaths from cancer are reducing in most age groups but at a slower rate in those aged 74 to 84 and are increasing in people aged 85 and over, the report said.

The report, The Age Old Excuse: the under treatment of older cancer patients, said treatment options are too often recommended on the basis of age rather than how fit the patient is…

Few clinical trials involve older people so clinicians are lacking evidence of how effective drugs may be in elderly people and few cancer specialists have had training in care of older people, the report said.

A survey found six in ten trainee oncologists had not received training in the additional care needs of the elderly such as preventing falls and incontinence management. This is despite half of all cancers occuring in the elderly, the report found…

“The NHS and social care providers must wake up to the specific issues older people face and ensure treatment decisions are based on their overall health not just their date of birth. Writing people off as too old for treatment is utterly shameful.”

This is the future of Obamacare.  This is what happens when the government pays for health care.  The government decides.  They decide who lives.  And who dies.  Who gets treatment.  And who is not worthy of treatment and should consider themselves lucky if they get a pill to dull their pain until they die.  When they finally stop being such an inconvenient and inconsiderate burden to government.

Why is the NHS like this?  Are the British cruel?  No.  It’s just business.  Health care costs continue to rise despite the power of government to stop these costs from rising.  Their population is aging.  And they have a massive budget deficit.  Made up primarily from the budget deficit in the NHS.  Taxes are already high.  And the economy is not doing as well as it once did.  Which means you can’t raise taxes anymore.  Unless you want to crash the economy and reduce tax revenues even further.  And with a massive deficit you can’t borrow anymore.  So if you can’t tax and you can’t borrow and you have an aging population consuming an ever larger share of the health care budget what do you do?  Why, you do what the NHS is doing.  You ration health care.  By making life and death decisions.  And the NHS has made a decision.  Old people over a certain age shall die of cancer.  And they will take that health care and give it to someone else who is more worthy of it.

Bureaucrats making life and death decisions for cost reasons?  Kind of sounds like a death panel, doesn’t it?  Now Obamacare doesn’t include anything called a ‘death panel’ but there will be a death panel.  Because there always is when you ration health care.  Which is what will happen as the government tries to rein in health care costs.  Because that’s the only way they can control costs.  By cutting costs.  And how to you cut costs?  You spend less on life-saving health care services.  And ration these services.  Deciding who has enough value to save.  And who doesn’t and should die.  By authority of the death panel.  The secretary.  Or some other bureaucrat.  Who you hope their life and death decisions are based on costs alone.  And not your politics.

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The National Health Service (NHS) Rations Cancer Treatment in Cumbria

Posted by PITHOCRATES - March 3rd, 2012

Week in Review

The supporters of Obamacare want to go farther.  They want to have what the British have.  A National Health Service (NHS).  Where there are no profits.  Only kind, loving care (see Radiotherapy campaigners march through Kendal posted 3/3/2012 on BBC News Cumbria).

About 2,000 people marched through the streets of a Cumbrian town to call for improved cancer services…

They want to stop cancer patients having to travel for treatment at hospitals outside South Lakeland…

Plans for a new £10m radiotherapy unit in Kendal are currently before health commissioners…

The MP handed a petition with 11,000 signatures to Cumbria director of public health, Dr John Ashton.

Mr Ashton said: “I’d like to see it happen sooner rather than later and I’m concerned that if the health bill goes through it will be in the long grass for some time because the national commissioners will have to make the decision and it won’t be a local decision.”

This is national health care in action.  Making treatment for cancer patients so difficult to get that many just go without and die sooner.  Proving once again national health care is all about costs.  And the rationing of services.  And if you have cancer and live in South Lakeland they will ration your treatment to reduce costs.  So enjoy your national health care.  Where they put people before profits.

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