11:37am UK, Sunday September 07, 2008
Thomas Moore, Health correspondent
Britain's top obesity surgeon has told Sky News he is considering legal action against the NHS for denying patients an operation that would prolong their lives.
Obesity operation
Stomach surgery can reduce appetite
Professor John Baxter said half of all primary care trusts are ignoring NHS guidelines that say morbidly obese patients should have stomach surgery to reduce their appetite.
He believes they strictly limit the procedure because it costs £6,000.
Professor Baxter, who is the president of the British Obesity Surgery Society, said cancer patients have successfully gone to court to win access to expensive new medicines.
He may take similar action to force the NHS to fund surgery - if patients do not beat him to it.
"The case for obesity surgery is overwhelming. It is clearly being rationed," he said.
Thursday, September 11, 2008
Wednesday, March 19, 2008
Health Care Rationing
Oldie but a goodie..
http://www.ncpa.org/w/w50.html
--------------------------------------------------------------------------------
Excerpted From:
John C. Goodman and Gerald L. Musgrave
Patient Power (Washington, DC: Cato Institute, 1992)
--------------------------------------------------------------------------------
Health Care Rationing
Because we could in principle spend many times our gross national product on health care, it must be rationed in some way. The primary way in which it is rationed in the United States is by individual choice. When the expected cost of medical care exceeds its expected benefit, people forego it. For example, some people choose self-medication with nonprescription drugs. What deters them from going to the doctor’s office every time is the physician’s fee, the time cost, the travel cost, lost wages, and other inconveniences. If everyone who purchased nonprescription drugs saw a physician instead, the United States would need 25 times the current number of physicians.
For years, advocates of a government-run health care system have argued that all health care should be free at the point of consumption and that it is unfair (and perhaps also unwise) to ask people to compare the value of health care with the cost of getting it. But if health care were made absolutely costless, the system that provides it would collapse into chaos. Thus, even in countries such as Britain and Canada where health care is theoretically free, people are deterred by other costs (including waiting costs) and an enormous amount of self-rationing goes on.
The alternative to self-rationing is bureaucratic rationing. For example, many large companies are seeking ways to deter health care spending. Most are opting for bureaucratic solutions. But at least one company, Hewlett Packard, announced a plan in 1990 that explicitly calls for employee rationing by choice. The plan involves giving patients more information, encouraging choices between money and medical care, and using physicians as "patient advisers rather than technicians or deliverers of care." Since that time, a number of employers have created Medical Savings Accounts for their employees. Until recently, rationing by bureaucracy in the private sector was rare, confined largely to organ transplants and occasional triage situations in hospitals. Rationing is more frequent in the public sector and is increasing in the Medicare and Medicaid programs.
Outside the United States, every country that has national health insurance rations health care through bureaucracies. It is almost never done through open rational debate. Instead, politicians limit the budgets of hospitals or of area health authorities and leave rationing decisions to the health care bureaucracy. Indeed, politicians almost never admit that they are in any way responsible for rationing.
Among the characteristics of health care rationing as practiced in other developed countries are the following. If health care is rationed by bureaucracies, the tendency is to discriminate in favor of higher-income patients, in favor of whites (especially male whites), and in favor of the young. The sophisticated, the wealthy, and the powerful almost always find their way to the head of rationing lines. Whereas markets empower individuals, bureaucracies empower special interests.
Rationing decisions in the United States appear to be no different. Studies have discovered that, when transplants are rationed, bureaucracies appear to discriminate on the basis of income, race, and sex. For example, a study by the Urban Institute found that, for black and white males, the higher their income, the more likely they are to receive an organ transplant. In 1988, according to the United Network for Organ Sharing, whites received 97.6 percent of the pancreases and high percentages of livers, kidneys, and hearts; and men received 79.2 percent of hearts, 60.6 percent of kidneys, and 54.4 percent of pancreases. According to the American Society of Transplant Physicians, although the rate of end-stage renal disease is four times higher among blacks than among whites, blacks constitute 28 percent of the kidney patients and receive only 21 percent of the kidney transplants. The Pittsburgh Press found that if the donors were not living relatives, the average wait for a kidney transplant in 1988 and 1989 was 14 months for black patients and only 8.8 months for whites.
In the United States, the elderly have a privileged position with respect to health care. Medicare covers virtually all of them, plus people under 65 who are disabled. But in other countries, where the entire population is part of the same government-funded health care plan, the elderly are usually pushed to the end of the rationing lines. Thus, in Britain, it is extremely difficult for an elderly patient to get kidney dialysis or a kidney transplant - or any other transplant, for that matter. Moreover, pressures that have developed in other countries are developing in our own. Former Colorado governor Richard Lamm and other prominent individuals (including "medical ethicists") are calling for rationing health care to the elderly and reallocating the funds to the younger population.
Until a few years ago, most health policy analysts did not believe in health care rationing. Their goal was to lower all financial barriers through public and private insurance and to meet any and all needs. Today, almost everyone recognizes that rationing is necessary. The all too often tendency, however, is to believe that rationing discussions should be controlled by health care bureaucracies and not by individual patients.
In an ideal system, rationing would be by patient choice wherever possible. The system would be organized so that people would have the funds necessary to purchase health care through medical savings and reimbursements from insurers. But people would have strong incentives not to purchase health care unless the expected value of the care were greater than the monetary costs. Patients, of course, could consult their physicians. But the power of choice would be in the hands of the patients, not the bureaucrats.
http://www.ncpa.org/w/w50.html
--------------------------------------------------------------------------------
Excerpted From:
John C. Goodman and Gerald L. Musgrave
Patient Power (Washington, DC: Cato Institute, 1992)
--------------------------------------------------------------------------------
Health Care Rationing
Because we could in principle spend many times our gross national product on health care, it must be rationed in some way. The primary way in which it is rationed in the United States is by individual choice. When the expected cost of medical care exceeds its expected benefit, people forego it. For example, some people choose self-medication with nonprescription drugs. What deters them from going to the doctor’s office every time is the physician’s fee, the time cost, the travel cost, lost wages, and other inconveniences. If everyone who purchased nonprescription drugs saw a physician instead, the United States would need 25 times the current number of physicians.
For years, advocates of a government-run health care system have argued that all health care should be free at the point of consumption and that it is unfair (and perhaps also unwise) to ask people to compare the value of health care with the cost of getting it. But if health care were made absolutely costless, the system that provides it would collapse into chaos. Thus, even in countries such as Britain and Canada where health care is theoretically free, people are deterred by other costs (including waiting costs) and an enormous amount of self-rationing goes on.
The alternative to self-rationing is bureaucratic rationing. For example, many large companies are seeking ways to deter health care spending. Most are opting for bureaucratic solutions. But at least one company, Hewlett Packard, announced a plan in 1990 that explicitly calls for employee rationing by choice. The plan involves giving patients more information, encouraging choices between money and medical care, and using physicians as "patient advisers rather than technicians or deliverers of care." Since that time, a number of employers have created Medical Savings Accounts for their employees. Until recently, rationing by bureaucracy in the private sector was rare, confined largely to organ transplants and occasional triage situations in hospitals. Rationing is more frequent in the public sector and is increasing in the Medicare and Medicaid programs.
Outside the United States, every country that has national health insurance rations health care through bureaucracies. It is almost never done through open rational debate. Instead, politicians limit the budgets of hospitals or of area health authorities and leave rationing decisions to the health care bureaucracy. Indeed, politicians almost never admit that they are in any way responsible for rationing.
Among the characteristics of health care rationing as practiced in other developed countries are the following. If health care is rationed by bureaucracies, the tendency is to discriminate in favor of higher-income patients, in favor of whites (especially male whites), and in favor of the young. The sophisticated, the wealthy, and the powerful almost always find their way to the head of rationing lines. Whereas markets empower individuals, bureaucracies empower special interests.
Rationing decisions in the United States appear to be no different. Studies have discovered that, when transplants are rationed, bureaucracies appear to discriminate on the basis of income, race, and sex. For example, a study by the Urban Institute found that, for black and white males, the higher their income, the more likely they are to receive an organ transplant. In 1988, according to the United Network for Organ Sharing, whites received 97.6 percent of the pancreases and high percentages of livers, kidneys, and hearts; and men received 79.2 percent of hearts, 60.6 percent of kidneys, and 54.4 percent of pancreases. According to the American Society of Transplant Physicians, although the rate of end-stage renal disease is four times higher among blacks than among whites, blacks constitute 28 percent of the kidney patients and receive only 21 percent of the kidney transplants. The Pittsburgh Press found that if the donors were not living relatives, the average wait for a kidney transplant in 1988 and 1989 was 14 months for black patients and only 8.8 months for whites.
In the United States, the elderly have a privileged position with respect to health care. Medicare covers virtually all of them, plus people under 65 who are disabled. But in other countries, where the entire population is part of the same government-funded health care plan, the elderly are usually pushed to the end of the rationing lines. Thus, in Britain, it is extremely difficult for an elderly patient to get kidney dialysis or a kidney transplant - or any other transplant, for that matter. Moreover, pressures that have developed in other countries are developing in our own. Former Colorado governor Richard Lamm and other prominent individuals (including "medical ethicists") are calling for rationing health care to the elderly and reallocating the funds to the younger population.
Until a few years ago, most health policy analysts did not believe in health care rationing. Their goal was to lower all financial barriers through public and private insurance and to meet any and all needs. Today, almost everyone recognizes that rationing is necessary. The all too often tendency, however, is to believe that rationing discussions should be controlled by health care bureaucracies and not by individual patients.
In an ideal system, rationing would be by patient choice wherever possible. The system would be organized so that people would have the funds necessary to purchase health care through medical savings and reimbursements from insurers. But people would have strong incentives not to purchase health care unless the expected value of the care were greater than the monetary costs. Patients, of course, could consult their physicians. But the power of choice would be in the hands of the patients, not the bureaucrats.
Tuesday, March 18, 2008
Granny victim of colostomy confusion
A German woman went into the hospital for a leg operation and came out with a colostomy. Gotta love that socialized medicine.
Published: 14 Mar 08 14:48 CET
Online: http://www.thelocal.de/10695/
German authorities said on Friday they are investigating an incident medical of malpractice involving an elderly woman in Bavaria, who has mistakenly received a colostomy instead of a leg operation.
The Friday edition of local daily Frankenpost reported a 78-year-old woman in the Bavarian town of Münchberg has been the victim of an operating table mix-up.
On February 29, the woman mistakenly underwent a colostomy procedure instead of a leg operation, the paper reported. Members of medical team involved in the incident have since been suspended from their duties. According to Frankenpost, two of these doctors were chief physicians.
A hospital official said the facility regrets the mistake, and reacted to the mix-up immediately by notifying the patient, her relatives, and the appropriate authorities.
Published: 14 Mar 08 14:48 CET
Online: http://www.thelocal.de/10695/
German authorities said on Friday they are investigating an incident medical of malpractice involving an elderly woman in Bavaria, who has mistakenly received a colostomy instead of a leg operation.
The Friday edition of local daily Frankenpost reported a 78-year-old woman in the Bavarian town of Münchberg has been the victim of an operating table mix-up.
On February 29, the woman mistakenly underwent a colostomy procedure instead of a leg operation, the paper reported. Members of medical team involved in the incident have since been suspended from their duties. According to Frankenpost, two of these doctors were chief physicians.
A hospital official said the facility regrets the mistake, and reacted to the mix-up immediately by notifying the patient, her relatives, and the appropriate authorities.
Thursday, February 14, 2008
Senior benefit costs up 24%
The cost for the government to spend your tax dollars for senior citizens soared to a record $27,289 per senior in 2007. Last year, for the first time ever, healthcare and nursing homes cost the tax payers more than Social Security payments, which averaged $13,184 per senior in 2007. That means that the government spent $952 billion of your tax dollars in 2007 on elderly benefits. That is up from $601 billion in 2000.
Remember this ... seniors vote. Seniors vote in large numbers. Politicians know where to spend the money to buy votes. Why do you think I call them the "Gimme Generation?"
Senior benefit costs up 24%
By Dennis Cauchon
USA TODAY
The cost of government benefits for seniors soared to a record $27,289 per senior in 2007, according to a USA TODAY analysis.
That's a 24% increase above the inflation rate since 2000. Medical costs are the biggest reason. Last year, for the first time, health care and nursing homes cost the government more than Social Security payments for seniors age 65 and older. The average Social Security benefit per senior in 2007 was $13,184.
"We have a health care crisis. We don't have an entitlement crisis," says David Certner, legislative policy director of the AARP, which represents seniors.
He says seniors shouldn't be blamed for the growing cost of government retirement programs.
The federal government spent $952 billion in 2007 on elderly benefits, up from $601 billion in 2000. It's the biggest function of the federal government. States chipped in $27 billion more in 2007, mostly for nursing homes.
All three major senior programs — Social Security, Medicare and Medicaid — experienced dramatically escalating costs that outstripped inflation and the growth in the senior population.
Benefits per senior are soaring at a time when the senior population is not. The portion of the U.S. population ages 65 and older has been constant at 12% since 2000.
The senior boom, however, starts big time in 2011, when the first baby boomers — 79 million people born between 1946 and 1964 — turn 65 and qualify for Medicare health insurance. The oldest baby boomers turn 62 this year and qualify for Social Security at reduced benefits.
USA TODAY used a variety of government data to calculate the cost of providing Social Security, medical benefits and long-term care to an aging population. Billions of dollars paid to non-seniors — the disabled, children and others in the programs — were removed to create an estimate that focuses exclusively on seniors.
Findings include:
•Medicare experienced the most explosive growth from 2000 to 2007. The Medicare prescription-drug benefit, started in 2006, accounts for about one-fourth of the increase in Medicare, which provides health benefits for people 65 and older.
•Long-term care costs per senior have declined slightly in the past three years because of a move away from nursing homes to less expensive home care.
•The cost of senior benefits is equal to $10,673 for every non-senior household.
•About 35% of the federal budget is spent on senior benefits, up from 32% in 2004.
Eugene Steuerle, a senior fellow at the non-partisan Urban Institute, notes that the full cost of senior benefits goes beyond Social Security, Medicare and Medicaid. A complete estimate would include other programs for retirees, such as military and civil servant pensions and medical benefits, he says.
The Urban Institute estimates that kids receive an average of about $4,000 per child in benefits, including the child tax credit and other indirect assistance.
Economist Dean Baker calls it "granny bashing" to focus on the cost of senior benefits. The elderly paid a designated tax for Social Security and Medicare taxes during their decades of working to support these programs when they retired, says Baker, co-director of the liberal Center for Economic Policy and Research.
Remember this ... seniors vote. Seniors vote in large numbers. Politicians know where to spend the money to buy votes. Why do you think I call them the "Gimme Generation?"
Senior benefit costs up 24%
By Dennis Cauchon
USA TODAY
The cost of government benefits for seniors soared to a record $27,289 per senior in 2007, according to a USA TODAY analysis.
That's a 24% increase above the inflation rate since 2000. Medical costs are the biggest reason. Last year, for the first time, health care and nursing homes cost the government more than Social Security payments for seniors age 65 and older. The average Social Security benefit per senior in 2007 was $13,184.
"We have a health care crisis. We don't have an entitlement crisis," says David Certner, legislative policy director of the AARP, which represents seniors.
He says seniors shouldn't be blamed for the growing cost of government retirement programs.
The federal government spent $952 billion in 2007 on elderly benefits, up from $601 billion in 2000. It's the biggest function of the federal government. States chipped in $27 billion more in 2007, mostly for nursing homes.
All three major senior programs — Social Security, Medicare and Medicaid — experienced dramatically escalating costs that outstripped inflation and the growth in the senior population.
Benefits per senior are soaring at a time when the senior population is not. The portion of the U.S. population ages 65 and older has been constant at 12% since 2000.
The senior boom, however, starts big time in 2011, when the first baby boomers — 79 million people born between 1946 and 1964 — turn 65 and qualify for Medicare health insurance. The oldest baby boomers turn 62 this year and qualify for Social Security at reduced benefits.
USA TODAY used a variety of government data to calculate the cost of providing Social Security, medical benefits and long-term care to an aging population. Billions of dollars paid to non-seniors — the disabled, children and others in the programs — were removed to create an estimate that focuses exclusively on seniors.
Findings include:
•Medicare experienced the most explosive growth from 2000 to 2007. The Medicare prescription-drug benefit, started in 2006, accounts for about one-fourth of the increase in Medicare, which provides health benefits for people 65 and older.
•Long-term care costs per senior have declined slightly in the past three years because of a move away from nursing homes to less expensive home care.
•The cost of senior benefits is equal to $10,673 for every non-senior household.
•About 35% of the federal budget is spent on senior benefits, up from 32% in 2004.
Eugene Steuerle, a senior fellow at the non-partisan Urban Institute, notes that the full cost of senior benefits goes beyond Social Security, Medicare and Medicaid. A complete estimate would include other programs for retirees, such as military and civil servant pensions and medical benefits, he says.
The Urban Institute estimates that kids receive an average of about $4,000 per child in benefits, including the child tax credit and other indirect assistance.
Economist Dean Baker calls it "granny bashing" to focus on the cost of senior benefits. The elderly paid a designated tax for Social Security and Medicare taxes during their decades of working to support these programs when they retired, says Baker, co-director of the liberal Center for Economic Policy and Research.
Thursday, January 17, 2008
Gordon Brown Wants Your Organs
by Susan Easton
Posted: 01/17/2008
The UK Nanny State just revealed its latest agenda item and it is decidedly ghoulish. Last week, British (but really Scottish) Prime Minister, Gordon Brown, announced his support of a Labour government plan to snatch the body parts of any citizen. The good news is that this policy only applies to dead people. The bad news is obvious. This is the ultimate death tax, surgically extracted.
Without any apparent squeamishness, Gordon Brown backed the Presumed Consent Scheme (they often call programs “schemes” in England) to redress the demand for transplanted organs by fiat. Here’s the deal. Rather than go looking for those bothersome donor cards on a fresh cadaver, the British populace is now fair game. If you don’t specifically carry a card saying “leave my corpse alone” -- known as “the opt out option”, or unless one’s family is on hand to object, one’s remains are considered fair game for an organ harvest festival.
The justification for adopting Presumed Consent is a function of a recognized market deficit. The Government has noticed that 1000 patients die annually while waiting for a critically-needed transplant. Another 8000 are on various organ waiting lists hoping to get lucky when they go critical or for just the right replacement part to turn up in the chop shop.
According to the NHS Organ Donor Registry, there are more than 14 million Brits who have voluntarily listed themselves as donors, however, one third of all families refuse consent for organ donation when a loved one dies, usually in unexpected circumstances. In typical fashion, the government plans to overcome this donor reluctance by setting up -- you guessed it -- a new Task Force to enlighten the populace about the importance of giving this gift of life.
Posted: 01/17/2008
The UK Nanny State just revealed its latest agenda item and it is decidedly ghoulish. Last week, British (but really Scottish) Prime Minister, Gordon Brown, announced his support of a Labour government plan to snatch the body parts of any citizen. The good news is that this policy only applies to dead people. The bad news is obvious. This is the ultimate death tax, surgically extracted.
Without any apparent squeamishness, Gordon Brown backed the Presumed Consent Scheme (they often call programs “schemes” in England) to redress the demand for transplanted organs by fiat. Here’s the deal. Rather than go looking for those bothersome donor cards on a fresh cadaver, the British populace is now fair game. If you don’t specifically carry a card saying “leave my corpse alone” -- known as “the opt out option”, or unless one’s family is on hand to object, one’s remains are considered fair game for an organ harvest festival.
The justification for adopting Presumed Consent is a function of a recognized market deficit. The Government has noticed that 1000 patients die annually while waiting for a critically-needed transplant. Another 8000 are on various organ waiting lists hoping to get lucky when they go critical or for just the right replacement part to turn up in the chop shop.
According to the NHS Organ Donor Registry, there are more than 14 million Brits who have voluntarily listed themselves as donors, however, one third of all families refuse consent for organ donation when a loved one dies, usually in unexpected circumstances. In typical fashion, the government plans to overcome this donor reluctance by setting up -- you guessed it -- a new Task Force to enlighten the populace about the importance of giving this gift of life.
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