The blogspot version of this blog is HERE. The Blogroll. My Home Page. Email John Ray here. Other mirror sites: Greenie Watch, Political Correctness Watch, Education Watch, Immigration Watch, Food & Health Skeptic, Gun Watch, Dissecting Leftism, Eye on Britain, Recipes, Tongue Tied and Australian Politics. For a list of backups viewable in China, see here. (Click "Refresh" on your browser if background colour is missing) See here or here for the archives of this site
****************************************************************************************



24 March, 2010

Blog suspended

Now that the battle against socialized medicine in America is largely over, I have decided to suspend publication of this blog. I will of course still be posting on the issue when matters of particular interest arise but I will do so on DISSECTING LEFTISM from now on -- as you will see currently. My AUSTRALIAN POLITICS blog will also continue to cover the disasters of socialized medicine in Australia.





23 March, 2010

Landmark health care plan passes

House Democrats rallied late Sunday night to pass President Obama's landmark health care overhaul plan and send to the president's desk the politically risky initiative, which Republicans vow to wield against the Democrats in November's mid-term elections. A companion package of repairs to the bill now heads to a Senate fight. But regardless of the outcome there, Mr. Obama's yearlong struggle for his signature initiative is just a stroke of his pen away from becoming law.

The Senate's health care bill squeaked through the House in a 219-212 vote, with 34 Democrats joining all 178 Republicans in opposition after a last-minute White House executive order convinced a small group of pro-life Democrats that the bill wouldn't fund abortions. The companion "fixes" bill passed 220 to 211, with 33 Democrats joining all 178 Republicans in opposition.

Democrats hailed the vote as one of the most significant change in American social policy since the creation of Medicare in 1965 or Social Security in 1935. "This is an American proposal that honors the traditions of our country," House Speaker Nancy Pelosi said, adding that access to health care is in the same league as the Declaration of Independence's claims about the inalienable rights to "life, liberty and the pursuit of happiness."

The 10-year, $940 billion overhaul plan aims to reshape the nation's health system by imposing new reforms on the insurance industry and guaranteeing insurance coverage to nearly all Americans with hopes of reducing health care costs and the federal deficit. "This is what change looks like," Mr. Obama said at the White House shortly after the vote, which he watched in the Roosevelt Room with Vice President Joseph R. Biden Jr.

Outside the Capitol, a few hundred protesters shouted "Kill the bill." Walking from a House office building to the Capitol on Sunday afternoon, Mrs. Pelosi linked arms with Rep. John Lewis, a Georgia Democrat who walked in the civil rights marches in Selma, Ala., in the 1960s and who said he was called a racial epithet by health care protesters on Saturday. Republicans called it an isolated incident and maintained their opposition to the health reform plan.

They argue that cuts to Medicare would undoubtedly hurt seniors' coverage, that insurance premiums for all Americans would spike, and that Democrats won't be able to make good on Mr. Obama's often-repeated promise that "if you like your plan, you can keep it." "The decisions we make will affect every man, woman and child in this nation for generations to come," Minority Leader John A. Boehner said. "This bill is not what the American people need." Mr. Boehner and Sen. Jim DeMint, South Carolina Republican, separately promised to introduce legislation to try to repeal the plan.

Mr. Obama, in his pitch to Democrats on Capitol Hill in recent weeks, said that much of his presidency is on the line with passage of his overhaul plan. It marks the most significant legislative accomplish of his presidency. But it would be a victory with a large asterisk. The Senate promised House members that it will be able to pass a companion bill to "repair" controversial provisions in the bill, such as a tax on high-cost insurance plans and state-specific deals that critics say were meant to buy votes. Mr. Obama could sign the Senate bill into law immediately. But doing so without the Senate repair bill would likely anger House members.

The debate over how to reform the $2.5 trillion health care industry has taken on a deeply partisan tone for more than a year. Many of the moderate Democrats who won Republican-leaning districts on Mr. Obama's coattails in 2008 acknowledged that their support may cost them their jobs this November as the overhaul hasn't polled well.

Democrats say that support will shift once Americans see the plan's benefits -- the poor will get tax credits to help them meet the requirement to buy insurance coverage; their insurance company won't be able to impose lifetime or annual caps on coverage or deny coverage because of pre-existing conditions; young adults can stay on their parents' plan until age 26; and Medicare's gap in drug coverage will be filled. It's paid for through cuts to Medicare funding, which Democrats say will only cut waste and fraud, and a new Medicare tax on unearned income, such as investment profits, of couples making over $250,000 and individuals making over $200,000.

Abortion threatened to hold up the vote until almost the last minute. A group of about 10 pro-life Democrats said they wouldn't vote for the Senate plan unless they had a guarantee that it wouldn't allow for federal funding of abortions. They were concerned the bill would allow federal tax subsidies to fund insurance policies that cover the procedure and that funding for community health centers would not come with a prohibition on covering abortions. But their objections were met with an executive order Mr. Obama issued on Sunday affirming that the bill wouldn't do so.

Catholic groups have been divided over whether the Senate bill would authorize the federal funding of abortions, with the U.S. Conference of Catholic Bishops staunchly opposed to the Senate plan; but others, such as a group of hundreds of nuns, endorsed the plan last week. Catholic Advocate, a 501(c)(3) lobbying group, said Sunday that passing the Senate bill would account for one of the greatest expansions of abortion since the landmark Roe v. Wade Supreme Court ruling and promised to contest House members who supported it.

But the executive order was thought to be enough to push Democrats over the 216 mark required for passage. The companion reconciliation bill would remove the Senate's tax on high-cost insurance plans, federal funding for Nebraska's Medicaid costs and other problems House members had with the Senate plan. The Senate is expected to start work on the bill on Tuesday.

Over the weekend, Democrats decided against using a controversial procedure, called "deem and pass," that would have allowed both bills to pass with one vote. Republicans had called it a parliamentary trick. The vote required House members to take a bit of a leap of faith that the Senate was going to be able to deliver on the companion bill. They now have no leverage left since the Senate bill can go to Mr. Obama's desk and become law despite their grave misgivings about it. Senate Democratic leaders are expected to easily come up with the 51 votes they need. "There's a strong desire to do what's in that bill," Sen. Debbie Stabenow, Michigan Democrat, told reporters last week.

But it's a potentially difficult climb for the Senate as reconciliation rules allow Republicans to introduce an unlimited number of amendments and require each provision of the bill to affect the budget or be struck by the Senate's nonpartisan parliamentarian. If the bill is changed at all, in the form of amendments or budget strikes, it will have to go back to the House for another vote, throwing another wrench into the process.

Republicans have promised a fight, warning they plan to put up every procedural obstacle they can. They've already eyed parts of the bill that they contend are not related to the budget and can be brought up as a violation of the so-called "Byrd" rule.

Mrs. Pelosi said Friday that she doesn't foresee any Byrd-rule violations surviving. "We tried to have a 'Byrd' scrub," she said, but "the parliamentarian would not necessarily give us definitive answers on anything."

Republicans said Sunday they like their chances on an objection that the bill affects Social Security, which would be a violation of budget rules. If the parliamentarian agrees and the presiding officer of the Senate upholds the decision, Democrats would need 60 votes to override the decision. All 41 Republicans recently signed a letter saying they will object to overriding the parliamentarian. "We've informed our colleagues in the House that we believe the bill they're now considering violates the clear language of Section 310g of the Congressional Budget Act, and the entire reconciliation bill is subject to a point of order and rejection in the Senate should it pass the House," said Don Stewart, spokesman for Senate Republican leader Mitch McConnell of Kentucky.

SOURCE




Democrats' death by suicide

The government takeover of health care will go down in history as the worst piece of legislation to emerge from a Congress held in general disdain by the American people. The only bipartisanship on the health bill was in the opposition.

Usually autopsies are reserved for after the patient has died, but in this case it is useful to get ahead of the matter. The malformed health legislation is not the only reason Democrats are facing political extinction in November, but it is one of the most dramatic. The legislative process in this country has never been so unseemly. Arm twisting, backroom deals, special privileges and potentially criminal "government jobs for votes" agreements became a normal way of doing business. House Speaker Nancy Pelosi fixated on the mantra that the Democrats' health plan is "historic," but so was the Black Plague.

President Obama went to Capitol Hill on Saturday to give a final pep talk to Democrats, where he absurdly called his socialist health care measure "one of the biggest deficit reduction measures in history." This contradicts the chief actuary at the Centers for Medicare and Medicaid Services, who says his staff currently has no idea what the impact of the plan is "due to the complexity of the legislation." Democrats have been hoodwinked into believing they won't pay a political price for their actions, but they will soon discover they miscalculated.

The new system will suffer a tsunami of bad publicity when states sue the federal government over unfunded mandates, when the IRS begins enforcing the aspects of the bill that voters never knew existed, when small businesses start firing employees because they cannot afford the higher costs of the new system, when new and unforeseen costs blow out the already record federal budget deficit, and when seniors begin to feel the impact of Medicare cuts. All of this is what Mr. Obama euphemistically calls "bending the curve" but which seniors will find out is better termed "denial of care." Whether the formal "death panels" will convene before the November elections is still to be determined.

Many members of Congress probably don't know exactly what is in the bill. The 2,300 pages of "fixes" to the Senate bill presented last week were only a draft, and no member can be certain what has been slipped in. A frantic Democratic Party memo sent out Thursday instructed members -- twice, in italics -- not to "get into a discussion of details of the [Congressional Budget Office] scores and the textual narrative" with the bill's opponents. But the devil was in those details. Mrs. Pelosi's offhand statement that members would learn what was in the bill after it was passed should have been a warning.

The majority party was even having problems over the weekend determining if they could vote to amend a law before it was signed by the president. It is a sad day for America when senior members of Congress either dont understand the Constitution or no longer think it applies.

Democrats in Congress refuse to believe the contempt with which the American people hold them. Gallup shows congressional approval ratings in the teens and headed downward. Gallup also found that "more Americans believe the new legislation will make things worse rather than better for the U.S. as a whole, as well as for them personally."

Democrats are in much worse shape than in 1994 when they lost power, and the opposition is far more energized. Once voters have a chance to tell the most irresponsible government in American history that enough is enough, the Democrats' brief reign will expire, and be deemed death by suicide.

SOURCE




Burned girl 'turned away' from British hospital

A five-year-old girl with severe burns was turned away from hospital and her parents forced to drive 25 miles before doctors would treat her. Madison Healy was turned away from Coventry's University Hospital after her clothes caught fire in a freak accident at home. Her mother Alana Regan, 27, took her to A&E, expecting her daughter's injuries to be treated swiftly.

Instead, she says a doctor merely "poked at her leg" before telling her and her partner John Austin, 33, they would have to drive Madison to a specialist burns unit 25 miles away themselves. The Coventry couple, who had no money for petrol and did not know the way drove for an hour before doctors at Birmingham Children's Hospital were able to treat her. There it was discovered Madison had third degree burns requiring a skin graft plus years of treatment and physiotherapy in the future.

Now, Ms Regan has filed an official complaint against University Hospital, saying they let down her seriously injured child. Ms Regan said: "She is only a five-year-old girl and she should have been treated with more priority. "She suffered long term, life-changing injuries and they should have treated her with more compassion and urgency."

A spokesman for University Hospital said Madison had been seen by triage staff within four minutes of arriving at A&E and given painkillers. He added within 50 minutes she went on to be reviewed again by a doctor. "In line with our pediatric pathway relating to burns and scalds Madison was referred to Birmingham Children's Hospital who were advised to expect her arrival and provide ongoing specialist service.

"As the burn was categorised as a small burn covering less than one per cent of the total body surface it is considered safe and within guidelines to transfer by car with a written referral and full directions. "The Trust do apologise if the family felt distressed, however Madison did not require resuscitation or treatment during her transfer."

SOURCE





22 March, 2010

MORE INSPIRATION FROM BRITAIN

Four articles below from ONE DAY show what Americans can expect under Obamacare

The NHS bungles never stop

Man left infertile after wrong testicle disabled

A man was left infertile when he had part of the wrong testicle removed by surgeons. Doctors were supposed to cut away the patient's right epididymis - one of two narrow tubes connected to the testes which is used to store mature sperm. But the patient's left epididymis was removed by mistake at the West Suffolk Hospital in Bury St Edmunds. Surgeons had to operate on his again to take out his other epididymis after the blunder was discovered and the man was left infertile.

Officials at the NHS hospital have refused to identify the man or confirm if he was paid compensation.

A major investigation was launched into the error and the hospital has now introduced more stringent procedures to stop it happening again. Nigel Kee, the hospital's interim chief operating officer, said: "The safety of our patients is our number one priority. "As such, we take any incidents which compromise safety extremely seriously.

"A thorough investigation into this case was carried out by an independent consultant, who advised us to introduce an additional hospital-wide policy giving clearer instructions on marking and verifying sites prior to surgery. "We implemented this recommendation immediately."

SOURCE




British TV star's death was 'unnecessary and preventable': Her doctor launches attack on NHS

Jade Goody's death was preventable and a result of 'incompetence and neglect' by the NHS, a leading doctor and Harley Street consultant claimed today. One year after the 27-year-old died on March 22, Dr Ann Coxon said Goody's symptoms - which included heavy and irregular bleeding, pain and abnormal smear tests - were 'glaringly obvious'.

The former NHS doctor claimed the reality television star had a tangerine-sized tumour which medical experts failed to spot. 'There should have been alarm bells ringing,' she told The Sun. 'Jade's death was completely unnecessary and preventable. She died of neglect and incompetence.'

Despite strong evidence of cervical cancer, Jade did not suspect anything serious was wrong due to her medical history. 'She'd had abnormal smear tests since she was 16 so by the time she was 27 it didn't worry her much, because she didn't really know what it meant,' Coxon said. 'It had never been properly explained to her.

'After she was diagnosed she said to me, in that typically Jade way, "I'm not daft. If I'd known it was to do with cancer, I'd have been checked out every three months". She added: 'Jade realised she had been let down. She simply said, "Sometimes people make mistakes".'

The mother-of-two, who became a star as a contestant on Big Brother, refused to attend scheduled smear tests after being told she could not have any more children, Coxon alleged. This was nine months prior to her diagnosis.

Jade was given an ultrasound at the Princess Alexandra Hospital in Harlow, Essex, in August 2008. She then flew to India to appear in a reality television show after doctors had confirmed she could travel. However, results of a smear test - only performed because a nurse noticed she had skipped appointments - revealed cancerous cells. Goody received the news she had cervical cancer on camera and flew back to the UK where she was treated by Coxon.

The doctor said: 'An ultrasound should be able to pick up lesions just 1.2mm wide, and Jade had a tumour the size of a tangerine. It should have been blindingly obvious.'

Jade underwent an emergency hysterectomy, chemotherapy and radiation therapy - but it was too late to save the star. 'She probably had cancer for at least a year before her diagnosis. The abnormal smear tests were signs that she was high-risk,' said Coxon. 'She was only diagnosed because of one nurse bothering to do her job.'

SOURCE




Girl, 9, saved by optician after NHS doctors fail to spot plum-sized brain tumour SIX times

For money reasons, diagnostic scans are avoided

A nine-year-old girl whose brain tumour was missed by doctors six times was saved by opticians after her worried mother took her for an eye test. Shanice Bailey could have been left paralysed by a rare plum-sized 'schwannoma' tumour growing out of a nerve and pressing on her brain stem. She visited GPs six times between September 2009 and January this year complaining of headaches and sickness but was repeatedly diagnosed with asthma and sent away.

Only when Shanice developed a squint in her left eye did her mother Laura, 27, decide to take her for an eye test - where Specsavers optician Nadia Ahmed immediately spotted the growth. Ms Ahmen told Ms Bailey to take her daughter straight to Queen Elizabeth Hospital in King's Lynn, Norfolk, where a scan revealed the two inch tumour. Eleven days later surgeons removed the tumour in a nine-hour operation.

Despite spending a month in hospital with side-effects Shanice is now at home recovering with her family. Ms Bailey, from Wisbech, Cambs., said she would be forever grateful to the optician. ‘It's so lucky we went to Specsavers when we did, otherwise the effects could have been devastating. ‘I kept taking Shanice back to the doctor as her symptoms got worse and more frequent. ‘Originally they said her symptoms could mean anything but then they thought it was asthma because she was coughing when she was sick. ‘She has been so brave it was unbelievable - she hasn't cried once.

‘If they hadn't have found the tumour she could have died because it was blocking fluid at the top of her spine. ‘I don't necessarily blame the doctors but they should be given more training to check for problems in these areas. Just because it's rare doesn't mean they should ignore it.’

Laura took Shanice to the Clarkson Surgery in Wisbech over five months where she was seen three times by one GP and by a different doctor on every other occasion. On their last visit, the doctor referred Shanice for an appointment with a paediatrician on January 20 to work out why her mystery symptoms were persisting.

But she had the eye appointment on January 3 where optician Ms Ahmen used a magnifying light that picked up swelling on the optic nerves.

The schwannoma tumour is usually only found in elderly women but the benign growth was coming out of Shanice's hyoglossal nerve and blocking fluid at the top of her spine. A week after her surgery the youngster also suffered from a vasospasm, where blood gets into the brain, and needed a second operation to drain cerebrospinal fluid.

Shanice said she felt great after her ordeal. ‘I feel so much better now. I can do things I couldn't do before like my favourite street dancing classes,’ she said.

Trevor Lawson, a spokesman for Brain Tumour UK, said Shanice's type of tumour was extremely rare in such a young child. ‘To my knowledge in the last five years no children were reported to have suffered that from type of tumour, which was responsible for only six per cent of all adult cases,’ he said. ‘The challenge for doctors is that brain tumours can present with common symptoms and we regularly support people who were diagnosed after an eye test.’

Paul Eagling, manager of Specsavers in Wisbech, said he was ‘extremely pleased’ they had been able to spot the growth. ‘Benign tumours can leave people with long term problems and we believe every brain tumour case should be given the same level of attention as cancer. ‘People tend to only go to the opticians when they have problems with their eyesight but regular visits to the optician are vital for checking general eye health.’

SOURCE




Hundreds may have died in British ambulance blunder

An inquiry is being demanded into ambulance services after a Sunday Telegraph investigation uncovered a major flaw in the 999 [emergency number] system that may have left hundreds dead. Doctors, politicians and charities have called for the inquiry to examine how a mistake by ambulance chiefs led to delays in despatching paramedics.

The scandal is exposed by the death of a woman who was left for 38 minutes after an emergency call was received despite the fact that she was unconscious and breathing abnormally, having fallen 12ft. Call handlers following automated advice provided by a computer program categorised the case of Bonnie Mason, who died last May, as a lower priority than that of a drunk woman who had fallen on the pavement. By the time paramedics reached Mrs Mason, 58, she could not be saved.

An investigation by The Sunday Telegraph has uncovered a critical danger placed in the software used by most ambulance services. It meant that for a decade, 999 calls in which a patient lay unconscious and struggled to breathe after a fall of 6ft or more were “downgraded”, with call handlers told not to send the most urgent response. Some services told operatives to “override” the flaw, but The Sunday Telegraph has established that five out of 12 of England’s ambulance trusts told call handlers not to diverge from the automated advice.

Last night experts demanded an inquiry to establish how many patients had suffered because of the blunders. John Heyworth, of the College of Emergency Medicine, said the potential risks were devastating. He said: “Any system which isn’t prioritising accurately needs review because the consequences are so catastrophic.”

Peter Walsh, of the charity Action Against Medical Accidents last night expressed horror at the dangers. He said: “Who knows how many people this could have harmed and how many may have died? Given the volumes of 999 calls involving people who have fallen and are unconscious, there is a risk that thousands were affected. Who knows how many might have died – it could be hundreds, but even if it’s just one needless death, we need a full review.”

The problem occurred when a government committee which governs the use of computerised 999 software allocated a lower priority to falls of 6ft or more than had been recommended by the system’s makers. As a result, the automated system instructed call handlers to class such calls as category B even if the person was also unconscious or breathing abnormally – life-threatening conditions which should have had the most urgent response. The Department of Health said the risk had been eliminated from the latest version of the software, introduced last year.

SOURCE





21 March, 2010

Paging Doctor Kildare

If Obamacare becomes law, about 30 percent of the primary care doctors in America will consider leaving the medical profession. That bit of brightness comes from a survey by The Medicus Firm, the results of which were posted by The New England Journal of Medicine. Medicus interviewed more than a thousand American physicians, and 55 percent of them believe the quality of medical care in America will decline if the Democrats pass the current health care reform proposals. Apparently, many of them want no part of it.

Although the media largely ignored the Medicus study, the story is huge. Perhaps as many as 30 million more Americans may have access to health insurance. The question is: Who will treat them? The Bureau of Labor Statistics projects a 22 percent increase in practicing physicians over the next decade. But that will not be enough to treat the universal health care crush, especially if a bunch of doctors now on the job pack it in.

There are essentially two reasons why Obamacare nauseates some doctors. First, control. Medical people simply do not want federal pinheads telling them how to treat their patients. The medical profession attracts intelligent, assertive people who are motivated to help others. This is not a docile crowd.

Second, money. Right now, many doctors are already seeing too many patients in order to pay the bills and provide a decent living for their families. Obamacare does nothing to bring down the outrageous expense of medical malpractice insurance, and it is likely to cut Medicaid and Medicare reimbursements. Doctors can do the math. Their expenses remain high; their incomes decline. Again, these are smart people who could make good money doing something else.

In Canada and Great Britain, where socialized medicine is practiced, it is difficult to actually see a doctor in some places. Instead, nurses, physician assistants and other medical personnel fill the need. That is what could happen in the United States if the feds begin calling the health care shots.

Not since the Iraq war has America been so divided on an issue. Yes, ideology is playing a part. Conservatives despise government intrusion in the marketplace, but liberals love it. Right now, however, most polls show that the majority has turned on Obamacare. The latest Wall Street Journal poll, for example, found 48 percent opposing and just 36 percent supporting.

Here's my question: What would Marcus Welby, M.D., and Dr. Kildare say? These guys usually had the answers, back when wise doctors were the subjects of TV programs and health care seemed to be a glamorous profession. Would Ben Casey support Obamacare? We know the "M*A*S*H" guys would. Dr. Jekyll might like it, but Mr. Hyde? I don't know. What I do know is that many Americans are sick of the whole health care thing. And no prescription on earth will change that.

SOURCE




16,500 more IRS agents needed to enforce Obamacare

New tax mandates and penalties included in Obamacare will cause the greatest expansion of the Internal Revenue Service since World War II, according to a release from Rep. Kevin Brady, R-Texas.

A new analysis by the Joint Economic Committee and the House Ways & Means Committee minority staff estimates up to 16,500 new IRS personnel will be needed to collect, examine and audit new tax information mandated on families and small businesses in the ‘reconciliation’ bill being taken up by the U.S. House of Representatives this weekend. ...

Scores of new federal mandates and fifteen different tax increases totaling $400 billion are imposed under the Democratic House bill. In addition to more complicated tax returns, families and small businesses will be forced to reveal further tax information to the IRS, provide proof of ‘government approved’ health care and submit detailed sales information to comply with new excise taxes.

Americans for Tax Reform has a good breakdown of the bill by the numbers. Isn't it reassuring that at a time of recession, government will do what's necessary to ensure its growth?

SOURCE




The corruption never stops

Health-vote ally Nelson to get new VA hospital for Nebraska

The Obama administration has delivered another budget plum to Democratic Sen. Ben Nelson and the state of Nebraska, adding more than a half-billion dollars for a new veterans hospital in Omaha.

The move reverses a decision by Mr. Obama's own Veterans Administration of a year ago, which called for repairing an existing hospital.

The Veterans Administration made the budget switch during internal deliberations in 2009 at a time when the White House was wooing the moderate Democrat to vote for President Obama's health care overhaul bill.

Mr. Nelson was among the last of the Senate Democrats to sign on to the health bill, deciding to vote "yes" after securing special Medicaid payments for Nebraska in a deal known as the "Cornhusker Kickback." Health care reform opponents have widely panned that deal.

At the time that deal was being made, Mr. Nelson was getting another boost from the VA as it formulated its next budget.

Jake Thompson, a spokesman for Mr. Nelson, rejected the idea the new hospital was awarded in exchange for the senator's health care vote.

"It was never discussed," Mr. Thompson said. "He wasn't discussing the Omaha VA hospital in any relation to health care. The answer is no."

The spokesman added that Mr. Nelson "has been advocating [a new hospital] with this administration, with the previous secretary of the VA and the current secretary of the VA. But in relation to health care, it wasn't discussed at all. I think the VA's own study was the principal reason it was moved up" on the construction priority list.

But Rep. Steve Buyer of Indiana, ranking Republican on the Veterans' Affairs Committee, said, "This one doesn't smell right or feel right."

Mr. Buyer said testimony by VA officials to the Senate last August showed managers recommended renovation and some expansion of the existing Omaha site -- not an entirely new hospital at a much higher cost.

More here




Study Shows ‘ObamaCare’ Could Cost 700K Jobs

As many as 698,000 jobs could be lost if the health care reform plan (a.k.a., “ObamaCare”) being pushed hard by liberal Democrats is passed by Congress and signed into law by President Barack Obama, according to a study released today that was the subject of a blogger conference call this morning.

The executive summary for the study, conducted by the Beacon Hill Institute in conjunction with Americans for Tax Reform, boils down the findings in a nutshell:

Nancy Pelosi, the Speaker of the House of Representatives, has urged passage of the massive health reform plan moving through Congress as a way to create up to 400,000 jobs. Speaker Pelosi bases her claim on a report by the Center for American Progress (CAP) in which the Center estimates that the Patient Protection and Affordable Care Act (PPACA) would create 250,000 to 400,000 jobs per year over 10 years.

This estimate by CAP amounts to a hurried effort to add academic heft to the claim that national health care reform offers a collateral benefit in the form of an economic “stimulus.” It turns out, however, that its methodology, stripped of unsupportable claims about savings in health care costs, shows just the opposite of what CAP intended. PPACA is a job killer, not a job creator.

SOURCE




MORE OF WHAT OBAMACARE HAS IN STORE FOR AMERICANS

Three new reports from just ONE DAY about Britain's NHS below

Life-saving cancer scans delayed in NHS funding crisis

Vital scans for patients who may have cancer are being postponed by up to six weeks as the NHS grapples with a major funding crisis. GPs have also been ordered not send elderly people for osteoporosis scans, to refer children with tonsillitis to specialists - or even allow men to have vasectomies. In addition, wards are threatened with closure and thousands of key staff have been told to work shorter hours or take unpaid 'career breaks'.

Charities and patient groups said the delays could have disastrous consequences if early signs for potentially fatal conditions go undetected.

The drastic cutbacks illustrate a funding nightmare threatening to overwhelm the NHS within months, as trusts battle to save millions of pounds in the wake of the credit crunch.

Last night the Royal College of Physicians warned ministers and NHS managers against 'slash and burn' cuts. In a strongly-worded pre-budget briefing to MPs, they said: 'Following a decade of growth, the NHS is being asked to deliver considerable efficiencies. 'There is a risk that without careful management, a supportive rather than confrontational culture and a high degree of medical engagement, any effort to reduce productivity could easily subside into a process where services and posts are indiscriminately slashed and burnt. 'Over-hasty decisions now to cut back on the medical workforce, biomedical research, and audit programmes could have implications for generations.'

Ministers say the NHS needs to save 20billion pounds over the next five years. Although both Labour and the Tories have pledged not to cut NHS funding, rising demand and an ageing population means the money will not go as far as in the past, necessitating cuts.

Dozens of hospitals are already considering closures of A&E departments and maternity wards, while others are asking staff to consider voluntary redundancy and early retirement. The respected King's Fund think tank says it may be necessary to freeze NHS pay until 2014.

One NHS trust under pressure is North East Essex primary care trust, which last month asked its GPs not to refer patients for MRI scans - used to diagnose possible tumours and kidney disease - and other tests until April 1.

Sarah Woolnough of Cancer Research UK said delays in MRI scans could run the risk of early signs of cancer being missed. She said: 'Speedy access to diagnostic tests and quick referral can help to diagnose cancer as early as possible which can ultimately lead to better treatment for patients and improved survival.'

Matt Bushell, director of commissioning at the trust, said: 'As part of the procedures to ensure budgets are balanced at the end of the current financial year, we have, just for the month of March, asked GPs to defer referrals for a very small number of non-urgent, therapeutic services: heel scans, vasectomies, ENT and nonurgent MRI scans. 'We have maintained priority for urgent MRI scans. These arrangements will remain in place only until April 1 2010.'

Other examples of cuts across the NHS include:

* GPs in Hertfordshire being told to get 'approval' before referring patients for hysterectomies, tooth extraction and removal of skin 'lumps and bumps';

* Planned closures of A&E wards at Whittington Hospital in North London, Queen Mary's in Sidcup, Chase Farm in Enfield and others;

* Almost 4,000 workers at Stepping Hill hospital in Stockport, and 2,000 at Scunthorpe general hospital, being asked to consider early retirement, voluntary job cuts or shorter hours.

Tory health spokesman Andrew Lansley said: 'This will be very worrying for patients. The NHS has had increased funding this year, so just where has the money gone?'

Matthew Elliott of the TaxPayers' Alliance said: 'It's infuriating that despite billions of pounds being poured into the NHS, patients are having treatment delayed thanks to a failure to plan properly.'

SOURCE




Blundering NHS surgeon in £10m lawsuit after 100 women patients take him to court

Bungling surgeon George Rowland was allowed to operate for almost FOUR YEARS after the first alarm was raised

More than 100 women suffered botched bladder surgery at the hands of a gynaecologist who continued to work for four years after the alarm was raised. Patients of George Rowland suffered chronic pain or worsening bladder symptoms after he operated on them. But it was only after doctors expressed concern about his behaviour that the scale of his mistakes was realised and he was told to stop carrying out procedures.

Yesterday, as a report criticised managers for not picking up on the problem sooner, it emerged that more than 100 of his patients are taking legal action - leaving the NHS facing a compensation payout of as much as £10million.

Ian Cohen, of Goodmans solicitors which is representing most of the women, said: 'There have been devastating, life-changing outcomes for many patients. We have a substantial number of women who should never have had that surgery, who have been left worse following the surgery. Some have been left in a bad state, with chronic pain. 'Some women have complete difficulty passing urine. 'The trust's board appears to have allowed an obsession with targets and anxiety about potential damage to its reputation - and that of the consultant - to bar earlier action to prevent patient harm.'

Mr Rowland, aged in his 50s, was a respected urogynaecologist performing hundreds of operations a year at Aintree Centre for Women's Health in Liverpool.

In 2004 concerns were raised that he was carrying out more surgery than colleagues, often 'bundling' different procedures into single operations, such as hysterectomies with surgery for incontinence. But it was not until colleagues began expressing concern in 2007 that an investigation was launched. Mr Rowland was not suspended until the following year.

Last year the General Medical Council barred him from performing urogynaecological procedures until further notice, and hundreds of his patients were recalled to the hospital for a further consultation. Some complained they had been left in chronic pain and that their incontinence had not improved. Lawyers representing others say the surgery was simply inappropriate for their conditions.

The highly regarded Liverpool Women's Hospital, which runs the Aintree centre, commissioned an independent report into the affair, and yesterday criticised bosses for not noticing the mistakes earlier. It pointed out that Mr Rowland was responsible for picking up such problems as the clinical governance lead - a clear conflict of interest, the women's lawyers say.

Its report found warning signs dating back to 2004 were not acted upon, criticised the 'cultural divide' between staff at the Aintree centre and the main hospital, and said more needed to be done to stop doctors from working in isolation from their departments. Jonathan Herod, clinical director of gynaecology, admitted Mr Rowland often worked alone. If the case was repeated, 'it would be picked up on straightaway', he added.

Trust chief executive Kathryn Thomson said: 'We decided it was important to look at governance practices more widely to ensure we learnt as much as possible.'

SOURCE




£250,000 victory for war vet who sold home to pay care bill that NHS should never have charged him

NHS bureaucrats don't care about people at all. Saving money is their no.1 priority

The family of a war veteran suffering from Alzheimer's has won more than £250,000 from the NHS for nursing home fees he should never have been charged. The payout, which is believed to be the biggest of its kind, was awarded to relatives of Leslie Terry, 86, whose home was sold to pay for his £3,500-a-month care. Despite being totally immobile - he has not been out of bed for four years - and in need of constant nursing, Mr Terry was denied funding under the NHS's ' Continuing Care' scheme.

The scheme is meant to fully fund patients with health needs resulting from conditions such as Alzheimer's and Parkinson's disease. It applies mainly to those who are in nursing homes, or long-term hospital or home care.

Mr Terry's nephew, Bryan Talbot, 71, from Banbury, Oxfordshire, who mounted a legal challenge to recover the backdated fees covering eight years, said: 'My uncle has been unable to get out of bed for four years, he is at risk of choking, has to be fed, and is unable to communicate verbally. 'I felt it was clear that his health needs meant he should be the responsibility of the Health Service. I am amazed that, despite him having annual assessments, the NHS did not inform me about possible available funding. It's important people take advice. 'We've had a rough ride to get to this point but I want other people to know you don't have to sell your home to get the care you need. He has received first class care from very professional staff at Gloucester House Nursing Home.'

The payout comes after three families last year won a total of £350,000 - with the family home sold in two cases - after being wrongly denied Continuing Care. So far, more than £9million has been recovered by solicitors representing 2,000 families who claim they have been wrongly charged nursing home fees. Under English law, the elderly must pay for residential care unless their needs are health-related, when the whole cost is met.

However, Department of Health criteria on who qualifies for health needs are subject to interpretation by individual NHS trusts. The Daily Mail's Dignity for the Elderly campaign has repeatedly highlighted the unfairness of the system, which means many families of Alzheimer's sufferers are being charged for long-term nursing care. Many are denied funding by Primary Care Trusts, which have to foot the bill, because the disease does not automatically make the patient eligible for NHS 'continuing care'.

Mr Terry, who joined the Army in 1942 and fought in India and Burma, retired from his job as a porter at Sevenoaks Hospital in Kent, in 1983 before succumbing to dementia in his 70s. He never married. Mr Terry also suffers from a severe skin disease, which needs monitoring.

Solicitor Lisa Morgan, of Welsh law firm Hugh James, who acted for him, said: 'Under current government policy, there should be a full assessment on health needs, which determines whether patients pay for their nursing care fees. 'That is not happening in many cases. With the cost of nursing homes averaging £675 per week, families are still being left with huge fees to pay. There is a clear disparity across the country and, despite national guidance, Primary Care Trusts still apply their own judgment.'

Michelle Mitchell, charity director for Age Concern and Help The Aged, said: 'The system for deciding where the line is drawn between free NHS Continuing Care, and paid for social care has been a mess for years. 'We are still very concerned older people may wrongly be forced to pay for their care when it should be free. We strongly encourage anyone who believes they are unfairly missing out to fight for their rights.'

SOURCE





20 March, 2010

Democrats offer a new budget of lies



In the final push to pass a health care overhaul, Democratic leaders on Thursday sought to sway anxious party members with a new $940 billion plan that cuts the deficit, raises Medicare revenue with a new tax on the investment income on wealthier Americans and placates unions by slashing the tax on high-end insurance plans.

The concept, backed by President Obama, is designed to build positive momentum ahead of a Sunday vote on the landmark health care overhaul, which would extend insurance coverage to more than 30 million Americans, fill the Medicare prescription drug "doughnut" hole of limited coverage and curb insurance industry abuses. It swung two former "no" votes to the "yes" column.

Majority Leader Steny H. Hoyer called the plan "the biggest deficit reduction bill that any member of Congress is going to have an opportunity to vote on" with hopes of swaying fiscally minded Democrats to support it.

Republicans remain steadfastly opposed to the plan, leaving Democrats to come up with all of the support themselves. "The reason House Democrats don't have the votes is because the American people know this is a government takeover of health care," said Rep. Mike Pence of Indiana.

The 153-page bill released Thursday represents repairs that Mr. Obama and House leaders requested in exchange for voting for the Senate's health care plan. If passed, the "repair" bill would also have to pass the Senate through complicated reconciliation procedures that can circumvent a Republican filibuster.

Critics of the plan already spotted two provisions that they say are tightly focused on specific states, possibly in exchange for support of the legislation similar to the now infamous "Cornhusker Kickback." They plan to rally against the bill as the final vote nears.

White House spokesman Robert Gibbs said Thursday that Mr. Obama would postpone his Asia trip, originally scheduled to start Sunday, to help corral votes for his chief domestic agenda item.

The Congressional Budget Office analysis found that the plan would reduce the deficit by $138 billion over the next 10 years - $20 billion more than the House's original plan - and continue to drive down the deficit in later years.

More here




Slaughter House Rules

How Democrats may 'deem' ObamaCare into law, without voting



We're not sure American schools teach civics any more, but once upon a time they taught that under the U.S. Constitution a bill had to pass both the House and Senate to become law. Until this week, that is, when Speaker Nancy Pelosi is moving to merely "deem" that the House has passed the Senate health-care bill and then send it to President Obama to sign anyway.

Under the "reconciliation" process that began yesterday afternoon, the House is supposed to approve the Senate's Christmas Eve bill and then use "sidecar" amendments to fix the things it doesn't like. Those amendments would then go to the Senate under rules that would let Democrats pass them while avoiding the ordinary 60-vote threshold for passing major legislation. This alone is an abuse of traditional Senate process.

But Mrs. Pelosi & Co. fear they lack the votes in the House to pass an identical Senate bill, even with the promise of these reconciliation fixes. House Members hate the thought of going on record voting for the Cornhusker kickback and other special-interest bribes that were added to get this mess through the Senate, as well as the new tax on high-cost insurance plans that Big Labor hates.

So at the Speaker's command, New York Democrat Louise Slaughter, who chairs the House Rules Committee, may insert what's known as a "self-executing rule," also known as a "hereby rule." Under this amazing procedural ruse, the House would then vote only once on the reconciliation corrections, but not on the underlying Senate bill. If those reconciliation corrections pass, the self-executing rule would say that the Senate bill is presumptively approved by the House—even without a formal up-or-down vote on the actual words of the Senate bill.

Democrats would thus send the Senate bill to President Obama for his signature even as they claimed to oppose the same Senate bill. They would be declaring themselves to be for and against the Senate bill in the same vote. Even John Kerry never went that far with his Iraq war machinations. As we went to press, the precise mechanics that Democrats will use remained unclear, though yesterday Mrs. Pelosi endorsed this "deem and pass" strategy in a meeting with left-wing bloggers.

This two-votes-in-one gambit is a brazen affront to the plain language of the Constitution, which is intended to require democratic accountability. Article 1, Section 7 of the Constitution says that in order for a "Bill" to "become a Law," it "shall have passed the House of Representatives and the Senate." This is why the House and Senate typically have a conference committee to work out differences in what each body passes. While sometimes one house cedes entirely to another, the expectation is that its Members must re-vote on the exact language of the other body's bill.

As Stanford law professor Michael McConnell pointed out in these pages yesterday, "The Slaughter solution attempts to allow the House to pass the Senate bill, plus a bill amending it, with a single vote. The senators would then vote only on the amendatory bill. But this means that no single bill will have passed both houses in the same form." If Congress can now decide that the House can vote for one bill and the Senate can vote for another, and the final result can be some arbitrary hybrid, then we have abandoned one of Madison's core checks and balances.

Yes, self-executing rules have been used in the past, but as the Congressional Research Service put it in a 2006 paper, "Originally, this type of rule was used to expedite House action in disposing of Senate amendments to House-passed bills." They've also been used for amendments such as to a 1998 bill that "would have permitted the CIA to offer employees an early-out retirement program"—but never before to elide a vote on the entire fundamental legislation.

We have entered a political wonderland, where the rules are whatever Democrats say they are. Mrs. Pelosi and the White House are resorting to these abuses because their bill is so unpopular that a majority even of their own party doesn't want to vote for it. Fence-sitting Members are being threatened with primary challengers, a withdrawal of union support and of course ostracism. Michigan's Bart Stupak is being pounded nightly by MSNBC for the high crime of refusing to vote for a bill that he believes will subsidize insurance for abortions.

Democrats are, literally, consuming their own majority for the sake of imposing new taxes, regulations and entitlements that the public has roundly rejected but that they believe will be the crowning achievement of the welfare state. They are also leaving behind a procedural bloody trail that will fuel public fury and make such a vast change of law seem illegitimate to millions of Americans.

The concoction has become so toxic that even Mrs. Pelosi isn't bothering to defend the merits anymore, saying instead last week that "we have to pass the bill so that you can find out what is in it." Or rather, "deeming" to have passed it.

SOURCE




Landmark Legal Foundation readies constitutional suit if Obamacare passes with Slaughter Solution

Landmark Legal Foundation president and Talk Radio powerhouse Mark Levin promised today that his foundation will file suit in federal court challenging the constitutionality of Obamacare if it is approved in the House using the Slaughter Solution.

“Landmark has already prepared a lawsuit that will be filed in federal court the moment the House acts. Such a brazen violation of the core functions of Congress simply cannot be ignored. Article I, Section 7 of the Constitution is clear respecting the manner in which a bill becomes law. Members are required to vote on this bill, not claim they did when they didn’t. The Speaker of the House and her lieutenants are temporary custodians of congressional authority. They are not empowered to do permanent violence to our Constitution," Levin said.

Even if Landmark never does another good thing for the Republic, what it has been doing for more than a decade to expose the facts about the partisan political partnership between the National Education Association and the Democratic Party makes it an invaluable asset. You can check that out here.

Landmark also has done superb work in exposing how federal bureaucrats at the EPA have funneled billions of tax dollars to radical environmental groups that lobby on behalf of more regulatory power, bigger budgets and expanded staffing for ... EPA. Check that out here.

Levin may be best known for his New York Times best-seller, "Liberty and Tyranny: A conservative manifesto." I knew something remarkable was bubbling "out there" among the American people last year when Levin's book zoomed to the top of the best-seller's list and people lined up for blocks in places like Fairfax County, Va., to buy signed copies of the book and to meet him.

SOURCE




Into the twilight zone

Nancy Pelosi has scheduled a vote for Sunday, maybe to vote by not voting. The president has canceled his trip to Asia and the atmosphere in Washington grows surreal and surrealer. The speaker yearns to be a suicide bomber, blowing up her party's November prospects, or at least the leader of the Democratic squadron of kamikaze pilots.

No one can quite remember when a party in power has been so determined to self-destruct, with the speaker as provocateur, egging everyone on. Rep. Mike Honda, a Californian of Japanese descent, objects to some of the metaphors applied to Mzz Pelosi's mission of death by obsession, but to neutral observers - assuming any are left - her execution of the president's obsession looks like the Bataan death march, or at least a ride to the gallows in a Toyota.

Everything the Democrats are doing is turning to mud, or maybe even the smelly stuff wives accuse husbands of tracking into the house. Barack Obama even chose this week to pick an unnecessary fight with Israel, our only true friend in the Middle East. When Joe Biden quickly wore out his welcome in Jerusalem, he was brought back to Washington to employ his considerable Irish charm to entertain the Irish prime minister, Brian Cowen, who dropped in for a St. Patrick's Day visit to the White House. Nobody could mess up such a jovial occasion, even with beer dyed green for the occasion.

Good old Joe, ever the bumbling uncle we've come to love (so far the president hasn't consigned him to the attic where crazy aunts and uncles usually live), nevertheless pronounced obsequies on the prime minister's ailing mother: "God rest her soul." Good old Joe quickly learned that the elderly Mrs. Cowen's soul is still among us. Never mind. He rewrote his benediction to "God bless her soul," and recalled the Irish proverb that "a silent mouth is sweet to hear." To the relief of all he turned the podium over to the president's teleprompter, and no further harm was done. No need for the media's Gaffe Patrol even to fire up the engines on their ancient Jennies.

But what other explanation for Mr. Obama's damn-the-torpedoes strategy could there be other than a suicide wish? The only outcome worse for him than losing the health care vote would be winning the health care vote. The debacle in Massachusetts has taught him nothing, but it has surely taught the public a lot. Gallup now puts the president's approval rating at 46 percent, the lowest yet, and his disapproval at 47 percent. These are dreadful numbers for any president, and particularly for a messiah who arrived at the White House little more than a year ago with approval ratings in the high 70s.

The debacle in Massachusetts will be small stuff if Mzz Pelosi proceeds with the aptly named "Slaughter solution," the bright idea of Rep. Louise M. Slaughter of New York, to dispense with actually voting for the Senate bill and declaring that the House "deems" the Senate measure enacted. This would avoid a voice vote and guilty congressmen could go home to tell credulous constituents that they should deem them as having voted against the monstrosity that almost nobody wants. Such a solution is so nutty that only Nancy Pelosi and Harry Reid would have imagined using it. But if they succeed Congress will have opened up vast new avenues of chicanery, deceit and dishonesty. A husband caught staying out all night can tell his angry wife that she should "deem" him to have slept on the sofa discarded in the garage; a schoolboy who wouldn't dare claim the dog ate his homework can now tell a teacher that she should "deem" the homework done.

Mr. Obama, who long ago perfected the verbal sleight of hand that has served him well until now, got particularly flustered and visibly irritated when he sat down for an interview with Fox News and learned for the first time how uncomfortable a real interview can be. The more interviewer Bret Baier pressed the more the president wiggled and the more the interviewer persisted. Soon it descended into presidential argle-bargle. The president doesn't have an opinion on "deeming" because "I don't spend a lot of time worrying about what the procedural rules are." He's not concerned about "the Louisiana Purchase" or the "Cornhusker Kickback" - special deals for Louisiana and Nebraska to buy Senate votes - because special deals "also affect Hawaii, which just went through an earthquake." It did?

But maybe it was a slip of the tongue and he meant Haiti. But surely he doesn't think Haiti is one of the 57 states. We can't be sure.

SOURCE




Hiding the true cost of Obamacare

President Obama keeps saying America needs the Democrats' health care bill to reduce costs. In reality, the government takeover of health care will raise costs and cause a large number of people to lose their health insurance.

"Well, if [the health care bill] doesn't pass, I'm more concerned about what it does to families out there who right now are getting crushed by rising health care costs and small businesses who were having to make a decision, 'Do I hire or do I fix health care?' " Mr. Obama claimed to Fox News on Wednesday.

Saying his bill will reduce costs doesn't make it true. Take the legislation's huge $500 billion cuts in Medicare. The government already reimburses hospitals and doctors less than their costs. Further cuts mean even more cost shifting to privately insured patients to cover deeper Medicare losses. Private insurance won't cover all of these exorbitant losses, which will force many doctors and hospitals out of business.

This week, the New England Journal of Medicine released a survey of doctors showing that 46.3 percent of "primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine." Not only will doctors leave medicine, but "27 percent [of physicians] would recommend medicine as a career but not if health reform passes." The survey is merely suggestive, but if the real reduction in the number of doctors is even 5 percent or 10 percent, medical costs will rise significantly. A lower supply of doctors amid rising demand for care means higher medical prices.

Another example is the ban on insurance companies charging different premiums based on pre-existing health conditions. Imagine what would happen if motorists could buy auto insurance after an accident and were allowed to drop it once a car was fixed. People would wait until they were in an accident to buy insurance, and insurance premiums would skyrocket. The same will happen if insurance companies can't charge higher premiums for sick people.

Even the few purported cost-reducing measures in the Senate bill are being gutted by the president's proposal. The reconciliation bill delays a tax on high-quality insurance, dubbed Cadillac plans. The idea was if the cost of insurance was raised, fewer people would want such extensive medical coverage and thus would not seek medical care as often. Reduced demand therefore would reduce the price of medical care. But after striking a deal with unions, Mr. Obama decided to delay the tax for eight years, until he's out of office.

The Democrats' plan will destroy American health care. Obamacare will dramatically raise the cost of medical care, forcing many Americans to drop their insurance. Responsible members of Congress have to vote this down.

SOURCE




The unbelievable NHS again

Bungling foreign nurse can KEEP his job... despite barely speaking English and 'worrying' lack of competence

An Indian nurse who could barely understand English and refused to learn the language was told yesterday he could return to his hospital and carry on working. The decision by the Nursing and Midwifery Council came despite despite the watchdog commenting on his ‘worrying’ lack of competence.

Biju John, 38, had insisted he was able to understand instructions and wrote to the council stating: ‘I never be confused at all.’ But staff felt they were ‘carrying’ him and did not feel safe leaving patients in his care, an NMC hearing was told.

Mr John also had a limited knowledge of basic nursing skills and did nothing when a patient was struggling to breathe, it was claimed. The NMC heard Mr John should have started basic airway management as the man gasped for breath after coming round from an operation. But instead he had to be helped by a colleague who rushed over when she heard the man’s wheezing from the other side of the anaesthetic unit at Leicester Royal Infirmary.

On another occasion Mr John almost caused a patient to go into shock when he wore latex gloves to treat him despite being told he was allergic to the material. The hospital then devised a set of objectives for the nurse, including meeting the required standard of English so he could effectively communicate with staff and colleagues. But he failed to reach the targets and was kept on supervised practice.

A further incident on October 20, 2004 led to Mr John being suspended and a disciplinary meeting was scheduled for January 20, 2005, but he quit seven days before. He was later reported to his regulating body. Mr John, from Cambridge, was found guilty of seven charges relating to his lack of competency when he worked at the hospital between July 2003 and December 2004. These include failing to complete basic skills required of a nurse, not demonstrating his English was sufficient to communicate with colleagues effectively – which gave rise to the incident with the latex gloves – and failing to take appropriate action when a patient’s oxygen levels dropped. He was cleared of mistaking the Surgical Assessment Unit for the Surgical Acute Care Unit.

NMC chairman David Kyle said his lack of competence was ‘worrying’ but ‘not irremediable’. He added: ‘Although the registrant was a caring nurse, he lacked confidence, was reluctant to act on his own initiative and could not be trusted to work unsupervised. ‘Other nurses felt they were carrying him. ‘Anaesthetists were nervous about leaving their patients in his care and adopted a practice of returning to check on their patients because they were concerned about them.

‘The panel has heard evidence of a worrying lack of competence demonstrated over a considerable period of time and that lack of competence, in some basic areas of practice for any registered nurse, particularly in communication, is still present.’

But the panel ruled Mr John could return to work subject to conditions. Mr John must tell the NMC where he is working, remain supervised, complete a personal development plan and an English language test he complies with the conditions he will be allowed to return to normal practice after 18 months.

SOURCE





19 March, 2010

SOCIALIZED MEDICINE IN PRACTICE

Below are five reports from just ONE DAY in Britain

Terrifyingly inept foreign doctors are a symptom of a sickness in the NHS - not the cause

By Professor Karol Sikora

When a supposed cure has instead become a new kind of sickness, then surely something is badly wrong. Yet that is what has happened in the modern NHS. The target culture brought in to benefit patients is having fatal consequences. A system that originally aimed to improve performance and efficiency is now threatening patients' lives, distorting clinical priorities and encouraging the use of foreign doctors, who may be too inexperienced or unqualified for the jobs they have been given.

The tragic case of 94-year-old Ena Dickinson is a heart-rending example of what can go wrong in a health service that puts compliance with political requirements above the real needs of patients. Mrs Dickinson, a Lincolnshire grandmother, died in 2008, soon after she underwent a hip replacement operation which was carried out at Grantham Hospital by a German locum surgeon, Dr Werner Kolb. In an appalling series of errors, Dr Kolb cut through the wrong muscle, severed an artery and used the wrong cutting tool, with the result that Mrs Dickinson lost almost half her blood in an operation that should have been routine. One witness, another doctor from the hospital, said he was 'horrified by what I saw', while an expert surgical witness, Professor Angus Wallace, told the inquest on Tuesday that he 'could not believe the level of neglect in the operation'.

The episode raises troubling questions about the NHS's increasing reliance on foreign doctors, both from the European Union and from further overseas, a practice that has been driven partly by the Government's fixation with meeting targets and partly by an inadequate supply in the number of domestic trained doctors.

We do not, of course, live in an insular world and overseas doctors have long been an integral part of the NHS. Indeed, when I first worked in the NHS in the early Seventies, I saw that the service would not have been able to function without the support of doctors from Asia. And, whether we like it or not, Britain is part of the European Union, one of whose guiding principles is the free movement of labour throughout the member states. So, without drastic political changes to the very nature of our society, we would not be able to adopt a siege mentality when it comes to employment in the NHS.

Nevertheless, the disastrously botched operation that Mrs Dickinson suffered highlights a worrying trend, where too often foreign doctors have been imported to provide cover in the NHS, without any proper checks on their background, their ability to speak English, their experience or their competence.

According to reports about Dr Werner Kolb, he had actually performed few hip operations during his career and had spent most of his recent years giving lectures, hardly a record to inspire confidence in the operating theatre. Dr Kolb's negligence may be particularly graphic, because of the way he sawed through the wrong muscle, like some grotesquely inept carpenter.

Some might argue, therefore, that it is particularly dangerous to let foreign doctors carry out surgery without rigorous monitoring. But this would be a fallacy. Every branch of medicine, from general practice to pathology, has the potential to do mortal harm because of its intimate connection with the delicate structure of the human body. In my own field of cancer care, disasters can occur because of a misdiagnosis or the administration of the wrong dosage of drug.

The calamitous risks of incompetence by GP locums were illustrated in early 2008 by Dr Daniel Ubani, who flew in from Germany to Cambridgeshire to provide weekend cover for a local practice, only to end up killing one pensioner, David Gray, by accidentally giving him ten times the maximum dosage of diamorphine. The coroner then said Mr Gray's death had been caused by 'gross negligence', words that carry a chilling echo in the Dickinson case.

One of the key problems is that, under an EU directive of 2004, doctors who qualify in any EU country can move to work in any other EU state without even the most limited examination of their skills, aptitude or language. In contrast, foreign doctors (ie from outside the EU) must pass a skills and English language test - yes, even the Australians and Americans.

EU countries are also not forced to provide information on their doctors' professional histories - for example, whether they have been struck off for committing a criminal offence or killing a patient through negligence.

There are estimated to be around 20,000 EU doctors registered to work in the NHS, a quarter of them from the former Eastern Bloc countries.

Now the vast majority of them are certainly perfectly competent, but, even so, difficulties will inevitably arise over language and culture. Every nation, for instance, has its own medical hierarchies, differing relationships between doctors and nurses, or unique approaches to patient care.

Moreover, foreign doctors without a sound grasp of English will not understand what their patients are telling them, something that is a particular concern in GP services.

It is telling that EU doctors are twice as likely to face disciplinary hearings before the General Medical Council as their British counterparts, in which foreign doctors from outside the EU are three times as likely to be struck off the medical register - statistics that point to the laxity of checks.

We cannot blame foreign doctors for wanting to work in the NHS. Britain has one of the best-rewarded medical professions in the world, with GPs earning on average over £100,000-a-year and leading consultants far more. These are incredible riches for doctors from the old Soviet sphere of influence. In Poland, where my family has some of its roots, a doctor is likely to earn around £500 a month or £6,000-a-year, a sum that can be made with a few weekend or holiday stints in Britain. As a consequence, one in six of Poland's doctors now works abroad.

Nor is the NHS management entirely to blame for the catalogue of controversies that has arisen from the employment of foreign staff. NHS bosses are under tremendous pressure to meet waiting lists targets set by the Government, so they will take any action, bear almost any cost, to achieve this. So rather than postpone operations during periods when staff are on leave, they bring in foreign doctors to keep the conveyor belt moving.

In Ena Dickinson's case, it would not have mattered if her hip replacement operation had been delayed by a week or two, but no doubt the management of Grantham Hospital was appalled at the idea of slipping behind the Government's arbitrary 18-week deadline for such routine surgery. So, in a disastrous misjudgment, Dr Kolb was brought in so the needs of bureaucracy, if not the patient, could be met.

The problem has been compounded by the Government's failure to assess correctly the needs of the NHS for doctors, with the result that foreign doctors have been brought in to cover gaps in supply. It must be admitted that the demands on the NHS have grown enormously in recent years as a consequence of increasing numbers of elderly patients, a growth in the British population and advances in medical care. Twenty years ago, the idea of carrying out a hip replacement operation on a 94-year-old grandmother would have been unthinkable.

Moreover, the EU working time directive drastically reduced the number of hours that any doctor could be on duty, which meant that more staff had to be made available. But the need to increase the supply of doctors only emphasises the need to scrutinise their competence more vigorously. What we need, therefore, is an assessment of their skills by practical and verbal demonstration, accompanied by checks on their background and a basic language test. We're doing it for our own graduates, after all. That is what our NHS patients deserve. We cannot allow any more tragedies like that of Ena Dickinson.

SOURCE




Killer Muslim doctor with repeated disregard for patients is suspended for just FOUR MONTHS by British regulators

A doctor with a 'disregard' for patient safety was suspended for just four months today for sending home a baby girl who died the next day from blood poisoning. Dr Salawati Abdul-Salam failed to spot little Aleesha Evans' deadly condition and sent her home saying she had a viral infection that needed only Calpol and Nurofen. She died the next day.

A year before the baby's death, another of Abdul-Salam's patients died after a wrong diagnosis, while a pensioner suffered a collapsed lung under the trainee's care. GMC panel chairman Professor Denis McDevitt said the doctor's actions demonstrated a 'total lack of attention to detail' and a 'serious degree of carelessness.'

Colin Perriam, 66, had died after Abdul-Salam analysed six-month old blood samples, then wrongly diagnosed a ruptured ulcer as constipation. Mr Perriam was discharged from Cardiff's University Hospital of Wales on December 15, 2004 with a prescription of laxatives.

Widow Pamela Perriam had told the hearing: 'She said that he was suffering from constipation. 'We were given some powders that you mix with water for mild constipation and we were not given any other instructions. 'We were not given anything else except to say that it was mild constipation and mild laxatives should deal with the problem.'

But the next day Mr Parriam could not get out of bed and when his stomach appeared swollen and blotchy the following evening, his wife called an ambulance. By the time it arrived her husband was unconscious. Mr Parriam underwent emergency surgery but never recovered and died the next day on February 5, 2005.

A month earlier, Abdul-Salam gave a 79-year-old woman an unnecessary chest drain after reading the wrong x-ray. She had to apologise after the elderly woman's lung collapsed.

On August 9, 2006, Aleesha Evans was rushed to the Royal Gwent Hospital in Newport, Wales, vomiting with a rash and a temperature of 37 degrees. But the trainee specialist registrar did not even examine the baby and discharged her two hours later after noting her condition was 'unremarkable.' The doctor had seen the patient by this stage and noted she appeared to be better than she had been and that she was playing. But her heart rate was still high and her temperature had risen to 39 degrees, the hearing was told. The baby was discharged at 11pm with a diagnosis of viral illness.

But she was suffering from meningococcal septicaemia - blood poisoning - and died the following day. Abdul-Salam was placed under supervision at the Princess of Wales Hospital in Bridgend after Aleesha's death. She was only allowed to perform three hours of clinical work a day and had to sign every patient off with a supervisor. But within three weeks Abdul-Salam had broken the terms of her training and more than a third of her patients had been discharged without her superior's consent.

One of these patients was a 10-year-old girl with a broken wrist who attended A&E on 22 September 2008. The child required treatment under anaesthetic but Abdul-Salam discharged her to the outpatient fracture clinic.

Prof McDevitt told Abdul-Salam: 'The panel has concluded that you have not yet fully appreciated the magnitude of your deficient performance and misconduct. 'You demonstrated poor judgment when under pressure. Your lack of careful clinical method resulted in the inadequate assessment and management of patients and you failed to appreciate fully the discordance between the patients' clinical condition and the results of investigations. 'The panel considers there remains of risk of you repeating errors and exercising poor judgment, particularly if you were to return to work in a more pressures environment than you are currently exposed to.'

Prof McDevitt said the panel had considered imposing conditions on Abdul-Salam's practice but concluded her actions involving baby Aleesha Evans were too serious: 'Taking all the factors into account, the panel concluded that your registration should be suspended for a period of four months. 'Your misconduct was sufficiently serious to undermine public confidence in the profession. It is also important that you, and the medical profession, are left in no doubt that such behaviour, which clearly had consequences for patient safety, is unacceptable.'

The doctor had been working as a locum at the Kent and Sussex Hospital in Tunbridge Wells, Kent for the last five months, but she will now be unable to keep her job.

SOURCE




British doctors who wouldn't listen allow little girl to die

An eight-year-old girl with an acute fear of dentists who starved to death after her milk teeth were taken out under anaesthetic died because of a “lack of communication” between health agencies, an investigation has concluded.

Sophie Waller refused to open her mouth even to eat after the operation. She had developed her phobia at the age of four when her tongue was scratched during a routine check-up. When she refused treatment after cracking a tooth on a boiled sweet her parents became so concerned they took her to their GP who referred her to the Royal Cornwall Hospital in Truro.

Surgeons decided to remove eight remaining milk teeth under anaesthetic to avoid problems in future. But she was left so traumatised by it she refused to open her mouth to eat or drink.

A report by the Local Safeguarding Children Board has now found there was a “lack of clarity” from the agencies responsible for Sophie’s care after her discharge from hospital. She was sent home despite her condition and her parents did not know who to turn to when her health deteriorated.

By the time of her death in December 2005 Sophie, from St Dennis in Cornwall, was severely malnourished and weighed just 22kg. Her parents had been feeding her a diet of yoghurt and mashed fruit and tried to get help from their GP and the hospital but were instead referred to a child psychologist.

She was found dead in bed by her mother four weeks after her discharge and the cause of death was given as kidney failure as a result of starvation and dehydration. An inquest in February 2009 found there was no blame attached to her parents who had tried to get help for their daughter.

The serious case review found of a lack of communication between all the health agencies involved in her care. The report says: “No clear written plan was made on discharge and there was lack of clarity about responsibility for medical review following discharge.

“The clinical psychologist made telephone contact with the child’s parents in the week after discharge but did not see her again. “There was a lack of clarity over the open door arrangement which was intended to allow the child’s parents to bring her back in the week following discharge. When they phoned for advice on the seventh day, they were referred back to the psychologist for support.”

Her mother Janet Waller, a nursery school teacher who has two other children, said the report highlighted how their pleas should have been heard. She said: “All we’ve wanted all along is for people to listen to us. People ask me how many children I have, I say three, but technically I haven’t any more. I’ve got to live with this for the rest of my life.”

At Sophie’s inquest in February last year the Cornwall coroner, Dr Emma Carlyon, said that the Royal Cornwall Hospital was guilty of a number of failings which led to Sophie’s death. She said: “The severity of her malnutrition and dehydration was not recognised. This prevented her from receiving the medical support that could have prevented her death.”

Dr Ellen Wilkinson, Medical Director of Royal Cornwall Hospital Trust, said: “We would like to apologise to the family of Sophie Waller. Everyone involved in her care was saddened by her tragic death. This was a very unusual case. “There were shortcomings in the communication between the health organisation and Sophie’s parents.”

SOURCE




'Blood-spattered walls and mouldy equipment': How a quarter of British government hospitals fail to meet basic hygiene tests

A quarter of NHS hospital trusts are failing to meet basic hygiene standards, with some treating patients on blood-spattered wards or with dirty equipment, a damning report has found. A third of ambulance trusts have also missed the targets set, according to the Care Quality Commission. The watchdog's report follows the introduction of tough new hygiene standards after a series of scandals at hospitals in Maidstone, Basildon and Stafford.

It also came as a survey of NHS employees found many are too overstretched to do their jobs properly because of staff shortages.

On hygiene, the CQC found 42 out of the 167 NHS trusts inspected were in 'breach' of registration requirements by failing to meet standards, with some hospitals being warned over blood-spattered wards and dirty equipment. In Basildon, where at least 70 patients died as a result of poor hygiene last year, investigators found a commode soiled under the seat and 'procedure trays, used by staff to carry equipment when they take blood samples or give injections, had blood spattered on them'.

At children's hospital Alder Hey, in Liverpool, the inspection revealed dirty toys, hair stuck to medical equipment and 'nappy changing mats stored on the floor next to a toilet'. Water 'ran brown' from taps in patient areas.

A total of 36 trusts did not provide areas to decontaminate instruments, three trusts failed to flush unused water regularly to control legionella outbreaks, and a dozen failed to keep clinical areas clean. The situation was so bad at four ambulance trusts that they were given written warnings about the state of their vehicles and stations.

Nigel Ellis, the CQC's head of inspection, said: 'We have on rare occasions found evidence of a direct risk to patients and have intervened using our enforcement powers to ensure swift improvements were made. 'In over half of trusts we have made some suggestions or requirements for improvements to ensure their practices are the best they can be.'

A spokesman for the Department of Health said: 'There's no doubt that the trusts rose to the challenge --we've seen swift and tangible improvements in their performance, and on follow-up meetings all met the required standards.'

Meanwhile, half of NHS workers claim that staff shortages are stopping them doing their jobs properly. Of the 160,000 workers questioned by the CQC, 46 per cent said they were unable to do a proper job.

SOURCE




One in ten doctors in Britain is foreign and untested

Almost one in ten doctors on the medical register comes from the EU and has not had to take any language or competence tests before working in Britain. The shocking figure exposes the lax controls over European locums taking up hospital posts in the NHS and providing out-of-hours GP cover. Unlike doctors from elsewhere in the world - who are forced to prove language skills and medical knowledge before being registered - such testing is forbidden for doctors qualified in Europe and Switzerland.

Campaigners want a complete overhaul of the system after the death of a grandmother following appalling blunders by a German surgeon flown in by the NHS. Ena Dickinson, 94, lost nearly half the blood in her body during what was meant to be a routine hip operation at Grantham Hospital in Lincolnshire. Werner Kolb, who had been working in the NHS for three weeks, severed an artery and became so flustered he started speaking German in the operating theatre.

An expert witness described it as the worst case of negligence he had come across - yet Dr Kolb, pictured today for the first time, was left free to work in the UK for a further eight months before being suspended by the General Medical Council.

Dr Kolb, who had been mainly lecturing for four years before the tragedy, refused to attend the inquest and denied his conduct had anything to do with Mrs Dickinson's death eight weeks later from pneumonia. Last night a colleague at Bethesda Hospital in Stuttgart insisted: 'I find it hard to reconcile the words said against him in Britain with the precise surgeon I know.'

But Mrs Dickinson's daughter Kathy Ingram, 57, said: 'The system is disgraceful and clearly isn't working. NHS trusts have to assume that locum doctors' qualifications from Europe are reliable without doing their own checks. 'You trust your doctor because he's in authority but if he hasn't been verified and isn't monitored, you never know what standard of treatment you'll get. The law has to be changed so that there is closer monitoring.'

Figures show there are more than 230,000 doctors on the GMC register of which 21,451 - almost 10 per cent - gained their qualifications in other EU countries. The ban on checks comes from a European directive ordering member states to allow workers free movement. This means the GMC is forced to accept qualifications at 'face value', according to its chief executive Niall Dickson.

The GMC has protested about the rights of doctors to work freely across Europe being put ahead of a patient's right to safe treatment. In a presentation to the EU's Green Paper on the European Workforce for Health, it said: 'Legislation must be amended to allow healthcare regulators across Europe to establish that a doctor has the level of language proficiency necessary to practise safely. 'We are also prevented from adopting a general requirement to prove competence and cannot specify the standard of acceptable competence. 'The current situation is profoundly at odds with the pursuit of safe and high quality health care.'

Dr Vivienne Nathanson, head of science and ethics at the British Medical Association, said: 'Whilst it is essential doctors are able to communicate with their patients and the regulatory authorities are able to assess fitness to practise, it is also important we don't make it impossible for those that do have the appropriate skills to work in the UK.'

SOURCE





18 March, 2010

Health care bill can be beaten

House passage of the Democrats' health care bill is not a foregone conclusion despite their 75-seat majority in the chamber. While party leaders such as Speaker Nancy Pelosi and White House spinmeister David Axelrod bravely express confidence, Rep. James E. Clyburn of South Carolina, the House majority whip, conceded on NBC's "Meet the Press" that Democrats don't have enough votes yet.

The all-out effort to ram through the legislation before Easter recess is telling. If members of Congress merely risked being confronted by Potemkin crowds that don't represent the majority of voters, there would be nothing to fear. However, Democratic strategists know these crowds are very real and very mad, and the mobs will rattle wavering congressional votes, especially in vulnerable districts. The latest Rasmussen poll shows that independents oppose the mass of new regulations and taxes by a wide margin of 64 percent to 32 percent.

Despite the barrage of political attacks on insurance companies over the past year, 76 percent of Americans with insurance still rate their coverage as "excellent" or "good." Rasmussen Reports notes that this group has "proven to be a major obstacle for advocates of reform." Last year, Mr. Obama repeatedly promised he wouldn't interfere with the insurance of those who liked their current policies, but that vow has been broken. It's no wonder a constant trickle of Democrats is expressing concern about the party's policy agenda.

According to the latest vote count, released early Tuesday morning by the Hill newspaper, 37 Democrats are either firm "no" votes or "leaning no." Add a wavering Rep. Timothy H. Bishop, New York Democrat, and the number is 38. That is the exact number needed to defeat the bill, and it is up from the 25 firm "no" or "leaning no" votes on Thursday. Of the 38, 28 voted against the bill in November. In total, 55 Democrats reportedly are undecided. If the nays hold and just two of those undecided votes switch, the bill will be defeated.

According to Rep. Bart Stupak, Michigan Democrat, special deals were offered recently to peel off one or two of the 11 Democrats who stood with him against government-funded abortions. He accused his party's leadership of never having had any intention of fixing the abortion language, a posture he attributed to the leaders' belief that the votes of the 12 pro-life Democrats wouldn't be needed. "We'll probably have to wait until the Republicans take back the majority to fix this," Mr. Stupak told National Review, almost sounding wistful for that day.

Democrats are full of a lot of false bravado. Through July, August and October, they kept claiming the votes to pass the health care takeover were imminent. They were wrong.

Democrats still may be able to cobble together enough backroom payoffs or use various tricks and pressure for passage. On Intrade, the largest prediction market, the betting is swinging in favor of the health care takeover, with the latest odds giving Democrats a 70 percent chance of passing it. Stopping this travesty depends on voters expressing their outrage to Democrats on Capitol Hill.

SOURCE




With Medicaid Cuts, Doctors and Patients Drop Out

If America can't afford to pay for Medicare, how can it afford Obamacare?

Carol Y. Vliet began chemotherapy to treat her cancer, but lost her doctor because he stopped seeing Medicaid patients. As she began a punishing regimen of chemotherapy and radiation, Mrs. Vliet found a measure of comfort in her monthly appointments with her primary care physician, Dr. Saed J. Sahouri, who had been monitoring her health for nearly two years. She was devastated, therefore, when Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid.

Dr. Sahouri said that his reimbursements from Medicaid were so low — often no more than $25 per office visit — that he was losing money every time a patient walked in his exam room. The final insult, he said, came when Michigan cut those payments by 8 percent last year to help close a gaping budget shortfall. “My office manager was telling me to do this for a long time, and I resisted,” Dr. Sahouri said. “But after a while you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”

It has not taken long for communities like Flint to feel the downstream effects of a nationwide torrent of state cuts to Medicaid, the government insurance program for the poor and disabled. With states squeezing payments to providers even as the economy fuels explosive growth in enrollment, patients are finding it increasingly difficult to locate doctors and dentists who will accept their coverage. Inevitably, many defer care or wind up in hospital emergency rooms, which are required to take anyone in an urgent condition.

Mrs. Vliet, 53, who lives just outside Flint, has yet to find a replacement for Dr. Sahouri. “When you build a relationship, you want to stay with that doctor,” she said recently, her face gaunt from disease, and her head wrapped in a floral bandanna. “You don’t want to go from doctor to doctor to doctor and have strangers looking at you that don’t have a clue who you are.”

The inadequacy of Medicaid payments is severe enough that it has become a rare point of agreement in the health care debate between President Obama and Congressional Republicans. In a letter to Congress after their February health care meeting, Mr. Obama wrote that rates might need to rise if Democrats achieved their goal of extending Medicaid eligibility to 15 million uninsured Americans.

In 2008, Medicaid reimbursements averaged only 72 percent of the rates paid by Medicare, which are themselves typically well below those of commercial insurers, according to the Urban Institute, a research group. At 63 percent, Michigan had the sixth-lowest rate in the country, even before the recent cuts.

In Flint, Dr. Nita M. Kulkarni, an obstetrician, receives $29.42 from Medicaid for a visit that would bill $69.63 from Blue Cross Blue Shield of Michigan. She receives $842.16 from Medicaid for a Caesarean delivery, compared with $1,393.31 from Blue Cross.

If she takes too many Medicaid patients, she said, she cannot afford overhead expenses like staff salaries, the office mortgage and malpractice insurance that will run $42,800 this year. She also said she feared being sued by Medicaid patients because they might be at higher risk for problem pregnancies, because of underlying health problems.

As a result, she takes new Medicaid patients only if they are relatives or friends of existing patients. But her guilt is assuaged somewhat, she said, because her husband, who is also her office mate, Dr. Bobby B. Mukkamala, an ear, nose and throat specialist, is able to take Medicaid. She said he is able to do so because only a modest share of his patients have it.

The states and the federal government share the cost of Medicaid, which saw a record enrollment increase of 3.3 million people last year. The program now benefits 47 million people, primarily children, pregnant women, disabled adults and nursing home residents. It falls to the states to control spending by setting limits on eligibility, benefits and provider payments within broad federal guidelines.

Michigan, like many other states, did just that last year, packaging the 8 percent reimbursement cut with the elimination of dental, vision, podiatry, hearing and chiropractic services for adults.

When Randy C. Smith showed up recently at a Hamilton Community Health Network clinic near Flint, complaining of a throbbing molar, Dr. Miriam L. Parker had to inform him that Medicaid no longer covered the root canal and crown he needed.

A landscaper who has been without work for 15 months, Mr. Smith, 46, said he could not afford the $2,000 cost. “I guess I’ll just take Tylenol or Motrin,” he said before leaving.

This year, Gov. Jennifer M. Granholm, a Democrat, has revived a proposal to impose a 3 percent tax on physician revenues. Without the tax, she has warned, the state may have to reduce payments to health care providers by 11 percent.

In Flint, the birthplace of General Motors, the collapse of automobile manufacturing has melded with the recession to drive unemployment to a staggering 27 percent. About one in four non-elderly residents of Genesee County are uninsured, and one in five depends on Medicaid. The county’s Medicaid rolls have grown by 37 percent since 2001, and the program now pays for half of all childbirths.

More here




Not So Fast! Will Medical “Reform” Cut Real Costs?

by William L. Anderson

It seems that the so-called health care “reform” bill will become law soon enough. (President Barack Obama has told recalcitrant Democrats in the House of Representatives that he won’t campaign for them if they vote no. Most will give into the President.)

Therefore, I am more interested in what will occur after the bill is passed, not the sordid politics behind it. Specifically, I want to take a hard look at the president’s claim (echoed by economists like Paul Krugman) that the new law will reduce costs.

According to the Congressional Budget Office, Obama’s plan will produce “savings” in medical procedures. Not surprisingly, much of the media (and especially the New York Times), has been echoing the same chorus.

However, I think this claim truly falls into the “Not So Fast” category. In my view there is no possibility that the President’s plan will even remotely cut real costs. The true legacy of this bill will be to add costs in ways we hardly can imagine.

Given that the bill imposes new mandates, further subsidizes the consumption of medical services, and orders insurance companies to cover applicants no matter their health status, one is hard-pressed to find the “cost savings.” Medicare will supposedly cost half a trillion dollars less because the government will order such a state of being into existence. The “waste, fraud, and abuse” that every preceding administration promised to root out will finally meet their match with the Obama administration.

Since the plan won’t really cut costs, medical price controls could be in our future. Without going into the various economic dislocations created by price controls, let me deal with an even more fundamental issue: the nature of costs. It is telling that economists who support the bill because of its alleged “costs savings” are exposing their own ignorance about costs. To them, a “cost” is nothing more than a monetary outlay that is paid for a certain good or service. If government orders the prices paid in those transactions to be lower, then — voila! — costs are lower.

Opportunity Costs

At best, this is a childish view of costs and certainly not a view that any serious economist would hold. Costs, according to basic economic theory, are opportunity costs, or the value to an individual of the closest forgone activity. By imposing lower prices, the government would be raising the opportunity costs to individuals taking part in the exchange. Far from lowering costs, the proposed measures ultimately would result in higher real costs.

For example, if the government forces down the price of a medical procedure below the level at which all service providers can be adequately compensated, then the procedure won’t be done at all. While that would mean no money outlays, “officially” lowering costs, the person for whom the procedure is denied would bear a real cost by having to suffer the malady that drove him or her to the doctor in the first place.

Supporters of ObamaCare claim that Canada and Great Britain have lower medical costs with their government-run systems than America does. However, many of those “savings” come about because people are denied care, or must make do with cheaper but inferior alternatives.

In other words, the “savings” come at the expense of individuals who wish to receive care. It might be possible, through accounting trickery, to show that the new medical “system” has lowered the federal deficit, but it cannot and will not lower the real costs we will pay.

SOURCE




The truth about health insurance premiums and profits

In a recent Fox News debate about health insurance, Democratic political strategist Bob Beckel explained that, "The president needed an enemy, and the insurance companies are it." Proving that point in a Pennsylvania stump speech, President Obama asked, "How much higher do premiums have to go before we do something about it? We can't have a system that works better for the insurance companies than it does for the American people."

On February 20, President Obama used his weekly radio show to express outrage that a fraction of Californians buying individual Anthem Blue Cross Blue Shield (BCBS) plans "are likely (sic) to see their rates go up anywhere from 35 to 39 percent." He used those figures to justify preempting state regulation "by ensuring that, if a rate increase is unreasonable and unjustified, health insurers must lower premiums, provide rebates, or take other actions to make premiums affordable."

There was always something peculiar about this desperate effort to demonize certain health insurers. Individual plans account for only 4 percent of the insurance market. So why do they account for 100 percent of the president's fulminations about insurance premiums? Could it be because insurance premiums for the other 96percent have not been rising much?

Nonprofit BCBS plans account for a third of the private health insurance market. Michigan's nonprofit asked for 56 percent premium hike without the national media taking that Hail Mary pass too seriously. But even Obama finds it difficult to accuse nonprofits of being too profitable, so he needed to pin his enemy badge on a for-profit firm – one of Wellpoint's "Anthem" BCBS plans.

Anthem of California's requested rate increase on individual policies was actually 20-35 percent. The only way it could get to 39percent would be if a policyholder insisted on a gold-plated Cadillac plan and also happened to move up into a higher age group. Besides, requesting a rate hike means nothing. Even Obama's radio address mentioned two requests that had been cut in half. Many are denied.

So, how many Californians have actually been faced with a 39 percent increase in their premiums? Exactly zero.

How many are really "likely" to be faced with even a 35 percent increase after state insurance regulators have their say? My forecast: Zero.

The president highlighted the "likely" increases of "35 to 39 percent" to suggest insurance companies in general were asking for huge premium increases just to boost their lavish profits. He complained that in the $1.2 trillion health insurance industry, "the five largest insurers made record profits of over $12 billion." But that puny sum includes WellPoint's sale of its pharmacy benefits management company NextRX to Express Scripts for $4.7 billion last April. Adding that $4.7 billion to WellPoint profits is like saying a family's income rose by $1 million because they sold a million-dollar home.

University of Michigan economist Mark Perry calculated that without the sale of NextRX, "WellPoint's profit margin would have been only 3.9 percent, the industry average profit margin would have been closer to 3percent"— $100 per policy. Yet Obama concluded that, "The bottom line is that the status quo is good for the insurance industry and bad for America."

The media echoed the president words endlessly, and wrote as though one company's hypothetical request for increases of 35 percent-39 percent were a nationwide threat—even to those with group insurance—rather than an unique and highly unlikely request that might (if magically approved) touch a miniscule number in a hostile state for health insurers.

"It doesn't take too many 39 percent increases, like the recent one proposed in California that has garnished so much attention, to put insurance out of reach," exclaimed a New York Times report. That same paper's editorial added, "The recently announced plan by Anthem Blue Cross in California to raise annual premiums by 35 to 39 percent for nearly a quarter of its individual subscribers is a chilling harbinger of what is to come if reform fails." Really?

Grasping for confirmation of the 39 percent figure, some reporters cited a Feb. 24 memo about Wellpoint written by journalist Scott Paltrow for The Center for American Progress Action Fund. Paltrow gathered news clippings suggesting premiums are "expected to" increase by "up to" some scary number in various states. For California, however, Paltrow's source was the president's speech. This Action Fund is a is no "liberal think tank," as the Wall Street Journal put it, but a 501(c)4 lobby which can participate in campaigns and elections. Founded by Bill Clinton's former chief of staff John Podesta, it's a propaganda arm of the Democratic Party.

A Wall Street Journal story about Wellpoint's wish list for higher premiums cites the Department of Health and Human Services as its source. That means a shoddy four-page polemic at HealthReform.gov, "Insurance Companies Prosper, Families Suffer." That pamphlet, like another from the Commonwealth Fund, cites Duke Helfand, an L.A. Times reporter who wrote on Feb. 4 that, "brokers who sell these policies say they are fielding numerous calls from customers incensed over premium increases of 30percent to 39 percent."

So, the president's 39 percent figure came from Duke Helfand, who heard it from insurance brokers who, in turn, said they heard it from customers. The 39 percent figure referred to one person named Mary. After rounding Helfand's 30 percent up to 35 percent, however, that was good enough for the president's purposes.

Like Obama, the "Insurance Companies Prosper" pamphlet repeatedly confuses asking with getting. "Anthem Blue Cross isn't alone in insisting on premium hikes," it says; "Anthem of Connecticut requested an increase of 24 percent last year, which was rejected by the state." So what? If you went to your boss and insisted on a 24 percent raise, would that constitute proof that wages are rising too fast?

If Obama has been reduced to basing the redistribution of health care on the cost of health insurance premiums, he will need much better facts. Fortunately, credible statistics on health insurance premiums are readily available from the Centers for Medicare and Medicaid Services (CMS) and Bureau of Labor Statistics.

CMS statistics (Table 12) reveal that the net cost of private health insurance – premiums minus benefits – fell by 2.8percent in 2008. Furthermore, CMS Health Spending Projections predict that spending on private health insurance will rise 2.5percent in 2010, while prices of medical goods and services rise by 2.8percent.

Consumers' cost of health premiums is also part of the detailed consumer price index. After all the overheated rhetoric about "requested" or "expected" increases of "up to" 39 percent, who would have imagined that the average consumer cost of health insurance premiums fell by 3.5 percent in 2008 and fell by another 3.2 percent in 2009?

The president's health insurance proposals hoped to use stern command-and-control techniques to run the health insurance system. It was all about minimizing free choice and maximizing brute force—forcing people to buy certain kinds of politically-designed insurance, forcing insurers to cover services many consumers do not want to pay for, and forcing insurers to curb or roll back premiums even as medical costs go up. The whole shaky apparatus was built upon even shakier statistics—including the purely hypothetical 39 percent increase in premiums that Mary's insurance agent reported to Duke Helfand.

SOURCE




British hospital trusts warned over poor infection control

Five health trusts were issued with warnings about serious breaches in hospital infection control by the health regulator last year.

An assessment of hospital infection standards resulted in the five warnings from the Care Quality Commission but the trusts responded quickly to all five warnings, which are no longer in a “red flag” category on the issue, the regulator said.

In last year's infection assessment 42 of 167 trusts were found by the CQC to be in "breach" of NHS registration requirements, although the regulator said all but five were minor breaches.

Ambulance services in the north-west, east of England and east Midlands were the worst offenders, and received formal warnings for the state of vehicles and stations. The regulator said all had responded and now met the requirements in follow-up assessments.

The CQC carried out the assessment as part of preparations for a new licensing regime beginning on April 1. Several trusts are expected to receive conditions in the registration process because of concerns about some core care standards.

SOURCE




Incompetent butcher doctors free to work in the NHS

An elderly woman died after a German locum doctor carried out one of the “worst botched operations” seen in a British hospital, an inquest heard yesterday. Ena Dickinson, a former NHS volunteer, was left unable to walk after the locum made a series of errors during a routine hip operation at Grantham & District Hospital. Werner Kolb removed bone that should have remained intact and severed a major artery during the operation.

Mrs Dickinson, a 94-year-old former nurse and Red Cross volunteer from Barrowby, Lincolnshire, was left bleeding to death on the operating table. It was only when a consultant at the hospital stepped in that her life was saved. However, two months after the August 2008 operation Mrs Dickinson died. Kathy Ingram, her daughter, said that after dedicating her life to the NHS it had “let her down” when she needed it most.

Orthopaedic specialist Professor Angus Wallace told the inquest it was “the worst botched operation” he had seen. The professor, who is based at Nottingham’s Queen’s Medical Centre, was so concerned about the case that he reported the doctor to the General Medical Council.

Last week MPs heard how a “gaping hole” in the rules on foreign doctors working in Britain is putting patients at risk. The Health Select Committee is currently investigating out-of-hours-care following the death of David Gray in Cambridgeshire in 2008. He was killed by another German doctor, Daniel Ubani, who administered 10 times the normal dose of diamorphine. Dr Ubani had flown to Britain to provide out of hours care under a contract from the local health authority.

In 2004, ministers gave GPs a controversial new contract that allowed them to give up responsibility for out-of-hours care. The General Medical Council said it is prevented from testing the qualifications of European locums who are brought in as cover.

Dr Kolb, 51, who is based in Stuttgart, was given an interim suspension by the GMC for 18 months last year. Giving a narrative verdict, coroner Stuart Fisher described it as a “most disturbing case”.

Mrs Ingram said: “We feel let down. We don’t quite understand how he got to operate on my mother. “My mother was somebody who was involved in the NHS and supported it even into her retirement working on the tea bar at her local hospital. After all those years the NHS let her down.”

A spokesman for United Lincolnshire Hospitals Trust said: “The Trust has apologised to Mrs Dickinson’s family for mistakes made during her operation. “Errors were made by the surgeon concerned which were rectified immediately by a senior member of staff. After the operation Mrs Dickinson was recovering well and assessed to be medically fit for discharge by 25 September 2008.

“The Trust has done everything possible to learn from this incident and to prevent it happening to another patient. Changes have been made to the recruitment of medical staff, including the appointment of locums, and a new surgical safety checklist produced by the World Health Organisation has now been implemented throughout the Trust.”

SOURCE





17 March, 2010

Obama hones final health care pitch

Fighting to overcome the impression of high spending and backroom deals, President Obama has honed his health care message to highlight his bill's benefits to consumers — from better Medicare prescription-drug coverage for seniors to guaranteeing insurance regardless of pre-existing conditions.

Supporters say the White House's public relations offensive has breathed new life into Democrats' last-ditch effort to pass the legislation by next week. "So much of his activity in the last few weeks has been around health care," said Karen Davenport, director of health policy at the liberal Center for American Progress. "And I think the power of the presidency drives the stories and makes a huge difference."

After months of drift, with the House and Senate arguing over competing bills, Mr. Obama has taken control of the debate, combining the two bills into a grand compromise, adding Republican ideas and dubbing it bipartisan. On Monday, both he and Democratic leaders said they were very optimistic it would become law.

Mr. Obama took his health care pitch on the road Monday for the third time in one week, traveling to Ohio to again make his case that Congress should ignore the political implications of supporting his bill and vote for it because it's the right thing to do. "The American people want to know if it's still possible for Washington to look out for these interests, for their future," Mr. Obama told a crowd in Strongsville. "So what they're looking for is some courage. They're waiting for us to act. They're waiting for us to lead. They don't want us putting our finger out to the wind. They don't want us reading polls."

Democrats don't yet have the 216 votes required to pass the bills, but House Speaker Nancy Pelosi reaffirmed Monday that they will collect them, dismissing the concerns of some House Democrats about federal funding of abortion, Medicaid funding, Medicare reimbursement rates and the exclusion of protections for illegal immigrants. She called them unfounded. "When we bring a bill to the floor, we will have the votes," she said at a press conference while surrounded by more than a dozen babies and representatives of children's groups that support the health care reform plan.

The yearlong push for health care has seen a series of starts and missteps, culminating with Republican Sen. Scott Brown's surprise victory in a special election to fill the seat of the late Sen. Edward M. Kennedy, Massachusetts Democrat. That victory denied Democrats their filibuster-proof majority in the Senate, and gave backers in both chambers pause.

More here




Talking Points vs. Realty

by Thomas Sowell

In a swindle that would make Bernie Madoff look like an amateur, Barack Obama has gotten a substantial segment of the population to believe that he can add millions of people to the government-insured rolls without increasing the already record-breaking federal deficit.

Those who think in terms of talking points, instead of realities, can point to the fact that the Congressional Budget Office has concurred with budget numbers that the Obama administration has presented. Anyone who is so old-fashioned as to stop and think, instead of being swept along by rhetoric, can understand that a budget-- any budget-- is not a record of hard facts but a projection of future financial plans. A budget tells us what will happen if everything works out according to plan.

The Congressional Budget Office can only deal with the numbers that Congress supplies. Those numbers may well be consistent with each other, even if they are wholly inconsistent with anything that is likely to happen in the real world.

The Obama health care plan can be financed without increasing the federal deficit-- if the administration takes hundreds of billions of dollars from Medicare. But Medicare itself does not have enough money to pay its own way over time.

However money is juggled in the short run, the government's financial liabilities are increased by adding this huge new entitlement of government-provided insurance. The fact that these new financial liabilities can be kept out of the official federal deficit projection, by claiming that they will be paid for with money taken from Medicare, changes nothing in the real world.

I can say that I can afford to buy a Rolls Royce, without going into debt, by using my inheritance from a rich uncle. But, in the real world, the question would arise immediately whether I in fact have a rich uncle, not to mention whether this hypothetical rich uncle would be likely to leave me enough money to buy a Rolls Royce.

In politics, however, you can say all sorts of things that have no relationship with reality. If you have a mainstream media that sees no evil, hears no evil and speaks no evil-- when it comes to Barack Obama-- you can say that you will pay for a vast expansion of government-provided insurance by taking money from the Medicare budget and using other gimmicks.

Whether this administration, or any future administration, will in fact take enough money from Medicare to pay for this new massive entitlement is a question that only the future can answer, regardless of what today's budget projection says. On paper, you can treat Medicare like the hypothetical rich uncle who is going to leave me enough money to buy a Rolls Royce. But only on paper. In real life, you can't get blood from a turnip, and you can't keep on getting money from a Medicare program that is itself running out of money.

An even more transparent gimmick is collecting money for the new Obama health care program for the first ten years but delaying the payments of its benefits for four years. By collecting money for 10 years and spending it for only 6 years, you can make the program look self-supporting, but only on paper and only in the short run. This is a game you can play just once, during the first decade. After that, you are going to be collecting money for 10 years and paying out money for 10 years. That is when you discover that your uncle doesn't have enough money to support himself, much less leave you an inheritance to pay for a Rolls Royce.

But a postponed revelation is not part of the official federal deficit today. And that provides a talking point, in order to soothe people who take talking points seriously.

Fraud has been at the heart of this medical care takeover plan from day one. The succession of wholly arbitrary deadlines for rushing this massive legislation through, before anyone has time to read it all, serves no other purpose than to keep its specifics from being scrutinized-- or even recognized-- before it becomes a fait accompli and "the law of the land." Would you buy a used car under these conditions, even if it was a Rolls Royce?

SOURCE




The Slaughter Rule: Yet Another Reason Obamacare Would Be Unconstitutional

As written, the current health care bill before Congress already is guaranteed to face serious constitutional challenges on enumerated powers, 5th Amendment, racial discrimination, and unequal state treatment. Now the White House seems determined to add a whole new reason courts will throw out Obamacare on sight. Director of the Stanford Constitutional Law Center at Stanford Law School and former-federal judge Michael McConnell explains:

To become law—hence eligible for amendment via reconciliation—the Senate health-care bill must actually be signed into law. The Constitution speaks directly to how that is done. According to Article I, Section 7, in order for a “Bill” to “become a Law,” it “shall have passed the House of Representatives and the Senate” and be “presented to the President of the United States” for signature or veto. Unless a bill actually has “passed” both Houses, it cannot be presented to the president and cannot become a law.

To be sure, each House of Congress has power to “determine the Rules of its Proceedings.” Each house can thus determine how much debate to permit, whether to allow amendments from the floor, and even to require supermajority votes for some types of proceeding. But House and Senate rules cannot dispense with the bare-bones requirements of the Constitution. Under Article I, Section 7, passage of one bill cannot be deemed to be enactment of another.

The Slaughter solution attempts to allow the House to pass the Senate bill, plus a bill amending it, with a single vote. The senators would then vote only on the amendatory bill. But this means that no single bill will have passed both houses in the same form. As the Supreme Court wrote in Clinton v. City of New York (1998), a bill containing the “exact text” must be approved by one house; the other house must approve “precisely the same text.”

These constitutional rules set forth in Article I are not mere exercises in formalism. They ensure the democratic accountability of our representatives. Under Section 7, no bill can become law unless it is put up for public vote by both houses of Congress, and under Section 5 “the Yeas and Nays of the Members of either House on any question . . . shall be entered on the Journal.” These requirements enable the people to evaluate whether their representatives are promoting their interests and the public good. Democratic leaders have not announced whether they will pursue the Slaughter solution. But the very purpose of it is to enable members of the House to vote for something without appearing to do so. The Constitution was drafted to prevent that.

SOURCE




Obama's Health Care 'Victim' Exposed

At his health care pep rally today, President Obama was introduced by Connie Anderson, sister of Natoma Canfield. The president said it was a touching letter written to him from Canfield that brought him to Ohio. (I'm sure the decision had nothing to do with rustbelt America being the source of Democrats' vote deficit at this point...)

In her letter, Canfield described her battle with cancer how she was forced to give up her health insurance after it became too costly--a sad story, to be sure. But, as Gateway Pundit reports, not likely an entirely true story:

Natoma Canfield is 50 years old. She was diagnosed with cancer 16 years ago. She quit her job or was laid off 12 years ago. She has reportedly held odd jobs cleaning homes the last few years. Natoma was paying $5,000 a year for her insurance but dropped it after it went up to $8,000. She wrote president Obama in December to tell him about it. She was worried she might lose her home. Some people might say she’s lucky to still have a home after losing her job 12 years ago.

Barack Obama came to Ohio today to prop Natoma up on stage with him. But, Natoma Canfield couldn’t make it. She is back in the hospital. (Our prayers for a quick recovery) She is getting cared for despite the fact that she has no insurance. She’s not out on the street. She’s not a statistic like Rep Alan Grayson would have you believe. Natoma is getting the care she needs.

And if Canfield were in favor of real reform, she should encourage President Obama to change the tax code to help insurers properly pool risks instead of additional taxation and government subsidies.

In addition, if the president really wanted to help people like Ms. Canfield, he would encourage the individual ownership rights over health care plans so the American people can maintain control over their health insurance, not employers or the government.

SOURCE




The Health Care Plan You are Going to Get

The itsy-bitsy spider climbed up the water spout and apparently bit the Speaker of the House. Ms. Pelosi had a delusional moment the other day, but she was clear on one thing. She never intended to listen to any Republican suggestions regarding the health care bill.

Close observation of the Bipartisan Health Care Summit provided clarity within the first half hour that there was not much bipartisan here. After listening to President Obama, Harry Reid, and Nancy Pelosi, it was obvious that there was no way that they were going to overhaul their 2,400 page (or is it 2,600) health care bill.

I recently enlisted expert advice on the issue. My source was Dr. Bill Cassidy, who doubles as the Congressman from the sixth district of Louisiana and is part of the growing breed of medical professionals that refuse to leave the administration of our country to interests hostile to a cost-effective, patient-oriented, health care system. Dr. Cassidy was elected to Congress in 2008 after spending 20 years serving the uninsured in Louisiana’s public hospital system and teaching at LSU’s outstanding medical school. His specialty is gastroenterology and like many other elected physicians, he still sees patients when he’s back in his district. He is one of the very few people in Congress who truly has first-hand knowledge of those that the omnibus health care bill supposedly seeks to help.

Dr. Cassidy reminded me of an interesting exchange that confirmed President Obama’s utter ignorance of how markets function. Republicans pointed out that the Congressional Budget Office (CBO) analysis stated that premiums would rise under the existing proposals. The President initially insisted that this was not true, but then backtracked, arguing that premiums would go up because the new policies would have additional benefits. What the President doesn’t understand is that for each additional mandate – every one of which increases premiums – more and more consumers would no longer be able to afford the policy. Dr. Cassidy pointed out that the price of health care insurance is not inelastic.

Dr. Cassidy cited Senator Max Baucus as a prime example of the problem with the proposals. Other than the fact that Senator Baucus had to be tone deaf when he stated that the two sides were not really that far apart – a stunning statement unto itself – he shockingly misstated the reality of Health Savings Accounts (HSAs). Dr. Cassidy knew that a Kaiser Family Foundation study showed that because the HSA program provides an affordable health insurance alternative, 27% of new HSA participants were previously uninsured. Just think what might happen if HSAs were widely known and encouraged by the government.

But what seems to upset Dr. Cassidy the most is that the legislation does not address the largest problem with the health care system. He believes the system needs to be changed from a volume-based to a value-based system. The system has come to this gradually over the last 45 years as government has become more in involved in health care decisions. Doctors today need to treat huge numbers of patients to generate enough revenue to cover their costs. They often don’t have the ability to properly focus on their patients’ needs and may prematurely kick their patient to a specialist or order costly tests. The value-based system that Dr. Cassidy envisions would create greater synergy between doctor and patient, reduce malpractice costs, and provide higher quality service. Unfortunately, Obamacare will force doctors to see even more patients – thereby reducing individual attention even further – because it cuts physician reimbursements to the bone.

The largest single challenge centers on how to pay for the plan. The Democrats propose that everyone be required to carry insurance. They blithely assume that everyone will happily buy expensive insurance to subsidize those who have pre-existing conditions. Welcome to Dreamland; there’s no way that healthy young Americans will incur these huge costs, even with the threat of harsh (but obviously unenforceable) penalties.

Republicans have offered a far more palatable solution. Instead of arm-twisting middle-class Americans, Republicans propose to focus subsidizes on the limited market of individuals with medical challenges, and allow everyone else to buy competitively-priced products.

Dr. Cassidy is one of less than 20 health professionals in Congress able to offer realistic solutions based on their first-hand experience within the health system, but unfortunately, their sensible solutions have fallen on deaf ears. Perhaps the spider that Ms. Pelosi was speaking about had a venomous bite that has driven her to push these disastrous policies. God willing, her colleagues will listen to Dr. Cassidy and the American people.

SOURCE




Big rise in complaints about NHS nursing care

But complaints are usually responded to by bureaucratic coverups and there are no apparent changes

For 12 months, while her son Kane underwent treatment for cancer, Rita Cronin sat by her youngest child's bedside. She fed him, gave him drinks, washed him and ensured he had a bedpan. And if Rita was unable to be there, husband Peter, daughter Emma or other son Matthew would take over the nursing duties.

'We'd learnt, quickly, that if we didn't carry out his basic care then we couldn't rely on the nurses to do so,' says Rita, 50, a civil servant from Balham, South-West London. 'It wasn't just Kane who was affected. We saw buzzers being left out of reach and patients missing meals, as no one had the time to feed them. 'The attitude was that patients had to wait. That nurses had other, more important, things to do. The more you asked for things, the more irritated they seemed to become. The night nurses were the worst - they were always "too busy" even to bring a bedpan. But the day ones were often unhelpful, too.'

St George's hospital, in Tooting, where Kane was a patient, 'is an award-winning hospital, yet we may as well have been in a third-world country for the nursing care my son got,' says Rita.

Strong words, but Rita is, tragically, qualified to say them. For three days after being admitted to the hospital for a hip replacement, her 22-year-old son was dead from dehydration. Kane had suffered brain cancer - while treatment was successful, the chemotherapy and radiotherapy had weakened his bones, causing him to the need the surgery. The cancer had affected his pituitary gland, which regulates the body's mechanisms, such as hydration. So, Kane was on desmopressin, medication to control the flow of fluid in his body. We later discovered that the day Kane was admitted in to hospital was the last time he took desmopressin,' says Rita.

Following his hip operation, a routine test showed Kane's sodium levels were high; his fluid levels were out of balance. A ward nurse was told this by the hospital lab, but she went off duty without sorting out treatment. He began begging for water. When his requests were turned down he became - understandably - aggressive. Inexplicably, instead of reading his notes which would have indicated the problem, nurses called security staff who restrained him.

An increasingly desperate Kane then rang the police and begged for help to get a drink. The police turned up, but were sent away by nurses who reassured them Kane was confused.

By the time Rita went to see him before work the next day, it was clear her son was very ill. 'The night nurse was standing outside the room handing over to the day nurse and I said I thought Kane was really ill,' she says. 'It was clear she thought I was being neurotic and said he was fine.'

It wasn't until the ward doctor appeared on his rounds, nearly 15 minutes later, that suddenly everything changed. He took one look at Kane and quickly called for help.'

The post mortem revealed Kane had died from dehydration. Rita has other ideas, and so, it seems, does the coroner who adjourned the inquest, calling the police in to investigate.

'Kane died because of sheer incompetence of the nurses who failed to do their job,' says Rita. 'I found out later that the nurses were offered counselling. They should have been in another job.'

Over the past few years there have been far too many similar accounts. Despite all the money poured into the NHS, and the proliferation of training, job titles and initiatives, it seems patient experience is not improving. Poor nursing care was a key factor in the 400 deaths at Mid Staffordshire NHS Foundation Trust, according to the recent official investigation. Staff numbers were allowed to fall 'dangerously low', causing nurses to neglect the most basic care. While many staff did their best, others showed a disturbing lack of compassion to patients, said Robert Francis QC, heading the inquiry.

Basic nursing care and lack of hygiene have also been blamed for 70 deaths at Basildon University Hospital, where the Care Quality Commission, the health service regulator, found, among other basic failings, blood-splattered equipment and patients lying on stained and soiled mattresses.

And statistics would suggest they are not one-offs. Complaints about nurses have risen by 18.9per cent in the past year, according to the Nursing and Midwifery Council (NMC) , the profession's regulatory body. Although the organisation points out that this figure represents just 0.2 per cent of their total membership, the fact is complaints investigated by them have risen by 30 per cent since 2005.

Experts think the problem is actually far more endemic than even these figures suggest, as many people don't know about the NMC - and instead complain through the hospital system. 'Even then, many incidents are not investigated properly,' says Vanessa Bourne, of the Patients' Association. 'Answers to complaints generally fall into one of two categories; either the letter will say: "You haven't been able to name the nurses responsible so we can't investigate". Or, "you have named the nurses responsible, but they deny any wrong-doing, so we can't take the investigation further".

'The NHS managers and nursing bodies like to say this poor treatment is from a minority of nurses, but it is more about a fundamental lack of decent nursing leadership and a refusal to admit that mistakes are being made. 'When the Staffordshire scandal broke last year, we were inundated with a deluge of heartbreaking cases where people had received careless, sloppy or even rude and cruel treatment at hospitals up and down the country, and where no investigation had ever been carried out. 'The Department of Health bring out endless guidelines and initiatives on patient satisfaction and safety, but our complaint rate doesn't drop.'

Nurses themselves are also concerned about levels of care. A recent survey for the Nursing Times found that only a third of nurses were confident the poor standards at Mid Staffordshire weren't being repeated to some degree in their own hospitals.

Last week, the government published the first comprehensive report on the profession in 40 years. The Commission into the future of nursing and midwifery made some recommendations on how nursing could be improved for the 'new challenges ahead'.

While it was initiated before the recent scandals broke, there's no doubt those events were key to its proposals. 'Events like Mid Staffs do tend to focus the mind,' says Heather Lawrence, a former nurse, now chief executive of Chelsea and Westminster Hospital and a member of the commission. 'And I would agree that in some areas of the country - not all - patient trust has been eroded. As a result there has now been an acceptance within the NHS that the way some wards have been managed has not always been in the patients' best interests.'

In order to help restore patient trust, the Commission wants all nurses to pledge their "commitment to society and service users... to give high-quality care to all and tackle unacceptable variations in standards". 'The Commission is clear that high-quality, safe and compassionate care must rise to the top of the agenda for a 21st-century worldclass NHS,' said health minister and commission chair Ann Keen.

It begs the question: if high-quality, safe and compassionate care is not a priority for some nurses, why are they nursing at all? 'We welcome the pledge, but it is a sad indictment that there is a need for one in the first place,' says Vanessa Bourne. 'Patients should expect compassion.'

'The bottom line is that in Mid Staffs - - and we believe in many other hospitals, still - - there was a culture of nurses saying "its not my job". But if everyone says that, then the job - whether it's feeding a patient, or getting them a bed pan simply doesn't get done. 'Nursing is about rolling up your sleeves and caring and too many nurses seem to forget that. 'Our response would be that if you don't want to do the nitty-gritty of spoon-feeding an elderly patient or changing soiled sheets, then don't go into nursing.

'Employers also have to accept that not everyone who comes into nursing will be cut out for the job. I was told by a university nursing tutor that some trainees on her course who were clearly not suited to nursing and not interested in caring, but it was impossible to remove them because of funding complications.

So what is the solution? The official response is that we need better leadership - giving ward sisters more authority. 'One of the things we found was that on many wards there was no one figure who had the authority to properly lead the ward,' says Heather Lawrence. 'In the Mid Staffs inquiry it was discovered that one nursing sister was in charge for three wards - an impossible task.'

Nurses acknowledge leadership is part of the problem; and the solution. The Nursing Standard magazine (the nurse's own trade magazine) is campaigning to boost the authority and status of ward sisters. 'All these NHS scandals have a common theme,' says editor Graham Scott. 'There was not a clear, identifiable person in charge of the ward. 'We have ward sisters, specialist nurses and nurse specialists, nurse consultants and modern-day matrons. No wonder people get confused about who is in charge.'

But will such a simple solution make the wards a better and safer place for patients? According to Graham Scott, it will. 'Research shows that on a ward where there is an identifiable - and, most importantly, accountable - person in charge, patients have a much better experience,' he says.

The finger of blame is also being pointed at healthcare assistants, who do the basic caring jobs, such as washing, feeding and changing bedpans. 'Some NHS Trusts do train nursing assistants properly,' explains Graham Scott. Others don't. Cleaning, washing and feeding a patient are actually quite complex tasks.'

The Commission recommended these staff need some form of regulation to ensure high-quality care. 'We have to be careful about blaming the healthcare assistants,' says Bourne. 'After all, they are supposed to be supervised by the nurses.'

But will any of this make a real --difference? It seems there will be no legal recommendations to abide by the regulations. 'We do tend to raise our eyebrows at these recommendations,' notes Bourne. 'There is a big noise about them, and then everything goes back to how it was. We still get horror stories like poor Kane's. We are told things will change and they don't.'

Indeed St George's has told Rita Cronin they've made changes to ensure what happened to her son can never happen again. 'But what exactly are these changes?' she asks. 'My son suffered a needless death. How I do know that the same thing isn't happening to someone else?'

A spokesman for the hospital said: "We are extremely sorry about the death of Kane Gorny. 'From the investigation it was clear that there had been failures in communication between clinical staff. Disciplinary action did result from our findings and a number of important changes have been introduced to help prevent such a tragic incident from happening again.'

SOURCE





16 March, 2010

Democratic leaders say health bill will pass

Democratic leaders scrambled Sunday to pull together enough support in the House for a make-or-break decision on health-care reform later this week, expressing optimism that a package will soon be signed into law by President Obama despite a lack of firm votes for passage.

The rosy predictions of success, combined with the difficult realities of mustering votes, underscore the gamble that the White House and congressional Democrats are poised to make in an attempt to push Obama's health-care plans across the finish line. The urgency of the effort illustrates growing agreement among Democratic leaders that passing the legislation is key to limiting damage to the party during this year's perilous midterm elections.

But House Minority Leader John A. Boehner (R-Ohio) pledged to do "everything we can to make it difficult for them, if not impossible, to pass the bill." He also joined other Republicans Sunday in warning that Democrats would pay for the legislation by losing even more seats than expected in November.

The most optimistic talk on Sunday came from the White House. Obama senior adviser David Axelrod predicted that Democrats "will have the votes to pass this," and press secretary Robert Gibbs declared that "this is the climactic week for health-care reform."

But Rep. James E. Clyburn (S.C.), the Democrats' chief head-counter in the House, cautioned that the party has not yet found the 216 votes needed to win approval of the health-care bill passed by the Senate in December. "We don't have them as of this morning, but we've been working this thing all weekend," Clyburn said on NBC's "Meet the Press." "I'm also very confident that we'll get this done."

Democratic leaders are struggling to assemble support amid opposition to the Senate legislation from conservative Democrats, who object to abortion-related language in the bill, and from liberals, who are disappointed about the lack of a public insurance option and other measures. Obama has postponed a trip to Indonesia and Australia to help whip up support for the package.

Republicans pressed ahead Sunday with a battery of arguments against the Democratic plans, saying that polls show firm public opposition to the legislation and that Senate leaders are using parliamentary gimmicks in an attempt to win final passage. Sen. Lindsey O. Graham (R-S.C.), who has signaled a willingness to work with the administration on immigration and detention issues, said Obama's "arrogant" push for health-care reform has divided the country and threatens bipartisan cooperation.

"When it comes to health care, he's been tone-deaf, he's been arrogant and they're pushing a legislative proposal and a way to that legislative proposal that's going to destroy the ability of this country to work together for a very long time," Graham said on ABC's "This Week."

The Democrats' strategy calls for the House to pass the Senate version of reform, followed by consideration of a package of fixes to that legislation known as a reconciliation bill. The fixes must meet specific budget requirements allowing it to be approved in the Senate with a simple majority vote. The approach avoids having to muster 60 votes to overcome a threatened GOP filibuster; Democrats control 59 seats.

House Democrats expect to receive a final cost estimate by Monday afternoon, when the House Budget Committee is scheduled to vote on the reconciliation package. It would then go to the House Rules Committee, where Chairman Louise M. Slaughter (D-N.Y.) could package it with the $875 billion measure the Senate passed on Christmas Eve. The package is also expected to include Obama's proposed overhaul of the student-loan system.

The full House is expected to vote on both measures by week's end, with the climactic moment coming as soon as Thursday but, more likely, Friday or Saturday, aides said.

SOURCE




An undead corpse

Almost nobody is happy with what Sarah Palin dismisses as President Obama's "hopey-changy stuff," but the worst outbreak of hopey-changy just won't stay dead. The president's health care "reform," regarded as road kill only a month ago, is headed for a close vote in the House that he might still win.

There's abundant evidence that Mr. Obama's toxic agenda seems to be disintegrating before our very eyes. Democrats with a bad case of nerves (this includes most of them) finally admit that Obamacare has "problems," and several Democratic office-holders in Missouri suddenly had business elsewhere when the president showed up for a rally in St. Louis this week. Robin Carnahan, the Missouri secretary of state who is the leading Democratic candidate in pursuit of the Senate seat that Kit Bond, a Republican, is relinquishing, wanted ever so to be there but she had to wash her hair, or buy a stamp, or couldn't find a taxi to get to the airport for a flight home. Or whatever.

Blanche Lincoln of Arkansas, the most vulnerable Democratic incumbent, got roughed up at a tea party and is running now against the Democratic Party. "I don't answer to my party," she says. "I answer to Arkansas." Actually, she slavishly answered to her party until she stumbled into the tea party, and, as they say down on the farm, "got a little religion." Her free fall in the public-opinion polls continues.

The president no doubt feels her pain, since it's similar to his own. A new Gallup Poll finds that the president's approval rating has fallen to 46 percent, against a 45 percent disapproval. Some polls find bad news worse than that. Some Democrats ask bluntly whether Mr. Obama is losing his base. Indeed, the only people more contemptuous of the president than the conservatives are the liberals on the president's left-most flank. A growing number of them, even those who insist on calling themselves progressives, warn - or boast - that they've had it with the messiah of Hyde Park and intend to pay him back in November with the handiest club they can find, i.e., sacrificial congressional candidates.

"The liberal wing of the Democratic Party is now in shock," Chris Bowland of Santa Rosa, Calif., once a community activist like Barack Obama, tells USA Today. "It's very clear that the party hates us and has no respect for [the] base. ... Obama has broken his campaign promises and now, 'We've had it. I'm done.' "

The conventional rap on the president is that he has been aloof and disengaged, reluctant to impose discipline and leadership, and allowed his radical agenda to drift into the congressional swamp presided over by Nancy Pelosi and Harry Reid.

But wait. Maybe he hasn't been so disengaged as the conventional wisdom supposes. His strategy of imposing no discipline on Congress may be a deliberate act of leadership. Barack Obama came to Washington with an agenda from his community-organizing days. He made his bones with Saul Alinsky, the evangelist of radical politics who put down the blueprint for making America over into a European-style welfare state, with commissars empowered to supervise every detail of how Americans would live lives regimented for their own good. The debate over health care reform has been messy and often chaotic, but here we are a year later and Barack Obama and his radical agenda might yet win. If it does, he will have put in place the structure for taking over everything else.

His remark several months ago that he was willing to be a one-term president if that's what it takes to reorder America was dismissed as an irrelevancy, an aside from a man having a bad hair day. But the remark revealed an insight into the man and his mission. Karl Rove, "the architect" of George W. Bush's two successful campaigns, thinks an Obama victory over Obamacare would be a pyrrhic victory, that it might insure a Republican takeover of both House and Senate. Perhaps. But it might be a price that the president is willing to pay to get his structure in place.

The Republicans could come to office determined to repeal the monstrous "reform," but that would be easier said than done. A new Republican Congress wouldn't have the numbers to override a presidential veto. Besides, boldness is not a Republican virtue. The Republican takeover of '94 is not a reassuring omen. Killing the corpse graveyard-dead is easier now.

SOURCE




If the Democrats break it, they bought it

If Obamacare passes this week, every American will rightly blame every problem they have with American medicine in the future on the Democrats.

Every inability to get an appointment with a specialist or even a general practitioner. Every increase in insurance rates. Every incomprehensible bill received. Every pharmacist's refusal to fill a prescription without charge or with the drug called for with the pill actually prescribed by the doctor. And especially every inability to actually get insurance or treatment.

Democrats from the president and the House speaker on down have told us over and over again that Obamacare is the salvation of American medicine. When it turns out not to be, and premiums skyrocket and the supply of doctors dwindles, the ownership of the scheme and the method of its passage -- by partisan trickery after clear expressions of voter will in polling and at polls in Massachusetts, Virginia and New Jersey -- will embed in every voter.

"You break it, you bought it" is a phrase familiar to and accepted by most Americans. Democrats are about to break American health care -- which is extraordinary in the cures it delivers and works quite well for hundreds of millions of Americans -- and they are doing so for partisan reasons.

The consequences of the jam-down, if it succeeds, will reshape American politics. Five Ohio Democratic members of Congress, for example, face a choice this week between the demands of Speaker Nancy Pelosi and the president, and the desires of their constituents.

Zack Space, Charles Wilson, Marcy Kaptur, Steve Driehaus and John Boccieri have districts that range across the Buckeye State, but each of those districts could easily turn red this fall and punish the members who voted for the deeply unpopular Obamacare. Space, Wilson, Kaptur, Driehaus and Boccieri are being asked to vote for the Cornhusker Kickback, the Louisiana Purchase and special deals for Florida's elderly, but not Ohio's. Are they that deeply in Pelosi's pocket?

At least 50 House Democrats, from Tim Bishop on Long Island, N.Y., to Gabrielle Giffords in Tucson, Ariz., are in the same bind, but the Ohio representatives come from a state that is reeling from job loss and is seeing a sharp turn back to common sense, led by the campaigns of John Kasich for governor and Rob Portman for senator. A wave is building in Ohio, and a vote for Obamacare will only increase the exposure of these incumbents.

Rank-and-file Democrats in office all across the country have to be asking themselves, why this rush to self-destruct? Not only will a "triumph" on Obamacare cost the party its huge majorities in both houses in 2010, it will saddle the party with the legacy of damaging American health care that will define it for generations.

This is the sort of risk that has brought other major legislative overhauls forward under bipartisan banners. In recent decades, the prescription drug benefit, No Child Left Behind and welfare reform advanced major change with bipartisan backing from Congress, thus immunizing either party from the political costs of major change.

But those programs were small compared with the massive assault on American medicine reaching its crucial vote this week. If enough congressional arms are twisted and the savaging of American medicine proceeds, it has "Democrat" written all over it. And from that day forward, every tragedy that isn't averted because a doctor wasn't there or a medicine hadn't been developed or a hospital had been obliged to close will be the fault of Democrats who gambled with the lives of Americans even as the country fairly screamed, "Don't do it."

SOURCE




Obama's sick obsession

Nationalized health care is the progressives' Golden Fleece. It is their obsession, the ultimate prize that was denied to previous administrations but is closer than it ever has been. As the ability of government to take over the health care system draws tantalizingly near, the president and leaders of the majority party have become infected with a kind of mania. President Obama and Democratic congressional leaders seem determined to ram through a severely flawed piece of legislation by any means necessary, heedless of the desires of the American people or the negative impact on the system they mistakenly say needs to be saved.

A large majority of Americans are satisfied with their current health care plans, though most also think the system could be improved. Yet proponents of the Democrats' radical health care overhaul brazenly claim the system is irretrievably broken and only radical surgery will save it. According to the latest Gallup poll numbers, less than a fifth of even those who favor health reform agree with that position. The majority of Americans are divided between those who want a scaled-back health care measure and those who want the current project dropped entirely. If any system is broken, it is the legislative process.

Long-time Democratic pollsters Patrick H. Caddell and Douglas E. Schoen warned last week that "the battle for public opinion has been lost" on heath care. Democrats have backed themselves into a corner. If the bill fails, they suffer a defeat. But if they win, they also lose because Democrats "will face a far greater calamitous reaction" in November. "Wishing, praying or pretending will not change these outcomes," they caution.

But the glittering prize is too near for such sage counsel. The liberal leadership is infused with a sense of mission. They are the midwives to history, shepherding landmark legislation that will revise the American social contract and usher in a new era, or some such foolishness. All they need to do is pass the bill, and the poor, frightened, deluded American people will see the wisdom of their decisions. Hence House Speaker Nancy Pelosi's memorable (and revealing) comment, "We have to pass the [health care] bill so that you can find out what is in it." In her imagination, once the bill is signed, voters won't remember the struggle, just the glow of the accomplishment. Rip off the bandage; you'll feel better after the sting.

The Democrats' headlong drive is leading to bouts of political insanity, such as the aptly named Slaughter rule, which potentially could allow the House of Representatives to "deem" the health bill passed without a final vote. That the Democratic leadership would consider resorting to such a stunt betrays a high degree of contempt for the electorate, whom they presumably think will not remember or care that their representatives would not go on the record on such a major piece of legislation.

Disaffected voters, however, will recognize cowardice for what it is. Add to this the Louisiana Purchase, the Cornhusker Kickback, the backroom dealing, special-interest loopholes and fundamental unsoundness of placing government at the center of the health care system, and November will be a slaughter indeed.

SOURCE




Betrayal of 20,000 cancer patients: British rationing body rejects ten drugs (allowed in Europe) that could have extended lives

Up to 20,000 people have died needlessly early after being denied cancer drugs on the NHS, it was revealed yesterday. The rationing body NICE has failed to keep a promise to make more life-extending drugs available. Treatments used widely in the U.S. and Europe have been rejected on grounds of cost-effectiveness, yet patients and their loved ones have seen the NHS waste astronomical sums. Last week it emerged that £21billion - a fifth of the entire annual budget - was spent on failed schemes to tackle inequality.

NICE, the National Institute of health and Clinical Excellence, promised a year ago to make it easier for drugs for rarer cancers to be approved. But since then four drugs which could have benefited 16,000 people have been turned down outright and a further six which could have helped 4,000 more have been provisionally rejected. Just five drugs have been accepted - benefiting 8,500 people - says a damning report by the Rarer Cancers Forum. Drugs for rarer forms of cancer are often much more expensive than those for common tumours because pharmaceutical companies cannot make economies of scale.

NICE's promise to approve more drugs was in response to widespread anger over its rejection of sunitinib, also known as Sutent, for advanced kidney cancer - even though it had been proved to double the life expectancy of patients compared to standard treatments.

Andrew Wilson, chief executive of the Rarer Cancers Forum, said: 'Although progress has been made, there is still more to do. 'It is unacceptable that thousands of patients are still missing out on the treatment they need, and their doctors want to give them, because NICE has decided that their treatment does not meet some arbitrary criteria. 'The changes introduced by NICE should be benefiting more patients than they are. An urgent review of NICE's processes is needed.'

The RCF also says NICE works so slowly that it takes 21 months to decide on a drug, during which time many patients die. This is despite promises from NICE bosses to get the decision time down to six months by the end of this year. Mike Hobday, head of campaigns at Macmillan Cancer Support, said: 'The system is failing people with rarer cancers. It's time for a more flexible approach.'

NICE's treatment of rarer cancer drugs contrasts sharply with its breast cancer drug herceptin, which has received far more funding following successful campaigns. If a patient is refused a drug, they are allowed in many cases to appeal to their primary care trust. But the RCF report uncovered a huge postcode lottery, with some trusts much more likely to back down on appeal. Of 62 PCTs, 11 approved all drugs and two approved none. And while 26 per cent of English patients have their 'exceptional case' requests rejected, the figure in Scotland is just 11 per cent.

The RCF says appeals are so expensive in terms of staff time that it would be cheaper just to give everyone the drugs they want. Its report also warns: 'PCTs are frequently using inappropriate processes to determine funding applications and a small minority of commissioners may be breaking the law by operating a blanket ban on the funding of treatments outside their licensed indication.'

In Bromley, for example, cancer treatments were less likely to be funded than cosmetic procedures. Another difference between PCTs is that some reimburse the cost of any private treatment but others do not.

NICE said last night: 'We have introduced significant additional latitude in appraisal of treatments for cancer, particularly where they are designed to extend life. 'Our End of Life Treatments protocol, introduced at the beginning of 2009, has already made it possible for very expensive cancer treatments to be recommended when our standard approach would have resulted in more cautious guidance.'

SOURCE




British retirees died after 'hospital staff ignored warnings over their conditions'

Two patients died after hospital staff repeatedly ignored warnings over their conditions, including one who choked on his false teeth, nursing chiefs admitted. Staff at Royal Sussex County Hospital, in Brighton, East Sussex, “could have done better” to prevent the deaths of two pensioners last year after failing to follow basic procedures, officials admitted.

After a corner’s damning ruling that staff at the hospital were guilty of repeated mismanagement and miscommunication, officials have made "major changes" [major bulldust, more likely] to nursing care and apologised to the patients' families.

An inquest at Hove Crown Court had heard that Brian Waller, 72, died after falling out of bed in April last year while a month later Edward Warneford, 66, died in the same ward after choking on his false teeth. In her ruling Veronica Hamilton-Deeley, the local coroner, strongly criticised the Brighton and Sussex University Hospitals NHS Trust, and said changes needed to be urgently made.

The inquest last month heard that Mr Waller, who was being treated for heart problems, fell out of his hospital bed despite wearing a wrist band with "risk of falls" written on it. He had landed on his head, broke his neck and suffered a massive bleed on his brain, which led to his death six days later. It was later discovered one of the guard rails on his bed had been left down. A doctor had also allegedly missed the fracture in his neck and cleared him to return to his ward, the inquest heard.

Mr Warneford, a former engineer, from Hove, East Sussex, died because staff did not even realise he was wearing dentures, his sister claimed. April Moss, 62, from Gosport, Hampshire, claimed her brother, who had alcohol problems, then choked on them as he ate, causing him to have a fatal heart attack.

Sherree Fagge, Brighton and Sussex University Hospitals’ chief nurse, admitted on Friday that staff could have done better. "We are however profoundly aware that for both Mr Waller and Mr Warneford we could have done better and we have met with both their families to apologise, listen to their concerns and assure them that lessons have been learned,” she said. "We have introduced some major changes focused completely on the quality of our nursing care. Every week all of our most senior nurses, including myself, are working on the wards undertaking direct patient care alongside front line nursing staff. "What I see … is that the majority of our nurses are working hard and carrying out their duties with the kindness and compassion we would want for our own families.”

SOURCE





15 March, 2010

Why the Health Bill Makes No Sense

So it's come down to this -- desperate Democratic leaders strong-arming members on the worst bill ever before they go home to explain to constituents why they decided to commit political suicide. We've said just about all we've had to say on this issue -- actually dating back to 1993-94, when we wrote nearly 100 editorials in opposition to HillaryCare. Since January of last year, we've weighed in 150 more times against the latest version of socialized medicine. But to review, here are just 15 reasons why a government takeover of the finest medical system in the world makes no sense at all:

1. The people don't want it! This, we would think, should have some bearing on decision-making. Yet the Democrats forge ahead without consent of the governed. In the latest Rasmussen poll, 53% opposed the Democrats' reform while 42% were in favor. More than four in 10 "strongly" opposed; just two in 10 "strongly" favored. This jibes with other surveys, including our own IBD/TIPP Poll, taken since last year.

2. Doctors don't want it! A survey we took last summer of 1,376 practicing physicians found that 45% would consider leaving their practices or taking early retirements if the Democrats' reform became law. In December, the results were validated by a Medicus poll in which 25% of doctors said they'd retire early if a public option is implemented and another 21% would stop practicing even though they were far from their retirement years. Even if the bill doesn't have a "public option," nearly 30% said they'd quit the profession under the plans being considered.

3. Half the Congress doesn't want it! Not a single Republican backed the health care bill that cleared the Senate on Christmas Eve 60-39. House passage was by a slim 220 to 215, and the lone Republican "aye" has since switched to "no." Columnist Michael Barone says other changes would put the House vote today at 216-215 in favor, and he has doubts Democrats can even muster 216.

House Speaker Nancy Pelosi made her job of securing yes votes even more difficult last week when she told a meeting of county officials that "we have to pass the bill so you can find out what is in it." Members of Congress aren't waiting: They've already exempted themselves from whatever they inflict on us.

4. People are happy with the health care they've got! Polls show that 84% of Americans have health insurance and that few are displeased with what they've got. Last month, the St. Petersburg Times looked at eight polls and reported that satisfaction rates averaged 87%.

5. It doesn't even cover the people they set out to cover! Supporters of government-run health care say there are as many as 47 million Americans ? 9 million to 10 million of them illegal aliens ? without medical insurance. The Democrats' plans, however, will put only 31 million of the uninsured under coverage.

6. Costs will go up, not down! Democrats say their plans will cost less than $1 trillion over the first decade. But analyst Michael Cannon at the Cato Institute puts the cost at $2.5 trillion over the first 10 years. Even if we go with the government's lower estimates, the cost is already on the rise. A new estimate by the Congressional Budget Office puts the cost of the Senate bill at $875 billion over 10 years, $4 billion more than its original projection. Imagine how fast costs would soar if one of the bills became public policy.

7. Real cost controls are nowhere to be found! The Democrats are offering no meaningful tort reform that will help push down the high malpractice insurance premiums that are a burden to doctors and their patients. Nor are they considering any other cost-saving provisions, such as allowing the sale of individual health plans across state lines or easing health insurance mandates.

8. Insurance premiums will rise, not fall! One goal of nationalizing health care is to lower costs, to bend the spending curve downward. Yet, as Democratic Sen. Dick Durbin acknowledged Wednesday, that won't be the case.

"Anyone who would stand before you and say, 'Well, if you pass health care reform, next year's health care premiums are going down,' I don't think is telling the truth," he said from the Senate floor. "I think it is likely they would go up."

An analysis completed by the CBO at the request of Sen. Evan Bayh confirms Durbin's suspicions. Insurance coverage in the individual market will "be about 10% to 13% higher in 2016 than the average premium for nongroup coverage in that same year under current law," it concluded.

9. Medicare is already bankrupting us! The Medicare trust fund, which has unfunded obligations of $37.8 trillion, will be insolvent in 2017. How can lawmakers justify another entitlement that will cost trillions when they can't pay for existing liabilities?

10. There aren't enough doctors now! Last month, 26% of physicians responding to a Web poll on Sermo.com, which calls itself "the largest online physician community," said they had been forced to close, or were considering closing, their solo practices. Providing coverage for an additional 31 million Americans when the number of doctors is shrinking won't improve our health care.

11. The doctor-patient relationship will be wrecked! The latest IBD/TIPP Poll, taken just last week, found that Americans, by a wide 48%-26% margin, believe the doctor-patient relationship will decline if the Democrats' plan is passed.

12. Medical care will also deteriorate! IBD/TIPP has also found that 51% of Americans believe care would get worse under government control. Only 10.5% said they felt it would improve. In our doctor poll, 72% disagreed with administration claims that the government could cover 47 million more people with better-quality care at lower cost.

13. Rationing of care is inevitable! Health care is not an unlimited resource and must be rationed, either by the individual, providers or government. In Britain and Canada, where the government does the rationing, medical treatment waiting lists are sometimes deadly and quite often excessively long.

For instance, late cancer diagnoses in an overcrowded public health care system cause up to 10,000 needless deaths a year in Britain. The reasons cited for the late diagnoses include doctor delay, delay in primary care, system delay and delay in secondary care.

14. Private health insurers will be destroyed! Added mandates and price controls will force many insurers to simply get out of the health plan business because it will no longer be profitable.

15. It's probably unconstitutional! One way to help bring down the number of uninsured is to demand that those without coverage buy health plans. But the government has never passed a law requiring Americans to buy any good or service. Constitutional scholars say any such mandate would likely draw a legal challenge.

SOURCE




Top Democrat Implies Obama Not ‘Telling the Truth’ about Health Care Premiums

Senate Majority Whip Dick Durbin (D-Ill.) on Wednesday contradicted President Barack Obama on whether the health care reform bill will lead to a decrease in health care premiums. Durbin claimed that rates would go up, while the president said the rates would go down. “Anyone who would stand before you and say well, if you pass health care reform, next year's health care premiums are going down, I don't think is telling the truth. I think it is likely they would go up, but what we are trying to do is slow the rate of increase,” Durbin said, speaking on the Senate floor.

Compare Durbin’s remarks to what President Barack Obama said during a speech at Arcadia University in Glenside, Pa., on Monday: “Our cost-cutting measures mirror most of the proposals in the current Senate bill, which reduces most people’s premiums and brings down our deficit by up to $1 trillion over the next decade because we’re spending our health care dollars more wisely,” the president said. “Those aren’t my numbers. Those aren’t my numbers --they are the savings determined by the Congressional Budget Office, which is the nonpartisan, independent referee of Congress for what things cost,” Obama added.

But as CNSNews.com reported, the Congressional Budget Office’s analysis of the final Senate health care bill indicates that it would impose a mandatory $15,000 annual fee on middle-class families that earn greater than 400 percent annually of the federal poverty level. That means $88,200 for a family of four.

Among the five basic facts that the CBO analysis cites about the bill is that “Your family insurance plan – if your employer drops your coverage and you are forced to buy it on your own – will cost about $15,000 per year when the legislation is in full force in 2016.”

SOURCE




Dems seek agreement, quick vote on health care

Under White House pressure to act swiftly, House and Senate Democratic leaders reached for agreement Friday on President Barack Obama's health care bill, sweetened suddenly by fresh billions for student aid and a sense that breakthroughs are at hand. "It won't be long," before lawmakers vote, predicted Speaker Nancy Pelosi. She said neither liberals' disappointment over the lack of a government health care option nor a traditional mistrust of the Senate would prevent passage in the House.

At the White House, officials worked to maximize Obama's influence over lawmakers who control the fate of legislation that has spawned a yearlong struggle. They announced he would make a campaign-style appearance in Ohio next week to pitch his health care proposals, as well as delay his departure for an Asian trip later in the month.

With Democrats deciding to incorporate changes in student aid into the bill, Republicans suddenly had a new reason to oppose legislation they have long sought to scuttle. "Well of course it's a very bad idea," said Senate Republican leader Mitch McConnell of Kentucky. "We now have the government running banks, insurance companies, car companies, and they do want to take over the student loan business." He said it was symptomatic of Democrats' determination to have the government expand its tentacles into absolutely everything."

At its core, the health care bill is designed to provide health care to tens of millions who lack it and ban insurance companies from denying medical coverage on the basis of pre-existing medical conditions. Obama also wants the measure to begin to slow the rate of growth in medical costs nationwide. Most people would have to get insurance by law, and families earning up to $88,000 would receive subsidies.

Whatever the outcome, there was no doubt the issue would reverberate into this fall's elections, with control of Congress at stake. The health care bill appeared on the cusp of passage in early January, but was derailed when Senate Republicans won a Senate seat in Massachusetts, and with it, the strength needed to sustain a filibuster and block a final vote.

In the weeks since, the White House and Democrats have embarked on a two-part rescue strategy. It calls for the House to pass legislation that cleared the Senate in December, despite numerous objections, and for both houses to follow immediately with a second bill that makes changes to the first. The second, fix-it bill would be drafted under rules that strip Senate Republicans of the ability to require Democrats produce a 60-vote majority.

Obama outlined numerous requested changes several weeks ago, many of them designed to satisfy the concerns of House Democrats. They would increase subsidies for lower income families who cannot afford insurance; give additional money to states that provide higher-than-average benefits under Medicaid, and gradually close a coverage gap in the Medicare prescription drug program used by millions of seniors.

Congressional officials said all three issued would be addressed in the fix-it bill, although other administration requests remained in doubt. The president wants creation of a commission with authority to force savings in Medicare and Medicaid, for example, and is seeking the deletion of items sought by individual senators. Those were among the issues still in dispute after days of secretive talks involving the White House and House and Senate leaders.

The decision to add far-reaching student aid changes to the bill had its roots in obscure parliamentary rules governing the Senate's debate of the legislation. But House Democrats and the White House quickly seized on it as a way to advance a top administration priority that lacks the 60 votes needed to clear the Senate otherwise. The measure would require the government to originate student loans, closing out a role for banks and other private lenders who charge a fee. Obama proposed taking the savings and plowing it into higher Pell Grants that go to needy college students. Officials said that under current estimates, the change would free as much as $66 billion over a decade, although Pelosi indicated she wanted it spread beyond Pell Grants to other education programs.

At a news conference, the speaker confessed to being disappointed that the legislation would not include a government-run health care option, but said other parts of the legislation would hold insurance companies accountable. The tussle over a public option roiled Democrats for months, but has subsided in recent weeks. "We've crossed that bridge," said Rep. Bill Pascrell, D-N.J. "Those people who were saying 'public option' are muted right now. That's done. It's not going to happen. They've hit the mute button."

At a closed-door meeting of the rank-and-file, House Democratic leaders sought to allay concerns that Senate Democrats might simply refuse to pass the fix-it bill after the House swallows the measure it doesn't like. Rep. G.K. Butterfield, D-N.C., said party leaders told the House caucus they have "a firm commitment" from the Senate to do its part.

SOURCE




Dereliction of Duty

How many flavors of crazy is it for President Obama and Democrat leaders to continue the forced march toward a vote on a health care bill despised by the majority of Americans? The New York Times lays out what's happening: "Leaving a meeting of the House Democratic Caucus, lawmakers said they had received few details about what would be in the [health care] legislation, on which they may be asked to vote in the next week or two".

Got that? This is legislation that would remake fully 1/6 of the US economy, and the House members who are being pushed to vote on it aren't even sure about what's in its final version. How, under any circumstances, can voting in favor of this -- given the rush, the uncertainty about the bill's contents, not to mention its effects (and including the widespread, fierce opposition to it) -- be anything other than a dereliction of duty?

Pat Caddell and Doug Schoen warn that passing the legislation will be a political disaster for the Democrats. Frankly, the point is so obvious that it's frightening that it needs to be made.

But the bigger problem now, for Democrats, is that their interests and President Obama's diverge. Many Blue Dogs can save themselves (and their party) if they take a principled stand against ObamaCare. But the President needs this victory -- in a sense, just to stay in the game. Without it, he's revealed as politically impotent. With it, he can at least comfort himself with his "historic" expansion of the welfare state.

Overall, though, the President's in trouble either way this goes. Even if he wins, he's paid a heavy price. First, he's lost the trust of the American people by his willingness to say anythign to get the bill passed; second, he's shown himself willing to ignore the expressed wishes of those he governs; and third, he's revealed himself as arrogant enough to believe that opponents are too stupid to understand what's in the bill -- but once ObamaCare is foisted upon them by the "platonic guardians" in The White House and on Capitol Hill, the ignorant rubes will love it.

A President can come back from political defeat. Recovering after losing the trust of the people is much more difficult.

SOURCE




Health-Care Hell

by Jonah Goldberg

The time for talk is over. So proclaimed the most talkative president in modern memory. I can't remember when Barack Obama said that. Maybe it was during the first "final showdown" on health care. Or maybe it was the third. The fifth? It's so hard to tell when pretty much every week since the dawn of the Mesozoic Era, Obama or Nancy Pelosi or Harry Reid has proclaimed that it is now Go Time for health-care reform. So you'll forgive me if I'm somewhat skeptical about the possibility that the health-care reform debate is about to come to an end.

The president recently said, "Everything there is to say about health care has been said, and just about everybody has said it." But wait. If everything, pro and con, has been said about the subject, by everybody, that means someone isn't telling the truth, right? I mean, if you've said X and not-X, that means you've probably said something that isn't true.

That, at least, is the impression I got this week listening to Obama make his closing arguments for health care at rallies in Pennsylvania and Missouri. It's telling that the president -- long in favor of a single-payer system -- is selling his health-care plan on the grounds that it will increase "choice" and "competition," reduce "government control" and "give you, the American people, more control over your own health insurance."

You know your sales pitch for a government takeover of health care hasn't worked when you have to crib rhetoric from free-market Republicans. And that's after you've already tried to pin your plan's unpopularity on the ignorance of the American people.

Obama's talking points track reality about as well as the screenplay for "Avatar." Indeed, the same week he was hawking competition, choice and less government, Obama backed a new Health Insurance Rate Authority that would do even more to cement big health insurance companies into their new role as government-run utilities.

This latest gambit is of a piece with the White House's demonization of the health-insurance industry. I have no love for that industry myself, but let's get some perspective. As of August, the health-insurance industry ranked 86th in terms of profit margins -- behind anemic industries such as book publishing (38th) specialty eateries (71st) and home furnishing stores (84th), according to data compiled by Mark Perry of the American Enterprise Institute.

Insurance companies account for less than 5 percent of American health-care spending -- less than hospitals (31 percent), doctors (21 percent) and medicine (10 percent). But because health-insurance companies are unpopular, Democrats are beating up on them, even though if Democrats are serious about containing costs, the cuts will have to come from those other slices of the pie.

But enough with the substance. The health-care debate ceased being about substance a long, long time ago. Fair or not, the Democrats' plan is unpopular, period. There is simply nothing Obama can say that will change that fact before Democrats vote for it. That hasn't stopped him from talking out of every side of his mouth. But outside the Obama bunker, no serious pollster, pundit or pol in Washington disputes this basic point: Obama cannot take the stink off this thing.

And that's why the Democrats are contorting themselves like a yoga swami in a hatbox trying to figure out how to pass it. (Note: If it were simply popular among Democrats, it would have passed months ago.) The latest idea involves the "Slaughter Solution" -- named after House Rules Committee Chairwoman Louise Slaughter -- which would allow the House to fix-and-pass the Senate version of the bill without ever voting on the senate version, or something like that.

But here's the thing: There is no "over" to this debate. Obama, Pelosi & Co. have demonstrated time and again that no deadline is final if it means losing. Meanwhile, if ObamaCare passes, Republicans will run on a promise to repeal it, and that means we'll be debating health-care reform at least through 2010. Then, depending on how the election goes, the repeal debate will become part of the legislative process. That will in all likelihood carry the debate into the 2012 presidential election. In other words, there will be time for talk as far as the eye can see.

Now, part of me thinks this is too cruel a future to contemplate. I can't remember whether it was pederasts or mattress-tag removers, but I'm pretty sure someone in Dante's Inferno is condemned to spend eternity listening to a C-SPAN panel on community rating, preexisting conditions and rate pools. But it's a better prospect than losing. That's one point that has bipartisan support.

SOURCE




Baby twins put in NHS hospitals 50 miles apart

Because of very limited facilities for premature births

The parents of two-month-old twins have criticised the NHS for placing their poorly daughters in separate hospitals, 50 miles apart. Stephanie Dawson, 25, and her partner Martin Collins, 38, have to take a 121-mile trip to visit Ruby and Krystal Dawson-Collins, which they said leaves them with just 10 minutes with each daughter.

The twins were born at just 26 weeks in Maidstone Hospital, Kent, weighing 1lb 9oz and 2lb 4oz respectively. They were suffering from Twin to Twin Transfusion Syndrome, where one twin gets more blood in the womb than the other. Following their birth by Caesarean section on January 18 they were transferred to a specialist neonatal unit at St Peter's Hospital in Chertsey, Surrey. After a few days Krystal was deemed well enough to be transferred to Pembury Hospital in Tunbridge Wells, Kent, and split up from her sister.

Her parents, who do not have a car, said they were struggling to visit each baby while still caring for their two other children Mitchel, 10, and Kym. They said that even with the help of friends and family the distance means they can only see their frail daughters twice a week as they cannot leave their Maidstone home until they have collected Mitchel from school. Mr Collins said: "We only get about 10 minutes with each of them, a quick update and a stroke of their heads, before we have to get going.

"It is so awkward getting up through Pembury then into Surrey. "I would have thought it was better for them to be together and it would be easier for us if they were in one place, even if that was in Surrey. "It's like no one realises we are miles away and don't have a car. It is a real struggle, but for the sake of our family, we cannot lose it."

A spokesman for the Maidstone and Tunbridge Wells NHS Trust said the girls needed very specialist care only provided in a handful of hospitals in the South East. He said: "We recognise this is a tough time for Stephanie and Martin and are helping them in any way we can."

Dr Paul Crawshaw, clinical director for paediatrics at the Ashford and St Peter's NHS Trust, Surrey, said the separation was a short-term situation. He said: "We always regret the separation of twins and are well aware of the difficulties it is causing the family. "We hope to get them reunited in the very near future."

SOURCE





14 March, 2010

Obamacare’s Two Americas

Here’s the worst thing you probably haven’t heard about President Barack Obama’s health care plan, which he and his allies are about to force through the Congress despite enormous opposition from the American people: it makes everything onetime vice presidential nominee John Edwards once said about the class divide of “two Americas” come true.

The dirty little secret of this plan—which wouldn’t be a secret if opponents of this legislative package weren’t distracted by a dozen other wrongheaded policies in it—is that it will bring a major and irreversible upheaval to America’s labor markets. In a time of economic tension, this plan will displace millions of workers and push more people into becoming contract employees, resulting in increased instability for working families.

One of the many original stated goals of the White House’s health care reforms was the promise that you can keep your health plan if you like it. However, the White House wanted to give businesses much-needed relief from burdensome health costs. Like the desire to create a new entitlement while reducing the budget deficit, these aims are nearly impossible to reconcile, so Obama chose a path that accomplishes neither.

The president’s plan penalizes an employer for not providing insurance, but the government will subsidize the health care of workers without employer-provided insurance. This effectively allows workers to receive the same compensation package they get today, but with government footing the health-benefits part of the bill, so employers have no need to make up the difference in cash.

The economic benefits of that subsidy far outweigh the penalties—for low income workers, it can result in an enormous difference of over $17,000 per year.

It’s obvious what will happen under this plan: it will not make economic sense for any small business which employs lower-income workers to offer health insurance. And any small business which does so will almost certainly fail, burdened by higher costs than their competitors.

This dilemma could be solved by making the penalties more draconian, but that too would cause business failures, and as with the individual insurance mandate, too steep a penalty would make the plan even more coercive and unpopular.

As John Goodman of the nonpartisan National Center for Policy Analysis recently described it, “High-paid workers with employer-paid insurance will cluster in some firms, while average- and below-average-wage workers will cluster in others. Overall, ObamaCare will create irresistible economic pressure to restructure the entire labor market.”

The only likely outcome of this plan will be for companies to drop coverage entirely. Younger, lower-income workers will be eligible for a subsidy and forced into the health exchanges. That will compel them to do something that doesn’t make economic sense. Most young workers don’t use health care much—unless you give them an incentive to over-consume care by paying for it up front for them.

There’s a final step here, though, that’s critical to understand: once those younger and lower-income workers are forced into a system that eliminates rational decision-making, they are made beholden to these taxpayer funded subsidies, and face massive penalties if their income rises such that they lose the subsidies. The marginal tax penalty for an individual moving up from to $40,000 a year to $45,000 is massive, as also for families earning $95,000 versus $90,000, creating an artificial cliff that dramatically penalizes success.

Thus a new picture of Obamacare emerges: it will force people to pay for what they don’t want and purchase what they don’t need, in a massive expansion of the size and power of government. The entire proposal functions not as a method of improving care or lowering premiums but as a massive regressive tax falling disproportionately on the young and those on the lower end of the income scale. And once in place, it will trap its supposed beneficiaries in ways that cannot be undone.

Combine this regressive tax with a massive increase in spending via a government entitlement which will only grow, and you have a recipe for long-term economic stagnation and the permanent enshrinement of two Americas into our national social policy.

SOURCE




ObamaCare Nuclear Option Deal Close

Behind closed doors, the Obama Administration, House and Senate Democrat leaders are cutting a secret deal on ObamaCare. They have come up with a way to pass the Senate version of ObamaCare in the House without any House members having to vote directly on the bill. Now The Hill is reporting that the House and Senate Parliamentarians are helping to advise Democrats on how to pass ObamaCare. When will the self proclaimed most ethical Congress in history start acting ethical and honest? This 111th Congress has proven, to date, to be the most secretive, non-transparent and devious Congress in recent history.

I explained in a blog on The Foundry yesterday the unethical procedure being used to pass ObamaCare:

House members have come up with a unique way to structure a vote that attempts to avoid the House voting on legislation before it goes to the President. First, the House Budget Committee will report out a reconciliation bill. It is unclear as to whether the Stupak Amendment will be added. This reconciliation measure would be reported for consideration by the House of Representatives as a whole. Speaker Nancy Pelosi (D-CA) would then package the Senate passed Obamacare bill and the House reconciliation measure into one measure. The House rules committee will report out a rule that will allow the Senate passed Obamacare bill to pass the House without a vote.

This seems to be a violation of the constitutional requirement of Article 1, Section 7. The Constitution states in part “Every Bill which shall have passed the House of Representatives and the Senate, shall, before it becomes a law, be presented to the President of the United States.” The House will avoid a direct vote on the Senate passed ObamaCare by passing a self-executing rule that deems ObamaCare to be passed, if the House approves the rule setting up debate on ObamaCare. Under the rule if the reconciliation measure passes, then the Senate passed ObamaCare bill will be deemed to have passed the House without a vote.

There is precedent in the House for self-executing rules. In 2007, the House to pass a self-executing rule during the debate on a War Supplemental. Also, during the budget process over the past few years, the House has inserted language into the annual budget resolutions that ”deems” as passed a debt limit increase. This type of rule allows the debt limit to pass the House without a vote and as similar rule would allow teh Senate version of ObamaCare to pass without a vote.

Late last night, The Hill reported that “Democrats Nearing Deal on Reconciliation”:

House and Senate Democratic leaders and White House officials were optimistic Wednesday evening that they were nearing a deal on a reconciliation package that would smooth the way for them to finally complete health care reform. Congressional leaders and senior administration officials met in Speaker Nancy Pelosi’s (D-Calif.) office late in the day to hammer out a deal on reconciliation, meant to act as a sidecar of adjustments to the original $871 billion Senate-passed health care reform bill.

This meeting was not transparent and not open to the public. Pelosi was behind closed doors in order to cut a deal on a reconciliation measure that the House may consider in the next week or two. Yet again, Democrat leaders have used a closed door secret procedure to craft legislation to impose on Americans.

House Democratic leaders will walk their rank and file through portions of the package in a Thursday morning meeting, a leadership aide said.

This means that only Democrat elites have been part of this negotiation. Not until later today will the House Democrat caucus be allowed to see the reconciliation measure. Republicans need not apply, because they will not be allowed to see the reconciliation measure, until Democrats say so. And for your average American who will have to live under this new health care government run regime, you are not allowed to participate in the legislative process at all.

Reid declined to talk specifics as he exited the meeting. But he sounded optimistic that Democratic leaders were on the verge of a deal on the reconciliation package. “We are making progress. A lot of decisions were made,” Reid said. “I really do believe that the goal we’ve been seeking for such a long time — health care reform — is going to be done. We don’t have it all worked out, but we made a lot of progress.” Reid refused to speculate on a deadline for reaching a deal. President Barack Obama has said he’d like Congress to get health care done this month, and lawmakers are set to head out on a two-week recess beginning March 26.

This story in The Hill indicates that Senate Majority Leader Harry Reid (D-Nev.) is involved in the negotiations. We know that no Republican Senators were allowed to participate in this negotiation. There is a big shocker at the end of this story in The Hill.

Sources said the House and Senate Parliamentarians also attended the meeting to advise on reconciliation rules.

Stop the press! If this report is true, this could be a major scandal for the House and Senate Parliamentarians. They are supposed to be dispassionate umpires. Any appearance of the Parliamentarian gaming the system to aid one side to beat the rules should be denounced by all sides.

This was a very political and partisan strategy meeting with representatives of the White House, Democrat Speaker Pelosi and Democrat Leader Reid. Even if these Parliamentarians were not cheating the system by giving Democrats tips on how to bend the rules, the secrecy of the meeting should have been reason enough for the Senate Parliamentarian and his House counterpart to run for the exit. If Republicans lose every procedural objection during the reconcilation debate, they have a strong argument that the parliamentarians should recuse themselves from this proceeding because of a strong appearance of impropriety.

SOURCE




The Slaughter solution?

I've been dubious that Nancy Pelosi lacks the juice to muscle Obamacare through the House, but her enforcers must be running into a wall. Minority Leader John Boehner's blog introduces us to the aptly named Slaughter solution via this Congress Daily report (PDF). Boehner's blog reports:

The twisted scheme by which Democratic leaders plan to bend the rules to ram President Obama's massive health care legislation through Congress now has a name: the Slaughter Solution.

The Slaughter Solution is a plan by Rep. Louise Slaughter (D-NY), the Democratic chair of the powerful House Rules Committee and a key ally of Speaker Nancy Pelosi (D-CA), to get the health care legislation through the House without an actual vote on the Senate-passed health care bill. You see, Democratic leaders currently lack the votes needed to pass the Senate health care bill through the House. Under Slaughter's scheme, Democratic leaders will overcome this problem by simply "deeming" the Senate bill passed in the House - without an actual vote by members of the House.

Is this some kind of a joke? At NRO, Daniel Foster explains that the joke may be on us. This must be one of the cases described by Brecht in which it is time for the government to dissolve the people and elect another.

JOHN adds: What we're seeing in Washington is appalling, but there is a bright side--the craziness is proof that the Democrats don't have the votes for Obamacare in the House. They've pulled out all the stops, pushed every chip they have into the center of the table, and they still don't have the votes. Will they get them? I don't think anyone knows. Normally I would take the cynical view and say, Sure, if they twist enough arms, in the House they can ultimately do what they want. But they've done pretty much everything they can think of, and they don't have the votes yet. So what reason is there to assume that one more stratagem will put them over the top?

If the Dems do try the Slaughter solution, I think we can deem Congress to be Republican after November.

SOURCE




The Nuclear Option A Neutron Bomb Aimed at the Democratic Majority

What they do today will be used against them in the future -- but they are now so fanatical that they have cast caution to the winds. The GOP backed off a nuclear option over GWB's judicial appointments. They probably won't do likewise in future if Pelosi has her way now. But it's typically Leftist to have no thought for the future. Like children, they must have what they want now

It’s looking more and more likely that Nancy Pelosi and Harry Reid will trigger the so called nuclear option to push through their health care legislation for the benefit of the American people; the very same people whom overwhelmingly have rejected it and its big government solutions to rising medical costs.

Her fanatical desire to pass this legislation has overwhelmed her ability to reason critically, as is evidenced by recent interviews in which she is quoted as saying, “Representatives are not in Washington to self perpetuate their political careers.” While Mrs. Pelosi may inhabit a very safe district, her words have probably come as quite a surprise to a number of her less safe Democratic colleagues. Hopefully she will give them enough advanced warning to begin in earnest the search for a new career.

It has become something of an urban legend among the Democrats that it was their inability to pass health care reform in the first Clinton administration that was responsible for their loss of the Majority in the House. In other words, the American people were deeply upset by the Democrats’ inability to deliver on legislation that would greatly increase their taxes and add mountains of new regulations to an already over regulated health care industry.

This is simply a major misread of history on their part. A more plausible reason for their rebuke and loss of Majority in the following Midterm elections were the Clinton tax increases and the arrogance of their members, as exemplified by the check kiting scandals of the house. This same arrogance was last displayed by members of the Republican party shortly before they lost their Majority status in the midterms in 2006.

Their fall back reasoning to vote for this legislation is no better. The idea that voters will seek retribution against the legislators who first cast a yes vote for the bill, and then once it became clear that nobody wanted it voted against it, is just silly. Do they really believe that if you vote for a bill that is hated by the majority of the public twice somehow you are safe? Have they never heard the old saying that “two wrongs don’t make a right?”

Before the Democrats trigger their Nuclear option, they should review their college physics text books one last time and realize that at it’s essence the Nuclear option, like the bomb it is named after, is an uncontrollable chain reaction. This Nuclear option has all the makings of a Political Neutron Bomb for their party; a tactical nuclear weapon designed to eliminate people but leave buildings intact. The Democratic Leadership should take a deep cleansing breath, remove their ideological 3D health care shades and have a look around. Somehow in the mass confusion that has been characteristic of this torturous process of producing health care legislation they have overlooked the Bright red rings outlining the bulls eye that this monstrosity has imprinted on their political careers.

SOURCE




GOP's Ryan Dissects ObamaCare, Lays Out 'Roadmap' To Health

Rep. Paul Ryan, R-Wis., took the national stage last month as he cut down Democratic health care plans point by point. If the GOP should win back the House In November, Ryan will become chairman of the House Budget Committee. And he has lots of ideas. He recently updated his "Roadmap for America's Future" to address many issues, including the budget deficit, entitlement programs, the tax system and health care.

IBD recently sat down with Ryan to discuss his ideas. In Part One he discusses ObamaCare's flaws and how his "Roadmap" would improve our health care system.

IBD: President Obama said his overhaul will "bring greater competition, choice, savings and efficiencies to our health care system."

Ryan: It will do the opposite of all three of those. It will mean less competition and less choice because it narrows the options consumers will have to get health insurance. It puts everybody on a glide path to go into an exchange where people will have three choices of policies — gold, silver and bronze. It standardizes health insurance and takes underwriting out of health insurance, which is how many insurers compete. At the end of the day you'll have a few big insurers selling different versions of the same color. With the kinds of mandates and rules they impose on insurers, the small and medium-sized insurance companies simply can't compete because they don't have the economies of scale. What you'll simply have are these handful of really large insurers simply becoming claims processors for federally run health insurance.

One example. There is a medium-sized insurer in Milwaukee that has 2,200 employees, 1,600 in Milwaukee. They sell in the individual market and they have the biggest share of policies with health savings accounts. If this bill becomes law, they'll have to close because of the rules and regulations. That means they lay off the 1,600 people in Milwaukee and send out cancellation notices to their 1.3 million policyholders.

The only ones that will survive are the really big companies. That will make prices go up. And what's so insidious from an entitlement standpoint is it's an open-ended entitlement that says to everyone who makes under $100,000, if your health care expenses exceed 2% to 9.8% (depending on income level), don't worry, taxpayers will pay the rest of it. That is an invitation of cost explosion.

IBD: Let's move to your Roadmap. On health insurance, you want to replace the employer-tax exclusion with a refundable tax credit of $2,300 for individuals and $5,700 for families. They can use it to buy insurance and pocket the difference.

Ryan: They should be able to pocket the difference because it is important to have a shopping incentive like that to put price pressure in the right place.

IBD: People fear that they won't be able to keep their employer-based coverage under ObamaCare. Doesn't the tax credit have the same weakness — you give people with employer-based coverage a tax credit in place of the tax exclusion, but there is no guarantee that the employer will keep that coverage?

Ryan: First, many employers who offered their employees health insurance 10 years ago don't anymore. More and more employers are dropping it anyway. So more and more people don't get health insurance from their jobs and they get no tax benefit. Let's end the discrimination against people who don't get health insurance through their jobs.

Second, I'm just de-linking the tax deduction for employees from the job and reattaching it to the individual. The employers still have the same tax incentive to provide health insurance to their employees.

I'm saying since more employers are dropping health insurance, since more people are changing jobs, losing jobs, going into business for themselves, make that tax benefit their property and not the property of employers.

IBD: John McCain proposed a similar plan in the 2008 presidential campaign. Obama attacked him because eliminating the exclusion, in effect, raised taxes, though only on upper-income earners. How can you deal with similar attacks?

Ryan: What's funny is Obama is doing it now under his bill. The president is proposing to take away the tax exclusion, at least for a certain segment of the market, and then use that money to spend on programs. That really is a tax increase. By contrast, I'm exchanging one tax benefit for another. You lose your exclusion, but you get it back as a tax credit.

I would argue that the current tax exclusion doesn't make any sense because we are subsidizing the wrong people. The people in the highest tax bracket get the biggest tax break for health insurance.

IBD: But how do you get around the political problem, that you're raising taxes?

Ryan: I'm not worried about the political problem. Economists from the left and right will tell you that one of the greatest sources of health inflation is this tax-exclusion system. It creates this third-party payer system that divorces consumer — the patient — from prices. You have to deal with that.

The vast majority of Americans will get a tax cut under my plan, on average about $1,400. If you don't have health care from your job, you'll get $5,700 more for your family for health care. Yes, people in the top tax bracket would not get as much from this system. But the people in the middle and lower brackets will get more, and they are the ones having a hard time buying health insurance. If we are trying to help get insurance to the uninsured and help middle-class families afford health insurance, the Roadmap is a far better way to do it.

IBD: Explain the state health insurance exchanges that the Roadmap would create. Also, why would they have to offer a plan that meets "the same statutory standard used for the health benefits given to members of Congress"?

Ryan: So, within the exchange, among the plans they have to offer is one like the standard Blue Cross option in the federal employee system. That way, people trapped in those states with extraordinarily high-cost plans can get basic insurance. If they want to buy more expensive insurance with all the bells and whistles, that cover acupuncture and hair plugs, they can still do so. It accomplishes much the same objective of interstate shopping, which I favor.

IBD: What if some people think that even the basic congressional plan is still bells and whistles? What if they want even less coverage?

Ryan: Then with interstate shopping they can go find a better plan. The point is not to create a floor, but to create an option that's not now available in many states.

IBD: The Roadmap would also reform Medicare. Starting in 2022, it would give seniors $11,000 annually to purchase private insurance. But critics have suggested that seniors don't have the sophistication to find cost-effective insurance.

Ryan: That's a paternalistic, arrogant and condescending notion. The seniors I represent sure analyze these things, they have children that look out for their best interests, and there are plenty of groups and service clubs that can help seniors.

But Medicare has a $38 trillion hole right now. It is unsustainable. What my plan says, if you are retired or above age 55, we're not going to make any changes. You're going to get Medicare as it exists now. But we've got to face up to the fact that Medicare will not be there for later generations.

For those under age 55, we put it on a path toward sustainability, and it works like the plan I get from the Federal Employee Health Benefit Plan. I get a list of plans that have been pre-certified by the Office of Personnel Management. I get a payment from my employer, the federal government— the taxpayers — and I apply that payment to the plan that works for me and my family.

That's what I propose for Medicare, with three changes. More support for low-income people to cover their out-of-pocket costs with a medical savings account. Less support for the wealthy because they can afford more on their own. Risk-adjusting the payments so as people's health deteriorates, they get more money to get affordable coverage. And seniors can select among a list of pre-certified Medicare plans.

That wipes out the unfunded liability and makes Medicare permanently solvent. That's been scored by Department of Health and Human Services actuaries and the Congressional Budget Office as achieving that.

SOURCE




Australia: Senior Citizen waits months for 'urgent' brain surgery

They're letting this guy walk around with a time-bomb in his head

A PENSIONER has been set a date for brain surgery after accusing Queensland Health of "playing God" and forcing him to wait more than 200 days longer than he should have for the urgent operation. The state opposition seized on the case of 70-year-old Hans Hagen, who understood himself to be on a category-one waiting list for more than seven months. That's despite him being listed as in need of surgery within 30 to 60 days.

Opposition health spokesman Mark McArdle tabled in parliament a copy of a letter from Mr Hagen to Health Minister Paul Lucas. It outlined the way his case had been handled since he was recommended for the aneurysm-correcting surgery in September last year. In it, Mr Hagen accuses Queensland Health of "playing God with my life". "My predicament is especially extreme as my life is threatened by two medical problems either of which could kill me without warning," Mr Hagen wrote. "Hence, I am at a loss to understand why my surgery has been delayed for such a long time."

He said he'd been told by Queensland Health staff that the extended wait was because he'd been reclassified to category two.

Mr McArdle demanded in question time that the health minister "explain to Mr Hagen in person why he has been waiting 267 days for urgent brain surgery".

Queensland Health district executive Dr David Theile said Mr Hagen had on Monday been scheduled for surgery in April. "Princess Alexandra Hospital apologises to the patient for any confusion about the surgical category assigned to him," Dr Theile said. "However, the hospital does not agree that his surgical condition, as has been published, is high risk." It is understood Mr Hagen's GP believed he was a category one patient, when specialists had classified him as category two.

Dr Theile said the hospital had been working with Mr Hagen since February to prepare him for surgery. "This has included consultations with specialist clinics in the hospital and privately as arranged by Mr Hagen's GP," Dr Theile said. "The hospital is sorry if this delay has caused concern for Mr Hagen, but he has expressed his satisfaction with his proposed surgery date with the hospital in communications today."

SOURCE





13 March, 2010

Dear America, Admit That You’re Stupid! Love, Nancy

The founding fathers debated bills for weeks. They then wrote them, referred them to committee’s of style and prose, brought them back to the floor, debated them again, wrote newspaper articles about them, went home to their districts to discuss them, and finally passed them — or not — after much deliberation.

Today’s Speaker of the House Nancy Pelosi wants us to just pass a bill so that later we can “find out what is in it.” Here’s what the zombie from San Francisco said about Obamacare yesterday:

“You’ve heard about the controversies within the bill, the process about the bill, one or the other. But I don’t know if you have heard that it is legislation for the future, not just about health care for America, but about a healthier America, where preventive care is not something that you have to pay a deductible for or out of pocket. Prevention, prevention, prevention–it’s about diet, not diabetes. It’s going to be very, very exciting. But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy.”

Why can’t we know what’s in the bill before you pass it, Nancy? Or are you afraid that once people find out the horrors contained in this abortion of a bill they might not want it passed? In fact, by nearly every accounting the American people don’t want this communist take over of one-sixth of the economy to proceed.

Of course, communists and socialists don’t care what the people have to say about anything. They, after all, know best, right? That’s why Nancy and her coven in D.C. just want us to shut up and let them pass this witch’s brew.

So let this Congress lumber forward like the living dead to pass a bill that will materially alter the relationship that citizen has to government in these great United States. Let Nancy “Fright Night” Pelosi destroy the United States as we know it… On second thought, let’s not. Call your Congressman and Senator today and tell them you do not want this destructive bill passed in your name.

SOURCE




Obama Wants to Exploit Physicians not Listen to Them

Doctors Treated to Abuse at White House and by Democrats in Congress

Americans recall how Obama amazed the nation with his straw-man characterizations of doctors who perform unnecessary amputations and tonsillectomies out of greed. What people don’t know is how doctors have been mistreated behind closed doors by the White House and by Democrats in Congress.

Here are two stories that show the kind of abuse doctors have been subjected to in Obama’s Washington. The first sordid tale was reported by Matt Latimer at Andrew Breitbart’s Big Government. I will follow excerpts of that story with an El Marco exclusive peek at how one group of doctors who support Obama was subjected to Rahm Emanuel’s beastly behavior in the White House. But first here’s Latimer’s account of doctors treated badly by congressional Democrats.

Attempting to enact his big-government health care scheme, President Obama and his supporters frequently claimed that a “majority” of doctors supported his health-care plans. When the American Medical Association – which had opposed HillaryCare – signed onto Obama’s plan last year, the organization seemed to make the President’s case. Most people assumed that the AMA represented most of the doctors in the country. But in fact, the AMA represents less than 20 percent of all physicians in the United States. And yet as the organization’s leadership moved more to the left, it held a near monopoly on media attention on issues pertaining to public health. No longer.

As the AMA has become increasingly politicized in recent years – issuing a statement in support of climate change, for example, in 2008 – a new group of doctors has risen to challenge them.

Docs4PaitientCare: Founded by Dr. Hal Scherz, a prominent Atlanta physician, the group of doctors expressed concern that like so many other professional groups, the AMA’s leadership have been thoroughly “Washingtonized” – caring more about the pleadings of other lobbyists on K Street, White House invitations and Capitol Hill committee appearances than the professions they are supposed to represent. As doctors have taken a battering over several decades from insurance companies, HMOS, and government agencies, Scherz says the AMA was a bystander. “As the insurance companies become more and more impossible and government intrusion keeps growing, we’ve seen our delivery of care to our patients compromised and our incomes decrease,” he said. But it was the AMA’s support for ObamaCare that really troubled Scherz and others in his field.

Many doctors run small businesses and by nature are entrepreneurial. Why then, he wondered, would the AMA favor ObamaCare’s regulatory and taxation burden? Why would they want a multitude of government panels interfering with the decisions doctors usually make with their patients about care and treatment? Recognizing that the AMA was compromised, Scherz decided to organize his own group in opposition to the Obama plan.

Wearing their scrubs and white jackets, the doctors drew attention as they walked the halls of congress and spoke at rallies on Capitol Hill. Often just showing up in the offices of members of the House and Senate, they would manage to get appointments with the members themselves or key staff members.

Joyce Lovett MD, an African American female pediatrician, got the doctors into a meeting of the Congressional Black Caucus. A debate opened up over the health care plan and soon the doctors were text-messaging their colleagues visiting other offices around the capitol for reinforcements. As the room began filling up, the doctors, doing well in the back and forth of debate, seemed to be changing some minds. At that point, a worried Black Caucus leader and diehard partisan, John Conyers, broke up the meeting, saying the doctors were more interested in embarrassing the first black president than in achieving real reform. Unused to this sort of political attack, the astonished doctors told other caucus members how they felt after taking time from their practices and patients to come all the way to Washington only to hear a member of Congress insinuate they were racists. One caucus member privately dismissed Conyers’ “old ways of thinking,” suggesting that the CBC might be ready for fresh, and more innovative, leadership.

Playing the race card against any American, black or white, who criticizes Obama is part of a strategic Democrat/MSM assault on free speech and dissent. This has become a standard Democrat debating tactic, and is but one example of how liberals are unwilling to compete in the arena of ideas.

With a flurry of recent headlines shedding light on Rahm “Dead Fish” Emanuel’s aggressive personality, a conversation I had last week with a doctor in New Jersey took on added relevance. The doctor, whom I have known since the late ’70s, related to me an incident told to him by a medical colleague who is a large financial supporter of Obama. A supporter, that is, until his recent invitation to the White House knocked the lenses out of his rose-colored glasses.

He told how he was invited as part of a group of other Obama stalwarts in the medical profession for what he mistakenly believed was an opportunity to offer input to the President’s ongoing health care initiative.

The colleague related how this group of doctors was seated in the White House and waited patiently as Obama’s TelePrompTers were assembled in front of them. When, after a long wait, Obama finally appeared, he delivered one of his trademark TelePrompTer performances lasting about five minutes. Obama thanked the doctors, via TelePrompTer, for their support, and then left the room. This is where it gets interesting.

Rahm Emanuel was left behind to face the doctors. When the doctors related to Emanuel that they thought they had been invited not merely to support Obama, but to advocate for doctors and patients, Rahm exploded with a verbal tirade. He was described as rude and abusive as he proclaimed that the doctors had been invited for one reason only, to show support for Obamacare. He made it clear that they were expected to be advocates for the administration’s policies.

The entire experience was profoundly disturbing to the doctor who experienced Emanuel’s bullying outburst. When he returned to his home state, he no longer supported Obama, who he now saw in a new light. He now considers Obama to be a “complete phony”. As for Rahm Emanuel, he vehemently described him as “a very dangerous personality” and “a dangerous menace to our country”

So doctors who oppose Obamacare run the risk of being called racists and docs who support Obamacare are told to shut-up and toe the line. Hows that hopey and changey thing going America?

When the Obama White House stages a media event using doctors as props, the intent is to create the illusion of support from the medical profession as a whole. One has to wonder if the doctors story cited above gives us a glimpse of the AstroTurf process for vetting Docs to appear at Obama events.

On Oct 5, 2009 one such Rose Garden event was staged and the NY Post published some embarrassing facts and photos:

President Obama rolled out the red carpet – and handed out doctors’ white coats as well, just so nobody missed his hard-sell health-care message.

In a heavy-handed attempt at reviving support for health-care reform, the White House orchestrated a massive photo op to buttress its claim that front-line physicians support Obama.

A sea of 150 white-coated doctors, all enthusiastically supportive of the president and representing all 50 states, looked as if they were at a costume party as they posed in the Rose Garden before hearing Obama’s pitch for the Democratic overhaul bills moving through Congress.

The physicians, all invited guests, were told to bring their white lab coats to make sure that TV cameras captured the image. But some docs apparently forgot, failing to meet the White House dress code by showing up in business suits or dresses. So the White House rustled up white coats for them and handed them to suited physicians who had taken seats in the sun-splashed lawn area.

All this to provide a visual counter to complaints from doctors that pending legislation is bad news for the medical profession.

What the media won’t tell you is that some of the doctors were former members of the “Doctors for Obama” organization. Oh, but it’s renamed after the election “Doctors for America”, which is part of “Organizing for America”, which was renamed from “Obama for America”, which was/is Obama’s campaign machine.

One of the Obama administrations early accomplishments was making the word AstroTurf a commonly understood term in America. Previously AstroTurf was an obscure term like “teabagger” known mainly by the small number of the liberal-left who were practitioners of it. Long associated with Obama’s chief strategist David Axelrod, AstroTurf as now employed by Obama’s White House is something voters are learning to recognize and reject.

SOURCE (Some good pix at the link)




Silver bullet from U.S. states kills 'mandatory' Obamacare

36 legislatures fight for citizens' rights to opt out of health-coverage demand

At least 36 state legislatures are considering legislation that would allow citizens to opt out of a key component of President Obama's health-care "reform" – an "individual mandate" requiring that all Americans have health insurance.

Both the House and Senate health-care bills require Americans to purchase health insurance or pay a penalty. The House bill establishes a fine based on percentage of a person's income, while the Senate version creates a penalty as a flat fee or percentage of income, whichever is higher. Those refusing to get insurance could be found guilty of a misdemeanor crime, punishable by another fine or even jail time.

Join nearly 100 members of Congress and 13,000 Americans in rejecting federal government health-care mandates on patients, employers, individuals and states – sign on to the Declaration of Health Care Independence.

"The president's proposal adopts the Senate approach but lowers the flat dollar assessments, and raises the percent of income assessment that individuals pay if they choose not to become insured," a White House plan released in February states.

States rejecting 'individual mandate'

According to the National Conference of State Legislatures, formal resolutions or bills have been filed in opposition to the individual mandate in Alabama, Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Utah, Washington, West Virginia, Wisconsin and Wyoming.

Also, as of March 4, Virginia became the first state to enact a new statute section titled, "Health insurance coverage not required." In Arizona, voters will cast ballots on a constitutional amendment in November 2010 that would "preserve the freedom of all residents of the state to provide for their own health care."

Lawmakers suggest approval of the legislation may spark a legal battle over states' rights versus the federal government's reach of power. The Boston Globe reported the measures could set the stage for "one of the greatest tests of federal power over the states since the civil rights era."

"The administration is trying to shift from a government by social compact, agreement between elected officials and citizens, to a government where the leaders tell the subjects what to do," Virginia Delegate Bob Marshall, chief sponsor of the measure in his state, told the Globe. "That is not what the American Revolution was about."

The American Legislative Exchange Council, or ALEC, has sparked nationwide interest with its model "Freedom of Choice in Health Care Act: How Your State Can Block Single-Payer and Protect Patients' Rights." ALEC warns that forcing patients to enroll in one-size-fits-all plans would cause massive increases in spending and force policymakers to ration care as a cost-containment measure.

Is mandatory insurance constitutional?

Minnesota State Rep. Tom Emmer told the New York Times in September 2009 that lawmakers in his state have proposed a state constitutional amendment to protect citizens from government interference in their private health decisions. "All I'm trying to do is protect the individual's right to make health-care decisions," Emmer said. "I just don't want the government getting between my decisions with my doctors." He said an amendment wouldn't prohibit anyone from participating in a federal health program. It would simply prevent them from being forced to enroll. "[T]ell me where in the U.S. Constitution it says the federal government has the right to provide health care," Emmer said. "This is the essence of the debate."

During the Democratic presidential primary, Obama took a jab at Hillary Clinton over the individual mandate. "The main difference between my plan and Sen. Clinton's plan," he said, "is that she'd require the government to force you to buy health insurance and she said she'd 'go after' your wages if you don't."

According to the Congressional Budget Office, or CBO, the federal government has never mandated that Americans purchase any good or service. In 1994, the CBO studied the individual mandate in Clinton's universal health-care plan and found that it was an unprecedented requirement. "A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action," the CBO report stated. "The government has never required people to buy any good or service as a condition of lawful residence in the United States. An individual mandate would have two features that, in combination, would make it unique. First, it would impose a duty on individuals as members of society. Second, it would require people to purchase a specific service that would be heavily regulated by the federal government."

Opponents say the individual mandate is unconstitutional because the Constitution doesn't grant the federal government power to fine citizens for refusing to purchase goods and services. Ken Klukowski, senior legal analyst with the American Civil Rights Union, explained in a Politico commentary why there is no constitutional basis for the individual mandate. "People who decline coverage are not receiving federal money, so that mandate can't fall under the spending part of the Tax and Spending Clause," he wrote.

Article I of the Constitution authorizes excise and capitation taxes, and the 16th Amendment created the income tax. However, Klukowski contends that government health insurance cannot be considered an excise, capitation or income tax. "It can't be an excise tax because that's a surcharge on a purchase, and here people are not buying anything," he explained. "It can't be a capitation (or 'direct') tax because that is a tax on every person in a state and must be equal for every person in the state; this would be a levy that some people would pay and others would not. And it can't be an income tax because that must be based on personal income, not purchase decisions."

He added, "All that's left is the Commerce Clause. And the people who declined to purchase government-mandated insurance would not be engaging in commercial activity, so there's no interstate commerce. That, in fact, is the government's problem with them: Those people refuse to take the money or play the game."

Likewise, the Congressional Research Service recently reported that determining whether an individual mandate is constitutional under the Commerce Clause "is perhaps the most challenging question posed by such a proposal, as it is a novel issue whether Congress may use this clause to require an individual to purchase a good or service."

Klukowski wrote that if Obama wants a plan that forces Americans to purchase insurance, he will need to "persuade the nation to adopt a constitutional amendment creating a right to health care." He added, "You might have better odds of getting struck by lightning."

Sen. Orrin Hatch, R-Utah, member of the Senate Judiciary Committee and outspoken critic of the individual mandate, told CNS News that if Congress can force Americans to buy health care, or mandate the purchase of anything, "we've lost our freedoms, and that means the federal government can do anything it wants to do to us."

SOURCE




Real competition among health plans

The flash point of last year’s health care debate was the public option. The proposal, which calls for a government-created health insurer to compete with private insurers, was praised by President Barack Obama and its liberal supporters as a way of “keeping insurance companies honest.” Conservatives criticized it as a slippery slope to a government-run single-payer system.

The public option appeared to be dead when Senate leaders decided not to include it in their health care reform bill. But prominent liberals have recently called for the Senate to add it to the new reform proposal. More than 100 House Democrats, 37 Senate Democrats and major progressive groups like MoveOn.org and the Progressive Change Campaign Committee have urged that the public option be added through reconciliation. The public option now has “a new pulse,” says the liberal website Talking Points Memo.

So far, arguments have been largely theoretical. Or they refer — positively or negatively — to government-run health care systems in foreign countries. A better comparison, however, might be to a “public option” Washington created in another part of the insurance industry.

Since September 2008, the government has infused billions into an insurer that provides coverage for cars, homes and business assets. Once this insurer got government funding, it began slashing premiums for many of the insurance policies it sells. Its private-sector competitors have cried foul, but new customers keep signing up.

Chances are that most readers have heard of this insurer — just not referred to as a “public option.” Rather, it is known by its initials: AIG. Though the primary argument for the government to pour more than $180 billion into American International Group’s coffers was to save the financial system from the company’s bad mortgage bets, the infusions have given the company an advantage over its rivals in its daily businesses. In the months after the bailout, The Wall Street Journal reported, “AIG at times has slashed insurance prices — by more than 30 percent in some cases — to fend off rivals and to keep or win contracts.”

AIG cut premiums by 34 percent, for example, to underbid three other firms and win renewal of a policy with the U.S. Olympic Committee, the Journal reported. It pried away a rival’s contract covering the city-owned airport in Mesa, Ariz., by bidding about 30 percent less. The company assuaged concerns about safety and soundness by pointing directly to the government infusion that, it says, “strengthens [AIG’s] capital positions.”

Rival insurers have complained loudly. So have trade groups like the American Insurance Association. But AIG’s competitors aren’t the only ones concerned. The Government Accountability Office and the insurance department of Pennsylvania are investigating whether the company has been charging inadequate amounts for the risks involved in its policies since it received bailout money. In a preliminary report, the GAO said it had not “drawn any final conclusions about how the assistance has impacted the overall competitiveness” of the market but did find that “AIG’s insurance companies have likely received some indirect benefit” from not having the parent company’s credit rating downgraded.

On the liberal website The Huffington Post, Don McNay, a personal finance columnist, decried AIG’s apparent use of its subsidies to distort the insurance market. “Undercutting the market,” he wrote, “is a bigger issue than the $165 million in bonuses. If AIG loses millions, or billions, in the future due to its ‘overly aggressive pricing,’ we are going to be picking up the tab.”

Indeed, liberals often complain about companies that use an advantage to allegedly engage in “predatory pricing,” even if it results in short-term benefits for consumers. They claim that airlines, discount retailers and other businesses that slash prices will drive out smaller competitors.

Though the Supreme Court concluded, in 1986, that “there is a consensus among commentators that predatory pricing schemes are rarely tried, and even more rarely successful,” it is a different story when the government gives one firm a direct subsidy or regulatory advantage.

Yet liberals have abandoned their fears of underpricing driving out competitors when it comes to a public option in health insurance. Another Huffington Post contributor, Sahil Kapur, argued that “if private insurers don’t survive” competition from the government plan, “it’s because they were ripping off customers or operating inefficiently.” A concern about unfair competition, he declared, “implicitly prioritizes the well-being of providers over consumers.”

Yet everyone eventually loses when the game is rigged through a subsidized insurance competitor — whether it’s AIG or the public option. Private insurers folding or leaving the market for a particular type of insurance means less innovation in pricing and risk prevention, leading to fewer options and higher costs for most consumers.

And if a price war engendered by subsidized competition meant premiums were inadequate to cover risk, the government might be faced with a bigger insurance tab. The quality of coverage could also suffer. Choice, in turn, would be limited even more.

Of course, competition isn’t the end goal of some public option advocates, who most likely see the public option as a way station for a single-payer system like Canada’s. But if that’s the case, why not have an honest debate, as Washington Post economist Robert Samuelson suggests, between single payer and “genuine competition among health plans over price and quality”?

To bring real competition, let customers buy health insurance across state lines and remove provisions of the tax code favoring employer-based health insurance. But let’s not bring the “too big to fail” model, which proved such a disaster for the financial industry, into our health care system, under the guise of the public option.

SOURCE




British toddler died of meningitis after five doctors failed to spot symptoms

A toddler who died of meningitis after five doctors failed to spot he was suffering from the disease was "completely failed by the medical profession", his family said.

An inquest heard 21-month-old Oliver Martin was rushed to hospital by his mother, a district nurse, when he fell seriously ill at home. He was displaying several of the major symptoms of meningitis, including a rash that disappeared when pressed, high temperature, pale complexion and lethargy. But the hearing was told the illness was "at the back of the mind" of the first doctor to examine Oliver who thought he was suffering from chicken pox.

He was subsequently seen by a further four other doctors - but was not given antibiotics until eight and a half hours after his arrival at the Leicester Royal Infirmary. By then it was too late, and Oliver, of Welford, Northants, died of meningococcal septicaemia, a type of blood poisoning caused by the same bacteria as meningitis, a short time later.

Oliver's mother, Louise Martin, 27, was too upset to attend the inquest at Leicester Town Hall. But speaking afterwards, his aunt, Susan Wilson, who sat through the evidence, said: "He was failed from the moment we walked through the door. "His treatment was disgusting. The medical profession let him down. I'm very, very angry. "The Government tells us through their leaflets to trust our instincts and not take any chances, to get children to hospital and get antibiotics. "And Oliver did - but eight-and-a-half hours later, and by then it was too late.

"If his mum had kept him at home and given him a dose of Nurofen, which is basically what the hospital did, she would be on a child neglect and manslaughter charge now. "But what have the Leicester Royal Infirmary got? Nothing. We've not even had an apology. "If this inquest prevents this happening again, then it will have been worthwhile."

Leicester City Coroner Catherine Mason, who recorded a narrative verdict, criticised "poor" communication between staff at the hospital which meant vital information about Oliver's condition and symptoms was not passed on when his case was handed over. She added: "Had earlier treatment been given Oliver may still have died, but on the balance of probabilities his chances of survival would have been better."

The inquest heard Oliver was taken to the hospital by his mother at around 10am on May 13 last year, and first seen by Accident and Emergency doctor Kalmjit Kaur. She noted a number of possible diagnoses, including meningitis, but suspected it was more likely he was suffering from chicken pox. Crucially, she chose not to administer antibiotics - and instead decided Oliver's condition should simply be monitored.

He was later moved to the children's ward, where concerned nurses tried to get the duty paediatric registrar, Dr Manjith Narayanan, to re-examine him. But he failed to do so for over an hour because he had been told at the start of his evening shift that Oliver's condition was "not serious". He said: "If I had been given all of the information I would've come out of the hand-over, gone to see him straight away and given him antibiotics." Doctors eventually suspected meningococcal septicaemia and ordered a course of the anti-viral drugs at 6.30pm. But Oliver died at around 10pm.

Kevin Harris, the acting medical director at University Hospitals of Leicester NHS Trust said: "We accept the coroner's verdict following the inquest into Oliver Martin's death. "We would like to express our sincere condolences to his family for the upset and distress caused. "If Oliver's family have any questions following the verdict we would welcome the opportunity to discuss these with them." [In other words: So sad, too bad]

SOURCE




Australia: Widow sues government over faulty ambulance equipment -- equipment KNOWN to be faulty

A woman is suing the Queensland government for $1.62 million over claims faulty ambulance equipment contributed to her husband's death. In a statement of claim filed this week in the Brisbane Supreme Court registry, Carmal Corsie and her three children allege the government was negligent in failing to ensure crucial equipment was working properly when an ambulance came to collect Iain Corsie on March 23, 2007.

According to the claim, the ambulance was called to the family's Mitchelton home after Mr Corsie, 38, suffered pains in his chest and arm. Mrs Corsie claims ambulance officers checked his condition and determined he was having a heart attack. They used a Heartstart 4000 monitor/defibrillator to conduct an ECG before he was allowed to walk to the ambulance.

Court documents claim the defibrillator malfunctioned while en route to the hospital, and that the paramedics elected to divert to the ambulance station to find a replacement piece of equipment. Shortly afterwards Mr Corsie lost consciousness and died.

The Corsie family claims it later learned the defibrillator had malfunctioned in late February and then failed to pass an equipment check the day before Mr Corsie's death. Court documents allege the machine was not serviced or taken out of use.

The family is suing the government for $1.62 million, claiming it was negligent in failing to ensure proper, working equipment was available to treat Mr Corsie. They also allege the ambulance took an unacceptable 19 minutes to arrive at their address after being called, and then should have travelled directly to hospital instead of making a detour to the station. "If the defendant had not been negligent, the deceased would not have died," the claim states.

SOURCE





12 March, 2010

A doctor savages Obama's healthcare reform plan

Dr Wolf is a distant relative of Obama's

"Primum nil nocere."First, do no harm. This guiding principle is a bedrock of medical care. Sadly, those politicians who would rewrite our health care laws do not live in the same universe as do the doctors and health care professionals who must practice it.

Imagine if, like physicians, politicians were personally held to the incredibly high level of scrutiny that includes civil and financial liability for any unintended consequence of their decisions. Imagine if they were forced to spend tens of thousands of dollars each year on malpractice insurance and still faced the threat of multimillion-dollar lawsuits with every single decision they made. If so, a government takeover of health care would be the furthest thing from their minds.

Obamacare proponents would have us believe that we will add 30 million patients to the system without adding providers, we will see no decline in the quality of care for the millions of Americans currently happy with the system, and -if you act now!- we will save money in the process. But why stop there? Why not promise it will no longer rain on weekends and every day will be a great hair day?

America has the finest health care delivery system in the world. Let's not forget that and put it at risk in the name of reform. Desperate souls across the globe flock to our shores and cross our borders every day to seek our care. Why? Our system provides cures while the government-run systems from which they flee do not. Compare Europe's common cancer mortality rates to America's: breast cancer - 52 percent higher in Germany and 88 percent higher in the United Kingdom; prostate cancer - a staggering 604 percent higher in the United Kingdom and 457 percent higher in Norway; colon cancer - 40 percent higher in the United Kingdom.

Look closer at the United Kingdom. Britain's higher cancer mortality rate results in 25,000 more cancer deaths per year compared to a similar population size in the United States. But because the U.S. population is roughly five times larger than the United Kingdom's, that would translate into 125,000 unnecessary American cancer deaths every year. This is more than all the mothers and fathers, aunts and uncles, cousins and children in Topeka, Kan. And keep in mind, these numbers are for cancer alone. America also has better survival rates for other major killers, such as heart attacks and strokes. Whatever we do, let us not surrender the great gains we have made. First, do no harm. Lives are at stake.

Obamacare: Fixing price at any cost

The justification for Obamacare has been to control costs, but the problem is there is little in Obamacare that will do that. Instead, there are provisions that will ration care and artificially set price. This is a confusion of costs and price.

As one example, consider the implications of Obamacare's financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently - no matter how valid the reasons - he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list. Many doctors will try to avoid the sickest patients, and others will simply refuse to accept Medicare. Already, 42 percent of doctors have chosen that route, and it will get worse. Your mother's shiny government-issued Medicare health card is meaningless without doctors who will accept it.

Obamacare will further diminish access to health care by lowering reimbursements for medical care without regard to the costs of that care. Price controls have failed spectacularly wherever they've been tried. They have turned neighborhoods into slums and have caused supply chains to dry up when producers can no longer profit from providing their goods. Remember the Carter-era gas lines? Medical care is not immune from this economic reality. We cannot hope that our best and brightest will pursue a career in medicine, setting aside years of their lives - for me, 13 years of school and training - to enter a field that might not even pay for the student loans it took to get there.

Giving power back to people

I believe there is a better way. The problems in the American health care system are not caused by a shortage of government intrusion. They will not be solved by more government intrusion. In fact, our current problems were precisely, though unintentionally, created by government.

World War II-era wage-control measures - a form of price controls - ushered in a perverted system in which we turn to our employers for insurance and the government penalizes us if we choose to purchase insurance for ourselves. You are not given the opportunity to be a wise consumer of health care and compare prices as well as quality in any meaningful way. Worse still, your insurance company is not answerable to you because you are not its customer. It is answerable to your employer, whose interests differ from your own.

Insurance companies have been vilified for following the perverse rules that government has created for them. But it gets worse. The government, always knowing best, deploys insurance commissioners across the land to dictate what the insurance companies must provide, whether you want it or not, and each time, your premiums increase. Obamacare will make all of this worse, not better.

One of America's founding principles is our trust in the people and their economic freedom to rule their own lives. We should decouple health insurance from employers and empower patients to be consumers once again. Allow them to determine the insurance plan that best meets their families' needs and which company will provide it. This will unleash a wave of competition that will drive costs down in a way that price controls never have. Eliminate the artificial state boundary rules that protect insurance companies from true competition and watch as voters demand that their state insurance commissioners get the heck out of the way. Innovative companies will drive down costs similar to how Geico and Progressive have worked for automobile insurance. And it won't cost taxpayers a trillion dollars in the process.

This free-market approach has worked for everything from high-definition TVs to breakfast cereals, but will it work for medicine? It already is. Take Lasik eye surgery, for example. Because patients are allowed to be informed consumers and can shop anywhere, doctors work hard for their business. Services, availability and expertise have all increased, and costs have decreased. Should consumers demand it, insurance companies - now answerable to you rather than your employer - would cover it.

Between Barack and a hard place

I have personally trained and practiced in both the government-run and free-market segments of American medicine. The difference is vast. Patients see this for themselves, and this may be why, according to a recent CNN poll, they oppose Obamacare nearly 3 to 1. I am with them. It is difficult for me to speak publicly against the president on his central issue, but too much is at stake.

I wish my cousin Barack the greatest of success in office. But I feel duty-bound to rise in opposition to Obamacare. I must take a stand for my patients, my profession and, ultimately, my country. The problems caused by government will not be solved by growing government. Now that this new era of big-government takeovers has spread to our health care system, it's not just our freedoms or our wallets that are at stake. It's our lives.

SOURCE




Hill Democrats brush back White House health deadline

As House Democratic leaders struggle to round up the 216 votes needed to pass President Obama's health care plan, they have all but set aside the March 18 deadline set by the White House and are hinting the debate could extend well past the upcoming Easter recess. A delay would likely make it even more difficult for the Democrats to pass a bill.

"I believe that if members of Congress go home for two weeks, they will hear from the American people what they really think about the bill and they will be less likely to vote for it when they come back," Senate Republican Conference Chairman Lamar Alexander, R-Tenn., said.

House Majority Leader Steny Hoyer, D-Md., said Democratic leaders have yet to begin negotiating with approximately one dozen pro-life Democrats who comprise one of the biggest obstacles in the House. Hoyer also discounted the deadline put forward last week by White House press secretary Robert Gibbs. "None of us have mentioned the 18th, other than Mr. Gibbs," Hoyer said.

Hoyer said Democrats are still wrangling with how to pass the Senate health care bill in the House and then follow with a smaller bill that makes corrections to the Senate bill. House Democrats are refusing to back the Senate bill unless it is done concurrently with a second bill that would purge several special deals cut for certain senators as well as an excise tax on expensive insurance plans. Hoyer called a pre-Easter vote "an objective, not a deadline."

Without some kind of concurrent passage of both bills, it will be nearly impossible for House Democratic leaders to come up with the votes because House Democrats don't trust the Senate to follow through with the corrections bill once the Senate health care bill is signed into law by Obama. The Senate would have to take up the second bill under budget reconciliation rules in order to pass it with just 51 votes, which could be difficult and politically dangerous, depending on what's in it. But senators on Tuesday said they are committed to taking up the second bill.

"I can tell you this," Sen. Dianne Feinstein, D-Calif., said. "Nobody wants to stab the House in the back. Every one of us understands the position the House is in. I guess what we ask is that the House understand our position as well."

Sen. Ben Nelson, D-Neb., who voted for the Senate version, said the national polls don't matter as much as the sense he gets from his constituents. The majority in Nebraska, he said, "do not" support the Democratic health care plan, but will decide whether to back it as soon as the bill is written and given a price tag by the Congressional Budget Office. "I'm not going to say I'm going to support something I haven't seen," Nelson said.

SOURCE




Obama's Reconciliation Lie

Less than one week ago, President Obama stood before an assembled audience of hand- picked sympathizers on healthcare reform at the White House and called on Congress to pass his healthcare reform package into law... again.

Having spent his entire year long presidency singularly focused on passing a massive, trillion dollar, federal government takeover of the healthcare industry in America, and failed -- Obama had a couple of choices going forward. With an American public now solidly against his healthcare proposal, and his Democrat margins in both houses of Congress now a wee bit slimmer, Obama was forced to choose between either a) substantially altering his healthcare proposal to make it more palatable and bipartisan as he claims is his goal, or b) forging ahead with virtually the same heavy-handed government takeover package and hope to woo skeptical Americans and Democratic lawmakers by the sheer force of his personality.

In Obama’s speech – a rather short one for him of only 21 minutes – he made it clear that he is opting for Plan B. Obama stated: “No matter which approach you favor, I believe the U.S. Congress owes the American people a final vote on healthcare reform. We have debated this issue thoroughly. Not just for the past year, but for decades. Reform has already passed the House with a majority. It has already passed the Senate with a super-majority of 60 votes. And now it deserves the same kind of up-or-down vote that was cast on welfare reform, that was cast on the children’s health insurance program, that was used for cobra health coverage for the unemployed, and by the way for both Bush tax cuts, all of which had to pass Congress with nothing more than a simple majority.”

In other words, he plans to utilize budget reconciliation to pass ObamaCare, which requires only a simple majority in both chambers. And Obama appealed to history, citing five specific examples of major legislation that was passed using reconciliation.

Here’s the only problem with Obama’s appeal: every bill he cited was passed with bipartisan support. This is, of course, precisely the opposite of what is occurring on ObamaCare, where the minority party is unanimously opposed to the entire package. In fact, reconciliation has been used nearly 20 times since it’s origination in 1981, but never once in a completely partisan fashion to pass major social legislation. Not once.

A quick review of the actual legislation Obama cited shows example after example of bipartisan support. Both Bush tax cuts were passed with Democrat votes in both chambers. Cobra was enacted in 1986 with a Republican controlled White House and Senate and a Democrat controlled House. Landmark welfare reform was passed by a Republican controlled Congress (with 125 Democrat votes from both chambers) and signed into law by President Clinton, as was the Children’s Health Program in 1997 within the Balanced Budget Act.

Republican claims that Obama’s intended use of reconciliation to pass his version of healthcare reform is unprecedented (what the word really means, not how Obama uses it) and hyper partisan is absolutely true. It would be complimenting Obama to say he was being merely disingenuous in his stated reason for using reconciliation.

In the same speech noted above, Obama portended to take the high road by maintaining “I do not know how this plays politically, but I know it’s right” and saying he would “provide the leadership” the American people so desperately want on healthcare reform. Perhaps Obama is genuine in stating he does not know how this will play politically, but Americans seem to know instinctively, and they are not calling it leadership, they’re calling it a lie.

SOURCE




Canadian Health Care System Bad Model for USA

During an interview prior to the health care town hall meeting hosted by U.S. Rep. Todd Akin (R-Mo.) this morning in St. Charles, Mo., I spoke with Joe DeVincent, a government retiree from nearby Wentzville, about the prospects of government-run health care (a.k.a., “ObamaCare”). He expressed deep reservations about ObamaCare based, in part, on his own daughter’s experience as the wife of a Canadian citizen living north of the border.

“She doesn’t like it at all,” he said. “You can’t see doctors when you want to see doctors. The few doctors that are even practicing there, their business is just so full…

“One time, my wife and I went with her to see her primary care physician. She had an appointment, and it took three hours to get in. The waiting room was just so jammed, because nobody one can see doctors there.

“The doctors only work until they’ve made a certain amount of money. When they make that amount of money, they don’t get paid anymore,” he continued. “We definitely don’t need this system in the United States.”

The problem is so bad, he said, that his daughter has been forced to come to the United States on more than one occasion.

A fix, he said, would be new legislation that gave everyone the same coverage. “If they want to put a health plan in, make it everybody, including Congressmen, senators, the president, everybody falls in that plan. Then, they’ll put one in there that’ll work.”

Asked if he thought it would ever happen, he was doubtful. “It’ll never happen. They’re gonna take care of themselves and, if this goes in, we’re gonna suffer.”

SOURCE




Dead body was left on bed next to me for eight hours: Patient tells of horror on packed NHS ward

An NHS patient has spoken of her horror after the body of a woman was left in an adjacent bed for up to eight hours. Sarah Stevenson, 64, said staff left the corpse on a packed ward from 1pm until after 8.30pm. Two other patients who died on the same day were also left for several hours behind thin curtains on the ward where Mrs Stevenson was being treated for pneumonia, she said. The three bodies were finally removed in front of distressed families and young children during visiting hours.

Bosses at Heartlands Hospital, in Birmingham, last night apologised. They said the wait was caused by delays in bringing specialist equipment to remove the bodies, but denied they remained for as long as eight hours.

Mrs Stevenson, a great-grandmother from Small Heath, Birmingham, was admitted to hospital on February 15 with suspected pneumonia. She was given a bed on a single-sex ward and was placed in a bay next to another woman. Two days later, at around 1.10pm, she noticed the woman had died. She told a nurse but says the body was not taken away until after 8.30pm. All that divided Mrs Stevenson - whose daughter is a nurse - and the patient was a thin curtain.

She said: 'At about 1.10pm the woman in the bed opposite me, a lady in her late-50s or early-60s, died and I had to alert the nurse that she had passed away. 'Another one died at around 2pm and the third a while later. I was upset because I was so ill myself and to lie next to a dead body all day was my worst nightmare. I don't think they showed the patient any dignity in death. My daughter is a nurse so I know bodies are only supposed to stay on the wards for a maximum of four to six hours, but it was nearly eight hours before they came to take her to the mortuary. 'It was appalling and it should never take that long. The nurses were pushed to the limit and couldn't control a lot of what was going on.'

Mrs Stevenson, who has been married and divorced twice and was a stay-at-home mother to her three children and four step-children, was discharged on February 22. Her allegations came after a damning survey revealed the Third World conditions on overcrowded NHS wards, despite the budget being tripled under Labour over the past ten years.

A survey of 900 nurses this week showed patients are routinely treated in kitchens, corridors, mop cupboards and TV rooms because wards are full. Four in ten told the Nursing Times that patients' dignity and privacy were not protected, while many spoke of chaotic mixed-sex wards where emergency buzzers were left out of reach. The shocking series of anecdotes followed a series of NHS scandals including the unnecessary deaths of up to 1,200 patients at Stafford Hospital.

The Heart of England Foundation Trust has launched an investigation into Mrs Stevenson's claims. Spokesman Charlotte Calder said: 'Three patients did die on the ward on the same day but two of those were further away from Mrs Stevenson. 'One terminally ill patient did unfortunately die in the bay where Mrs Stevenson was being treated. 'It was felt that it would be more respectful to prepare the deceased patient in the bay with the curtain drawn. 'The transfer of this patient took four and a half hours - longer than normal - due to the clinical condition of the deceased patient and the need for specialist equipment.

'We are sorry that this may have disturbed and caused Mrs Stevenson distress. 'Our stance is that no patient's body had been left on the ward for more than five hours but we are investigating the matter.'

SOURCE




NHS 'wasted £21bn tackling life gap between rich and poor'

Billions of pounds may have been wasted on a high-profile Government pledge to reduce the gap in life expectancy between rich and poor, a watchdog revealed yesterday. A total of £21billion - more than a fifth of the entire National Health Service budget - has been set aside to cut inequalities in this financial year alone. But an Audit Commission report says it can't find any evidence that it provides value for money.

The health of people in England has improved since Labour started pumping billions into the NHS, but the health of richer people has improved far more quickly than those in deprived areas. Instead of the Government meeting its much-vaunted goal of reducing health inequalities, the gap has widened.

Ministers pledged that by 2010, they would reduce by 10 per cent the gap in life expectancy at birth between people living in the bottom 20 per cent of the most deprived areas and the population as a whole. But the report has found that 'stark problems remain'. The report said: 'It is hard to see an obvious link between spending and improvement, or get any clear view of value for money. 'Progress in reducing inequalities, and in some aspects of health such as that of very young children, has been disappointing, even if general progress on, for example, life expectancy and other broad measures has been very positive. 'Without such a link, it is hard to argue that higher spending - even if it were an option - would itself result in significant gains.'

The report said problems such as teenage pregnancy 'have proved challenging, despite some progress'. 'New problems have emerged, for example obesity,' it added. 'Problems with alcohol have grown. If today's trends continue, NHS hospitals in England will admit one million patients with alcohol-related conditions in 2011.' A Government target to reduce teenage conceptions by 50 per cent by 2010 has also failed dismally. The rate has fallen by only 13 per cent and in some regions, it has soared by almost 50 per cent.

NHS spending in England rose from £40billion in 1999/2000 to £98billion in 2009/10, the report said. But it is hard to know how much has been spent on reducing health inequalities, or what the impact has been. The report said: 'There needs to be more ruthless targeting of money and services and close attention to outcomes. This requires much clearer sight of what is being spent and much sharper evaluation of its impact.'

The report did congratulate ministers on meeting targets to cut deaths from heart disease and stroke by 2010. It said life expectancy was on the up, and infant death rates were going down.

Andy McKeon, the commission's managing director for health, said: 'We know the health of the nation is improving. But variation in the health of people living in different parts of the country remains stark.'

A Department of Health spokesman said: 'We are pleased the Audit Commission recognises that life expectancy is the highest it has been and infant mortality is at an all-time low, but more needs to be done to narrow the gap between disadvantaged areas and the rest of England.'

SOURCE





11 March, 2010

ObamaCare Means a Two-Tier Health Care System

As is true in all socialist countries, there will be one standard of health care for you and me — and then a higher standard for the ruling class

The most important amendment Republicans must propose for Obama’s Medi-Grab bill is a very easy one: "Resolved: that all federal and state employees must enroll in ObamaCare, without exception. Any violation of this amendment will be punishable by a fine, imprisonment, and/or loss of federal or state employment. Enforcement of this provision will be overseen by a popularly elected commission, whose proceedings will be open to the public via the worldwide web."

“All federal and state employees” includes every member of Congress and the executive branch — those who currently have the finest medical insurance available in the country today (courtesy of you and me).

This is the key test for the Medi-Grab bill. Any member of Congress who votes against it reveals his or her true stand on America’s founding principles. Anyone who votes for it shows that he or she actually gets it. There are many terrifying parts of this Medi-Grab bill, but this is the simplest litmus test. It’s so simple that everyone in the country can understand it. It’s do-or-die in terms of the integrity and honesty of the takeover of one-sixth of the economy that Obama is so determined to drive through Congress.

Socialist regimes reveal their true nature by the special treatment they give to their permanent ruling class; they deny such treatment for ordinary schlubs like you and me. The worst corruption in socialist regimes flows from that simple two-caste system. In Europe, the ruling class hardly bothers with elections any more. The same people just turn over in their lifelong careers, or they just stay in the tenured bureaucracy.

The so-called European Parliament is elected by the voters, all right, but it does not have the power to legislate — or even to investigate the all-powerful EU bureaucracy, which is unelected. The European Parliament is therefore an elaborate front. In typical fashion, the EU has a special term for that: the “democracy deficit.” It is regrettable, to be sure. Only trouble is, nobody does anything about it, and they won’t because the dual caste system is the key power grab whereby all sovereign power in European nations is now flowing into the EU — like so much water draining out of a bathtub.

Obama’s medical takeover bill is a monstrosity in many ways, but the biggest danger comes from the separate treatment it reserves for the ruling left compared to us ordinary folks. Obama’s Medi-Grab will force ordinary people into a medico-legal corral. But it exempts members of the ruling left, and by creating a political monopoly over medical care, it ensures that we must all go begging, hat in hand, to the bureaucracy for our very survival.

If Obama wins, Europe is our future. In Britain, Gordon Brown does not go to his local NHS clinic to get substandard medical care, nor does he go to the scandalously dirty hospitals in the Midlands. In Brussels, the European Union bureaucrats would just sneer at medical care for ordinary folks. They get nothing but the best. That hypocrisy is all over the American ruling left as it is emerging today: Obama and Al Gore both attended special upper-class schools from early on in life. Bill Clinton was a Rhodes scholar. They are special, these well-born rulers, not like you and me.

Real power in Europe now flows from the Brussels bureaucracy, which issues a mighty and endless tide of top-down decrees for regular folks to obey. EU decrees cannot be overturned by the voters, because the judiciary is just another appointed arm of the EU bureaucracy. They cannot be resisted, on pain of very real bureaucratic penalties. The left controls the media (like the BBC) as well as the schools. The European Parliament is therefore a sort of Hollywood movie set: the real power holders don’t bother with elections, and the elected Members of Parliament have no power. Simple, clean, tyrannical. This is not an accident. It’s the key to the way they operate. That is Obama’s goal.

When a blog reporter (the only honest kind of reporter today) challenged Rep. Fortney (Pete) Stark in his office on a YouTube video, Mr. Stark’s first question was: “What college did you go to?” The congressman simply resorted to insults when the reporter answered: “the University of Puerto Rico.” Notice Pete Stark’s standard: it’s not what you know, but whether you went to an elite college. Stark never answered the basic economics question, needless to say. In his mind, he didn’t need to. Behold, the ruling class of America.

The American left adores Europe. But Europe today is bowing down to another permanent aristocracy, not much different from the 19th century version. The results are plainly visible in the shoddy and unhygienic conditions at the National Health Service hospitals and clinics in the UK, compared to the special treatment given to the political class. They are visible in the long waiting lists for life-saving cancer and cardiac operations — for ordinary folks, that is. This is what the “death panels” (presided over by the National Institute for Health and Clinical Excellence in Britain) are about: they reserve expensive treatments for the politically powerful and well-connected. Expensive treatments for ordinary folks are not considered to be “cost-effective.” As Robert Reich has said so clearly about these critical treatments, “It’s too expensive … so we’re going to let you die.”

That’s because there’s only so much money in the national medical kitty, and it is distributed according to your high-quality life expectancy. If you are severely depressed, suffer from a disabling illness, or are just old, your life is worth that much less. The young (who need little care) are allocated more of the nation’s medical kitty, because they have greater life expectancy at a higher quality of life — at least according to the health bureaucrats. Down Syndrome fetuses are aborted, according to the same logic, at the very beginning of life. You see, Down Syndrome kids may live a long time, but they don’t have high-quality lives. So they just abort them.

I’ve personally attended a European lecture given by an utterly arrogant chief of an acute care unit. He explained his criteria for pulling the plug on unconscious patients at a major European university hospital. His answer was: budget. His ward was budgeted to keep people on life support for a maximum of two weeks. After that, it’s “goodbye, Sally” — we need your bed for another case. That is what Obama has in store for us. Unless you are Obama or Hillary, of course. It’s the value of our lives versus theirs, and we won’t have a voice in that decision.

Not after ObamaCare passes.

SOURCE




At least the States are aware of economic reality

At the heart of President Obama’s drive to rein in health costs is a proposal for federal review and regulation of health insurance premiums, with a new agency empowered to block excessive rate increases. State officials are leery of the proposal, which raises a host of questions: How would Congress define “excessive”? How would the new federal power relate to state insurance regulation?

The proposal has great political appeal. But experts see a serious potential problem: Federal officials will focus on holding down premiums while state officials focus on the solvency of insurers, the ultimate consumer protection.

Economists say that holding down premiums does not necessarily hold down the cost of care, which reflects the prices charged by doctors and hospitals and the volume of services.

State officials worry that they would be left to police the solvency of health insurance companies while federal officials pressured insurers to reduce premiums, as Mr. Obama has done in recent days. “You can’t separate the underlying solvency of companies from the rates they charge,” said Sean Dilweg, the insurance commissioner in Wisconsin. “The federal proposal would be a huge pre-emption of decisions that states have made over their history.”

Mary Beth Senkewicz, a deputy insurance commissioner in Florida, said, “If you divorce rate-setting from financial oversight, that’s a fundamental flaw. Premiums must be reasonable in relation to the benefits,” Ms. Senkewicz said. “That becomes a fairly complex analysis.”

Insurance commissioners said they fully supported efforts to expand coverage and rein in health costs. But they said it would be risky to hold down premiums before costs were under control. And they do not expect the federal legislation to drive down costs anytime soon.

Sandy Praeger of Kansas, one of several insurance commissioners who met with Mr. Obama at the White House last week, said: “From a consumer protection standpoint, the most important thing we do is ensure the solvency of companies. We would strenuously resist not having the ability to approve rates or having the commissioners’ oversight of rates overturned.” “You are not necessarily helping the consumer if you keep rates artificially low,” Ms. Praeger said. “What’s worse for the consumer: having a premium increase or having to pay the full amount of a medical expense because the company is out of business?”

More here




For Key Democrats, Health Care Becomes Ego Trip

In the entire health care debate, among all the competing lawmakers, politicians, experts and pundits, there's just one person who has seen things from both sides of the political aisle. That is Rep. Parker Griffith of Alabama, who was elected as a Democrat in 2008 and was part of the House Democratic caucus until last Dec. 22, when he switched sides to become a Republican. (Republican-turned-Democrat Sen. Arlen Specter doesn't count, because he switched parties in April 2009, before the current health care debate got underway.)

Given Griffith's unique perspective -- he is also a doctor, with 30 years' experience as an oncologist -- perhaps he has some insight into why the White House and his former Democratic allies in Congress continue to press forward on a national health care bill despite widespread public opposition.

It's gotten personal, Griffith says. "You have personalities who have bet the farm, bet their reputations, on shoving a health care bill through the Congress. It's no longer about health care reform. It's all about ego now. The president's ego. Nancy Pelosi's ego. This is about personalities, saving face, and it has very little to do with what's good for the American people."

Conflicts driven by personal feelings can lead to self-destructive outcomes. Ask Griffith whether Speaker Pelosi, his old leader, would accept losing Democratic control of the House as the price for passing the health care bill, and he answers quickly. "Oh yeah. This is a trophy for the speaker, it's a trophy for several committee chairs, and it's a trophy for the president." It does not seem to matter that if Democrats lose the House, the speaker will no longer be speaker, the chairmen will no longer be chairmen, and the president will be significantly weakened.

As Griffith sees his former colleagues, Democratic leaders have become so consumed with the idea of achieving the historical goal of a national health care system that they are able to explain away the scores of opinion polls over the last six months that show people solidly opposed to the Democratic proposal.

The polls are wrong, they say. Or the polls are contradictory. Or the polls actually show that people love the health care plan. And even if the polls are right, and people hate the plan, real leaders don't govern by following the polls. So just pass the bill.

That's easy for Democrats like Pelosi, who occupy safe seats. Not so for dozens of moderate House Democrats whose votes are required for passage, but who face likely defeat for it. "I don't think there are that many moderate or conservative Democrats who want to be sacrificial representatives," says Griffith.

Just for the record, the RealClearPolitics average of polls on the Democratic health care plan shows 51 percent opposed and 40 percent in favor. A similar compilation of surveys by Pollster.com shows the gap at 51 percent to 43 percent. There have been more opponents than supporters of the plan since last July, when Democrats first began to unveil concrete health care proposals.

Can Democrats really ignore the polls all the way to the end? Yes, but it gets a little harder with each passing day. George W. Bush couldn't ignore public opinion when he wanted to remake Social Security and pass comprehensive immigration reform. Faced with broad opposition, Bush ultimately gave up.

And now Democratic leaders are showing signs of weakness. Why would they suddenly express interest, even feigned interest, in Republican ideas they derided for months? Why would they invite GOP lawmakers to a high-profile discussion of health care? Because they don't have the votes to pass the bill. "If they had the votes, we wouldn't have had the summit," said Tennessee Republican Rep. Marsha Blackburn recently, referring to the day-long White House health care confab on Feb. 25.

That's a change from the heady days of last year, when Democrats, as Griffith says, "never really wanted anyone else's input" on health care. When a Republican offered a suggestion, "There was a polite smile and a comment like, 'That's very interesting, and we'll take a look,'" Griffith recalls. Of course, they never did. Now, they make a big show of listening.

But it's too late to make the fundamental changes that would be required to improve the bill. It's too late to change public opinion. It's too late to reassure nervous lawmakers. The Democratic leadership has made the decision to push the bill to the very end, and so they will.

It's personal.

SOURCE




Insurers: Obama's scapegoat

President Barack Obama obviously has no qualms about slandering people or industries that interfere with his agenda. In the same creepy manner he defamed the Cambridge Police Department without benefit of the facts, he is scapegoating the insurance companies based on his distorted version of facts.

In the past week, he has ratcheted up his war on insurance companies, who, he apparently figures, must be destroyed if he is to accomplish his Utopian dream of socialized health care. He made them the focus of his wrath again, in his umpteenth health care speech, Monday in Philadelphia. Even the White House blog, in a post titled "Moving Forward to Put the American People Ahead of Insurance Companies," frames this debate as between insurance companies and the people.

Who is Obama to be smearing health insurance companies for allegedly bankrupting people to increase their profits when his policy agenda is already bankrupting America to increase government power? As the late Milton Friedman asked the clueless leftist Phil Donahue, "Is it really true that political self-interest is nobler somehow than economic self-interest?" It's not the insurance industry versus the American people; it is Obama's socialist leviathan versus the American people, with the insurance companies as necessary collateral damage.

Is it fair to accuse the insurance companies of arbitrariness when they refuse to cover what their contracts don't require them to cover? And isn't Obama implying that if the government were to take full control over health care, there would be no denial of coverage? We don't have to wait for his plan to take effect to know that's false. Everyone, including Obama, is aware of Medicare's denying or reducing reimbursements so drastically that an increasing number of doctors are refusing Medicare patients. Does he call that arbitrary?

In addition, whether or not you bristle at those suggesting Obamacare would usher in death panels, you are in fantasyland if you think Obamacare doesn't contemplate increased rationing -- by the government. The Democrats' plans involve the formation of an administrative board, which would make determinations on what kind of coverage the government would pay for and, perhaps, even allow.

What's the difference between that and an insurance company's denying coverage? Well, it's worse for the government to do it, actually. The government's coverage decisions would be dictated not by a private and at least somewhat consensual contract, but by the fiat of a largely unaccountable bureaucrat whose authority would be derived from powers delegated to him by whatever administrative bodies Congress might outsource to do its dirty work. The bureaucrat's charge would not be to infuse compassion in his decision, but to coldly cut costs. Read the Democratic bills!

Though I don't belong to the "Obama is a genius" school, I know he's smart enough to realize that insurance company profits are but a fraction of rising health care costs and that it's grossly misleading to make insurers the primary villains. This is simply Chicago politics writ large in a last-gasp effort to enslave us with government health care.

Obama is also dishonest in portraying his still-unwritten plan as middle-of-the-road between the extreme position of those who want socialized medicine and the extreme position of those who want to relax all regulations on the health insurance industry and just pass reforms in "baby steps."

First, he is intentionally mischaracterizing the Republicans' position. They don't advocate baby steps, but a series of market reforms that would not entail restructuring the entire system under government control.

Nor do they want to relax all regulations on insurance companies. They do want to remove some of the coverage mandates, not for the purpose of helping insurers, but to benefit consumers, who ultimately would have to bear the costs of elective procedures for others. Republicans also want to relax arbitrary laws preventing consumers from buying across state lines.

Further, Obama is misrepresenting his own plan as centrist and a composite of Democratic and Republican ideas. It is the last thing from centrist. His plan contemplates -- and would eventuate in -- full-blown government control, which is also deliberate and which he's on record advocating.

He has rejected outright all Republican ideas except for tort reform and "fraud and abuse." But he is just pretending to support tort reform with some meaningless smoke and mirrors. As for fraud and abuse, it's revealing that he would credit Republicans with a franchise on the concept, but his lip service promise to curb it is just more cynical sophistry. He already has a track record on this with his stimulus plan. Enough said.

Everything about this unprecedented federal power grab stinks, not least of which are the highhanded, unconstitutional and otherwise illegal methods Obama is explicitly advocating to pass this monstrosity over the informed will of the American people. We must pray he fails.

SOURCE




NHS doctors thought pregnancy was gout!

No scans, of course. They cost money



STUNNED Belinda Waite became a mum for the first time — just THREE hours after doctors discovered she was pregnant. The 21-year-old had been in and out of hospital for nine months after being told she was suffering from a severe case of Irritable Bowel Syndrome and gout. It was only after she was admitted to hospital in agony that medics realised she was expecting.

They told Belinda she was around three months pregnant and sent her back home to Bampton, Devon, just before midnight. But at 2.30am the following morning baby daughter Louise arrived weighing a healthy 8lb 14oz to the amazement of Belinda and partner Wayne Boyles, 28.

Wayne's mum Sylvia helped with the unexpected arrival and hairdresser Belinda said she had "not been feeling right" for eight months. She said: "I can't believe I was pregnant all this time - you'd have thought the doctors would have noticed something like that. "I think Wayne was even more shocked than me because we had no idea, but she is a beautiful baby and we're really happy. "I did feel like something was moving inside me as the months went on. "But I never considered I was pregnant - and it doesn't seem to have crossed the doctors' minds. "It was obviously a huge shock for us all but you have to get on with these things - and we are all really enjoying it."

Belinda gave birth after she was taken to Tiverton Hospital at 10pm on February 6 suffering with pains throughout her body. Doctors announced she was around three months pregnant and sent her home. Belinda said: "I was really shocked. They told me to get some rest and make an appointment with the doctors the following Monday. "Three hours later, Louise was born. I don't think Wayne could believe it was happening. "We hardly had time to think about it; no one believed us when we told them we suddenly had a child. "You read about these stories in magazines, but you never think they happen to real people - and I certainly never thought it would happen to me."

Belinda said Louise was perfectly healthy despite her being very active through her pregnancy. She said: "I went on rollercoasters at Alton Towers, on water slides in Spain, I probably ate all the wrong foods. Luckily I do not smoke and I stopped drinking alcohol as it made me feel sick." The hospital, run by NHS Devon, was unavailable for comment.

SOURCE




NHS hospital ignores clear suicide danger -- even after warning

A woman leapt to her death hours after her father begged a psychiatric unit not to release her. Graham Nye warned them: 'If she goes back to her flat she will throw herself off the balcony.' Just seven hours later his chilling prediction came true when Victoria jumped from her 13th-floor flat.

Mr Nye is now demanding to know why his daughter - who had a history of suicide attempts - was allowed out of the unit at the Royal South Hampshire Hospital. The NHS trust has launched an independent investigation.

Mr Nye, 55, has told how his daughter had suffered for eight years with mental illness. She was diagnosed with bipolar disorder two years ago but, after reacting badly to medication, experts told her they believed she was suffering from a personality disorder, which required separate treatment.

Miss Nye, 22, admitted herself to the unit in an attempt to turn her life around. But after a fortnight of treatment, Mr Nye claimed, she was told by psychiatrists that she 'could not be helped', despite a family doctor telling them she was in need of urgent care. She phoned her father around 5pm on March 3 to say she was being sent home. Within the hour he had called doctors asking them not to release her. He says he was told his comments would be shared with doctors. At 12.40am the next day Miss Nye's body was discovered by neighbours outside the tower block where she lived in Southampton.

Mr Nye, a freelance television producer, said: 'She said they told her they could not help her. She took this to mean that although she had something wrong with her she could not be helped. 'I have no doubt she killed herself because she felt there was no help for her.'

Dr Huw Stone, Hampshire NHS Foundation Trust's medical director, said: 'In any serious incident we always carry out a thorough investigation into all aspects of the patient's care.'

Marjorie Wallace, chief executive of mental health charity SANE, said: 'We find it unforgivable that people in distress can be discharged from hospital before they are ready to leave.'

SOURCE





10 March, 2010

Four big obstacles remain for Obamacare

House Democratic leaders concede they do not have enough support to pass President Obama's health care package, but the party is hopeful it will come up with the 216 votes needed to pass the bill before the March 18 deadline set by the White House. But first they will have to clear a number of hurdles standing in the way of passage.

1. The Senate -- Looming large in the minds of nearly every House member are the 290 or so House bills the Senate has ignored since January 2009. Many House Democrats are refusing to pass the Senate's health care legislation without a guarantee that the Senate will take up a corrections bill using an exhaustive and potentially politically damaging parliamentary tactic that would require just 51 votes to pass it in their chamber. "There are too many deficiencies in the Senate bill for us to just go on faith," Rep. Anthony Weiner, D-N.Y., said.

2. Pro-life Democrats -- Up to a dozen Democrats, led by Rep. Bart Stupak, D-Mich., stand ready to vote against the Senate bill because of its effect on federal funding of abortion. While House Speaker Nancy Pelosi, D-Calif., has insisted the bill does not expend taxpayer money on the procedure, Stupak and others point to provisions in the Senate bill like one that would provide funding for elective abortions by private health insurance plans that receive federal dollars. Stupak told The Examiner that Pelosi is working around the pro-life Democrats, trying to find other former "no" votes to make up the deficit, but Democratic strategist Peter Fenn said the leadership will have to find a way to win the votes of at least some pro-life Democrats. "If you lose the Stupak crowd, you are going to be in trouble," Fenn said.

3. Fiscal moderates -- As Pelosi goes fishing for new "yes" votes among the 39 Democrats who voted against the House health care bill, she may have hard time reeling anyone in. That's because the vast majority of these lawmakers represent red districts. Seven of them won their last election by less than 5 percentage points and 14 are vulnerable freshmen. Many of these members dislike the bill's $1 trillion cost and size. "My top concern is cost containment and delivery system reform," Rep. Jason Altmire, D-Pa., who voted against the House health care bill, told The Examiner. "I'm going to do what's right by my constituents and right by my district."

4. House liberals -- While it is expected that many of the 80 or so of the most liberal members of the Democratic caucus will vote for the Senate bill because it's better than nothing, don't rule out the possibility that at least a few of them will defect and vote down the bill because it does not include a government-run public option that was part of the House-passed version. Upon resigning from the House on Monday over sexual harassment charges, freshman Rep. Eric Massa, D-N.Y., said Democratic leaders were forcing him out because he planned to vote against the Senate bill because it did not create a European-style, single-payer system of health care delivery. "I suspect that most will fall in line and vote for it, but there may be some holdouts that we don't know about," said Merrill Matthews, director of the Council for Affordable Health Insurance, a research and advocacy organization.

SOURCE




Obama: Time to debate health care over

President Obama on Monday tore into private health insurers for recent rate hikes, taking a more aggressive rhetorical turn as he pushes for final congressional passage of his top domestic priority. Obama repeated his assertion that the plan under consideration includes the best Democratic and Republican ideas. The time for debate has ended, he argued. Congress "owes the American people a final up or down vote on health care. It's time to make a decision," he told an enthusiastic crowd at Arcadia University near Philadelphia. "Stand with me and fight with me. ... Let's seize reform. It's within our grasp."

The administration is ramping up its health care push in the coming weeks. The White House has called for legislation to be on the president's desk at the end of March before the congressional Easter vacation. Two Democratic leadership aides told CNN last week that House Speaker Nancy Pelosi, D-California, is aiming to have the House of Representatives pass the Senate's health care bill by March 17.

A separate package of changes designed in part to make the overall measure more palatable to House liberals then would be approved by both chambers through a legislative maneuver known as reconciliation. Bills passed under reconciliation require a Senate majority of 51 votes. Democrats lost their filibuster-proof, 60-seat Senate supermajority with the January election of Sen. Scott Brown, R-Massachusetts.

Obama opened his remarks Monday by targeting Anthem Blue Cross in California for recently boosting its rates by almost 40 percent. A diabetic Philadelphia-area woman introduced the president. Her insurer reportedly told her in January that her rates would more than double. "The price of health care is one of the most punishing costs for families, businesses and our government," Obama said. "The insurance companies continue to ration health care. ... That's the status quo in America, and it's a status quo that's unsustainable."

Insurance companies, the president argued, have made a calculation. He cited a recent Goldman Sachs conference call in which an insurance broker told investors that insurers are willing to lose some customers through premium hikes because of an overall lack of competition in the industry. "They will keep doing this for as long as they can get away with it," Obama said. "How much higher do premiums have to rise until we do something about it? How many more Americans have to lose their health insurance? How many more businesses have to drop coverage?"

Obama dismissed GOP criticism that his nearly $1 trillion proposal fails to control spiraling medical costs. "You had 10 years," Obama said in reference to GOP control of Congress. "What were you doing?" He also brushed aside warnings by political observers that health care reform may lead to major Democratic losses in midterm elections. Washington is "obsessed with the sport of politics," he said. "We have debated health care in Washington for more than a year. ... When's the right time? If not now, when? If not us, who?"

Meanwhile, the Senate's top Republican made it clear Sunday his party won't relax any of its efforts to halt the reform package. "What the American people would like us to do is not make this gargantuan mistake," Senate Minority Leader Mitch McConnell, R-Kentucky, told ABC's "This Week."

If the bill does go through, avoiding a GOP filibuster by using the reconciliation tactic in the Senate, the battle moves to its next stage. "Every election this fall will be a referendum on this bill," McConnell said.

Obama said Monday he's not inclined to take "advice about what's good for Democrats" from McConnell. But "the issue here is not the politics of it," he asserted, saying Congress and the president were sent to Washington to "solve the big challenges."

SOURCE




Liberals want to suspend self-government for Obamacare

President Obama is demanding a final vote on Obamacare before the members of the House and Senate return home for the Easter recess, which begins March 29. Whatever your views on the merits of the variety of health care reform proposals that collectively have been debated over the course of the past 15 months, you should be offended and repulsed by this schedule. Why? Because there is no bill to look at and debate; no text to read; no budget estimate to examine for its assumptions and calculations.

This is a massive proposed law, thousands of pages long, with extraordinarily dense language. The president has promised even more new provisions touching on such important subjects as tort reform and Medicare taxes, provisions that have never seen the light of day or been debated in any committee. His whole pitch is "Trust me," and the American people clearly do not, but still he pushes for a rapid conclusion to the debate.

This is not how free people govern themselves, and there can be no rhetorical cover for this attempted diktat. There is no urgency for a program the benefits of which do not begin to arrive in great measure for many years. There is no conceivable argument for voting in essence "sight unseen" except that the bill cannot withstand scrutiny, so scrutiny must be avoided.

Time and time again we have seen how the legislative process tosses up unseen and unread provisions that shock and appall. Most recently in the law to reauthorize the Patriot Act, there appeared out of nowhere a provision that would have criminalized various interrogation procedures. The "McDermott Amendment" was stopped, but not for lack of trying.

There will be no end to the fine print in Obamacare 4.0. The outrages of the "Cornhusker Kickback" and the "Louisiana Purchase" will have plenty of cousins in the newest proposals pushed by the president. With enough time, they can be discovered, and public opinion can be brought to bear to force them out.

Once into law, however, the worst provisions of Obamacare, passed in darkness and with undue speed, will require enormous effort to repeal and supermajorities if the president wields his veto to protect the special interests that benefit from the law's nooks and crannies.

Look at the fiasco that is the Consumer Product Safety Improvement Act of 2008, which has cost tens of thousands of jobs and hundreds of millions of dollars. The Congress cannot move itself to remedy even its most absurd overreaches. Once on the books, we are stuck with Obamacare with all of its unseen deals.

Nor will we be able to see until it is too late what hasn't happened. Is the tort reform being promised by the president in any way real? Do the numbers add up? Will the Medicare cuts be as deeply destructive as advertised, or will they be suspended and thus the deficits in the out years far greater than advertised?

Liberals who are pushing for a final vote are pushing for a suspension of self-government, for an astonishing and sickening descent into "who cares, just do it" extremism that departs from the long legacy of the American constitutional project.

Every legislator who votes to proceed in this fashion is participating in a shameful humbling of the role of the Congress. They will deserve to be thrown out regardless of the merits of Obamacare because they could not possibly have known what those merits are.

SOURCE




Obama Bribes, Threatens, and Rewards Congress to Pass Health Care

All aspects of President Obama's Chicago-style tactics are on display as he cajoles, bullies and bribes the House to pass his health care proposals despite the overwhelming public rejection with which they have been met.

To some, he offers bribes. Rep. Jim Matheson, endangered species -- a Utah Democrat -- succeeded in getting his brother Scott appointed to a federal judgeship. Matheson voted against Obamacare when it first passed the House. With his new-found winnings in his pocket, he now professes to be undecided. He faces a clear conflict between his district and his conscience on the one hand and the bribe to his brother on the other. The conscience will probably lose.

Matheson supports his party 91 percent of the time according to The Washington Post even though John McCain got 58 percent of the vote in his district in 2008. But Matheson got re-elected -- by professing independence from the Democratic Party's liberal line -- with 63 percent of the vote, so he probably figures he can sneak in a vote for health care and still con his district into re-electing him. After all, he's not heavy. He's my brother.

Even as Matheson basks in the glow of presidential bribery, Eric Massa, a renegade Democrat from the Southern Tier of New York state faces his wrath. Massa's sin was to vote against Obamacare. So Pelosi and the ethically challenged House Ethics Committee are investigating him for "verbally abusing" a male member of his staff.

In this age of more serious offenses, using "salty language" to express his displeasure with staff work would not seem to rank high on the list of indictable offenses. If it were, Lyndon Johnson would have been impeached. But Massa is being hung out to dry as an example to other would-be independent-minded Democrats. The attacks on him have gotten so bad that Massa has announced his retirement after only one term in office.

But there is a reward waiting for House members who ignore the wishes and interests of their constituents and vote for Obama's health care proposals. Alan Mollohan has had a pesky FBI investigation hanging over his head for a few years. Now, presto, right before the health care vote, it went away. The Justice Department, headed by Attorney General Eric Holder, announced that the FBI was closing the inquiry.

Mollohan's sin? He pushed for earmarks for nonprofit enterprises in his district and then went into a real estate deal in Florida with the head of the company under financial terms that were distinctly favorable to the congressman. But Mollohan toes the party line and is now getting his unjust reward.

With health care reform coming up for a vote in the next few days, such tactics send a message to the House, where Nancy Pelosi is having trouble lining up her votes: Obama will do anything -- anything at all -- to pass this bill.

For those of us without judgeships or the FBI at our disposal, we can only call and write the swing congressmen (go to dickmorris.com for a list and their phone numbers) or donate to the League of American Voters to step up its fierce media offensive in their districts to urge them to vote no.

SOURCE




Leftist British government ignored safety warnings for years over children's heart surgery

Ministers repeatedly ignored warnings about the safety of Britain's child heart surgery units, it can be revealed. In 2001, a public inquiry into the deaths of dozens of babies at Bristol Royal Infirmary said cardiac units should be barred from carrying out paediatric surgery unless they met safety standards, including carrying out a minimum number of operations per year. The recommendation to ensure surgery was only carried out by those skilled enough to perform the most delicate procedures was made to prevent the recurrence of a scandal such as Bristol – dubbed "the killing fields" in the 1990s.

Later this month, the Department of Health (DoH) will say no unit will be allowed to operate unless it has four surgeons and carries out at least 400 operations a year. The ruling will mean around half of Britain's 11 child heart surgery units must close, while the remainder expand. It means departments such as that at John Radcliffe Hospital, which suspended surgery last week following four deaths, and carried out just 100 operations in the last year, could not continue in their current form.

Today we reveal how:

* Ministers dismissed a warning in 2003 by the UK's most senior heart surgeon that half of Britain's units should be closed. As President of the Society for Cardiothoracic Surgeons (SCTS) of Great Britain and Ireland, Prof James Monro was commissioned by ministers to propose changes following the Bristol inquiry, yet "the Government did absolutely nothing" about his key demand, he told The Sunday Telegraph;

* Sir Bruce Keogh, medical director of the health service, told NHS bosses two years ago that he feared "another Bristol" tragedy because specialists were so thinly spread;

* The consultant told this newspaper "there has been frankly little progress" reorganising services to make them safer since the public inquiry reported in 2001. Sir Bruce recently told colleagues that failing to make changes now would leave "a stain on the soul" of his profession.

* Britain's leading children's heart charity says Labour ministers "ran scared" from introducing an overhaul of the specialist system which could have saved lives, and prevented major disabilities.

The public inquiry into the Bristol heart deaths scandal was the most damning in the history of the NHS. It said botched heart operations killed 30 to 35 babies between 1990 and 1995, while over a longer period, up to 170 babies died who might have been saved elsewhere. Sir Ian Kennedy, the inquiry's chairman, ordered a reorganisation of services to improve safety, with each unit carrying out a specified minimum number of operations.

The DoH asked Prof James Monro, then President of the Society for Cardiothoracic Surgeons, to carry out a review, which in 2003 said the figure should be set at 300 operations annually – meaning the closure of at least half of the centres. Prof Monro told The Sunday Telegraph: "That was our main recommendation and the Government did absolutely nothing about it at all. Not a single unit was closed, and many of them should have closed years ago".

The surgeon, now retired, said he thought it was "extraordinary" that the whole process was being started again now, years after the recommendations were shelved. Prof Monro said he never received an explanation for the rejection of his report, but said "politicians had their fingers in the pie" and were fearful of making changes which might upset local constituencies. In 2003, Stephen Ladyman, the then-health minister, dismissed the recommendation claiming the report contained "no evidence" to justify such closures, despite its inclusion of studies showing higher mortality at small units.

Four years later, Sir Bruce Keogh, then President of the SCTS wrote to health service bosses, expressing concerns about the current and future safety of Britain's paediatric cardiac units. He wrote the letter because he feared several units had become perilously short-staffed. Sir Bruce told this newspaper: "A number of surgeons had retired or stopped doing paediatric work, and I was worried things were looking a bit unstable. "In short, I was worried about the risk of another 'Bristol', and I felt anxious that we had a situation where two or three units were working single-handed."

Months after sending the letter, he was appointed NHS medical director, and ordered an urgent review of the service, which will result in a blueprint for children's heart surgery, to be published later this month. The document will say each service should carry out at least 400 and ideally 500 operations a year, and have 4 surgeons, so it can provide safe around-the-clock cover and perform a larger range of complex procedures. As a result, about half of England's 11 centres will be earmarked to close.

Sir Bruce was so fearful of an immediate crisis in cardiac care that in a letter seen by this newspaper, and sent in May 2008, he warned the head of NHS specialist services to draw up a "risk strategy" in case immediate problems emerged before the reorganisation could be carried out. The letter followed his explicit warning to the NHS management board that "another Bristol" could emerge in the foreseeable future.

Anne Keatley-Clarke, chief executive of the Children's Heart Federation, said families who had experienced the trauma of high-risk surgery were furious that politicians had delayed changes which could have saved lives. "Parents who know about heart surgery are hugely angry and frustrated about this. The clinicians were ready to do this a long time ago, the parents expected it; we think the politicians ran scared and blocked it," Mrs Keatley-Clarke said. She added: "We will never know how many children these delays have affected; whether that is in terms of needless deaths, or more children ending up with learning disabilities because they suffered neurological damage which could have been avoided."

Sir Bruce said there had been "frankly little progress" to make the changes since Kennedy reported in 2001, but said it was "too easy" to blame politicians given the likelihood of fierce constituency battles once the names of the units to close become public. He urged fellow surgeons to show leadership, and support changes even if it meant uprooting themselves and moving hundreds of miles to a different unit. Any more delays would create "a stain on the soul" of his profession, he said.

The largest units at Great Ormond Street and Royal Brompton Hospital in London, and Birmingham Children's Hospital, currently carry out more than 400 operations a year, while Alder Hey Hospital in Liverpool and Evelina Hospital, part of Guys and St Thomas' Foundation trust in London carry out around 350. The threat of closure looms largest over units at John Radcliffe Hospital in Oxford, which carried out just 100 operations in the last year, while hospitals in Leicester, Southampton, Newcastle, Bristol and Leeds all did less than 300.

This review will report this autumn, after considering which hospitals can best expand, and taking into account transport links for families. However Sir Bruce indicated that the John Radcliffe, which last week suspended its service amid an investigation into the deaths of four babies operated on by surgeon Caner Salih, is at greatest threat of closure. Sir Bruce said: "All of the judgements have yet to be taken, but the eye does fall on Oxford, given it's got the lowest number of operations by far, and only one surgeon [since the departure of Salih]".

Yesterday grieving mother Aida Lo, 29, from Oxford, spoke of her shock and anger at finding out that the death of her daughter, three-week old Nathalie, was one of four cases in less than three months which will form part of the inquiry announced last week. The hospital said Mr Salih, who started work at the hospital just three months ago, has left the hospital to work elsewhere. A spokesman said his departure was not connected to the investigation.

Sir Ian, who headed the public inquiry into the Bristol deaths, has recently been appointed to run the Government panel which will decide which paediatric cardiac units can stay open. Asked about the delay of almost a decade since he made his recommendations, he said only: "I did my bit – it was for others to take action. "Obviously I made the recommendation in the expectation action will be taken; I look forward to that happening."

The DoH said it had been monitoring children's heart surgery closely, and that to date, all units were providing acceptable results.

SOURCE




NHS patients routinely treated in mop cupboards and corridors, nurses' survey says

A shortage of space in overcrowded NHS hospitals means patients are routinely treated in television rooms, mop cupboards and corridors, a survey of nurses suggests today. Kitchens and storage areas are also used while extra beds are put on wards, increasing the the risk of infections spreading.

The poll of more than 900 nurses for Nursing Times found that 63 per cent were aware of patients being placed in areas not designed for clinical care. Almost eight in 10 respondents (79 per cent) said they believed this resulted in patient safety being put at risk, due to patients not having access to call bells or water, or fire exits being blocked.

Of those who were aware of the practice, 29 per cent said it happened every day, 29 per cent said several times a week and 11 per cent said once a week. The remainder said it happened once a month or less.

Reasons cited for the use of non-clinical areas included the hospital being “full”, A&E being “under pressure” or a risk that the Government’s four hour target for people to be seen in A&E may be breached, leading to unnecessary hospital admissions.

More than 300 nurses who responded to the survey revealed specific examples of what happened to patients. One anonymous nurse said the areas had been described as an “overspill car park”, while another said: “If a patient’s condition suddenly deteriorated resulting in them having a cardiac arrest we would not be able to get the crash trolley to them.” Another nurse added: “Urine bottles are not emptied, meals are missed, as staff are not aware of the patient.”

A total of 83 per cent of nurses said they had raised concerns about the practice with senior staff but only 4 per cent said it had then been stopped. Others said the move had been authorised by senior managers, while some nurses said they had been bullied and accused of “not being a team player” for raising their concerns.

In a statement, the Department of Health said that the vast majority of NHS patients experienced good quality, safe and effective care. “However, we acknowledge there is more to do and will continue to strive to make services even safer.”” It was for local health authorities and providers to assess services locally, a spokesman added. “Every nurse must comply with the standards, performance and ethics outlined in the Nursing and Midwifery Council code. In particular, any nurse who is concerned about any risk to their patients should report their concerns to their manager, in writing if necessary.”

Katherine Murphy, director of the Patients Association, added: “Not only is this potentially unsafe, but it is completely undignified. In extreme circumstances the NHS might need to resort to this, but the results of this survey suggest it is a widespread practice.”

SOURCE





9 March, 2010

Dems' splintering threatens health bill

The escalating battle among Democrats over abortion has grabbed headlines, but a few other intraparty disputes are endangering President Obama's proposed health care overhaul. From stemming rising health care costs and addressing regional disparities on Medicare rates to a general skepticism of the Senate, rank-and-file House Democrats are struggling to support Mr. Obama's plan as they close in on midterm elections. Voters have become increasingly hostile to the effort. "Any time the Senate is involved, I become nervous," said Rep. Emanuel Cleaver II, Missouri Democrat.

Polls show that certain provisions in the Democrats' plan are popular but that the American public is frustrated with the process, which has included deeply partisan attacks and accusations of legislating state-specific carve-outs in exchange for votes.

It's unclear how much can be changed from the president's plan, which is based largely on the Senate bill. Even if Democrats reach compromises on tough sticking points, some provisions can't be changed if Democrats keep to their plan to wrap up work on health care reform under complex budget reconciliation rules in the Senate.

Liberal Democrats are disappointed that the president's plan doesn't have a public option and say the tax subsidies aren't generous enough to help the poor and middle class meet the bill's insurance requirements.

Mr. Obama may have eased some of those concerns in a White House meeting last week when he pledged to try to push through a public insurance plan once he gains momentum with the health care overhaul bill, said Rep. Raul M. Grijalva, Arizona Democrat and co-chairman of the Congressional Progressive Caucus.

Another group of members, largely from the New Democrat Coalition, says the Senate bill doesn't do enough to repair the broken system that pays physicians and hospitals for treating Medicare patients. "I've always felt that the key to successful health care reform is changing the way we pay for health care, so it's outcome- and value-based, not volume-based as is fee-for-service today. And I'd like to see more in that direction," said Rep. Ron Kind, Wisconsin Democrat and one of the lawmakers who met with Mr. Obama last week. The Senate bill reforms the payment process for physicians but not hospitals or other parts of the health care system, he said. "The House did a better job of that when we passed our bill," Mr. Kind said.

Rep. John Adler, New Jersey Democrat, said on "Fox News Sunday" that "I'm not sure we've gone far enough in terms of fixing the underlying system to make it affordable for businesses and for taxpayers."

House members also have taken serious issue with the Senate's tax on high-cost insurance plans over concern that it would hurt unions, a group loyal to Democrats. The House's plan instead would increase taxes for Americans with the highest incomes. Mr. Obama's plan tried to address that concern by scaling back the tax and delaying the date it takes effect.

House Speaker Nancy Pelosi, California Democrat, promised to reform the nation's health care system soon but said it wouldn't be easy. "Every legislative vote is a heavy lift around here," she told reporters last week. "Assume nothing as to where we were before and where people may be now. We start, one, two, three, four, all the way up to a majority vote."

Rep. Chris Van Hollen, Maryland Democrat, said on Sunday's political talk shows that passage is uncertain. "Do we have a mortal lock? No," he said, though he repeated that he does "believe it will pass." "I think the trend is in the right direction because people see that the status quo is absolutely broken," he told CNN's "State of the Union," adding that his party caucus wants to see how the Congressional Budget Office analyzes a final plan's fiscal impact before committing to any votes.

The abortion issue threatens to untie support in the House as well. A dozen Democrats who voted for the House bill, led by Rep. Bart Stupak of Michigan, say the Senate bill would allow for federal funding of abortion and won't support it. The group proved its strength when it inserted strong restrictions into the House bill. These Democrats say the Senate plan would allow federal funding to cover community health care centers that provide abortions and allow tax subsidies for insurance plans that cover the procedure.

Underlying the policy differences is the House's skepticism of the Senate. The House has passed nearly 300 bills during this session of Congress that are still waiting for consideration by the Senate. Some of the bills, including a cap-and-trade proposal to curb greenhouse gas emissions, were approved with votes that were politically risky for House Democrats.

Under the president's plan, the House would pass the Senate bill and then a companion bill that repairs the Senate's plan would be introduced into both chambers. In the Senate, it would have to pass under complex budget reconciliation rules. Senate Republicans are threatening to make that process more complex in attempt to increase the wedge among skeptical House members. Republicans in the House and Senate have said they plan to make health care reform a central issue in the November elections.

The American public largely favors many of the proposed reforms but has grown frustrated with the process. Twenty-five percent of respondents in a CNN poll conducted in mid- to late February said Congress should pass a bill along the lines of what already has been proposed. That is down from 30 percent a month earlier. Proposals that have majority of public support include those requiring large and midsize businesses to provide insurance to employees (72 percent), preventing insurance companies from denying coverage for pre-existing conditions (58 percent) and the public insurance plan (51 percent) that liberals favor but Mr. Obama removed from his plans.

SOURCE




The same rotten Rx

If at first you don't succeed, try, try, try, try again

With Plans A, B and C having failed miserably, President Obama yesterday unveiled his latest "new and improved" version of health-care reform. He says that this incarnation "incorporates the best ideas from Democrats and Republicans — including some of the ideas that Republicans offered during the health-care summit." Unfortunately, its fundamental premise remains exactly the same — a government takeover of the health-care system.

Start with those "Republican ideas": Though mostly not bad, they're hardly game changing.

* Increase the financial incentives for states to experiment with malpractice reform by $50 million. Wow — a million dollars per state! That undoubtedly has the trial lawyers quaking in their boots.

* Undercover stings to help root out Medicare and Medicaid fraud. Fine — but when fighting fraud in government programs becomes a major concession, it shows just how out of touch Washington has become.

* Increase Medicare reimbursements. OK, higher spending for a program that's already going broke may well be a Republican idea, but it doesn't exactly make Obama's better.

* Allow health-savings accounts to be sold through the government-sponsored exchanges. This could be a positive step — but the details are key, and they remain to be seen.

HSAs have been proven to reduce the cost of health care and have added nearly 3 million people to the ranks of the insured since their inception. But they only really work in conjunction with high-deductible insurance — if your policy already pays for everything, there's not much point to saving for health expenses.

And every version of ObamaCare to date has restricted high-deductible insurance and/or mandated low-deductible policies. Unless the president is prepared to make major changes in those areas, the HSA concession is just bait-and-switch.

All in all, saying that these changes represent a "compromise" with Republicans is a bit like saying that Yankee speedster Brett Gardner is a home-run hitter. It's technically true (he hit three dingers last year), but no one's going to mistake him for Babe Ruth.

The president has also touted the new plan as "smaller" and "leaner." Smaller and leaner than what? This version may actually cost more than the last one — breaking the $1 trillion mark even under the White House's rosy assumptions.

At its heart, ObamaCare hasn't changed. It still represents a top-down, centralized, command-and-control approach to reform. The government would require everyone to have health insurance, would determine what benefits that insurance must include, would regulate insurance prices and physician reimbursement and would micromanage how medicine is practiced. All this would be accompanied by higher taxes and, most likely, higher insurance premiums.

It is a plan that says the government knows best — when it comes to a sixth of the US economy and some of the most important, personal and private decisions in people's lives. A few cosmetic concessions can't fix that basic premise.

Obama also made it clear yesterday that he wants Congress to use an obscure parliamentary gimmick known as "reconciliation" to bypass a Republican filibuster and force the bill through the Senate. Democrats will likely manage to get the 50 votes needed in the Senate to use this tactic — but the vote will be far closer in the House, where deaths, defections and resignations have erased the three-vote margin of victory Democrats had last November.

The president was right about one thing yesterday. As he said, "Every argument has been made. Everything there is to say about health care has been said, and just about everyone has said it. So now is the time to make a decision."

Reportedly, as many as nine House Democrats who once voted against ObamaCare, including Rep. Scott Murphy of upstate New York, are now open to supporting the latest version. If they do, in the face of overwhelming public opposition, this new version of health reform could turn out to be Plan L — for "loser."

SOURCE




Dems turn risky health vote into manhood contest

There's no way around it. Things in the House of Representatives are about to get very, very rough. With their backs to the wall, Democratic leaders are preparing a complicated plan to pass their national health care bill. Standing in the way are Democrats who oppose the bill, whether on principle or out of fear that voting for a wildly unpopular measure will spell defeat for them in November.

If you think House Speaker Nancy Pelosi is going to let them off easy, allowing them to kill the party's top policy priority in more than a generation -- well, that's not gonna happen. Democrats who are considering voting against the bill are about to experience arm-twisting, threats, and pressure like they've never experienced.

I called a Democratic strategist with a question: Say I'm a moderate Democrat. I voted for the House bill last November, but I've seen the polls, I know a majority in my district opposes the bill, and I feel certain that voting for final passage will end my time in office. Why should I vote yes?

"Look, you voted for it before," said the strategist, who asked to remain anonymous. "You should have thought about that then. You're stuck with the vote, it's around your neck, you're going to wear it like an albatross. The ad that's going to run against you is going to be the same whether you vote for it now or not. "The Republicans are going to be able to frame what you did their way, and you're going to need to be able to frame it a different way, to say that you fought to make health insurance more affordable and insurance companies more accountable. "And if you're a bedwetting crybaby, you should just go home right now." If you get the idea that, in private at least, Democrats are going to make this vote a serious test of manhood, you're right.

"You big weenie, you know what I'd like to say to you?" the strategist continued. "You sit there and you're willing to go send an 18-year-old to go fight for his country, knowing he might die, and here you are unwilling to take a tough vote on an issue that you promised your constituents and you voted for once before? You don't deserve to be here!"

What about this argument, I asked: Yes, I voted for it once, but why compound the damage by doing it again? Say you've cheated on your spouse. You can tell them you only did it once, that it was a mistake, and that you won't do it again. Or you can assume the damage has been done and carry on like Tiger Woods. Which is more likely to save the relationship?

Sorry, I was told. Real men don't turn back. "If they're bedwetters, they're bedwetters, and a lot of them are bedwetters," the strategist said of his fellow Democrats. "BUT THEY ALREADY VOTED FOR IT."

Well then, what about those Democrats who voted against the bill? To get to the 217 votes required for passage, Pelosi needs some of them to change their votes. "That's a much harder case," said the strategist. "You say to them, 'Look, we're Democrats. If we fail on this, we all fail together and everybody's going to pay the price. If you think it's important for the party -- the one that you're a member of -- to get something done, then you need to reconsider your vote. We need you. If we didn't need you, we wouldn't be asking.'"

"There are ways we can help you explain it. The Senate bill that you'd be voting for is less progressive than the House one, less costly, less tax-raising. So you can say, 'I was always for health care reform, but I wasn't going to raise taxes on families to do it.'"

But what happens when the lawmaker, however he voted the first time, raises the ultimate objection: If I vote for this, I'll lose my seat. "Let's assume you do get beat, and you have to live with it for the rest of your life," the strategist explained. "Would you rather get beat because you did something big that changed the country, or would you rather get beat because you're a weenie and sat around saying, 'I was too scared, so I got beat?'"

In the hallways and the hideaways of Capitol Hill, the Democratic message is clear: Real men don't cross the party. Understand?

SOURCE




One Giant Government Leap Backwards

Rather than a post-partisan olive branch to congressional Republicans and the American public, President Obama’s latest health-care speech was a declaration of war. He’s more than willing to use a 51-vote reconciliation majority to jam through a roughly $2 trillion health-care plan that amounts to a government takeover of nearly one-fifth of the economy. He’s prepared to stick Uncle Sam right in the middle of the age-old relationship between patients and doctors, and doctors and hospitals, all while subjugating the private health-care insurance system to the status of a government-run utility -- without bending the cost curve downward.

More spending. More tax hikes on investors, businesses, and individuals. New government boards to control prices, ration care, and redistribute income. The Obama administration is basically taking a giant government leap backwards that the country doesn’t want to take.

One of the most galling features of this plan is a taxpayer-subsidized government-insurance entitlement for people earning up to 400 percent above the poverty line, or nearly $100,000 for a family of four. In other words, a middle-class health-care entitlement that will add millions of people to the federal dole. It’s all too reminiscent of the political dictum of the old New Dealer Harry Hopkins: tax and tax, spend and spend, elect and elect.

The spending has been well chronicled by congressman Paul Ryan, who baffled President Obama at the so-called health-care summit with his cogent analysis of a ten-year cost of $2.3 trillion that sets a floor, rather than ceiling, for the likely expense of this entitlement package. Obama had no rebuttal.

On taxing, let’s not forget that the current health-care payroll tax of 2.9 percent will be expanded to cover all forms of investment and capital formation, on top of the repeal of the Bush tax cuts. The anti-growth consequences are incalculable. As the late Jack Kemp used to say, you can’t have capitalism without capital.

The White House says job creation is priority number one. But you can’t have new jobs without healthy businesses. And healthy businesses require investment. However, by taxing investment more we’ll get fewer jobs, reduced real wages, and slower economic growth.

And how stupid is it for the president to support a six-month payroll-tax cut for small businesses in the name of job creation while imposing a 1 percent permanent increase in that very same tax to fund the massive new health-care entitlement. Talk about self-defeating.

Oh, by the way, a government takeover of health care will cripple one of our most productive job-creating sectors. Over the deep two-year recession, while overall corporate payrolls fell by about 7.5 million, private health-care firms created almost 700,000 new jobs.

And the health-care industry is one of our fastest-growing, most technologically advanced areas. With constant breakthroughs in biotech, pharmaceuticals, medical equipment, and diagnostics, the growing demand for more health care could elevate this prosperous job-creating sector to a third of the economy in the decades ahead. What’s wrong with that? Why crush it?

Health-care reform was supposed to be about getting 10 million low-income, chronically uninsured people some health insurance. But that can be solved by playing small ball. Health-care reform also was supposed to slow down cost increases. But that will never happen until the third-party payment system, run by Big Government and Big Business, is replaced by true consumer choice and market competition.

Just give consumers the tax break, and let them shop across state lines to find the right insurance plan. And young people who are already paying taxes into Medicare should not be mandated to pay more taxes into this entitlement plan. The young will pay for health insurance when they’re ready to pay for it.

Clearly this new New Deal, or new Great Society, or whatever it is, is the government selling a product that the rest of the country doesn’t want. Ironically, polls show that roughly 80 percent of voters believe their health insurance is satisfactory, good, or excellent. Polls even show that the public knows that a simple majority vote on reconciliation is an insufficient check on runaway government.

The Byrd rule says that reconciliation is for budget control and deficit reduction. But the Obama Democrats think they can use reconciliation to install a massive new social policy that would emulate the socialist-labor entitlement state now prevalent in Western Europe. As the Greece crisis amply shows, that entitlement state is on the verge of bankruptcy.

Perhaps Obama’s throwing down the gauntlet on nationalized health care will be the political gift that keeps on giving, in terms of political regime change come November. But if Obamacare does pass, a future rollback will be very difficult, and American health care and economic prosperity will be put in grave jeopardy.

SOURCE




Doctor's lives already being burdened by too much bureaucracy

Leading to a REDUCTION in available medical services. Yet Obama wants to impose yet another level of bureaucracy

Some years ago, one of my favorite doctors retired. On my last visit to his office, he took some time to explain to me why he was retiring early and in good health. Being a doctor was becoming more of a hassle as the years went by, he said, and also less fulfilling. It was becoming more of a hassle because of the increasing paperwork, and it was less fulfilling because of the way patients came to him.

He was currently being asked to Xerox lots of records from his files, in order to be reimbursed for another patient he was treating. He said it just wasn't worth it. Whoever was paying-- it might have been an insurance company or the government-- would either pay him or not, he said, but he wasn't going to jump through all those hoops.

My doctor said that doctor-patient relationships were not the same as they had been when he entered the profession. Back then, people came to him because someone had recommended him to them, but now increasing numbers of people were sent to him because they had some group insurance plan that included his group. He said that the mutual confidence that was part of the doctor-patient relationship was not the same with people who came to his office only because his name was on some list of eligible physicians.

The loss of one doctor-- even a very good doctor-- may not seem very important in the grand scheme of heady medical care "reform" and glittering phrases about "universal health care." But making the medical profession more of a hassle for doctors risks losing more doctors, while increasing the demand for treatment.

A study published in the November 2009 issue of the Journal of Law & Economics showed that a rise in the cost of medical liability insurance led to more reductions of hours of medical service supplied by older doctors than among younger doctors. Younger doctors, more recently out of medical school and often with huge debts to pay off for the cost of that expensive training, may have no choice but to continue working as hard as possible to try to recoup that huge investment of money and time. Younger doctors will probably continue working, even if bureaucrats load them down with increasing amounts of paperwork and the government continues to lower reimbursements for Medicare, Medicaid and-- heaven help us-- the new proposed "universal health care" legislation that is supposed to "bring down the cost of medical care."

The confusion between lowering costs and refusing to pay the costs can have a real impact on the supply of doctors. The real costs of medical care include both the financial conditions and the working conditions that will insure a continuing supply of both the quantity and the quality of doctors required to maintain medical care standards for a growing number of patients.

Although younger doctors may be trapped in a profession that some of them might not have entered if they had known in advance what all its pluses and minuses would turn out to be, there are two other important groups who are in a position to decide whether or not it is worth it.

Those who are old enough to have paid off their medical school debts long ago, and successful enough that they can afford to retire early, or to take jobs as medical consultants, can opt out of the whole elaborate third-party payment system and its problems. What the rising costs of medical liability insurance has already done for some, other hassles that bureaucracies and politicians create can have the same effect for others.

There is another group that doesn't have to put up with these hassles. These are young people who have reached the stage in their lives when they are choosing which profession to enter, and weighing the pluses and minuses before making their decisions. Some of these young people might prefer becoming a doctor, other things being equal. But the heady schemes of government-controlled medicine, and the ever more bloated bureaucracies that these heady schemes will require, can make it very unlikely that other things will be equal in the medical profession.

Paying doctors less and hassling them more may be some people's idea of "lowering the cost of medical care," but it is instead refusing to pay the costs-- and taking the consequences.

SOURCE




Ten complaints a day from new mothers in NHS maternity wards

Ten new mothers a day complain about the appalling treatment they receive on overstretched and underfunded maternity wards. The catalogue of complaints ranges from patronising and rude midwives and doctors, to botched deliveries and babies being born in toilets and on reception floors. They paint a bleak picture of a hospital service that is routinely failing women and babies when they are at their most vulnerable.

Hospital spokesmen say the vast majority of new mothers are happy with the service they receive, but MPs and campaigners say the shocking figures are symptomatic of a target-driven health service dangerously short of midwives. Horror stories uncovered by a string of Freedom Of Information requests include:

* An anaesthetist who slurred his words and fell asleep twice in front of a mother-to-be.

* Women giving birth on toilets, in wheelchairs and even on the floor of the reception area.

* Midwives talking on their mobile phones while treating women and arguing with doctors in front of a patients.

* A nurse dropping a gas-and-air unit on the head of a patient.

The FOI requests to 149 hospital trusts with maternity units revealed that 2,792 complaints were lodged last year. However, just 111 trusts replied to the survey. If all had responded, the total number of complaints is likely to have reached 3,700 - or ten a day.

Almost half of the complaints related to bullying, unsympathetic, rude and apathetic staff. Seventy complaints were made about maternity care at Southampton's Princess Anne Hospital, the subject of a Channel 4 fly-on-the-wall documentary called One Born Every Minute.

The Royal College of Midwives says Britain needs another 3,000 midwives to give new mothers the one-to-one care they need. It emerged last year that the nation's midwives are more overworked than they have been for at least a decade and experts believe up to 1,000 babies a year die needlessly because doctors and midwives are too overstretched or poorly trained to detect the warning signs. Maternity units paid out almost £200million in compensation last year.

Lib Dem health spokesman Norman Lamb said the Government warned a culture of red tape and targets was putting midwives under unbearable strain. He added: 'You have good and highly dedicated people but it goes wrong if they are constantly under pressure to meet administrative requirements rather than being able to deliver the best service.'

Anna Davidson, of the Birth Trauma Association, said: 'These figures and examples are not surprising given the things we hear. 'The shortage of midwives is a real problem. We hear of women left on their own to give birth or one midwife trying to cope with eight cases at a time. 'I am sure there are examples of fantastic care and dedication, but we hear from mothers who suffer nightmares, flashbacks and panic attacks. 'They say they have suffered uncontrollable pain, haven't been listened to and were not able to follow their birth plan.'

A Department of Health spokesman said: 'The NHS delivers hundreds of thousands of babies safely every year and England is one of the safest places in the world to have a baby.'

SOURCE





8 March, 2010

The Health Care Bill That Just Won't Die

Just when you think that the Democrats' Health Care Bill is dead . it rises from the grave like a zombie propelled by the sheer will of liberals in Washington who think they alone know what's best for the American people. President Obama today ordered Congress to pass the Health Care Bill in the next two weeks so that it can be written into law by a strategy called "reconciliation". The promise of bipartisanship has faded. Now, the bill will pass without Republican support.

While the Democrats in the House are busy lining up their votes, one wonders if any will take the time to read the more than 2,000 page monstrosity. In the meantime, the American people are left to question what the role of government should be on health care.

Everyone in this country wants better and more affordable health care made available to a larger number of people. Those in this debate are not arguing about whether more people should be insured, the debate is about how to increase coverage for more people. The Democrats make it seem like our choice is between the current, albeit imperfect system, and radical reform. This is not true. As we saw in the last election, voting for change doesn't necessarily get you the kind of change you want. Sometimes a change can be a change for the worse.

The federal mandate to purchase health insurance has been part of this bill for several months. However, President Obama recently pegged the penalty to not comply with the mandate at 2.5% of annual income. The problem is the mandate. The mandate exists to force people to purchase the amount and type of insurance favored by the federal government. The decision about what kind of health care you want to buy - or if you want to buy it - is fundamentally the same kind of decision as where you want to live or where you want to work: a private matter that is related to fundamental values about how you want to live your life. A mandate of this kind is a substantial infringement on your individual freedom.

Mandating universal health coverage and making the government the ultimate provider of health insurance takes our private choices about lifestyle, health, and medicine and turns them into public, social choices. Whether you eat donuts or hamburgers or get a check-up so many times a year is no longer a choice about your life, but rather a public, political choice about how politicians will control the distribution of resources in society. Since we'll all be tied together through a social health care system, you will no longer make private decisions about your lifestyle. This is a scary prospect. We don't want to live in a society where a National Health Director can decide that it is verboten to eat Krispy Kreme donuts because those who do have become a social liability.

This Health Care debate is about the American Dream. It is about the personal decisions each of us make every day as we live our own, respective lives. It is time to dare to dream again about an America that celebrates and protects the freedom to live your life based on what you think is best, not what a gaggle of Washington politicians believe.

SOURCE




Obama comforts House liberals: Don’t worry, this bill is just the beginning of what we’ll do with health care

Thus confirming what many conservatives have predicted

Don’t look surprised. The left has been remarkably candid about this over the past year or two. Again and again and again and again and again and again and again they’ve warned people that the dream is bigger than universal coverage or even the public option. Memo from The One to progressives: Keep the dream alive.

Obama argued to the group of progressive members that his health care reform bill should be looked at as the foundation of reform, that can be built on in the future. He asked them to help gather votes for the final health care battle and promised that as soon as the bill was signed into law, he’d continue to push to make it stronger. But in a matter of weeks, he stressed, he could sign into law legislation that would lead to 31 million new people being insured, including the woman who wrote him…

“He just said that the public option, something that he has supported along the way, is not something that we can pass. And he emphasized the fact that the decision now is between doing as much as we can do and doing nothing. That’s it. He thought the whole foundation thing — that this is definitely something we could be proud of, something we could build off [of],” said Schakowsky.

Woolsey told Obama that she’d be introducing legislation to create a public option and Obama said he encouraged the effort, according to Schakowsky.

Here’s an especially fun passage. Remember, Obama was self-described proponent of single-payer as recently as 2003 before deciding that it’s simply too impractical to pass. For now.

None of the members, including Kucinich, indicated that they would vote any differently this time around. “I think [Kucinich] left the meeting leaving the impression with the president that he’s a no-go,” said Schakowsky.

But, said one attendee, Obama pointed Kucinich toward single-payer language that Sen. Bernie Sanders (I-Vt.) was able to get into the bill. Kucinich fought for an amendment that would allow states to adopt single-payer systems without getting sued by insurance companies. Obama told Kucinich that Sanders’s measure was similar but doesn’t kick in for several years. “He definitely wrote it down,” said one member of Kucinich, suggesting that he’d look into it.

I can’t decide between thinking that he’s saying this earnestly — if so, given the fallout in November, he’s going to be waiting awhile for ye olde public option — or just telling these idiots what they need to hear to vote for the much-despised Reid bill. This would, in theory, give him some cover even if he goes ahead and stabs them in the back by dropping reconciliation. After all, if this is just the first small step towards socialized medicine, who cares how small that step is? Pass anything. Just get a foot in the door so that you can swing it open in a decade or two when the wheel turns towards progressivism again.

Exit question: Think anyone in the White House press corps will lean on Gibbs tomorrow to explain what, specifically, this bill is a “foundation” for?

SOURCE




A proposal built on lies

“No one has talked about reconciliation,” Senate Majority Leader Harry Reid declared during last week’s health care summit. It was a lie shocking in its boldness.

Live on national television, the Democrats’ leader in the U.S. Senate told the nation that not a single person had discussed even the possibility of using the Senate’s budget reconciliation rules, which require a simple majority vote instead of 60, as needed under regular Senate rules, to pass President Obama’s health care reform plan. Yet, a week before, Reid himself had said publicly that reconciliation was an option for passing the plan, Politico.com reported. Of the Senate’s 59 Democrats, 23 had already signed a letter urging the president to pass the plan via reconciliation by the time Reid said “no one” was even talking about it. And of course, a week later, President Obama, as expected, urged Democrats to pass the bill through the reconciliation process if necessary.

In other words, the Democratic Party leadership in Washington hadn’t just talked about reconciliation. It was central to their strategy.

Reid’s blatant revisionism perfectly encapsulates the Democratic leadership’s plan for passing legislation to completely remake health care in the United States. Simply put, the plan is this: Lie. Thus, President Obama and the leadership in Congress have lied about nearly everything, from start to finish. Obama said that if you have health insurance you like, you’ll absolutely get to keep it under his plan. That was a lie. As he eventually acknowledged, millions of Americans will lose their existing coverage if the changes he wants become law.

Similarly, Obama spent all last summer saying health care reform wouldn’t raise taxes on anyone but the rich. But on August 2 the Associated Press reported that the administration admitted that taxes might have to be raised on the middle class to pay for the health care bill.

Obama has said repeatedly that insured families pay about $1,000 a year to cover the costs of the uninsured. Factcheck.org puts the figure at $200.

Obama said our current health care system causes a bankruptcy every 30 seconds. That’s not remotely true. If every bankruptcy in the United States in which health care costs played any factor at all were counted as a bankruptcy caused by health care, the figure would be one per minute, not double that.

In the summer, Obama was claiming that health care reform was paid for. At the time, the Congressional Budget Office concluded that the House bill added $239 billion to the federal deficit over a decade and the Senate bill $597 billion. The president’s claims still aren’t true because of tricks such as removing the “doc fix” provisions and putting them into a separate bill.

Obama claimed health care reform would save the average American family $2,500 a year. Factcheck.org could find no evidence for that at all. Obama apparently just made it up.

Obama promised at least eight times that the health care negotiations would be televised live on C-SPAN. They weren’t. They were done, as everything in Washington is done, behind closed doors.

There us no shortage of additional examples. When it comes to health care, on point after point after point, the American people have been lied to – systematically, methodically and deliberately.

It should go without saying that opponents of the Democrats’ plans haven’t always been truthful, either. Some attacks have contained intentional falsehoods, others inadvertent ones. I don’t defend any of those. But they don’t make any less outrageous the fact that our own government has systematically misled us in an attempt to generate support for a plan the president and leaders in Congress knew we would never accept if we knew the whole truth about it.

Sure, politicians have always lied. But this administration, with its campaign theme of hopeful “change,” was supposed to be the most open and transparent administration in history. Even Congress was supposed to be different. Nancy Pelosi promised the most ethical Congress in history. Instead, the White House and its Congressional allies have joined forces to launch an almost daily barrage of falsehoods designed to trick us into supporting a dramatic transformation of one sixth of the American economy. And here’s the worst part about the politics of the healthcare debacle: We have at least three more years of this to look forward to.

SOURCE




Government medical records are already a shambles

But Obama wants more of the same. If government bureaucrats can't keep records for 4 million people straight, what chance with 300 million?

The electronic health record (EHR) network portal for the U.S. Department of Defense (DoD) and Department of Veterans Affairs (VA) was shut down this week after the VA found errors in some patients' medical data that clinicians downloaded from the defense network, according to a patient safety alert. Among the errors the VA detected through the Computerized Patient Record System's (CPRS) Remote Data View (RDV) -- its graphical user interface for clinicians -- was a prescription for vardenafil for a female patient. Vardenafil is used for treating male erectile dysfunction.

"The DoD pharmacy staff checked the prescription number and determined the vardenafil prescription was for another patient and verified the vardenafil prescription had not been ordered for or dispensed to the female VA patient," the alert stated.

The decision to shut down the portal was first reported by Nextgov.com. As of Monday, all access to electronic Defense Department records through the computerized record system and VistAWeb was disabled, the VA said. The agency was not sure when the system would be restored.

VistAWeb is the VA's intranet portal to eHealth records through CPRS, and it allows remote medical facilities access to the VA's VistA EHR system. VistA stands for Veterans Health Information Systems and Technology Architecture.

Jean Scott, director of the Veterans Health Administration's Information Technology Patient Safety Office, said in the alert that the VA pulled the plug on the system because "the potential exists for decisions regarding patient care to be made using incorrect or incomplete data."

The VistAWeb is operated by the VA and is the largest and most comprehensive EHR system in existence, serving more than four million service members. Many medical IT experts consider it to be the archetype for EHR systems in the private sector, and vendors have copied its architecture in their own products. As of March 13, all medical records for the DoD will be accessed by phone, fax, paper or other alternative methodologies, the VA said.

Other errors with VistAWeb and CPRS system include displaying some patient data incorrectly, incompletely or not displaying queried data at all. "The VA clinician may see the patient's data during one session, but another session may not display the data previously seen," the VA said in its alert. "This problem occurs intermittently and has been reported when querying DoD Laboratory, Pharmacy, and Radiology reports."

The government has uncovered other prescription errors related to EHR systems that have been rolled out in private-sector hospitals as well. Sen. Charles E. Grassley (R-Iowa), sent a letter in January to some of the nation's largest health care facilities asking for any information on "issues or concerns that have been raised by your health care providers" over the past two years.

Grassley said the letter was prompted by concerns brought to his attention in recent months about EHR systems that included "administrative complications, formatting and usability issues, errors and interoperability." In some of the most serious cases, incorrect medication dosages are being miscalculated by software that is interchanging patient body weights with kilograms and pounds.

IT managers also have voiced concerns that new regulatory deadlines from the government aimed a spurring EHR adoption in the private sector could wind up causing problems as people rush to deploy systems so they can claim a portion of billions of dollars in federal incentive monies.

According to the VA, no patients were harmed as a result of the errors in the EHR system. Although the agency moved to shut down down the eHealth records exchange this week, it said it first discovered the problem in February with the Defense Department's EHR system, known as the Armed Forces Health Longitudinal Technology Application. That's when the erectile dysfunction prescription error occurred.

SOURCE




Mencken on Merchants of Idiotic Ideas

Last night, driving back from teaching my wonderful Principles of Microeconomics students, I heard on a DC radio station an interview with an aide to House Speaker Nancy Pelosi approvingly repeat Pres. Obama’s insistence that, once those Americans who now oppose Obamacare actually get that care, they’ll grow to love it.

This outcome is unlikely – or, rather, it would be unlikely if all the problems with collective decision-making (as identified by public-choice economics) didn’t distort political perceptions. As H.L. Mencken observed: “The kind of man who demands that government enforce his ideas is always the kind whose ideas are idiotic.*”

Being sensible, sensible ideas seldom must be imposed by force. Sometimes sensible ideas are adopted gradually, as practices with widespread advantages displace less-advantageous practices and become part of customary behavior. Sometimes sensible ideas are adopted consciously and quickly, through the art of persuasion or the rigors of scientific demonstration.

In contrast, idiotic ideas have nothing going for them. Most people who voluntarily adopt idiotic ideas in their private lives soon abandon them if these ideas hamper their ability to thrive in the real world. The only way to implement an idiotic idea widely and surely is through force – which is the root of Obamacare.

SOURCE




Canadian healthcare at work

Incompetent surgeon allowed to keep operating -- with grievous results

A Leamington, Ont., woman, who had an unnecessary mastectomy last fall, has launched a $2.2 million lawsuit against the surgeon who removed her breast, the pathologist who analyzed her biopsy and two hospitals in the Windsor, Ont.-area. Laurie Johnston, who never had breast cancer, is suing surgeon Dr. Barbara Heartwell, pathologist Dr. Olive Williams, Hotel-Dieu Grace Hospital and Leamington District Memorial Hospital.

At a news conference in Toronto Wednesday, Johnston said she believed she was in the hands of a good surgeon who would help her fight breast cancer, a disease that also struck her mother and sister. Instead, Johnston says she walked out of Heartwell's office a "disfigured" and forever-changed woman — for no reason. Johnston underwent radical surgery last fall in which Heartwell removed her left breast and six lymph nodes, only to find out she never had cancer.

Johnston is seeking $1 million in general and special damages and another $1 million in punitive and aggravated damages. Her daughters, aged 22 and 15, and her sister are seeking another $200,000 in damages under the Family Law Act. "To learn that my breast was removed unnecessarily is devastating for me and (my family)," Johnston told a throng of reporters Wednesday at the office of Toronto law firm Torkin Manes LLP. "Sometimes, I'm alone and I just sit there and think about it, and I start to cry," she said. "If I'm not crying, I'm angry, I'm anxious."

The lawsuit, filed Tuesday in Windsor, alleges Heartwell failed to properly diagnose Johnston and "failed to read or properly understand" the pathology report which showed Johnston's lump was benign. The suit also alleges Williams, who examined Johnston's biopsy samples taken at Leamington hospital, produced a confusing pathology report which contributed to Heartwell's error. The allegations have not been proven in court.

Hotel-Dieu officials have said that Williams' pathology report was correct but that Heartwell misread it. The top of the report lists a clinical diagnosis of ductal carcinoma, based on initial findings. Further down the page, Williams listed a pathological diagnosis of fibroadenoma — a benign growth in the breast.

Johnston's lawyer, Barbara MacFarlane, said Hotel-Dieu ought to have known at the time of Johnston's surgery that Heartwell had performed another unnecessary mastectomy in 2001 on Janice Laporte, who was cancer-free. Laporte, who now lives in Sarnia, Ont., came forward with her story after hearing about Johnston in the media. Laporte settled a lawsuit against Heartwell out of court. That suit did not name Hotel-Dieu.

MacFarlane said both Hotel-Dieu and Leamington hospitals should have known that Williams was "incompetent." Williams was suspended Jan. 4. Heartwell voluntarily stopped performing surgeries at Hotel-Dieu last week. The hospital is also reviewing her past cases. Both physicians are under investigation by the College of Physicians and Surgeons of Ontario. The Ontario Ministry of Health has also launched a probe into surgical and pathology errors in Windsor.

In a statement, Hotel-Dieu said it has not yet received official notice of Johnston's claim. "We are profoundly sorry that this tragic situation has occurred and we know this is an extremely difficult time for Ms. Johnston," hospital CEO Warren Chant said, adding that Hotel-Dieu has offered support to Johnston and "will we will continue to do so."

Meantime, a Toronto hospital where Williams worked more than 12 years ago will be conducting its own review of her old cases. Wolf Klassen, vice-president of program support at Toronto East General Hospital, told Canwest News Service Wednesday the hospital will pull a random sample of Williams's pathology reports to check for mistakes. "In light of everything that's been reported in the media, we are doing this as a precaution," he said.

The ministry-appointed investigators, Dr. John Srigley, Dr. Robin McLeod and Dr. Barry McLellan, will also look more broadly at the quality of patient care. "When I heard about what happened in Windsor, I thought that was important enough to send in (investigators)," said Ontario Health Minister Deb Matthews. "It's a very rare thing to do, but I thought the circumstances warranted it."

Despite calls for a provincewide pathology review, Matthews said the probe will remain focused on Windsor. Matthews said she has been in frequent contact with McLellan, Ontario's former chief coroner who is heading up the investigation, and if he believes the review should be expanded beyond Windsor, "then I will take that very seriously."

SOURCE




The British Labour party hid the ugly truth about the National Health Service

DAMNING reports on the state of the National Health Service, suppressed by the government, reveal how patients’ needs have been neglected. They diagnose a blind pursuit of political and managerial targets as the root cause of a string of hospital scandals that have cost thousands of lives.

The harsh verdict on the state of the NHS, after a spending splurge under Labour between 2000 and 2008, raises worrying questions about the future quality of the health service as budgets are squeezed. One report, based on the advice of almost 200 top managers and doctors, says hospitals ignored basic hygiene to cram in patients to meet waiting-time targets. It says “several interviewees” cited the Maidstone and Tunbridge Wells [NHS Trust in Kent where 269 deaths during 2005-6 were caused by infection with Clostridium difficile bacteria].

“Managers crowded in patients in order to meet waiting-time targets and, in the process, lost sight of the fundamental hygiene requirements for infection prevention,” the report stated. There were subsequent failings at health trusts in Basildon in Essex, and Mid Staffordshire. Filthy wards and nurse shortages led to up to 1,200 deaths at Stafford hospital.

Lord Darzi, the former health minister, commissioned the three reports from international consultancies to assess the progress of the NHS as it approached its 60th anniversary in 2008. They have come to light after a freedom of information request.

The first report, by the Massachusetts-based Institute for Healthcare Improvements (IHI), identified the neglect of patients as a serious obstacle to improving the NHS. “The lack of a prominent focus on patients’ interests and needs ... represents a significant barrier to shifting the trajectory of quality improvement in the NHS.” One heading in the report says: “The patient doesn’t seem to be in the picture.” It adds: “We were struck by the virtual absence of mention of patients and families ... whether we were discussing aims and ambition for improvement, measurement of progress or any other topic relevant to quality. “Most targets and standards appear to be defined in professional, organisational and political terms, not in terms of patients’ experience of care.”

This weekend it emerged the recommendations of the reports, intended to help the NHS improve, have not even been circulated. The stark assessments, collected from leading NHS clinicians and managers, include:

* A damaging rift between doctors and managers: “The GP and consultant contracts are de-professionalising, and have had the peculiar effect of simultaneously demoralising and enriching doctors. We’ve lost the volitional work of the doctors and far too many of us are now just working to rule.”

* Pointless new structures. “Stop the restructurings. The only thing they generate is redundancy payments.” One body responsible for improving standards reported to five different ministers and had three different names in the space of 30 months.

* A culture of fear and slavish compliance. “The risk of consequences to managers is much greater for not meeting expectations from above than for not meeting expectations of patients and families.”

The IHI report, whose interviewees included Lord Crisp, chief executive of the NHS between 2000 and 2006, also described a system of self-assessment where only 4% of trusts are externally inspected.

A similar picture emerges in the second report, by the US-based Joint Commission International. It says the “quality and integrity of [NHS]performance data is suspect”. Dennis O’Leary, its lead author and an international expert on patient safety and improvement, said it was not intended as an exposé but as a series of useful suggestions for change. “Our instructions were to pull no punches and tell it like it was, but the report wasn’t overstated,” he said. “It was how we saw things based on interviews with more than 50 people.”

The third report, by the US-based Rand Corporation, expresses surprise at the lack of a requirement to identify the specific drug involved when patient accidents are reported.

In 2008 Darzi issued his own blueprint for the future of the NHS, High Quality Care for All, but resigned from the government last July to return to his surgical commitments. Last week he said: “The NHS is continuing a journey of improvements, moving from a service that has rightly focused on increasing the quantity of care to one that focuses on improving the quality of care.

“High Quality Care for All has gone to every NHS organisation in the country where it is being implemented to ensure that the NHS delivers safe and effective treatment every time, with our patients being treated with compassion, dignity and respect when in our care." A Department of Health spokesman maintained that the three reports were never intended for “wider circulation” and said they were extensively discussed by experts advising Darzi on the production of his report.

However, Brian Jarman, emeritus professor at Imperial College London and an expert in hospital standards, said the findings should have been made available to Robert Francis QC, who led the inquiry into the Mid Staffordshire NHS Foundation Trust. He said: “These reports have never seen the light of day. We desperately need a better monitoring system for the NHS which actually works.”

SOURCE





7 March, 2010

Democratic divides on health care keep multiplying

House Democratic leaders pledge to hold a vote on health care by their Easter break, which gives lawmakers about three weeks to resolve dozens of disagreements that stand in the way of passing legislation. "There is all kinds of stuff in the ether," Rep. Anthony Weiner, D-N.Y., said, referring to the long list of differences Democrats have over how to write the health care bill.

Democrats plan to have the House vote on a Senate-passed version of the plan and then make corrections in a smaller bill that would have to be approved by both chambers. Democrats so far can't agree on what would go in the smaller bill and there may not be enough support among House Democrats to pass the Senate bill in the first place.

House Speaker Nancy Pelosi said she will convince members of her caucus to vote for the bill, but conceded she is unable to persuade members yet because there is no proposal in writing and no accompanying price tag for it. "When I talk to my members, I have to have two important pieces of information," Pelosi said. "One is, what is the final status of the bill? And two, what is the Senate going to do about it? What are the actions the Senate is going to take? The Senate cannot tell us that until they see the final product as well."

Senate leaders said they are at the mercy of the Congressional Budget Office, which is responsible for scoring any new proposal. But there is no proposal yet, because Democrats cannot agree on a final product.

Despite House Majority Leader Steny Hoyer's pledge for a pre-Easter vote, even he said on Thursday there is still a lot to work out first. "You have to resolve this in a way that gives a comfort level to both sides," Hoyer told The Examiner, referring to differences between the House and Senate. The comfort level, he said, "is missing over here."

While Senate and House Democratic leaders met in the Capitol to hash out a compromise, President Obama continued to play referee at the White House, inviting the liberal and moderate Democratic factions of the House to separate meetings. On attendee was Ron Kind, D-Wis., who said he and many other moderates want the health care plan to do more to rein in costs and improve Medicare. The Senate bill, he said, "seems inadequate."

Liberals like Weiner actually want to spend more on reform, saying that in the end it will save more money. "Some of the problems can be easily fixed if the president loses his love affair with a specific number for the bill," Weiner said, referring to the $900 billion spending limit Obama has publicly put on the legislation.

But it may be harder to resolve other, smaller problems that could create big headaches for the leadership, such as the desire by the Hispanic caucus to include Puerto Rico in the health care reform plan. "There are a lot of people who feel they have been taken for granted here," Weiner said. "It doesn't take much to create a firestorm."

SOURCE




No flip-floppery, just flim-flammery

Mr. Obama is loath to say the word "reconciliation," because he knows "reconciliation" is this season's synonym for suicide. So he warns of the danger of flip-floppery. His health care "reform" passed the House by only five votes, and deaths and resignations have reduced the margin. There's no margin left for flip-floppery. That's the message the president's desperate lobbyists are taking to Capitol Hill. He wants a vote before Congress departs for its Easter vacation at the end of the month, and promises his loyalists that he will apply enough flim-flammery over the next fortnight to discourage flip-floppery.

The president's men remind wavering congressmen of Sen. John Kerry's boast that he voted for the second war in Iraq before he voted against it, and everyone knows how that turned out. They could draw a lesson from Bill Clinton as well, who once tried to explain away his support for sending troops to the first Gulf War as a straddle: "I was for it but I was really for those who were against it."

This time, Mr. Obama wants an up-or-down vote, and no straddling. But unless there's an irresistible congressional impulse for suicide, the White House has a tough sell, and the president knows it. "The American people want to know if it's still possible for Washington to look out for their interests and their future," he says. "I don't know how this plays politically, but I know it's right."

That's not quite what the American people want to know, and besides, it's a weak appeal to a frightened congressman. It sounds like the beginning of a concession speech. A congressman, like a president, is always calculating the politics. Doing the right thing is OK, unless you overdo it and certainly not if it ends a career. Mr. Obama has been in Washington long enough to recognize the difference between community organizing, which is about stirring up trouble, and congressional politics, which is first about getting re-elected.

The president and his party loyalists have been forced into a defensive game. They can't afford to lose a single vote, and the temper of the times encourages flip-floppery. Retreating from an earlier vote to enact Obamacare to a new vote to kill Mr. Obama's poisonous "reform" is merely a desperate attempt at survival. The Republicans and the Democratic Blue Dogs who are riding the crest of sentiment against Obamacare will hardly be tempted to change their votes.

After months of tea parties, presidential threats, pleading harangues and enough hot air to melt the polar bears there's not anything left to say, but certain embattled Democratic incumbents are trying to hide behind words. Sen. Blanche Lincoln of Arkansas, the most seriously threatened Democratic incumbent, is in trouble at home for her vote for the Senate bill. She can't explain it away, since it's on the record, but now she vows she will vote against "reconciliation." She doesn't say how she will vote when "reconciliation" by another name is used to silence Senate dissent. Sen. Mitch McConnell of Kentucky, the leader of the Republican minority, promises that the Republicans will make "every election in America this fall a referendum on this issue."

The latest obstacle in the president's way is the vow of Rep. Bart Stupak of Michigan to destroy the legislation unless stronger language to prevent subsidization of abortion is written into the Senate bill. He says he has 10 House colleagues with him. The abortionistas in the House insist they won't vote for the Senate bill if the president caves.

Nancy Pelosi, the speaker and leader of the San Francisco Democrats, says her members "are very excited about what comes next." For many of them, that's "excited" as in "hysterical." If White House pressure prevails and Mr. Obama wins the vote, the campaign of 2012 begins at once with a Republican promise to repeal the monstrosity. That's when the real fun begins.

SOURCE




Obama vs. Insurers and the People

President Barack Obama's obsessive, opportunistic demonization of insurance companies in his quest to pass his not-yet-written health care proposal is growing tiresome. Aren't you getting sick of a president attacking American citizens and businesses as if they -- not Obama's beloved government -- were the enemy? His repeated implication that insurance companies are the primary reason for rising health care costs is politically expedient, but it's still untrue. Government is the main culprit.

Throughout his yearlong push for Obamacare, he has called insurance companies every name in the book. He has blamed them for soaring costs, bludgeoned them for taking profits, condemned their executives' salaries and savaged them for denying coverage for pre-existing conditions. He even says insurers are the final arbiters of who gets care and who doesn't: "And insurance companies freely ration health care based on who's sick and who's healthy, who can pay and who can't."

Obama has framed the entire debate as if it were an insurance problem. In his theatrical speech Wednesday -- while flanked from all sides by white-coated props -- he said, "We began our push to reform health insurance last March," as if the thrust of his health care efforts has been to rein in insurers and little else.

Though Obama surely hates insurance companies, we all know he is up to much more than just punishing them. This is about a government takeover, even if it takes several incremental steps. Vilifying insurers sells better than glorifying government to a center-right nation generally suspicious of government.

Insurance companies are not the main reason for our exploding health care costs. If they were, the solution would not be to increase regulations on them, but to deregulate them and let the market work its magic. To blame insurers for increasing costs is to imply they are guilty of some kind of collusion or price fixing. Does Obama really believe we have an evil insurance cartel in America?

Could it be that their rates are symptomatic of higher health care costs rather than the main driver of those costs? That said, aren't we likelier to see more competitive rates if we relax onerous regulations, such as laws preventing the purchase of health insurance across state lines (one of the many Republican proposals)?

It's very clever -- and reminiscent of his street-agitating mentor Saul Alinsky -- for Obama to adopt the anti-government language of conservatives to use against insurance companies. They are "rationing" care, he says. No, they enter into contracts with individuals and groups to provide insurance coverage as defined in the contract. They don't arbitrarily deny coverage if they have contractually agreed to provide it. But if they do, legal remedies are available.

I realize Obama has no qualms about violating the contracts clause of the Constitution and interfering with private contracts, but that's not the way it's supposed to work in America. For him to suggest that insurers must be forced to cover pre-existing conditions is tantamount to saying the government is going to convert them from insurance companies to unconditional guarantors. How can you call it insurance if you remove their ability to calculate their own risk assessments? If, in his dictatorial omniscience, Obama tells insurance companies what they must cover, how many of them will remain in business while forced to take losing deals -- absent government subsidies?

Even if you believe insurers are culpable, you will still be hard-pressed to demonstrate that any insurance pricing abuses are responsible for more than a fractional percentage of our rising health care costs. Republicans made that point quite cogently during Obama's bogus summit, and he didn't even pretend to have an answer for it.

I believe our rising costs are attributable mostly to government interference with free market forces. The price mechanism is not allowed to work because, due to tax laws, most people get their insurance through their employers and don't have to pay out of pocket for their own insurance and so the costs are invisible to them. They don't base their consumption on what they can reasonably afford.

In addition, the government has mucked things up with Medicare and Medicaid, mandates insurance coverage for unnecessary procedures, prevents interstate insurance purchases, as noted, and obstructs health savings account reforms and tort reform.

By demonizing insurers, Obama is diverting attention from the real villain here -- an intrusive federal government -- so he can give it even more control. The people know better, which is why he's endorsing legislative shenanigans to get it done, despite condemning that approach in the recent past.

Oh, yes, and if you believe he's going to rein in government costs and "fraud and abuse," there's some real estate I'd like to sell you at a fictitious address with a phantom ZIP code.

SOURCE




Under Obamacare, fewer people will choose to make a career of medicine, which will cause untold ripple effects

In Britain the result has been that the government has to pay very high salaries to get doctors into its government hospitals -- and even then a large proportion of its doctors and nurses are poorly-trained third-world imports

I have rarely been as troubled as I was when I read a Facebook conversation, probably 8 months ago now, about socialized medicine. One of the participants opined that it probably wouldn’t be a bad idea to downplay the profit motive in the health care industry. You might assert that such an ivory towered notion could only emerge from the hallowed halls of academia and sadly, you would be right in this instance.

Our family doctor’s HMO already is refusing to take many patients with Anthem/Blue Cross/Blue Shields insurance because Anthem will only pay the Medicare baseline. (He consented to continue accepting us as patients in spite of our Anthem coverage, because of our relationship with him, which now spans a good number of years.) What will transpire when insurance companies go out of business because they can’t compete with government undercutting their prices under all of the enhanced powers government accrues as the price negotiator of first resort? Or alternatively, when more insurance companies begin to adopt Anthem’s tactics?

The profit incentive is central to the human condition. People excel when there is accomplishment for which to strive. Such achievement is codified in the possession of private property, of which money in the bank account is a key component. This is not to say that motivated workers cannot also be charitable. America’s record of voluntary local giving and worldwide monetary assistance is second to none, as all statistics show. But can anyone truly give from the heart if the donation is not voluntarily rendered? Indeed, is it not, in the end, forceful taxation if the dollars that are forfeited are done so on other than a wholeheartedly willing basis?

Why should doctors be any different, simply because they practice healing the sick? Most medical professionals, after all, spend around 10 years of their lives in arduous and expensive academic programs before they earn their first penny. What fool will continue to do this if not assured a comfortable income and standard of living upon graduation that will remunerate all of the costs absorbed in transit? (I’m fairly sure that the academic I observed making the comment about the “profit motive in healthcare” makes a high 5-figure salary, with a lush package of perks and didn’t have to go to an Ivy League-level school to obtain his/her current job.)

If fewer doctors practice medicine, costs will not only rise (and don’t kid yourself; they will), but treatment will have to be rationed. And yes, call it what you will, but death panels will result. Does anyone really believe that if the government is financing health care for an increasing percentage of the population, with a finite money supply, it will not decide what will be paid for and who will reap the benefits? It is simple economics: Tinker with the supply curve of anything and demand is always impacted.

(This reminds me of a discussion I had with an economist a couple of years ago when I expressed bewilderment at the inability of many politicians to grasp basic economic concepts. His reply? “Look at the industry most of them come from. The vast majority are attorneys.”)

If the President, Harry Reid and Nancy Pelosi really wanted to reform health care, they would implement measures that would increase competition on every conceivable front. Malpractice lawsuit reform and freedom to purchase insurance across state lines are great places to start.

But if this were really about reform, the President would have listened to the ever-growing majority by now and either forged a legitimate consensus of some kind or started over. With statists like Barack Obama, it is always about further government control, a far more apt description that the chameleonic term “reform” which can be imbued with any meaning with which the user determines to endow it.

One final question: If (pray God, it is so!) this monstrosity of a bill does not pass, how soon will we forget, in our bleary fatigue, that we have waged this fight and that we must continue to explain, with clarity and detail, to the next generation why we did it? One hopes that the residual memory lingers. Unfortunately, the lesson of history teaches that the reality should rather lead us to expect otherwise.

SOURCE




Neglected by 'lazy' British nurses, man, 22, dying of thirst rang the police to beg for water

A man of 22 died in agony of dehydration after three days in a leading teaching hospital. Kane Gorny was so desperate for a drink that he rang police to beg for their help. They arrived on the ward only to be told by doctors that everything was under control.

The next day his mother Rita Cronin found him delirious and he died within hours. She said nurses had failed to give him vital drugs which controlled fluid levels in his body. 'He was totally dependent on the nurses to help him and they totally betrayed him.'

A coroner has such grave concerns about the case that it has been referred to police. Sources say they are investigating the possibility of a corporate manslaughter charge against St George's Hospital in Tooting, South London.

Mr Gorny, from Balham, worked for Waitrose and had been a keen footballer and runner until he was diagnosed with a brain tumour the year before his death. The medication he took caused his bones to weaken and he was admitted to St George's for a hip replacement in May last year. The operation left him immobile and unable to get out of bed. His 50-year-old mother says that he needed to take drugs three times a day to regulate his hormones. Doctors had told him that without the drugs he would die.

Although he had stressed to staff how important his medication was, she said, no one gave him the drugs. She said that two days after his hip operation, while Miss Cronin was at work, he became severely dehydrated but his requests for water were refused. He became aggressive and nurses called in security guards to restrain him. After they had left, he rang the police from his bed to demand their help.

Miss Cronin, who is divorced from her son's father Peter, said: 'The police told me he'd said, "Please help me. All I want is a drink and no one is helping me". 'By this time my son was confused due to his lack of medication and I think the nurses just ignored him because they thought he was just being badly behaved. 'They were lazy, careless and hadn't bothered to check his charts and see his medication was essential.'

That evening, Miss Cronin visited him. She said: 'I told Kane to behave himself because I thought he had been causing trouble - and I feel so bad about that now. I thought maybe he was having a bad reaction to the morphine he was on but in fact it was because he had not had his medication.' The next morning she visited him before going to work. 'He was delirious and his mouth was open,' she said. 'I gave him a drink of Ribena.

'I told three nurses there was something wrong with my son and they said, "He's fine" and walked off. I started to cry and a locum doctor who was there told me not to worry. 'Eventually the ward doctor came round, took one look at Kane and started shouting for help.'

Miss Cronin was asked to leave her son's bedside. 'He died an hour later,' she said. 'I didn't even realise he was dying. I didn't even have a chance to say goodbye.'

The death certificate said Mr Gorny had died because of a 'water deficit' and 'hypernatraemia' - a medical term for dehydration [Rubbish! It means too much salt. But it probably is a misprint for hyponatremia -- lack of salt]. His mother added: 'When I went back to the hospital I was told that all the nurses had been offered counselling as they were so traumatised, but nothing was offered to me. 'The whole thing is a disgrace. This hospital has a brilliant reputation and boasts of its excellent standards and safety record. 'But as soon as my son walked into that ward, his death warrant was signed. Of the 32 people who were involved in my son's care, every one made a mistake that ultimately led to his death, from the consultant to the care assistant.

'There has been an internal investigation but St George's never made it public and it was a whitewash- After his death the hospital never phoned me or wrote to me to apologise. How could this happen in the 21st century?'

A Metropolitan Police spokesman said: 'Detectives from the Homicide and Serious Crime Command are investigating the death of Kane Gorny at St George's Hospital after this was referred to us by Westminster Coroner's Court.'

A spokesman for St George's Hospital said: 'We are extremely sorry about the death of Kane Gorny and understand the distress that this has caused to his family. 'A full investigation was carried out and new procedures introduced to ensure that such a case cannot happen in future. [Ho, ho!] 'We have written to the family to explain the actions that have been taken and to answer their concerns about Mr Gorny's care. The family has also been invited to meet with trust staff to discuss the case in detail.'

The tragedy emerged a week after a report into hundreds of deaths at Stafford Hospital revealed the appalling quality of care given by many of the nurses. This week a task force called on nurses to sign a public pledge that they will treat everyone with compassion and dignity.

SOURCE




Hundreds of NHS wards to be shut in secret plans

Plans that could lead to the closure of hundreds of hospital wards are being drawn up but will not be made public until after the general election, opposition parties have said.

Last year, the Government asked NHS authorities to come up with proposals to reorganise the service to save money as a result of the recession. Details have started to emerge of what is likely to be a rolling programme of cuts that contrasts sharply with assurances from Labour and the Tories that the NHS was “safe”. So far, only the plans for London have come to light. Campaigners claimed the proposals threatened services such as casualty and maternity units at 13 out of 36 hospitals in the capital.

The failure of health authorities in other areas to disclose their response has prompted allegations that proposed closures, which could be politically damaging to the Government, will not be published until after polling day.

The scale of the cuts has caused a rebellion among Labour ministers who have openly defied the Government by publicly protesting at closures at their local hospitals.

Next week, health ministers will come under pressure from the Conservatives and Liberal Democrats to disclose the scale of the plans, with the Tories calling an emergency debate on the issue. Norman Lamb, the Liberal Democrats’ shadow health spokesman, said the scale of the cuts to hospitals was likely to be “vast”, with potentially “hundreds” of wards closing. He said: “The Government will be desperate to avoid these cuts ahead of an election. We could end up with the threat of cuts to services being a key issue in the election campaign. The electorate will feel conned if they come out after the campaign. “It is hard to judge the scale of this but it could be vast. It could be hundreds [of wards]. The savings they have to achieve are enormous. What has emerged in London could be the tip of the iceberg and the public is unaware of the scale of potential cuts.”

Mike Penning, the Tory shadow minister for health in London, said: “I see no reason why these reports cannot be published before the election. Labour must be straight with people about the cuts that they are planning to make to their local NHS.”

The cutbacks are partly as a result of Lord Darzi’s 2008 review of the NHS, which recommended more community based treatment in large GP centres and bigger, specialist treatment centres in hospitals. Authorities were asked by the Department of Health to draw up plans to implement Lord Darzi’s review. But last year, they were told to reconsider their proposals after the recession.

Opposition parties have claimed that health authorities were considering closing or merging key hospital departments, many of which have received millions of pounds in investment in recent years.

The NHS is coming under pressure to find other savings despite government claims that the health service would be protected from widespread public spending cuts. In this month’s budget, Alistair Darling, the Chancellor, is expected to announce that the NHS will have to find savings of up to £10 billion a year. Liam Byrne, a Treasury minister, said last month that hospital buildings were likely to be mothballed as services were moved to community based health centres. Dr John Lister, the author of the British Medical Association’s recent report on the plans, described the scale of the cuts being proposed as “a disaster”.

Threatened hospital closures are likely to become one of the key election issues. Labour ministers and MPs faced claims of hypocrisy after starting pre-election campaigns to block closures at their local hospitals. Ministers were pictured protesting against closures and writing to residents setting out their opposition. Many fear they will lose their seats if they are seen to back government policy.

Last weekend, David Lammy, the Higher Education minister, was joined by other local Labour MPs when he led a march to “save” the Whittington Hospital casualty department in north London. The Whittington also faces cuts to maternity services, although £600,000 of public money was recently spent on its new birth centre. Other high-profile Labour MPs campaigning to protect hospitals in their constituencies include Margaret Hodge, the Culture and Tourism Minister who represents the marginal seat of Barking. She has led a campaign to save the Accident and Emergency unit at King George Hospital in Ilford.

Mike Gapes, the Labour MP for Ilford South, also backs the campaign. “I will fight a Labour government, a Conservative government or a Martian government to keep a hospital in my constituency,” he said yesterday.

Last night, Andrew Lansley, the shadow health secretary, said: “Labour MPs are campaigning on a general election manifesto which would lead to the first cuts to the NHS budget for years, but yet they still try to portray themselves as local champions by protesting against cuts in their own backyards.”

A department spokesman said any discussion of the scale of cuts was “speculation”. The local NHS plans would be published after the budget, she said. “These are tough times and we are committed to continuous improvement in efficiency. The NHS locally is best placed to identify savings based on their circumstances and priorities.”

SOURCE





6 March, 2010

Obama calls Dems to Pickett's Charge

They started out in perfect alignment, 12,500 men stretching more than a mile, battle flags waving, bayonets fixed, and gazes focused on the enemy across the valley, tensely waiting for them on Cemetery Ridge. Less than an hour later, it was over, with more than half of them dead or wounded, their cause having reached its high-water mark and failed.

It was Pickett's Charge of the Confederates at Gettysburg in 1863, a horrendous, bloody carnage that could have been avoided, had not their commander, Gen. Robert E. Lee, been so determined to do it his way -- a massed frontal assault against a nearly impregnable position.

It is to just such a political Pickett's Charge that President Obama now summons congressional Democrats on behalf of his health care reform proposal, a last desperate gamble to overcome a sturdy, strengthening line of Republican opposition reinforced beyond measure in recent months by the knowledge they stand with a solid majority of their countrymen. Obama and Democratic brigade commanders Harry Reid and Nancy Pelosi know there will be terrible casualties among their troops come November, but still they urge them on, to sacrifice their jobs, careers and political futures for ... 2,700 pages of new bureaucratic rules, mandates, directives and edicts that will surely destroy the finest health care system in the world.

Pelosi in particular seems eager to give her troops the order to charge. She continually invokes past glories, imploring House Democrats to remember that "this will take courage. It took courage to pass Social Security. It took courage to pass Medicare. But the American people need it, why are we here? We're not here just to self-perpetuate our service in Congress." That last line may ring hollow for three dozen or so Democrats representing districts carried by Sen. John McCain in 2008, especially since there is only the faintest of possibilities that Pelosi will be a casualty, representing a district in which 80 percent of the voters think she is exactly what they need in Congress.

And there is another reason Pelosi's invocation of Social Security and Medicare votes could give many House Democrats reason to think twice about voting for Obamacare. The votes for final passage on both programs were solidly bipartisan, with clear majorities of Democrats and Republicans voting in favor. For better or worse, those programs each enjoyed a broad public consensus of support at their inception. The only public consensus now is that Congress should junk Obamacare and start over on health care reform. House Democrats should ponder Pickett's assessment of Lee years after Gettysburg: "That man destroyed my brigade."

SOURCE




Obama’s Gamble On Health Care Bill May Be Losing Bet

President Obama fleshed out his health care overhaul Wednesday with a few nods to GOP ideas. But with Republicans likely to collectively reject the latest last-ditch effort, some experts say the White House is really trying to get some Democrats to switch their votes from no to yes. Yet it's not at all clear House Speaker Nancy Pelosi, D-Calif., can round up the votes.

"This is where we've ended up," said Obama. "It's an approach that has been debated and changed and I believe improved over the last year. It incorporates the best ideas from Democrats and Republicans — including some of the ideas that Republicans offered during the health care summit."

The four GOP ideas in the plan were: engaging medical professionals to conduct random undercover probes to combat Medicare and Medicaid waste and fraud; more funding for demonstration projects of alternatives for resolving medical malpractice disputes; increasing Medicaid reimbursements for doctors; and ensuring Health Savings Accounts (HSAs) are in the insurance exchange.

Cosmetic, Not Bipartisan

But Minority Whip Eric Cantor, R-Va., dismissed it as "a last minute effort to try and throw a few Republican proposals on top of a trillion-dollar measure . . . that's not bipartisanship."

The White House likely isn't seeking GOP votes. Instead it wants to portray its plan as bipartisan enough to give cover to House Democrats who voted no in November to vote yes this time. "It's going to be very difficult for any Democrat to switch," said Brian Darling, director of Senate relations at the conservative Heritage Foundation. "It's one thing with retiring members since they don't have to face the voters. But any members who have to face the voters, it will be very hard to move from the no category to yes and keep their jobs, especially this close to an election."

To get Obama's plan through, the House would have to pass the Senate health bill and then make "fixes" via the reconciliation process. That requires just 51 votes to pass in the Senate, thus avoiding the 60 needed to end filibusters. Reconciliation typically is limited to budget matters. "I'm optimistic, but this is a real challenge," said Ralph Neas, CEO of the liberal National Coalition on Health Care. "The president has been showing stronger and stronger leadership, but it will take a retail effort."

Can Pelosi Find The Votes?

Democratic congressional leaders have threatened to go the reconciliation route for weeks now, but it's not clear if they have the votes, especially in the House. The House passed its version, 220-215, back in November. But Pelosi has lost four supporters with two recent retirements, the death of Rep. John Murtha, D-Pa., and Rep. Joseph Cao, R-La., the lone Republican to vote for the bill, saying he'll vote no next time. Pelosi needs 217 to pass the Senate bill and reconciliation after accounting for vacancies. But Rep. Bart Stupak, D-Mich., has threatened to vote no because the Senate bill does not have anti-abortion language strong enough to his liking. Stupak says 10 or 11 other Democrats would join him. Also, New York's Mike Arcuri and Arizona's Raul Grijalva signaled Wednesday that they will switch and oppose the Senate bill.

It's not clear where Pelosi can get additional votes. The Associated Press reported late Tuesday that there were nine Democrats who voted no in November but are uncommitted now. Three aren't running for re-election. But if the "Stu-pack" and others move to no, Pelosi would still be a few votes shy if all nine switch, and it's far from clear that they will. "It's not really a switch to say he's undecided," said a spokesman for Rep. John Tanner, D-Tenn., one of the AP nine. "We're expecting an entirely different bill than what he voted against on the House floor. He's undecided until he sees what the final bill will look like and the Congressional Budget Office score."

SOURCE




House, Senate Dems split on health care tactics

President Obama's latest sweeping health care proposal has pitted House and Senate Democrats against each other over who should go first in passing legislation GOP leaders promised will put them in the majority.

Even after Obama's announcement aimed at pushing his plan over the finish line, Democrats in the House were reluctant to take the lead, saying they want the Senate to first pass a bill crafted more to their liking. Animosity between the two chambers is reaching a boiling point. House lawmakers are complaining that the Senate has yet to act on about 290 bills the House has sent its way this Congress, which makes them reluctant to go first on health care. "We're waiting for that cooling saucer of democracy that is the United States Senate to get off their high horse and start to pass some of these bills," said Rep. Anthony Weiner, D-N.Y., Wednesday.

The Senate wants the House to pass their health-care reform legislation first, and then a second, smaller legislative package would be introduced containing corrective provisions sought by House lawmakers and the president.

But House Democrats fear the corrective bill will never clear the Senate, where Democrats there no longer control a 60-vote supermajority and the legislation would have to be filtered through the difficult "reconciliation" process in order to pass with just 51 votes. "I think we have 290 reasons why we don't trust them to do it," said Rep. Bart Stupak, D-Mich., who is opposed to the Senate bill because it does not prohibit subsidies for insurance policies that fund elective abortions.

House Speaker Nancy Pelosi declared that Congress is finalizing a new bill, but that the House would not be taking it up right away. Pelosi said, "We will see what the Senate can do" after the Congressional Budget Office puts a price tag on the measure.

But across the Capitol, in the offices of Senate Majority Leader Harry Reid, D-Nev., Democratic lawmakers had already made up their minds that the House should the Senate's health care bill first. When presented with the scenario put forward by Senate Democrats, one top House leadership aide signaled there was no such agreement, adding, "We're still talking."

The discord between the House and the Senate stems in part from lack of Democratic enthusiasm for the bill, which the GOP has pledged to use as a campaign weapon if it passes. Republicans have pledged their 2010 campaigns would be based on repealing the bill if it passes.

Democrats may try to find a way to pass the Senate bill and the corrections bill at the same time in order to alleviate the worries of House Democrats. "If we are going to take their dramatically deficient bill and bring it up to House standards, we are going to have to have a piece of companion legislation that moves at the same time," said Weiner.

SOURCE




Not One Major Poll Favors Obama's Health Proposal

by Matt Towery

In my entire career, I have never been as confounded as I am over President Obama and the Democratic leadership's obsession with a piece of legislation that not one major national poll has shown to be popular. A quick glance at this week's surveys shows about a 10 percent spread between those who favor the latest health care legislation and those who oppose it. In the world of politics, that's a blowout. So I have to ask, why are the president and the leaders of Congress willing to see their entire party and a multitude of other policy proposals go down in flames over something that the public can't stand?

Well, we could be altruistic and say they believe that strongly in the merits of health care reform. Indeed, there are parts of the proposal I might support. But I've been around this game far too long to believe in pure altruism from politicians. After all, I was one myself. This isn't to say that elected officials don't try to do the right thing. But when you see the public hating what you are doing, you generally start to question whether what you are promoting is really the right thing.

Folks, this is nothing more than a power grab. It's an effort to take one of the most essential elements of every person's life -- their health -- and put it under the control of government.

In the past, I have written about a growing "political royalty" in this nation. At first, I felt it was just developing out of benign neglect of the public and the naturally big egos that come with politicians. My opinion has changed. I now believe there are many in Washington who not only consider themselves a cut above the rest of us, but who believe they must manage every aspect of our lives because we are just the common folks who need to be tended to like cattle on a ranch.

This thing is an act of madness. What the White House and Democrats are hoping is that, after the legislation passes, people will forget about the costs and the hassles in the several years that the whole thing takes to implement. They are wrong.

And just to show that I can be even-handed in my judgment about these sorts of things, let me say that I was totally opposed to the Republican impeachment of Bill Clinton. Was the impeachment "altruistic"? Absolutely. But it got us nowhere. When we decided to release Ken Starr's report, which included rather prurient information on the Internet, I argued vehemently against it.

The GOP leadership was convinced the nation would turn on Clinton, his approval ratings would sink, and he would be asked to resign the following week. Instead, his numbers went up because we Republicans looked like we were ignoring other important issues in order to pursue Bill Clinton's removal from office -- something that was never going to happen. I guess you could say that entire impeachment episode was a power grab, as well. And it failed miserably. It also diverted our time and energy from other issues that needed to be addressed.

And that gets me back to this current insane decision by President Obama and Congress to consider a gimmick -- much like our release of the Starr Report -- of passing a health care bill as part of what is known as "reconciliation" budget legislation. (That means it would require a simple majority vote and avoid the possibility of needing 60 votes to prevent a filibuster.)

When we tried the Starr gimmick, we were too cute. The public was smart, and they viewed it as us putting sexually explicit material on the Web where kids and others might see it. Well, guess what? The public, which hates this legislation, will treat the gimmick of "reconciliation" in the same manner. And take it from me, the tumble the Democrats will take for such a silly move will be massive.

SOURCE




"Dysfunctional" NHS hospital kills kids

Up to half of England’s child heart surgery units are likely to close as a result of a national review triggered by concerns about the risks posed by some. The Times understands that the review will recommend the merging of smaller units such as The John Radcliffe hospital in Oxford, which has suspended services after the deaths of four children in three months. The hospital has started an investigation into the cases, conducted by one surgeon. It said that the temporary suspension was a precaution taken while reasons for the high death rate were examined.

Senior surgical sources said that the concerns “came as no surprise” at a unit which had a “culture of dysfunctionality”. It has been the subject of a number of inquiries in recent years. The national review, conducted by the National Specialist Commissioning Group, is due to report in July. It was ordered in 2008 by Sir Bruce Keogh, the NHS medical director, to ensure that the sector, considered to have the most advanced monitoring of patient outcomes in the world, can meet the rising demand for increasingly complex procedures.

The review is expected to recommend that units should have a minimum of four surgeons seeing 400 patients a year to ensure enough skill and experience are pooled and a sufficient number of difficult cases is seen. The number of units is likely to be reduced from eleven to about five or six centres of expertise.

The unit at John Radcliffe, the smallest in the country, sees just 100 cases and currently has one paediatric cardiac surgeon. Caner Salih, the surgeon linked to the four deaths, announced his resignation at the end of last year after less than a year in post. The consultant, who is considered highly skilled, is understood to have stepped down over exasperation at the working environment at the unit. The hospital would not comment on Mr Salih’s reasons for leaving or suggestions that its unit was not functioning properly. Mr Salih was recently appointed to a similar role at Guy’s and St Thomas’ Hospital trust.

The hospital said that each of the deaths of the “seriously ill children” would be reviewed, while the 26 patients due to have surgery would be sent to other units. The investigation will examine all aspects of care involving the four children who died, rather than limiting itself to the surgery. The senior source told The Times that the deaths — after the previous inquiries and several senior staff resignations — “looked very much like another example of dysfunction” at the Radcliffe. “The situation there is unstable,” the source said.

Leslie Hamilton, president of the Society of Cardiothoracic Surgery, said that sources were right to suggest that expertise was overstretched in paediatric heart surgery. “There are 25 to 30 surgeons involved in the whole country,” he said. “We feel they are spread too thinly across those units.”

Professor Keogh confirmed that the review would report in the summer, when it would be put out to consultation. He said of the Radcliffe: “This highlights the need for the current review of paediatric cardiac surgery which will result in a reduction in paediatric units. We need to concentrate expertise in fewer large units. “The quality of care across the sector as a whole is very high. Our concern is that there are areas that will have increasing difficulty coping in the future as the technical complexity of this surgery carries on increasing.”

All 11 units have been asked to submit business plans, while Sir Ian Kennedy, who conducted the inquiry into the Bristol heart scandal more than a decade ago, has been asked to assess their ability to fulfil the latest requirements.

The Oxford hospital has been subject to investigations in the past over the number of deaths linked to such surgery in adults. An investigation into adult cardiac surgery, conducted by the Healthcare Commission in 2007, concluded that while death rates were “acceptable” improvements were needed urgently. It highlighted issues over data collection, saying: “Bearing in mind the history of the cardiac unit at Oxford, and the number of questions about the trust’s rates of mortality, there had been a surprising lack of robust processes to validate and cross-check the completeness and quality of its data.”

Since the Bristol heart scandal, monitoring of all cardiac surgery has been stepped up. Any unexplained series of deaths should automatically trigger both trust and external investigations. Survival rates for heart surgery units and individual surgeons are published and can be compared. The Care Quality Commission, the health regulator, has said that it is not investigating the John Radcliffe at present, but would monitor the trust’s own review “extremely closely”.

SOURCE




'Scandalous' NHS maternity unit under fresh scrutiny over failures

A hospital maternity unit condemned as “scandalous” after the deaths of two babies has come under renewed scrutiny after failing to improve standards. A team of clinical advisers is being sent in to monitor services at Milton Keynes General Hospital amid concerns that it has been too slow to resolve problems which led to the children’s deaths.

Milton Keynes NHS Foundation Trust was heavily criticised last year following the death of Ebony McCall. An inquest heard that Ebony would probably have survived if her mother, Amanda, was given a Caesarean section when she asked for one. But staff were too busy and told her they would only carry out the procedure in an emergency. The scandal came despite having already been investigated over the death of Romy Feast in the same unit in 2007, who died after her heart condition was misinterpreted.

The health watchdog, the Care Quality Commission (CQC), issued a damning report last month saying the unit still had too few midwives and beds. Monitor, the independent regulator of NHS foundation trusts, has now intervened by sending in an action squad to ensure that services are improved. A spokesman for Monitor said: “Our aim in taking this regulatory action is to ensure swift progress to safeguard future access to high quality maternity care by the Trust’s patients.”

Monitor said the trust had failed to address 12 recommendations by the Healthcare Commission in 2008. Its failure to recruit a consultant midwife and a sufficient number of additional midwives was particularly worrying, Monitor said. It warned that further sanctions would be imposed if the trust does not take “rapid and effective action to deliver the necessary improvements”.

Dr Nicholas Hicks, chief executive of NHS Milton Keynes and director of public health, said: “We welcome the decision announced by Monitor which requires the hospital to appoint external expert clinical advisers. “The safety and quality of the care provided by all NHS organisations in Milton Keynes is of paramount importance to us all and we therefore welcome the steps taken to help accelerate the delivery of improvements within the hospital’s maternity service. “NHS Milton Keynes will continue to support and work with the hospital, the CQC, Monitor and other partners to ensure patients receive the quality of care they deserve. “We hope this intervention will improve public confidence in the service.”

Dr Walter Greaves, the trust’s chairman, added: “We are pleased that Monitor has examined our plan with such care and we look forward to working with these experts. “We will be working as hard as we can to ensure the very best of care for local people throughout our hospital. “Our maternity department provides a safe and quality service for local mothers, many of whom compliment us on the care they and their babies receive. I would like to reassure local women they can feel entirely safe coming to Milton Keynes Hospital to have their babies.”

At an inquest in December, Thomas Osborne, deputy coroner for Milton Keynes, said "systems failures" which were "nothing short of scandalous" contributed to the death of Ebony McCall. Miss McCall, who suffered a string of medical complications including cardiac arrest, went into labour, but by the time a Caesarean was ordered, it was it was too late to save Ebony. She was born with a faint and erratic heartbeat that had allegedly been previously undetected, and died minutes later through lack of oxygen.

The inquest heard that between January 2007 and October 2009 there were 2,114 incidents reported on the labour or maternity wards and of those, more than 25 per cent related to staff shortages.

SOURCE





5 March, 2010

Obama demands vote on health care

The end game at hand, President Barack Obama took command Wednesday of one final attempt by Democrats to enact bitterly contested health care legislation, calling for an "up or down vote" within weeks under rules denying Republicans the ability to kill the bill with mere talk.

Appearing before a White House audience of invited guests, many of them wearing white medical coats, Obama firmly rejected calls from Republicans to draft new legislation from scratch. "I don't see how another year of negotiations would help. Moreover, the insurance companies aren't starting over," the president said, referring to a recent round of announced premium increases affecting millions who purchase individual coverage.

While Obama said he wanted action within a few weeks, Senate Majority Leader Harry Reid, D-Nev., seemed to hint a final outcome could take far longer. "We remain committed to this effort and we'll use every option available to deliver meaningful reform this year," he said.

The results will affect nearly every American, mandating major changes in the ways they receive and pay for health care or leaving in place current systems that leave tens of millions with no coverage and many others dissatisfied with what they do get. With Republicans united in opposition, there is no certainty about the outcome in Congress - or even that Democrats will go along with changes Obama urged on Wednesday in what he described as a bipartisan gesture.

With polls showing voters unhappy and Democrats worried about this fall's elections, Obama also sought to cast the coming showdown in terms larger than health care, which is an enormously ambitious undertaking in its own right. "At stake right now is not just our ability to solve this problem, but our ability to solve any problem," he said.

Republicans dug in for another struggle on an issue that they agreed would echo into the fall campaign. The Senate GOP leader, Mitch McConnell of Kentucky, said a decision by Democrats to invoke rules that bar filibusters would be "met with outrage" by the public. "This is really not an argument between Democrats and Republicans. It's an argument between Democrats and the American people," he said.

At its core, the legislation under discussion still is largely along the lines Obama has long sought and GOP critics attack as a government takeover of health care. It would extend coverage care to tens of millions of uninsured Americans while cracking down on insurance company practices such as denying policies on the basis of a pre-existing medical conditions.

A new "insurance exchange" would be created in which private companies could sell policies to consumers under terms fixed by the federal government. Much of the cost of the legislation, nearly $1 trillion over a decade, would be financed by cuts in future Medicare payments to hospitals and other providers and higher payroll taxes on individuals earning more than $200,000 and couples over $250,000.

The president's appearance marked a presumably final pivot point in a long, uphill effort by Obama and other Democrats to enact far-reaching changes to the health care system - and with his own administration at an important crossroads. Eager to turn attention to efforts to stimulate the economy and create jobs, the president is seeking a victory on health care that can also give him a boost on other priority legislation. At the same time, a defeat could damage Obama's ability to help fellow Democrats heading into the fall campaign. Failure on health care could well lead to a shake-up of the president's White House team, which has received criticism recently from Democratic lawmakers.

After nearly a year of struggle, the House and Senate passed separate bills late last year, and appeared on course for approving a final compromise version early in 2010. But those efforts were abruptly abandoned when Republicans unexpectedly won a special election in Massachusetts. Sen. Scott Brown's victory gave the GOP an ability they had lacked, the strength to sustain a filibuster, a form of opposition that requires supporters of a bill to post 60 Senate votes in order to cut off debate and force a final decision. Democrats went into something of a political fetal position, and have begun to stir in recent days only as Obama asserted his determination with a bipartisan summit followed by a revised set of proposals.

Obama said the use of rules that deny the minority the right to a filibuster had been used numerous times in recent years, including on passage of welfare reform legislation in the 1990s and twice when President George W. Bush pushed tax cuts to passage. Health care "deserves the same kind of up or down vote" as those earlier measures, he said.

Under the rather complicated approach under discussion, the House would be asked to approve the bill that passed the Senate late last year, despite objections by many members of the rank and file to several provisions. Simultaneously, both houses would also vote for a companion measure whose purpose would be to make changes in the first bill sought by either House Democrats or the White House.

Obama said he was exploring GOP proposals for cracking down on fraudulent medical charges, revamping ways to resolve malpractice disputes, boosting doctors' Medicaid reimbursements and offering tax incentives to curb unnecessary patient visits to doctors. The ideas include an experiment that would establish special courts in which judges with medical expertise would decide malpractice allegations. The idea has been criticized by the Center for Justice & Democracy, a consumer group that prefers the current system of awarding damages. It said health courts would be "anti-patient."

The White House and Democratic leaders said they hoped that Obama's maneuvering would at least win the votes of wavering conservative and moderates in their own party, even if it didn't entice Republicans. But there was no guarantee of success, despite Obama's vow to do everything in his power to succeed - and a White House announcement that he would travel to Pennsylvania and Missouri next week to campaign for the legislation.

SOURCE




Pelosi tells vulnerable Dems to take one for the team on Obamacare

House Speaker Nancy Pelosi says vulnerable Democrats in Congress need to be willing to sacrifice their own political futures for the sake of passing the party's health care plan.

But Republicans say they plan to use the majority party's insistence on the unpopular package to win races this fall and then repeal the package if Pelosi and her team can actually pass it. With nearly 50 Democratic House candidates in highly competitive races, Pelosi has yet to come up with the 217 votes needed to pass the $1 trillion health care bill President Obama has proposed.

Making the talk show rounds Sunday, Pelosi sent a message to the dozens of vulnerable Democratic lawmakers who are reluctant to vote for the plan. "We're not here just to self-perpetuate our service in Congress," Pelosi said on ABC's "This Week." "We're here to do the job for the American people."

Republicans, though, warned that the Democrats are putting their majority in peril, particularly if the legislation is passed in the Senate using budget reconciliation, a parliamentary maneuver that would require just 51 votes, rather than the traditional 60.

Support for the health care bill has continued to wane in public opinion polls, with more people wanting Congress to avoid using reconciliation and to start over on a new bill. "If they ram through this bill using reconciliation, they will lose their majority in Congress in November," House Minority Whip Eric Cantor, R-Va., said on NBC's "Meet the Press."

Pelosi will have the toughest time convincing moderate Democrats, some of whom hint they could vote against the plan even though they voted for the more liberal House version that passed by just three votes in November.

Sen. Lamar Alexander, R-Tenn., appearing on "This Week," defined the political risk for Democrats. "For the next three months, Washington will be consumed with the Democrats trying to jam ... through in a very messy procedure an unpopular health care bill," Alexander said. "And then for the rest of the year, we're going to be involved in a campaign to repeal it."

Pelosi signaled that the Senate would have to take the first, painful step toward passage. She said she is waiting for a new bill that reflects the changes to the Senate plan outlined by President Obama before his health summit last week. "When we have the bill, we'll see what the Senate can do, and then the House will act upon that," Pelosi said.

Pelosi's comments could signify a potential rift with her Senate counterparts who want her chamber to first pass its version of the president's plan. Both chambers would then vote on a second bill with the changes desired by the House. The Senate would use the 51-vote reconciliation tactic to clear the second bill in its chamber. Sen. Kent Conrad, D-N.D., last week declared health care "dead" unless the House passed the Senate bill first.

SOURCE




No health care summit bounce, apparently

The first evidence on whether Barack Obama got a bounce from the health care summit comes from the overnight Rasmussen polling. The short answer: No. Or perhaps: au contraire. Rasmussen shows Obama’s strong approval at 22% and strong disapproval at 43%, for a net approval index—this is Rasmussen’s term—of minus 21. That matches the low recorded in Rasmusssen polling on December 21 (reported on December 22), as the Senate was preparing to pass its health care bill and Senate Majority Leader Harry Reid was in the process of delivering the Louisiana Purchase and the Cornhusker Kickback.

One night’s results are not overwhelming proof of anything, and the one-day downtick in Obama’s numbers is not statistically significant. But it’s interesting that his numbers fall when health care legislation leads the news. Not what White House strategists want to see.

SOURCE




Alice in Health Care

What is most like Alice in Wonderland is discussing medical care reform in the abstract, as if there are not already government-run medical care systems in this country and elsewhere. Yet there seems to be remarkably little interest in examining how government-run medical care actually turns out-- medically and financially-- whether in Medicare, Medicaid, Veterans Administration hospitals in this country, or in government-run medical systems in other countries.

We are repeatedly being told that we need to have a government-controlled medical care system, because other countries have it-- as if our policies on something as serious as medical care should be based on the principle of monkey see, monkey do. By all means look at other countries, but not just to see what to imitate. See how it actually turns out. Yet there seems to be an amazing lack of interest in examining what government-controlled medical care produces.

While our so-called health care "summit" last week was going on, British newspapers were carrying exposes of terrible, and often deadly, conditions in British hospitals under that country's National Health Service. But this has not become part of our debate on what to expect from government-controlled medical care. Such scandals are an old story under the National Health Service in Britain, one repeatedly producing fresh scandals that their newspapers carry, but ours ignore.

In addition to a whole series of National Health Service scandals in Britain over the years, the government-run medical system in Britain has far less high-tech medical equipment than there is in the United States. Neither in Britain, Canada, nor in other countries with government-run medical care systems can people get to see doctors, especially surgeons, in as short a time as in the United States.

It is not uncommon for patients in those countries to have to wait for months before getting operations that Americans get within weeks, or even days, after being diagnosed with a condition that requires surgery. You can always "bring down the cost of medical care" by having a lower level of quality or availability.

But, again, you may never learn any of this by following most of the American mainstream media. It is not that they don't make comparisons between medical care in different countries. But they tend to feature news that will promote government-controlled care. One of the statistics they spin endlessly is that life expectancy in some countries with government-controlled medical care is higher than in the United States. What they don't tell you is that, in some of these countries, all the infants that die are not included in infant mortality statistics, as they are in the United States.

More important, both political and media supporters of government-controlled medical care consistently confuse medical care with health care. Much, if not most, of health care depends on what individuals do in the way they live their own lives-- including eating habits, alcohol intake, exercise, narcotics and homicide. A study some years ago found that Mormons live a decade longer than other Americans. But nobody believes that Mormons' doctors are that much better than other doctors. When you don't do a lot of things that shorten your life, you live longer. That is not rocket science. Americans tend to have higher rates of obesity, narcotics use and homicide than people in some other countries. And there is not much that doctors can do about that.

If those who make international comparisons were serious, instead of clever, they would compare the things that medical science can have a great effect on-- cancer survival rates, for example. Americans have some of the highest cancer survival rates in the world, and for some particular cancers, the highest.

When you can get to see a doctor faster, and get treatments underway without waiting for months, while the cancer grows and spreads, you have a better chance of surviving. That, too, is not rocket science. But it is also something that you are not likely to see featured in most of the media, where people are promoting their own pet notions and agendas, instead of giving you the facts on which you can make up your own mind.

SOURCE




Doubling down

The president’s determination to enact his collectivist health-reform agenda at any political cost despite overwhelming public opposition is unprecedented in modern times.

Today, Mr. Obama is expected to say he will not heed the will of three-quarters of the American people who either want Congress to stop work on health reform altogether or start over, and will instead tell Congress to charge ahead through the minefield of budget reconciliation to pass a bill that will put one-sixth of our economy under government control.

Rational arguments and facts are discarded. When Rep. Paul Ryan (R., Wisc.) detailed at the summit the budget gimmicks in the bills that would put executives of private companies in jail, the president just brushed past his remarks and said he “disagrees.”

That means Mr. Obama disagrees with the Congressional Budget Office and the chief Medicare actuary whose analyses are based upon the facts of his double-counting of Medicare savings, ten years of taxes with six years of spending, creation of new budget-busting entitlements, one-fifth of Medicare providers going out of business and jeopardizing care for seniors, and health-insurance premiums rising even faster if the bill is passed than if not.

The president’s offer to adopt four Republican ornaments, including one very bad idea by Sen. Tom Coburn, is a joke. Senator Coburn’s idea to send federal undercover agents into doctors’ offices to pose as patients is a police-state tactic that will compromise care for every patient and make it even more difficult for new patients — strangers who might be federal plants — to get appointments.

The White House clearly has no new ideas. The president is expected to ask the Senate to twist its rules to force its health-overhaul legislation through a process designed exclusively for budget and spending-related issues. These are desperate, hard-ball political tactics.

In order to move the president’s process forward, House members who fear for their political lives will be forced to vote for a Senate bill that they hate. That means they will have to vote for a bill that contains the Cornhusker Kickback, the Louisiana Purchase, the Union Payback, and liberal abortion language. And then they must trust that the Senate can fix it through a second reconciliation bill that also must pass both houses of Congress, followed by a likely third piece of legislation to address changes that can pass through reconciliation. That is going to require an unprecedented level of trust that no one has seen on Capitol Hill in a very long time.

The American people are doing everything they can to stop this. If Congress manages to pass this before the Easter Recess as planned, the uprising during Easter recess town-hall meeting will make August look like a children’s tea party.

SOURCE




British Hospital sent toddler home with plaster cast on the wrong leg

And then they blame the mother!

A toddler with a broken leg was sent home from hospital with a plaster cast on the wrong limb. Medical staff blamed Rafe Powell’s mother for not noticing their mistake after they strapped up her 21-month-old son’s healthy right leg – leaving him in agony with a fractured left leg. Bella Powell, 45, took Rafe to the accident and emergency department at Torbay Hospital in Devon after he fell out of his high chair at their home in nearby Brixham.

X-rays revealed that he had broken his tibia, and after nurses had fitted the crying child with a cast, he was discharged. But when they arrived home, Mrs Powell and husband Guy, 48, who have six children, noticed that Rafe’s left leg had become red and swollen. They made a second trip to the hospital – where staff implied that Mrs Powell was at fault for failing to spot the error during the first visit.

On Wednesday, the hospital apologised for its mistake and the ‘unacceptable comments’ made to Mrs Powell.

Mr Powell, a retired policeman, said: ‘For a mistake like this to be made is too surreal to believe. The worst thing is that they tried to deflect the blame on to my wife. Bella had to do her best to comfort our son as they held his broken leg down and put a cast on the wrong leg. ‘He is a 21-month-old boy – he was upset and in shock and unable to point out which leg hurt so you have to trust the hospital staff to treat the right one. ‘The hospital staff were very dismissive the whole time. It was like we were invisible.’

'Housewife Mrs Powell added: ‘It was all quite an ordeal, with Rafe crying as they held him down while they tried to plaster his leg. ‘I couldn’t believe my ears when the doctor tried to say it was my fault and why hadn’t I said – I felt absolutely awful.’

A hospital spokesman said they had sent a letter of apology to the family and implemented changes to avoid a repeat of the mistake. He added: ‘We have taken measures ensuring all plaster casts that are applied are checked by another member of staff. ‘The two male members of staff who they felt made inappropriate comments have also offered their apologies.’

Rafe will return to the hospital next week for further X-rays to check whether his leg has healed and the cast can be removed.

SOURCE




How stupid can you get? British bureaucrats think they can improve nursing standards in NHS hospitals by getting nurses to sign yet another piece of paper

A fat lot of good all the previous paperwork has done

Nurses have been told to remember their bedside manner after a series of scandals exposed poor standards of care across the NHS. A commission set up by the Prime Minister yesterday called on nurses and midwives to help strengthen battered public trust in the health service by signing a pledge to treat patients with compassion and dignity.

It comes a week after a report into hundreds of deaths at Stafford Hospital found nurses ignored requests to use the toilet or change sheets - forcing patients to remain dirty for up to a month. And last year it emerged that nurses in Basildon hospital, Essex, were so lazy they did not help frail elderly patients eat meals.

Critics said it was astonishing standards had dropped so low that nurses needed to be reminded to treat people well. There are increasing concerns that trainee nurses spend too much time in lecture halls and not enough on wards - meaning they no longer see cleaning and feeding patients as part of their job.

The solution, according to the Prime Minister's Commission on the Future of Nursing and Midwifery in England, which was set up a year ago, is to ask all hospital trusts to make nurses and midwives sign a six-point pledge.

The commission said patients and staff wanted a new beginning. 'As one nurse from Trafford Hospital put it,' the report stated, 'it was time to remind nurses of the pledge they made when they qualified and received their badges.' Nurses already sign the code of the Nursing and Midwifery Council before they are allowed to work in the NHS. This states: 'The people in your care must be able to trust you with their health and wellbeing. 'To justify that trust, you must make the care of people your first concern, treating them as individuals and respecting their dignity.'

The commission's public pledge would reaffirms the code and adds that nurses 'will accept responsibility for and take charge of the quality of care, service and outcomes for every service user in their care'. It also says: 'Each one of us will speak out and act wherever and whenever care falls below the agreed standard.'

While another section appears to suggest a responsibility among nurses to avoid becoming obese. 'We acknowledge that we are seen as role models of healthy living and will try to live up to this responsibility,' it says.

But last night Patients' Association director Katherine Murphy said: 'While we welcome the pledge, it's a sad indictment that there is a need to restate the commitment of nurses and midwives to high-quality patient care.' Gordon Brown called the publication of the commission's report a 'great day for nursing', adding: 'There hasn't been the recognition of how much training and expertise, science and knowledge a nurse needs to do the job.'

And Government health spokesman Ann Keen said the public image of nursing needed to be updated. 'We need to demonstrate they are not poorly educated handmaidens to doctors,' she said.

SOURCE





4 March, 2010

Two Steps Forward, No Steps Back

It's not the size that matters

Today President Barack Obama will unveil health care proposal Part VII. The new House bill, according to Speaker Nancy Pelosi, will be "much smaller" than previous efforts. After surveying the brutal political conditions facing them, Democrats, it seems, believe that if they lay claim to more modest legislation, they lay claim to a less horrid bill. If only that were true.

Though a political victory is a must for the Obama presidency, those who are invested ideologically in the promise of government-run health care understand that even a small victory today can be an enduring one. Once Washington gains a toehold -- and considering government controls 49 cents on every health care dollar spent, by "toehold" I mean "bearhug" -- it is an inescapable reality that whatever it comes up with will be expansive and expensive.

That's the message Pelosi was telegraphing to her allies when -- in addition to pointing out how itty-bitty the bill will be -- she added that it will be "big enough" to put the country on a "path" toward sustainable health care reform. The righteous "path," naturally, ends at the gates of a single-payer system. The infrastructure to reach this objective -- price controls, new entitlements and wide-ranging mandates -- will be set in place once Democrats use reconciliation to pass the bill, deal with the short-term electoral consequences and let history work itself out.

You know how it goes: Did you hear about the appalling conditions those children are living under? Gotta expand it. How about the old lady who has 12 prescriptions when she only needs eight? Gotta control costs.

A minor victory for liberalism today also would be a colossal triumph tomorrow because it's improbable -- implausible, actually -- that Republicans ever would have the fortitude (or the votes in Congress) to repeal most of Obamacare should they regain power.

Remember that state participation in Medicaid is voluntary. What governor would pull out of that or any entitlement program? Remember that Congress estimated Medicare's cost at $12 billion for 1990 (adjusted for inflation) when the program kicked off, in 1965. Medicare cost $107 billion in 1990 and quickly is approaching $500 billion. Who's going to stop it? The template is used over and over again. Government is a growth industry.

When you unwrap today's health care reform legislation, nearly every Democratic initiative, small or large, is designed to affect the choices people make through some mechanism of top-down control. On the flip side, so far, reform legislation has been devoid of any meaningful market-based solutions that would spur a healthier private-insurance sector, guaranteeing consumers will see rates rise and Democrats will have a boogeyman to point to as they "fix" the bill down the road.

I remember asking liberal Rep. Diana DeGette of Colorado -- after she, for the umpteenth time, claimed that Republicans had presented no ideas in the health care debate -- what she thought of the GOP bills in the House at the time. She replied that they were too small and not "comprehensive" enough to really matter.

Now, apparently, small is OK. Why? It never has been an issue of how comprehensive a plan is, but how invasive it could be. And no matter how many iterations of health care "reform" are foisted on the nation by Democrats -- or what the exact dimensions of those iterations may be or how many public relations angles are deployed to sell them -- the core issue has not changed. Though, it is clear, the tactic of incremental "progress" has been relearned. Don't be fooled. The endgame has not changed.

SOURCE




Obama considers GOP health bill input

President Obama said Tuesday that he is considering adding four Republican ideas to his health overhaul plan, a bipartisan overture that Republicans said still does not get at the root of their objections with the bill. The move comes a day ahead of Mr. Obama's expected announcement on how to move the plan through Congress, which many lawmakers expect will include the use of reconciliation - a complicated procedural tool to circumvent a Republican filibuster in the Senate.

In a letter to congressional leaders, Mr. Obama said he's interested in several Republican suggestions, including: allowing private "health savings accounts" into the insurance exchanges; addressing disparities among the states in Medicaid reimbursements to doctors; authorizing another $50 million in medical malpractice grants to the states; and using undercover investigators to ferret out waste in the Medicare and Medicaid programs. "I said throughout this process that I'd continue to draw on the best ideas from both parties, and I'm open to these proposals in that spirit," he wrote.

Mr. Obama's letter merely said he is exploring the policy ideas, which Republicans outlined in the White House's bipartisan health care summit last week. But minority lawmakers said Tuesday that added provisions wouldn't change the bill's underlying new taxes and cuts to Medicare funding.

"Unless you're going to attack the cost of health care, which those bills obviously don't - they increase the cost of health care and they spend more money when we should be spending less - you haven't solved the underlying problem," said Sen. Tom Coburn, the Oklahoma Republican who proposed the medical malpractice grants and the anti-fraud measures.

The other proposals came from GOP Sens. Charles E. Grassley of Iowa, Richard M. Burr of North Carolina and John Barrasso of Wyoming.

Mr. Obama also said he would remove from the final health overhaul plan extra Medicare Advantage funding for Florida and extra Medicaid funding for Nebraska - two provisions targeted by Republicans, including his 2008 presidential rival, Sen. John McCain of Arizona, as "sweetheart" deals designed to buy the support of wavering lawmakers.

Instead, Mr. Obama said his proposal would gradually reduce Medicare Advantage payments across the country and provide more federal funding to the states to help them with their Medicaid bills, which would grow under the Democrats' plan.

More here




Yes they can (and will)

On last night’s podcast, I argued that Democrats in Congress will indeed pass something called “health care reform” even if the bill doesn’t accomplish almost anything they claimed it would. For close to a century, government-controlled health care has been the holy grail of the statist set, and they aren’t about to pass up the best (and perhaps last) opportunity they have to see that goal through. Andy McCarthy admonished Republicans to keep this in mind when counting unhatched Senate and House seats from this Fall’s elections:

Today’s Democrats are controlled by the radical Left, and it is more important to them to execute the permanent transformation of American society than it is to win the upcoming election cycles. They have already factored in losing in November — even losing big. For them, winning big now outweighs that. I think they’re right.

I hear Republicans getting giddy over the fact that “reconciliation,” if it comes to that, is a huge political loser. That’s the wrong way to look at it. The Democratic leadership has already internalized the inevitablility of taking its political lumps. That makes reconciliation truly scary. Since the Dems know they will have to ram this monstrosity through, they figure it might as well be as monstrous as they can get wavering Democrats to go along with. Clipping the leadership’s statist ambitions in order to peel off a few Republicans is not going to work.

I’m glad Republicans have held firm, but let’s not be under any illusions about what that means. In the Democrat leadership, we are not dealing with conventional politicians for whom the goal of being reelected is paramount and will rein in their radicalism. They want socialized medicine and all it entails about government control even more than they want to win elections. After all, if the party of government transforms the relationship between the citizen and the state, its power over our lives will be vast even in those cycles when it is not in the majority. This is about power, and there is more to power than winning elections, especially if you’ve calculated that your opposition does not have the gumption to dismantle your ballooning welfare state.

Bruce thinks McCarthy is being overly generous with respect to the courageousness of congress members, and that in the end the House will not have enough votes to pass the Senate bill, and thus start the reconciliation process (which Keith Hennessey describes quite well). Enmity between the two houses of congress, in particular the House’s distrust of the Senate to pass a new bill “fixing” the first bill, may make passage of the first bill impossible. Making the task of passing a reconciliation bill even more herculean are some procedural quirks that potentially allow an infinite series of amendments to be offered during the vote-a-rama process in the Senate, and the great likelihood that much of the bill will violate the Byrd Rule, which negates provisions that do not deal with the budget (for a great explanation of both, once again, visit Mr. Hennessey). To top it all off, if the reconciliation bill increases the long-term budget (more than ten years out), then the whole thing automatically gets scrapped (again, see Hennessey). That’s quite a lot to overcome.

However, I think the Democrats, and especially President Obama, are bound and determined to pass something regardless of the high hurdles to be faced in the process or the eventual political costs. This is Obama’s legacy, after all, and the only thing he’s really spent any time on during his presidency. If there is any way that Congress can pass something resembling a health care bill, they will do it. The Senate has already done it’s job on this score, and voting weaknesses in the House virtually ensure that Nancy Pelosi can wrangle assurances from Harry Reid that the Senate will pass the reconciliation bill. The final version may be swiss cheese, and the Byrd Rule is likely to knock out several provisions that are necessary to get votes (think “Stupak amendment”), but in the end I believe that the Democrats can cobble something together that will garner majority votes in both houses and be sent to the president for his signature. This issue is simply too important to the left to let go.

Something else to keep in mind, with respect to vote counting, is that any Democrat congress member who has decided to “retire” ahead of this Fall’s elections will have no repercussions from voting for either the Senate bill or the reconciliation bill. The seats of these lame-duck congressmen are viewed by Republicans a potential pick-up’s for the next congress, when they should be worried about how the lame ducks will be voting.

In the end, I think that Reid and Pelosi deliver something in the way of a public option with tax hikes and that Obama will declare victory when he signs the bill into law. There’s certainly no virtue in this process, but then, there’s really no virtue left in Washington, so that should come as no surprise.

UPDATE: “The Biden Situation”

According to Norman Ornstein, of AEI, and Robert Dove, former Senate parliamentarian, the unlimited amendment tactic during vote-a-rama may not be all it’s cracked up to be [HT: AllahPundit]:

Should passing health care reform come down to the use of reconciliation — and all signs point that way — Vice President Joseph Biden could play a hugely influential role in determining not only what’s in the bill but whether or not it passes.

Two experts in the arcane rules of the Senate said on Monday that, as president of the Senate, Biden has the capacity not just to overrule any ruling that the parliamentarian may make but also to cut off efforts by Republicans to offer unlimited amendments.

“Ultimately it’s the Vice President of the United States [who has the power over the reconciliation process],” Robert Dove, who served as Senate parliamentarian on and off from 1981-2001, told MSNBC this morning. “It is the decision of the Vice President whether or not to play a role here… And I have seen Vice Presidents play that role in other very important situations… The parliamentarian can only advise. It is the vice president who rules.” [...]

“The vice president can rule that amendments are dilatory,” Norm Ornstein, a fellow at the American Enterprise Institute and one of the foremost experts on congressional process, told the Huffington Post. “That they are not serious attempts to amend the bill but are designed without substance to obstruct. He can rule them out of order and he can do that on bloc.”

“There are time limits,” Ornstein added. “It is not that they can keep doing it over and over again.”

How ironic that the same man who famously mangled the VP’s constitutional role in the Senate might possibly wield that very power to foist ObamaCare on us. Well, I guess it’s no more ironic than the “Kennedy seat” busting a filibuster-proof majority that was depended upon to deliver Kennedy’s life-long dream of government-run health care.

Just the same, I wouldn’t count on ObamaCare being dead and gone just yet.

SOURCE




ObamaCare's Partisan peril

A recurring theme struck by defenders of ObamaCare has been that it is similar to previous measures expanding the welfare state. On ABC's "This Week," in an interview with guest hostess Elizabeth Vargas, Speaker Nancy Pelosi had this to say:

Vargas: What do you say to your members, when it does come to the House to vote on this, who are in real fear of losing their seats in November if they support you now?

Pelosi: Well first of all our members--every one of them--wants health care. I think everybody wants affordable health care for all Americans. They know that this will take courage. It took courage to pass Social Security. It took courage to pass Medicare. And many of the same forces that were at work decades ago are at work again against this bill.

Later, interviewing Sen. Lamar Alexander, Vargas made the same comparison, and the Tennessee Republican hinted at why it is flawed:

Vargas: You also said in your remarks at the summit that Republicans have come to the conclusion that Congress, quote, "doesn't do comprehensive well," that our country is too big and too complicated for Washington. But Congress has passed many historic and sweeping and comprehensive bills in the past: Medicare, the civil rights bill, the Americans with Disabilities Act. Are you saying that this Congress is uniquely incapable of doing something sweeping and massive and dramatic?

Alexander: Well, the answer's yes, in that sense.

Vargas: That's not good.

Alexander: But no--but let me go back. You mentioned the civil rights bill. I was a very young aide here when President Johnson, who had more Democratic votes in Congress than President Obama had, had the civil rights bill written in Everett Dirksen's office. He was the Republican leader.

He did that not just to pass it. He did it to make sure that, when it was passed, it would be accepted by the people and there wouldn't be a campaign as there will be in health care to repeal it from the day it's passed.

All of the laws Pelosi and Vargas cited--the Social Security Act of 1935, the Civil Rights Act of 1964, the Social Security Act of 1965 (which created Medicare) and the Americans With Disabilities Act of 1990--were passed when Democrats held majorities in Congress. But all had substantial Republican support (including, in the case of the ADA, from a GOP president).

By contrast, at this juncture not a single Republican in Congress supports ObamaCare. Why should they, given that the public overwhelmingly opposes it? That's why ObamaCare now cannot be enacted without a combination of partisan bullying and procedural flimflam.

This leads us to doubt the common assumption that ObamaCare would be irreversible if passed. Not that we want to put it to a test, mind you: Repeal would require an enormous effort, and would almost certainly be impossible before 2013 (with 42 Senate seats held by Democrats not up for re-election this year, a veto-proof GOP Senate majority is not even a mathematical possibility in the next Congress).

But there is no precedent for a massive, unpopular expansion of the welfare state that has support only within one party. It's possible that Americans would grudgingly come to accept it anyway. It's also possible that they would hate it even more once it had been imposed upon them. It may turn out that Obama and Pelosi not only are trifling with their party's short-term prospects, but are putting at risk its long-term viability, and perhaps even the political stability of the country.

SOURCE




Budget deficits cause third of British hospitals to cut number of operations performed

One in three hospital trusts is having to make cuts in the number of operations it performs because they are in the red, according to new research. Casualty departments are also facing the axe because primary care trusts are over budget and running a deficit – despite a record Department of Health budget of around £100 billion this year.

A new study by the think tank Civitas of figures provided at the public board meetings of 100 trusts has found that health service overspend is set to hit £130 million. And last night the health think tank the King’s Fund warned that one in three hospital beds in London could face the axe as spending cuts bite.

The Department of Health has warned trusts they cannot enter the new financial year and hospitals that don’t get their budgets back in balance will have to hand back money from next year’s budget or find themselves subjected to central control. The study found that GPs in Hertfordshire were told to get ‘approval’ before recommending hysterectomies, tooth extraction and the removal of 'skin lumps and bumps'. In a memo to doctors, hospital managers warned: ‘It is usually better to wait to see if symptoms resolve themselves.’

The primary care trust in Enfield, North London, was the worst affected in the survey. There hospital bosses are £17.5m in the red despite a budget of £450m. Trust chiefs have decided to axe an accident and emergency department at Chase Farm hospital in Enfield and replace it with an urgent care centre that is only open for half the day and will not take blue light ambulance cases.

The findings are particularly stark since they suggest that hospitals cannot live within their means even during a time of record growth in spending—making cuts all the more likely when the taps are turned off by the next government. The last public spending review in 2007 decided that health spending will rise from just over £90 billion in 2007/08 to £110 billion in 2010/11. That is a real terms increase of 4 per cent year on year.

The Tories have pledged to give the NHS continuing real terms rises and Labour have promised to protect ‘frontline’ health services. But whoever wins the election the rate of growth in health spending is expected to be cut dramatically after a decade that has seen the NHS budget treble in real terms.

Analysts say that simply leaving the NHS to make do with rises that keep up with inflation will lead to an NHS shortfall of £20bn by 2013, rising to £38bn by 2016. James Gubb, head of health policy at Civitas, said: ‘If financial control cannot be exercised in times of plenty, it does not bode well for times of famine. ‘With billions to effectively be cut from the NHS we are looking at huge productivity improvements to maintain today's standards. Prudent organisations would be looking to set money aside to invest for such times.’

John Appleby, chief economist of the King's Fund, warned of drastic cutbacks: ‘In London there is a plan to close a third of hospital beds that is being floated by the NHS. It's not out in the open yet and already it's attracted huge opposition,’ he told the Guardian.

Health trusts say the deficits are the result of increased demand as a result of swine flu, the coldest winter for decades and record numbers of emergency admissions. [No mention of the ever-expanding bureaucracy?]

SOURCE




Musician dies after fall at troubled British hospital

A talented musician died after falling from a trolley where he had allegedly been left untreated for hours in the accident and emergency unit of the shamed Stafford hospital, it was claimed yesterday. Andy Stubbs, 41, who had a three-year-old son, died last August after being admitted to the hospital with a head injury following a fall at his home. According to his family Mr Stubbs, who was bleeding profusely from a head wound, suffered two further falls while in hospital but was not given a brain scan until the following morning, by which point it was too late to save him. He died as a result of a cardiac arrest after suffering bleeding on the brain.

Last week Stafford hospital was the subject of a damning independent report which catalogued a litany of patient neglect and abuse over a four year period. The Francis Inquiry unearthed evidence of elderly patients not being washed for several weeks, being deprived of food and water and left to lie in soiled sheets for hours at a time. The report also heard evidence from patients who had been misdiagnosed and others who were ignored for hours after being admitted to A&E.

Mr Stubbs's death came six months after the shocking details of the hospital's failings were first uncovered and during a period when they were supposed to have begun to put their house in order. An inquest into his death, held yesterday at Cannock Coroner's Court, ruled that he had died as a the result of an accident.

But his father Bernard Stubbs, speaking from his holiday home in Portugal said: "How can it be accidental death when they have allowed him to fall in hospital. He went into A&E at 4pm and was still there four hours later. "I left him and when I came back I was told he had fallen twice. He did not receive a scan until the following morning when they said to me, 'It's too late, there is nothing we can do'." He added: "If he had received a scan when he first arrived, he may well be still be with us today."

Mr Stubbs from Stone in Staffordshire, had just received a writing credit on the latest Robbie Williams album and was a well respected pop composer and musician. A family friend said he had been undergoing some personal difficulties after splitting from his girlfriend and had battled alcoholism. But the friend added: "The coroner said Andy was intoxicated when he was admitted to A&E. He had been having some problems and was upset about the break-up of his relationship but that is not an excuse for him not being treated properly in hospital. "He was a loving kind gentle man who adored his son Ruben. Now a little boy is going to grow up without his father and yet again with the Stafford hospital no one is being held to account. His death has left a huge hole in a lot of people's lives."

A spokesman for the Mid Staffordshire NHS Trust said: "I would like to offer our sincere condolences to Mr Stubbs’ family for their sad loss. "Mr Stubbs’ death was reported as a Serious Untoward Incident in accordance with the Trust’s policy and a full investigation into his care and treatment was carried out. "The recommendations from the investigation have been implemented and actions will continue to be monitored. Patient safety is our priority and it is extremely important that we learn from incidents to improve care for other patients."

Earlier this month a jury inquest returned a verdict of accidental death on 58-year-old Christopher Wooley who died after falling from a trolley in the A&E department of Stafford hospital.

Julie Bailey, founder of the Cure the NHS campaign group said: "This is the second incident of a patient dying after a fall in the A&E department of Stafford hospital, you would hope they might have learned the lessons after one tragedy. It is a depressingly familiar story of vulnerable patients being left alone when they ought to be being looked after and treated. "We need a public inquiry in order to find out the truth of what has been happening."

SOURCE





3 March, 2010

Democrats dig in for last stand

Democrats took heat over the “Louisiana Purchase,” and ultimately disavowed the “Cornhusker Kickback.” Now, they are racing to keep Republicans from defining the only legislative tool left to salvage the health care reform bill as yet another tactic hatched in a Democratic back room. During a year in which “deal” is a dirty word, Democratic congressional leaders are already waging a battle to defend reconciliation and beat back Republican charges that the fast-track rules are an abuse of power.

Democrats, including President Barack Obama, like to say Americans care more about the shape of a final bill than the way it was passed. But the Senate health care bill has suffered, in part, because of a voter backlash over the tactics Democrats employed to secure 60 votes in the Senate.

Republicans are craving a repeat. “I’ll tell you one thing, if Speaker Pelosi rams this bill through the House using a reconciliation process, they will lose their majority in Congress in November,” House Minority Whip Eric Cantor (R-Va.) said on NBC’s “Meet the Press.”

The battle lines crystallized over the past week. From Thursday’s White House health care summit to the Sunday talk shows, Republicans have blasted reconciliation as everything from “cataclysmic” to a “trick” to push the bill through Congress.

Democrats, in turn, argued Republicans have no grounds to criticize, accusing them of rank hypocrisy given their frequent embrace of the tactic during the past 30 years, when they passed several major bills using the threshold of a 51-vote Senate majority, not the usual 60.

In a rhetorical shift, Democrats have begun avoiding the word “reconciliation,” in favor of “simple majority.” “Health care reform has already passed both the House and the Senate with not only a majority in the Senate but a supermajority,” White House health care czar Nancy-Ann DeParle said on NBC’s “Meet the Press.” “And we’re not talking about changing any rules here. All the president’s talking about is: Do we need to address this problem, and does it make sense to have a simple, up-or-down vote on whether or not we want to fix these problems.”

Since 1980, Republican presidents have signed 14 of the 19 reconciliation bills into law, including two tax cuts in the George W. Bush administration that did not reduce the deficit, which the reconciliation rules explicitly require. And it was a Republican Congress that used reconciliation in 1996 to pass a sweeping overhaul of the welfare reform system, proposed by Democratic President Bill Clinton. “The criticism of us is absolutely duplicitous,” said Ron Pollack, executive director of Families USA, a leading proponent of health reform. “It is chutzpah. How can those who have championed the use of reconciliation, and far more frequently, how can they come and criticize us?”

There is truth in the Democratic and Republican arguments, said Marty Gold, an expert on Senate procedure who served three members, including former Majority Leader Bill Frist (R-Tenn.). “To a degree both sides are correct,” Gold said. Republicans have used the tool frequently and for far more than just minor fiscal adjustments. But Gold believes the reason Democrats will deploy the strategy is blatantly political — in “express defiance of an election outcome” — and would set a negative precedent in the Senate. If Democrats succeed, reconciliation will be used more often as a default mechanism to pass legislation, making the Senate more of a majority-rules body than it has traditionally been, Gold said. “This will come around again,” Gold said. “If it’s used in this case and gotten away with, the process will be revisited, and that will cause immense consternation on the other side when it is used in reverse.”

Reconciliation has never drawn quite as much scrutiny. In the 2001 tax cut debate, Democrats, including Sen. Kent Conrad (D-N.D.), objected to reconciliation as an “abuse of the process” that was “trampling on the minority’s rights.” But the tactic never appeared to generate as much buzz as it has with health care reform.

More here




Democrats will impose Obamacare no matter the cost

By: Hugh Hewitt

President Obama, House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid are embarked on a radical plan to fundamentally change American health care. The operative term is "radical," and the media should use that term in order to accurately convey the nature not just of the scope of the changes being pushed, or of the level of Medicare cuts on which those changes are premised, but also to accurately describe the process by which the radical Democrats propose to impose their vision.

The plan is to push Obamacare through the House on the promise of a subsequent "fix" that will use an arcane Senate procedure known as "reconciliation" to modify the health care legislation in order to bypass the Senate's 60-vote requirement for substantive legislation.

No matter what rhetoric the Democrats employ, this is indeed a radical -- there's that word again -- maneuver, one that will demolish forever the Senate's long-standing tradition of requiring a supermajority to enact sweeping legislation that fundamentally alters an area of complex law. Reconciliation has indeed been used for tax rate changes, which go up and down, and on two occasions for very focused initiatives on welfare reform and continuance of health care coverage.

But reconciliation is a recent and rare exception to the rule of supermajority, and its use here will forever spell the end of the 60-vote requirement for major legislation. If the vast changes contemplated by Obamacare can be pushed through reconciliation, then there is no limiting principle for the future.

Expect both conservatives and liberals to insist that, if the process could be made to fit for Obamacare in 2010, then it surely must be able to accommodate any other fervently hoped for piece of legislation. Thus in the space of 10 years the Senate Democrats will have re-engineered the supermajority tradition of the "Greatest Deliberative Body in the World" into one that is routinely applied to judicial nominees but waived for the most sweeping, most partisan legislative jam-downs.

With the exception of the bipartisan filibuster of President Johnson's ethically compromised pick of Abe Fortas as chief justice of the Supreme Court in 1968, judicial filibusters were unheard of before 2003. Though "blue slips" and "holds" did hobble many nominees in committee or on the floor, these procedures are distinct from the requirement of 60-plus votes to pass new laws. As rare as a judicial filibuster was in the last century, so, too, was the use of reconciliation to avoid the requirement of supermajority in law-making. Senate Democrats have trashed both traditions, and both were done in the service of ideology over basic traditions of governance.

Pelosi's tired talking point about "majority rule" asks the public to dismiss as irrelevant the jettisoning of a long-standing approach to governance that limited the speed with which Congress could act. This has been a virtue of the American republic since "The Federalist Papers" defended the Constitution's original design as one intended to keep factions from moving too quickly to dominate politics for short times of abrupt change.

We are not a majority rule system, and never have been. Government's ability to move quickly was cabined from the start and for the very good reason that sudden swings in law are not often to the advantage of freedom.

If Obamacare does indeed make it into law, the damage it will do to health care will be immense. But just as great a cost will be the injury done to the Senate and to the measured approach to legislation that has marked America as a deliberate and deliberating republic.

SOURCE




The big bluff?

The Democrats in the Senate and Democrats in the House don't trust each other

President Obama's revised health-care plan is an ambitious attempt to bridge the divisions between two warring camps of Democrats who do not trust each other -- Democrats in the Senate and Democrats in the House. Both factions have passed versions of a health care plan, but neither believes the other can deliver what is necessary for a compromise to become law.

In the House, Speaker Nancy Pelosi only muscled through her more-liberal version -- which included a public-option insurance program -- by 220 to 215 votes last November. Since then, Rep. Robert Wexler of Florida has resigned, Rep. John Murtha of Pennsylvania has died, and Rep. Neil Abercrombie plans to resign next week to run for governor of Hawaii. In addition, Rep. Joseph Cao, the lone Republican to back the bill in November, has said he won't do so again.

That leaves Ms. Pelosi with 216 votes, shy of a majority. She will have to find new "yes" votes from some of the 39 Democrats who declined to support the bill last time as well as hold the votes of nervous Blue Dogs who voted with her and a dozen or so pro-life Democrats led by Rep. Bart Stupak, who demand tougher curbs on federal funding of abortion than President Obama or the Senate want.

Senators have yet to be convinced Ms. Pelosi can pull this off. Privately, Democratic members tell me she doesn't have anywhere near the votes yet. Rep. Heath Shuler, the North Carolina Democrat and former football star who heads the 54-member Blue Dog group, isn't optimistic. "I don't think a comprehensive bill can pass," he told reporters. "I hate to use a football analogy, but first downs are a lot better than throwing the bomb route or the Hail Mary."

In the Senate, Majority Leader Reid is close to lining up 50 Democrats who could join with Vice President Biden in ramming through a bill using parliamentary maneuvers that allow spending legislation to be passed with a simple majority. But those same maneuvers make it extremely difficult to craft a "health care" bill unless the Senate parliamentarian runs roughshod over every precedent. Republicans would also be able to drag out the process by offering hundreds of amendments.

The most likely explanation for what President Obama and his Democratic allies are up to by pressing forward with a bill is the following: 1) They are hoping his "bipartisan" summit meeting this Thursday will somehow be a game-changer and give health-care reform new momentum; 2) Democrats are trying to show unions and other allies that the Democratic leadership is making a maximum effort on health care before pivoting and blaming GOP obstructionism for its failure.

The best health-care analysts I know say Democrats have perhaps a 15% chance of threading the needle and getting a comprehensive bill signed into law. But even that success could be costly politically if voters came to believe Democrats had ignored the public's feelings and rammed through a bill anyway. The most recent surveys show that 61% of the American people want Democrats to put aside the existing bills and start over.

SOURCE




An FDR lesson Obama missed

Barack Obama is trying to be the new FDR before the concrete settles around his image as the new Jimmy Carter. History will ultimately decide, but last week's celebrated health care summit made him look more like Mr. Jimmy than FDR.

The president was full of self-righteous talk, mostly about himself, and he twice felt it necessary to remind everyone that he's the president, recalling Richard Nixon's bizarre reassurance that he was not a crook. Some things are self-evident, and if they're not, such things are usually not true. We can stipulate that, like it or not, he's the president.

The Democrats relished the opportunity to portray the Republicans as the wrinkled party of "no," a crabby relic of the 20th century, devoid of anything that anybody could want, and Barack Obama's low-church eloquence would melt skepticism like butter on warm toast. But it didn't happen. Setting out the idea of a plain and simple alternative to Obamacare — smaller measures to reform, taken step by step — the Republicans sounded like the party of common sense, purveyors of the kind of kitchen-table solution that would work a lot better than an elaborate welfare-state scheme.

The health care summit was not the demolition derby the Democrats expected, instead it's a pothole the president and his party will have difficulty climbing out of. The first public-opinion polls this week will measure who won and who lost. But the prospect of a lot of changed minds in the wake of the talkfest is a small prospect.

The president was in his favorite role, the long-winded professor trying hard to be patient with half-bright students who hadn't done their homework. Like most liberals, he suffers from a severe occupational hazard. Anyone who disagrees with him must be dumb, unlettered and redneck crazy. If Lamar Alexander, John McCain and Eric Cantor had only gone to the right Ivy League university they could understand the prescription for what's good for them. It's a fatal mindset that afflicts the cult. Jonathan Chait of New Republic put it plainly in a revealing blog post: "President Obama is so much smarter and a better communicator than members of Congress in either party. The contrast, side by side, is almost ridiculous."

The contrast was so stark that he could only liken the professor's summit seminar to basketball, our least cerebral sport, where oversized men in gaudy underwear run up and down a court to stuff a ball down a hole. The president is "treating [Republicans] really nice, letting his teammates take shots and allowing the other team to try to score. 'Nice try, Timmy, you almost got it in.' But after a couple minutes I want him to just grab the ball and dunk on these clowns already."

No one would have confused FDR — or Harry Truman or Ronald Reagan — with somebody shooting hoops on a schoolyard. Nor would anyone have confused one of those presidents with a professor showing off his mastery of detail and trivia by presiding over a congressional seminar. Mr. Obama should remind himself that he's the president, not a professor.

The president who would be FDR has squandered much of his authority and mystique in pursuit of something the people clearly don't want. The more he pursues it the more the people don't want it. He has yet to understand any of the parts of "no." He is learning too late, if he is learning at all, that too much of a good thing is too much. The powerful hold a president can have on the public is weakened by too much visibility. "The public psychology," FDR once wrote to a friend, "cannot be attuned for long periods of time to a constant repetition of the highest note on the scale."

Mr. Obama's profligate use of the highest note on the scale follows the example of his immediate predecessors, and it may be that the presidential mystique, with its power to accomplish a president's aims, was gravely wounded by the invention of the jet airplane. Air Force One is not only an impressive presidential icon, it makes every congressional district convenient to visit, and presidents are tempted to use it ever more frequently. In his 15 years in the White House, FDR, who preferred trains and was the first president to fly, never got around to visiting all the states.

A visit by a president meant something. Now it's often a hindrance and a distraction. Last week, Mr. Obama should have stood in bed. That may be the ultimate lesson from his great health care summit.

SOURCE




Health bill critics target Democrats

Advocacy groups that oppose the health care overhaul bill are taking aim at House Democrats who support President Obama's signature policy item, pouring money into television ads attacking vulnerable lawmakers in conservative-leaning districts.

While the bigger players keep their powder dry and await Wednesday's announcement by Mr. Obama on how to proceed, conservative groups such as the 60-Plus Association, an alternative to AARP, is attacking 18 Democrats in their home districts for writing "backroom deals" and is asking them to start over. "It's our job to remind the congressmen who they really serve - the people," said Bob Adams, executive director of the League of American Voters. "Americans believe in second chances. We're offering the congressmen that chance, but we're just getting started."

The League of American Voters is airing ads designed to counterbalance pressure rank-and-file Democrats are facing from their leaders on Capitol Hill. It has ads up in the districts of 11 lawmakers who voted for the bill and plans to hit 19 others.

Over the weekend, the White House and Democrats on Capitol Hill defended using reconciliation, a complicated procedural tool that circumvents the chance for a Republican filibuster, suggesting that's how they'll proceed. But House Speaker Nancy Pelosi said Monday that Mr. Obama's proposal will be "much smaller" than the legislation that previously passed the House and Senate, according to Fox News.

Major players in the previous ad war, including overhaul supporters such as the Pharmaceutical Research and Manufacturers of America (PhRMA) and AARP, are staying quiet for now. AARP pledged to reduce the political pressure on lawmakers with hopes that doing so would allow them to work together. "We promise to make no new statements, send no new letters, run no new ads about health reform, and we are urging all other interest groups to do the same," AARP Chief Executive Officer A. Barry Rand said ahead of last week's bipartisan health summit. "Let's turn down the volume on the outside noise so that our leaders might actually listen," he said. But of course, they won't stay quiet indefinitely. Mr. Rand stressed that failure isn't an option and that AARP will fight to pass health care reform.

Some groups are focusing more on lobbying now than televised campaigns. The National Right to Life Committee is talking with House members about the abortion language in the Senate's health bill. America's Health Insurance Plans is trying to get out its message that health costs are rising not because of insurers, but because of the underlying medical costs.

The Progressive Change Campaign Committee, which supports passing a public insurance plan favored by liberals, is aggressively searching for support of the plan. It has compiled a petition of 30 Democratic senators who support the public option and is airing online ads pressuring other Democrats to sign on.

Wednesday's announcement from Mr. Obama is expected to send the debate in a new direction. A spokesman for one group that has already spent millions on advertising on the reform issue said they're in "limbo" right now, awaiting the formal announcement of the Democrats' plans.

Meanwhile on Monday, billionaire investor Warren Buffett said on CNBC that the Democrats' health bills don't do enough to address rising costs that are hurting business and that he would start over on the effort, a call Republicans had made. "I would try to get a unified effort, say this is a national emergency to do something about this," said Mr. Buffett, who supported Mr. Obama's presidential campaign. "We need the Republicans, we need the Democrats. ... We're just going to focus on costs, and we're not going to dream up 2,000 pages of other things." He said he prefers the Senate bill to the House bill, but favors creating new legislation that does more to lower costs and generates more public support.

SOURCE




The best and worst health care reform ideas

President Obama wants to work with Republicans on health care reform. "I am going to be starting from scratch," he says, "in the sense that I will be open to any ideas that help promote" controlling health care costs and making health insurance more widely available. As it happens, many of the worst ideas are in the legislation Obama supports. Republicans have embraced some of the best ideas, but also some of the worst.

Best Ideas

Tax reform: The president is right: the tax code inadvertently drives health care costs higher. But the solution is not to a new tax on health insurance that would hit union, older, female, and small-business workers hardest. The solution is to give those workers the largest effective tax cuts by changing the tax code so that workers control the money that employers now use to purchase health coverage – which averages $10,000 per family per year.

Tax credits for health insurance would give workers that $10,000, but only over the long term. That would leave many families in the lurch. Rep. Jeff Flake (R-Ariz.) has introduced legislation to create "large" health savings accounts, which would give workers that money immediately.

Medicare reform: Obama advisor Peter Orszag correctly argues that consumers will eliminate wasteful health care spending if they can keep the savings.

That's why, as Rep. Paul Ryan (R-Wis.) proposes, Congress should give each senior a fixed voucher to purchase their medical care. Poorer and sicker seniors would get larger vouchers. But the key is that seniors would keep whatever money they save. Only then can Congress reduce Medicare spending, as both Republicans and Democrats propose, while protecting seniors from government rationing.

Medicaid reform: President Obama should reform Medicaid the same way President Clinton reformed welfare: by providing each state with a fixed block grant, and the flexibility to target those funds to the truly needy.

Making regulators compete: Each state's health insurance regulators enjoy a monopoly over providing and enforcing consumer protections. Like all monopolies, that creates high-cost, low-quality consumer protections. Indeed, state regulations increase the cost of health insurance by an estimated 15 percent.

Letting individuals and employers purchase insurance regulated by other states would give them regulatory protections they need—and let them avoid unwanted and costly regulations.

Worst Ideas

Expanding Government Programs: The entitlement programs we have are bankrupting the government, crowding out private insurance, increasing costs, and reducing quality. Medicare is the main reason medical practice is dangerously uncoordinated, and why medical errors kill as many as 100,000 Americans each year.

Mandating Insurance Coverage: Forcing Americans to purchase coverage would effectively turn private markets into a government program. In addition to being unconstitutional, an individual mandate would reduce health insurance choices by outlawing economical health plans, just as the Massachusetts mandate has done.

Price controls: Obama advisor Larry Summers says, "Price and exchange controls inevitably create harmful economic distortions. Both the distortions and the economic damage get worse with time."

Democrats nevertheless want to use price controls to cover people with pre-existing conditions, which would perversely lead insurers to avoid and mistreat those patients. Obama advisor David Cutler finds they also reduce choice by eliminating comprehensive insurance plans. The reforms above would do a better job of reducing the problem of pre-existing conditions.

Democrats also want to use price controls to curb Medicare spending. That's merely a veiled form of government rationing.

Federal Med Mal Reform: Republicans want federal law to limit medical malpractice lawsuits. But the Constitution does not give Congress the power to do so.

Setting those rules is a state responsibility. Many states have enacted reforms, and other states are learning from those experiments. A one-size-fits-all federal law could harm patients, preventing them from filing legitimate claims.

If health care reform were simple, we would have done it already. Yet both Democrats and Republicans are making it unnecessarily difficult by pushing reforms that reduce choice and competition. That's not what the doctor ordered.

SOURCE





2 March, 2010

Dems' Health Strategy Doesn't Add Up to a Win

"More talk, no deal" was The Wall Street Journal's headline on Thursday's Blair House health care summit. "After summit flop, Democrats prepare to go it alone on Obamacare," proclaimed the headline here at The Washington Examiner. These were appropriate verdicts if you viewed the summit as an attempt to reach bipartisan agreement or even a limited consensus.

But that of course was not why Barack Obama convened this unique colloquy. He did so as part of an attempt to pass some Democratic health care bill, somehow, through both houses of Congress -- and to discredit the Republicans who opposed the bills passed by the House in November and the Senate in December.

In that he seems to have failed. The Atlantic's Clive Crook, who supports the Democratic bills, concluded that "the Republicans did not come across as the party of no. They looked well-informed, pragmatic and engaged in the discussion. It was the Democrats who leaned more heavily on talking points, and seemed evasive and unspecific."

Kevin Drum, blogging for the left-wing Mother Jones, agreed. "My take is that the summit was basically a draw, but with a slight edge to the Republicans. They didn't have to win, after all. They just had to seem non-insane, and for the most part they did. What's more, Obama missed a chance to provide a punchy 60-second sales pitch for the Democratic plan."

Obama and the Democrats face problems with both public opinion -- their bills are hugely unpopular -- and with legislative procedure. The problem with public opinion has been undeniable since Republican Sen. Scott Brown's victory five weeks ago in Massachusetts. The problem with legislative procedure is more complex.

Democrats could theoretically solve that problem by having the House pass the Senate bill in toto, ready for Obama's signature. But Speaker Nancy Pelosi, who has proved herself a fine vote-counter, doesn't have the votes. Last month, she said "unease would be the gentlest word" to describe House Democrats' resistance. They understandably don't want to cast votes for the Senate's Cornhusker Kickback and Louisiana Purchase.

In November, Pelosi had 220 votes for the House bill. The one Republican is now a no, one Democrat has died, one resigned last month, and another turned in his resignation Friday. That leaves her with 216, one less than the 217 she needs.

There is another problem. The Senate bill lacks the amendment sponsored by House Democrat Bart Stupak banning abortion coverage, and Stupak says that he and about 10 other Democrats will accordingly vote no. That leaves Pelosi around 205. She may have commitments from former no voters to switch to yes (especially from three who've announced they're retiring), but she doesn't have more than 10 other votes in her pocket -- or she wouldn't have accepted the Stupak amendment.

So the House wants the Senate to go first and pass changes to its bill through the reconciliation process that requires 51 rather than 60 votes. But Senate Budget Chairman Kent Conrad says that you can't use reconciliation on a bill that hasn't already become law. And reconciliation is probably not available on abortion issues.

All of which reminds me of Alaska Sen. Ted Stevens' attempt to allow oil drilling in the Arctic National Wildlife Reservation in 2005. Stevens got it in the reconciliation process in the Senate, where it had 51 but not 60 votes. But House Republicans couldn't get it into reconciliation, even though a majority of House members were for it. The Senate could pass it by reconciliation but not regular order; the House could pass it by regular order but not reconciliation. Result: It never passed.

There are two differences here. ANWR drilling would have little effect on most Americans. The health care bill would affect almost everybody -- by raising taxes, cutting Medicare spending, abolishing current insurance -- as Republicans pointed out in Blair House.

The second difference is that ANWR drilling was reasonably popular with the public, and there were majorities in both houses for it. Neither is true of the Democrats' health care bills today.

Last month, we were told that Obama would switch his focus from health care to jobs. But Democrats have spent February and seem about to spend March focusing on health care. It's hard to see how they can navigate the legislative process successfully -- and even harder to see how they turn around public opinion. Summit flop indeed.

SOURCE




"Individual Mandate" at Core of ObamaCare is Unconstitutional, New Report Concludes

Arguments by backers of President Obama's health care proposals that the U.S. Congress has the constitutional authority to mandate that individual Americans purchase health insurance through the 16th Amendment to the Constitution, which permits the federal income tax, are incorrect.

So concludes a new "What Conservatives Think" publication, "Is a Health Insurance "Individual Mandate" Constitutional?" written by policy analyst Matt Patterson of the National Center For Public Policy Research. Among the findings:

* Both the House and Senate versions of ObamaCare contain penalty taxes on Americans who do not have government-approved health insurance, the so-called "individual mandate."

* Such a tax would function as a direct, or capitation, tax, as opposed to a tax on activity, such as excise or income taxes, and would therefore fall outside Congress' authority to tax income granted by the 16th Amendment to the Constitution.

* The Constitution places strict restrictions on Congress' power to lay capitation taxes under But Article I, Sec. 9, which reads "No Capitation, or other direct, Tax shall be laid, unless in P