Healthcare foes use fear, not reason – link to original article

LEONARD PITTS 

Miami Herald – August 16, 2009

    ‘‘F ear is the most powerful enemy of reason. Both fear and reason are essential to human survival, but the relationship between them is unbalanced. Reason may sometimes dissipate fear, but fear frequently shuts down reason.’’ — from The Assault on Reason by Al Gore 

    ‘‘I’m afraid of Obama!’’ — woman at a Town Hall meeting on health care reform 

    I have no opinion on H.R. 3200. Mainly because I haven’t read it. 

    Pardon my presumption, but chances are beyond excellent that you haven’t, either. The PDF file of the bill, otherwise known as the America’s Affordable Health Choices Act of 2009, clocks in at 1,017 pages of often-dense legalese and jargon. I’d like to read it, but I’d also like to have a life, and the two are incompatible. 

    So excuse me, beg pardon, but it would be really valuable to hear an explanation of the bill by those who presumably have read it, followed by vigorous questioning. Instead, the circus has come to town. 

    I refer, of course, to the chaos that has erupted at townhall meetings as Democratic lawmakers try to sell the bill. The New York Times reports shouting matches, fistfights, threats, injuries and arrests. Georgia Congressman David Scott says he’s had death threats and a visit from vandals who painted a swastika outside his office. 

    If you wonder what the Nazis have to do with this, join the club. It’s an incoherent protest, and where there is incoherence, naturally, there is Sarah Palin. The former governor of Alaska weighed in on Facebook with a claim that Democrats were proposing a ‘‘downright evil’’ system in which the fate of the elderly and the disabled would be determined by ‘‘death panels.’’ 

    She said she was referring to Sec. 1233 of the bill, so I read it. It would allow your doctor to regularly consult with you on the need for a living will and advanced-care directives, i.e., decide ahead of time if you’d want to be kept alive in a persistent vegetative state. The provision may or may not be a good idea but it’s hardly ‘‘downright evil’’ and it bears no resemblance to the image Palin conjures: granny forced to justify her continued existence before a panel of men in black hoods. 

    Conservatives would have you believe this pandemonium is spontaneous. Truth is, it’s about as spontaneous as a shuttle launch. The Times account tells us a banner appeared on the web site of Fox News host Sean Hannity inviting people to ’’Become a part of the mob!’’ A group calling itself Tea Party Patriots advises its members to pack the hall and ‘‘yell out.’’ This is manufactured outrage. 

    And that’s fine. If people choose to become part of a synchronized protest, they have every right to. Nor is there anything wrong with dissent. As many of us pointed out when George W. Bush’s enablers sought to silence his critics, dissent is patriotic. 

    But shouting down those who disagree with you is not. Neither is threatening, shoving, hitting, painting swastikas or otherwise rendering reasoned debate impossible. That’s not love of country, it’s not dissent, it’s not even civilized. It’s boorish, oafish and crude, the rantings of people panicked beyond reason. 

    In other words, conservatives. OK, not all of them. But too many of them? Definitely. 

    By now, it has become reflex, this instinct of theirs to manipulate the debate and muddy the waters by stoking people’s primal fears, whether of gays, Muslims, Hispanics or now, healthcare reform. ‘‘I’m afraid of Obama!’’ screams a woman. And doesn’t that just say it all? Doesn’t that speak volumes about the intellectual bankruptcy and decayed moral authority of the political right? With apologies to Franklin Roosevelt, the only thing they have to sell is fear itself. 

    And no, that’s not patriotism. It is the cynical behavior of people who have little faith in their ability to win the debate. So they pick a fight and try to win that instead.

Britons rally to defend their healthcare system, say U.S. attacks aren’t cricket – link to original article

It’s one thing for the British to criticize their National Health Service, quite another for Yanks to malign it. A backlash against U.S. criticism has erupted in cyberspace.

By Henry Chu

LA Times

August 15, 2009

Reporting from London

Castigating their public healthcare system may be a national pastime for the British, but it’s not one they care to share with Americans, thank you very much.

In fact, Britain’s oft-maligned National Health Service on Friday was on the receiving end of an outpouring of love and affection it hasn’t felt in years, owing to a growing backlash against what many here see as lies and calumnies being spread about the NHS by conservative critics of President Obama’s plan for healthcare changes in the United States.

Those critics have branded the NHS as “evil” and “Orwellian,” an example of socialized medicine to be avoided at all costs. They blast the system, which offers free healthcare to all, as an expensive failure that denies new drugs to cancer victims, blocks the elderly from receiving certain kinds of treatment and generally puts a low value on human life.

But such allegations have set the blood boiling in many Britons, who this week hit back in the blogosphere, in print and over the airwaves to defend one of their country’s most jealously guarded institutions from an unexpected attack from across the pond.

Ordinary people have piped up with stories of excellent care given by committed doctors and nurses.

A Twitter campaign to rally support for the NHS has attracted so many thousands of messages that the new “welovetheNHS” site crashed this week. Among the contributors: Prime Minister Gordon Brown, who felt moved to “tweet” his encouragement while vacationing in Scotland.

The NHS “often makes the difference between pain and comfort, despair and hope, life and death,” Brown wrote, adding: “Thanks for always being there.”

The groundswell of reaction against U.S. criticism of the NHS has offered a rare show of national unity in a country whose people are outraged and puzzled over why their system, along with Canada’s, has been cast as the boogeyman in the U.S. healthcare debate.

Not that the British believe their system to be perfect. Before the pendulum swung the other way this week, complaints about waiting lists for hip replacements, the risk of infection by “superbugs” in public hospitals and poor bedside manners of healthcare personnel were the norm.

But such grumblings were considered a domestic affair. A smear campaign in another country, based on misinformation and falsehoods, is simply not cricket, the British say.

“We’re OK to have a fair analysis of the NHS, but let’s have it fair,” Andy Burnham, Britain’s health secretary, told the BBC on Friday.

The left-leaning Guardian newspaper devoted an entire page to debunking some of the more scandalous accusations circulating in the U.S., including Iowa Republican Sen. Charles E. Grassley’s claim that fellow Sen. Edward M. Kennedy (D-Mass.) wouldn’t receive treatment in Britain for his brain tumor because of his age.

The right-wing tabloid the Sun, meanwhile, ran a scathing commentary headlined “Why Yanks Must Stop Bashing the NHS.” 

Severely disabled scientist Stephen Hawking declared, “I wouldn’t be here today if it were not for the NHS,” pointedly rebutting claims by Los Angeles-based Investor’s Business Daily that he “wouldn’t have a chance” of surviving here in his homeland because of treatment-rationing.

The passion roused by the controversy is further testament to how strongly people here feel about the NHS, regarded as perhaps the greatest triumph of Britain’s welfare state since its launch in 1948, when the country was struggling mightily to keep body and soul together in the aftermath of World War II.

The service now treats 1 million patients every 36 hours, employs 1.5 million people and operates with a budget of about $169 billion, according to official statistics.

Accusations of inefficiency and waste have dogged the NHS for years, leading a growing number of Britons to buy private insurance as a substitute or fallback.

But so unassailable a place does the NHS occupy in the national imagination that Britain’s political parties dare speak only of revising and strengthening the system; any talk of abolishing it is political suicide.

Both Brown, the head of the ruling Labor Party, and David Cameron, the leader of the Conservative opposition, have given moving accounts of how they have benefited personally from the NHS. Doctors saved the sight in one of Brown’s eyes after a rugby injury when he was as a teenager. Cameron praised the health service for doing “their utmost” in caring for his 6-year-old son Ivan, who was afflicted with a severe form of cerebral palsy and died in February.

“One of the wonderful things about living in this country is that the moment you’re injured or fall ill — no matter who you are, where you are from, or how much money you’ve got — you know that the NHS will look after you,” Cameron said in a statement.

On Friday, Cameron swiftly disowned comments by a member of his party, Daniel Hannan, who serves in the European Parliament and appeared on Fox News attacking the NHS, saying he “wouldn’t wish” it on anyone.

Hannan’s words have caused a minor buzz in the United States, as have remarks by two British women featured in a video made by the lobbying group Conservatives for Patients’ Rights, which opposes Obama’s healthcare proposals.

The women are seen criticizing the NHS for its policies on cancer treatment; one says that not getting a Pap smear in time signed her “death warrant.” But the two women have told the British news media that they were misled into thinking they were being interviewed for a documentary on healthcare reform, not a political attack ad.

Kate Spall, whose mother died of kidney cancer while awaiting treatment, said she was appalled by how her words were being used by the lobbying group.

“I feel I was duped,” she told the Times of London. “The irony is that I campaign for exactly the people that socialized healthcare supports. I would not align myself with this group at all.”

In addition to defending the NHS from conservative critics in the U.S., some in Britain have now gone on the offensive, expressing incredulity that the U.S. boasts of being a superpower while leaving tens of millions of its people uninsured.

“The United States lies between Costa Rica and Slovenia in the World Health Organization’s ranking of healthcare systems . . . which puts them in 37th place,” Keith Hopcroft, a doctor, wrote in the Sun’s commentary piece. “The U.K.? 18th. I rest my doctor’s case.”

henry.chu@latimes.com

Copyright © 2009, The Los Angeles Times

No Matter What Lies the Right Wing Screams, the Brits Love Their Health Care System – link to original article

By Denis Campbell, The Guardian. link to original article

Posted August 13, 2009.

Republicans and right-wing pundits in the US have tried to scare us about Britain’s public health system — because it works. Tools

AlterNet Social Networks:

The claim

Ted Kennedy, 77, would not be treated for his brain tumor if he was in Britain because he is too old – Charles Grassley, Republican senator from Iowa.

The response

Untrue, says the Department of Health. “There is no ban on anyone of any age receiving any treatment, ” said a spokesman. “Whether to prescribe drugs or recommend surgery is rightly a clinical decision taken on a case by case basis.”

The claim

Government health officials in England have decided that $22,750 (£14,000) is what six months’ life is worth. Under their socialised system, if a medical treatment costs more, you’re out of luck – Club for Growth

The response

The National Institute of Health and Clinical Excellence (Nice) decides whether new drugs represent value for money for the NHS in England and Wales. It replied: “This is a gross misrepresentation of how Nice applies health economics to try and address the central issue: how to allocate healthcare rationally within the context of limited healthcare resources. Nice assesses the cost of a treatment in terms of a cost-utility analysis which takes account of the quality adjusted life year – the amount and quality of extended life it is hoped the patient will gain. The current ceiling is £30,000 but exceptions are made.”

The claim

In England, anyone over 59 years of age cannot receive heart repairs, stents or bypass because it is not covered as being too expensive and not needed – an anonymously authored, but widely circulated, email, largely sent to older voters

The response

Totally untrue. Growing numbers of patients over 65 with heart conditions are having surgery, including valve repairs and heart bypass surgery, says Professor Peter Weissberg, the British Heart Foundation’s (BHF) medical director. For example, the average age at which people have a bypass operation has risen from 58 in 1991 to 66 in 2008.

The claim

Breast cancer kills 46% of its targets in Britain, compared with 25% in the US; prostate cancer kills 57% of the Britons it strikes, compared with 25% of American victims; Britain’s heart attack fatality rate was 19.5% higher than America’s in 2005 – Pacific Research Institute, a San Francisco-based thinktank

The response

Breast cancer does claim more lives, proportionally, here than in the US. According to the 2002 Globocan database run by the World Health Organisation’s cancer advisers, 19.2 of every 100,000 Americans die of the disease, but 24.3 per 100,000 here die. On prostate cancer, a Lancet Oncology global study last year found that 91.9% of Americans with the disease were still alive after five years compared to just 51.1% in the UK. With heart attacks, 40% of Britons who suffer one die from it compared to 38% in the States – nowhere near the difference claimed.

The claim

In Britain, 40% of cancer patients are never able to see an oncologist; there is explicit rationing for services such as kidney dialysis, open heart surgery and care for the terminally ill – Conservatives for Patients’ Rights

The response

“The claim that 40% of cancer patients are never able to see an oncologist comes from a 15-year-old study which is completely out of date. Since then we have had the Nice Improving Outcomes Guidance series and the NHS Cancer Plan for England, which has increased the number of cancer consultants and established specialist multidisciplinary teams,” said Duleep Allirajah of Macmillan Cancer Support. However, “some people with serious kidney failure are unable to obtain dialysis on the NHS and die”, said Tim Statham, chief executive of the National Kidney Federation. “Some parts of the NHS can’t cope, because patient numbers are increasing by 6% a year, which is a huge burden. Of about 100 renal units in the UK, probably 20% are working at 100% capacity or above,” he added. The claim about open heart surgery is not true, said the BHF’s Weissberg. “There’s no explicit rationing. Some people don’t get treatment, but those decisions are made solely on the basis of clinical criteria and their risk of dying. We only operate on people who are likely to benefit and not die.” The three main political parties agree that Britain provides good quality end-of-life care but that access to it can be patchy, depending on location and the patient’s condition. The government is working to improve the situation.

The claim

In the UK, breast cancer survival rates are 11% lower than they are here in the United States – Sue Myrick, a Republican congresswoman from North Carolina

The response

If anything the gap is wider than Myrick says. Breakthrough Breast Cancer cite two recent studies from Lancet Oncology. One says that 83.9% of women in the US diagnosed with breast cancer between 1990-94 lived for at least five years compared to 69.7% in the UK – a 14.2% difference. The second showed that, among women diagnosed with the disease in 2000-02, 90.1% in the States survived for at least five years whereas in England it was 77.8% – a 12.3% gap.

The claim

The British healthcare system is infamous for denying state-of-the-art drugs to cancer patients – National Center for Policy Analysis

The response

Nice has recently reformed its procedures after a series of controversies over the unavailability of certain cancer treatments. “The vast majority of new cancer drugs are made available to patients with notable exceptions, such as the likely rejection of several new kidney cancer drugs,” said Allirajah of Macmillan Cancer Support. “However, the Nice process does need reforming to ensure decisions are made more quickly and patients’ quality of life is taken more into account.”

The claim

The British NHS “does not allow” women under 25 to receive screening for cervical cancer – Jim DeMint, Republican senator from South Carolina

The response

The NHS invites women in Wales, Scotland and Northern Ireland to attend for cervical cancer screening from 20 upwards. But in England screening for the disease starts at 25. That policy was recently reviewed and remains unchanged.