John Stossel reports on Obama\’s American \’Health Care\’ Plan

One million NHS patients have been the victims of appalling care in hospitals across Britain, according to a major report released today.

Telegraph.co.uk – link to original article

By Rebecca Smith, Medical Editor

Published: 12:01AM BST 27 Aug 2009

In the last six years, the Patients Association claims hundreds of thousands have suffered from poor standards of nursing, often with ‘neglectful, demeaning, painful and sometimes downright cruel’ treatment.

Related Articles

• Hospital care: Colin Purkiss Smith’s wife forced to bring him blankets 
• I bet those old folk don’t #lovethenhs 
• Hospital care: Ann McNeill was called a drama queen 
• Hospital care: Florence Weston was left without food or drink 
• Hospital care: Pamela Goddard’s bed sores were inadequately treated 
• ‘Appalling care’ cost up to 1200 lives in Staffordshire 

The charity has disclosed a horrifying catalogue of elderly people left in pain, in soiled bed clothes, denied adequate food and drink, and suffering from repeatedly cancelled operations, missed diagnoses and dismissive staff.

The Patients Association said the dossier proves that while the scale of the scandal at Mid-Staffordshire NHS Foundation Trust – where up to 1,200 people died through failings in urgent care – was a one off, there are repeated examples they have uncovered of the same appalling standards throughout the NHS.

While the criticisms cover all aspects of hospital care, the treatment and attitude of nurses stands out as a repeated theme across almost all of the cases.

They have called on Government and the Care Quality Commission to conduct an urgent review of standards of basic hospital care and to enforce stricter supervision and regulation.

Claire Rayner, President of the Patients Association and a former nurse, said:“For far too long now, the Patients Association has been receiving calls on our helpline from people wanting to talk about the dreadful, neglectful, demeaning, painful and sometimes downright cruel treatment their elderly relatives had experienced at the hands of NHS nurses.

“I am sickened by what has happened to some part of my profession of which I was so proud.

“These bad, cruel nurses may be – probably are – a tiny proportion of the nursing work force, but even if they are only one or two percent of the whole they should be identified and struck off the Register.”

The charity has published a selection of personal accounts from hundreds of relatives of patients, most of whom died, following their care in NHS hospitals.

They cite patient surveys which show the vast majority of patients highly rate their NHS care – but, with some ten million treated a year, even a small percentage means hundreds of thousands have suffered.

Ms Rayner said it was by “sad coincidence” that she trained as a nurse with one of the patients who had “suffered so much”.

She went on: “I know that she, like me, was horrified by the appalling care she had before she died.

“We both came from a generation of nurses who were trained at the bedside and in whom the core values of nursing were deeply inculcated.”

Katherine Murphy, Director of the Patients Association, said “Whilst Mid Staffordshire may have been an anomaly in terms of scale the PA knew the kinds of appalling treatment given there could be found across the NHS. This report removes any doubt and makes this clear to all. Two of the accounts come from Stafford, and they sadly fail to stand out from the others.

“These accounts tell the story of the two percent of patients that consistently rate their care as poor (in NHS patient surveys).

“If this was extrapolated to the whole of the NHS from 2002 to 2008 it would equate to over one million patients. Very often these are the most vulnerable elderly and terminally ill patients. It’s a sad indictment of the care they receive.”

The Patients Association said one hospital had threatened it with legal action if it chose to publish the material.

Pamela Goddard, a piano teacher from Bletchingley, in Surrey, was 82 and suffering with cancer but was left in her own excrement and her condition deteriorated due to her bed sores.

Florence Weston, from Sedgley in the West Midlands, died aged 85 and had to remain without food or water for several days as her hip operation was repeated cancelled.

The charity released the dossier to highlight the poor care which a minority of patients in the NHS are subjected to.

Ms Murphy said the numbers rating care as poor came despite investment in the NHS doubling and the number of frontline nurses increasing by more than a quarter since 1996.

The personal stories were revealed to prevent their cases being ignored as only representing a small portion of patients.

The report said: “These are patients, not numbers. These are people, not statistics.”

Dr Peter Carter, Chief Executive of the Royal College of Nursing, said he was concerned that public confidence in the NHS could be undermined by the examples cited and it would affect morale in hardworking staff.

He said: “The level of care described by these families is completely unacceptable, and we will not condone nurses who behave in ways that are contrary to the principles and ethics of the profession.

“However we believe that the vast majority of nurses are decent, highly skilled individuals.

“This report is based on the two per cent of patients who feel that their care was unacceptable. Two per cent is too many but we are concerned that this might undermine the public’s confidence in the world-class care they can expect to receive from the NHS.”

Barbara Young, Chairman of the Care Quality Commission, the super-regulator, said: “It is absolutely right to highlight that standards of hospital care can vary from very good to poor.

“Many people are happy with the care they receive, but we also know that there are problems.

“I am in no doubt that many hospitals need to raise their game in this area.

“Where NHS trusts fail to meet the mark, we have tough new enforcement powers, ranging from warnings and fines to closure in extreme cases. We will not hesitate to use these powers when necessary to bring improvement.

“We will be asking NHS trusts and primary care trusts how they are ensuring that the needs of patients and their safety and dignity are kept at the heart of care.”

Chris Beasley, Chief Nursing Officer at the Department of Health said the care in the cases highlighted by the PA was “simply unacceptable”.

She added: “It is important to note this is not representative of the picture across the NHS.

“The NHS treats millions of people every day and the vast majority of patients experience good quality, safe and effective care – the Care Quality Commission’s recent patient experience survey shows that 93 percent of patients rate their overall care as good or excellent.

“We will shortly be publishing complaints data on the NHS Choices website and expect trusts to publish the number of complaints they receive, setting out how these are successfully resolved.”

Tell us about your experience of the NHS

Seeking healthcare abroad – link to original article

In the new world of medical tourism, hundreds of thousands of U.S. residents are going overseas for healthcare

Similar Stories:

•

Oregon construction worker, Miami surgeon go to Trinidad

•

South Florida hospitals compete for international patients

•

Visa card encourages medical tourism growth

•

Rational instead of rationing

BY JOHN DORSCHNER

JDORSCHNER@MIAMIHERALD.COM

Miami Herald – 9/30/07

Hammered by lack of insurance and high prices for healthcare, many Americans are looking overseas for care.

No one has exact numbers, but the new Medical Tourism Association, based in West Palm Beach, estimates that hundreds of thousands of Americans are now traveling out of the country for care.

Prime example: Madeline Del Sol of Pembroke Pines. With no insurance, she needed extensive dental work, including an implant, root canals and fillings replaced. South Florida dentists gave her estimates of $11,000 and $13,000.

A Colombian friend suggested she go to Barranquilla, and recommended a dentist. Del Sol was impressed by how warmly she was treated. “I felt like a human being. In the United States, I’m just a dollar sign.”

She had a bone implant, two root canals and 13 old fillings replaced for $2,000. The work was superb, she said. “It’s probably the best experience I’ve ever had with doctors.”

Still, in the world of medical tourism, it is a matter of buyer beware. Earlier this summer, a woman in Royal Palm Beach died from complications of gastric bypass surgery in Mexico, according to the Palm Beach Post.

Stephan Baker, a cosmetic plastic surgeon in Coral Gables, said he’s treated two patients who suffered overseas disasters — a tummy tuck done in Panama that resulted in a fluid build-up in the abdomen and a tummy tuck done in Costa Rica that ended up with “a pretty significant infection.”

Those patients may have saved money on the front end, Baker said, but the resulting problems would have caused them huge post-operative expenses that could have been much more than the savings.

For some years, dental work and plastic surgery have been the primary healthcare reasons for going to Latin America, but with the graying of the baby boomer generation and the number of uninsured climbing toward 50 million, Americans’ interest in Latin America healthcare is broadening.

“What’s mostly on the increase is the complexity of surgeries, ” said Carole Veloso, chief executive of the CIMA San Jose Hospital in Costa Rica.

“People are now actually asking about heart surgery, orthopedics and a lot of gastric bypass surgery or banding” of the stomach.

Veloso said gastric bypass in San Jose can be done for about $7,000, not including travel costs — a huge reduction over the $20,000 to $30,000 it’s likely to cost in South Florida.

CIMA is part of a chain owned by the Dallas-based International Hospital Corp., which is dedicated to maintaining U.S. quality standards at its eight hospitals in Mexico, Brazil and Costa Rica.

While most of its patients are local, CIMA Chief Operating Officer Clifton Orme said the chain is working hard to gain accreditation through Joint Commission International, a sister organization of the group that accredits U.S. hospitals.

Such approval could take several years of preparation. In Latin America, the commission has so far accredited just 11 hospitals in Brazil.

For consumers, another possibility is seeking out an overseas facility with links to the United States. Johns Hopkins, for example, has working relationships with four hospitals and clinics in Latin America. The University of Miami is working to set up its own links, starting with Cartagena, Colombia, where several UM-trained doctors practice.

“There are great physicians everywhere in the world, ” said Eduardo de Marchena, director of UM International Medicine Institute. “But it is very difficult to know where you are going to find quality.”

Trying to bring order to that uncertain marketplace is the not-for-profit Medical Tourism Association.

Its goals include controlling standards and credentials, protecting “the reputation of medical tourism from disreputable hospitals” and creating “a comprehensive Web portal for people to learn about medical tourism.”

“A lot of people are trying to fill this market, ” said John F. P. Bridges, a Johns Hopkins professor who is on the MTA’s advisory board.

“Far too many of them are dot-com entrepreneurs” seeking a new business. “I call them vultures.”

Bridges, an economist, said many details need to be worked out — guidelines about quality, healthcare information and much more — but he sees a certain inevitability in moving to a global healthcare system.

“Mexico isn’t a third-world country when it comes to healthcare, ” Bridges said. “If someone’s going to say it’s a spin of Russian roulette when you go south of the border, I don’t think that’s the case . . . Every other market has embraced globalization, why not healthcare?”

Overseas healthcare simply presents consumers with another choice, Bridges said, and they should research doctors and facilities overseas the same way they would in the United States — looking for credentials, board certifications of doctors and word-of-mouth recommendations.

We’ve got the rest of the world baffled – link to original article

BY FRIDA GHITIS

FJGHITIS@GMAIL.COM

The Miami Herald – 8/22/09

The entire world has long enjoyed kicking back and watching what goes on in America. This year, those condemned to stay at home for their summer vacation have found much entertainment in the healthcare follies playing out in a land many see as alternating between inspirational, infuriating and just plain baffling.

In much of the Western world, the three emotions conjured by the different installments of the America Show in recent years have come in intense and time-compressed fashion. The war in Iraq infuriated, the election of Barack Obama inspired and the “debate” over healthcare reform simply astonishes.

In Amsterdam, where I spend part of the year, every time I go to the pharmacy and take out cash to pay for a prescription, the pharmacist and all the customers who never seem to pay for anything watch me like I’ve pulled a frog out of my pocket. Then the pharmacist looks at me and my money with pity and says, “Oh, you’re American.” She doesn’t elaborate.

Those watching the passions boiling over in the United States this August have known for a long time that something is wrong with healthcare in the land of the free. But they didn’t expect this.

“The debate raging in the United States,” declares the French daily Le Monde, “is simply surreal.”

In the Ottawa Citizen, Karen Heartfield’s column The crazy spectacle in America says America’s wild debate “has made me feel extraordinarily grateful to be a Canadian.” She goes on to explain that, “We have our idiots, but we’ve got nobody that even compares to Rush Limbaugh.”

In Germany, where people know the real meaning of Nazism, TV viewers’ eyes popped and jaws dropped at the sight of Hitler mustaches painted on Obama’s face as protestors suggested the plan would bring Nazi medicine to America. The British, for their part, might enjoy the American shout-show, except that they find the disparaging of their healthcare system more than a little annoying.

British experts say suggestions that, for example, in Britain, Ted Kennedy would be left to die without care are the most ridiculous thing they’ve heard.

Clearly, a debate over healthcare is needed. The discussion is long overdue. Americans must make tough decisions over something that matters to every single person. That’s why it is so tragic that the vital conversation has veered away from the facts. But, as Switzerland’s Le Temps explains with curious certainty, “This culture of confrontation is a given in U.S. politics.”

The American healthcare system has long proved incomprehensible to those living in other rich industrialized countries where long ago all people gained access to good medical care. The real mystery has been why Americans have accepted that in the richest country on Earth, which spends far, far more on healthcare than any other country on the planet, almost 50 million people go without health insurance. Others have explained that Americans are worried about the exorbitant cost they might leave their children and concerned that the parts of the system that now work will deteriorate.

Serious analysis, however, looks remote. And the possibility that Americans may ultimately decide to keep the current system — one that leaves more people behind every day, costs trillions of dollars and is slowly destroying the U.S. economy — is simply beyond belief. To people in other countries, it makes absolutely no sense. The Telegraph’s Stryker McGuire all but throws up his hands, writing, “It’s one of those things — like America’s gun culture — that never cease to baffle people outside the United States.”

Outsiders have a tendency to caricature the United States, drawing rough lines that exaggerate and oversimplify the traits of a complex and diverse nation. In truth, I’m afraid, the healthcare debate has become cartoonish. Consider the spectacle of a constituent asking Rep. Barney Frank why he “continues to support a Nazi plan,” and his response, “Ma’am, trying to have a conversation with you would be like trying to argue with a dining-room table.”

It’s not too late. Now that America has provided some free entertainment for the rest of the world, perhaps it can get back to that other version of the country. Maybe America the Inspiring can push aside America the Baffling and take the discussion in a more fruitful direction, even if that provides less amusement for television viewers in Germany, Switzerland or Canada.

Frida Ghitis writes on global affairs.

Healthcare reform: What it means to you – link to original article

With some of the highest healthcare costs in the United States, South Florida has a lot at stake in the current reform proposals.

BY JOHN DORSCHNER

JDORSCHNER@MIAMIHERALD.COM

Miami Herald August 16, 2009

As the national debate about healthcare reform intensifies, South Florida stands out as a place that has a lot to gain and a lot to lose, depending on the details hammered out by Congress next month. 

A lot to gain because the region has an unusually high percentage of uninsured and people who seek to buy insurance on the individual coverage market, which is often highpriced and unavailable to those with chronic diseases. The reforms are aimed at helping both of these groups get coverage they can afford.

A lot to lose because almost all experts say the only way the country can afford reform is to reduce its healthcare costs. The United States has the highest healthcare costs in the world, and South Florida is among the highest in the nation. Under reform, quite a few of the 218,000 healthcare workers in Miami-Dade and Broward could lose their jobs.

Healthcare leaders like Brian Keeley, chief executive of Baptist Health South Florida, says these two points are closely connected: The higher the costs get, the fewer businesses can afford coverage, which increases the number of uninsured, who often delay treatment until they are extremely sick and go to the emergency room.

There, they run up big bills they can’t pay for, and hospitals compensate by hiking rates for private insurance, causing more businesses to drop coverage, which increases the number of uninsured.

“This is a `death spiral,’ ” says Keeley.

“The system is totally unsustainable for all parties. Drug companies, insurance companies, the SEIU [Service Employees International Union], you talk about strange bedfellows — all agree something has to be done.”

With accusations flying in all directions and much confusion about the details in proposals Congress will be considering when it returns from its August recess, here is a quick primer about healthcare, dealing with the misconceptions and the realities: Where the system stands now, how it stacks up to other countries, what is being proposed and what changes mean for South Florida residents.

What we have now

The United States has a public/private mixture. Fifty-three percent get their insurance at work, according to the Kaiser Family Foundation; 27 percent have a government plan (Medicare for seniors, Medicaid for the poor); 5 percent buy on the individual market.

Fifteen percent have no insurance — 45 million in 2007 and thought by many to have risen to 50 million during the recession.

In South Florida, one million are uninsured. In Miami-Dade, 625,000 have no coverage — 30.9 percent of the population under 65. In Broward, it’s 408,000 — 27.1 percent of those under 65. This is Census Bureau data for 2006, which was just released. The numbers have likely increased during the recession.

In one sense, the United States already has universal healthcare. Under federal law, everyone in the country — including immigrants here illegally — must be treated in hospital emergency rooms.

Those unpaid hospital bills get passed on to people with insurance.

A study by Families USA released this week found that in the past 10 years, family healthcare premiums rose an estimated 3.7 times faster than earnings for Florida workers.

The one group that has a hard time passing on these costs are the public hospitals, because so many of their patients are poor or uninsured.

That’s why places like Jackson Health System are in dire financial shape, which is expected to get worse.

What other countries do

The rest of the industrialized world — Europe, Canada, Australia — essentially guarantees the right to basic healthcare, as it does the right to public education.

Many critics of reform point to problems in Canada, where patients often complain about long waits for elective surgery. But experts like Steven Ullmann, director of health policy programs at the University of Miami, say Canada’s system is essentially a government entity — unlike what’s being proposed in the United States.

Ullmann and many others say a better comparison is the Netherlands, where employers and individuals pay into the system. People choose among private insurers. Costs are regulated.

The bottom line: The Dutch live to 80, on average, for an average annual healthcare cost of $3,383, according to the World Health Organization. In the United States, it’s 78 years of life for $6,714.

Most Dutch doctors have their own private practices. A survey sponsored by the Commonwealth Fund of patients with chronic diseases found that 60 percent in the Netherlands say they can get a same-day appointment with a doctor when they’re sick. Only 26 percent in the United States said they could.

Ninety-nine percent of those patients in the Netherlands said they have a doctor that they usually see, compared with 82 percent in the United States.

Even so, many are not entirely satisfied with their system: 46 percent of the Dutch want fundamental changes, and 9 percent say the system needs a complete overhaul.

In the United States, Commonwealth reported, 46 percent want fundamental changes, 33 percent demand a complete overhaul.

Much of the dissatisfaction may be based on not getting everything we want: Unlike buying, say, a television, healthcare in the industrialized world works through a third party: Patients get treated and providers get paid — by a third-party insurer.

As Keeley puts it: “We all want the very best healthcare — and we want someone else to pay for it.” In such a system, neither patients nor providers worry much about costs.

In Europe, governments generally have price controls. In the United States, private and government insurers have tried to control costs — generally without success.

Plans for reform

The proposals now before the House and Senate are complex. Some highlights:

• In all proposals before Congress, private health plans provided by employers will remain the fundamental form of insurance for most Americans. One key issue creating bitter debate is whether to add a “public plan” — a government alternative to compete with private insurers.

• Most proposals require all Americans to have health insurance. Individuals who can not afford the premiums could be eligible for subsidies, a provision that will cost billions. This would enlarge the insurance pool — and make private insurers happy. In return, the insurers promise not to reject people because of preexisting conditions, although this provision would be phased in slowly over time.

• One of the biggest uncertainties: What happens to small businesses. Should businesses of a certain size be forced to provide insurance or pay a tax? How big a tax? If there was a public plan, many small businesses might be better off paying a tax and putting their employees in a public plan, where a large risk pool would spread costs.

Some small-business owners that don’t provide coverage,like Miriam Vilariño of Las Vegas Cuban Restaurants, warn that one proposal — a payroll tax of 8 percent for companies that don’t offer insurance — could destroy the family business.

• How to pay for all this? This is the toughest part: Proposals include new taxes on the wealthy, and/or businesses that don’t offer healthcare, and/or insurers that offer “Cadillac plans,” which offer unusually rich benefit packages.

But what makes a Cadillac? Laurie Amber, a South Miami lawyer, worries that her $1,700-a-month policy might qualify, even though it includes a $2,000 deductible. “We really have a bare bones. It’s just expensive.” Expensive because healthcare in South Florida tends to cost far more than elsewhere.

Cutting costs

Republicans and Democrats agree that any reform must be funded in part by cutting costs. But they say that doesn’t mean denying care or simply cutting payments to doctors or hospitals.

Dartmouth researchers and the Midwest Business Group on Health have said about 30 percent of current health spending is completely wasted — duplicative or unnecessary tests, too many trips to specialists, too much reliance on expensive drugs when cheaper generics could do just as well.

Dartmouth studies show that South Florida is a poster child for such high costs: A Miami senior costs Medicare twice as much annually as a senior in Minneapolis, but lives no longer and gets no healthier.

“That difference is so big that if you got rid of it, you could afford to lease a Lexus 400 for every senior in Miami,” says Becky Cherney of the Florida Health Care Coalition. Of course, policy makers want the money saved to help the uninsured, not another car program.

One major issue lost in the present debate: With or without reform, Medicare is in financial trouble. “At the year 2013, Medicare starts going broke,” warns Tommy Thompson, George W. Bush’s secretary of Health and Human Services.

Reform critics say that Medicare’s problems are a good reason why Congress should not add another “public plan.”

Politics of reform

In the past month, the rhetoric of the debate has escalated so much to include even an accusation that the government is planning “death panels” to decide who should live and who should die.

There’s nothing like that in the proposed legislation. Ullmann says the fear comes from a benign provision that, if a senior wants a consultation with her doctor about end-of-life decisions, insurance should pay for this.

But with more than a thousand pages of proposals, there’s the possibility for a lot of argument. Insurers don’t want a public plan. Big Pharma is preparing to spend millions on ads supporting reform — as long as the government doesn’t set drug prices.

The intensity of the debate has clearly split voters. A Gallup Poll conducted about the time of the “death panel” accusation found that 35 percent of the nation wants Congress to pass a reform bill when it returns from its August recess, 36 percent recommend a vote against and 29 percent have no opinion.

Talk of controlling costs has many frightened. A Gallup Poll last month showed 42 percent of those over 65 believed reform will “worsen medical care in the United States.”

Many critics have concerns not about what is in the legislation, but implications about what the reform could lead to later: A public plan could open the door to “socialized medicine.” Cost controls might lead to euthanasia.

The healthcare coalition’s Cherney, who has read the entire 1,000-page House bill, says euthanasia is nowhere in the legislation. “There’s a lot of misconceptions out there.”

She says the thick package has many valuable provisions — such as the government helping doctors pay for converting their offices to electronic records.

But Ullmann at UM says the “very complex” proposal “by itself causes anxiety about what might be hidden in there.” He suggests that policymakers may have erred by including too many details. “There’s something to be said for that old saying: Keep it simple, stupid.’ says the “very complex” proposal “by itself causes anxiety about what might be hidden in there.” He suggests that policymakers may have erred by including too many details. “There’s something to be said for that old saying: Keep it simple, stupid.’

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.

A Short Course in Brain Surgery