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Health Care be careful what you wish for

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Pacman Quote  Post ReplyReply Direct Link To This Post Topic: Health Care be careful what you wish for
    Posted: Aug 27 2009 at 8:10am

Vive Le French Care?

By INVESTOR'S BUSINESS DAILY | Posted Wednesday, August 26, 2009 4:20 PM PT

Health Systems: Health care in France is often held up as a model the U.S. might follow. Yet the French have their own problems that show there's no such thing as a free lunch — or a free doctor's visit.

IBD Exclusive Series: Government-Run Healthcare: A Prescription For Failure


Call it the grass-is-greener syndrome. Advocates of national health care, acknowledging the flaws in ObamaCare yet despising the current U.S. system that has the best medicines, the best medical equipment and the shortest waiting lists, have turned their eyes lovingly to places like France.

As City Journal contributing editor Guy Sorman notes, the French would also love to have the low-cost, high-service system some Americans gush about. Unfortunately, they don't. France's system isn't that cheap and is financed by high taxes on labor that have heavy economic consequences.

Sorman notes that a Frenchman making a monthly salary of 3,000 euros has 350 of them deducted for health insurance. Then the employer throws in an additional 1,200 euros. This raises the cost of labor to prohibitive levels and puts a brake on economic growth. This helps explain why French unemployment hovers around 10%.

France imposes an additional tax levy to cover the constant deficits that national health insurance runs.

The French Parliament raises this levy, which applies to all forms of income, every year. Altogether, Sorman writes, "25% of French national income goes toward what's called Social Security, which includes health care and basic retirement pensions for all."

Drugs developed in America at enormous expense do cost less in France, which decides what drugs are to be used and at what prices. American patients in effect subsidize the French, who take the same pills at half the price because American pharmaceutical companies don't want to lose the French market.

French taxpayers fund a state health insurer, Assurance Maladie. Assurance Maladie has run in the red since 1989, and this year's shortfall is expected to be 9.4 billion euros ($13.5 billion) and 15 billion euros in 2010, about 10% of its budget.

Regardless of the cost, does the French system produce better outcomes? Not always. Infant mortality rates are often cited as a reason socialized medicine and single-payer systems are better than what we have here. But according to Dr. Linda Halderman, a policy adviser in the California State Senate, these comparisons are bogus.

Official World Health Organization statistics show the U.S. lagging behind France in infant mortality rates — 6.7 per 1,000 live births vs. 3.8 for France. Halderman notes that in the U.S., any infant born that shows any sign of life for any length of time is considered a live birth. In France — in fact, in most of the European Union — any baby born before 26 weeks' gestation is not considered alive and therefore doesn't "count" in reported infant mortality rates.

France reimburses its doctors at a far lower rate than U.S. physicians would accept.

As David Gratzer, a physician and senior fellow at the Manhattan Institute, wrote in the summer 2007 issue of City Journal: "In France, the supply of doctors is so limited that during an August 2003 heat wave — when many doctors were on vacation and hospitals were stretched beyond capacity — 15,000 elderly citizens died."

After the tragedy, the French parliament released a harshly worded report blaming the deaths on a complex health system, widespread failure among agencies and health services to coordinate efforts, and chronically insufficient care for the elderly.

It's hard to imagine that happening here, where hospitals have enough air-conditioned beds and doctors that aren't on vacation.

Fact is, most Americans like their health care. There are ways to provide expanded coverage at lower cost, such as pushing individually owned health savings accounts, malpractice reform and allowing insurance to be bought across state lines.

We needn't be forced to sacrifice quality for cost. Nor do we need to look to the French for a better solution. They don't have one.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Pacman Quote  Post ReplyReply Direct Link To This Post Posted: Aug 27 2009 at 8:12am

'Cruel and neglectful' care of one million NHS patients exposed

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

 

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.

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."

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