Ontario Sends Cancer Patients to Buffalo, Detroit
WINDSOR STAR -- Between April 2007 and April of this year, 55 Ontario patients have been referred to Roswell Park in Buffalo, NY to receive IL-2 treatments for stage IV melanoma, and four patients were sent to the Harper University Hospital and the Karmanos Cancer Center in Detroit, Michigan.
The story is about a 30-year old Canadian man with melanoma who lives in Windsor, Ontario and has been approved for IL-2 treatments in the U.S. by Canadian authorities, but is being forced to drive four hours to Buffalo instead of across the Detroit River for treatment in Detroit. Reason? Cost savings.
Is this really the kind of government-run health care system we want in the U.S.? Where will we send cancer patients if we adopt a Canadian-style health care system?
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Patients across the country are waiting more than two years for a hearing aid, and up to five years to have old-fashioned equipment replaced by modern technology.
Almost 50,000 people, many of them elderly, are stuck on NHS waiting lists and 10 primary care trusts have admitted to delays of more than a year for patients in need of their first hearing aid.
[...]
The Royal National Institute for the Deaf, which uncovered the findings under the Freedom of Information Act, described the misery endured by thousands of Britons who are hard of hearing as a "national scandal" requiring urgent Government action.
A separate survey by the British Society of Audiologists found even longer delays for patients seeking to swap old-fashioned analogue hearing aids for modern digital ones recommended by the NHS.
In total, 59 hospitals had waiting times longer than a year for patients in need of a digital upgrade. Patients suffered the longest waiting times in two East Yorkshire hospitals, Beverley Westwood and Hull Royal Infirmary, with delays of five years.
Telegraph
Dozens of incentive schemes have been uncovered which allow GPs to profit by slashing the number of patients they refer for hospital care.
[...]
Torbay care trust in Devon will pay up to £15,000 to the average-sized GP practice if it hits a swathe of targets, including reducing hospital referrals.
NHS managers say referral rates, which rose 16 per cent nationwide during the first quarter of this year, have to be cut to save money. They claim many patients can receive equally good care from community NHS staff, such as physiotherapists and nurses.
But critics fear that patients could suffer if GPs' decisions are swayed by the prospect of a cash bonus.
A leading surgeon said that patients' cancers had already gone undiagnosed after they were denied specialist care under two such "referral management" schemes.
Orthopaedic surgeon Stephen Cannon, former president of the British Orthopaedic Association and a consultant surgeon at the Royal National Orthopaedic Hospital, described the cases as an "absolutely terrible" warning that decisions by non-specialist doctors could have devastating consequences.
He said: "I recently encountered two cases in which patients referred to physiotherapists later turned out to have a malignant tumour. If they had been sent to a consultant the outcome may have been very different.
"In one case a young man was referred to a physiotherapist because of sudden knee pain. Had he come to a specialist the symptoms should have been recognised and he should have been urgently referred to an oncologist. In this case, after the delays, the outcome was amputation. It was devastating for the patient and his family."
Telegraph
In the latest jarring illustration of the country's doctor shortage, a family physician in Northern Ontario has used a lottery to determine which patients would be ejected from his overloaded practice.
Dr. Ken Runciman says he reluctantly eliminated about 100 patients in two separate draws to avoid having to provide assembly-line service or extend already onerous work hours, and admits the move has divided the close-knit community of Powassan.
Yet it was not the first time such methods have been employed to determine medical service. A new family practice in Newfoundland held a lottery last month to pick its caseload from among thousands of applicants. An Edmonton doctor selected names randomly earlier this year to pare 500 people from his heavy caseload. And in Ontario, regulators have heard reports of a number of other physicians also using draws to choose, or remove, patients.
[...]
The unusual practice seems to be a symptom of the times, said Jill Hefley, spokeswoman for the College of Physicians and Surgeons of Ontario. A paucity of medical professionals has left an estimated five million Canadians without a family doctor.
National Post
Large numbers of people are going without dental treatment and some even report extracting their own teeth because they cannot find an NHS dentist in their area, a survey reveals today.
The Dentistry Watch survey of more than 5,000 people, from the Commission for Patient and Public Involvement in Health, found widespread unhappiness among both patients and dentists despite government reforms to increase the availability of NHS dentistry.
Gaurdian
At least 30,000 patients were left starving on NHS wards last year, despite ministers’ pledges to make proper nutrition in hospitals a priority.
Last year, Health Minister Ivan Lewis admitted that some patients were given a single scoop of mash as a meal.
Others were ‘tortured’ with trays of food placed just beyond their reach while nurses said they were too busy to help them eat.
And now, official figures show that between 2005 and 2007, there was an 88 per cent rise in reported cases of poor nutrition leading to a serious deterioration in a patient’s health.
Last year, NHS whistleblowers reported 29,138 such errors to the National Patient Safety Agency – up from 15,473 in 2005.
They refer to elderly patients who are not properly fed and those given the wrong types of food, causing their health to worsen.
UK Mail
The National Institute for Health and Clinical Guidelines (Nice) has ruled for the first time that saving a life cannot be justified at any cost, in a review of its ethical guidelines.
The ruling - made by the board of the controversial organisation - contradicts advice it received from its own 'Citizens Council' which offers advice from a representative sample of the general public.
Nice is facing growing criticism over the number of drugs it is now rejecting which are available throughout Europe and in America. Last week, it refused to sanction four kidney cancer drugs which can double life expectancy.
It has now rejected the so-called "rule of rescue" which stipulates that people facing death should be treated regardless of the costs. The rule is based on the natural impulse to aid individuals in trouble.
In a report on "social values judgement" the regulator says: "There is a powerful human impulse, known as the 'rule of rescue', to attempt to help an identifiable person whose life is in danger, no matter how much it costs. When there are limited resources for healthcare, applying the 'rule of rescue' may mean that other people will not be able to have the care or treatment they need.
Telegraph
Well, yes. That's what Capitalism is all about, isn't it? Buying from the most "competitive" supplier?
Buffalo has the best price; Buffalo gets the business.
The growing waits to see a specialist and to receive treatment were not the only delays facing patients in 2007. Patients also experienced significant waiting times for various diagnostic technologies across Canada: computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound scans. The median wait for a CT scan across Canada was 4.8 weeks. British Columbia, Alberta, Ontario, New Brunswick, and Nova Scotia had the shortest wait for computed tomography (4.0 weeks), while the longest wait occurred in Manitoba (8.0 weeks). The median wait for an MRI across Canada was 10.1 weeks. Patients in Ontario experienced the shortest wait for an MRI (7.8 weeks), while Newfoundland residents waited longest (20.0 weeks). Finally, the median wait for ultrasound was 3.9 weeks across Canada. Alberta and Ontario displayed the shortest wait for ultrasound (2.0 weeks), while Prince Edward Island and Manitoba exhibited the longest ultrasound waiting time, 10.0 weeks.
Fraser Institute
Dufus,
Capitalism is not about having some government bureaucrat making life and death decisions for you. In a free market an individual is allowed to consider all factors, including cost, for himself and make his own decisions.
Capitalism, in this case, has made a service available that socialists, like you, have rationed out of existence elsewhere.
I know that in your fantasy world everyone will receive the same level of care they do now in the U.S., only the government will pay, so it will be "free". Grow up.
We tend to point out the many problems with the universal systems in Canada and Great Britain because those are the models the U.S. is encouraged to follow. But the misery isn't limited to those nations.
[...]
In the spring issue of the Journal of American Physicians and Surgeons, Sven Larson, president of Hill City Skunkworks in Saratoga Springs, N.Y., provides a few examples of just how bureaucratic rationing has impacted lives Sweden.
Larson's most troubling example is that of the baby boy who died within a few days of birth due to a lack of care, even though his parents followed the process of the system. Also disturbing is the story of the 3-year-old boy who died of heart failure because no health care professional had the time to treat him. It was a case of "too many patients and too little staff," Larson wrote.
At the other end of life's aging spectrum is the man in his 60s who died shortly after being diagnosed with cancer. The man had been seen at a local clinic 14 times over 18 months but was not referred to a specialist nor given a blood test "because of budget restrictions imposed by government bureaucrats." Imagine how his family felt when it learned that the cancer was treatable in its early stages — at the very time he was making futile visits to the local clinic.
IBD
Colette Mills has been condemned to death by the NHS. We should pay attention to her story now, because one day it could very well be our own.
Mrs Mills, a former nurse who has breast cancer, was told back in September that her local hospital trust would not pay for Avastin, a drug which would double the time her disease was kept under control.
Colette, 58, and her husband Eric, said they would buy the Avastin out of their savings. Imagine their shock when they learned that, if they purchased the drug, the mother-of-two would have to pay for all her future NHS care - to the tune of £15,000 a month.
Health Secretary Alan Johnson has ruled that patients can no longer combine private and NHS care as this creates a "two-tier" system.
[...]
... they threaten to withhold free chemotherapy if the customer makes so bold as to use their own cash to alleviate their suffering.
Daily Mail
Waiting lists for surgery and other procedures had long been a problem in Sweden. Like most government-run systems, the Swedish health care system was already plagued by declining productivity - a consequence of which included delays in care. Global budgeting, however, worsened the problem of waiting lists. With county councils now operating with fixed budgets and citizens facing few restraints on demand for health care, county councils needed to ration health care services. An increase in wait times was the result. By 1988 the wait time for an angiogram - a heart X-ray - was up to eleven months. The wait time for bypass surgery could be an additional eight months.
National Center for Public Policy Research
One of NSW's busiest area health services is slashing the number of orthopedic surgeons it employs, despite more than 3000 people waiting for operations such as hip and knee replacements.
In what has been described as blatant cost-cutting, South Eastern-Illawarra Area Health Service is set to make up to eight orthopedic surgeons redundant from Prince of Wales, St George, Sutherland and Sydney hospitals.
The chairman of the NSW branch of the Australian Orthopedic Association, David Wood, said patients would be badly affected by the move, which is part of a reorganisation of clinical services in the area.
He said he feared the plan would almost halve the number of surgeons covering the four hospitals and then require them to double their surgery time.
"I have an 18-month waiting list and there is no way I intend to double my workload in the public system by being on at two hospitals," Dr Wood said.
It appeared, he said, to be all about costs - every joint replacement costs between $5000 and $10,000 and "every procedure you don't do saves money".
Sydney Morning Herald
I recently came face to face with a level of Western ignorance that I hadn't encountered since the 1980s, when Russian immigrants were still a novelty to Americans. A British-American asked my father a question that could only come from someone who has known freedom his whole life: "Why did you leave Russia? Your family was there, you had a job, you had free health care. Why did you leave?" The questioner, a former editor with the New York Times, then proceeded to assert that today's Britain and U.S. are no longer free.
The exchange reminded me just how out of touch many who live in the free world are with the reality of life under tyranny--and why, therefore, so many Americans and Brits think nothing is scarier than war. On the subject even of that oft-cited "perk" of Soviet life, universal health care, a picture of the system in practice on its happiest occasion would shock Americans and Western Europeans alike.
WSJ
One of Scotland's leading cancer specialists will tomorrow call on the public to confront the ultimate NHS taboo: that life cannot be "priceless" in a health system where cash is finite.
Speaking ahead of his lecture at the Edinburgh Science Festival, entitled The Future Of Cancer Treatment: Can We Afford It?, Professor John Smyth called for a more "rational" debate on how we apportion healthcare, and warned that society will face more "moral dilemmas" as pressure on NHS resources grows.
Smyth, a professor of medical oncology at Edinburgh University, explained that it was the very success of cancer research over the past 30 years which had created the ethical minefield. Public expectation for new drugs and procedures had to be balanced against the demands of age-related diseases, and rising numbers of once-fatal conditions which can now be cured or managed.
Cancer, heart disease and strokes are now Scotland's biggest killers, and NHS costs have soared.
Smyth also cites the new bowel cancer screening and HPV vaccinations for cervical cancer as treatments which do not necessarily represent the best financial logic, at least not in the short-term. He also takes issue with the "public clamour" over issues such as Herceptin, the breast cancer drug initially rejected in Scotland on the basis of cost - a ruling that was overturned after public outcry.
"The best way to deal with these emotive issues is not patient advocacy; people have got far too much on board.
Sunday Herald
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German Doctors Flee Socialized System
The Council's latest report shows that more than 3,000 medical staff, most of whom were trained in Germany, left the country in 2008. That brings the total number of German doctors working abroad to 19,000. Meanwhile, Bade points out, there are places in the eastern part of the country, the former GDR, where the lack of medical practitioners is reaching crisis proportions.
In order for the situation to change, Bade says it's crucial to take a new look at immigration laws. He suggests a system which would give priority to people who could offer Germany needed skills.
Deutsche Welle
Yeah, I'm a "Dufus." And, I guess, a "Communust." Bah.
I "know" young people that are trapped in poverty by diseases they CAN'T get treated in the U.S.
NO, they Can't "go to the ER," and get treated. The ER will run some very expensive tests (that YOU are paying for, one way or the other,) determine that the illness isn't "Immediately Life Threatening," write a prescription for a couple of day's pain meds, and send them home.
One week later, Rinse, repeat.
What some of those that would call me "Dufus" are missing is that it would be cheaper to "Treat" these uninsured (they can't get insurance for a pre-existing condition) than to keep going through the incredibly expensive cycle they're on now.
When a young gal with Endo, or Krohns walks into an ER they ARE going to run MRIs, etc. And, when they come back in two, or three weeks they're going to run them again.
No, I'm NOT arguing for a Canadian plan; but we need to take a look at Mass, for instance, to see how that's working. Don't you think?
Okay, let's bash socialized medicine.
We seem to have repeated posts about the evils of the minimum wage and socialized medicine. Fine.
How about a few on the evils of public universities? The Department of Agriculture? Or a military, that more than a decade after the collapse of the USSR, still spends horrendous gobs of money, and must make mountains out of molehills (a few dozen, or even hundred, punk terrorist means we have to have a fleet of 11 aircraft carrier groups).
There is no sovereign nation even remotely threatening our borders, and those punk terrorists who do threaten us can easily slip across the vast unguarded borders we have. An aircraft carrier means nothing to the sick-headed 9/11 terrorists, who in fact were mostly from Saudi Arabia. They slipped through our borders, and perpetrated mayhem here.
Why don't we maintain a small fleet of U.S. based bombers, and a few nuke-armed subs, stand down our military for 10 years and save $6 trillion, not counting inflation and accumulating interest?
Sorry, that's the true libertarian, free marketeer in me speaking out loud.
I "know" young people that are trapped in poverty by diseases they CAN'T get treated in the U.S.
NO, they Can't "go to the ER," and get treated.
People "trapped in poverty" in the U.S. qualify for state programs, like MediCal in California, or federal programs, like Medicaid. Got that? These programs are available to people with pre-existing conditions. No one - repeat after me - no one, is denied care, period. If you are truly in need, you can find coverage. California, where I live, has a program that pools people with pre-existing conditions and the means to purchase health care. Yes, it's more expensive but it's available.
"There is no sovereign nation even remotely threatening our borders ..."
North Korea May Fire Missile Toward Hawaii
Here's a thought, read the Constitution. The military is provided for, your socialist welfare schemes are not.
Maybe you should move to Cuba. They have a small military, good weather and "free" health care.
We'll all be happy.
I "know" young people that are trapped in poverty by diseases they CAN'T get treated in the U.S.
Ooops, I almost forgot SCHIP which covers chilren in families with incomes in excess of 200 percent of poverty and in some states has been extended to parents as well.
The program was orinally intended for people who made too much to qualify for Medicaid but still could not afford private health insurance.
It's not that liberals are ignorant; it's just that they know so much that isn't so.
-Ronald Reagan
We live in an age of unprecedented medical innovation. Unfortunately, most of today's cutting-edge research is conducted outside Europe, which was once a pioneer in this field. About 78% of global biotechnology research funds are spent in the U.S., compared to just 16% in Europe. Americans therefore have better access to modern drugs. One result is that in the U.S., the annual death rate from cancer is 196 per 100,000 people, compared to 235 in Britain, 244 in France, 270 in Italy and 273 in Germany.
It is both a tragedy and an embarrassment that Europe hasn't kept up with the U.S. in saving and improving lives. What's to blame? The Continent's misguided policies and state-run health-care systems. The reasons vary from country to country, but broadly speaking, the custodians of public health budgets aren't devoting the necessary resources to get patients the most modern and advanced medicines, and are happier with the status quo. We often see news headlines about promising new cures and vaccines next to headlines about patients who can't get life-saving drugs as politicians impose ever stricter prescription controls on doctors.
[...]
This situation is especially dire in Italy. The government has capped spending on pharmaceuticals at 13% of total health-care expenditures while letting expenses for infrastructure and staff skyrocket. From 2001 to 2005, general health expenses in Italy grew by 31% while expenditure on medicines increased a mere 1.7%. Italian patients might well have been better off if the reverse was the case, but the state bureaucrats who make these decisions refuse to acknowledge the benefits of advanced drugs.
WSJ
Am I the only one who finds it ironic that Canada's largest and wealthiest province -- Ontario -- has to send its worst-off medical cases to Detroit, the poorest city in the U.S. and to Buffalo, the third-poorest city in the country?
Even in their poverty, their medical facilities outshine the best Canada can offer. I should think Canadians would be ashamed of themselves.
Rufus,
Massachusetts health care is a great example of a system collapsing under its own weught. People are fleeing Massachusetts.
Anonymous, you are a Fool.
I have never voted for the Liberal in my life.
But, your Reagan quote was perfect. However, it applies in this case to you and the other members of the "Party of Stupid." You are mouthing about something of which you know nothing.
First Everyone doesn't live in Ca. Trust me, Mississippi is MUCH different. Second There's a "Pool in California," but what if it's priced out of reason for your income? The Door is, effectively, shut.
SChip is different in all states, but, leaves a lot of people uninsured everywhere.
You've got yours, Anonymous. Your fear is that you won't get quite as much if the poor get a little bit. You're the kind of ignorant fool that put Obama in the White House, and will probably keep Republicans out for many years.
"No, I'm NOT arguing for a Canadian plan; but we need to take a look at Mass, for instance, to see how that's working. Don't you think?"...
Who's making the claim that Mass is working and what credible material out there shows that its working rufus?
Would you care to fisk the following editorial from the Washinton Examiner rufus?
Universal coverage? First, look at the disaster in Massachusetts
Anon: We need a $600 billion military...to handle North Korea? RU Kidding? We have from fearing the USSR to pooping in our pants about N. Korea?
And what happened to S. Korea? Since they adopted a roughly free-market system (well, sort of, they have huge bank-business conglomerates) their economy is 10 times the size of N. Korea's.
Can't S Korea handle the N. Korea threat? Why is it the job of the US taxpayer?
I don't want to move to Cuba. I am a libertarian, free-marketeer. As such, I believe in the absolute minimum of government, including the military, and I deeply skeptical of government bureaucracies and their lifespans, including the military.
And the great, great R-Party President, and Five-Star General Eisenhower thought a bloated militarty-industrial complex was a serious concern.
He never moved to Cuba either.
--Benjamin
1,
I clicked on your link. All I found was an "editorial" by some unnamed editor at a newspaper I know nothing about.
The whole article was vague semi-anecdotes. No numbers. No facts. Just . . . someone's opinion. Pretty weak.
Rufus Medicaid can be found in every state of the union.
rufus bleets: "I clicked on your link. All I found was an "editorial" by some unnamed editor at a newspaper I know nothing about"...
So apparently even though you were told it was an editorial you couldn't figure it out because it was in a newspaper you knew nothing about?!?!
"The whole article was vague semi-anecdotes. No numbers"...
There were no numbers?!?!...
"No facts. Just . . . someone's opinion. Pretty weak"...
No rufus, your original, factless comment was the weak part in all this...
That's why I asked you wanted to fisk it...
Apparently you found this weak, right and numberless, right?
From the editorial:
'According to Dr. Paul Hsieh, a physician and founding member of Freedom and Individual Rights in Medicine, 43 mandatory benefits — including those that many people did not want or need, such as invitro fertilization — raised the costs of coverage for Massachusetts residents by as much as 56 percent, depending upon an individual’s income status'...
Was this also weak and numberless?
'Small businesses with more than 10 employees were required to provide health insurance or pay an extra fee to subsidize uninsured low-income residents, yet the overall costs of the program increased more than $400 million — 85 percent higher than original projections'...
How weak is this statement from the editorial?
'Government mandates — even those originally billed as “market-based solutions” — always turn into a “rights-violating road to disaster,” Hsieh says. Barack Obama’s health policy advisers should take a good look at the smoldering wreckage in the Bay State before trying to impose any such “universal coverage” on the rest of the nation'...
"Am I the only one who finds it ironic that Canada's largest and wealthiest province -- Ontario -- has to send its worst-off medical cases to Detroit, the poorest city in the U.S. and to Buffalo, the third-poorest city in the country?"
Yes Craig, you are the only one, because Ontario isn't even the top half of wealthest provinces any longer. Alberta, BC, Saskatchewan, and Newfoundland are all "wealther" than Ontario. Second, the gentleman comes from Windsor, the city which has the highest unemployment and least economic prospects outside seal-hunting communities in Canada.
If you're going to be ironic, try to use sensible facts.
Almost 50 million Americans would gladly drive 4 hours if they could get care. These are the Americans that have no health care of course.
To the last anon posting: that's nonsense. If you really need care, go to an ER. They can't turn you away. Not something I would advocate, but have you ever heard of the hospitals going under on our southern border because of non-payment for ER services?
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