Saturday, April 30, 2011

HnC Vault: Mad Docs and Englishmen

Originally published July 27, 2010

In order to make Obamacare a perfect copy of England's National Health Service, the president recently appointed Dr. Donald Berwick to preside over Medicare and Medicaid. Berwick, an enthusiastic proponent of wealth distribution, is also quoted as saying "I'm romantic about the NHS. I love it. She is such a seductress."

Which is why it's both ironic and frightening that the U.K. has just announced that it will soon be slashing and rationing even basic medical services - especially for the elderly and dying - because their healthcare system is economically unsustainable. Among the money-saying changes:

• Reduction in hip and knee replacements for the elderly.
• Reduction in cataract surgery, orthopedic surgery, and over 50 other common procedures.
• Slash care for the terminally ill, and offer them no pain management services on evenings or weekends.
• Close nursing homes for the elderly.
• Reduce treatment for the mentally ill, and penalize doctors who refer such patients.
• Reduce medical staff and number of hospital beds.
• Send patients home to die.

One expert is appalled that the revised healthcare plans "attempt to save money by leaving people in pain," and declared that it is “incredibly cruel to draw up savings plans based on denying care to the dying."

What's that, Dr. Berwick? There are Death Panels in your beloved National Health Service?

Apparently the seductress is also an executioner.

Update 4/30/2011

Today's cartoon from the vault offers a tip of the hat to jolly olde England on the heels of the Royal Wedding and reminds us that even though the United States lacks a monarchy, Obamacare promises to give us all a Royal Screwing.

Besides the ubiquitous waivers that the alleged president (we'll continue calling him that despite
the birth certificate, as we're still not 100% satisfied that Hawaii is a real state) has handed out to political cronies and lobbyist-connected businesses, the Obama administration has just okayed $6.7 billion in temporary payments to Medicare Advantage plans...even though Obamacare specifically seeks to eliminate those plans. But why?

The answer is that if those very popular plans are ended, as Obamacare demands, senior citizens will get angry and show their resentment at the polls. So by artificially keeping those programs alive, Mr. Obama gets another 2 years (or, God help us, 6 years) to get Obamacare so deeply ingrained in our system that it will be impossible to remove.

At which point, seniors with serious medical conditions will be given a jolly "pip-pip, cheerio" from our UK-style health system as they're sent home to die.



Pete(Detroit) said...

Never mind the women lying in hallways to give birth

Or the people dying of starvation

Note - these are BRITISH issues being reported in BRITISH media... I'm NOT making this up

Don't even ask me what we learned about Canadian health care workers in Detroit on 9/11... hint - 1/3 of Detroit "health care workers" are commuting from Canada.. why? Better pay, better bene's... and when we sealed the borders we found out REAL fast just how many OF them there were, stuck one side or the other of the border...

Remember - When YOU pay for your health care, you get what YOU are willing to pay for.
When the STATE pays for your heath care, you get what your NEIGHBORS are willing to pay for you to get...
Slippery slope, or wall on cliff?
Your call...
Or your neighbor's...

moronpolitics said...

True story: My parents had Medicare (for old people -- I cannot keep M-care and M-aid straight) plus Blue Cross - highest cost option; my Dad (had JUST died at this point after 43 years with FAA inspecting airline repair and maintainence -- adding in his time with post office and arm or SOMETHING he actually had a 50 year pin. They forced him out at 78 by putting his office in the basement with no one but storerooms. Anyway, Mom had great insurance and they/we were willing to pay out of pocket for this procedure coming up in our story.
She had been dying of Ovarian Cancer for awhile had no more options, great doctor but it was all over and she expected to die in something between 6 and 26 weeks, reasonably 90 days. All of a sudden she starts with these dizzy spells, not an ear infection and SHE PAYS for an MRI. NON MALIGNANT BRAIN TUMOR, "unrelated". Whatever. Point is, it's putting pressure on an artery and instead of 90-120 days she has 24-48 hours from NOW, tops then coma and death in another couple days tops.
This was NOT, as they say, what had "planned". I was going to move in with Mom in a week or so for the "duration" and had set up a leave etc and now they are saying she won't reach the weekend. She is willing to pay whatever, has been paying insurance for 40plus years and this tumor can be cut out and we reset to the aforeplanned schedule wil a 95 percent chance of perfection, childs play for the right surgeon and I've got him.
We paid, they cut, she lived another 7 weeks before she went to bed for the last week and died at home. These were the most important 6 weeks of "our" life, living back at home, talking, watching movies and TV, my wife's mini-dach came and slept in her lap etc. My mother died in my arms and while the last hour could have gone better...
My older brother wouldn't have paid. We KNOW that Pres.Obama had "Toot" put down rather than have her die a week or two later and screw up election night or inauguration or his golf day or whatever. Certainly no service would have given us those 6 weeks whether we paid or not. Read Daschles D SD book about how people make silly wasteful choices. Sorry, Obama. but I say it was her money and if she wanted to spend every penny then so be it. Depression baby, WW2 etc. I don't think she would have spent it ALL, but those 7 weeks were easily worth 100g's. they cost 80. She left about 600K for my lawyer brother and me to split. That's her RIGHT. It's called a PROPERTY RIGHT in one's self. Somebody wants to take that away from her and from me-- and from me and from my own children. That somebody better be ready to fight and I mean F I G H T, fight as in Life and Death. Think about now while you still can think clearly. The President wants to help you make good decisions early. Where's the DEATH certificate?'s going to be the new question. And how come it's already signed and dated?

Anonymous said...

After those serious posts, I almost didn't post this:

We should all prepare for the "Scotch-Irish Cure" -- drink a shot of Scotch; chase it with a shot of Irish; alternate treatments until you can't feel anything, and really don't care.

I can hear the "rim shots" coming now.


Andrew said...

At its essence, any government paid health plan has a vested interest in the cheapest outcome--which in most cases means death, with as little spent, er, 'wasted' on care as possible. Deny & delay takes on new meaning with a critically ill patient, or one with a progressive disease that past some predictable point will become fatal if left untreated.
The UK NHS is a nightmare of mismanagement, even amid a strong cultural tradition of compassion and cherishing of all life. Letting patients die to save money is built into the system. 'Death panels' are inevitable because they are essential to that system.
First heart attack at 63? Mid-level state employee nearing retirement (Soc Security liability next 25-30 years) plus state pension (second liability next 25-30 years) and nearing end of taxpaying ability. It doesn't
make economic 'sense' under any national health care anywhere to keep that worker drone, er, citizen alive. Send him home from ER with some generic pills, schedule his first 'real' cardio exam a year or 18 months out. If he's still alive then, ration care by postponing each necessary followup procedure into the distant future until nature solves your economic 'problem'. Pension and social security 'problems' solved also.

Suzy said...

Pete, that first article is not too far from the truth even here....when I had my last baby 3 1/2 years ago, I went to a hospital that was having a problem with overcrowding. Why? Because several other local hospitals could no longer afford to keep open their childbirth centers...I assume because more people were forcing the hospital to deliver for free, rather than paying or having insurance...and the government programs do NOT reimburse enough to keep the hospital running. So several closed (just the maternity parts), and that meant more people were going to the particular hospital I had chosen. I had heard stories of mothers having to do much of their labor in the hallways.

When I was there, it wasn't *quite* as bad as all that. However, I went in via ER, and it did take me a good 6-8 hours (can't remember now) to get a bed in order to get an induction.

The Medicare and Medicaid cannot even keep the system are they supposed to cover the entire country?!

Suzy said...

Oh and Pete...unfortunately it won't work like know, getting what the neighbors want to pay for...cuz I don't want to pay for my neighbor's AIDS or smoking-induced emphysema...but the government will make me. Especially the AIDS. Because its politically advantageous to them. Of course then there will be no money left to keep our white Christian grandma alive....

Stan said...

The "alleged" gag is getting old. Time to retire it.

Stilton Jarlsberg said...

@Moronpolitics- Thank you for sharing your experience. Obama loves to use personal anecdotes which support his takeover plans, but neither he nor the media share the other anecdotes, like yours, about people who have scrimped and saved and should have the right to spend their money however they want...especially to buy themselves even a little more time or comfort near the end.

But even when stumping for Obamacare, the president said we should look to "painkillers, not pacemakers" to save money. Except one treatment saves lives, and the other doesn't.

"Death Panels" will be the new and unavoidable reality under Obamacare. And the SOB knows it and wants it because it will be a political/economic "twofer" - if you don't pay to treat serious illness in seniors, you'll also save a lot of Social Security money when they die prematurely. Actually, it's a "threefer" because you'll also be killing off statistically conservative voters.

@Anonymous- Actually I thought your "Scotch/Irish" Cure would be to have a shot of Scotch and then say "Irish that bastard was never elected president."

Pete(Detroit) said...

Mpol - Thanks for sharing.
Suzy, it's not just the 'freebies' that are closing maternity wards - malpractice rates are so high for OB/GYN that no one wants to do it anymore.
And yes, why SHOULD anyone pay for someone else's free choices? How much medical services are needed purely as a result of diet / exercise, or lack thereof? If I make the effort to take care of myself, shouldn't my costs be lower?

Stilton Jarlsberg said...

@Suzy- Even the CBO has said that many medical facilities will close under Obamacare (especially those which serve seniors), so the circumstances you're describing will only become more widespread.

@Stan- Actually the "alleged president" gag was already heading for the mothballs without your prompting. I just wanted to give it a little tongue-in-cheek send off in today's commentary. On the other hand, I might still refer to the president as an alleged budget-cutter, alleged Christian, or alleged male.

@Pete(Detroit)- Tort reform would go a long way to bringing down medical costs and keeping physicians in practice...and it wouldn't cost the taxpayers an effing dime. But it would cost the Democrats campaign donations from the trial lawyers, and so it's been taken off the table. Maddening.

And the point that you and Suzy make about the results of "free choice" are compelling. Why should my insurance rates go up because of the high risk behaviors of others? Once again, as it nearly always does with liberals, we see a desire to remove consequences from personal which point the system has also removed the disincentives for bad behavior, or rewards for good behavior.

It's a simple equation: tax what you want less of, and send tax dollars to what you want more of. Unfortunately, our system is increasingly bass-ackwards.

John the Econ said...

It's sad that even with the Internet making it so free and easy, people don't make the effort to see how this all works out in other countries that are living it. Just read the British and Canadian newspapers for a few minutes each morning. If their systems are so wonderful, then why are the number subject of the front pages nearly every single day? Our supposedly awful and unfair system doesn't even get that much attention.

As for personal "property rights": They simply do not exist under socialism. When the government gets to run the entire health system, (as opposed to the 50% it runs now) we will all be slaves to the state. Literally.

Andrew said...

Illegal immigration and 'open borders' place a huge overload on public medical infrastructure, and play a huge role in crashing the system, both locally and nationally.
Another example of how insanely suicidal 'open borders' is. But for Obama and his tools, the sooner they can crash the existing system, the sooner we peons can be reduced to being beggingly THANKFUL, with no other medical system remaining, for even the miserable crumbs of Obamacare.

Suzy said...

John the Econ, the bad thing is that there are people in Canada who really do like their health system...but its because they have not seen the bad side of it yet. I got a surgery a few years ago, paid for by my insurance....and the time from the first visit until my surgery was like 3 months and that only because I had some complications in some pre-op testing. On a discussion board I was a part of, the Canadian people wanting the exact same surgery had to wait at least a year....the lucky ones, only 6 months.

People in Canada and England do not know how bad their system is until they really really need help...and by then, its too late.

Which is how its going to be here too! People are going to go along thinking everything's cool until their favorite gramma gets cancer and cannot get prompt treatment, or until their father breaks a leg and has to sit in a hospital hallway for 8 hours before getting help...and then there's nothing anybody can do about it.

HeroHog said...

They could at least allow us to die with dignity! We put down sick animals don't we? Not to do so is considered cruel and hateful! If we are going to do this, the very least you can do is provide for a legal way to end your suffering and the "drain on society" by allowing some form of euthanasia for the terminally ill.

Doktor Paulie said...

SJ: the "alleged president" gag may be headed temporarily for the mothballs, but to the extent that it accurately describes the man it should be re-deployed at suitable intervals. Not that we WANT him to lead or do anything beyond take vacations or play basketball...

MPol: thanks for that wonderful story about your mom. You made my day. Agree, anyone who tries to take that sort of option, I can't think of a more appropriate term at the moment, away from us had better be ready to fight. Life and death, big bore.

Speaking of which, I live in Texas and have a concealed handgun license. Whenever and wherever it's legal to do so, I commonly carry a .44 magnum in the left pocket of my vest and a .45 auto in the right pocket. If two guns were good for Doc Holliday, they're good for me. They aren't quite as easy to carry as some itty-bitty 9 or .40, but it's not particularly difficult, and there's just nothing like heavy artillery when the ball opens. Clears the sinuses nicely, too.

Earl said...

I imagine the "pink shot" will be here sooner rather than later. I can think of some dire situations where it could be the right choice for a family to make with their doctor, but I fear how it is more likely to become not a choice, but the "final solution" for keeping costs down. Remember how legal abortions were touted as being safe but rare. Yeah.

Doktor Paulie said...

Oh, and I do NOT drink and carry. Screamingly bad idea. The only thing I can think of that's worse is to vote for any liberal (dem, rino, whatever) anywhere, anytime.

Stilton Jarlsberg said...

@John the Econ & Andrew- You've got it exactly right. Full implementation of Obamacare will make us wards of the state, which is what I've always claimed: this "healthcare reform" isn't about healthcare, it's about power. Absolute power.

And "crashing the system" with illegal immigrants and others who don't pay into the system, as well as reducing payments to doctors, is all part of the plan to eliminate anything BUT government-only healthcare. For all of the Obama administration's claims that they hate torture, watch how quickly they'll be willing to let their political enemies (or anyone simply useless to their agenda) suffer in unneeded agony.

@HeroHog- You bring up another HUGE issue. Personally, I support the idea of euthanasia... but have tremendous fears about how it might be implemented. Compare it to the way abortion has become common and abused and destructive to the very way we all view "life."

Now think of the ways that well-intended euthanasia legislation could be abused (including greedy relatives trying to talk Grandma into taking the "quick way out" in order to leave an inheritance). And don't forget that part of Obamacare is the regular "end of life planning" review, in which government questioners will ask the elderly how they feel about "being a drain on your children" before presenting treatment options.

Watch Edward G. Robinson's death scene in Soylent Green for a truly frightening look at how the government euthanasia system could be sanitized and implemented.

@Doktor Paulie- Oh, I'm sure you'll continue to see the word "alleged" around here from time to time until the president actually becomes truthful about his actions and intentions.

@Earl- I believe you're referring to the shot we give our beloved pets "when the time comes." If it's mercy for them, it seems pretty clear that it could also be mercy for humans in similar circumstances. But as I said (and you do too) the possibilities for abuse are terrifying.

And what happens when the majority of voter/taxpayers decides that the elderly ill, like the "almost born," are simply inconvenient masses of tissue who can be done away with without a second thought?

Doktor Paulie said...

SJ: I agree totally that the terrible problem with euthanasia is that it brings us to the edge of a precipice that it's far better to avoid. For all the good that it might do, the easy likelyhood of vast harm thereby opened would far outweigh the good. An example: alleged benign and wise government officials being empowered, once the basic concept of euthanasia was accepted, those wise ones being empowered to make euthanasia decisions based on "quality of life" judgments. Or based on "usefull life remaining" judgments as costs increase.The elderly, the mentally impaired, the disabled, anyone not considered a useful and productive member of society. So on. Look at Holland as a specific illustration. No thanks. If I need to depart, I can handle the task. I don't need some bureaucrat or his executioner to hurry things along.And with proper pain management measures there will usually be little need for euthanasia to relieve actual suffering. Enacting euthanasia is like using h-bombs for urban renewal. It sure clears the slums, but, golly! The collateral damage!

Suzy said...

I dunno if animal euthenasia is a very good likeness (or maybe it IS...)...after all, it may be "humane" but its used as number control in shelters by the hundreds and thousands every day.

Something to think about.

I do have big questions about the millions and millions of dollars spent every week on machines that are keeping people alive....but it would be far too deep of a discussion to carry on here. In a nutshell, though, being kept alive on a machine for months on end seems to be a luxury that should be paid for, not expected as a basic human right....but I refrain.

Suzy said...

Yikes the above post makes me sound anti-life...I'm actually about as pro-life as one can get....I'm anti euthenasia as well...however I'm also anti-sponging-off-the-government-to-live-on-a-machine too. Okay I'll shut up now....

Doktor Paulie said...

Right, Suzy! Much as we love our pets, they are animals and not people so there IS a fundamental difference. With a living will, someone CAN have extraordinary life support measures stopped. But this is not a huge drain on the resources of society anyway. When in doubt, keep them plugged in. But opening the door to positive measures to end an otherwise, even temporarily, viable life - euthanasia - opens the door to, well, words fail me.

I do not want to give any bureaucrat the power to make any such life and death decisions, or any initial authority that can lead eventually to such power, because I have never yet seen any bureaucrat anywhere that did not exercise their authority to the max, seek new ways to extend their authority, and hungrily pursue all possible enlargements of the scope and freedom of the exercise of any authority they had. They metastacize!

Doktor Paulie said...

Sorry everyone, not to hog the bandwidth, and not to drift too far afield, but in a followup on my earlier snarky comment about "itty-bitty 9's" and so on, a good solid hit with even something as small as a .22 is worlds better than harsh words, should the need arise, God forbid. "I think therefore I am armed."

moronpolitics said...

"Why should my insurance rates go up because of (fill in the blank) of others? Hello? Reality calling?? What do you think insurance is? It is NOT like the old xmas clubs where you put in 20 dollars a month and SHAZAM! in December you have 240 dollars to spend for xmas. You are pooled with those "others" and your rates go up AND down because of the behaviours and/or dumb luck of your group. It'
s like the lottery. MOST people lose, but not a whole lot. A few people win and they win big. In this case "winning" is getting cancer. Get it?

Stilton Jarlsberg said...

@moronpolitics- You're right, all insurance is a risk pool in which most people won't get out what they put in (which is what makes it work). But the system gets badly skewed when the government tries to add 30 million people to the "insured" roles without having them pay a freakin' penny towards their policies, and offers subsidies of $20kP+ to everyone below a certain income level. My rates will skyrocket because I have to pay for those who pay nothing at all.

Pete(Detroit) said...

Doktor Paulie - I like BIG 9's - I'm a fan of High Capacity... ((-'pb
8 - shot .357's are fun too, but the wheel gets REALLY big...

And yes, the .22 you can HIT with is more useful than the .45 you can't (or left in the car...) Fired a .45 the first time about a year ago - was really surprised how mild the recoil was.

MPol - I don't mind so much being tossed into the pool for 'catastrophic' coverage - cancer, for instance, or severe injury. Those things are pretty accurately estimated on an 'event per 100k people' kind of basis. And people who have 'high risk' hobbies / lifestyles (skydivers and race car drivers jump to mind) have higher premiums. But for basic, routine stuff - checkups, etc - we'd all be far better off to just dump the insurance, and pay cash. Medical IRA anyone? what you don't spend, you keep? Get people invested in their health? (you think they would be, but given how many people don't even brush / floss regularly... )
And you're right - we would NOT "all" be better off - the indigent, destitute and those with skewed priorities (no, I don't have insurance, but I've sure got beer!) will be in the same position, abusing / clogging the system, that they are now.

John the Econ said...

Suzy: People who only think of health care in terms of not having to pay anything directly out of their pocket think that it's wonderful. Are these the people we really wish to have driving policy?

Actually, your pet in Canada is likely to get faster service than you are.