US Healthcare Reform

[Stoday]

Gosh! I never realised that you had a separate health service for American Indians. Why is it different from everyone else?

[BigSky]

In treaties with various Indian tribes they were provided with health care and is given to all recognized tribes.

So most reservations have health care provided or funded by the US government on their reservations.

Even off the reservation in some areas there are IHS funded Indian Clinics to provide some basic needs.

However Indians are free to use the same system as anyone else if they wish, they just have to pay for it like everyone else.

[kristina]

I was not sure where to put this thought: News Article (Te: UK outrage...) or Healthcare Reform?
Here it is:

Many NHS/GP’s/doctors/specialist do not appear as if they respect
NHS-patients and they use them as guinea-pigs without consideration.

I have been trying very hard to find a rheumatologist/nephrologist who can
medically stop my Lupus/SLE-flare-up destroying my kidneys (kidney-function ~10%).

Some of the specialists I have contacted (in other countries) informed me, that
they were assured by NHS-authorities that I am being medically cared for under the NHS.

That is not true, I have not  seen a NHS-GP for almost 6 years
& I am under no NHS-specialist/rheumatologist/nephrologist.

In fact, I have not been informed by any NHS-doctor about dialysis, transplant etc. or anything else.

Furthermore, a medical letter (11th April 2005) states, no NHS-specialist with medical expertise/experience
can be found in the UK to treat my Lupus/SLE/MCTD. In other words, the letter states clearly that
I have no medical treatment because there is no medical expertise under the NHS to treat my Lupus/SLE/MCTD.

Why are specialists in other countries, who are willing to help me medically,

told that I am medically cared for under the NHS when the truth is
 
that I have no NHS-medical care and no NHS-GP/doctor/rheumatologist/nephrologist to go to?

[BigSky]

Find out from those doctors in another country whom they talked to with NHS.  From there confront that person within NHS and tell boldly ask them why they are telling the doctors in other countries saying you are being treated when in fact you have a letter from NHS stating you are not in fact being treated because there is no medical expertise under the NHS system to treat you and in fact you havent been able to get treatment in the past 6 years.



If anything contact another doctor out of country, tell them of the problems and forward a copy of the letter about not being able to get treatment but that NHS openly lies to outside doctors telling them you are being treated.

[kristina]

I always include a copy of the medical letter (dated 11th April 2005) which states there is no medical expertise in the UK-NHS to treat my SLE/MCTD. My application is to receive health-care & treatment to stop my SLE/MCTD-flare-up destroying my kidneys further. My kidney function is only 10% now.

This letter of 11th April 2005 is vitally important, because the NHS-Medical-Chairman of my District NHS-Health-Authority (who happens to be the NHS-GP with whom I am registered with & whom I have not seen for almost 6 years now...no other NHS-GP in my district lets me register with them...) explains very clearly, that I do NOT receive NHS-medical care and it explains a lack of expertise/experience to treat my Lupus/SLE/MCTD in the UK; this letter of 11th April 2005 also explains, why my Lupus/SLE/MCTD was NOT diagnosed in the UK in the first place.

This letter of 11th April 2005 is backed up by a proceeding letter (30th March 2005) by Professor L.T. Gilmore formerly of the Royal College of Physicians, that “it looks as if all avenues have been explored” for me to receive NHS-health-care in the UK.

No solicitor/lawyer in the UK takes my case.

I have been told on the phone on 4th November 2003 by Ms Lee Morris (Personal Secretary to Sir Liam Joseph Donaldson) that the NHS-GP with whom I am registered with, informs people, who enquire about my well-being, that he provides me with NHS-medical care. Not true. This NHS-GP also tells people that he gives me regular check-ups on the NHS. Not true. I have not been to his NHS-Surgery for almost 6 years. This NHS-GP is also the NHS-Chief Medical Adviser to my NHS-Health-Authority and no other NHS-GP in the district lets me register with them. I am registered under the NHS with the Chief Medical Adviser to my Health Authority (PCT) & do not receive NHS-health-care in my ESRF. Unfortunately no one challenges this NHS-GP’s misleading statements.

I have read that some NHS-GP’s have up to three thousand NHS-patients registered with them in their NHS-Surgery. They get paid by the Health-Authority (& government) for every NHS-patient who is REGISTERED with them...but no one checks-up whether these registered NHS-patients do receive NHS-health-care. It is my experience that NHS-GP’s/doctors/specialists do not take the time/are not medically interested to medically care for NHS-patient with a rare, chronic, genetically inherited disease (in my case Lupus-SLE/MCTD with very rare components).

... It is very easy for NHS-GP’s/doctors to behave in an abusive manner towards a NHS-patient like myself. I already have been totally traumatized by past experiences of medical negligence, medical catastrophies, very abusing NHS-GP’s/doctors etc.
NHS-GP’s/doctors “only” have to behave in an abusive manner towards me to make sure I would never ever enter their NHS-Surgery again. They get paid by the NHS annually to have me registered with them, whilst doing nothing medically for me and no one cares. To back themselves up they “only” have to send me by post a letter like the one from 11th April 2005, stating there is no medical expertise in the UK-NHS to treat my SLE/MCTD.

There is no NHS-authority to investigate and no solicitor/lawyer takes my case.

Because of my first kidney failure in 1971, I have been registered with “the best NHS-nephrologists” in London from 1980-1995. None of them investigated my medical symptoms or my ill-health, and that is why my SLE/MCTD was not diagnosed in the UK despite the fact that these NHS-nephrologists knew how I suffered: kidney failure in 1971, ten years later cerebral haemorrhages, chron. osteomyelitis and in 1991 the stroke. It never occurred to these NHS-nephrologists that there was a medical reason for my ill-health and medical catastrophies at a very young age. I suffered because I had no NHS-medical care when I needed it.

I was told by Sara, on Friday, 5th September 2003, on her very last day of work at my NHS-Health Authority (PCT) in London, (before she returned to Australia), that it was well known I was being discriminated against, and NHS-PCT-Chief Executive Paul Haigh knew about it. (I do not comprehend, why he should have an interest in me being discriminated against, but that is what Sara told me). She also told me on the phone it was well known that I was being sent to useless NHS-medical-appointments, so that it appeared as if I was receiving NHS-health care, but it was known these appointments were of no medical value to me whatsoever. She told me she felt sorry for me. That was on the 5th September 2003. If I can locate Sara and if she is willing to testify there is still no solicitor/lawyer in the UK to take my case. The NHS does not seem to tolerate criticism & there is no lawyer in the country to fight for the human rights of a NHS-patient in ESRF to receive medical care.

On 23rd September 2003 I received a letter from Miss Lee Morris, Personal Secretary to Sir Liam Joseph Donaldson, NHS-UK-Chief, informing me that my “difficulties to receive healthcare are being investigated” and that my NHS-Health Authority is aware that Sir Liam Joseph Donaldson has an interest in the outcome of the investigation. To my knowledge nothing was ever investigated and I know of no outcome except that I am in a Lupus/SLE-flare-up causing my ESRF, without NHS-medical care and without any NHS-GP/specialist/rheumatologist/nephrologist to go to, but with a letter of 11th April 2005 confirming there is no NHS-specialist with medical expertise/experience to be found in the UK to treat me.

When I complained about dirty NHS-Hospital rooms, useless NHS-appointments, men & women-patients cluttered in the same NHS-Hospital room in their beds without any dignity, abusing NHS-GP’s, abusing NHS-doctors, drunken NHS-doctors, bad NHS-health service, No NHS-GP/specialist for medical NHS-care for over 13 months after suffering a stroke, abuse before suffering a stroke, terrible abuse whilst in Hospital with the stroke, no NHS-health-service, no NHS-stroke-rehabilitation, no NHS-information about dialysis or transplant in my current ESRF, no NHS-nephrologist to go to in my ESRF, no SLE/MCTD specialist who could try to stop my SLE/flare-up destroying my kidneys further etc, no NHS-eye-specialist, no NHS-gynaecological examination for over 7 years, etc... I am always told that on the NHS “you pay nothing ... therefore:  you expect nothing and get nothing...” and “there is no such thing as a free lunch...”

My very serious complaints have been “investigated” by Ombuds”man” Ms Abraham, Health-Care Commissioner Miss Warner, Miss Sally Taber and many others, stating  that they cannot find fault with the medical and personal abuse on my person through the NHS. How can I possibly put my trust into such a health-service?

 I have tried to ask private health Insurances for help, but – even if I would be able to afford it now - because of my terrible health history (first kidney failure when just over 17 years old, ten years later cerebral haemorrhages, then in 1987 chronic osteomyelitis, a stroke in 1991 and now ESRF), private Health Insurance Companies in the UK would not allow me to register with them.
 
The only chance I see is to find a SLE/MCTD-specialist in another country who is willing to assist me to stop my SLE-MCTD-flare-up destroying my kidneys further.
I don’t know how much time there is left, because I know from privately paid blood-tests that my kidneys only function now ~10%....

[kitkatz]

In my humble opinion: we are screwed.

[kristina]

Hello kitkatz, I have just googled what your expression means
and I believe you summed it all up in one short sentence:

"Screw-up" (the noun)  = a big mistake.
"To screw up" ............. = to make such a mistake.
"Screwed up" .............. = something which has been severely damaged and/or very poorly designed.

Thanks for your understanding... the question is now: why has it been so severely damaged and/or so very poorly designed?

[ahamner]

Patients 'routinely neglected' at NHS hospital where hundreds died in squalor
By Fay Schlesinger, Andy Dolan and Tim Shipman
Last updated at 12:02 AM on 25th February 2010
•   Up to 1,200 patients died unnecessarily because of appalling care
•   Labour's obsession with targets and box ticking blamed for scandal
•   Patients were 'routinely neglected' at hospital
•   Report calls for FOURTH investigation into scandal
Not a single official has been disciplined over the worst-ever NHS hospital scandal, it emerged last night.
Up to 1,200 people lost their lives needlessly because Mid-Staffordshire NHS Trust put government targets and cost-cutting ahead of patient care.
But none of the doctors, nurses and managers who failed them has suffered any formal sanction.
Indeed, some have either retired on lucrative pensions or have swiftly found new jobs.
Former chief executive Martin Yeates, who has since left with a £1million pension pot, six months' salary and a reported £400,000 payoff, did not even give evidence to the inquiry which detailed the scale of the scandal yesterday.
He was said to be medically unfit to do so, though he sent some information to chairman Robert Francis through his solicitor.
The devastating-report into the Stafford Hospital-shambles' laid waste to Labour's decade-long obsession with box-ticking and league tables.
The independent inquiry headed by Robert Francis QC found the safety of sick and dying patients was 'routinely neglected'. Others were subjected to ' inhumane treatment', 'bullying', 'abuse' and 'rudeness'.
The shocking estimated death toll, three times the previous figure of 400, has prompted calls for a full public inquiry.
Bosses at the Trust - officially an 'elite' NHS institution - were condemned for their fixation with cutting waiting times to hit Labour targets and leaving neglected patients to die.
But after a probe that was controversially held in secret, not a single individual has been publicly blamed.
The inquiry found that:
• Patients were left unwashed in their own filth for up to a month as nurses ignored their requests to use the toilet or change their sheets;
• Four members of one family. including a new-born baby girl. died within 18 months after of blunders at the hospital;
•  Medics discharged patients hastily out of fear they risked being sacked for delaying;
•  Wards were left filthy with blood, discarded needles and used dressings while bullying managers made whistleblowers too frightened to come forward.
Last night the General Medical Council announced it was investigating several doctors. The Nursing and Midwifery Council is investigating at least one nurse and is considering other cases.  Ministers suggested the report highlighted a dreadful 'local' scandal, but its overall conclusions are a blistering condemnation of Labour's approach to the NHS.
It found that hospital were so preoccupied with saving money and pursuit of elite foundation trust status that they 'lost sight of its fundamental responsibility to provide safe care'.
Health Secretary Andy Burnham accepted 18 recommendations from Mr Francis and immediately announced plans for a new inquiry, to be held in public, into how Department of Health and NHS regulators failed to spot the disaster.
But Julie Bailey, head of the campaign group Cure the NHS, condemned his response as 'outrageous' and backed Tory and Liberal Democrat demands for a full public inquiry into what went wrong.
Tory leader David Cameron said: 'We need openness, clarity and transparency to stop this happening again.' Gordon Brown described the scandal as a 'completely unacceptable management failure' and revealed that the cases of 300 patients are now under investigation.
He told MPs the Government was belatedly working on plans to 'strike off' hospital managers responsible for failures. The hospital could also lose its cherished foundation status.
Shadow Health Secretary Andrew Lansley said 'These awful events show how badly Labour has let down NHS patients. It should never again be possible for managers to put a tick in a box marked "target met" while patients are pushed off to a ward and left to die.'
The Francis probe was launched following a Healthcare Commission report on Stafford Hospital in March last year. It found that deaths at the hospital were 27 to 45 per cent higher than normal, meaning some 400 to 1,200 people died unnecessarily between 2005 and 2008.
 Two weeks before the report's publication, the Trust's chief executive Martin Yeates was suspended. He eventually resigned in May after being offered £400,000 and a £1million pension pot.
•   Cheerleader has leg amputated after doctors dismiss cancer as 'growing pains'
The Francis report said staff numbers were allowed to fall 'dangerously low', causing nurses to neglect the most basic care. It said: 'Requests for assistance to use a bedpan or to get to and from the toilet were not responded to.
'Some families were left to take soiled sheets home to wash or to change beds when this should have been undertaken by the hospital and its staff.' Food and drink were left out of reach, forcing patients to drink water from flower vases.
While many staff did their best, Mr Francis said, others showed a disturbing lack of compassion to patients.
He added: 'I heard so many stories of shocking care. These patients were not simply numbers. They were husbands, wives, sons, daughters, fathers, mothers, grandparents. They were people who entered Stafford Hospital and rightly expected to be well cared for and treated.'
Family who lost four loved ones
Kelsey Lintern was at the centre of one of the worst tragedies in the hospital’s appalling catalogue of failure.
She lost four members of her family within 18 months, her grandmother, uncle, sister and six-day-old baby.
Mrs Lintern, 36, almost became the fifth victim when a nurse tried to give her pethidine while she was in labour, despite her medical notes and a wristband clearly stating she was allergic to the drug.
The horrific story began in January 2007 when her baby daughter Nyah had to be delivered by her own grandmother because a distracted midwife was not looking.
The baby was not breathing but she was resuscitated, then discharged by a junior paediatrician just two days later, despite the family’s fears she was seriously ill.
She was not feeding properly and still appeared blue. She died four days later. A post-mortem examination revealed four holes in her heart. Mrs Lintern accepts that Nyah may have died in any case, but said the hospital should at least have ‘realised there was a problem’.
It was when she was in labour with Nyah that a nurse arrived with a syringe of potentially-fatal pethidine, oblivious to the fact Mrs Lintern was allergic to it.
In April 2007, Mrs Lintern’s sister, Laurie Gethin, 37, died of lung, bone and lymph cancer, which had taken 18 months to be diagnosed, even though she was displaying tell-tale symptoms.
Her body, with her eyes still open, was left on her blood-splattered bed in full view of other patients. Tests revealed that Mrs Gethin had ‘markers’ in her blood which can indicated cancer.
But it was only when she was sent for a scan at another hospital that tumours were discovered. Mrs Lintern’s uncle, Tom Warriner, 48, died in January 2008 after his intestine was accidentally pierced in an operation for bowel cancer.
A coroner ruled the death was accidental. That summer, her grandmother Lilian Wood Latta, 80, died hungry and dehydrated after suffering a stroke. She was left in her own excrement during her final days and the family said the dehydration was caused by staff failing to give her adequate fluids.
Mrs Wood Latta had been referred to the hospital by her GP after suffering a series of mini-strokes at home. She was moved between wards three times, and it was left to relatives to change her incontinence pads.
Her dying wish had been to see Mrs Lintern’s new baby Khalen, so, after checking with staff, Mrs Lintern took her daughter in. But as the frail pensioner held her great-grandchild, a nurse appeared and said: ‘What on earth is a baby doing here? You do know we’ve got MRSA and C-Diff on this ward?’
Mrs Lintern, who lives in Cannock, Staffordshire, with husband David and their two daughters, said: ‘It is called the caring profession. But where is the care?’
James Reay died in agony after a junior doctor at Stafford Hospital failed to check his medical history and gave him the wrong drug.
The 67-year-old former miner was admitted to A&E in May 2006 with a swollen leg. Medics administered the anticoagulant Heparin – but failed to take into account Mr Reay’s history of stomach ulcers, which are known to react badly to the drug.
Two days later he was rushed to another hospital where he died from internal bleeding after three weeks of intense pain. Yesterday his widow Olwen won a five-figure pay-off in an out-of-court settlement after Mid Staffordshire NHS Trust admitted liability.
Mrs Reay, 69, said: ‘I have won my case but to me it is blood money and I cannot enjoy it. I would rather have my husband.’

[MooseMom]

Just some random thoughts and/or observations;

1.  I am not sure why those people who are afraid of "government control" of health care in the US are so willing to submit to "corporate control".  I can understand not wanting the government to be in the decision making process that should exist only between a doctor and patient, but I don't understand the corresponding willingness to allow a profit-making business get to decide which procedures or which drugs you should have access to.

2.  I am currently undergoing the pre-transplant process which involves getting lots of tests done.  I can't just go to a lab and have these things done.  No, I first have to get permission from a corporation...my health care company.  This seems so anti-American to me.  We yabber on about how we love our freedom, yet we allow a bunch of suits to decide how much dialysis we get.  Do you ever wonder why, if frequent dialysis is so good, we don't get it in a clinic?  It's because three days a week is all insurance companies will pay for.  So much for freedom and liberty.

3.  An insurance company is there to make a profit, no more and no less.  They do not see you as a suffering patient.  They see you as a liability, as a threat to their bottom line.  All businesses in our capitalist economy that we so cherish are there to make a profit.  They are there to maximize profits by increasing income (raising your premium) and reducing costs (denying your claims).

[MooseMom]

4.  We have all heard that we should let our access to health care be governed by the rules of the free market.  In a truly free market, there is wide competition and choice of demand.  In other words, I get to decide when I want new shoes.  I can decide to just hang on to my old ones.  Or, I can decide to get the cheapest ones.  Or, I can get Manolos.  I get to choose.  I can even go barefoot if I truly want to.  My life doesn't depend upon it.  Then, I can go to a huge variety of shops to get the shoes I want.

Our health care "market" is not free.  How many of you have chosen to become ill?  None, I suspect, so you are being forced to buy a product that you don't really want under normal circumstances.  Now, how many of you have done lots of research and have decided exactly what kind of treatment you will get and from which set of doctors?  I suspect that many of you don't have a choice of insurance company...you have your coverage through your employer, and IT IS YOUR EMPLOYER that gets to choose how you access health care in this country, NOT YOU.  And if you have a pre-existing condition and can get health care, it will most likely be under an HMO, and THEY get to choose your PCP.  Again, this seems very anti-American to me.  Again, so much for liberty and freedom.

[MooseMom]

5.  When I first moved back to the US, I bought my own annual policy.  One week before expiration, I landed in the hospital.  I accrued $25,000 in claims.  The insurance company ended up denying my claims for all sorts of made up reasons.  I went through their arbitration process, but they stonewalled me and never again communicated with me.  I sued them and won.  Are all of you that willing to let your health care be treated so dismissively?  Do you really trust corporations that much?

6.  How many of you know exactly how much your healthcare costs?  The last time you were in a hospital having surgery, did anyone ever come to you with a price list of all treatments/procedures/drugs and ask you which ones you'd like to purchase?  When some doctor you never heard of sticks his face in your room and asks how you are doing, do you get to say, "No, I don't choose to partake of your services, so don't send me a bill, thank you very much"?  No, because this is NOT a free market.  You are being forced to buy goods and services that you may not even need.

7.  If you are so eager to put a cap on medical malpractice suits, that's fine, but don't complain if in the future, some medical mistake gives your kid brain damage and you have to pay for his care out of your own pocket for the rest of your life.

[MooseMom]

8.  If you do not want to buy health insurance, then don't expect me to pay for you when you have an accident.  The young and healthy may not think they will get ill, but they are often the ones who are in accidents.  Anyone who for any reason may have to ever see a doctor should pay for health insurance and should contribute to the pool. 

9.  If you don't want any government interference in your health care, opt out of Medicare and see where that gets you.

10. All of this is moot as long as medical costs soar.  We all pay, one way or another, and as long as medical costs keep rising so quickly, this debate will never be resolved.

11.  Bottom line, it is immoral for the United States of America to let corporate interests decide the health of our nation.  The Supreme Court's recent decision regarding the "personhood" of Corporate America is profoundly disturbing because it allows corporations to be treated as PEOPLE.  You may hate the idea of "big government", but constitutionally, our government is by the people and for the people.  A Corporation is for the profit for a few of the people, and if this is who you want making your health care decisions, then America is no longer representative of the ideal set out by our Constitution.  Our current health care/insurance system is utterly and profoundly anti-American.

[Stoday]

The UK national health scheme may have disadvantages compared to the USA but the perverse incentive to increase the number of surgical procedures isn't one of them.

I find the fact that 40% of children in the USA undergo cosmetic surgery astonishing. It's evident that this is entirely unnecessary because the corresponding rate in the UK is 1%.

[glitter]

The UK national health scheme may have disadvantages compared to the USA but the perverse incentive to increase the number of surgical procedures isn't one of them.

I find the fact that 40% of children in the USA undergo cosmetic surgery astonishing. It's evident that this is entirely unnecessary because the corresponding rate in the UK is 1%.

I would like to know where that stat came from- I think that is a gross exaggeration op., maybe among the rich- but not average kids-no way.

[Stoday]

It does indeed appear to be a gross exaggeration, glitter. So I checked out the statistics with those on the World Health Organisation's web page.

The rate for the USA is 37.8%; corresponding statistic for the UK is 4.1% according to the WHO. So I guess my initial figures were sexed up a bit.

[glitter]

still- there is no way 37 % of kids are getting cosmetic surgury no way- thats almost half  - my kids are very popular and have tons of friends, they went to a 3000 kid highschool ( they graduated last year) and I asked them and they have never heard of anyone in their school doing it either. but 37% might WANT it- its too expensive and I cant see parents struggling to send their kids to college paying for it. Maybe a few here and their but over 1/3- I dont beleive it.

[Stoday]

The incidence does vary from one state to another. Florida is a state with low incidence, half the average for the whole of the US. States with double the average are HI; IA; KY; MI; NE; WV and WI.

I can understand your disbelief, glitter. This medically-unnecessary non-therapeutic surgery is euphemistically given a name that's different from my choice of "cosmetic". That's why such an outrageous procedure is so widely accepted.

Have a look here: http://www.cirp.org/library/statistics/USA/state-by-state/

[Zach]

The rate for the USA is 37.8%

 

[MooseMom]

Oh, wait a minute.  I looked at that link, and those were statistics for "medically unnecessary" infant circumcision.  If you want to call that "cosmetic surgery", that's fair enough, but you need to be clearer on your definition.

[Stoday]

You have a point moosemom.

I had equated "medically-unnecessary non-therapeutic" with "cosmetic". Cosmetic surgery would have a theraputic value.

[kitkatz]

We, the taxpayers, are so screwed.