Newsletter – June 22, 2012

Vermonters for Health Care Freedom

Vermont Single Payer Advocates: Bigger is Better 

VTDigger ran an excellent story about global budgets, hospital budget cuts and Vermont’s reforms. The authors of Vermont’s reforms promote the path of centralized control, reduction in the number of practicing specialists and aggregation of health services into the large hospitals and Accountable Care Organizations, or ACOs, as the best means of containing health care cost increases. This assumption is disputed by the findings of a study conducted by the Massachusetts Attorney General’s Office and recently presented to the Green Mountain Care Board. See the story below for more information on this study.

The VTDigger article by Alan Panebaker is here: http://vtdigger.org/2012/06/18/with-eye-toward-changes-hospitals-mull-where-to-trim/

***

Massachusetts Study: Bigger is Costlier

Last week Newsletter drew attention to a study conducted by the Massachusetts Attorney General regarding the cause of disparities in health care prices among Bay State hospitals. The links below will take you to the study itself and a commentary written by VHCF’s Jeff Wennberg on the implications for Vermont’s reform. The report found no correlation between providers paid through global budgets, or risk-sharing contracts, and those paid through the traditional fee-for-service method. Indeed, the report states,

“Contrary to what one might expect in a risk-sharing contract, some risk-sharing provider groups are among the highest cost providers in the state. The lack of correlation between payment methodology (e.g., fee-for-service versus risk-sharing payments) and [total medical expenses] has important implications for payment reform initiatives.”

Will Vermont seek to learn the real causes of cost increases, or will our leaders continue to ignore the evidence from Canada and studies like this one and implement measures that are doomed to fail?

The Massachusetts’ Attorney General’s report is here: http://www.mass.gov/ago/docs/healthcare/final-report-w-cover-appendices-glossary.pdf

VHCF’s commentary is here: http://vthealthcarefreedom.org/sites/default/files/06-20-12%20MA%20OAG%20Report%20Oped.pdf

***

Dean sees Supreme Court Defeat as Door to Single Payer

Former Vermont Governor Howard Dean hopes to see the Affordable Care Act’s individual mandate tossed out by the Supreme Court, according to the Huffington Post.

“If this individual mandate gets thrown out, it is an opportunity for us to organize right away,” Ellison said. “We’ve got to go in, we’ve got to shape the debate right away, because the issue will be, ‘If not this, what?’ Well, the “what’ is single payer health care. We’ve got to prepare ourselves to literally pounce.”

The full Huffington Post article is here: http://www.huffingtonpost.com/2012/06/19/howard-dean-individual-mandate_n_1609171.html?utm_hp_ref=email_share#s=809599

***

Samuelson: ACA is “Dreadful Pubic Policy

The Washington Post carried a column by Robert J. Samuelson listing the reasons why the ACA is “dreadful public policy:”

• It increases uncertainty and decreases confidence when recovery from the Great Recession requires more confidence and less uncertainty.

• The ACA discourages job creation by raising the price of hiring.

• Uncontrolled health spending is the U.S. system’s main problem — and the ACA makes it worse.

• Obama’s program also worsens the federal budget problem.

• The ACA discriminates against the young in favor of the old.

Vermont’s Green Mountain Care single payer experiment shares or expands upon many of the same attributes as the ACA.

The full column is available here: http://www.washingtonpost.com/opinions/robert-samuelson-the-folly-of-obamacare/2012/06/17/gJQAf5o1jV_print.html

 

***

Socialized Health System in Greece Headed for Collapse

Reuters carried a story titled “Greek health system crumbles under weight of crisis,” detailing the collapse of the Greek government controlled health system in the midst of that nation’s economic crisis. The situation there reads like a description of government-controlled health care in George Orwell’s “1984”. Even basic examining room supplies are unavailable; one oncological radiologist reported that the shortage of examining table paper has forced them to use and reuse bed sheets, which are shared by multiple patients. Greeks had long adopted the growing Canadian practice of bribing doctors and health officials for better or quicker care, but with unemployment soaring many Greeks can no longer afford the payments:

“Even before the crisis, public hospitals were under strain and the notorious cash-filled “fakelaki” or “little envelope” which patients have had to hand over to get good treatment have become a byword for the corruption in the system.”

The Reuters story is available here: http://www.reuters.com/article/2012/06/14/us-greece-health-idUSBRE85D1IO20120614

***

UK Doctors “Ending the Lives of Thousands of Elderly Patients to Free Beds

Express.co.uk carried an article describing how tight budgets in the United Kingdom’s government controlled National Health Service (NHS) are encouraging doctors there to employ “The Liverpool Care Pathway (LCP),” for the elderly. LCP is more commonly used in hospitals for the severely ill, when doctors consider it impossible for a patient to recover and death is imminent. Under the pathway, doctors can withdraw treatment, food and water while patients are heavily sedated in an attempt to make their final days pass quickly and comfortably – normally resulting in a patient’s death within 33 hours. The news came to light after Professor Patrick Pullicino revealed NHS doctors are using the controversial ‘death pathway’ as a form of euthanasia for the elderly.

“Professor Pullicino, who revealed one patient he took off the LCP went on to be successfully treated, claimed that elderly patients who could live longer are being put on an “assisted death pathway rather than a care pathway.”

The consultant neurologist for East Kent Hospitals said that often claims that a patient required LCP because they had hours or days left are “palpably false”.”

The article goes on to analyze the crisis looming for Britain’s NHS program. The full article is available here: http://www.express.co.uk/posts/view/327779

***

Canadian Health Care Waiting Times Getting Worse

Wesley J. Smith writes in the blog Second Hand Smoke about the latest report of waiting times for health care treatment in Canada, based on a report in the Toronto Star. Both the blog and the Star report on a study from an association of health care providers called the Wait Time Alliance, organized to advocate for government benchmarks and reporting of Canadians’ wait times for health care services. Smith notes that the benchmark for heart surgery is one-half year and 20% of patients were required to wait longer. The Star reports that Ontario got a grade of “F” for the time it took for emergency room registrants to be admitted as an in-patient (greater Toronto area hospitals ranged from 20.6 to 34.4 hours), and the Wait Times Alliance report concluded:

“Unlike the past several years, the 2012 results show a worsening of performance with regard to patients receiving care within the pan-Canadian benchmarks set by governments. Although some provinces have shown improvement, the overall results point toward lengthier waits for Canadians.”

Smith’s Blog is available here: http://www.firstthings.com/blogs/secondhandsmoke/2012/06/19/single-payer-long-waits-for-care/

The Toronto Star Story is here: http://www.thestar.com/news/canada/article/1213599–wait-times-for-key-surgeries-no-improvement-in-national-average

And the report from Wait Time Alliance upon which all of this is based can be read here: http://www.waittimealliance.ca/media/2012reportcard/WTA2012-reportcard_e.pdf