Health Care

This is amusing in a macabre manner:

Meanwhile, £1.7 billion is spent treating diseases caused by smoking, such as lung cancer, bronchitis and emphysema, with a similar sum spent by the NHS on alcohol problems.

A survey of doctors says that many believe that such treatment should not in fact be given to those who have brought it on themselves. The amusement comes from the idea that those who pay more tax than others will be denied tax funded treatment.

…while one in five said taxpayers should not pay for "social abortions" and fertility treatment.

The amusement there is similarly macabre: for of course we don\’t have social abortions in the UK. Only when two doctors sign off on a form stating likely harm to mother and or child.

Now in this particular pair of cases, there\’s no evidence of a causal relationship.

Two girls have died suddenly after being given the vaccine against the virus which causes cervical cancer, the European drugs watchdog has revealed.

But before the anti-vaccination crowd (with this specific one that crowd is expanded by those who claim that vaccinating against a sexually transmitted disease will lead to more people having sex.  Given that the vast majority of people do in fact go on to have sex at some point in their lives this isn\’t really all that strong an argument) leap upon this as evidence that the programme must be stopped, some news just in.

All vaccination programmes kill people.

Yes, really. Everyone in medicine knows this, everyone in government (that part of it that understands the subject, at least) knows this. We have a compensation scheme for those killed or damaged by vaccinations. (Here\’s the US reporting system.)

What we actually do here is use, well, you can call it accounting, call it economics, but it\’s a cost benefit analysis. Say that one in a million die from the vaccine (not all that far off the true number for some of them I think). How many are saved by having the vaccine? A multiple of that, many times.

Yes, vaccination kills people and non-vaccination kills many more. That\’s why we vaccinate.

Decorating children’s hospital wards with images of clowns is likely to frighten rather than cheer young patients, research suggests.

But just think how much worse it would be if they were using mimes?

Of course, she\’s happy that the State gets that little bit more power over us. But the thing that rather gets me is that she completely ignores one other method of increasing organ donations. Having a market.

I\’m really rather conflicted over the whole subject myself, but I do have this feeling that I would, if people think that organ transplants are so important, think them more honest if they supported both presumed consent and compensated donations.

I\’m not sure that, in public policy terms, this is actually a bad idea:

The proposals would mean consent for organ donation after death would be automatically presumed, unless individuals had opted out of the national register or family members objected.

However, it does grate. The most transplanted organ is the kidney and there\’s a much better solution there, a regulated market.

But then what did we actualy expect of Brown? Your body belongs to the State (unless you object) or a market based solution to the same problem? Betrays a certain mindset.

Via Crippen, they do seem to come out when health is discussed.

…Medical scientists including myself have been developing a safe alternative to antibiotics in the form of non-ionic silver-charged water which inactivates most viruses and bacteria. When ingested orally the silver atoms act only as a catalyst in the body (human and animal) and are excreted unchanged since even hydrochloric acid cannot dissolve silver…

No ill effects, eh? Man turns blue perhaps?

In the news about Philip Agee\’s death:

"He had several operations for perforated ulcers and didn\’t survive all the surgery," Dwyer wrote, adding that Agee was cremated Tuesday and that friends planned a memorial ceremony for him Sunday…

Ulcers? But ulcers are, as we know, caused by bacterial infections, to be treated with antibiotics. There\’s even been a Nobel awarded (to an Australian called, of all things, Barry) for it.

Has that much vaunted Cuban health care system (never mind the poverty, the lack of freedom, the oppression, they\’ve got universal health care you know!) not caught up with this yet?

According to the study, moderate drinking combined with exercise is the best combination to prevent life-threatening conditions – even better than total abstention.

The survey of more than 11,000 people over 20 years showed that drinking and exercising – though not together – were particularly effective against fatal heart disease, reducing the risk by up to 50 per cent compared with those who were inactive and teetotal.

When widened to risk from all deaths the reduction was up to a third, the survey claimed.

While heavier drinking when combined with exercise dulled the health-giving effects it was still only found to be as bad as exercising and not drinking.

Once again we find that the guidelines on drinking are complete and total tosh. As we all now know, you need to get to 65 units a week before the risks are the same as beeing teetotal. However, I\’m not going to hold my breath waiting for the prodnoses who issue such advice to actually change their message to one that accords with reality. They won\’t do so, for reality isn\’t the game, it\’s stopping people from doing things they don\’t like which is.

* Well, what else did you think I\’d use as a headline?

It\’s taken as an item of faith that medicine is going to continue to get ever more expensive:

First is rationing. Nearly all of us now know that the NHS � the taxpayer � cannot afford to pay for all the treatments and drugs that are already available, still less for those that will be developed in the future.

The demand is going to be almost infinite; tax receipts are not. As more conditions become treatable and patients’ demands become more sophisticated, this problem will soon be a great deal worse.

I\’m not convinced.

Yes, the services part of health care, the labour that goes into it, is going to continue to get more expensive as compared to manufacturing (Baumol\’s Cost Disease). But the drugs part of treatments? I have a feeling that, a decade or two down the line, they\’re going to be vastly cheaper. The reason is patents.

I don\’t think it\’s all that controversial to say that we\’re going through a technological revolution in medicine. The human genome, new drug testing methods, advances in cancer drugs and so on. We also know that this is leading to some very expensive treatments (£ 20,000 for a course of Herceptin, isn\’t it?). But patents on such drugs only last 17 years. Perhaps a decade from the time they first come into use (given the time it takes for approval). At the end of that time they are available for generics manufacturers to make. And thus end up costing something closer to spit, rather than the $ 1 billion or so that has been recouped to pay for the development and testing process implicit in the pricing while under patent protection.

So this rise in medical costs is only going to continue as this technological revolution works its way through the system: costs should fall after that.

Take the productive ward scheme. The ward manager, a nurse, has reorganised everything so that colleagues spend 40% more time nursing – no longer interrupted on average 115 times a shift, with less form-filling and no more hunting for supplies.

Having a matron who is in charge of the ward. What an amazing innovation, eh? I wonder who thought of it?

The rest of it is simply how much better the NHS is than it was. Which is of course true. But nowhere does she get the point that the NHS is not as good as it could be: as evidenced by the fact that every other European nation of similar wealth has a better system because none of them use the insane centralisation of the NHS.

You\’ll recall how Rudy Giuliani was mocked for his insistence that early treatment of prostate cancer enabled him to survive? The way in which everyone leapt up and down and insisted that the difference between the US and European numbers on years of survival was simply earlier diagnosis, not actually better outcomes?

Taking hormonal therapy early can help to slow the spread of prostate cancer by up to eight years, a study has shown.

Four months of hormone therapy delayed the spread of prostate cancer by eight years, American researchers report online in the Journal of Clinical Oncology. The effect of the treatment is to lower levels of the male sex hormone testosterone in the blood. It is an established treatment, but is generally given later in the course of the disease and for longer periods, when it can have damaging side-effects. “By taking a little bit of hormonal therapy early, patients may avoid having to take a lot of it later,” said Mack Roach, of the University of California in San Francisco, who led the team.

My word, seems he\’s right (even if for the wrong reasons).

A drug that reverses severe liver damage could be used to treat disease in heavy drinkers who find it impossible to give up alcohol. Scientists developed the drug after discovering a way to prevent the formation of excessive scar tissue caused by cirrhosis, hepatitis and other medical conditions.

To their surprise the drug not only slowed progression of the disease but also reversed damage to the organ.

Decent present for the New Year, ain\’t it?

So the NHS is going to use regulation to put private competition out of business:

The \’worried well\’ are putting their health at risk by going for expensive body scans which use dangerous blasts of radiation, according to Government experts.

Now yes, such scans do indeed expose one to radiation, but:

Private clinics should stop offering whole body computed tomography (CT) scans and regulation of the industry should be tightened, Government advisers will say in a new report.

The scans could even be banned.

The risks of massive doses of radiation used to carry out the scans do not outweigh the risks for people who are not displaying symptoms, the report from Committee on the Medical Aspects of Radiation will say.

Some private healthcare clinics offer scans, ranging in price from £500 to £2,000, claiming to pick up early signs of cancer and heart disease.

You do not have to be a complete cynic to note that the State funded monopoly is suggestin that its private sector competitors, those offering a service which it does not and thus showing it up, are at risk of being banned.

Why shouldn\’t people spend their money as they wish?

Ooops, sorry, I forgot, that\’s the point, isn\’t it?

The ethos of the NHS laid out for you:

A WOMAN will be denied free National Health Service treatment for breast cancer if she seeks to improve her chances by paying privately for an additional drug.

Colette Mills, a former nurse, has been told that if she attempts to top up her treatment privately, she will have to foot the entire £10,000 bill for her drugs and care. The bizarre threat stems from the refusal by the government to let patients pay for additional drugs that are not prescribed on the NHS.

Ministers say it is unfair on patients who cannot afford such top-up drugs and that it will create a two-tier NHS. It is thought thousands of patients suffer as a result of the policy.

Better that she die rather than use her own money to live: equality is all.

Nice to see NICE being called what it actually is:

A life-saving treatment will be denied to tens of thousands of victims of Britain\’s most common male cancer after a U-turn by the NHS rationing body.

Prostate cancer treatment, by comparison with any of the female cancers (ovarian, breast etc) is already vastly underfunded.

The groundbreaking ultrasound therapy has been shown to kill nine out of 10 prostate tumours, and five years after treatment, 80 per cent of patients show no sign of the cancer recurring.

Compared with surgery or conventional radiotherapy treatment, it is not invasive and is far less likely to lead to devastating side effects such as impotence or incontinence.

But it costs £13,000 per treatment, not £4k or £5k.

You get what you\’re given in a Stalinist system, not what you might want nor what might actually be good for you.

He doesn\’t quite get it, does he?

Hospitals should be fined if patients get bad care that extends their stay or if they catch an infection, the Government chief medical officer has said.

You can see the thought process at work here. For profit companies would indeed be incentivised by such actions.

Sir Liam said the system of fines worked well in America, where private health care companies operate,

Indeed. The problem is, as some have noted, that we don\’t have such for profit healtth care here:

but critics said introducing it in the UK was \’absurd\’ as the taxpayer would end up paying the fine anyway.

In fact, one young shaver made the point very well:

Matthew Sinclair, Policy Analyst at the TaxPayers\’ Alliance, said: "Whether the Primary Care Trust or the hospital pays the cost of treating someone who has fallen victim to poor medical standards the taxpayer will still foot the final bill.

"This proposal might make sense in an insurance-based healthcare system which leaves provision to private companies, as seen in the most successful Continental countries, but not in the NHS as it currently stands.

"Without that separation between funding and provision we will never get proper incentives for reliable, safe and effective medical care. We would be in the absurd position of robbing Peter to pay Peter."

Is it possible to buy shares in the future of certain youngsters, to partake in the benefits of their obvious future success*?

* To be, at 22, and not yet a year out of university, the go to guy for a national newspaper on bureaucratic stupidity rather marks one out as one to watch.

There\’s good and bad in everything:

Hundreds of below standard hearts, lungs and kidneys have been taken from drug addicts and transplanted into critically-ill patients, The Daily Telegraph has been told.

That\’s the bad.

"We are getting desperate," he said. "We were much more careful 10 or 15 years ago because there were more donors. The age of donors is going up.

That\’s the good. Fewer people are dying of accidents at a young age (the most likely source for transplant organs).