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Going Blind Waiting for the National Health Service–So Sorry!
Sorry about that! That’s the British government’s reaction to the two-year delay in approving a drug that combats blindness. Too expensive, dear chap … anyway, keeping your sight is so 20th century!
The head of the NHS rationing watchdog has said he is ‘genuinely sorry’ for a delay in approving a new treatment for blindness.
But campaigners said Andrew Dillon’s comments would be of little consolation to the thousands of Britons who have lost their sight in the two years it took NICE to make its final decision.
The watchdog has now approved Lucentis, which is used to treat wet age-related macular degeneration, a condition which affects 26,000 new sufferers every year.
NICE’s original recommendation was that patients had to wait until they went blind in one eye before they would be given treatment to save the sight in the other.
The proposal caused a huge public outcry from doctors and campaigners, prompting a U-turn in December last year before further consultation resulted in the final decision today.
Mr Dillon, the chief executive of NICE, seemed to blame these protests for slowing the decision to make Lucentis more widely available.
He claimed that because NICE’s rulings were not made behind ‘closed doors’ and were open to being challenged, lengthy delays often occurred.
But campaigners said the procrastination, which potentially cost the sight of 50 patients a day, was not their fault.
The Royal College of Ophthalmologists said the latest guidance was nearly identical to the suggestions it made two years ago and campaign groups pointed out that without their intervention, NICE might never have overturned its original decision.
Another great argument for socializing medicine in America!
The Nutrition Nazis are Back
The consume’rs right to know. It’s hard to disagree with the nanny-state proposal now before the California legislature (I know, I know … what nanny-state procedure isn’t before the California legislature!?) to require full disclosure of calories on menus by restaurants. The target, of course, is supposedly unhealthy fast food outlets. Once people see the calorie count, it is assumed that they will desert en masse to the local veggie bar. But as Jacob Sullum of Reason points out, if people really wanted that information, companies would compete to provide it. It’s fair to assume that most people who show up at McDonald’s don’t expect a healthy meal!
They certainly aren’t likely to change their eating habits. Writes Sullum:
The only chain where a substantial share of customers said they noticed nutritional information was Subway, where 32 percent reported seeing it, compared to 4 percent at the other chains. Since Subway promotes a subset of its menu as lower in calories and fat than its competitors’ offerings, using a pitchman who lost hundreds of pounds while eating at the chain every day, this disparity is not surprising.
But even at Subway, calorie information seemed to make a difference for just one in eight customers. Of those who reported seeing the calorie information at Subway, 37 percent—12 percent of all Subway customers—said it affected their purchases. Subway customers who said they used calorie information bought about 100 fewer calories than those who said they didn’t see it and those who said they saw it but didn’t use it.
Notably, “there was no significant difference in mean calories purchased by patrons reporting seeing but not using calorie information and patrons who reported not seeing calorie information.” In other words, simply making people aware of calorie content is not enough to affect their food choices.
The information’s influence may be limited to people who are predisposed to count calories. If so, the impact of menu mandates will depend on the extent to which those people are not taking advantage of less obtrusive nutritional information already provided by restaurants.
The importance of pre-existing preferences also suggests that it’s risky to extrapolate from Subway customers (who, given the chain’s marketing, are probably especially weight-conscious) to fast food consumers in general. Another unresolved question is whether people compensate for fewer calories consumed at McDonald’s or KFC by eating more at home or elsewhere.
Even if menu regulations don’t make any difference on balance, Yale obesity researcher Kelly Brownell recently told the Los Angeles Times, “there’s still the issue of the consumer’s right to know.” What about the consumer’s right not to know? The same research that supporters of menu mandates like to cite indicates that most consumers prefer to avoid calorie counts, enjoying their food in blissful ignorance. There’s a difference between informing people and nagging them.
And that’s really what the rule is all about. Busy-bodies and nutrition nazis determined to badger the rest of us into eating they believe is best for us. Which, alas, almost certainly means the bill will pass the California legislature.
Stop the Presses: More Private Health Care in Canada?
It can’t be true. Canada, that paragon of health equality, the place where all health shortages are shared and shared alike, might have more private health care in the future. At least, that’s what Robert Ouellet, head of the Canadian Medical Association, wants.
The natural next step for Canada’s health system is allowing more private delivery, which will give patients more choice, and better access to care, the new president of the Canadian Medical Association says.
“My whole career has been about resolving access issues. This is my battle horse,” said Robert Ouellet, who takes over today as president of the CMA.
“Private delivery is an accepted practice everywhere in the world and it’s time Canada accepted this reality.”
A radiologist by training, Dr. Ouellet, 62, owns and operates five medical imaging clinics in suburban Montreal. He is an unabashed promoter of private-sector delivery of medical care and keen to introduce more competition into Canada’s health-care system, and he knows this will make him a lightning rod for criticism.
Hasn’t anyone told Dr. Ouellet that Canadians are supposed to be proud of their lengthy waiting lists?
Want an Operation in Great Britain?
You’d better keep two or three dates open. It seems that the National Health Service likes to cancel operations even after they are scheduled. A third of the 124 NHS “trusts” canceled an operation at least twice for patients.
More than 7,000 patients had an NHS operation cancelled more than once in the past year, figures from the Conservatives reveal today.
One patient had an operation cancelled 21 times and around a third (34 per cent) of trusts cancelled an operation for the same patient three times or more.
The figures were calculated from 124 NHS trusts across England and referred to operations cancelled for non-clinical reasons, including a shortage of beds, missing patient records, staffing problems and a lack of equipment.
According to the statistics, 77,302 operations in total were cancelled for non-clinical reasons. Another patient took precedence in 5,968 cases; 10,714 cases related to a shortage of beds; 16,614 were due to problems relating to the operating theatre and 2,635 were down to administrative problems. Another 3,946 were due to difficulties with equipment, 11,370 related to staffing, 404 operations were cancelled because the patient’s notes were missing and 11,585 were due to patient-related problems.
it turns out “cheap” health care is, well, cheap. That’s something we should keep in mind as politicians promise to “fix” American health care by increasing government control over the system.
Leaving Patients to Die–Literally
The next time you hear someone complain about Americans who don’t get needed health care, think of Great Britain, where the government has decided that cancer patients are not worth saving. Since the government controls the health care system, that means the patients, unless they are lucky enough to be wealthy, will die. Reports the Daily Mail:
Thousands of kidney cancer patients have been handed an ‘early death sentence’ under plans to ban life-extending new drugs.
Four drugs which can offer patients extra years with their loved ones have been rejected by the Government’s rationing body because they cost too much.
The National Institute for Health and Clinical Excellence admits the drugs work, but says that if they are approved, patients with other diseases will have to go without.
Campaigners claim the Health Service is being plunged into the Dark Ages, as other western European countries use the drugs as standard.
Instead, NICE has limited treatment to a drug called interferon that doctors claim is ineffective for 75 per cent of patients.
Kidney specialist Tim Eisen, professor of medical oncology at the Cambridge Research Institute, said: ‘Patients here are receiving medieval treatment.
‘Together these drugs are the single greatest advance for kidney cancer patients in the last 20 years, yet I and my colleagues face the prospect of being unable to offer treatment that is absolutely standard in every other western European country.’
‘This decision will mean that the UK will have the poorest survival figures in Europe.’
The ban is the latest controversial move by NICE, which has already seen its decision-making process in restrictions on Alzheimer’s drugs successfully challenged in the High Court.
Hope: Cancer patient Jean Murphy now has access to the drug thanks to an anonymous donation
Instead doctors will be forced to offer interferon - a medication of such limited use that it is prescribed for just one in ten patients in some cancer units.
Trade-offs have to be made in every system, but in a nationalized system the bottom line is determined politically. With very negative results for most people–especially cancer patients in Great Britain.
Socialized Medicine Says: Let ‘Em Die
There are trade-offs every where, we all know, including for health care. How much do you spend to provide how much treatment to which payments? These decisions often are not easy. But at least in a decentralized, private system lots of people are making those decisions. Nationalized systems centralize the decisions over life and death, and hand them to politicians and bureaucrats.
The National Health System in Great Britain is refreshingly honest. If we don’t think it’s worth the money to save your life, tough. It’s the public interest, you know!
Patients cannot rely on the NHS to save their lives if the cost of doing so is too great, the Government’s medicines watchdog has ruled for the first time.
The National Institute for Clinical Excellence (Nice) has said the natural impulse to go to the aid of individuals in trouble – as when vast resources are used to save a sailor lost at sea – should not apply to the NHS.
The disclosure follows last week’s controversial decision by Nice to reject four new drugs for kidney cancer even though they have been shown to extend life by five to six months.
Nice has been under pressure from the drug industry to apply the so-called “rule of rescue” to such cases, setting aside costs in instances where treatment is necessary to save life. But the institute has decided that if drugs are too expensive they should not be prescribed even if they prolong life, because the money could be better spent elsewhere. The judgement overrules advice from Nice’s own citizen’s council, which recommended two years ago that it should adopt a “rule of rescue” as an essential mark of a humane society.
Give me the messy U.S. system, with all of its many flaws, anytime, compared to the NHS.
Don’t Get Kidney Cancer in Great Britain
There are drugs to treat the disease, and they are available in America. But the National Health Service won’t pay for them. Writes Jonathan Waxman in the Times of London:
But there are areas of healthcare where things have gone badly wrong, where wrong meets bad, becomes worse, and then spirals to appalling, and these areas are approached through the bloodstained portals of the National Institute for Health and Clinical Excellence (NICE).
This week’s NICE announcement on treating kidney cancer, a preliminary opinion about the value of new drugs, has sent doctors into apoplexy. Kidney cancer affects approximately 7,500 people in the UK each year, and there are 2,500 deaths. We have recently begun to understand the molecular biology of kidney cancer, and to know of its specific characteristics. Understanding these characteristics allows us to design treatments that exploit the differences between kidney cancer cells and normal cells. As a result, we have wonderful new treatments that double life expectancy in this condition.
NICE has evaluated these four new drugs for kidney cancer and indicated that these drugs will not be recommended for use in patients. This is against all sense, and contrary to the situation in the rest of Europe and in the United States, where these drugs are available. NICE has made its decision on the basis of an arcane and extraordinarily complex calculation which relates the benefit of treatment with these new drugs to a treatment that is comparatively ineffective.
But at least all Britons are equal. Everyone is at risk of being denied necessary, life-saving treatment!
Is Green Fanaticism on its Way Out?
Maybe so. At least, that’s what Alice Thomson argues in the Times of London:
Julie Burchill can’t stand them. According to her new book, Not in my Name: A Compendium of Modern Hypocrisy, she thinks all environmentalists are po-faced, unsexy, public school alumni who drivel on about the end of the world because they don’t want the working classes to have any fun, go on foreign holidays or buy cheap clothes.
Michael O’Leary, the chief executive of Ryanair, agrees. In an interview with Rachel Sylvester and me, he told us that the “nutbag ecologists” are the overindulged rich who have nothing better to do with their lives than talk about hot air and beans.
So the salad days are over; it’s the end of the greens. Where only a year ago the smart new eco-warriors were revered, wormeries and unbleached cashmere jeans are now seen as a middle-class indulgence.
But the problem for the green lobby isn’t that it has been overrun by “toffs”: it’s the chilly economic climate that has frozen the shoots of environmentalism. Espousing the green life, with its misshapen vegetables and non-disposable nappies, is increasingly being seen as a luxury by everyone.
Want New Medicines? Stay Away from Great Britain
Explains Peter Pitts of the Center for Medicine in the Public Interest:
Experimental cures are often the last hope for dying patients in the U. K. health system. Thanks to the British government, however, many sick Britons will soon have their last hopes dashed.
Why? Pharmaceutical companies from around the world have been scaling back clinical research in the United Kingdom, largely because of government parsimony. And British citizens have paid the price.
Britain’s National Health Service seems to have made Britain inhospitable to new drug research. By covering only the lowest-cost treatment options and denying patients access to more expensive breakthrough drugs, the NHS has erected serious roadblocks for companies trying to develop new cures.
The main culprit is Britain’s National Institute for Health and Clinical Excellence, the government agency responsible for comparing the effectiveness of different treatment options. Using the institute’s studies, the British government determines which treatments to cover and which ones aren’t worth the cost.
When the NHS decides not to cover a drug — as happened recently with the new macular degeneration drug Avastin — it hinders the ability of drug companies to recoup research and development expenses. That means less money for research into tomorrow’s cures.
Such practices don’t just fleece pharmaceutical research firms; they also make British patients less-than-appealing subjects for clinical trials.
Think about it. You wouldn’t want to conduct a taste-test of a new soft drink by giving one test group the new beverage and another group a warm glass of tap water. Obviously those who tasted the soda would react better. Similarly, comparing an experimental cancer drug to the low-quality treatments that many in Britain receive won’t reveal how effective the new drug is.
America has its own set of problems with health care, but the failings of socialized systems are far more grievous and fundamental.
Whiny Germans Think Climate Change Legislation Costs Too Much!
It’s terrible. The Europeans, who routinely claim to be morally superior to the greedy American species, are now yelping about the cost of climate change legislation. The Germans, in this case, actually want to sacrifice the planet’s future for their own selfish purposes. Explains Deutsche Welle:
At a meeting of government and industry officials on Tuesday, July 15, Germany’s Deputy Economics Minister Jochen Homann and all other speakers said that the EU plan was not business-friendly.
“The conclusion of the conference is that there is only limited scope for reducing “emissions” in the industrial sector and the EU climate package needs improvement in key areas,” said the ministry in a statement.
The ministry was particularly critical of the EU’s goal to cut the quota of emissions trading permits by 21 percent, compared to 2005 levels, saying this would cost Germany both jobs and growth. As a major burner of fossil-fuels, which cause unwanted CO2 emissions, Germany would be especially hard hit by the plan, added the ministry.
The statement also pointed out that an emissions trading program would result in a price hike for products that are useful in reaching climate goals, such as insulation glass and insulating construction materials.
Where will it end? Next they will start claiming that a wealthier society is better able to meet environmental challenges.
Insourcing Brings Jobs Home–So Much for the Great Sucking Sound From Free Trade!
One reason trade is said to be a bad thing is because jobs are “outsourced” overseas. Never mind that more new jobs have been created than lost in recent decades. The visible effects create political lobbies. The largely invisible results of free trade are usually ignored.
Now, however, we see “insourcing.” Reports ABC News:
But some experts say there is a bright spot on the jobs front: At least a handful of American companies who had relied on workers stationed overseas are now bringing jobs back to the United States. In addition, foreign companies are continuing to expand U.S. operations and hiring more local residents, instead of flying in foreign staff for business.
It’s called “insourcing” or “reverse outsourcing.” It’s the opposite of outsourcing, the oft-criticized practice of American companies’ shipping jobs abroad to take advantage of lower labor costs and other incentives.
Some observers are skeptical that insourcing is yet a significant trend, and one pointed out to ABC News that it cannot easily be seen in economic numbers — but others see anecdotal cases where it appears to be happening.
Do ya’ think the critics of free trade will now endorse this free international economic system which is creating jobs in America?
Egads. Physicists Debate Global Warming. Call Al Gore!
This can’t be. There apparently are PHYSICISTS who don’t believe the world is about to end due to climate change. They even disagree with the UN’s IPCC. My god! What further horrors await all true believers in the Goracle’s pronouncements??
Observes Jeffrey Marque, the editor of the Forum on Physics & Society:
With this issue of Physics & Society, we kick off a debate concerning one of the main conclusions of the International Panel on Climate Change (IPCC), the UN body which, together with Al Gore, recently won the Nobel Prize for its work concerning climate change research. There is a considerable presence within the scientific community of people who do not agree with the IPCC conclusion that anthropogenic CO2 emissions are very probably likely to be primarily responsible for the global warming that has occurred since the Industrial Revolution. Since the correctness or fallacy of that conclusion has immense implications for public policy and for the future of the biosphere, we thought it appropriate to present a debate within the pages of P&S concerning that conclusion. This editor (JJM) invited several people to contribute articles that were either pro or con. Christopher Monckton responded with this issue’s article that argues against the correctness of the IPCC conclusion, and a pair from Cal Poly San Luis Obispo, David Hafemeister and Peter Schwartz, responded with this issue’s article in favor of the IPCC conclusion. We, the editors of P&S, invite reasoned rebuttals from the authors as well as further contributions from the physics community. Please contact me (jjmarque@sbcglobal.net) if you wish to jump into this fray with comments or articles that are scientific in nature. However, we will not publish articles that are political or polemical in nature. Stick to the science! (JJM)
If the physicists can open up a genuine debate global warming, when might the politicians follow suit?
Fruits and Nuts in California
I love California, but the fruits and nuts truly have taken control. The city of Los Angeles has initiated a moratorium on fast food restaurants–but only in poor neighborhoods–to iimprove the people’s health. Reports the Associated Press:
City officials are putting South Los Angeles on a diet.
The City Council voted unanimously Tuesday to place a moratorium on new fast food restaurants in an impoverished swath of the city with a proliferation of such eateries and above average rates of obesity.
The yearlong moratorium is intended to give the city time to attract restaurants that serve healthier food. The action, which the mayor must still sign into law, is believed to be the first of its kind by a major city to protect public health.
In the city council’s view, too many residents of South Los Angeles are fat. But if people there prefer junk food, why do the city fathers (and mothers) believe tofu bars are going to rush in? Unless I missed something, none of the fast food restaurants were forcing people to eat there at gun point. The restaurants came because people wanted their food.
Of course, it’s probably dangerous to point this out. The next step for Los Angeles may be forcible round-ups of fat people and incarceration in reeducation camps to teach the wonders of dressing-free salads. It is California, after all.
Government Service with an Oops!
Remember stories about the horrors of the American medical system? Operations performed on the wrong leg and such? Guess what: it’s also a problem in Great Britain, with its wonderful, equal, fair National Health Service. Reports the Independent:
The cases of 14 brain surgery patients who were the victims of catastrophic errors when neurosurgeons operated on the wrong side of the head are to spearhead a government drive to make operations safer.
Sir Liam Donaldson, the Government’s chief medical officer, will highlight the cases at the launch of his annual report today when he will announce the establishment of a new clinical board for surgical safety to reduce errors and eliminate “wrong site” mistakes.
About 7.9 million operations are performed in Britain each year, nearly 10 times the number of births, yet surgical safety attracts far less attention than the safety of maternity care.
In 2007 more than one operation a month – 16 in all – was done on the wrong site. Examples include knee replacements on the wrong (healthy) knee, cochlear implants – surgically implanted hearing aids – in the wrong ear, removing bone from the wrong foot and wrong incisions to gain access to organs in the abdomen.
One patient a day was listed for the wrong operation in 2007, and there were 1,136 errors involving operating lists, including mistaken surgery, wrongly identified patients or operations performed in the wrong place.
The 14 brain surgery patients had suffered head injuries causing bleeding in the brain leading to increased pressure in the head. The standard treatment is to drill holes in the skull to release the pressure, but in the 14 cases the “burr-holes”, were drilled on the wrong side. A second set of burr-holes then had to be drilled on the correct side. The 14 cases, all in the UK, were reported to the National Patient Safety Agency over the past three years.
That’s a pleasant thought. Wake up from brain surgery and find they’ve punched holes all over your head! People just might want to keep Britain’s experience in mind before pushing to collective our medical system.
Senate Should Look Before it Leaps on the Law of the Sea Treaty
The Law of the Sea Treaty just won’t go away. Ronald Reagan attempted to kill it a quarter century ago. But it’s still with us. In the Washington Times I warn the Senate to look carefully before leaping into the bureaucratic monstrosity.
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