US citizens treated in India say healthcare here is ‘top class’

On Wednesday in Virginia, US President Obama said

“My preference would be that you don't have to travel to Mexico or to get cheap health care. I'd like you to be able to get it right here in the United States of America that is high quality.”


A majority of the leading healthcare providers across the country are “disappointed” with US President Barack Obama’s statement, discouraging US citizens from visiting India or Mexico for cheap medical treatment.


By saying such a thing, Obama hinted that the quality of healthcare in India is poor. It would be fine to say that the healthcare in India is cheap but it is not acceptable to hint that it is of poor quality,” said Sujit Chatterjee, chief executive officer (CEO) of Hiranandani Hospital.


Medical tourism on the rise

Last year, a total of 1.5 lakh foreigners visited India for various medical facilities of which only 17 per cent were US citizens.

Every year there is two-three per cent increase in the number of foreign patients. Chatterjee said that US should conduct a study of patients who visit India and also record their experiences.

Sharing her healthcare experience, US citizen Sydney Gambill, who is here for a knee replacement surgery said, “I had done my left knee replacement surgery here in 2007.

Not only the money, but the facilities and post-operative care here is excellent,” said Gambill, who was operated at Fortis Hospital.

A nurse by profession, Gambill read on the Internet about the Joint Commission International (JCI) accredited hospitals and the packages they offered. “The cost for the surgery in US was $60,000 whereas in India, I paid only $7000,” Gambill said.

Another patient, Mary Knoll, 62, a school teacher from Massachusetts, who got a facelift here said, “The surgery was done extremely well and the hospital facilities here is top class.” She added that the facelift surgery was around $25,000 in the US but cost her 20 per cent less in India.


Sydney Gambill (left) who had a successful knee replacement surgery in India has returned for the operation on her other leg. Mary Knoll who had a facelift done here. Both women say the facilities in India are good

What Obama said

On Wednesday, Obama described medicare as one of the most important pillars of social safety net. He had said, “My preference would be that you don’t have to travel to Mexico or India to get cheap healthcare. I’d like you to be able to get it right here in the United States of America that’s of high quality”.

Healthcare comparison

According to Chatterjee, India is doing extremely well on all the healthcare parameters. “The hospital infection rate in India is far less as compared to the US. The average hospital stay of patients in India is less than that in US.

The infrastructure in tertiary care hospitals is better or at par with the US hospitals. Even we have high-end machines that are used in US,” he said.

Airing a similar view, Dr Lloyd Nazareth, chief operating officer of Fortis Hospitals said that US cannot match up with the healthcare rates offered by top Indian hospitals. “Therefore, there is no fear of losing any medical tourism,” he said.

However, Dr Mohan Thomas, a senior cosmetic surgery consultant from Breach Candy Hospital, who is also a member of the Medical Tourism Advisory Council said, “As a responsible head of the country, we can’t blame Obama for making such a statement. The country is facing a bad economic downturn. Foreign patients will continue coming to India for treatment.”



~ Jyoti Shelar, Times Group (Jyoti.Shelar@timesgroup.com)




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US: Diagnosed for obesity surgery in the US, 35 year Old American Lady weighing 136 kg was correctly detected of brain tumor at Fortis Hospitals Mulund

Diagnosed for obesity surgery in the US, 35 year Old American Lady weighing 136 kg was correctly detected of brain tumor


In the unique case which will strengthen the confidence of the World in the abilities of Indian doctors, team of specialist Fortis Hospitals Mulund correctly diagnosed and treated a 35 year old US national Ms Michelle Hardin of brain tumor. The US doctors had earlier diagnosed the condition as a case of obesity and recommended Gastric Bypass Surgery.



In the last few years Ms Hardin’s weight increased from 190 pounds to 300 pounds (86 kg to 136 kg). She also suffered from diabetes and hypertension. “I tried various diet control measures but to no avail. Also I had excessive thirst and would drink almost 8 liter of liquid daily and would feel always hungry. My obesity caused breathing difficulty (sleep apnea) and for which I used a special machine (CPAP Machine) to keep oxygen under pressure. Seven months back I took an expert opinion in US, where I was asked to undergo Gastric Bypass Surgery (GBS) to treat obesity. Since GBS was very expensive in US, I thought of undergoing the treatment in India.” Ms Hardin


Ms Hardin decided to visit Fortis Hospital to consult Dr Ramen Goel who has a vast experience of performing thousands of advanced laparoscopic surgeries including bariatric surgeries.

“Ms Hardin visited us with the known fact that she had to undergo Bariatric surgery through Gastric Bypass method. Detailed investigations at the hospital however revealed that she actually had a Pituitary Tumor on the right side of the pituitary gland of about 1cm in diameter. The weight gained was actually because of this pituitary tumour and not because of any case of obesity. I referred her to Dr Milind Vaidya, Consultant Neurosurgeon who has an expertise to remove the tumour through minimally invasive procedure.” said Dr Ramen Goel.


Dr. Milind Vaidya, Consultant Neurosurgeon, Fortis Hospitals Mulund said, “The tumor, situated in pituitary gland at the base of the brain, triggered excessive production of cortisol hormone by the adrenal glands leading to complications like uncontrolled diabetes, hypertension and weight gain. We treated her by transnasal- transsphenoidal excision of the pituitary tumor (a minimally invasive procedure) on 14th Jan 2011.”


Dr Vaidya used an endoscope & microscope to reach the tumour through her nostrils. He used both the nasal openings to reach the tumour to avoid incision or scar. He took special care to remove every bit of the tumour, to achieve cure and preserve the normal pituitary gland.


Ms Hardin had an uneventful excision of the right sided tumor and the normal pituitary on the left side was left untouched. Her nasal pack has been removed and she is doing well post-operation, with diabetes & hypertension under good control.


“I was shocked to learn that I suffered from tumour. I thank the doctors of Fortis Hospital. Had there been no timely intervention from them I wouldn’t know what would have happened to my life. Post operative my thirst & appetite have reduced markedly to normal levels. Doctor assured that my weight will be restored to normalcy gradually.” Ms Hardin.


According to Dr Vaidya, “Ms Hardin’s life is today safe and secure only because of timely detection. Had we continued the treatment of GBS or had we wrongly diagnosed the case, her condition could have been critical. Hence timely detection and right expertise is very crucial. This case is a testimony to the quality and credibility of Indian Healthcare expertise.”


Today India is considered as the best treatment destination by foreign patients as they can avail the finest medical facilities at affordable rates.



~ fortishospitals.wordpress.com






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US: Osteoporosis Affects 10 Million Americans

Somewhere in the neighborhood of 10 million Americans suffer from osteoporosis, a disease that causes the bone mass to go down resulting in porous bones that lead to bones that are easily breakable or easily fractured by a small fall or even a hefty sneeze.

It’s estimated that one in two women and one in four men will suffer from this disease at some point in the later years.

The disease is also quite costly. In 2005 alone, 2 million fractures related to osteoporosis added up to around $19 million in health care bills. It’s also quite costly in the non-financial area of a person’s well being and quality of life.

The most typical places for fractures to occur are on the spine, wrist, hips and ribs. In women, the occurrence of hip fractures is two to three time higher than in men. Additionally, the one year mortality marker after a hip fracture is twice as high in women than their male counterparts.

On average, 24% of people who have a hip fracture after 50 years of age die within one year, and 20% require some form of long-term care afterwards. A total of 15% of them are unable to walk across a room without assistance just six months after their injury.

Meanwhile, research shows that taking calcium supplements to protect bone density could cause heart problems.



~ Posted by Cindy Tweed on Fri, 04/29/2011 in 'Top News' (http://www.topnews.us)






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AUSTRALIA: Elective surgery waiting times climb again

ELECTIVE surgery waiting times are again on the rise after two years of zero growth, putting the effectiveness of the federal government's hospital rescue measures under renewed scrutiny.

The latest hospital statistics released by the Australian Institute of Health and Welfare show average waiting times for elective surgery rose to 36 days nationally in 2009-10, two days more than in either 2008-09 or 2007-08.

The rate of elective surgery admissions remained steady at about 30 admissions per 1000 people, the report showed.

In numerical terms, admissions for elective surgery rose from 1.8 million in 2008-09 to 1.9 million in 2009-10.

The report also found admissions to private hospitals were growing more strongly than those to public facilities, with annual increases averaging 3.5 per cent for public hospitals compared with 5 per cent for private.

The performance came on the back of strongly increased spending on public hospitals, which burned through $33.7 billion in 2009-10 after rising by 5.4 per cent, adjusted for inflation, each year over the past five years.

Health Minister Nicola Roxon said the figures showed the government's "50 per cent boost to hospital funding in 2008 is starting to pay dividends".

A spokesman for the minister said the figures showing waiting times had lengthened "should be treated with caution".

"An increase may mean hospitals are targeting those patients who have been waiting the longest, instead of revealing a general increase in waiting times across all patients," he said.



~ Posted by Adam Cresswell, Health editor; From: The Australian, April 29, 2011
(http://www.theaustralian.com.au)





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US: Hospitals in US make more mistakes!!!

New research suggests that one in three people will experience some sort of mistake while staying in a U.S. hospital.

According to msnbc.com, the discovery is about 10 times higher than older estimates. These medical errors could range anywhere from bedsores to having objects left in the body after surgery.

David Classen and colleagues at the University of Utah compared a new yardstick method with two common older ways of detecting hospital errors. The research team tracked errors of the same set of medical records from three different hospitals to find the best yardstick

"Our findings indicate that two methods commonly used by most care delivery organizations and supported by policy makers to measure the safety of care ... fail to detect more than 90 percent of the adverse events that occur among hospitalized patients," the team wrote.

This suggests that many errors go undetected.

A separate study also estimated the annual cost of the medical errors that harm patients is close to $17.1 billion. Both studies were supported by the Robert Wood Johnson Foundation.



~from Reuters






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Australian Surgeons told to go slow on elective surgeries!!!

Doctors claim staff at some Perth Hospitals are being told to go slow on elective surgeries because their budgets are running low.

The Australian Medical Association WA, said it has reports of at least one hospital instructing surgeons to limit the number of patients they booked for elective surgeries because administration are running out of money for t his financial year.

Health Minister Kim Hames said, that he was unware of any hospitals giving such directive issues. The AMA President Dave Mountain, said he was concerned about hospitals under pressure to limit the amount of surgeries carried out. He further said that we have reports of hospitals going at half pace because money was running out.

The claims coincide with the release of January's waiting list figures which show a number of patients rising to 16,689 which rose to a 3 year record high in the previous month. A quarter of cateogory 1 patients considered to be the most urgernt had a 60 day waiting period.

Shadow Health Minister Roger Cook said that the figures were at odd with the Goverments claim to ensure that West Australian Patients were being seen within this record time of 60 days.

There are some people on the waiting list and the situation is worsening. He was disappointed with this January's total and further said surgeons who were being told to slow down should contact him.



~ The West Australian Newspaper.




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AUSTRALIA: Hospital waiting times blow out

MORE Australians are being admitted to hospital and they're also waiting longer for elective surgery, the latest statistics show.

According to the Australian Hospital Statistics report, Australians had to wait an average 36 days in 2009/10 for planned elective surgery, two more days than the year before.

The rate of elective surgery overall has risen slightly - by 2.4 per cent or about 30 people for every 1000 each year.

The annual report by the Australian Institute of Health and Welfare monitors how the country's 1,326 hospitals are operating.

It showed that admissions in 2009/10 grew to 8.5 million, up from 8.1 million the year before.

That included 5.1 million admissions in public hospitals, and 3.5 million in private ones.

But it appears Australians are increasingly going private over public, with the latter rising by an average 3.5 per cent each year, compared to five per cent for private hospital admissions.

Stays have gone down - with patients spending an average 5.9 days in hospital, down from 6.2 days the previous four years.

There were 7.4 million accident and emergency services provided in public hospitals in 2009/10 compared to 7.2 million in 2008/09.

Of that, 70 per cent were seen within the recommended time depending on their injury, while there was a 100 per cent strike rate for those needing immediate treatment.

Federal Health Minister Nicola Roxon said the statistics proved a $20 billion cash injection into the public health system was helping more patients get treated.

"For the first time ever, there has been over 600,000 elective surgery operations in the public system, thanks to Labor's funding boost," she said in a statement.



~ From- Daily Mercury (http://www.dailymercury.com.au)






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Australia: A DYING newborn had to be resuscitated in a chair!!

A DYING newborn had to be taken from her distressed grandparents' arms and resuscitated on a chair because nowhere else was available in an overcrowded emergency department.

The horror case is just one of dozens of incidents in which patients' lives are being needlessly put at risk because of a lack of resources, emergency doctors claim.

Fed-up doctors have decided to lift the lid on the issues in Melbourne's emergency departments, saying shocking ambulance bypass figures released by the Victorian Government last week barely scratched the surface of the crisis.

Cases highlighted by the Victorian Emergency Physicians Association show a wider risk to public safety because of bed shortages.

Last March, a heartbroken doctor had to ask a grandparent holding an infant to leave so they could treat her on a bedside chair - no other space was available and all resuscitation cubicles at the hospital in Melbourne's southeast had patients on life support.

"Although baby survived, the incredulous looks between the grandparent, the infant's family, myself and staff are unforgettable," the doctor said.

Melbourne's busiest emergency departments turned away ambulances for more than 4300 hours in just six months last year.

But VEPA president Dr Con Georgakas said the situation was even worse, with hospital administrators blocking physician requests to go on bypass when it was in the interests of patient safety.

"If we were able to get those patients who need to stay in hospital overnight up to the hospital wards promptly, then new patients arriving by ambulance would go straight to a bed in the emergency department," he said.

"The real problem here is a lack of capacity in our hospital system."

"VEPA is calling on the State Government to fulfil its promise of more beds before this situation deteriorates further. We need those beds available 24 hours a day, seven days a week."

Health Minister David Davis said "the Government is determined to turn around Labor's 11 years of mismanagement".



~ from Reuters.







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Biggest hospital in England facing a £40 Million budget crisis!!!

England’s biggest hospital trust is facing a £40million black hole in its budget for next year, it has emerged, capping a disastrous week for Andrew Lansley’s NHS reforms


Imperial College Healthcare Trust, which runs several well-known hospitals in west London and has a turnover of £910m, has also seen three senior executives announce their departure in the past few days. It is still desperately trying to balance its books and may yet have to announce job cuts, while a “hit squad” could be ordered in by the capital’s health authority to clear up its financial problems.


The news is yet another blow to the ambitious plans of Mr Lansley, the Health Secretary, to reform the NHS. Earlier this week he was humiliated as David Cameron and Nick Clegg announced an unprecedented “pause” in the passage of his flagship Health and Social Care Bill that could lead to substantial changes, following criticism from the public and the medical profession. On Thursday his Cabinet colleague Iain Duncan Smith, the former Conservative Party leader, said publicly that patient waiting times had increased over the past year as he delivered a petition to Downing Street opposing local hospital unit closures.


Mr Lansley's troubles will likely continue into next week as the Royal College of Nursing holds its annual conference in Liverpool. He will not make a formal speech to the meeting, the first time a Health Secretary or Prime Minister has not done so in eight years, but still faces a rough reception as he attends a seminar to hear what nurses think of his policies. Imperial’s financial problems will trouble the Health Secretary partly because it illustrates the difficulties the NHS faces in making savings of £20billion over the next three years, with many trusts already cutting posts and rationing services.


But Mr Lansley also wants all trusts to achieve Foundation Trust status by 2014, giving them more independence, which involves proving that they are financially viable and well-governed.
If Imperial - which runs Charing Cross, Hammersmith, Queen Charlotte’s & Chelsea, St Mary’s and the Western Eye hospitals – struggles meet the requirements to reach Foundation Trust status it means many more trusts are also likely to face difficulties.


According to the Health Service Journal, Imperial has published papers showing that current financial pressures will mean an underlying deficit for 2011-12, and despite a massive cost savings plan an “unidentified gap of £40m” between income and expenditure will remain. This is mainly because the Primary Care Trusts that currently provide its funding are cutting back on the treatment they commission.It has also missed a target of recording 13 or fewer cases of the superbug MRSA and has a backlog of patients waiting more than the desired 18 weeks for treatment.


Meanwhile the resignations of Steve Smith, its chief executive, Tony Graff, its chief financial officer, and the retirement of Alistair Shearin, its chief information officer, will make it more difficult for the trust to ensure it is managed well.


Imperial has been working with the consultancy Ernst & Young on its cost-saving plans and is still trying to finalise its budget and submit a balanced operating plan. If it is not approved by NHS London, the Strategic Health Authority for the capital, Imperial may have to apply for emergency funding from a body called the Challenged Trust Board and may have new directors imposed on it from above to turn around its performance.


Cymbeline Moore, head of public relations at Imperial, said: “The financial environment faced by acute trusts is extremely tough. The size and scale of cost reduction plans that large research-based trusts are being asked to make is very challenging. As with many of our counterparts, we are in ongoing constructive discussions with NHS London regarding our financial plans. We can confirm we are not in turnaround nor classed as a challenged trust.”


A spokesman for NHS London added: “There are always robust discussions at this time of year regarding hospital budgets. NHS trusts must agree their budgets and we are working closely with commissioners and providers of NHS care in London to make sure that their plans are credible and can be delivered. Imperial, like the whole of the NHS, is committed to managing constrained levels of funding, and using its budget more efficiently to meet demand for better services. The NHS in London is working hard to do this, while at the same time radically slimming down its management structures and managing the process of fundamental reform of the system.”


~from reuters

9 Million uninsured in US

Millions of Americans who lost their jobs and their health benefits during the recession often had no way to regain affordable health coverage, leaving them and their families at risk of financial ruin, according to a new report from The Commonwealth Fund.


The spate of layoffs during the recession catapulted 9 million more Americans — or 57% of those who had had health insurance in a job that evaporated over the last two years — into the ranks of the millions already uninsured.


In addition, 19 million people anxiously seeking private coverage over the last three years were either turned down or could not find a plan that was affordable and met their needs, the report found. The Biennial Health Insurance Survey also found a whopping 60% increase in skipped care due to cost in the past decade. The survey reported that medical debt problems and out-of-pocket spending costs were on the rise as well, with 29 million Americans using up their entire life savings to pay for medical bills and millions more unable to afford food, heat and rent due to medical payments.



"The report tells the story of the continuing deterioration of health care accessibility, efficiency, safety and affordability over the past decade," Commonwealth Fund president Karen Davis said during a noon press conference Tuesday. All this despite the fact that the United States spends more than any other country on health care, she added. "Most recently it has failed the millions of Americans who lost their jobs during the recession and lost health benefits as well, leaving them with no place to turn for affordable health care coverage," Davis said.



The Commonwealth Fund report focused on the struggles of the 43 million adults under 65 who have lost their health insurance along with their job over the past two years. "The silver lining is that the Patient Protection and Affordable Care Act has already begun to bring relief to families," Davis added. "Once the new law is fully implemented, we can be confident that no future recession will have the power to strip so many Americans of their health security."



According to the report, people who lost employer-based health insurance found new coverage exceedingly hard to come by. In fact, only 25% of these people were able to find a source for health insurance, and only 14% continued their coverage through COBRA (Consolidated Omnibus Budget Reconciliation Act), which allows the employee to buy continued coverage under the employer-based health plan for a limited amount of time.



COBRA, even with increased government participation, is still unaffordable for most people who have lost their job, Davis explained. Moreover, 71% of Americans who tried to purchase an individual plan — 19 million people — found it difficult or impossible to find a plan they could afford or that met their needs, or they were turned down or charged extra because of a pre-existing condition, the researchers found.



The problem of the uninsured in the United States has been getting worse. During 2010, some 52 million Americans went without health insurance, compared to 38 million in 2001, the survey revealed. The hardest hit were adults with family incomes of less than $22,050 for a family of four (54 percent of whom were uninsured) and those with family incomes between $22,050 and $44,100 (41 percent of whom were uninsured). Among those with higher incomes, only 13% had no coverage during 2010, the researchers noted.



As health care costs continued to climb, both insured and uninsured had trouble affording care, the report states. In fact, an estimated 75 million Americans skipped doctor visits, prescriptions and recommended tests or treatments in 2010 because of costs. That's up from 47 million in 2001, the researchers noted. The most likely to skip care were the uninsured, with 66% reporting just that. Among people with insurance — some of whom had high deductibles — 31% skipped care due to cost, the survey found.



Moreover, out-of-pocket costs continue to soar. According to the report, 49 million working adults spent 10% or more of their income on these costs and premiums in 2010, an increase from 31 million in 2001.


In addition, health insurance doesn't cover what it used to. A full 31% of insured Americans spent 10% or more of their income on health care in 2010, up from 19% in 2001.


With rising costs comes more medical debt, the report added. In 2010, 73 million Americans reported they had trouble paying for medical care or were saddled with medical debt. That's up from 58 million in 2005, the researchers pointed out.



These debts have forced 29 million people to use their savings to pay medical bills, while 17 million have put these costs on credit cards and 22 million couldn't afford food, heat and rent due to medical bills. In addition, medical bills forced 4 million into bankruptcy, the researchers found.



Some of these problems will be dealt with by the Affordable Care Act. Already the act prevents insurance companies from denying coverage due to a pre-existing condition, allows people up to age 26 to stay on their parents' insurance plans, gives tax credits to small businesses, has no lifetime limits on benefits, and mandates coverage of some preventive care without co-payments.



When the provisions of the law are fully in effect in 2014, almost all of the currently uninsured will have access to comprehensive health insurance through Medicaid or private health plans. There will also be consumer protections and tax credits for those with low and moderate incomes to help them buy insurance.



In addition, health plans will have to meet a basic benefit standard and will not be allowed to deny coverage or charge more because of pre-existing health conditions.


The data for The Commonwealth Fund report were collected by a phone survey of a nationally representative sample of 4,005 U.S. adults between July and November 2010.


~ from Reuters

NHS staff do not recommend their own hospitals

We wouldn't want family treated at OUR hospital say a third of NHS staff

Nearly a third of NHS workers said they were thinking about leaving their jobs
15 per cent of staff said they had been subjected to bullying or harassment
45 per cent say staff shortages stop them doing their jobs properly

One in three NHS staff would be unhappy to have their relatives treated in the hospital where they work, a survey reveals. Only 64 per cent said they would be happy with the standard of care provided by their health trust if their relative needed treatment.
Experts believe that asking staff if they would be happy for themselves or relatives to be treated at their own hospital is an important way of assessing standards.

Doctors, nurses, radiographers and administrators were among the 165,000 staff questioned in England by the Care Quality Commission, the regulatory watchdog, in 388 trusts between October and December last year.

Elderly cancer patients denied surgery due to reluctance to operate by NHS

Elderly people are being denied cancer surgery because NHS doctors are reluctant to operate on them, according to a study.

It found the number of people treated for breast cancer falls by a third over the age of 60.

Meanwhile only two per cent of patients over the age of 80 have surgery for six of the top 13 cancers.

Researchers said workers in the NHS often believed performing surgery on elderly patients was inappropriate and said this attitude was one of the key reasons for the decline in operations.

The biggest drop in operations is seen in the over-7ps but the study found a decline across all forms of cancer treatment is evident from the age of 50.

Dr Mick Peake, lead clinician at the National Cancer Intelligence Network which carried out the study said: 'While this isn’t intrinsically surprising, the drop in some cancers begins in age groups as young as the 50s. This is a cause for concern.

'And, crucially, it raises questions about the underlying reasons for these variations and, in turn, what can be done to reduce them.

'Inevitably, there may be reasons for variations by age and geography that are not directly related to the quality of care in our hospitals.

'Such reasons may include the stage of the disease at diagnosis, late presentation by patients with symptoms, patients – especially older ones – choosing not to have surgery, different numbers of patients with other illnesses which mean surgery would be ill-advised.

But because complete data on these factors is not available, the report can’t attribute any of the variation to them, highlighting the importance of NCIN’s ongoing work in improving the information collected about cancer patients.

'Despite all these caveats, the new facts and figures suggest that some parts of the country may have different rates compared to other regions.

'This report provides the basis for further analyses to try and understand what the underlying causes of these differences are.

'This is a good basis for cancer networks to examine why they might have lower surgery rates than their neighbours. So publishing this type of analysis could actually help to make things better.'
The study found that 'There was evidence of small but significant decreases in the proportion of patients receiving a major resection (organ or tumour removal) in the more deprived socio-economic groups and also of variation in surgical rates between cancer networks.'

Less than 16 per cent of people with cancers of the oesophagus, stomach, bladder, prostate, lung, pancreas and liver had a record of a major resection. With liver cancer only six per cent had surgery before a drop to two per cent for all of these cancers for the over 80s.

Over the age of 40 and until someone reaches 80 the drop in the number of people receiving surgery for cancer of the ovaries was 56 per cent, kidney 49 per cent and cervical 48 per cent.

The difference between the number of patients from poor areas being treated compared to the more affluent was surprisingly narrow with the largest difference being cervical cancer - 10 per cent. However this did not take into account treatment in the private sector.


FROM ~ The Daily Mail (UK) - (www.dailymail.co.uk)

Are healthy people ripped off by health insurance?

On April 1, health insurance premiums rose across the board by an average of 5.56 per cent. The increase happens every year, while the percentage that premiums increase by differs. This year’s increase, according to research by iSelect, equates to around five million baskets of groceries or eight million tanks of petrol. It would also be enough to buy groceries for 100,000 families for a year. In individual dollar terms it works out to an average annual increase in premiums of $190 per family.

So last week I did a number of radio interviews, talking about the increase and suggesting ways that consumers can try to reduce their personal cost while making sure that they have appropriate cover. And one question that I was asked (fortunately off-air, because it took me aback a little) was whether I thought it was fair that everyone – regardless of size or health – paid the same premium.

It’s a version of a question that I’ve been asked a number of times: Should health insurance should be medically underwritten. In other words, should the overweight, underweight, smokers and otherwise-unhealthy among us be paying more for their health insurance? The crux of the reasoning, of course, being that the healthy consumers in the population are paying more than their fair share of premiums. And that’s not fair, right?

So – given that premiums have just risen I thought it might be timely to mention how health insurance premiums are calculated and how – if you’re a fit and healthy person – you can partially avoid paying more than your biologically fair share.

First up, medical underwriting is not something that health funds in Australia are currently allowed to do. Under the Private Health Insurance Act 2007, a health insurance fund cannot refuse you health insurance or charge you more for it based on your health or how often you’re likely to claim.

With the exception of the Lifetime Healthcover bonus, health insurance is “community rated”, whereby the health of the community overall is calculated and the resulting average is applied to everyone. What that means is that a non-drinking, non-smoking, fit and healthy 30 year-old will pay the same premium for the same product as a morbidly obese, chain smoking 30 year-old.

This is in direct contrast to most life, total and permanent disability, income protection and trauma insurance covers (except for the industry ones taken out through super funds). For most other personal insurances, applicants are medically assessed and premiums are set (or denied) accordingly.

So when it comes to health insurance, is it fair on the healthy person to be paying a higher premium than their personal situation warrants? Probably not. But is it fair on the unhealthy person to be otherwise barred from having private health cover, or charged an unaffordable premium? Probably not.

Taking fairness out of it (seeing as it’s a lose/lose situation) it comes down to economics, marketing and consumer choice – and the key to making sure that you’re not paying more than you need to for health insurance is exercising your consumer choice.

The thing is, there are 39 health fund providers in the market. And there are more than 20,000 different products. In the absence of medical underwriting, health funds have created multitudes of different health insurance products, designed to appeal to demographically different groups of people.

Each of these products is priced differently, depending on how much income is being received (in the form of premium payments) compared to how much the fund reckons it’s going to cost them to pay the health bills of the members. So – a product that’s targeted at a young, fit demographic (for example, some products rebate gym memberships) is probably going to be better value if – well – if you’re fit.

You can see a detailed explanation of how premiums are calculated here.

According to research released by iSelect, 80 per cent of us want a better deal on our health insurance – but only 43 per cent of us know what we’re covered for in the first place. Yet there is so much choice out there!

You can exclude certain conditions from your hospital cover, can choose the level of excess you want to pay and can decide what extras you do and don’t want to insure for. It really is a situation where a little bit of research and shopping around could save you some dollars.


[Posted by Justine Davies in 'The Punch'- http://www.thepunch.com.au]

Wait-Lists for Non-Vital Surgical Procedures...

In several  European and  non-European countries it is not  possible  for  patients to  get  a (non-vital) surgical operation immediately or at a specific date that has been determined as optimal  by patient and doctor.   Rather,  there   is  a  waiting   time   to   be respected. As the table below shows, such waiting times are not  the  exception but  the  rule, and  a considerable part  of the population is affected.

The  average  waiting  time  can be substantial, as is the  case  for  cataract operations in Finland  (60 to 360 days)  or  for  orthopaedic operations in Great Britain  (165 days) or for plastic surgery  in Norway (246 days). In most of the countries that experience waiting  times  the  waiting  is organised in the  form of official waiting lists which are often made  transparent by internet publication.

Waiting  lists  can  be  regarded as a type  of (non- price)   rationing,  an   instrument  to   cope   with under-capacity  of  surgeons and/or  equipment.  In   a  public   health  system that offers free medical treatment an obvious explanation of waiting times is the lack of surgical capacity.

	Waiting- time	Population on waiting-lists	Cataract surgery	Orthopedic surgery	Plastic surgery
Australia	yes	0.9 %	73 days	53 days	24 days
Austria	no	–	–	–	–
Belgium	no	–	n.a.	–	–
Canada	yes	1.6 %	70 days	48 days	46 days
Denmark	yes	n.a.	184 days	n.a.	n.a.
Finland	yes	2.5 %	60 - 360 days	180 days	n.a.
France	no	–	–	–	–
Germany	no	–	–	–	–
Greece	yes	n.a.	n.a.	n.a.	n.a.
Ireland	yes	0.7 %	n.a.	n.a.	n.a.
Italy	yes	n.a.	n.a.	n.a.	n.a.
Luxembourg	no	–	–	–	–
Netherlands	yes	0.9 %	112 days	98 days	168 days
New Zealand	yes	2.2 %	n.a.	n.a.	n.a.
Norway	yes	0.9 %	139 days	160 days	246 days
Portugal	n.a.	n.a.	n.a.	n.a.
Spain	yes	0.4 %	59 days	66 days	63 days
Sweden	yes	n.a.	n.a.	n.a.	n.a.
Switzerland	no	–	–	–	–
UK	yes	2.1 %	190 days	165 days	113 days
US	no	–	–	–	–

Notes: The figures relate mainly to 2001.
For more detailed information on waiting time for medical treatment see www.cesifo.de/DICE.

Sources: www.cesifo.de/DICE;
OECD Health data 2002; World Health Report 2000.

Kidney disease treatment options

The treatment method used for a patient with kidney disease depends on the type of kidney disease he has and its severity. Dialysis and kidney transplants are two treatment options. These are serious treatments used when a person loses 10% or more of his kidney function. There are also other less serious treatment options for kidney disease.  

Preventing kidney disease is the best treatment. If you eat right, practice safe sex, and have good hygiene habits, you can avoid kidney disease in some cases. If you already have kidney disease, these won't help.

Changing your diet is one of the treatments for kidney disease. If your kidney is not functioning, your body tends to retain more protein so you will need to avoid eating too much protein so your kidneys don't have to work as hard. You can also drink less fluids because that will help your kidney have less work to do as far as regulating fluid levels in your body goes. If you have a kidney infection, though, fluids are needed to flush the infection out.

Antibiotics are another of the treatment options used to treat upper urinary tract infections that are in danger of affecting the kidneys. If you aren't seeing the infection go away with fluids and time, you may need to take something like Levaquin or Maacrodantin.

Treating any underlying illnesses is helpful as well. Often renal insufficiency, a milder form of kidney disease, is caused by conditions like diabetes and high blood pressure. These illnesses can endanger the health of your kidneys.

Treating diabetes can include changing the way you eat as well as taking insulin regularly.

You can keep your blood pressure controlled with medication like ACEs and ARBs. ACE counteracts the enzymes that constrict the blood flow in blood vessels which is a cause of high blood pressure. ARB counteracts another chemical in the body that increases your blood pressure. When you regulate your blood pressure, you are less likely to have problems with kidney disease because the kidneys will be under less pressure.

The future holds great things for kidney disease treatments. There are new compounds like CFTR inhibitors that are thought to help treat Polycystic Kidney Disease, which is a common form of the illness. UCLA is also experimenting with artificial kidneys that are worn outside the body and can help patients avoid dialysis. Kidney treatments are only going to get better.

As time goes on, hopefully kidney disease will go the way of polio and influenza and become a disease that no longer is fatal to millions of people around the world.

~courtesy www.healthhints.org

Nurse shortages impact patient mortality!!!

Nursing shortages in hospitals have a direct impact on patient mortality rates, a new US study has found.

According to researchers, nurses are the frontline caregivers to hospital patients and the goal for any hospital is to ensure that all of its units have an adequate number of nurses during every shift.

Ideally, the proper number of hours nurses work - known as the ‘target level' - should be adjusted for each shift, depending on the ebb and flow of patients and their need for care. Too many nurses can be costly for hospitals, but too few can put a patient's health in danger.

The researchers analysed the records of nearly 198,000 admitted patients and 177,000 eight-hour nursing shifts across 43 patient care units at a large hospital in the US. They calculated the difference between the target nurse staffing level and the actual nurse staffing level for each shift they examined.

They found that for each shift patients were exposed to that was substantially understaffed - falling eight or more hours below the target level - patients' overall mortality risk increased by 2%. Because the average patient in the study was exposed to three nursing shifts that fell below target levels, the mortality risk for these patients was about 6% higher than for patients on units that were always fully staffed.

The study also found that when nurses' workloads increased because of high patient turnover in individual units, mortality risk also increased. In fact, for each shift in which the number of admissions, discharges and transfers were substantially higher than usual, the risk of mortality among patients was 4% higher.

The average patient in the study was exposed to one high turnover shift.

"Since the hospital we studied delivers high quality care, has low mortality rates, has high nurse staffing targets and meets its targets over 85% of the time, it's unlikely the increased mortality we observed is due to general quality problems. We believe that these findings apply to all hospitals where staffing is generally high and targets are usually met," the researchers said.

In recent years, the Irish Nurses and Midwives Organisation (INMO) has continually highlighted the impact of nursing shortages in Irish hospitals. Following Dr James Reilly's recent appointment as Minister for Health, the organisation called on him to immediately amend the recruitment moratorium that is currently in place within the health system.

This ‘crude' moratorium, it said, is having a ‘corrosive and damaging effect on patient care'.

In an interview with Irishhealth.com, Minister Reilly ruled out lifting this controversial staff moratorium. However, he said it would be made more flexible in order to maintain frontline staff.

Details of the US study are published in the New England Journal of Medicine

[Posted: Sun 20/03/2011 by Deborah Condon - www.irishhealth.com]

U.S. Hospital Errors Run Rampant and Often Go Unreported!!!

Medical errors occur much more often in U.S. hospitals than previously estimated. According to a study recently published in the journal Health Affairs, numerous hospital errors go undetected. In fact, at least 90 percent of hospital errors resulting in patient injury, infection, and other issues are not recorded.

The research indicates that about one in three Americans will suffer from a medical error during a hospital stay, and range from bedsores, to foreign objects left in the body from surgical procedures, to deadly staph infections. Findings indicate that about ten times as many hospital errors occur than previously estimated.

A 1999 report by the U.S. Institute of Medicine estimating that as many as 98,000 deaths and over 1 million injuries occur due to medical errors each year sparked strong efforts to track patient safety. Although progress has being made, the standard of quality is still sorely lacking. Susan Dentzer, editor-in-chief of Health Affairs, pointed out, “Without doubt, we’ve seen improvements in health care over the past decade, and even pockets of excellence, but overall progress has been agonizingly slow.” She went on to explain, “It’s clear that we still have a great deal of work to do in order to achieve a health care system that is consistently high-quality—that is, safe, effective, patient-centered, efficient, timely, and devoid of disparities based on race or ethnicity.”

David Classen, a professor at the University of Utah School of Medicine in Salt Lake City, and colleagues, studied 795 patient records among three U.S. teaching hospitals and found that adverse events occurred among one-third of those admitted to hospitals. Findings showed that voluntary reporting by hospitals, in addition to the U.S. Agency for Healthcare Research and Quality’s method for tracking adverse events, were not sufficient in providing accurate information.

The authors wrote, “Hospitals that use such methods alone to measure their overall performance on patient safety may be seriously misjudging actual performance.” They further noted, “Reliance on such methods could produce misleading conclusions about safety in the U.S. health-care system and could misdirect patient-safety improvement efforts.

n the research team’s comparison of measuring systems for medical error detection, while voluntary reporting programs recorded only four medical errors, the use of system designed by the federal Agency for Healthcare Research and Quality for measuring hospital errors identified 35. However, use of the Institute for Healthcare Improvement’s new measuring tool detected 354 events that occurred among patients in the three facilities.

The researchers noted, “Our findings indicate that two methods commonly used by most care delivery organizations and supported by policy makers to measure the safety of care fail to detect more than 90 percent of the adverse events that occur among hospitalized patients.”

According to the research team, administrative data collected by hospitals is used in the U.S. Agency for Healthcare Research and Quality method of detecting medical errors and this is the standard method used by the Centers for Medicare and Medicaid Services in evaluating hospital safety. The Institute for Healthcare Improvement method detects incidences of “unintended physical injury resulting from, or contributed to, by medical care.” The new tool is now used by many American hospitals.

~ from reuters