Tag Archives: Medicare

The double check

This is at times essential, we need (at times) double check what we did. Not the double check before we speak (which tends to be essential), but after we spoke, we get the setting that we need to make certain that we had it right. There is no shame in getting it wrong, it is the non-adjusted view that follows that makes what we do (completely) wrong.

In this, I decided to take another look at ‘Cross here to die’ an article I wrote on December 11th (at https://lawlordtobe.com/2021/12/11/cross-here-to-die/), there I wrote “And there is more we get to see “a wave of infection is projected that could lead to a peak of more than 2,000 daily hospital admissions, with 175,000 hospital admissions and 24,700 deaths between 1 December this year and 30 April 2022.” And it is natural that these people hide behind ‘could lead to’, Yet the stage does not match. 175,000 admissions leading to 24,700, deaths. It goes against the numbers I have so far over a lot of nations and Omicron is stated (several sources) that it is a mild version that is more easily transmitted, yet not more deadly, so the numbers do not add up”, I stand by what I wrote, yet yesterday I was given “the UK has 78,610 new cases”, which is a massive jump from the 7-day moving average of 57,000 cases. Yet (for now) the non-living rate is still 115 per 7-day average, so my view holds up, to get to the trend of 161 deaths per 7 day average, a lot more people need to stop breathing. And in the setting of the 78,610 new cases (not specific Omicron), the setting needs to be a mortality rate of a lot (too tired to do the calculation), yet if the trend continues, the numbers shift, so there is a chance it might come to fruition, but we would need to see a continuing rise of new cases of 75,000 per day for close to a month, at which case hospitals will have collapsed and those in dire need can no longer be aided in any way. So at the current rate the mortality rate will have to increase by well over 50%, which is not logical, but with 30,000 new cases the stage might not be too unrealistic, although the original article gave us ‘Omicron could cause 75,000 deaths in England by end of April, say scientists’ requires the daily death rate to increase to 496 a day, up from 115 a day? That is a massive jump and that is why I questioned the numbers given to us. On the plus side, housing prices in London will drop dramatically, so there is always an upside to be found.

There is another side that I actually did not look at, the idea of “175,000 hospital admissions”, even over 5 months (Dec 1st – Apr 30th) that implies 1158 admissions a day, which is almost double of what is at present the case, And consider that the average length of stay in a hospital is 8-9 days for non ICU patients and 12-18 days when ICU is required. In that setting the numbers reveal that before the end of January all hospitals are beyond breaking point and no hospital in the UK will have any beds available with optional settings that London patients might have to be  be transferred to Wales, which is hilarious on a few levels. In the first their UK passport might be rejected, they will not speak the local language and after all the joke the people in Cardiff will not stomach people from England, at times life gives them a handle on humour.

DANGER WILL ROBINSON DANGER DANGER

The next is speculation and presumption. There are facts, but they were facts given to us based on what was, there is too much unknown with Omicron. 

Now consider the numbers given and the fact that the numbers are from decently reliable sources, but there is still a lot we do not know on Omicron. I still have massive doubts on the numbers given to us and there will not be any decent reliability until mid January. Yet the speed at which Omicron pushes forward and the amount of people who refuse to be vaccinated, and moreover the large amount of people who refuse to wear masks are now becoming danger factors in all this. 

When you consider the image, it might not mean much, but the percentages (seen elsewhere) are 90%, 70%, 5% and 1.5%. A stage where mandatory masks lower the dangers from up to 90% to 1.5% is a massive decrease and should not be ignored. Yes, you can decide to ignore it but when your family members start dying (become non-living) do not cry like a husky, or blame Medicare, NHS or whatever. You did this (too)! I still have doubts and question marks regarding the numbers given to us, but the stage of other elements were out in the open and even as Omicron is a mild version, if the spread continues as we saw yesterday there is every chance that the hospitals will collapse before February 2022 starts , so if you do not have a relative who is a medical trained person, feel free to reserve your urn or coffin, because this will get bad soon enough (I still doubt the fear mongering 50% increased dead people). Yet the numbers if continues will also mean that the mortality rate exploded because no more medical help was available. 

As far as I can tell there is no data model for me to predict that, too many unknown factors and before you start the blame game, if hospital staff does walk out, it is because of the stupid people attacking and blaming these exhausted medical people in the street (as we can see in loads of YouTube videos). 

I believe in the double check, I believe it was essential to do so and so far my views hold up, but they are under scrutiny of the explosion of cases that were not known when I wrote this and that is why I did the double check, in other news, there is also the ‘missed’ cases of reporting as ABC (Australia) gives us 14 hours ago ‘Omicron spread leads to UK record of 78,610 COVID-19 cases in single day’, yes the 78,610 is correct, but we have no idea HOW MANY of them are Omicron, there will be a decent amount of them (speculation) but in the end we do not know and until that is known there is a larger stage that comes to mind. If a person gets Alpha, Beta or Delta now. Is there a chance they might miss Omicron? This is an important question because it takes us back to 1796. Then English doctor Edward Jenner noticed that milkmaids who had gotten cowpox were protected from smallpox. As such people got injected with the mild version (cowpox) to avoid and be protected from smallpox. (See https://www.cdc.gov/smallpox/history/history.html). The event was known to me (I had history in high school), but there could speculatively a case that a similar stage exists (I am not claiming it is). And scientists have made clear statements that previous covid infections may not protect against Omicron, which I tend to believe. You see, the other speculation is done on the premise of the past where was about a very different disease. So we need to be careful and rely on SCIENTISTS to give us the goods and it would really help if the media stops being a FEAR MONGER factor here. 

We have enough problems, it would be best for the media to remember that, because after whatever this was comes to a halt the people will (hopefully) DEMAND that some media outlets lose their 0% VAT rights (as they should not be regarded as newspapers). At that point we get editors crying like little Chihuahua’s that they have a right to expression, but expression and exploitation is not the same and Justice Leveson was clear bout that, was he not?

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When walls close in

I had an interesting day, my mind designed another game, I dreamt of a new movie and I considered what comes next in the entire Covid mess. I will say upfront that it is all speculation, the issues skating close to the truth usually are. It all started with the news. The BBC gives us ‘Trump: A safe gradual and phased opening’, which might be nice and OK, yet the people who actually know about sickness and disease think it is a bad idea. With 2,347,887 sick and 161,138 dead people some will get to say ‘I see dead people’, and they might be telling the truth. I will not waste your time to consider the 739K sick people in the US and the connected 39K dead people, the math there does not hold up completely because of the timeline and the speed at which it pushes through due to large cities like New York. And what do hundreds of Americans do, people without any level of medical education mind you? They protest against the Covid rules, they are the source of propagating the disease and that is good. You see Wall Street and its vassals need to learn the one lesson they forgot about, if you bank on a consumer based wealth cuve, you need actual consumers and the US lost over 39K consumers. Their debts cannot be collected and the curve changes. Even as some Texans push to reopen to open their business, we will see that the rents are due but a lot of customers will stay away. Open business without mindful consumers spending money. Yes it is the time for Amazon to really reel in the cash, but in the end, the shops still lose. And remember resident Trump making some waves in proclaiming against all evidence that the mortality rate of Covid would be no more than 1.8%? It is over 5% in the US at present. No one seems to be asking the right questions. The economic model must be adhered to and the EU is starting to realise that it is a mere tool in the needs of the US, AUS has not figured that out yet, but they will, or perhaps AUS will become the 53rd state of the US. All speculative options at present,something that will be merketter as the A state of the US.

In my view there is a lot of overreaction regarding the flu, yet I am willing to accept that it is done to lower the curve and to keep casualties down, OK, I get it. I might not like it, but I get it and that feeling remains absent for a lot in the US.

Andin all this as we see the reactions to investigations on the World Health Organisation, I am content to write those names down, the pretentious Marise Payne who is all about bi-partisanship. The interesting thing is that this all happened right after the accusations by President D. Trump, yet not unlike the Huawei situation no evidence of any kind was ever produced, and again the A state of the US is following. It is one of those times when ‘bipartisan’ seems to meen, ‘a tool for the US’. 

Why am I here?

You see a flu this amazing where mortality rate is in the sewers and all over the place, jumping from 2% to 10% whilst there are over 100K patients in that country is not natural. There can always be some fluctuation, but if you merely look at Germany and France, where the amount of dead people are apart by almost 500%, there is a larger issue, that issue is that there is more to the disease and nations are in denial of that part, yet blaming China makes it all OK, or so they think.

Let’s make sure that I am not stating that they are innocent, I am stating that so far we see no evidence of any kind and the open hostilities of the US towards China are not set in any light in the media. That too is a piece of evidence that needs to be illuminated.

The stage where Marise Payne is stating that the WHO should not run the investigation and that she is stating that China should allow for transparency whilst she herself is in a doubtful stage is unmentioned. I agree that the coronavirus needs to be investigated, yet it needs to be done by the right people, the fact that she wants to invalidate the WHO from the get go is weird to say the least. In all this the first station of the flu is healthcare and they have been underfunded for over a decade, the health of consumers was overplayed and the effects underestimated. This is visible in AUS, the UK, many nations in the EU and the US. I know too little of Japan to add them to the list. 

THese consumers are adamant and directly involved, because without them the Wall Street formula fails and someone is finally realising it. Forbes stated on April 13th (a Monday) ‘Wall street Wobbles as investors ignore the science of Covid-19’ and there we see “its transmissibility and mortality rate are known to health officials. All of this information has been communicated publicly” yet there are clear open souces out there as well as the numbers in Germany,Spain, Italy and China that makes for a shoddy case in both matters and the people are just ignoring it. The article shows a few other parts and also the fact that when it comes to Wall Street, it is erratic, especially when the numbers go down and that is what will happen, as the US surpasses a mortality numbers of 50K, we will see panic by investors, especially as the disease does not differentiate between the rich and the poor, the worker and the abuser, a flu that merely kills. And when they realise that the death rate in the US is five times that of Germany, we will see initial inklings that there is a larger play and it is not seen in the death numbers, it will be seen in the stage where economies cannot get started because it requires consumers and they are dead. Yet the total deaths is lower than those in Syria and Yemen, so why bother now?

Because now they are consumers that these companies vie for and they no longer answer their phones, and for the most the health officials are ignored to avoid the danger that the message is too negative. As we see in the UK that the NHS people are wearing aprons instead of gowns. As they are on life support, we see a much larger danger. A nation where health care falls away, it took 114K patients and 15K deaths to pull that off, so when will Americans realise that their numbers are a lot worse and their levels of inequality. The Guardian gave us ‘Profit over people, cost over care: America’s broken healthcare’, and no one in the US is actively investigating that part? Australia is almost in a similar place. 

It is not the beginning or the middle, this is the beginning of the beginning and things will get worse. I wonder how many people realise that, even as we see all kinds of numbers, when we do get sick and healthcare falls away, the world has a problem and the US will be one of the first ones to learn what happens when the Wall Street formula cannot be matched. For them profit is everything, lives are not.

So whilst you are in lockdown, consider the fact that when the walls fall in, it is not a case of the walls falling in, but you have been placed in a coffin and you are a number on the covid stats, no matter where you live. And optionally, you will be one of the forgotten, especially as the BBC and others are stating that these numbers are so much higher than expected. In the UK has 2,000 home care locations with the Coronavirus, yet ABC claims that their numbers are not to be found, so how high is the problem and what else is unknown at present. So whilst we are not in possession of the numbers, some are still willing to blame China, all whilst for too long too many places left the border open until specifics were known, that failing in foresight is also unmentioned in many places, I wonder what that investigation will bring to the table of Marie Payne, if she looks at it at all.

 

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In sadness we rejoice

It sounds harsh, but it is not. Last night, two days before the elections, Australia lost one of its most legendary politicians. Bob Hawke, born 9 December 1929 has passed away.

It brings a moment of sadness to the Australians. It does not matter which party you are connected to, every party in Australia recognises the amazing achievements that Bob Hawke made. An MP for Wills (1980-1992) and leader of the Labor party from 1983-1991.

His achievements stand in many places as creator of Landcare and Medicare; he established APEC and introduced the Family Assistance Scheme. He created several services that have now outlived him and will continue to do so for a long time to come. Even the students have a lot to celebrate as the Hawke Labor Government gradually re-introducing fees for university study (1989). It also set up the Higher Education Contributions Scheme (HECS), so that anyone could get a tertiary education, a solution that is still with us today.

My political view goes in another direction, but you cannot have anything but the highest regard and admiration for what he has achieved. We should show the highest reverence to his accomplishments, many of them still functioning today, still here after he left office 27 years ago.

So why do we rejoice?

We rejoice because a man like this, what he did for all Australians should be celebrated by every Australian regardless of political view and even regardless of age. Medicare and HECS might be the most visible icons for the young, but not the only one. If there is one part that we need to quote Channel Nine: “World-class universities, where places are earned on merit not purchased by privilege“, I was alive and old enough before there were HECS options, and I agree. When the option was on my doorstep, I never regarded Law of Medicine as an option, those two educations were for the rich and those with a family in either law or medicine (basically they were rich). As a mature student I got my Master degree in Law (IP law). I was able to prove to myself that I was able to get to a place I never thought I was able to get to and that might be the strongest feeling of achievement that a person could ever have.

So take the expression ‘Bob’s your uncle‘ into your heart, because the actions of Bob Hawke show that he was the Uncle for all Australians (figure of speech), the welcome relative to an entire nation. If you are Australian (even if you are not), when you are in a bar, raise your glass to his memory and rejoice as you cheer him, an Australian titan that has left our sights, but not our hearts.

May another political titan rise one day, hopefully surpassing what he was able to do, it will be the tallest order ever, but it would be a journey worthy for any politician who is serious about trying to scale new heights.

 

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A political minefield

If there is one place where politics have bungled the ball on near titanic proportions, than it would be healthcare. The UK with the NHS issues, Australia with Medicare, the Netherlands with Gezondsheidszorg and the less we say about Obamacare, the better it is for all of us. They all made massive errors which changed the game for any nation that needs to take care of healthcare.

The UK has had its own issues for some time, yet now we see a new event coming up. Let’s take a look at ‘Cancer diagnosis ‘within four weeks’ under new care plan‘ (at http://www.bbc.com/news/health-33574233). First off, it is a good article by Nick Triggle, he looks at it from a decent viewpoint, but is there an issue?

The first part is “The five-year plan will cost £400m a year but experts say earlier treatment will result in similar savings. They say the plan could help an extra 30,000 patients survive for 10 years“, so basically there is no additional cost, which sounds good, let’s face it, in the increasing pull of funds, breaking even over the next 5 years does sound awesome, the people get to live up to another decade, which is just a bonus.

My initial issue is with the quote “Harpal Kumar, chief executive of Cancer Research UK and chairman of NHS England’s task force, said the changes could help create a “world class” service over the coming years“, the term ‘world class‘ seems a little out of bounds and that also sets the tone, let me go on so that it will all make sense.

The second quote is “We have an opportunity to save many thousands of lives from cancer“, which in light of all this does not make sense, especially when we see “But Mr Kumar believes another 30,000 people a year could end up surviving that long once the changes have been put in place – a third of them simply through diagnosing the disease earlier

I admit that I am splitting hairs, because giving them an additional 10 years is not saving a life, it is prolonging it. Apart from that, is there an objection? You see, healthcare is about keeping people healthy (and saving lives whenever possible) so there is no real objection is there? Giving a person up to 10 years more is a noble goal, especially when 130,000 people die each year, letting them enjoy life a little longer is not wrong at all. So why am I looking at this article?

For that we need to look at the steps. These 7 steps is what brought the light in

  • The creation of a four-week target for diagnosis from GP referral. Currently patients are meant to see a specialist within two weeks of a GP referral but can then face weeks of waiting for tests, meaning a growing number of patients do not get their treatment started within 62 days as they should
  • An 80% increase in the number of tests being carried out, including increasing the ability of GPs to order tests directly – for many they have to go through a hospital specialist
  • Replacing more than 100 radiotherapy machines – half of England’s stock – with new, better models
  • Recruiting extra staff in areas such as specialist nurses and radiologists, with the latter needing to nearly double in number
  • Cancer patients to get online access to all their test results and a specialist nurse or other key worker to co-ordinate their care
  • A call for action on smoking and obesity – four in 10 cancers could be prevented through lifestyle improvements
  • All cancer survivors to be given a recovery package so they get the support they need to recover from their treatment and stay cancer-free

The first premise is shown in dots 3 and 4. Replacing 100 radio therapy machines with newer ones and recruiting extra staff (especially radiologists). The fact that the article implies that there are 200 radiotherapy machines is equally disturbing. You see, 280,000 diagnosed people implies 4 people a day and that is if every machine is properly managed, monitored and staffed. The issue is not complete and facts are missing.

For this we take a look at breast cancer. The site Jezebel had an interesting article linking to all this. ‘Can You Be Diagnosed With Breast Cancer In Just One Day?‘ (at http://jezebel.com/5865123/can-you-be-diagnosed-with-breast-cancer-in-just-one-day), where we read “I wrote to Dr. Karla Kerlikowske, professor of medicine and epidemiology/biostatistics at USCF’s Helen Diller Family Comprehensive Cancer Center. She explained: Mammograms can identify a site likely to be cancer, but it requires taking a sample of breast tissue and looking at it under a microscope to know a person has breast cancer. Rarely, less than 1% of the time a radiologist can look at a mammogram and based on the mammogram know a woman has breast cancer, even then it requires a tissue diagnosis for confirmation“. This seems to be a universal truth. In (as I see it) nearly all forms of cancer, confirmation is needed), which is part of the entire issue.

This does not change one essential truth “simply through diagnosing the disease earlier“, that is again a universal truth, so even for that mere fact this project should go on. The issue is not with the idea, or the plan or what we read, but by what we are not reading here.

Part 5 is the first real kicker, giving online to test results is a dangerous step, often cancer will hit the elderly, who do not comprehend the need for proper approach to common cyber sense and as such too many medical details will ends up in the open air, a place where medical details should not be allowed. Now, issue number 2 is one that can be handled, there is no reason why not to do this, yet we must acknowledge that specialists are there for a reason, as such, we can accept that GP’s could call for the test yet, here is also the danger that a GP will act under the ‘better be safe than sorry premise‘ which will now give the situation that 80% more tests are being made, yet it will also include the stronger increase of false alarm results, even under an issue of the best intentions. A mere consequence of people doing the best possible for the patient, an anticipated side effect of ‘world class cancer care‘. I do not object to these parts (or fight the approach here), but it calls into question the given budget already from this point on. So what is expected to be £400m a year, could end up being £520m a year. In addition to issue 4 where we see the need for specialist nurses and radiologists, there will also be the need for additional technicians and re-schooling of technicians and upgrading other peripheral devices. It is possible that these parts had been added to the cart of costs, yet the fact that they are not mentioned, the fact that some parts might not have been looked at yet makes the anticipated £400m a year incorrect and dangerous. The Labour party made a 12 billion IT fiasco, let’s not add to that, shall we?

You see, the cancer confirmation part is not always possible on the spot. So when we accept that ‘Most incisional and excisional biopsies are performed by surgeons‘, we see that additional costs and additional resources will be required. This means that there will be additional pressure on surgeons, was that factored in? You see, there is already a massive backlog. The Guardian reported on July 4th 2014 in the article ‘NHS patients waiting longer for routine operations under coalition‘ (at http://www.theguardian.com/society/2014/jul/04/nhs-patients-waiting-longer-for-routine-operations-under-coalition), that delays had been reported of up to 215 days.

So the entire ‘speed need’ in cancer diagnoses is going to take another matter of growth entirely.

So as I give you these facts and the thoughts around this, you might get a first idea what was wrong with the article by Nick Triggle. I am an ample Medici, but I never studied medicine and it took me roughly 17 seconds to get my question marks up, so why did Nick Triggle not voice these concerns?

The quote by Dr Maureen Baker, of the Royal College of GPs, who welcomed the plans was “The system is already overloaded and we must ensure that there is sufficient imaging and specialist capacity to cope with the increased number of referrals before promises are made to patients that cannot be delivered“. Yet her quote is equally incomplete. I would have expected the quote to be “The system is already overloaded and radiology is only one step in determining the path for a cancer patient. We must ensure that there is growth in several ways in several divisions of hospitals to cope with the increased number of referrals before promises are made to patients that cannot be delivered“, which would have been more correct and as lacking as the quote seems to be from my point of view, I personally would acknowledge that the BBC article could have been used to emphasize on how much work the NHS needs and how much more needs to be done.

None of that can be seen in the article.

It seems to be that the response from Lynda Thomas, chief executive at Macmillan Cancer Support is more on point. Even though it is ambitious, she states “This report has to be more than a set of recommendations on paper. It has to inspire action and lead to meaningful improvements for the lives of people with cancer“. I think that she is playing the game carefully as she wants to get whatever she can for people with cancer, yet the though in my mind is (based on the BBC article) that I would have phrased “This report has to be more than just a set of incomplete recommendations on paper“. That will lead to questions and that will lead to proper dimensioning of a massive problem. I agree that this needs to be done, but without the fact that the pressure for surgeons is already beyond believe (not just in the UK), not addressing this part will lead to another fiasco for NHS, which is what we need to avoid at all costs.

So we are facing a political minefield, one that Labour did not survive, I hope that the conservatives and especially the Rt Hon Jeremy Hunt MP takes more than just a few additional looks at it. And even though he might dread sitting down with a collection of ‘funny and entertaining people’ (like hospital administrators), he will do so and get a proper scope of what will be impacted, because spending another 2 billion only to learn that the term ‘similar savings‘ will never be an option is one he must be willing to accept having to deal with.

There is nothing against spending it on treatment and diagnoses of cancer patients, I just want to make certain that they do not end up becoming the group who ends up with the short straw, a draw they never got a choice in voted for.

 

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