Socialized medicine and "universal" (?) access in the UK

We have already heard about smokers and the obese not having access by
the NHS to some procedures and now this:


http://www.telegraph.co.uk/news/main.../14/nold14.xml
Shock as doctors admit to ageism

By Celia Hall, Medical Editor
Last Updated: 2:42am GMT 14/02/2007

# Your view: Are the elderly less deserving of the best medical care
than others?

Doctors in Britain regularly discriminate against older patients by
denying them tests and treatments they offer to younger people,
research shows today.

GPs, heart specialists and doctors who care for the elderly were all
found to be influenced by a patient's age when making their
recommendations -and older doctors were more likely to discriminate
than younger doctors.

An eldely couple, age discrimination in NHS
Older patients are less likely to be referred to a cardiologist and
given heart treatments than patients under 65

The study in Quality and Safety in Health Care, a specialist
publication from the British Medical Journal, found that half of
doctors in each of the professional groups treated elderly patients
differently.

The researchers compared the responses of doctors to people aged under
65 and over 65. They pointed out that 65 was no longer regarded as
being particularly old in British society.

Prof Ann Bowling, of the department of psychology, at University
College London, led the study. She said: "Resources are limited and
doctors have to make difficult decisions. Maybe they have run out of
options and are using age as an excuse.

"When we spoke to the doctors they were quite ready to justify their
reasons. They may see older people as less deserving," she said.

In the study 85 doctors agreed to "examine" 72 fictional patients with
possible angina, aged between 45 and 92, using a website.

Histories of the patients and their pictures were produced, allowing
the doctors to gather information. All the doctors agreed to behave as
they would with a real patient.
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Results showed that older patients were less likely to be referred to
a cardiologist, given an angiogram [artery scan] or given a heart
stress test than patients under 65.

Cardiologists were also less likely to recommend operations to open up
blocked coronary arteries for older patients, and they were less
likely to be prescribed statins to reduce cholesterol.

They were, however, more likely to be offered a follow-up appointment
and more likely to have existing drugs reviewed.

Although one doctor said he believed he treated all his patients as
individuals, he added. "I don't think by-pass surgery in an 87 year
old is in their best interests".

Another said: "If they are in their 90s with chest pain and angina, I
might be less likely to refer". A third commented "They wouldn't want
an angiogram if they were over 70".

The researchers found that those doctors who were influenced by age
were on average five years older than those who were not.

Dr Vivienne Nathanson, the head of science and ethics at the British
Medical Association, said they were in the process of producing their
own information for doctors on age discrimination, as they had with
race and gender discrimination.

"Research like this is very useful in helping us to inspect our
attitudes and the subtle patterns of locked-in behaviour that doctors
may not be aware of," she said.

There could be good reasons why a doctor would not subject an elderly
person to tests or treatments, she said. "A doctor needs to know that
if they do a test and it is positive that they can then do something
to help. We would not subject anybody to a test needlessly.

"But to deny a person tests just because of age is unfair and wrong.
Decisions should be made for clinical reasons.

"There is research that shows that older people actually do better
with some high-risk procedures, and more research now includes people
over 65."

Commenting on the finding that older doctors might be more
discriminatory, she said that they may be working from the premise
that it would be wrong to offer a test or treatment that had not been
tested on older people.

Dr Lorna Layward, a research manager for Help the Aged, said: "It is
shocking that such blatant age discrimination exists in GP practices
today. A person's age should never be used as a factor to determine
treatment.

"What a backward system to suggest that people are prioritised solely
on the basis of their age, when a 65-year-old may actually be in
better health than a 45-year-old. What is far more alarming is the
fact that little is actually known about the appropriateness of many
treatments for older people.

"Many older people have been paying into the NHS since its inception
and believed they would be looked after from cradle to grave, but all
this does is help see them into an early grave."

Gordon Lishman, the director-general of Age Concern, said: "This is
further shocking evidence that age discrimination in the NHS is still
rife.

"It is heart-breaking that even though the NHS acknowledged this
problem over five years ago, it has failed to rid itself of ageist
attitudes, even in the treatment of serious conditions such as angina.

"Not only are older people denied NHS services because of ageist
attitudes, but also because of current blatant ageist policies.

"For example, it is particularly perverse that as the risk of breast
cancer increases with age, invitations to breast screening for women
stop at 70.

"People are also often denied mental health services on the basis of
their age, and one in six over-65s says they have been discriminated
against in health care or health insurance because of their age.

"The NHS needs to address ageist attitudes. We call on the Government
to adopt a duty on all public services to promote age equality which
already exists for race and gender," he said.

Related articles
Leader: Too old to be treated?
Agonising death at care home with 999 ban
This is how NHS cash crisis is biting
10 November 2006: Patients face service cuts as NHS debt hits £1.2bn
28 March 2006: Pledge to ensure dignified treatment for elderly in
hospital
9 December 2005: NHS may not treat smokers, drinkers or obese
25 May 2005: Older people 'left to die without help or dignity'
6 May 2005: Plan to bias NHS treatment against the elderly
14 September 2004[Health]: Screening must not be stopped

External links
British Medical Association
Help the Aged
Age Concern

"Pajamas O'Donovan" wrote in message news:
...

We have already heard about smokers and the obese not having access by
the NHS to some procedures and now this:
snip

January 27, 2007

By Justin Webb
BBC, Washington

Senator Barack Obama, an early frontrunner in the 2008 presidential
race, advocates something the US has never had - universal health
care, but just how bad a state is America's health care service really
in?

It was the summer of 1981.

Mrs Thatcher was only two years into her first term and Ronald Reagan
only months into his.

I was starting out as well. Writing stories for the Beaver newspaper
at the London School of Economics (LSE) about students throwing eggs
at government ministers and the iniquities of low-cost coach travel to
Greece.

I had arrived in London from a boarding school in the West Country and
a black and white world had suddenly burst into colour.

My room mate in our hall of residence was a cheerful American with
lively eyes and a vague resemblance to Bruce Springstein (a
resemblance of which he was enormously proud).

Bo Nora was exotic. My friends at school had been called Patrick or
Adrian, and mostly hailed from Somerset.

Bo came from Chicago and studied at the University of California. He
was at the LSE for only a few months.

Bo and I never felt the slightest bit mortal.

I remember us listening to a programme on the local London radio
station where people with emotional problems would call in for
counselling.

We laughed.

We had no problems.

I said goodbye to Bo on Great Portland Street tube station and we
stayed in touch for a few years.

And then life took over and Bo Nora became a memory.

I moved to Northern Ireland, back to London, to Brussels and here to
the US.

A few months ago, 25 years after that central London goodbye, I
tracked Bo down.

I found his e-mail address and sent him a message.

His reply talked of marriage and career and children and then came
these words: "After several years of increasing physical difficulties,
I saw a doctor in 1991 and was diagnosed with multiple sclerosis. I
retired due to further disability and incapacity. Presently, I am
spastic quadriplegic."

I went to see Bo the other day in his home on the outskirts of
Chicago.

We had supper.

Bo's eyes flashing with recognition as we talked about London and
university and people we had known.

His wife fed him.

Bo is not a bitter person - funny how happiness is wired into some
people whatever life brings - but one subject genuinely pained him.

Bo has health insurance, I presume provided by the law firm he worked
for when he was diagnosed.

This is good news for Bo - bad news for the insurance company.

Bo is expensive and the insurers do not want him... and they make it
obvious.

Every year Bo gets a letter asking him if he is still ill.

The story of American healthcare is one of huge expenditure for little
obvious benefit

Someone has to fill in a form for him: "Yes, I am quadriplegic; no, no
miracle appears to have happened."

He told me recently he had to have a minor procedure associated with
the condition.

The bill was $78,000 (£40,000).

In the end he paid only a small part of it himself but of the various
entities that chipped in - the state, the insurer, the hospital - you
can bet that no-one wanted to, and everyone would have got out of it
if they could.

Americans who fall ill are cut no slack. A society which expects
everyone to pay their way, expects it of them as well.

As a jolly man selling life insurance pointed out to me the other day,
most personal bankruptcies in the US are the result of illness.

The story of American healthcare is one of huge expenditure for little
obvious benefit.

By head of population America spends twice the amount Britain does on
health.

But life expectancy here is lower and infant mortality is higher, way
higher in some ethnic groups.

Most of the money seems to go on overheads and on profits for the many
private companies providing care, the hospital groups, the drug
manufacturers, and above all the insurance companies which write
letters to Bo inquiring about his MS and write incessantly to all
their other customers as well, endlessly negotiating, fussing,
harassing.

As the costs spiral upwards and private employers ditch their health
care schemes to stave off bankruptcy, increasing numbers of Americans
have reduced their health insurance to the barest minimum, and when
something goes wrong they are dependent on the back-up provided by the
state.

So in a nation where socialised medicine is a phrase to be spat out
contemptuously, Americans are on course by the year 2050 to spend
every cent the government takes in tax, on health-related claims.
Nothing left even for the tiniest war.

For the time being, Bo Nora will go on getting his annual letter but
all of America is cottoning on to what Bo has known for years: there
must be a better way of looking after sick Americans.

If Iraq is eventually resolved, the issue waiting next in line for the
president, or more likely for his successors, is restoring health to
American health care.

Talk Your Way Out Of A Ticket
Refinance Your Home In Minutes

wrote:
"Pajamas O'Donovan" wrote in message news:
...

We have already heard about smokers and the obese not having access by
the NHS to some procedures and now this:
snip

January 27, 2007

By Justin Webb
BBC, Washington

Senator Barack Obama, an early frontrunner in the 2008 presidential
race, advocates something the US has never had - universal health
care, but just how bad a state is America's health care service really
in?

A good opportunity for the US to have a nationwide referendum on whether
the nation would like a universal healthcare system, free at the point
of use. I wonder how many voters would say no!

"PJ O'Donovan" wrote in message
oups.com...
(snipped)
We have already heard about smokers and the obese not having access by
the NHS to some procedures and now this:

I wonder why anyone would take all the trouble to gather statistics to come
to a conclusion what common sense tells you anyway and has always been
practiced.

Seems to me a lot of 'research' money was badly spent.

And also, why should obese and smokers get free medical attention. They
are self inflicted wounds. These are the very people who absorb the time
and skills of doctors in a once workable system for treating real medical
illnesses.

"Mike O'Sullivan" wrote in message
...
wrote:
"Pajamas O'Donovan" wrote in message news:
...

We have already heard about smokers and the obese not having access by
the NHS to some procedures and now this:
snip

January 27, 2007

By Justin Webb
BBC, Washington

Senator Barack Obama, an early frontrunner in the 2008 presidential
race, advocates something the US has never had - universal health
care, but just how bad a state is America's health care service really
in?

A good opportunity for the US to have a nationwide referendum on whether the
nation would like a universal healthcare system, free at the point of use. I
wonder how many voters would say no!

No one has ever lost money betting on the stupidity of voters of
any country.


Planet Visitor II
Official publisher of AADP Official dictionary
http://www.planetvisitor.name/dictionary.html

Mike O'Sullivan wrote:

wrote:
"Pajamas O'Donovan" wrote in message news:
...

We have already heard about smokers and the obese not having access by
the NHS to some procedures and now this:
snip

January 27, 2007

By Justin Webb
BBC, Washington

Senator Barack Obama, an early frontrunner in the 2008 presidential
race, advocates something the US has never had - universal health
care, but just how bad a state is America's health care service really
in?

A good opportunity for the US to have a nationwide referendum on whether
the nation would like a universal healthcare system, free at the point
of use. I wonder how many voters would say no!

There is no legal way to have a national referendum in the United
States. I suspect that some people would vote against it because they'd
know that nothing is free, it all has to be paid for.


--
Bush say global warm-warm not real
Even though ice gone and no seals
Polar bears can't find their meals
Grow as thin as Ally McBeals

Senator Barack Obama, an early frontrunner in the 2008 presidential
race, advocates something the US has never had - universal health
care, but just how bad a state is America's health care service really
in?

A good opportunity for the US to have a nationwide referendum
on whether the nation would like a universal healthcare system,
free at the point of use. I wonder how many voters would say no!

Universal Health Care would be the quickest way to turn medical care
in the US into that of a 2nd world nation. Read the HillaryCare
proposal and decide if that is how you want your health care to be
delivered. Pay particular attention to the mandatory participation
clause. Which only has exemptions for Congress, their families, and
congressional staff. The select group who will continue to enjoy the
best medical care that tax dollars can provide.

Whatever health care is enacted by congress, remember that those
responsible will not have to personally experience the results.

And this doesn't happen in marketised medicine?

On 14 Feb 2007 04:18:13 -0800, "PJ O'Donovan" wrote:

We have already heard about smokers and the obese not having access by
the NHS to some procedures and now this:


http://www.telegraph.co.uk/news/main...YWX5IXHQFIQMF=
CFGGAVCBQYIV0?xml=3D/news/2007/02/14/nold14.xml
Shock as doctors admit to ageism

Patrick Wallace wrote:

And this doesn't happen in marketised medicine?

If you have good insurance, you are likely to have a lot of access
irrespective age.



On 14 Feb 2007 04:18:13 -0800, "PJ O'Donovan" wrote:

We have already heard about smokers and the obese not having access by
the NHS to some procedures and now this:


http://www.telegraph.co.uk/news/main...YWX5IXHQFIQMF=
CFGGAVCBQYIV0?xml=3D/news/2007/02/14/nold14.xml
Shock as doctors admit to ageism

--
Bush say global warm-warm not real
Even though ice gone and no seals
Polar bears can't find their meals
Grow as thin as Ally McBeals

On Feb 16, 3:00 pm, "Don't Wait Up" wrote:
Senator Barack Obama, an early frontrunner in the 2008 presidential
race, advocates something the US has never had - universal health
care, but just how bad a state is America's health care service really
in?
A good opportunity for the US to have a nationwide referendum
on whether the nation would like a universal healthcare system,
free at the point of use. I wonder how many voters would say no!

Universal Health Care would be the quickest way to turn medical care
in the US into that of a 2nd world nation.

Got news for you the US already has 2nd world health care, even Cuba
does a better job in providing health care to its citizens. With
about 50 million Americans uninsured, America still spends the highest
percent of GDP on health care, over 13% of any western country,
compared to 8% of GDP for countries like Australia that has universal
health care. And health care cost is so expensive that American car
companies can no longer compete with Japanese companies that don't pay
for private health care for employees. So you can keep your failed
system, just pray you don't lose your job and get sick.


Read the HillaryCare
proposal and decide if that is how you want your health care to be
delivered. Pay particular attention to the mandatory participation
clause. Which only has exemptions for Congress, their families, and
congressional staff. The select group who will continue to enjoy the
best medical care that tax dollars can provide.

Whatever health care is enacted by congress, remember that those
responsible will not have to personally experience the results.