The National Health Service of Great Britain costs the taxpayers about $200 billion per year. And by the way, that is more than double what it cost ten years ago … but that is beside the point. The NHS is getting to the point where it must choose between buying expensive drugs for terminally ill patients or providing more care to more people.

Is that really a choice that you want anyone to make about your healthcare? Even worse, why should the government be the one making that choice for you?   Because you’ve virtually begged for it. Americans now think that their health care is someone else’s responsibility: either their employer or the government. We’re asking for it and begging for but the truth is that we’re not going to be pleased with it at all. Politicians will love it though.  Just think of the power! How powerful you must feel when you tell an elderly American that they can’t have a specific drug or medical procedure because someone younger needs it more.  Sorry people, but that’s the truth.

In Great Britain, 800 out of every 3,000 cancer patients lose their chance at getting life-saving drugs because it would cost too much for the NHS budget. And that number is only going to get bigger and bigger. In fact, the UK is now considering making a permanent ruling that certain medications that are “too expensive” should be excluded from government-funded treatment. So even if there are better treatments out there, you can’t have them because the government doesn’t want to pay for it.

Of course though, Americans have been taught all their lives that government is the answer for everything.  That government is supposed to make all our problems go away and that we don’t need to take any responsibility for ourselves or our children.  I just can’t believe how many pathetic people live in this country that are willing to sacrafice their childs future just so government can support their lazy fat ass.

The NHS has frequently been the target of criticism over the years. Examples of such criticism include:

Access controls

Treatments determined by NICE to be ineffective (e.g. homeopathy) or relatively cost-ineffective (i.e. drugs that have only minor effect at great cost) are simply not offered by the NHS though may be available privately. These controls have been labelled “rationing” though others argue that these are a sensible cost-control mechanism to fund only cost-effective^, evidence-based medicine although this argument is controversial as many drugs with proven efficacy (e.g. anticholinesterase for Alzheimer’s Disease^, are not fully funded.

In the NHS, GP referrals are needed to access specialist care and one of the original roles of general practitioner was to act as ‘the gatekeeper’. This role as gatekeeper has become more prominent in the 1990s with the introduction of the ‘internal market’ with GPs managing funds to buy clinical services. In 2000s, the role of gatekeeper has been increasingly moved to primary care trusts (PCTs) that issue guidelines to limit referrals to secondary care. ‘Referral management centres’ are also another recent innovation to divert referrals from GPs to cheaper nursing or therapy-led alternatives.

It has been argued that a nominal charge for an appointment with a GP could be introduced to prevent patients consulting their GP for frivolous reasons. To date, this has never been introduced to avoid the danger of patients avoiding consultations (for financial reasons) for conditions which might be potentially serious.

Politicisation

Over time, increased demand leads to continual political pressures to increase spending and widen the range of treatments available.

Supporters of the NHS would point out that the NHS has wide public support and the English population has as good a health outcome as many other similar countries, and often at much lower cost. Political pressure could work both ways, but the Blair government was elected in 1997 largely on a promise to invest more taxpayers money in health to bring spending closer to the European average. Most people would prefer to see gradual improvements within the current framework and be able to hold politicians to account for the service. This is the position of all the major political parties, none of which has an agenda to replace or make a wholesale reform to the system. The Conservative Party says its policies are aimed at “Protecting and improving our health service by putting patients back at the heart of the NHS, and trusting the professionals to ensure that they are able to use their skills to make the fullest possible contribution to patient care.”

“Paying twice”

Taxpayers who choose to pay for private healthcare must nonetheless still contribute to the NHS via taxation, and in effect “pay twice”, although the vast majority of emergency medical treatment is carried out by the NHS. This is not an effect specific to the NHS, and occurs whenever a choice between a publicly-funded and privately-funded service exists.

Some patients with complex illnesses pay for some medical services privately, while turning to the NHS for the rest of their care. In one recent case a cancer patient was told that if she paid privately for a drug that was not covered by the NHS she would have to pay for the rest of her care. NHS officials argue that allowing the practice would give wealthy patients an unfair advantage and undermine the philosophy of the system.

Waiting lists and the 18 week target

Rationing is a part of all health care systems because resources are necessarily finite. In purely private systems, health care is rationed via the price mechanism, with those being able to or wanting to pay for care getting it immediately and those not able waiting indefinitely (until they can afford it, which may be never). In the NHS, which aims to give a broad coverage of care to all without charging, health care is rationed on the grounds of clinical need, meaning that emergency cases (e.g. heart attacks) get instant access where those with less urgent needs (e.g. cataract surgery) are given lower priority and so wait longer.

Although there are obvious arguments in favour of prioritising by clinical need rather than ability to pay, it can mean that waiting lists vary widely between regions. Patients waiting can choose to have a procedure done outside their local NHS district in order to be seen more quickly, and if the waiting time is long can often get private treatment at public expense, either in the UK or abroad. A major programme is underway in the NHS to reduce all wait times to 18 weeks by December 2008. This new target starts at the point the time the patient’s own doctor writes to the hospital specialist and ends when treatment begins. It therefore includes the time to make the first appointment, and the time for all diagnostic tests to be completed, evaluated, and discussed with the patient, which were not in the previous target. It has been widely criticised by doctors, healthcare professionals, and think-tanks as diverting resources from more serious conditions to achieve politically-motivated goals, and doubts persist over its achievability.

The term bed-blockers is often used to refer to patients still receiving care, even though their acute ailment has been treated and they are fit for discharge. This strains hospital resources, through both increased costs and longer waiting times for other patients. In the UK, bed-blockers are frequently geriatric patients awaiting a placement in a nursing or residential facility.

“Superbugs”

Fatal outbreaks of antibiotic-resistant bacteria (”superbugs”), such as Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile, in NHS hospitals has led to criticism of standards of hygiene across the NHS.

Both C. difficile and MRSA are, however, not exclusive to the NHS, existing in British private hospitals and throughout other western healthcare systems; for instance, cases doubled in the USA’s private healthcare system between 1999 and 2005, and the UK’s death rate is half that of the USA’s. The introduction of Private Finance Initiative cleaning contractors into the NHS and the associated “cutting corners on cleaning” have been blamed for the problem, as has increased drug resistance due to inappropriate prescribing of antibiotics and patients failing to complete courses of antibiotics.

Another viewpoint is that the spread of communicable diseases in hospitals is facilitated by the overcrowding in NHS hospitals with high bed occupancy rates (as the NHS has a low bed:population ratio produced by hospital bed closures and the increasing emphasis on increasing bed ‘turnaround time’).

Computerisation

The NHS has been criticised over the implementation of its National Programme for IT which is designed to provide the infrastructure for electronic prescribing, booking appointments and elective surgery, and a national care records service. The programme has run into delays and overspends, with the initial budget of £2.3 billion over three years officially revised to £12.4bn over 10 years and some sources putting it as high as £20bn. Critics including the House of Commons Public Accounts Committee and the National Audit Office claim the project is falling behind schedule. In addition, 93% of doctors within the NHS are not confident their patients’ data will be secure, some GP practices have begun to advise all their patients to opt-out of the scheme, and privacy campaigners have claimed the national care records system breaches patients’ privacy rights.

The Government and NHS national leadership have consistently argued that major capital investment in IT is necessary to transform services. Fragmented information systems, as in the US, prevent health services providing consistent data and can damage patient care where doctors may not have an overview of patients records held by another NHS body.

Dentistry

There has been a decreasing availability of NHS dentistry following the new government contract and a trend towards dentists accepting private patients only, with 10% of dentists having rejected the contract offered.

Coverage

The lack of availability of some treatments due to their perceived poor cost-effectiveness sometimes leads to what some call a “postcode lottery”.

NHS supporters would argue that the NHS has a duty to ensure that taxpayers money is used wisely and such denials are effective controls. People can always choose to go private, if they can afford it, if the treatment is legally available in the UK or elsewhere.

Deficits

Some hospitals and trusts were running a financial deficit and getting into debt.

Scandals

Several high-profile scandals have occurred within the NHS over the years such as the Alder Hey organs scandal, Harold Shipman and the Bristol Royal Infirmary inquiry.

Supporters would argue that there is nothing endemic about such issues which might equally have occurred in other types of health care establishments. They might also point out that the detection of such issues leads to better controls being established throughout the NHS for the benefit of all.

An October 14, 2008 article in The Daily Telegraph stated, “An NHS trust has spent more than £12,000 on private treatment for hospital staff because its own waiting times are too long.”

Some interesting articles to read:

George Will says that the best way to save Detroit is to let it go bankrupt. Here here!

The big news of the week: The Obama girls will have to wait until after they move into the White House to get a dog.

Bush is going to leave half of the $700 billion bailout for Obama to decide what to do with it. Meanwhile, Bernie Sanders wants to make sure Bush sticks with that plan.

John McCain and Barack Obama sat down to talk yesterday. They say that they are going to work together in the coming years. Work together for what? Did anyone bother to ask that question?

Here’s the latest on our Georgia Senate run off. You knew this one was coming - Jim Martin admits that he will be Barack Obama’s dog washer. Add those duties to being Harry Reid’s sock puppet and Martin will be a very busy man indeed …. Unless, that is, you actually show up at the polls.

Howard Kurtz explores the current pop-culture fascination with Barack Obama. Come January 20th, expectations become reality.

Rupert Murdoch says that the media has dug itself into a hole because it has failed to maintain the readers’ trust.

Mayors across the country are looking for Barack Obama to implement FDR-style public work projects to help their cities get back on their feet.

Sen. Tom Carper of Delaware says that there should be significant consequences for Joe Lieberman, who supported John McCain for president.

This statistic should astound you (then again … maybe not): Since 2000, government spending has increased by more than55%.

A sign of the times from the San Francisco Chronicle: “Are you an idiot to keep paying your mortgage?”

There is an Irish film out there challenging the current global warming hysteria.

Apparently it is “Green Week” on the Today Show so you can see first-hand the affects of climate change. I’m sure this is must-see television.

A church in Kansas refuses to remove a sign saying “America we have a Muslim president. This is sin against the Lord.” Sigh.  If you goto church, you need to stop doing that.  Religion is for weak minded people.

The mayors—Michael Nutter of Philadelphia, Shirley Franklin of Atlanta and Phil Gordon of Phoenix—made their request in a letter to Treasury Secretary Henry Paulson. The three mayors proposed providing loans to help cities pay pension costs. They also want $50 billion in loans for investment in infrastructure, and additional one-year loans to cities unable to borrow cash because of the tight credit markets.

Nutter said cities are facing an economic crisis not seen since the Depression and need help just like financial institutions.

“I want to make sure that cities and metro areas are at the table, that their voices are being heard, that our challenges and problems are well understood, so that we can get relief,” Nutter said.

The federal government opened up a can of worms with this bailout.  Everybody and there brother is coming to them for money now.  This kind of reminds of the movie “The Jerk” with Steve Martin and when he became very wealthy all these organizations showed up at his house and was asking for money from him.  They would give these sad stories and he would just stroke these checks until he went BANKRUPT!

Read the full story.

Nancy Pelosi came up with a plan that she believes will be enticing enough to get enough Republican support. This plan includes adding certain strings to the auto bailout: new fuel-efficiency standards, development of new technology “to compete in the domestic and global market” and restructuring company finances.

The Democrats also want to include limiting executive pay. In other words, the Democrats feel that they, rather than the consumers, are the ones who know just what kind of cars the manufacturers build. All this is going to do is force the automakers to build cars that the American people have already shown that they just do not want to buy.  Sounds more like communism to me.

The Democrats also want to limit executive pay, but what about the over-inflated pay of the workers at these auto companies, thanks to union contracts.  Did you know that $1,600 of every GM car you buy goes toward the healthcare costs of union workers?  For companies like Toyota that aren’t unionized - that cost is only $200 per car. GM also spends another $1,000 per vehicle on holiday pay, work rules, plant-shutdown-pay and line-relief to UAW workers. Those are costs that auto makers such as Toyota don’t have to worry about. The average Ford, GM or Chrysler union worker makes about $71.00 or more per hour. For Toyota, Nissan and the rest … about $48.00 per hour.  Do you detect a small problem here?

A great article by John Stossel:

When so many politicians speak with one voice in support of the biggest act of government intervention in the economy in generations, I cringe.

Everybody talked about the “freeze” in the credit markets, but why, I wonder, were the cable news programs that repeated the credit-freeze mantra, pausing for commercials from companies trying to lend me money? Ditech and LendingTree still hawk mortgages at under 6 percent. Some credit freeze.

Economist Robert Higgs of the Independent Institute looked at the credit numbers kept by the Federal Reserve. He writes: “Although certain financial institutions are undeniably in deep trouble — difficulties of their own making … — credit markets in general have not ceased to operate. Moreover, lenders are extending credit in historically great amounts.”

Maybe this is why CNN business reporter Ali Velshi broke ranks when reporting on “dried up” credit and said, “When I say ‘dried up,’ I don’t mean there’s no money. But you’d better have good collateral and good credit.”

What’s wrong with that?

To those who say that, without banks, nobody can borrow, economist Steven Landsburg offers this response: “Banks don’t lend their own money; they lend other people’s (their depositors’ and their stockholders’). Just because the banks disappear doesn’t mean the lenders will. Borrowers will still want to borrow, and lenders will still want to lend.

Read the full story.

Overview
For over 70 years American taxpayers have been doling out billions of dollars every year to underwrite the agriculture sectors’ cost of doing business. Established as “temporary” emergency measures during the Great Depression, these antiquated policies have since devolved into a gravy train supporting corporate agribusiness at the expense of the public purse. Only a handful of crops receive subsidies at all, and the majority of these subsidies flow only to corporate farms. And five types of crops, corn, wheat, rice, and soybeans receive the majority of all payments. Instead of supporting a struggling sector or promoting rural development these subsidies are only icing on the cake for the wealthiest and largest farmers.

Commodity Prices and Farm Income
2007 saw record crop prices and record farm income, according to USDA. Those records are expected to be surpassed in 2008, with crop value projected to be more than $201 billion – a 17 % increase over 2007. Net farm income is also projected to reach a new high in 2008 of $92.3 billion, 51 % above the 10-year average. The average farm household’s income is estimated to be $89,434 in 2008, according to USDA.

Many factors are contributing to the price increases being experienced by the commodity sector. These include the pressure for planting more corn generated by the ethanol mandates, which reduces the amount of land available for other crops, increased food demand from other countries, and crop losses due to flooding and drought here and abroad. But while record crop prices means that the amount of government handouts will be lower than in recent years, USDA still anticipates padding farmers’ pocket with an additional $13.4 billion in taxpayer funded payments in 2008.

Concentrating the Wealth
According to an a analysis of U.S. Department of Agriculture data on subsidy payments, for farm program years 2003 to 2005, almost $39 billion in farm subsidy payments have been paid out. Just 10 % of recipients receive 66% of the payments, according to the data.  Overall, the analysis finds that the top 1% (measured by income) of recipients received 17 % of the subsidy benefits over the period.  Payments are also concentrated among large producers. The top 1% of producers receives 17% of the subsidies. Their average benefit was $377,484 per person for the three program years. Meanwhile, 80% of producers get just 16% of all subsidies.

While high crop prices are expected to keep some subsidy payments from being necessary in the near future, direct payments will continue to go out regardless of crop price, production, or whether a crop is even harvested. These payments are estimated to cost more than $5 billion per year. And under the new 2008 farm bill, households making up to $1.5 million in farm income and up to $1 million in non-farm income are still eligible to receive subsidies.

Conclusion
The farm economy is prospering. With record crop prices, farm incomes are also setting records. Meanwhile, direct payments that have no relationship to production levels or crop prices will continue to go out at a rate of over $5 billion per year. Under such circumstances the farm subsidy system deserves much greater reform than occurred in the new 2008 farm bill.

Information was obtained from Taxpayers for Common Sense.

Hedge fund manager plead their case on Capitol Hill this past week:

The five hedge fund managers who testified Thursday before the House Oversight and Government Reform Committee are more likely to find friends among Democrats, who have received 65 percent of the total $14.2 million the unregulated industry has given this election cycle to federal candidates, committees and parties. But the managers didn’t appear to be asking members of Congress for protection from regulation–instead they seemed resigned to the fact that it will happen and wanted to have a hand in shaping it, according to the Washington Post.

The managers who testified–George Soros, Philip Falcone, John Paulson, James Simons and Kenneth Griffin–have themselves contributed $179,200 to Congress this election cycle, favoring Democrats with 74 percent of their money. Soros, however, is the only one of them to have given money to president-elect Barack Obama, who received a total of $2.6 million from the hedge fund and private equity industry this election cycle. (John McCain received about $1.6 million.) Employees from the five companies represented by these men (Soros Fund Management, Harbinger Capital, Paulson & Co., Renaissance Technologies Corp and Citadel Investment Group) gave $269,550 to Obama. Citadel employees were responsible for nearly $200,000 of that. Collectively, employees of the companies represented at Thursday’s hearing have given all candidates and committees $915,900 this cycle.

Read the full story.

The veto — Latin for “I forbid” — was not always such an expansive tool of presidential power. Early presidents used it sparingly, only when they believed Congress had violated the Constitution.  Violated the Constitution?  Hmmm…I wonder how many times our recent government has violated the Constitution? Or maybe, the Democrats and Republicans don’t even know that the Constitution even exists

Bill Clinton would be the first president to use the line item veto. But in 1998, the Supreme Court decided that the line-item veto was unconstitutional.  It ruled that Congress did not have the the authority to hand that power to the president. In the 1970s and 1980s many opponents of the line item veto accused fiscal conservatives of supporting the measure only as a partisan power grab because Republicans had generally controlled the White House, and Democrats had long controlled Congress. The 104th Congress proved these allegations to be wrong.  We will get back to the line item veto later.

George Washington issued two vetoes; John Adams and Thomas Jefferson, none. When James Monroe exercised his first and only veto, rejecting a bill imposing tolls on the Cumberland Road because he believed a constitutional amendment was required, he issued a 25,000-word explanation along with it.

Franklin Delano Roosevelt rejected or failed to sign 635 bills during his 12 years in office, using his veto power to keep Congress — run by his fellow Democrats — subservient. Harry S. Truman vetoed 250 bills; Dwight D. Eisenhower, 181.   George Bush senior vetoed 44 bills and Bill Clinton used one of 37 vetoes (not including the line item veto) to reject a law banning a particular type of abortion.

Now getting back to President Clinton and the line item veto.  First, and most critical, is the question of whether the line item veto worked to reduce wasteful spending. In 1997 President Clinton used this new budget cutting tool 82 times to delete unnecessary expenditures in 11 spending bills. The total savings have come to nearly $2 billion over five years. True, in a $1.8 trillion annual budget, this is not a huge sum. But $2 billion is not an insignificant level of savings–even by Washington standards. Moreover, as Gene Sperling, the President’s chief economic adviser has noted, “You have to use the line item veto a few times before its deterrent power sinks in.”

In 1998, President Clinton used the veto to eliminate funding for a $600,000 solar aquatic wastewater treatment demonstration project in Vermont; a $2 million Chena River dredging project in Fairbanks, Alaska to benefit a single tour boat operator; a $1 million corporate welfare grant to the Carter County Montana Chamber of Commerce; $900,000 for a Veterans Admin. cemetery the VA says it doesn’t need; $1.9 million for dredging a Mississippi lake that primarily serves yachts and pleasure boats; $500,000 for the Neabsco Creek Project in Virginia for removal of creek debris; and other such absurdities.

Congress approved the line item veto and the public demanded it, precisely to purge the budget of these kinds of white elephant projects. So, yes, on balance the line item veto works as intended.

Second, did the President abuse the power of the line item veto as was feared? The answer to this question is, on balance, no. Of course, many complaints have been made about Bill Clinton’s use of the line item veto. Senate Appropriations Committee Chairman Ted Stevens, complained that Clinton’s line item vetoes have been a “raw abuse of power.”  Ted Stevens says “raw abuse of power”?  How about his abuse of power in the senate and all the pork projects he was associated with?  Anyways, Robert Livingston, the Republican House Appropriations Committee Chairman charges that Clinton is used the veto to “threaten and intimidate” members of Congress. It is also true that there was one incident reported by The Wall Street Journal where the administration reportedly offered to withdraw a threatened line item veto of a $1.5 million cemetery expansion in Rep. Sonny Callahan’s (R-AL) district in exchange for his support of IMF funding. Such political horse trading constituted an abuse of the item veto.

As their lists of unproductive federal spending demonstrates, we need the president to have the line item veto authority; but, we also need a president who is not reluctant to wield this power.

President Bush went more than five years without exercising his veto power simply because he did not have to: the Republicans who controlled Congress gave him everything he wanted.

But Mr. Bush has also found ways of exercising control over (or circumventing) Congress without using the veto. When Bush wanted to empower federal authorities to monitor the international communications of suspected terrorists, he did so by issuing a secret executive order, avoiding a possible legislative battle — and the potential veto that might go along with it.

And when Congress last year passed a legislative amendment barring cruel, inhumane and degrading treatment of detainees in American custody, Mr. Bush — who had threatened a veto but ultimately backed down — tacked a “signing statement” onto the measure, asserting that he could interpret the amendment as he deemed fit with his constitutional authority as commander in chief.

“President Bush has vetoed things without vetoing them,” said Julian Zelizer, a professor of history at Boston University. “He’s kind of found alternative ways in which he can basically say no to Congress without publicly saying no, or publicly having the confrontation.”

The Bush administration says it has issued 141 such threats since taking office. Some involved disputes over federal spending, an area where Mr. Bush has used veto threats to force compromise with fellow Republicans on Capitol Hill.

Yet some in the party, irate over the federal deficit, say they wish Mr. Bush had exercised his veto power sooner.

In 2002, the president came close to vetoing a $190 billion farm bill that expanded subsidies for growers.

“I think he should have vetoed the farm bill, because it was a lousy bill that perpetuated a really bad system,” said Nicholas E. Calio, who was then Mr. Bush’s assistant for legislative affairs. “But some people convinced him that discretion was the better part of valor.”

That is why Norman Ornstein, a scholar at the American Enterprise Institute, advises presidents not to follow Mr. Bush’s veto path.

“I tell every president or adviser, take one of the first 10 bills that come to you, pick it at random and veto it,” Mr. Ornstein said. “You want to get it out of the way, otherwise the first veto takes on an enhanced importance, and you’ve got to explain and justify why this one and not all the others.”

Barack Obama wants Congress to approve $50 billion for the auto industry. He also wants to appoint a czar or board to “oversee the companies.” This would be the person or committee in charge of restructuring the auto industry.

Since when is it the government’s job to restructure the auto industry? The auto industry got itself into this mess, and it doesn’t need government or the tax payers to get it out of this mess.  That’s how capitalism works people.  If a company has made bad executive decisions, that means that they should file for bankruptcy and not have the taxpayers try to bail them out.  Also, there will always be another company their to either purchase it or pick up the slack.   And besides, what makes the auto makers believe that government could do a better job of restructuring their industry? Politicians aren’t in the industry … let the companies that once enjoyed such great success build on the ingenuity that made them great. The only guarantee you will have from government is mediocrity.

In the mean time, all three automakers will be hoping their lobbying efforts pay off, though none of the companies is on track to spend much more than they did last year–perhaps another indicator of their dire financial situation.

Through September, DaimlerChrysler has spent $5.3 million on federal lobbying, GM has spent $10 million and Ford has spent $5.8 million. Next week executives from the three manufacturers are set to testify before the House Financial Services Committee, whose members have received $1.5 million, collectively, from transportation sector PACs this election cycle. Ford and GM have both given slightly more money to Democrats this election cycle than to Republicans, marking the first time Ford has done so since the 1990 election cycle (and if GM has ever done so, it was before 1990, when CRP started tracking contributions by industry). Chrysler has given just a little more money to Republicans in 2008 (51 percent to 49 percent), indicating a strategic change from the last election cycle, when the company gave Republicans 63 percent of its total. So far the Bush administration seems set to reject the $25 billion in aid, and if that happens, GM, at least, might be forced to file for bankruptcy.

UAW is planning to ask the government for an additional $25 million to cover a union-run trust to take over the car companies’ retiree pensions and health benefits. UAW has reported spending about $1.2 million on lobbying efforts so far this year.

Information was obtaind from the Center for Responsive Politics.