Preventable death rate U.S.higher than Canada

Canada's health care system offers "excellent value for the money" says a British researcher who has studied preventable deaths in 19 industrialized nations.

The study, to be released today in Health Affairs, looks at "amenable mortality", deaths that would not have occurred if effective health care had been available.

Conditions that caused these deaths included bacterial infections, treatable cancers, diabetes, some cardiovascular disease and the complications of common surgical procedures. The study, which looked at figures from 2002-03, updated a similar report based on 1997-98 figures.
Its goal was to compare amenable deaths in the United States with 14 western European nations, plus Canada, Australia, New Zealand and Japan.

The study also tracked whether gaps in these countries had narrowed or widened. The figures were computed according to amenable deaths per 100,000 population under the age of 75.
In the first study, the researchers found that amenable deaths in the U.S. stood at 114.74 per 100,000 population, exceeded only by Ireland, Portugal, Finland and the United Kingdom.

In that time period, Canada's amenable mortality rate was 88.77, the seventh-lowest rate after France, Japan, Spain, Australia, Sweden and Italy.
In the most recent study, Canada's amenable death rate had dropped to 76.83, putting Canada sixth after France, Japan, Australia, Spain and Italy.

Meanwhile, amenable mortality rates in the U.S. have barely budged from 114.74 to 109.65 in 2002-03, taking the U.S. from 15th place to last place among the 19 countries.

"This study shows that Canada's health system has performed very well in its ability to prevent people from dying from treatable conditions," said Martin McKee, a researcher at the London School of Hygiene and Tropical Medicine, and co-author of the study.

"While everyone has to die from something, sometime, in an ideal world, no-one would die from the causes we have looked at, in the age groups we have included."

"Of course, we don't live in an ideal world," said McKee.
"However, the bottom line is that the Canadian health system delivers outcomes that are substantially better than those in its southern neighbour."

"More importantly, outcomes in Canada are improving more quickly than those in the U.S.," he said.
"Given that the U.S health care system is far more expensive, this suggests that Canadians are getting excellent value for money."

The researchers expect there will be further improvements in amenable mortality rates in industrialized countries, but the rate will slow down.

The most significant gains were made in the 1970s and 1980s, when drugs to treat common conditions such as hypertension became widely available, said McKee.
That raises questions about whether the U.S. will be able to narrow the gap between itself and countries with much lower amenable mortality rates, he said.

"Other research shows that many Americans are unable to afford the prescription drugs they need," said McKee.

"So, if some future administration can tackle this then we could see real improvements there." In countries like Canada, he expects the main gains will be less in amenable mortality and more the the quality of life, especially for older people.

Source: Ottawa Citizen

Revolutionary device will improve Heart Surgery dramatically

Experts in the U.K. are developing a flexible surgical robot, known as the i-Snake, which they say could revolutionize keyhole surgery.

The i-Snake is not the latest gadget from the Apple company, but it's a long tube housing special motors, sensors and imaging tools that could be used for heart bypass surgery.
It could enable surgeons to do complex procedures previously possible only through more invasive techniques.

But it could also be used to diagnose problems in the gut and bowel by acting as the surgeon's hands and eyes in hard to reach places inside the body.

A team at Imperial College London has been granted £2.1 million for the work.
The Imperial College team will test the device initially in the laboratory before it is used on patients.

Minimally invasive surgery has obvious advantages: it can mean smaller scars, reduced hospital stays and shorter recovery times.
Surgeons are also looking at ways to avoid skin incisions altogether.

One approach is Natural Orifice Translumenal Endoscopic Surgery or Notes.
This means operating in the peritoneal space through natural orifices or cavities, such as the bowel.

England's Health Minister and surgeon Lord Darzi said: "The unrivalled imaging and sensing capabilities coupled with the accessibility and sensitivity of i-Snake will enable more complex diagnostic and therapeutic procedures than are currently possible."

Source: Telegraph

Editor:

"In the coming years, we will see more and more that nifty technology will dominate the scalpel in the operating room"

Nova Scotian doesn't get his wife back from British hospital

Sandy Munroe from Tennycape, Nova Scotia, was not surprised to hear Thursday that a British hospital will not send his wife back to Canada. But he was undeniably devastated.

"They said it was not in her best interest to send her back," he said.

"They don’t think she should be sent over to be close to her husband of almost 45 years."

Mr. Munroe was notified of the decision in an e-mail from Billingham Grange, the North Yorkshire hospital where 65-year-old Alzheimer’s patient Helena (Heli) Munroe has lived since last spring.

Many people close to Mr. Munroe believe members of the hospital panel changed their minds after the CBC aired a television report on the couple last month in which their son accused Mr. Munroe of physically abusing his wife.

"I can’t even begin to talk about The Fifth Estate," Mr. Munroe said. "It was a wicked misrepresentation of a loving marriage."

"It broke my heart to hear the things they accused me of. . . . I love my wife and I treated her well. . . . I always did."

"This has been devastating, and Billingham Grange is a good, good hospital, but they did the wrong thing."

Mr. Munroe’s voice quavered as he talked about his two-year battle to get his wife returned to Nova Scotia from her native England, where her brother took her in November 2005.

Mrs. Munroe who herself, held a doctorate in cognitive therapy and was an expert in Alzheimer’s disease, was declared mentally incompetent by her Canadian geriatricians in early 2005.

Read the full story here

U.K. public health care system flops, unlike Canadian health care system

Most Canadians are proud of their public health care system.

It's paid for by everybody and used by everybody, it pools the cost of treatment and care.

Like every other health care system in the developed world it has its problems but, contrary to the claims of its enemies, it isn't in crisis.
Until recently, Britain has been like Canada.
Canada's National Health Service, despite its problems, is doing a good job and improving. But its future has been put at risk by the introduction of market forces and profit-seeking providers.

Some B.C. politicians and other private health care lobbyists are claiming that U.K. health care privatization is a success. Nothing could be further from the truth.

Britain recently introduced private hospitals, much like B.C.'s private surgical clinics, to carry out the cheap, less-risky operations on generally healthy patients.
In other words, they "cherry-pick" the profitable work and leave the NHS hospitals to care for less healthy people and all the other complex procedures.

Yet operations in these private hospitals cost on average 11 percent more than in public ones. And these profit-seeking companies are a guaranteed flow of funding.
So if their contract specifies 5,000 patients a year and only 4,500 go there, the private hospital gets paid for the full 5,000.

The former chair of the British Medical Association, James Johnson, has said, "I see hospital services destabilized as a result of over-emphasis on the use of the independent sector . . . the money could often have been better spent making greater use of existing NHS capacity."

While the incomes of private sector hospitals are guaranteed, public hospitals have been forced to compete, not just with the for-profit outfits, but with each other. To do that, the government introduced payment by results, the politicians call this "patient focused funding."

The result has been a mess. The new system was supposed to introduce fiscal discipline, but in its first year the NHS overspent its budget for the first time in 60 years. Hospitals cut back on services to clear deficits, resulting in major backlashes against the Labour party government all over the country.

The troubles don't end there.

The introduction of "patient-focused funding" and market forces has increased the proportion of the health budget spent on bureaucracy from four per cent to approximately 15 percent.

If the money is "patient focused," you have to set up and run a system that tracks both the patients and the money.

Preparing bids costs money. Lawyers and accountants have to be paid. Hospitals have to calculate, log and code each patient's costs. Then they have to send off the bills. The purchaser has to check them.

Some bills are challenged, more lawyers and accountants. And clinicians have to divert time from treating patients to tracking paperwork.

When privatization was introduced, it was presented as a solution for reducing waiting lists and costs. But in reality neither the private sector nor the "patient focused" funding are responsible for cutting the waiting lists in the U.K.

The Vancouver Sun

Editor's opinion:

"I think that governments of countries with a public health care system should keep an active eye on competition. They should impose laws on treatment in private health care facilities that compete with public facilities when the particular treatment is covered by the system."