Saturday, August 23, 2008

Obama's Health-Care Tipoff

'If I were designing a system from scratch, I would probably go ahead with a single-payer system," Barack Obama told an audience in Albuquerque on Monday. He was lauding the idea of a health-care market -- or nonmarket -- entirely run by the government.

Most liberals support single payer, aka "Medicare for All," because it would eliminate the profit motive, which by their lights is the reason Americans are uninsured. The Democratic Presidential candidate takes a more moderate campaign line, though we suppose just about everything is "moderate" compared to a total government takeover. While preferring that option in theory, Mr. Obama continued, his health-care plan is designed to "build up the system we got," and over time, "we may . . . decide that there are other ways for us to provide care more effectively."

The Senator has expressed similar sentiments before, including throughout his combat with Hillary Clinton. But repetition doesn't make it any less telling, especially about his political instincts and the breadth of his ambitions. Mr. Obama's health-care plan includes a taxpayer-funded insurance program, much like Medicare but open to everyone. The goal, like HillaryCare in the 1990s, is to displace current private coverage and switch people to the default government option. What's new is Mr. Obama's smoother political packaging.

With good reason, critics often call this a back-door route to a centrally planned health-care bureaucracy. For all his lawyerly qualifications, Mr. Obama has essentially admitted that his proposal is really the front door.

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Disorganized British paramedics kill woman

A Midland widower whose wife died after alleged delays by paramedics in getting her to hospital has criticised the ambulance service for not apologising four years after her death. Roger Bereza, who lives in Coventry, spoke out after West Midlands Ambulance Service (WMAS) paid an undisclosed six-figure-sum in an out of court settlement earlier this month.

His 41-year-old wife Tracey had suffered asthma since childhood but on April 11, 2004 she had an acute attack and her condition continued to worsen, so Mr Bereza dialled 999 for an ambulance.

As well as complaints about the way the ambulance crew treated his wife at the scene, he said they had to ask him for directions to the nearest hospital and went the wrong way. A crew of two paramedics arrived at the family home at just after 9.20pm but, he said, it took more than 75 minutes to take his wife to hospital during which time she went into respiratory arrest.

Mr Bereza, a 47-year-old RAC patrolman, claimed there was a series of shortcomings in the way his wife's care was handled and once in the ambulance she suffered a respiratory arrest. He said he could only watch as his wife vomited blood, turned blue and arrested in front of him, as his three daughters looked on from the house. "By now I knew I had to do something, so I started doing chest compressions on Tracey's chest while one of the paramedics tried to get the defibrilator to work. Monitors were showing her pulse was at zero, and we were still on the driveway. I couldn't give up on her, even though I realised it was the beginning of the end."

They arrived at Coventry & Warwickshire A&E at 10.35pm. Mrs Bereza never regained consciousness and died four days later after her family took the difficult decision to turn off her life support machine. The couple, who had three daughters aged 20, 19 and nine, were due to celebrate their 21st wedding anniversary in June 2004.

Despite the pay-out from WMAS, the family said they had yet to receive a formal apology or admission of liability. A trust spokesman said: "WMAS first became involved in the treatment of Mrs Bereza on the evening April 11, 2004 when her husband called for an ambulance. Mrs Bereza had suffered an asthma attack after inhaling polish fumes. "The trust wrote to Mr Bereza on July 22, 2008 in regard to his claims about the level of care given to his wife and expressed its `sincere regret'. "WMAS is always learning from its experiences and strives constantly to find ways of improving patient care. "In light of this case, further inquiries into the trust's protocols were undertaken to ensure that the training and actions of staff are appropriate at all times."

Mr Bereza added: "I am still extremely angry. This tragedy should never have happened. "Although Tracey had suffered from asthma since childhood, it was controlled most of the time. We knew that if she had a severe attack we had to get her to hospital as soon as possible. Even though we live just 10 minutes from the nearest A&E, I had always been told to call an ambulance and not to attempt to drive there myself in case we got stuck in traffic or Tracey required emergency oxygen for her nebuliser. "I wish I'd ignored this advice and taken Tracey to hospital myself."

Lindsay Gibb, a medical negligence expert with Birmingham-based law firm Irwin Mitchell, said: "This is a hollow victory for the family because despite agreeing to pay a significant sum by way of compensation, the trust has not apologised to the family or accepted that its paramedics were negligent in any way. "The relevant guidelines state that: .'in a life threatening or acute severe asthma attack - do not delay transportation. Load and go to nearest suitable receiving hospital and provide nebulisation en route'. "This clearly was not the case on this occasion and the evidence suggests these delays were responsible for the fatal outcome."

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