If there’s any lesson to show that healthcare today is an industry, take a look at Greece. With the economy heading south, even healthcare is affected just like any of the other industries in Greece – production problems, delivery issues and lack of supplies are for real. What with the current economic turmoil, a leading global pharma company has even decided to pull the rug and stop supplying a state-of-the-art medication to the beleaguered country.
Novo Nordisk, a Danish company and the world’s leading supplier of insulin (a drug used for treating diabetes) is withdrawing the Novopen from Greece as it objects to a government decree ordering a 25% price cut in all medicines (see here).A spokesman for the Danish pharmaceutical company said it was withdrawing the product from the Greek market because the price cut would force its business in Greece to run at a loss.
This has resulted in local action groups condemning the move as brutal, bad timing and a neglect of corporate social responsibility. Novo Nordisc on the other hand claims that it is owed $36m (£24.9m) dollars already by the Greek state, whose coffers are now empty.
Most likely, many other big pharmas will follow suit soon and is likely going to cause a crisis within a crisis soon. (Doctor2008: its now reported that another firm, Leo Pharma is also withdrawing sales). Which is a shame, because Greece in recent times ensured everyone of its citizens received free healthcare services and at the same time had one of the most admired private healthcare services in Europe, the so-called “Greek Paradox”.
Back to my opening sentence – its all very well for some activist groups to proclaim universal healthcare rights for all, but this has to be tempered with the realities of the economics of modern healthcare delivery. No country in the world can afford a liver transplant for every patient with advanced cirrhosis of the liver; so I beg to differ with those who say healthcare is a basic human right…I would amend it to say that basic healthcare is a basic human right.
Developing countries like Malaysia could do well looking at what’s happening to Greece, because when push comes to shove, healthcare, like any other industry, will be subject to ups and downs of economic forces and suffer the same consequences as any other industry.
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The death of the Polish President and 95 members of his entourage recently on April 10th in an air-crash has now been speculated, not to be due to pilot error, but to this modern-day syndrome.
‘VIP passenger syndrome’ means simply that a very important passenger uses his or her clout to influence the pilot and/or crew to make a bad decision under pressure. Could this also be the real reason for the deaths of Dodi and Diana when their chauffeur could have been persuaded to drive at extreme speeds to avoid the pursuing paparazzi?
In the Polish president’s case, the Telegraph speculated that President Lech Kaczynski had previously tried to sack a pilot who refused to land a plane for him in dangerous circumstances. In that incident in 2008, the President shouted furiously at a pilot who had disobeyed his order to land his plane in then war-torn Georgia for safety reasons. He later tried to have the pilot removed from his post for insubordination.
In last Saturday’s crash, black box recordings have confirmed that the pilot, Arkadiusz Protasiuk, an experienced airman serving with the Polish air force, had ignored warnings to divert to another airport because of heavy fog. It was speculated that the late President may have put some pressure to land as he did not want to miss a ceremony for the 22,000 Poles massacred by Soviet forces in the Second World War and may have urged the air crew to continue trying to land the plane.
I must confess that I have never heard this syndrome before, and it surely ranks as one more of new modernistic terminology describing illnesses of the new millennium!
More examples of VIP Passenger Syndrome:
http://gvk2.wordpress.com/2009/10/21/a-matter-of-accountability/ -an Indian leader.
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Making history, President Obama signed into law the healthcare bill yesterday, making it the first time that there is healthcare coverage for every American. Well, this certainly made the Republicans unhappy, they citing that the phenomenal costs involved will drive the nation deeper in debt.
Also not looking forward to the new law will be all the private health insurance companies, who for years have been making handsome profits, mainly by including various escape clauses to exclude payments for health expenditure where it mattered most, such as in claims for pre-existing illnesses.
Even so, one of the more unpublicised facts from the new law, hidden within the massive pages of the bill, is a requirement that will make calorie counts mandatory for thousands of restaurants. More than 200,000 fast-food and chain restaurants will now have to state the number of calories each item on their menu has, the idea being to inform the consumer the number of calories they are consuming.
Grumblings are also being heard from doctors. The new law introduces curbs on doctor-owned hospitals and promotes an independent payment advisory board that does not include doctors, However, it does not include a performance-based payment system and does not address reforms meant to reduce medico-legal litigation costs (this being arguably one of the main reasons why heathcare costs are so high).
While the healthcare bill has become law with the President’s signature, storm clouds are looming – attorneys general from 13 states – 12 Republicans and one Democrat – have begun legal proceedings against the federal government seeking to stop the reforms on the grounds that they are unconstitutional. So it does look like the ‘victory’ is not yet sealed in stone..
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The US spent $2.472 trillion on healthcare in 2009..that works out to $282 million an hour, give or take some loose change.
According to this article in the Journal of Health Affairs, this means that the healthcare portion of the GDP rose to an all-time high 17.3%, more than double of that of most other countries.
No wonder President Obama is placing healthcare reforms as a top priority – at the rate its going, healthcare expenditure will soon burst at its seams. Even more alarming is the fact that, for the first time in the next few years, public spending for healthcare services (Medicare, Mediaid, Veteran hospitals, children insurance program) will outstrip the largely private-sector driven healthcare expenditure. Put in another way, by 2012, public (government) spending will account for more than half of the total healthcare spending in the US.
Why is this so?
The main reason appears to be that healthcare spending continued to rise despite the recession that resulted in reduced spending in other areas of the economy.. After all, people do continue to get sick, in good times or bad.
This healthcare spending continued to rise partly due to the aging population; but the real reason is due to increasing prices (3.2% a year) and increasing use –utilisation in tech-jargon – at 1.5% annually.
Quite naturally, President Obama is looking at cutting expenditure like reducing Medicare costs, but this has not gone down well with the Democrats, creating delays in approval at Congress. Already, the President has backed down quite a bit from his original proposals and the way ahead appears to be for the Democrats and the Republicans to work together for a common solution – which is easier said than done.
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The news of the enormity of the earthquake that hit Haiti on 12 January has been rather muted up till now, maybe because of the difficulty in establishing proper communication channels. There is even a page on Facebook called Earthquake Haiti for people to look for the missing. But consider the following:
-estimates of deaths may reach 200,000.(the 2004 Indian Ocean tsunami caused about the same number of deaths)
-a large number of foreigners are missing, including 1,415 Canadians.
-75% of the capital Port-au-Prince has been destroyed.
Added to the misery is the fact that only 2 hospitals are operational, the rest destroyed, including the 3 clinics run by Doctors Without Borders. This is on top of the fact that there’s no running water, no sanitation, no food, and no electricity.
While the immediate health problems are obvious to the 3 million Haitians that need urgent medical help, the real challenge will come in the weeks ahead when diarrhoea, lung infections and complications of chronic disease set in because of the poor sanitation, nutrition and inferior medical facilities.This is when international agencies like the WHO and Red Cross can lead by example, just like when they did it for the H1N1 pandemic. Perhaps they can do it with the same resolve,urgency and resource?
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Ah..the soaring human spirit knows no limits. Time after time, upon the completion of a record-breaking skyscraper, the economic health of that country takes a fast spiral south. Its as if the higher a building reaches for the skies, the deeper the economic misfortunes are.
The Empire State Building, completed in 1931, marked the start of the Great Depression in the US.
The opening of London’s Canary Wharf Tower in 1991 coincided with the onset of the UK recession.
Malaysia’s Petronas Twin Towers was completed in 1998 which heralded the Asian economic crisis.
Now, the same fate appears to befall Dubai’s Burj Dubai. The world’s tallest skyscraper, 808 metres and 162 floors high, has had its opening postponed several times, the latest for the New Year, amid the financial turmoil currently enveloping Dubai.
Certainly, one useful indicator of when countries will slip into recession or economic downturn is the completion dates of major skyscrapers. City planners and building developers may like to take heed of this fact. Cynics say this pattern is no surprise, as projects are conceived when the economy is booming; by the time the planning and construction is completed, most countries are ready to welcome (yet again) the cycle of recession.
Taking a peep into the future, will the Shanghai Centre, the proposed tallest building in China due to be completed 2014, herald the onset of China’s recession? If that’s too far away, the APIIC Tower (100 storeys) in Hyderabad is due to be ready in 2010. Will this spell doom for India? Hold your breath for not too long..
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There are many reasons to push through President Obama’s health reforms urgently despite the rhetoric – escalating health costs, 80 million uninsured Americans, inefficient delivery systems, to name a few. But there’s one question that needs to be addressed for which the answer is practically unanimous.
Are Americans dying too soon? The answer is a resounding YES.
When it comes to “preventable deaths” – illnesses and injuries that should not kill at an early age with access to timely and effective health care – the United States ranks last among 19 industrialised nations, according to the Commonwealth Fund.
Well, the study may be a few years old, but the fact remains that not much has changed since and the belief is that the US continues to lose ground. And what are the diseases Americans most likely to die from that can be prevented? Gun-shot injuries and motor vehicle accidents top the list but chronic diseases like diabetes, stroke and epilepsy are bigger drivers of healthcare costs.
Many will defend US healthcare as one of the finest in the world. True, to a certain extent. When its good, its really good. But when its bad, it can be really terrible. The OECD (Organisation for Economic Cooperation and Development) describes the performance of the U.S. system as a mix, at best.
It ought to be noted that diseases like complicated cancers, AIDS and most heart diseases, while often treatable, are not considered preventable, because even with the best of modern medicine, patients often die before old age.
As the health reform debate rages on as to the best methodology to resuscitate, rehabilitate and enhance healthcare delivery in the US, thousands will continue to die from preventable causes. Many are asking whether the President will have the panacea for the ailing system.
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..so says a UN report on migration and development. In the United Nations Development Program’s Human Development Report 2009, published yesterday, 182 countries were ranked according to the Human Development Index (HDI), a composite measure of three dimensions of human development:
- living a long and healthy life (measured by life expectancy),
- being educated (measured by adult literacy and gross enrolment in education) and
- having a decent standard of living (measured by purchasing power parity, PPP, income).
The agency claims that the HDI is more accurate than the GDP as a measure of human development, although it admits HDI does not by itself give a comprehensive measure of human development within a country. For instance, it does not measure sex or income inequality and degree of human rights.
Another downside – while the report was labeled 2009, it was really based on data collected for 2007. Therefore, it does not take into account the economic crisis which befell most of the world in 2008 and 2009. Even so, I feel Australia is one of the few countries which will not fall in the rankings, considering it never fell into economic recession, according to official trade data.
Here are some selected rankings:
United States 13
United Kingdom 21
(You can obtain the complete rankings here)
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(Courtesy: USA TODAY)