Posted on 12/12/2010 1:12:26 PM PST by KeyLargo
Published on Otago Daily Times Online News
Threshold raised for eye surgery By Elspeth McLean Created 13/12/2010 - 05:00
Increased demand for cataract surgery and a lack of capacity to carry out extra work has resulted in Dunedin Hospital raising the threshold for such operations.
Emergency medicine and surgery group manager Dr Colleen Coop said it was a matter of finite resources versus infinite demand.
The hospital was planning to carry out about 500 procedures this year, about the same number as last year.
The threshold for the surgery had been increased by five points on the clinical priority assessment criteria (CPAC) scoring system.
The information used for this is compiled by the consultant assessing the patient and allocating scores and also the patient filling out a social score about how they are affected by their condition.
The points now need to add up to 55 to qualify.
Some people visually unfit to drive may have a long wait before surgery, but Dr Coop said not being fit to drive was not a sole factor which would qualify a patient for surgery.
Limited capacity and resources meant patients regarded as having non urgent or routine conditions would be returned to the care of their family doctor. (The doctor would monitor the condition and refer the patient again if it was considered the situation had worsened to the stage of meeting the criteria.)
This had been happening for at least the last three years, she said.
A patient who contacted the Otago Daily Times expressed concern that as the eyesight of a patient in this situationdeteriorated further they were in danger of having falls, which could be much more expensive to both the patient and the health system. It seemed an unreasonable risk when cataract surgery was usually a relatively simple procedure which only took about 20 minutes.
He said he could not afford to have private surgery, which he understood would cost about $5000, and faced an uncertain waiting time for surgery, even though he was legally unable to drive.
Dr Coop said what had also compounded the situation was the introduction of a service for vitreoretinal surgery (known as VR and including surgery for such conditions as retinal detachment). Such patients had previously been seen in Christchurch.
This service was still in the setting-up phase, and initially would be getting through "a hump of patients awaiting this surgery since the start of the year", affecting the slots available for other patients. It was expected this would be temporary.
Dr Coop said patients who were already in the hospital's system and approved for surgery when the points threshold was raised were not affected by the increases as they had already been given certainty about their operations.
"How do I pay for my healthcare in New Zealand? New Zealand's healthcare system is funded mainly through general taxation. Treatments are usually free or subsidised."
http://www.emigratenz.org/healthcare-migrants-newzealand.html
Once the government has your money, it’s theirs, and they have no interest in seeing it used for your benefit.
You don't pay nothin' and you get what you pay for.
They actually have public and private sectors to their health care system. They tightly manage their public sector but the private aspect runs the way any private practice would.
New Zealand, the same country that has disarmed their police and citizens.
Calls to arm NZ police after attack
There were fresh calls for New Zealand’s unarmed police to carry guns after a lone constable was attacked
Saturday December 11 2010
There were fresh calls for New Zealand’s unarmed police to carry guns after a lone constable was attacked with a machete, leaving him with slashes across his face, deep cuts and fractures to his head and arms and a finger severed from one hand.
Detective Inspector Chris Bensemann said senior constable Bruce Mellor was attacked and left to die after he pulled over two teenagers driving a stolen car during a routine stop.
A passing motorist spotted the bloodied Mellor, 57, lying on the roadside and called emergency services.
Mellor, who suffered a fractured jaw and eye socket and has several skull fractures,is in a serious but stable condition after surgery.
Police Association president Greg O’Connor says it’s time for every police officer to have access to firearms.
New Zealand police patrol unarmed, but pressure to give officers ready access to guns has mounted in recent years.
http://www.independent.ie/breaking-news/world-news/calls-to-arm-nz-police-after-attack-2457616.html
Officer brutally attacked with machete
http://www.stuff.co.nz/dominion-post/news/4450744/Officer-brutally-attacked-with-machete
When you make something of value free, it tends to create infinite demand. Funny how government can't inflate supply so easily.
I'm a proud and productive worker working for 47% of what I am worth then.
Just so they spend it wisely.../s
The alternative is blindness, and that is more costly.
True however I would argue that the rationing of care in public hospitals (which typically are the academic medical centers) holds back the advancement of care in nations with such a system in place.
That’s why the U.S. has always had the most advanced, world-class care. Period.
Well, you’re right about that, but surgery can often be delayed for a long time, and often never becomes indicated (that is, the person dies first). Something made the demand in NZ far outstrip the supply, and whether it was people seeking the surgery earlier than necessary, or doctors leaving practice or leaving the country due to inadequate compensation, the market is out of whack there.
Or, the shift from watching sheep to watching CRTs. There are numerous reasons why the incidence of cataracts could be up.
Or, maybe it was the case that they simply didn't treat the problem promptly in the past but with the coming of the internet people can read all about it and make their own diagnosis. PLUS, they can watch the movies and see that it's not all that bad.
A preview of 0-care.
Too many people needing the procedure costs the government too much? Lower demand by reducing the number who qualify for it by raising the eligibility threshhold (note -- except for congressthings)
The cost of a procedure is too high? Lower the cost by restricting the procedure to only a few people, or by eliminating some of the peripheral costs (note -- except for congressthings).
But no worries -- regular people can apply for waivers -- through their elected representatives. That gives legislators wonderfully touching sound-bite moments, when they introduce a tear-jerking story, complete with live prop, of a deserving soul whose courageous journey brought them to the door of their congressthing, a congressthing whose compassion and deep concern for constituents and campaign theater moved them to push a waiver through (and, incidentally, to vote for the waivers of dozens of other congressthings who were, purely by coincidence, also on the campaign trail).
Excuse me, I think I need to go vomit now.
Remember -- they had to pass it so the U.S. could find out what was in it.
Immigration is another possibility. I believe net immigration is fairly high there.
“The alternative is blindness, and that is more costly.”
No problem.
The “threshold” for blindness will also be raised 5 points on their CPAC scoring system.
The Accountants (a greedy bunch) wanted to keep it at 15 days ~ which, with certainty, generated hundreds, if not thousands of cases per year and required us to train and employ several people specialized in the matter.
I won. They lost. The public (customers) won.
They must have moved to New Zealand in my absence.
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