Tannhäuser to B Minor Mass: NHS & Simon Stevens

The Cockroach Catcher managed to get to Tannhäuser on its last night and will be going to Bach's B Minor Mass. What is he hoping for?

The thing that hath been,

it is that which shall be; and that which is done is that which shall be done:

and there is no new thing under the sun.

Ecclesiastes 1:9

Last summer’s entertainment has been that of the alleged ritualistic sexual activity of some well known politician.

Why should so much media time be wasted on such matter or was it a deliberate distraction from something more important?

Tannhäuser in the kingdom of the goddess Venus, by Henri Fantin-Latour. Photograph: akg-images

The sexual exploits of the elite Parisians were no different to that of modern day politicians:

Wagner's decision to place the obligatory ballet in the opening scene also offended the influential Jockey Club, whose members were in the habit of arriving at the interval to see their mistresses dance before going backstage for sex. By the third night, dog whistles could be bought in the streets outside the Opéra for the express purpose of interrupting the performance.

Tannhäuser, Wilde & Freud

But what is most important is the new NHS Vanguard:

Without new legislation or public debate a new NHS is happening or so we thought. The Cockroach Catcher wrote on September 7 2015:

Simon Stevens spent some years in the US. Is Vanguard a re-working of Kaiser Permanente?

I have always admired Simon Stevens and his ability to quickly picked some of the best loved people in the NHS to promote Vanguard. The like of which has not been seen in any State run change since Bevan. But Vanguard is going to mean a good deal more than we were led to believe. I suspect that the people working for him are either not aware or they were told not to divulge it. Like Steve Jobs, the smartest people keep their main aim to themselves. He has picked the people that were very savvy with Social Media and that part of the NHS is exploding with little reference to the plight of Junior Doctors or the bribery of GPs. Nothing should distract now! But is everything about Vanguard new inventions of Simon Stevens?

Remember:

The thing that hath been,

it is that which shall be; and that which is done is that which shall be done:

and there is no new thing under the sun.

Ecclesiastes 1:9

Simon Stevens: Tannhäuser & Vanguard!

Animal Farm & Junior Doctors : 2016 Special Sale!

Looks like we have a big new idea: sell the Junior Doctors to Hedge Funds.

The truth is that despite the recent happenings, Junior Doctors are most valuable for our future PIGS as they will become consultants that can sort out our cardiac arteries and failing knees. So no one better than the best of the City to deal with them as their new commodity. Then when one firm cannot supply the doctors another firm will. The beauty of competition. So, run and get cracking, not crackling!!! Strikes will no longer be our problem!

Looks like someone stole our idea at the 2012 special meeting:

There will be two kinds of CCGs. They may look the same, but in truth they are going to be different. In simple terms, the ones you people are going to run will be different to those run by non-supporters.

We have promise that there will be choice. Yes, there will be. Your choice!

You can choose the healthy patients and leave those in care homes or those with chronic illnesses to the others. We will make sure that the other CCGs cannot refuse.

Animal Farm: 2012 Special Meeting!

Reform is happening too down in the farm & the pig called a special meeting but only of supporters:

©2012 Am Ang Zhang

Dear Supporters, thanks for coming today. The dissenters did not realise the most important part of our plan.

There will be two kinds of CCGs. They may look the same, but in truth they are going to be different. In simple terms, the ones you people are going to run will be different to those run by non-supporters.

We have promise that there will be choice. Yes, there will be. Your choice!

You can choose the healthy patients and leave those in care homes or those with chronic illnesses to the others. We will make sure that the other CCGs cannot refuse.

There will be integration but here we really mean our kind of integration. Or was it your kind? Anyway, your kind of CCGs will run the special Hospitals that will have the help of great financiers from the City. Like Kaiser Permanente (which we should not mention outside these doors) we will not let other hospitals make money. No true competition, just think about airlines, utility companies and ADM.

Some hospital will fail and you can buy them up and run it profitably and we already have people that know about Real Estate helping you. Imagine a Central Luxury Apartment with easy access to the best hospitals in the world? World Class Real Estate and World Class Medicine!

Just in case you are worried about the few Hospital Consultants that did not agree, do not worry, we have people everywhere.

Run, get cracking!

    ©2012 Am Ang Zhang

20 years in the planning and we are nearly there.

“In the case of the consultants, a show was made of trying to make them accept much closer supervision by hospital managers, and cut back on their private work. But it soon came to seem that the real aim of doing this was to make them feel more disenchanted with working as salaried NHS employees and readier to go into business – to form doctors chambers, on the model of barristers, or other kinds of business, and sell their services to any employer, public or private, that offered them the best terms. A significant number began to plan to do so and some have begun to. And as the cuts begin to bite there will be unemployment among hospital doctors. As you will have read, consultants are among those scheduled to be laid off by St George’s hospital in Tooting, and elsewhere. Working for private providers will become normal again in a way it hasn’t been since 1948.”

                                                                                      The Plot Against the NHS

I think there is something fundamentally scary about our democracy…. Because I think people have a sense that the system is rigged, and it’s hard to argue that it isn’t.

Michael Lewis: The Big Short

Animal Farm

Kaiser Permanente:

NHS-Kaiser Permanente: Summary Posts

Animal Farm

Animal Farm: Democracy!!!

First Emperor, Animal Farm & Allyson Pollock

For ‘Liberating the NHS’ read ‘Dismantling the NHS’

The internal market has been a costly disaster. Let the professionals manage medicine 

Mayo Clinic: Health Care is not a Commodity!!!

The NHS & Southern Cross Healthcare: The future is now!!!

Price competition links: airlines, utility companies and ADM.

Tioman Island: Un-bleached & Outside the Box!

Ideas without precedent are generally looked upon with disfavour
and men are shocked if their conceptions of an orderly world are challenged.
Bretz, J Harlen 1928.

We have always been led to believe that bleaching of the world's coral reefs is final proof of global warming. Not quite according to the NOAA:

When corals are stressed by changes in conditions such as temperature, light, or nutrients, they expel the symbiotic algae living in their tissues, causing them to turn completely white.

Warmer water temperatures can result in coral bleaching. When water is too warm, corals will expel the algae (zooxanthellae) living in their tissues causing the coral to turn completely white. This is called coral bleaching. When a coral bleaches, it is not dead. Corals can survive a bleaching event, but they are under more stress and are subject to mortality.

In 2005, the U.S. lost half of its coral reefs in the Caribbean in one year due to a massive bleaching event. The warm waters centered around the northern Antilles near the Virgin Islands and Puerto Rico expanded southward. Comparison of satellite data from the previous 20 years confirmed that thermal stress from the 2005 event was greater than the previous 20 years combined.

Not all bleaching events are due to warm water.

In January 2010, cold water temperatures in the Florida Keys caused a coral bleaching event that resulted in some coral death. Water temperatures dropped 12.06 degrees Fahrenheit lower than the typical temperatures observed at this time of year. Researchers will evaluate if this cold-stress event will make corals more susceptible to disease in the same way that warmer waters impact corals.

These are doing fine at Tioman Island,  2.8167°N

All photos©2014 Am Ang Zhang

Medicine and Snorkelling: Think outside the box!

The first modern snorkel was invented by none other than Leonardo da Vinci, apparently at the request of the Venetian senate. It consisted of a hollow breathing tube attached to a diver's helmet of leather.

You may wonder why I wrote about snorkels in my book The Cockroach Catcher. The evolution of the snorkel tube makes me think about progress in medicine.

“... In those days we had snorkels that had a Ping Pong ball at the top end – a sort of umbrella handle at the top with the Ping PongBall inside a little cage so that it floated up to stop water coming in. ….

Imagine the shock when we went to the Great Barrier Reef and were given snorkels that bore no resemblance to the ones I used in my childhood. There was no Ping Pong ball in a cage and there was a drain at the bottom. The top was slightly curved with a clever design so that water from waves could not get in. Any water that managed to get in was drained away at the bottom. I looked at it and smiled. One must always question traditional beliefs. We can be blinded by what looks like a most sensible and reasonable approach – Ping Pong ball in a cage. ...

Medical Schools should remember to teach future doctors that without breaking rules and old dogma, no progress would ever be made in medicine....”

                                                                         

My Point is that doctors sometimes need to “think outside the box”.

Snorkelling is one of my favourite hobbies. I find it so relaxing and therapeutic. Slow breathing, say for 15 minutes a day, is now proven to help reduce blood pressure by a clinically significant amount. What better way to do it than in the sea, surrounded by fish and corals?                                                                                                                                                                       

 Dry Falls-Thinking Outside The Box

Review on Amazon

Readers' views.

The Cockroach Catcher on Amazon Kindle UK, Amazon Kindle US        

Porto: Old but Good!

Like our NHS & London Medical Schools:

©2016 Am Ang Zhang

Just like the best Ports!!!

Best Health Care: France & The NHS

NHS Strikes Back: BUPA & Health Insurers!

How the NHS can strike back!!!

1: Legislate that Insurers must pay for NHS treatment.

2: Offer Cappuccino/Green Tea if patients provide BUPA or other insurance details.

3: Patients will still be allowed to be paid by BUPA. Ha!

"In fact, to save money, government can buy insurance 

for 

the mental patients and the chronically ill."

 ©2016 Am Ang Zhang

BUPA is right now paying insured to use NHS!!!

The official letter from Bupa detailing the scheme is headlined: “Giving our members improved choice.”

The patient, speaking on condition of anonymity, said he was “shocked” to be encouraged to seek treatment on the NHS in exchange for money.

The letter said: “The payment you will receive depends on the cardiac treatment you need.

"Payments usually range from between £500 to £2,000.”

Operations can cost fives times more than the cash payments offered by Bupa. One procedure patients can pocket £2,000 for having on the NHS is for a pacemaker to be fitted.

BUPA raked in a staggering £2.57billion in revenue last year, and pocketed £139million in profit - up 26% on 2012.

Consultant oncologist Dr Clive Peedell, co-leader of the National Health Action party, accused Bupa of “cashing in on the NHS”.

He said: “It’s disgusting that a leading private healthcare company is paying patients to use the NHS.

“This is an outrageous example of how the private healthcare sector is happy to take patients’ money but then has to turn to the NHS when it realises it can’t afford to meet the high cost of treating patients privately.

“This underlines yet again that private healthcare is all about the money.”

Dr Peedell added: “It looks like Bupa have calculated that it’s cheaper for them to pay patients to use the NHS than fork out themselves for private treatment which would cost them thousands of pounds.

"They are effectively cashing in on the NHS.”

It must be very obvious that all the talk about medical cover for visitors to England never mention the need for health insurance.

Could this be because insurers have managed not to cover for everything. One need to ask the question on how one ever travel to the US where cost of medical care is extremely high.

There is of course the need to fully control Health Insurers for those that live in England if they want cover. 

Let people opt out of the NHS if it is so bad! But Insurers need to cover every thing. 

Citizens could be given a tax break and yet have the insurance policy incorporated into their NI/NHS number so that those with the tax break, the insurer will be charged for every kind of medical care they receive if they were within the NHS.

 

Summary of a popular post:

 ©2016 Am Ang Zhang

·                     Ends discrimination against people with pre-existing conditions.

·                     Limits premium spread to normal, high risk and healthy risk to say under 20% either way of normal.

·                     Limits premium discrimination based on gender and age.

·                     Prevents insurance companies from dropping coverage when people are sick and need it most.

·                     Caps out-of-pocket expenses so people don’t go broke when they get sick.

·                     Eliminates extra charges for preventive care.

·                     Contribute to an ABTA style cover.

We could legislate that Insurers will have to pay for any NHS treatment for those covered by them. It will stop Insurers “gaming” NHS hospitals. This will prevent them saving on costly dialysis and Intensive Care. Legislate for full disclosure of Insured status.

Insurers cannot drop coverage or treatment after a set period and even if they do they will still be charged if the patient is transferred to an NHS Hospital.

This will eliminate problems like PIP breast implants.

It will indeed encourage those that could afford it to buy insurance and in any case most firms offer insurance for their employees including the GMC.

To prevent gaming of Insurers by individual patients (I look after their interest too), the medical fee should be paid up front by the patient and then deduction taken from premiums. Corporate clients like those with the GMC should not be gaming Insurers.

Imagine the situation where those with “Personal Health Budgets ” being able to “buy” their own insurance!

In fact, to save money, government can buy insurance for the mental patients and the chronically ill.

This way there will be real choice and insurers will be competing with each other to provide the worst deal.

Why?

What Health Insurer will want the business?

Perhaps they will go back to the US and we will have our own NHS back.