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Archive for September 22, 2013

Patients brace for a ‘deeper cut’ over fees for specialist procedures

PETALING JAYA: Patients will have to brace themselves for a “deeper cut” if a proposal to increase fees for specialist procedures is adopted by the government.

Association of Third Party Medical Claims Administrators Malaysia (TPA) vice-president Paul Cheok said the Malaysian Medical Association (MMA), in asking for a 30% increase in consultation charges last month, had also proposed staggering increases in charges for specialist procedures.

TPA members, who form part of the country’s managed care organisations, provide administrative and medical claim processing services for insurance companies and more than 1,000 employers, mostly corporations.

“We are not against the approved 14.5% hike in consultation fees agreed on by the Health Ministry, but the MMA’s proposal for an increase in surgical procedures and anaesthetist fees must not be allowed. Patient volume has increased over the years, so based on the current rates, specialists are already fairly compensated,” he said.

“Specialists think private hospitals make a lot of money, but the reverse is true.”

TPA estimates that there are about 800 to 1,000 procedures listed in the 5th Edition of the MMA Fee Schedule.

Cheok said the MMA must also justify why certain procedures have been upgraded to a higher surgical fee category.

“Some procedures which were previously categorised as minor, have been pushed into the ‘major category’.

“Coupled with the new rates, this will lead to patients paying more than 200% of current charges.

“Patients should be more concerned over the proposed cost of surgical procedures instead of worrying about a rise in consultation fees,” he said, adding that often, one operation consists of multiple surgical procedures which could lead to multiple charges.

MMA president Datuk Dr NKS Tharmaseelan however said specialist procedure fees in Malaysia were still the lowest in the region.

He said doctors should not be blamed for high hospital bills as their fees only amounted to 20% of the bills.

“If hospital bills have risen, it is due to the hospitals charging higher fees for their services and other items,” he claimed.

“Many specialists in private practice can hardly make ends meet. And, they have to pay exorbitant indemnity insurance. For example, obstetricians and gynaecologist and plastic surgeons pay almost RM80,000 per annum in premiums.”

On TPA’s claim that MMA’s proposal to increase the fees for surgical procedures would lead to patients paying more than 200% than current charges, he said their calculations for the new fee rates for specialist procedures were “mere conjecture”.

“I don’t know where they are plucking the numbers from,” he said.

Medical Practitioners Coalition Association of Malaysia (MPCAM) and Malaysian Primary Care Network (MPCN) president Dr Jim Loi said the proposed rate for procedures are justified if “100% goes to the specialists”.

“The cost of items and materials have risen in tandem with the current economic state and the total cost of procedures. Specialists need to invest a lot of money,” he said.

via Patients brace for a ‘deeper cut’ over fees for specialist procedures – Nation | The Star Online.

Portuguese Baked Eggs



¼ cup olive oil

3 bell peppers, any color, thinly sliced

1 medium red onion, thinly sliced

2 beefsteak tomatoes, cut into wedges

8 garlic cloves, thinly sliced

1 jalapeño, with seeds, halved lengthwise

¼ cup fresh basil leaves

2 tablespoons fresh oregano leaves

1½ teaspoons chili powder

1 teaspoon paprika

Kosher salt and freshly ground black pepper

1 cup ricotta

6 large eggs

1 cup grated sharp white cheddar (about 4 oz.)

¼ cup grated Parmesan (about 1 oz.)

Toasted country-style bread (for serving)



  • Heat oil in a large heavy pot over medium heat. Add bell peppers and onion and cook, stirring occasionally, until softened and just beginning to brown, 10–12 minutes.
  • Add tomatoes, garlic, jalapeño, basil, oregano, chili powder, and paprika to pot. Reduce heat to medium-low and continue to cook, stirring occasionally, until vegetables are very soft and liquid is thickened, 20–30 minutes; season with salt and pepper. Discard jalapeño.
  • Preheat oven to 400°. Transfer bell pepper mixture to a 13×9” baking dish. Using the back of a spoon, make 6 evenly spaced divots in mixture. Spoon a dollop of ricotta into each divot, then crack 1 egg into each. Top with cheddar and Parmesan; season with salt and pepper. Bake, rotating dish halfway through, until Parmesan is melted and egg whites are almost set but yolks are still runny, 15–18 minutes.
  • Serve baked eggs with toast. (Yolks will continue to cook as dish sits, so serve right away if you prefer your eggs soft.)
  • DO AHEAD: Bell pepper mixture can be cooked 1 day ahead. Let cool; cover and chill.

via Portuguese Baked Eggs – Bon Appétit.



Quickoffice (3 stars with 345 Ratings) 
iPad App
Originally, this app was only available to Google Business App users. Separate paid versions of QuickOffice Pro for iPhone and iPad were selling for over $10 each. Perhaps they’re following Apple’s route of making iWork free for new device buyers, because now the paid versions are gone, and you can get the whole QuickOffice suite for free yourself.

Edit Word, Excel, and PowerPoint documents on the go with relative ease in an environment that closely mimics that of their counterparts. You can access the files in your Google Drive and on your device, as well as open and view PDF files, and share files through previously shared Google Drive Folders. All you need to use the app is a generic Google Account, so grab this bundle and get going.

via Best Free Apps of the Day on 9/20. QuickOffice, Pro Camera, Astronaut Spacewalk, & More! | App Chronicles.

Rise in number of A&Es failing to hit targets

Monitor’s report warned that ongoing problems could result in ‘unsatisfactory care’


The number of NHS trusts in England failing to meet target A&E waiting times has more than doubled in the last year, the regulator Monitor has said.

Between April and June, 31 trusts failed to meet their target of seeing patients within four hours of their arrival.

Just 13 trusts missed their waiting times commitment over the same period last year.

The Department of Health said A&Es saw 95% of patients within their targets.

But Monitor raised concerns that services – which usually improve over the spring and summer months – had instead remained challenging.

The regulator’s report looks at the key trends drawn from individual reports of England’s 146 foundation trusts.

Winter warning

It warned that ongoing problems meeting A&E targets may result in “unsatisfactory care” for patients, adding that trusts should prepare for the winter months by putting the right funding in place.

The number of trusts running a financial deficit increased from 36 in the first quarter of 2012/13, to 48 over the same period this year.

During that time, trusts generated £57m less in cost savings than originally planned.

Jason Dorsett, Monitor’s financial risk and reporting director, said: “The increased demand has also prevented trusts from delivering their planned financial savings.

“We expect to see trusts planning now for how the increased demand will impact on their finances, so that they are not storing up trouble for the future.”

‘Severe storms ahead’

Labour responded to the figures by warning there will be “severe storms ahead” for A&E units this winter unless the government addresses issues in staffing and social care.

Shadow health secretary Andy Burnham said: “David Cameron’s ill-judged… re-organisation has placed the NHS in the danger zone.”

A Department of Health spokesperson said the ageing population had put pressure on departments across the UK – with more than a million extra visits made to A&E over the past four years.

The spokesperson said: “A&E departments have been seeing 95% of their patients within four hours since the end of April – as they were before last winter. This is testament to the hard work of staff working throughout the health and care system.”

The government is investing £500m over the next two years to help ensure A&E departments are prepared for the winter.

via BBC News – Rise in number of A&Es failing to hit targets.

Disabled facing technology barriers using common gadgets


A report from a disability charity says that people with disabilities face barriers when using common gadgets, despite huge technological advances in recent years.

Scope says that there is huge untapped potential for mainstream devices, like smart phones and tablets, to provide support.

Michael Buchanan reports.

via BBC News – Disabled facing technology barriers using common gadgets.

Elderly care needs ‘set to treble’ by 2050

Care needs can put huge pressure on families


The number of older people needing care is set to nearly treble globally by 2050, campaigners say.

Currently 101 million people require care, but a report from Alzheimer’s Disease International warns the figure will rise to to 277 million.

Many needing care have dementia, and the report warns there will be a “global Alzheimer’s epidemic”.

The report’s author said countries like India and China would be hard hit – and must start planning services now.

Alzheimer’s is the most common cause of dementia. Symptoms include loss of memory, mood changes, and problems with communicating and reasoning.

More than 35 million people live with dementia across the world, according to the World Health Organization. More than half are living in low and middle income countries.

The report reveals that as the world population ages, the traditional system of informal care by family, friends and the community will need much greater support.

Just over one in 10 people aged 60 or over needs long-term care, according to the report. This includes daily help with things like washing, eating, dressing and using the toilet.

It can put huge pressure on families. Carers often have to give up work to look after elderly relatives.

‘Older people left behind’

Treating and caring for people with dementia currently costs the world more than £376bn per year. That includes the cost of health and social care as well as the loss of earnings.

This report is a wake-up call to governments across the world about the immediate need to put in place more care and support”

Alzheimer’s Society UK

Prof Martin Prince, from King’s College London’s Institute of Psychiatry, the author of the report, said lower and middle income countries including India and China need to urgently start planning services to deal with the “epidemic”.

“The social and economic changes happening in those countries are inevitably going to mean that family carers will be less available.

“Things like the decline in fertility rates mean people are going to have fewer children.

“Women are also better educated so are more likely to join the paid workforce and are going to be less likely to be available to provide care.”

And he said an increase in migration between countries, and from rural to urban areas amongst younger people meant there would be a lot of older people “left behind”.

The report makes a range of recommendations including giving paid and unpaid carers “appropriate financial rewards” and monitoring the quality of care both in care homes and in the community.

A spokesperson for the Alzheimer’s Society in the UK said: “Dementia is the biggest health crisis facing the world today.

“This report is a wake-up call to governments across the world about the immediate need to put in place more care and support.

“The UK government’s G8 summit on dementia this year will be a key opportunity to rally support from world leaders to tackle dementia together. We need to see political leadership to avoid a spiralling global crisis,” the spokesperson added.

via BBC News – Elderly care needs ‘set to treble’ by 2050.

Tooth decay hits quarter of five-year-olds, survey suggests


Tooth decay is caused by a build-up of plaque on the teeth


More than a quarter of five-year-olds in England have tooth decay, although the number is down, a survey suggests.

The analysis by Public Health England looked at data from 133,000 dental examinations across the country, covering 21% of five-year-olds.

It suggested 27% of all five-year-olds had tooth decay, down from 30% in a 2008 survey.

The British Dental Association (BDA) said there remained a “deep chasm” between the best and worst areas.

Deprived areas had the highest numbers affected by decay.

Figures ranged from 21.2% of five-year-olds in the south-east to 34.8% in the north-west.

When the researchers looked at more localised data, Brighton and Hove was found to have the lowest percentage affected by tooth decay, at 12.5%, compared with the highest figure of 53.2% in Leicester.

Ingrained habits ‘danger’

Tooth decay is caused by a build-up of plaque on the teeth. Bacteria in the plaque feed on sugars from food and drink, and produce an acid that slowly destroys teeth.

It reminds us of the deep chasm that exists between those with the best and worst oral health”

Dr Christopher Allen,British Dental Association

Decay stems largely from a poor diet, but also poor dental care – not brushing teeth properly and not visiting the dentist often enough.

Although healthy adult teeth will come through in children whose milk teeth have been affected by decay, if such bad habits become ingrained, there will also be problems with those teeth.

A five-year-old normally has 20 milk teeth.

Children with decay had, on average, between three and four affected teeth.

The analysis found 3% of those with decay had one or more teeth removed, a painful procedure often carried out in hospital under anaesthetic.

There have been improvements – 72% of five-year-olds have no tooth decay, up from 69% in 2008.

Public Health England suggests part of this improvement may be down to increased levels of fluoride in most children’s toothpastes.

‘Lowest decay rates’

Prof Kevin Fenton, director of health and well-being at Public Health England said: “This latest survey shows the numbers of five-year-olds free from tooth decay have improved but there is still much to do, dental decay is preventable.

“Parents should brush their children’s teeth for at least two minutes twice a day, once just before bedtime and at least one other time during the day.

“Also supervise tooth brushing until your child is seven or eight years old, either by brushing their teeth yourself or, if they brush their own teeth, by watching how they do it.”

From April this year, local authorities have taken over responsibility for oral health.

Health Minister Lord Howe, said: “We know more work is needed to make sure good oral health is more consistent right across the country.

“However, we have some of the lowest decay rates in the world.”

Dr Christopher Allen, chairman of the BDA’s public health committee, said: “This report highlights a welcome improvement to the overall oral health of five-year-old children across England, but it also reminds us of the deep chasm that exists between those with the best and worst oral health.

“That divide is based not just on geography, but also on deprivation.”

The BDA’s scientific adviser, Prof Damien Walmsley said: “There remain pockets of inequality. It’s really about targeting resources so we can get to those people.”

He said trying to instil healthy eating habits as early as possible was key, as was ensuring parents regularly took their children to the dentist.

via BBC News – Tooth decay hits quarter of five-year-olds, survey suggests.

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