Gov. Jan Brewer's death panel

[daveman]

Krugman says what happened to this guy needs to happen all the time.

Does that make it okay in your mind?

It looks like Krugman said:

PAUL KRUGMAN, NEW YORK TIMES: If they were going to do reality therapy, they should have said, OK, look, Medicare is going to have to decide what it's going to pay for. And at least for starters, it's going to have to decide which medical procedures are not effective at all and should not be paid for at all. In other words, it should have endorsed the panel that was part of the health care reform.

If it's not even -- if the commission isn't even brave enough to take on the death panels people, then it's doing no good at all. It's not educating the public. It's not telling people about the kinds of choices that need to be made. [...]

KRUGMAN: No. Some years down the pike, we're going to get the real solution, which is going to be a combination of death panels and sales taxes. It's going to be that we're actually going to take Medicare under control, and we're going to have to get some additional revenue, probably from a VAT. But it's not going to happen now.

So, we've got to get Medicare under control by deciding "what it's going to pay for...which medical procedures are not effective at all and should not be paid for at all."

AKA "death panels."​

Are you arguing that a liver transplant is not an effective procedure?

It's not when the Hep C the patient has will kill the donor liver.

But, hey...didn't mean to sidetrack from the "eeeeevil conservatives want to kill sick people" circle-jerk. Carry on.

 

[daveman]

What do you think ObamaCare is anyway?

Liberal government making decisions that kill people is good. Conservative government making decisions that kill people is bad.

Right, USMB lefties?

Why don't you give your opinion on the topic?

Keep reading.

 

[Greenbeard]

It's not when the Hep C the patient has will kill the donor liver.

Then it sounds like "death panels" in the sense Krugman used the term (which is not how Palin used it) are common sense medicine.

 

[daveman]

It's not when the Hep C the patient has will kill the donor liver.

Then it sounds like "death panels" in the sense Krugman used the term (which is not how Palin used it) are common sense medicine.

How was Palin's usage different? She said death panels were making health care decisions based on economics...which is what Krugman is calling for.

 

[Greenbeard]

How was Palin's usage different? She said death panels were making health care decisions based on economics...which is what Krugman is calling for.

Well, let's look at it:

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.​

An analysis of the medical effectiveness or appropriateness of a given treatment for an ailment has nothing to do with judgment of how valuable the patient is to society.

"This treatment won't work" and "this patient is not 'worthy' of care" are radically different propositions. Krugman is talking about the former, Palin the latter.

 

[daveman]

How was Palin's usage different? She said death panels were making health care decisions based on economics...which is what Krugman is calling for.

Well, let's look at it:

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.​

An analysis of the medical effectiveness or appropriateness of a given treatment for an ailment has nothing to do with judgment of how valuable the patient is to society.

"This treatment won't work" and "this patient is not 'worthy' of care" are radically different propositions. Krugman is talking about the former, Palin the latter.

It's the same argument. People will be deemed not worthy of care due to their value to society. Who's going to get the expensive cancer treatment -- the Down Syndrome patient or the union member patient? We can't afford to treat both. Krugman said so.

 

[rightwinger]

It's not when the Hep C the patient has will kill the donor liver.

Then it sounds like "death panels" in the sense Krugman used the term (which is not how Palin used it) are common sense medicine.

How was Palin's usage different? She said death panels were making health care decisions based on economics...which is what Krugman is calling for.

That is not what Palin said.

Palin said Obama would be making decisions based on her babies ability to contribute to society.

She basically said...Obama is going to kill my baby

 

[Greenbeard]

It's the same argument.

No, it's actually the opposite argument. The basic premise behind what Krugman is saying is that we can treat more people (or, in the case of Medicare, treat the same amount of people for less money) if we stop paying for ineffective treatments. We can provide more necessary treatment if we reduce unnecessary treatment. That's a consequence of using your existing resources well.

The issue you're talking about is something that probably should be discussed but it's not what anyone is discussing or has been discussing.

 

[daveman]

Then it sounds like "death panels" in the sense Krugman used the term (which is not how Palin used it) are common sense medicine.

How was Palin's usage different? She said death panels were making health care decisions based on economics...which is what Krugman is calling for.

That is not what Palin said.

Palin said Obama would be making decisions based on her babies ability to contribute to society.

She basically said...Obama is going to kill my baby

Keep reading.

 

[daveman]

It's the same argument.

No, it's actually the opposite argument. The basic premise behind what Krugman is saying is that we can treat more people (or, in the case of Medicare, treat the same amount of people for less money) if we stop paying for ineffective treatments. We can provide more necessary treatment if we reduce unnecessary treatment. That's a consequence of using your existing resources well.

The issue you're talking about is something that probably should be discussed but it's not what anyone is discussing or has been discussing.

It's the same argument. There is no such thing as a globally ineffective treatment. They benefit people to varying degrees. The decision to fund that treatment will be based on the potential good it can do the patient and, when treatment is rationed (as it will inevitably be), the benefit to society to treating the patient.

 

[Greenbeard]

The decision to fund that treatment will be based on the potential good it can do the patient

So far this is a statement about the worth of the treatment, not the patient.

and, when treatment is rationed (as it will inevitably be), the benefit to society to treating the patient.

If I understand what you're saying here, treatment is not rationed now. Ergo infinite treatment is currently available for all illnesses and I'm not sure what you foresee altering that.

Of course, the reality is that we do have limits to our health resources (and always have) and thus health care is rationed right now, as it always has been. The problem is that without a strong evidence base on the comparative effectiveness of different treatments, we've been wandering around blindly. We don't know how to allocate our resources most effectively (and maximize health for the largest number of people possible) because we don't know what to invest in/pay for to achieve good health outcomes. This should be a fairly obvious point but people get into trouble for pointing that out. Don Berwick made that point a year and a half ago--and of course he'll pay a political price for it--in an interview on comparative effectiveness research when he pointed out: "the decision is not whether or not we will ration care - the decision is whether we will ration with our eyes open."

We don't have unlimited resources today and we won't have them tomorrow. Which means if we want to get better health outcomes and treat more people while slowing cost growth, we need to identify the past of least resistance to achieving health. That's the point Krugman was making (and in fact the point lots of people are making) and it has nothing to do with subjective judgments about patients.

What Palin is talking about and what you're talking about is something completely different. You're talking about the need for price rationing above and beyond that which is covered by your payer (i.e. if your plan doesn't cover it, you have to pay for it yourself if you want it). Guess what? Even in completely socialized systems that exists. You may not realize this, but they still use currency in Europe and Canada. They're not living in the United Federation of Planets. They still have a private spending component of their health systems. But, again, you're trying to have two different conversations at the same time and these are not the same concept.

 

[Gadawg73]

What do you think ObamaCare is anyway?

ObamaCare I oppose as it is everyone has to carry insurance.

The one thing I was for under the Obama plan was the $200 to a doctor to counselfamilies on ho to draft a living will.
Without a living will doctors and hospitals are filling hospital beds and running up hundreds of thousands of dollars in unneeded care.
The right wing kooks call this death panels and that was all a joke.
A doctor in the ER where they brought my Dad 2 weeks before he died authorized him to be sent to a nursing home when we had a DNR order in place per Dad's living will. It gets better Frank. The good doctor authorized OCCUPATIONAL THERAPY for my 89 year old father on his death bed for an entire week along with speech therapy and other unneeded therapy to the tune of 13K.
And Medicare paid.
Tell us Frank, how does an economy survive when 25% of the entire economy is medical care? You do know Frank that in less than 20 years that is where we will be under the current system, don't you?
And how does a family, business or government afford topay on average $48K a year in healt insuranced premiums fora family of 5 in less than 15 years Frank?
You do know that based on 15% increases,which is the average over the last 30years, that is what it will be in less than 15 years as that figure is 12K a year NOW oer family of 5.
Please get head out of sand and readand know the facts.
But you folks love this system!

I've said many many many times that the twin reasons medical costs in the USA are skewed is that first, we are the only country that lets its lawyers make a living off of medical care and second and far more importantly, there is a total divorce between the patient and doctor so that the insurance company or government is the patient and dictates the treatment because they are the payee and that must end.

And like you, I know this first hand too. My Dad was recently asked if he wanted to start Chemo and some of us, myself included, were trying to dissuade him, but he went ahead with in and in a very short space of time I watched him go from a guy gallantly battling cancer to a cancer patient.

Well guess what Frank?
NO lawyer has any case anywhere UNLESS he has a TEAM of DOCTORS to testify as expert witnesses against another doctor.
Same with personal injury cases as you have to have a doctor statement of the medical damages before you can ask for payment in court.
Doctors, not lawyers, are the problem. Without lawyers, who work for no hourly wage and ONLY get paid if a jury or the insurance company agrees with their facts, the insurance companies would never pay on large cases.
But I am getting to the point where I DISLIKE lawyers AND doctors.
I feel for your Dad and you brother as we went through the same things. Been a tough year!

 

[mudwhistle]

It's not when the Hep C the patient has will kill the donor liver.

Then it sounds like "death panels" in the sense Krugman used the term (which is not how Palin used it) are common sense medicine.

There's a difference between life-saving medicine and useless procedures.

Giving him a new liver while his virus is still active is useless.

Saying that you're too old or not productive enough for a surgery is what the administration is talking about. They'd rather give you a pill and let you die rather then extend out your life 10 years.

 

[Gadawg73]

It's not when the Hep C the patient has will kill the donor liver.

Then it sounds like "death panels" in the sense Krugman used the term (which is not how Palin used it) are common sense medicine.

There's a difference between life-saving medicine and useless procedures.

Giving him a new liver while his virus is still active is useless.

Saying that you're too old or not productive enough for a surgery is what the administration is talking about. They'd rather give you a pill and let you die rather then extend out your life 10 years.

So you favor blank check health care for the elderly?
All those hospitals and doctors in south Florida sure do. Why else do they give heart surgery to 90 year old folks there?
How do we pay for it?

 

[daveman]

The decision to fund that treatment will be based on the potential good it can do the patient

So far this is a statement about the worth of the treatment, not the patient.

and, when treatment is rationed (as it will inevitably be), the benefit to society to treating the patient.

If I understand what you're saying here, treatment is not rationed now. Ergo infinite treatment is currently available for all illnesses and I'm not sure what you foresee altering that.

Of course, the reality is that we do have limits to our health resources (and always have) and thus health care is rationed right now, as it always has been. The problem is that without a strong evidence base on the comparative effectiveness of different treatments, we've been wandering around blindly. We don't know how to allocate our resources most effectively (and maximize health for the largest number of people possible) because we don't know what to invest in/pay for to achieve good health outcomes. This should be a fairly obvious point but people get into trouble for pointing that out. Don Berwick made that point a year and a half ago--and of course he'll pay a political price for it--in an interview on comparative effectiveness research when he pointed out: "the decision is not whether or not we will ration care - the decision is whether we will ration with our eyes open."

We don't have unlimited resources today and we won't have them tomorrow. Which means if we want to get better health outcomes and treat more people while slowing cost growth, we need to identify the past of least resistance to achieving health. That's the point Krugman was making (and in fact the point lots of people are making) and it has nothing to do with subjective judgments about patients.

What Palin is talking about and what you're talking about is something completely different. You're talking about the need for price rationing above and beyond that which is covered by your payer (i.e. if your plan doesn't cover it, you have to pay for it yourself if you want it). Guess what? Even in completely socialized systems that exists. You may not realize this, but they still use currency in Europe and Canada. They're not living in the United Federation of Planets. They still have a private spending component of their health systems. But, again, you're trying to have two different conversations at the same time and these are not the same concept.

That you're not willing to accept that Palin's and Krugman's death panels are the same thing has no bearing on the fact that they are.

You object to insurance companies rationing health care...but have no problem with the government doing so?

 

[Greenbeard]

You object to insurance companies rationing health care...but have no problem with the government doing so?

Do you have me confused with someone else? I object to private insurers manipulating risk pools and dumping or denying clients but I'm not fond of state Medicaid programs doing that, either. I'm certainly not opposed, however, to any of those payers defining their benefit package, in accordance with the relevant standard, and applying an appropriate medical necessity standard when it comes to making payment decisions.

 

[daveman]

You object to insurance companies rationing health care...but have no problem with the government doing so?

Do you have me confused with someone else? I object to private insurers manipulating risk pools and dumping or denying clients but I'm not fond of state Medicaid programs doing that, either. I'm certainly not opposed, however, to any of those payers defining their benefit package, in accordance with the relevant standard, and applying an appropriate medical necessity standard when it comes to making payment decisions.

In that case, my apologies.

 

[mudwhistle]

You object to insurance companies rationing health care...but have no problem with the government doing so?

Do you have me confused with someone else? I object to private insurers manipulating risk pools and dumping or denying clients but I'm not fond of state Medicaid programs doing that, either. I'm certainly not opposed, however, to any of those payers defining their benefit package, in accordance with the relevant standard, and applying an appropriate medical necessity standard when it comes to making payment decisions.

The problem I see is before it was insurance companies that were making the decisions. You were treated according to how much your insurance was willing to pay.

The rub in all of this is the simple fact that a government agency that is yet to be formed and funded will be making the decisions. I don't think anyone can say that the government is gonna run health care more efficiently then the way it has been run in the past and it seems from my experience that they will only do a worse job. It always turns out that way.

Evidently they intend on taxing what they call "Cadillac Plans" which cover everything under the Sun, so these policies will be next to impossible to afford or possibly even obtain once the government starts regulating. When this happens insurance providers eventually go out of business due to lack of affordability. The government does not know how to run the health care insurance business better then someone that has been doing it for decades.

This is all geared to attain a single-payer system where Washington is calling all of the shots and forcing whomever they don't like out of business with ridiculous regulations.

In all honesty everyone can agree that a government that's broke will never be able to run a system this immense.....correct?

 

[Mr. Shaman]

That's terrible! He should go back to Mexico right away and get the life saving liver transplant he needs.

She needs to go-back to where SHE came-from.....HOLLYWOOD!!!!!​

 

[mudwhistle]

That's terrible! He should go back to Mexico right away and get the life saving liver transplant he needs.

She needs to go-back to where SHE came-from.....HOLLYWOOD!!!!!​

What's the difference.

They're both part of California and flushed with Hispanics.