Obama Returns to End-of-Life Plan That Caused Stir

[jillian]

Government is interested in cost reduction. Insurance companies are interested in profit. Is there really a difference? Probably not. Still, government has become too involved in too many facets of . . . . everything.

Ah well, someday we will all be dead. That there is a fact, Jack. Off to the mall!

perhaps, but insurance companies are way better at making a profit than government is at cutting costs.

have fun at the mall.

 

[theHawk]

well well

By ROBERT PEAR
Published: December 25, 2010

LinkedinDiggMixxMySpaceYahoo! BuzzPermalink.WASHINGTON — When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.


.Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.

read it all.
http://www.nytimes.com/2010/12/26/us/politics/26death.html?_r=2&hp

The liberals health care plan: You're not one of the lucky few chosen to receive rationed end-of-life care, go smoke some medical marijauna and die.

 

[logical4u]

I love the hypocrisy of Republicans. It's so expected, so normal, so "them".

Remember when Sarah Palin endorsed April 16th 2008 as “Healthcare Decisions Day” for the state of Alaska? It was the same end of life counseling that Republicans now call euthanasia.

It's like the stimulus package. Republicans were against it, then show up at ribbon cuttings to "take credit" for it.

They have no ideas. All they have is nothing, except to take credit for what Democrats accomplish.

It really is pathetic. Seriously pathetic.

Wtf are you babbling about

Do a search on: Sarah Palin endorsed April 16th 2008 as “Healthcare Decisions Day”

Google

You guys sit in front of a computer, use it!!!!

NOTE: This is not copyrighted material. This is out of Sarah Palin's document "Health Care Decisions Day" which she signed when she was governor of Alaska.

WHEREAS, Healthcare Decisions Day is designed to raise public awareness of the need to plan ahead for healthcare decisions, related to end of life care and medical decision-making whenever patients are unable to speak for themselves and to encourage the specific use of advance directives to communicate these important healthcare decisions.

WHEREAS, one of the principal goals of Healthcare Decisions Day is to encourage hospitals, nursing homes, assisted living facilities, continuing care retirement communities, and hospices to participate in a statewide effort to provide clear and consistent information to the public about advance directives, as well as to encourage medical professionals and lawyers to volunteer their time and efforts to improve public knowledge and increase the number of Alaska’s citizens with advance directives.

WHEREAS, the Foundation for End of Life Care in Juneau, Alaska, and other organizations throughout the United States have endorsed this event and are committed to educating the public about the importance of discussing healthcare choices and executing advance directives.

Where does it say there is financial incentive for this "education"?
Currently, you can talk to your doctor about this. Obama's plan will encourage doctors to "discuss" this by paying them for it (every year doctors will want to get the extra money from the government, so it will be done). That is what is currently being written into the administrative rules for health care (will those rules change to syphon more of the money paid into health care to the fed gov?).

 

[logical4u]

"WHEREAS, the Foundation for End of Life Care in Juneau, Alaska, and other organizations throughout the United States have endorsed this event and are committed to educating the public about the importance of discussing healthcare choices and executing advance directives."

Doesn't sound exactly like (and this is from memory so I could get a few words wrong)

"Maybe Grandma doesn't need a pacemaker or an operation, maybe she only needs a pill."

If grandma is going to die in six months anyways, and is already on hospice, she probably only needs a pill. This plan, doesn't mean she can't get a pacemaker if she wants one. It just means the doctor will inform her of her options, and what would be her best option.

You are right. There is waste.
Some of us are looking back at history: when the Nazis took the mentally ill out of small towns for "re-education", they all mysteriously died within a few months. When the US government was responsible for the "health care" of native Americans, many died of "ill health" or starvation (it wasn't that they didn't want to feed them, it was that the bureaucracy took so long to get the food there). We see this "bill" as an infringement on our rights. We know where rules like this have led in the past and are very fearful the same type of power will lead to widespread abuse and neglect.
You have seen some "wasteful" medical treatments. Systems similar to this "new system" of ours has resulted in people laying in the hospitals in their own filth, dead, because of bureaucracy. Systems where broken limbs are allowed to heal, unset, because, the medical "permissions were not given by the almighty government.
I would rather see a ton of medical care thrown at those that are dying, than to be withheld from the living.

 

[logical4u]

You are an idiot.

I have seen three people with END STAGE dementia die within weeks of having hip replacements. I have also seen a lady receive chemo for breast cancer, when she was in the last stages of dementia, and couldn't even remember she had received chemo or that she had breast cancer by the time she got home from the appointment. Like I said, you have no clue what you are talking about.
One of the ladies who received a hip replacement, died a week later. She had end stage dementia and cogestive heart failure. The place I used to work for, turned the doctor in for medicare fraud. The doctor should have proved end of life counceling for her and her and her family, instead of performing a hip replacement.
This bill also does not mean they cannot decide to receive certain care, it just means the doctor will explain their options, and what the proper plan should be.

I don't give a shit about your sob stories. I watched My mother die last year and had to make decisions about her. And guess what, we did it all WITHOUT the stinking Guberment sticking their friggen noses in it.
now you are dismissed.

Sorry for your loss, may she rest with the Lord.

 

[jillian]

I don't give a shit about your sob stories. I watched My mother die last year and had to make decisions about her. And guess what, we did it all WITHOUT the stinking Guberment sticking their friggen noses in it.
now you are dismissed.

sorry for your loss.

but because you did it without the doctor being PAID to help you want to deprive others.

who gives a rat's patoot what you did with or without.

now *you* are dismissed.

 

[TossObama]

This "end of life" crap is exactly the same nazi scheme that was used in WWII to exterminate those the Vatican, Hitler and the nazis considered "useless eaters".


Tell you what, folks. Another thing they did was yank a retarded guy out of an institution and dress him in street clothes. Then the nazis burned down one of their own buildings, killed the guy and threw his body where it appeared he had done the "crime". It was one of the many ways those nazi freaks manipulated the public feeling against the sick, the poor, the elderly, and the disabled.

 

[Meister]

If they took this out of the Bill to help get it passed, why in the hell are they putting it back in? It disengenuous at best, also....if they are paying the doctors for this needless service, it's just going to cost more. WTF?

 

[logical4u]

I never want to end up a vegetable, laying in a hospital bed, staring at the ceiling, hooked to machines.

Is this what right wingers are advocating?

I am a conservative. I would advocate paying for your own health care. If you are 80 years old and get pneumonia, and you can afford antibiotics, you should be able to get them without the government saying "okay". If you are 60 years old and still working and have heart problems, if you are paying the bills, you should be able to have heart surgery without the government "weighing" the costs. If you are seventy years old and active and you need a hip or knee replacement and can pay the costs, you should not need government approval.
If you cannot pay for your own healthcare, then you do not have a choice, the government (or who ever is paying the bills) has a big sayso in your care.
If you are a vegetable, and your money is paying for the hospital bed, then you should be allowed the hospitable bed for as long as your family agrees to pay (in this way, hospitals can accually make up some of their losses for providing discount and free services).
I am a conservative. I believe that your personal care should be up to you and the person that agrees (for a price) to provide that care. The government is an additional middleman that will add layers of bureaucracy and costs to a relatively simple issue.

 

[bigrebnc1775]

If they took this out of the Bill to help get it passed, why in the hell are they putting it back in? It disengenuous at best, also....if they are paying the doctors for this needless service, it's just going to cost more. WTF?

You actually thought they were going to leave anything out?

 

[logical4u]

Stephanie quit while you are ahead, you have no clue what you are talking about.

First off this programs would be good, especially now that baby boomers are starting to get dementia and alzheimers. These doctors will only be ADVISING on what a patient should do when they are close to death, so maybe they don't waste large amounts of money on treatments that will not help, or could speed up the death process.

[ame]http://www.youtube.com/watch?v=mS2kUY6j73s&feature=recentlik[/ame]

Yes, this will be good because in most incidents where the government took control of the population, huge numbers of people didn't die...like Russia, Nazi Germany, USSR, Cambodia, China, Vietnam, Cuba....

It will be different this time..... (famous last words, before history repeats itself).

 

[Greenbeard]

Right there the government is getting involved, monetarily, with end of life care.

Read the 2 links from a liberal source you might be interested. If you want balance I'll posts something from a conservative source but I know you dont believe those sites.

It's not a matter of belief. Medicare already does this. It covers a one-time "Welcome" visit for preventative care and physicians billing for that visit have to offer end-of-life-planning (beneficiaries, of course, can decline it if they wish). What the ACA does is add coverage for an annual wellness visit so seniors can get a check-up every year and have it covered. Just as with the existing Welcome visit, the annual wellness visits must (under this new rule) also offer end-of-life planning services.

Your claim is that end-of-life planning offered by the physician must result in physician recommendations that some unnamed government official allows them to recommend. Well, this shouldn't be a matter of speculation, as end-of-life consultation is already covered in the existing Medicare wellness visit--show us where the physician is required to give only government-approved advice, please. I'll wait, I'm genuinely curious.

 

[Meister]

I never want to end up a vegetable, laying in a hospital bed, staring at the ceiling, hooked to machines.

Is this what right wingers are advocating?

No, it's not, you can sign a paper at the hospital, or tell your loved ones that you don't want any extraordinary care. This is what's known as self responsibility, deen'o. It's a concept that's been around for along time, until the government told you they can do better.

 

[PLYMCO_PILGRIM]

Right there the government is getting involved, monetarily, with end of life care.

Read the 2 links from a liberal source you might be interested. If you want balance I'll posts something from a conservative source but I know you dont believe those sites.

It's not a matter of belief. Medicare already does this. It covers a one-time "Welcome" visit for preventative care and physicians billing for that visit have to offer end-of-life-planning (beneficiaries, of course, can decline it if they wish). What the ACA does is add coverage for an annual wellness visit so seniors can get a check-up every year and have it covered. Just as with the existing Welcome visit, the annual wellness visits must (under this new rule) also offer end-of-life planning services.

Your claim is that end-of-life planning offered by the physician must result in physician recommendations that some unnamed government official allows them to recommend. Well, this shouldn't be a matter of speculation, as end-of-life consultation is already covered in the existing Medicare wellness visit--show us where the physician is required to give only government-approved advice, please. I'll wait, I'm genuinely curious.

Its not in the old medicare laws like that. Its part of the new bills (notice the S on bills) that the doctors wont get paid unless the perscribe a corse of action that falls in line with what some government panel decides based on factors including your age.

If the panel deems you are too old for certain treatments then the doctor will not be able to peform them and get paid for it......this could lead to you dying from whatever you need treatment from which has led to the term "death panel" being applied to the "health benefits advisory council" which is part of the health care and stimulus bills.

 

[SFC Ollie]

If they took this out of the Bill to help get it passed, why in the hell are they putting it back in? It disengenuous at best, also....if they are paying the doctors for this needless service, it's just going to cost more. WTF?

And that is what should be discussed here because this is just the beginning. Mr Obama is resorting to writing the new rules to get what he wants. And as long as there is no law forbidding the rule he can write whatever he likes. They took this out of the legislation but did not say it couldn't be done. So Obama is having it written in as a rule.

Look for a lot more of these as he loses his agenda to the new congress.

 

[theDoctorisIn]

You do realize that doctors already have end of life counceling, and provide information on what a patient should do? I love how people who have no clue what goes into providing end of life care, try to act like they know what this means.
You do realize filling out your DNR status falls under end of life counceling?

Now the gov't will be able to cecide whether or not to DNR..... right?

Yep.... they will.

In order to save money....

No, they won't.

 

[theDoctorisIn]

If they took this out of the Bill to help get it passed, why in the hell are they putting it back in? It disengenuous at best, also....if they are paying the doctors for this needless service, it's just going to cost more. WTF?

They took it out because Sarah Palin is an idiot fearmongerer, and Americans as a whole are pretty fucking gullible.

 

[theDoctorisIn]

Seems to me that this "counseling" is little more than the Doctor giving you your treatment options. Which he is already paid to do. Do you go see your doctor just to talk about dying?

First: discussing Advanced Directives is not discussing "treatment options". Unless you are at the end of life and the pathology is known, there is no way to know what your treatment options are. It's more basic (i.e. would you want to be intubated? How long would you want your life to be prolonged?). Discussing this topic with patients is part of good medical care. Guess what? Death is a medical issue that every person will face and Physicians will be the ones who see you to the end in the vast majority of cases.

Second: Patients still maintain the autonomy (rightfully) to change their mind, even if it is up to the last days of their life. The verbal directive from a patient trumps all previous documentation.

As a medical student, I see it from the other end. Ever walk through an ICU? What about hospice?

There is absolutely nothing wrong (short of the histrionics of people who are scared to frigging death about their own mortality) with coming up with a pragmatic plan so that, when the time comes, your wishes are articulated and respected.

As, I said, this is becoming a standard of care. Furthermore, since it will be a primary care doctor that does this, it is doubtful that it will be the same Doctor that sees that your wishes are executed.

Either way, whether you choose to die on your own terms or not, it won't matter in the end. If you refuse to put your decisions down on paper, then someone else will decide for you. Either way, you aren't going to cheat death by utilizing the defense mechanism of denial.

To make things even worse, if someone else makes that decision for you, it's either going to be a physician who may not be acting in what you would truly want to happen or your family members who are trying to act in what they think your wishes would be (and this usually results in inter-family fighting).

You would think that after Quinlin, Cruzan, and now Schiavo, we would realize how devastating this issue can be for families and move beyond the idiotic hyperbole and have a rational debate about it.

However, the outrage pimps (I am talking about the politicians and pundits here) are more interested in seeing the matter turn into a food fight so they can gin up votes. In the end, they aren't going to be the ones that make the decision to pull the plug. Your health is just a cynical campaign issue for them.

Wake up guys. Seriously.

All that is well and good until you change your mind and decide you want a treatment and a government bureaucrat decides you don't have enough "intrinsic value to society" for them to perform said treatment.

Thats the part your ignoring. You are talking about something very similar, but not the same, as the issue most have with this. That issue being a government official will be the one deciding what treatments are and are not available based on your societal worth.

Except that's decidedly not the case. You're talking about something that simply has NOTHING to do with these "end of life care" conversations.

All of your claims about government denying treatment based on "societal worth" is fear-mongering bullshit with no basis in reality.

 

[Meister]

If they took this out of the Bill to help get it passed, why in the hell are they putting it back in? It disengenuous at best, also....if they are paying the doctors for this needless service, it's just going to cost more. WTF?

They took it out because Sarah Palin is an idiot fearmongerer, and Americans as a whole are pretty fucking gullible.

I guess you would rather miss my point completely and point a finger at someone. Got it.

 

[theDoctorisIn]

If they took this out of the Bill to help get it passed, why in the hell are they putting it back in? It disengenuous at best, also....if they are paying the doctors for this needless service, it's just going to cost more. WTF?

They took it out because Sarah Palin is an idiot fearmongerer, and Americans as a whole are pretty fucking gullible.

I guess you would rather miss my point completely and point a finger at someone. Got it.

If I missed your point, I apologize.

What exactly was your point?