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Republicans should talk less about "death panels" and more about cutting the overuse of expensive medical procedures, said a powerful GOP lawmaker [Darrell Issa] who has the health industry in his sights.
[...]
"If I can help every senior get the same care they're getting and still save tens of billions of dollars and have no doctors cheated out of what they're entitled to, what's not to like?" he said.
[...]
Under current rules, Medicare cannot consider cost-effectiveness in its coverage decisions. But Mr. Issa said it may be time to consider costs as well as efficacy, as long as medical decisions are made by doctors, not by "bureaucrats" in government.
"My committee can help by looking at whether the government is answering and informing about the lowest-cost, least-invasive procedures," he said.
Cost-effectiveness became the center of controversy during the debate leading up to the passage of the Democrats' health-care bill in March. Some critics of the bill claimed the Obama administration's plans could lead to government "death panels."
Mr. Issa said he shares the view of his colleague, Rep. Charles Boustany (R., La.), a surgeon. Citing Mr. Boustany, Mr. Issa said that "medical panels of people who care about what's best for their patients" and about appropriate procedures "is good science and good medicine."
"Republicans have to step back from the words 'death panels,' " Mr. Issa said.
Sometimes it just takes a little space from the next election for someone to start making sense. And, surprisingly (I must say), today it's Darrell Issa, who seems to recognize that it's time to jettison the "death panel" nonsense and start talking like adults about important questions. Some choice bits from the WSJ article:
Republicans should talk less about "death panels" and more about cutting the overuse of expensive medical procedures, said a powerful GOP lawmaker [Darrell Issa] who has the health industry in his sights.
[...]
"If I can help every senior get the same care they're getting and still save tens of billions of dollars and have no doctors cheated out of what they're entitled to, what's not to like?" he said.
[...]
Under current rules, Medicare cannot consider cost-effectiveness in its coverage decisions. But Mr. Issa said it may be time to consider costs as well as efficacy, as long as medical decisions are made by doctors, not by "bureaucrats" in government.
"My committee can help by looking at whether the government is answering and informing about the lowest-cost, least-invasive procedures," he said.
Cost-effectiveness became the center of controversy during the debate leading up to the passage of the Democrats' health-care bill in March. Some critics of the bill claimed the Obama administration's plans could lead to government "death panels."
Mr. Issa said he shares the view of his colleague, Rep. Charles Boustany (R., La.), a surgeon. Citing Mr. Boustany, Mr. Issa said that "medical panels of people who care about what's best for their patients" and about appropriate procedures "is good science and good medicine."
"Republicans have to step back from the words 'death panels,' " Mr. Issa said.
Good for him.
Mesa resident Randy Shepherd, a 36-year-old father of three, has been living with a pacemaker for several years and now is facing what he says is his last treatment option: a heart transplant.
But Shepherds hopes for a transplant were dashed when the state cut Medicaid funding for certain transplants under the Arizona Health Care Cost Containment System.
Look at all of us who need these transplants, Shepherd said, joined Tuesday by three others who say they are unable to get live-saving transplants due to the cuts. Its not an option for us; its a necessity.
A real-life death panel and its real-life victims | Jay Bookman
That's because it's OK when Republicans make "death panels".
“Mesa resident Randy Shepherd, a 36-year-old father of three, has been living with a pacemaker for several years and now is facing what he says is his last treatment option: a heart transplant.
But Shepherd’s hopes for a transplant were dashed when the state cut Medicaid funding for certain transplants under the Arizona Health Care Cost Containment System.
“Look at all of us who need these transplants,” Shepherd said, joined Tuesday by three others who say they are unable to get live-saving transplants due to the cuts. “It’s not an option for us; it’s a necessity.”
A real-life ‘death panel’ and its real-life victims | Jay Bookman
That's because it's OK when Republicans make "death panels".
The concept of the death panel stems from the fact that health care costs more than what government can pay for. They coudn't collect enough taxes if they wanted to (not without rioting in the streets anyway) to cover health care costs. And since you can't run deficits forever, somthing will have to give at some point. Reimbursement rates will have to go down, salaries will have to go down, and/or taxes will have to go up to break even. And invariably one place government will have to look at to cut costs will be what they will cover. THAT is where the term 'death panel' ultimately stems from. The fact that government will have to decide what treatments it will pay for and what it won't because the simple fact is they won't have the money to cover everyone for everything.
Mesa resident Randy Shepherd, a 36-year-old father of three, has been living with a pacemaker for several years and now is facing what he says is his last treatment option: a heart transplant.
But Shepherds hopes for a transplant were dashed when the state cut Medicaid funding for certain transplants under the Arizona Health Care Cost Containment System.
Look at all of us who need these transplants, Shepherd said, joined Tuesday by three others who say they are unable to get live-saving transplants due to the cuts. Its not an option for us; its a necessity.
A real-life death panel and its real-life victims | Jay Bookman
That's because it's OK when Republicans make "death panels".
It wasn't Republicans who mandated coverage for 30 million more and left the mandate unfunded. Was it?
Good for him.
Sometimes it just takes a little space from the next election for someone to start making sense. And, surprisingly (I must say), today it's Darrell Issa, who seems to recognize that it's time to jettison the "death panel" nonsense and start talking like adults about important questions. Some choice bits from the WSJ article:
Republicans should talk less about "death panels" and more about cutting the overuse of expensive medical procedures, said a powerful GOP lawmaker [Darrell Issa] who has the health industry in his sights.
[...]
"If I can help every senior get the same care they're getting and still save tens of billions of dollars and have no doctors cheated out of what they're entitled to, what's not to like?" he said.
[...]
Under current rules, Medicare cannot consider cost-effectiveness in its coverage decisions. But Mr. Issa said it may be time to consider costs as well as efficacy, as long as medical decisions are made by doctors, not by "bureaucrats" in government.
"My committee can help by looking at whether the government is answering and informing about the lowest-cost, least-invasive procedures," he said.
Cost-effectiveness became the center of controversy during the debate leading up to the passage of the Democrats' health-care bill in March. Some critics of the bill claimed the Obama administration's plans could lead to government "death panels."
Mr. Issa said he shares the view of his colleague, Rep. Charles Boustany (R., La.), a surgeon. Citing Mr. Boustany, Mr. Issa said that "medical panels of people who care about what's best for their patients" and about appropriate procedures "is good science and good medicine."
"Republicans have to step back from the words 'death panels,' " Mr. Issa said.
Good for him.
Amazing how goobers with the (R)s by their name start talking like the goobers with the (D)s by their names, once they get ahold of the reins.Sometimes it just takes a little space from the next election for someone to start making sense. And, surprisingly (I must say), today it's Darrell Issa, who seems to recognize that it's time to jettison the "death panel" nonsense and start talking like adults about important questions. Some choice bits from the WSJ article:
Republicans should talk less about "death panels" and more about cutting the overuse of expensive medical procedures, said a powerful GOP lawmaker [Darrell Issa] who has the health industry in his sights.
[...]
"If I can help every senior get the same care they're getting and still save tens of billions of dollars and have no doctors cheated out of what they're entitled to, what's not to like?" he said.
[...]
Under current rules, Medicare cannot consider cost-effectiveness in its coverage decisions. But Mr. Issa said it may be time to consider costs as well as efficacy, as long as medical decisions are made by doctors, not by "bureaucrats" in government.
"My committee can help by looking at whether the government is answering and informing about the lowest-cost, least-invasive procedures," he said.
Cost-effectiveness became the center of controversy during the debate leading up to the passage of the Democrats' health-care bill in March. Some critics of the bill claimed the Obama administration's plans could lead to government "death panels."
Mr. Issa said he shares the view of his colleague, Rep. Charles Boustany (R., La.), a surgeon. Citing Mr. Boustany, Mr. Issa said that "medical panels of people who care about what's best for their patients" and about appropriate procedures "is good science and good medicine."
"Republicans have to step back from the words 'death panels,' " Mr. Issa said.
Good for him.
Good for him.
Amazing what winning an election and being put in a position where people actually expect you to do something will do for a person's sense of pragmatism.
But good for Issa for saying what anyone with two neurons to rub together already knew.
The concept of the death panel stems from the fact that health care costs more than what government can pay for. They coudn't collect enough taxes if they wanted to (not without rioting in the streets anyway) to cover health care costs. And since you can't run deficits forever, somthing will have to give at some point. Reimbursement rates will have to go down, salaries will have to go down, and/or taxes will have to go up to break even. And invariably one place government will have to look at to cut costs will be what they will cover. THAT is where the term 'death panel' ultimately stems from. The fact that government will have to decide what treatments it will pay for and what it won't because the simple fact is they won't have the money to cover everyone for everything.
There is no single concept of a death panel, which is reason alone to retire that silly phrase. As originally used, it referred to an imaginary panel that made case-by-case decisions, based on judgment of an individual person's "level of productivity in society", whether a person is "worthy of health care." Then, when pressed, it became a reference to things like Medicare coverage of palliative care and voluntary consultations on end-of-life care planning. Now it seems to have morphed into the much less sensational observation that insurance plans (public and private alike) don't cover every possible procedure. (See the flip in focus there from being on what a payer does cover--proposed Medicare coverage for consultations--to what payers don't cover?)
This is where it intersects with hysterical references to rationing. Every payer decides what it will and will not (can or cannot) pay for. That even includes individuals, such as those whose insurer won't pay for a procedure. They're still free to pay for it themselves. The reason they don't (like these transplant patients covered by AHCCCS in Arizona) is often that they simply cannot. That's rationing and it always has been: a prior approval request turned down by a "bureaucrat" at Blue Cross or Medicaid, or a price signal that results in care being withheld from those who are unable to pay.
The reality is that references to "death panels," and very often cries of "rationing," are made by very unserious people whose primary concern is 1) political point scoring, 2) obfuscation, and 3) plain and simple fear-mongering. The point I make in calling them unserious isn't that rationing doesn't exist. Quite the opposite. The point is that their implicit assertion with their hysterics is that there is some system, some structure, some reality in which it doesn't exist. They are effectively telling you that we have (or can have) infinite care but Proposal X must be defeated because it will result in rationing. Be afraid of Proposal X!
Yes, every payer--public, private, and, in the cost-conscious HSA/HDHP utopia, individual--has to decide what to pay for. And yet when the suggestion is made that we try to ensure that a clinical evidence base exists so that these decisions can be made on the merits, with the best science available, what do we hear from the knuckledraggers? "Death panels! Rationing" Research is bad, something to be afraid of (and defunded, of course).
But it comes down to two facts: 1) we don't have infinite health resources and 2) we're using the ones we have very badly right now. We spend lots and lots on things that don't work or work just as well as something far less expensive and much of the time we don't even know it. What happened when Don Berwick pointed these two facts out ("The decision is not whether or not we will ration care. The decision is whether we will ration with our eyes open. And right now, we are doing it blindly.")? Predictably, the death panels nuts had a field day. We heard, often from folks who hadn't heard of him before his nomination, that "Dr. Death"--or whatever they call him--isn't fit to lead CMS. Clearly, the best person for the job would be one that doesn't realize health resources don't exist in infinite supply and who doesn't believe we ought to be getting value for what we buy.
But I digress. The point of this thread is that Darrell Issa of all people is apparently capable of talking about these issues like an adult. And for that I commend him.
The concept of the death panel stems from the fact that health care costs more than what government can pay for. They coudn't collect enough taxes if they wanted to (not without rioting in the streets anyway) to cover health care costs. And since you can't run deficits forever, somthing will have to give at some point. Reimbursement rates will have to go down, salaries will have to go down, and/or taxes will have to go up to break even. And invariably one place government will have to look at to cut costs will be what they will cover. THAT is where the term 'death panel' ultimately stems from. The fact that government will have to decide what treatments it will pay for and what it won't because the simple fact is they won't have the money to cover everyone for everything.
There is no single concept of a death panel, which is reason alone to retire that silly phrase. As originally used, it referred to an imaginary panel that made case-by-case decisions, based on judgment of an individual person's "level of productivity in society", whether a person is "worthy of health care." Then, when pressed, it became a reference to things like Medicare coverage of palliative care and voluntary consultations on end-of-life care planning. Now it seems to have morphed into the much less sensational observation that insurance plans (public and private alike) don't cover every possible procedure. (See the flip in focus there from being on what a payer does cover--proposed Medicare coverage for consultations--to what payers don't cover?)
This is where it intersects with hysterical references to rationing. Every payer decides what it will and will not (can or cannot) pay for. That even includes individuals, such as those whose insurer won't pay for a procedure. They're still free to pay for it themselves. The reason they don't (like these transplant patients covered by AHCCCS in Arizona) is often that they simply cannot. That's rationing and it always has been: a prior approval request turned down by a "bureaucrat" at Blue Cross or Medicaid, or a price signal that results in care being withheld from those who are unable to pay.
The reality is that references to "death panels," and very often cries of "rationing," are made by very unserious people whose primary concern is 1) political point scoring, 2) obfuscation, and 3) plain and simple fear-mongering. The point I make in calling them unserious isn't that rationing doesn't exist. Quite the opposite. The point is that their implicit assertion with their hysterics is that there is some system, some structure, some reality in which it doesn't exist. They are effectively telling you that we have (or can have) infinite care but Proposal X must be defeated because it will result in rationing. Be afraid of Proposal X!
Yes, every payer--public, private, and, in the cost-conscious HSA/HDHP utopia, individual--has to decide what to pay for. And yet when the suggestion is made that we try to ensure that a clinical evidence base exists so that these decisions can be made on the merits, with the best science available, what do we hear from the knuckledraggers? "Death panels! Rationing" Research is bad, something to be afraid of (and defunded, of course).
But it comes down to two facts: 1) we don't have infinite health resources and 2) we're using the ones we have very badly right now. We spend lots and lots on things that don't work or work just as well as something far less expensive and much of the time we don't even know it. What happened when Don Berwick pointed these two facts out ("The decision is not whether or not we will ration care. The decision is whether we will ration with our eyes open. And right now, we are doing it blindly.")? Predictably, the death panels nuts had a field day. We heard, often from folks who hadn't heard of him before his nomination, that "Dr. Death"--or whatever they call him--isn't fit to lead CMS. Clearly, the best person for the job would be one that doesn't realize health resources don't exist in infinite supply and who doesn't believe we ought to be getting value for what we buy.
Sometimes it just takes a little space from the next election for someone to start making sense. And, surprisingly (I must say), today it's Darrell Issa, who seems to recognize that it's time to jettison the "death panel" nonsense and start talking like adults about important questions. Some choice bits from the WSJ article:
Republicans should talk less about "death panels" and more about cutting the overuse of expensive medical procedures, said a powerful GOP lawmaker [Darrell Issa] who has the health industry in his sights.
[...]
"If I can help every senior get the same care they're getting and still save tens of billions of dollars and have no doctors cheated out of what they're entitled to, what's not to like?" he said.
[...]
Under current rules, Medicare cannot consider cost-effectiveness in its coverage decisions. But Mr. Issa said it may be time to consider costs as well as efficacy, as long as medical decisions are made by doctors, not by "bureaucrats" in government.
"My committee can help by looking at whether the government is answering and informing about the lowest-cost, least-invasive procedures," he said.
Cost-effectiveness became the center of controversy during the debate leading up to the passage of the Democrats' health-care bill in March. Some critics of the bill claimed the Obama administration's plans could lead to government "death panels."
Mr. Issa said he shares the view of his colleague, Rep. Charles Boustany (R., La.), a surgeon. Citing Mr. Boustany, Mr. Issa said that "medical panels of people who care about what's best for their patients" and about appropriate procedures "is good science and good medicine."
"Republicans have to step back from the words 'death panels,' " Mr. Issa said.
Good for him.
The term 'death panel' may get thrown around for political reasons, but it is also symbolic of the issues that will surround a larger government role in health care. It may sound like a fear monger term, but in a ot of ways it is appropriate with regards to government's role in health care. The simple issue is sustainability. It is an issue that most countries with some form of UHC face. France, for examle, had 9 billion dollar debt for it's government run program last year and is estimated to be about 11 million next year.
The concept of the death panel stems from the fact that health care costs more than what government can pay for. They coudn't collect enough taxes if they wanted to (not without rioting in the streets anyway) to cover health care costs. And since you can't run deficits forever, somthing will have to give at some point. Reimbursement rates will have to go down, salaries will have to go down, and/or taxes will have to go up to break even. And invariably one place government will have to look at to cut costs will be what they will cover. THAT is where the term 'death panel' ultimately stems from. The fact that government will have to decide what treatments it will pay for and what it won't because the simple fact is they won't have the money to cover everyone for everything.
“Mesa resident Randy Shepherd, a 36-year-old father of three, has been living with a pacemaker for several years and now is facing what he says is his last treatment option: a heart transplant.
But Shepherd’s hopes for a transplant were dashed when the state cut Medicaid funding for certain transplants under the Arizona Health Care Cost Containment System.
“Look at all of us who need these transplants,” Shepherd said, joined Tuesday by three others who say they are unable to get live-saving transplants due to the cuts. “It’s not an option for us; it’s a necessity.”
A real-life ‘death panel’ and its real-life victims | Jay Bookman
That's because it's OK when Republicans make "death panels".
In other words the mistake was not so much in someone coining the word death panels for the health care debate. The mistake was in pretending such a thing didn't exist already.
If government's role in health care already forces them to make decisions that have essentially given this guy a death sentence, why on earth would anyone think that expanding government's role, by being responsible for more people, is going to keep things like this from happening?
The issue, for conservatives, is that ObamaCare was hailed as a 'cure all' for our healthcare problems. The point is not that there were already 'death panels', but that Obama Care was not gonna stop the 'death panels'. Read the research on which Obama's plan was based. I did. Some interesting concepts of "care" in that research.
Mesa resident Randy Shepherd, a 36-year-old father of three, has been living with a pacemaker for several years and now is facing what he says is his last treatment option: a heart transplant.
But Shepherds hopes for a transplant were dashed when the state cut Medicaid funding for certain transplants under the Arizona Health Care Cost Containment System.
Look at all of us who need these transplants, Shepherd said, joined Tuesday by three others who say they are unable to get live-saving transplants due to the cuts. Its not an option for us; its a necessity.
A real-life death panel and its real-life victims | Jay Bookman
That's because it's OK when Republicans make "death panels".
