Discussion in 'Current Events' started by annie52, Jul 31, 2009.
Fred Thompson: Interviews
It doesn't shock me. This is pure progressivism and today's liberalism. The elderly, the ill, and the people who live outside of cities are disposable, and they have every intention of disposing of them.
my mother has a living will. she did it during the shivo debate. it states that she be taken off food and water...i told her...fuck no...and that is how i feel about it. there are times you have the dnr order but that is a family decision not a government one.
What a load of horse hocky.
We read this part of the bill, remember?
It does NOT say what this person is saying it does.
She's fucking making shit up, folks.
It is amazing the reactionary nonsense that corporate tools imagine. It is bad enough they think the stuff but then to scare others they repeat the junk that bangs around their empty heads. Every move forward from the cave to UHC is met with the same negativity, even democracy. Healthcare since Truman has been a concern and a goal, but corporate money stopped it - will the tools succeed again?
[ame=http://www.amazon.com/Rhetoric-Reaction-Perversity-Futility-Jeopardy/dp/067476868X/ref=sr_1_4?ie=UTF8&s=books&qid=1249125394&sr=1-4]Amazon.com: The Rhetoric of Reaction: Perversity, Futility, Jeopardy (9780674768680): Albert O. Hirschman: Books[/ame]
[ame=http://www.amazon.com/Manufacturing-Consent-Political-Economy-Media/dp/0375714499/ref=sr_1_2?ie=UTF8&s=books&qid=1249125348&sr=1-2]Amazon.com: Manufacturing Consent: The Political Economy of the Mass Media (9780375714498): Edward S. Herman, Noam Chomsky: Books[/ame]
well the conspirator's in the details Editec, and i (for one) lack the legal-speak to sort it out as well....*(i believe this is what she's talking about below...)one thing that is evident is the gov seems to be moving in the direction of end-of life directives
In light of Big Bro's many other good intents that would seem to be doing just that, who can blame the skeptism..?
SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
(a) M EDICARE .
(1) I N GENERAL .Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended (A) in subsection (s)(2) (i) by striking and at the end of subparagraph (DD); (ii) by adding and at the end of subparagraph (EE); and (iii) by adding at the end the following new subparagraph: HCA0~1.XML HOLCPC
(FF) advance care planning consultation (as defined in subsection (hhh)(1));; and (B) by adding at the end the following new subsection:
Advance Care Planning Consultation (hhh)(1) Subject to paragraphs (3) and (4), the term advance care planning consultation means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:
(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.
(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).
(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include
(I) the reasons why the development of such an order is beneficial to the individual and the individuals family and the reasons why such an order should be updated periodically as the health of the individual changes;
(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and
(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decision maker (also known as a health care proxy).
(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State
(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and
(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that
(I) ensures such orders are standardized and uniquely identifiable throughout the State;
(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professionals authority under State law) may sign orders for life sustaining treatment;
(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and
(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.
(2) A practitioner described in this paragraph is
(A) a physician (as defined in subsection (r)(1)); and
(B) a nurse practitioner or physicians assistant who has the authority under State law to sign orders for life sustaining treatments.
(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1).
(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.
(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.
(5)(A) For purposes of this section, the term order regarding life sustaining treatment means, with respect to an individual, an actionable medical order relating to the treatment of that individual that
(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professionals authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;
(ii) effectively communicates the individuals preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;
(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and
(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.
(B) The level of treatment indicated under subparagraph
(A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items
(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;
(ii) the individuals desire regarding transfer to a hospital or remaining at the current care setting;
(iii) the use of antibiotics; and
(iv) the use of artificially administered nutrition and hydration..
(c) I NCLUSION OF I NFORMATION IN M EDICARE & Y OU H ANDBOOK .
(1) M EDICARE & YOU HANDBOOK .
(A) I N GENERAL .Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall update the online version of the Medicare & You Handbook to include the following:
(i) An explanation of advance care planning and advance directives, including
(I) living wills;
(II) durable power of attorney;
(III) orders of life-sustaining treatment; and
(IV) health care proxies.
(ii) A description of Federal and State resources available to assist individuals and their families with advance care planning and advance directives, including
(I) available State legal service organizations to assist individuals with advance care planning, including those organizations that receive funding pursuant to the Older Americans Act of 1965 (42 U.S.C. 93001 et seq.);
(II) website links or addresses for 6 State-specific advance directive forms; and
(III) any additional information, as determined by the Secretary.
10 (B) U PDATE OF PAPER AND SUBSEQUENT VERSIONS .The Secretary shall include the information described in subparagraph (A) in all paper and electronic versions of the Medicare & You Handbook that are published on or after the date that is year after the date of the enactment of this Act.
I guess I should put this in my sig line.
This is about Medicare benefits and reimbursement. The ONLY thing mandatory is that IF a physician/NP provides counseling regarding advance care planning, Medicare will reimburse the provider but not more often than every 5 years (except in certain circumstances). It is not mandating advance care planning. It is not mandating living wills. It is amending the current regulations to allow for medicare reimbursement of advance care planning and setting the guidelines for same in order to qualify for reimbursement.
I'm going to need advance care planning soon if this shit doesn't stop. I can feel my BP shoot through the roof every time I hear this nonsense.
That's all this shit is!
Show me ANYWHERE in the law where it says that the Advanced Directives discussion is MANDATORY!
From the audio clip:
"...the congress would make it MANDATORY...absolutely required every 5 years..."
So annie52...the ball is in your court! You can either prove yourself RIGHT, or you can be a FAILURE!
I find it mind-boggling that so many are willing to put the future of their health care in the hands of the government. Your trust and faith in them astounds me.
Separate names with a comma.