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

[Luissa]

My Father had a living will. He insisted that he was not to be a burden to any of us and that he was to have no artificial prolonged life. When he decided not to eat (he was conscious and speaking) And the Hospital wanted to place him on life support and force feed him through a tube, we moved him from the Hospital to a Hospice. A week later he was eating and doing so much better we had to move him back to a full service assisted living. He died a week later from a blood clot. But the Government had no bearing on what actions we took or the decisions he had earlier made.

What is so hard to get? The government will have no bearing on your decisions.

 

[Zoom-boing]

My Father had a living will. He insisted that he was not to be a burden to any of us and that he was to have no artificial prolonged life. When he decided not to eat (he was conscious and speaking) And the Hospital wanted to place him on life support and force feed him through a tube, we moved him from the Hospital to a Hospice. A week later he was eating and doing so much better we had to move him back to a full service assisted living. He died a week later from a blood clot. But the Government had no bearing on what actions we took or the decisions he had earlier made.

What is so hard to get? The government will have no bearing on your decisions.

My mom was in the hospital all last week for congestive heart failure. She's home now on oxygen 24/7, hospital bed in the den, nurse coming several times a week to check on her. The nurse was there on Friday when I got there. She told me that as of 1/1/11, due to the enactment of Obamacare, if you are hospitalized for xxx and need to be rehospialized for xxx within a month of release, Medicare will not pay for it. Medicare, which they have paid into their whole lives (my parents are 88 and 83), will not cover another hospital stay within a 30 day period. Now, you tell me . . . who made that decision? Certainly not my mom or her doctors.

Gee, I sure hope my mom doesn't need to go into the hospital twice in a 30 day period if the c.h.f. can't be managed at home.

 

[SFC Ollie]

My Father had a living will. He insisted that he was not to be a burden to any of us and that he was to have no artificial prolonged life. When he decided not to eat (he was conscious and speaking) And the Hospital wanted to place him on life support and force feed him through a tube, we moved him from the Hospital to a Hospice. A week later he was eating and doing so much better we had to move him back to a full service assisted living. He died a week later from a blood clot. But the Government had no bearing on what actions we took or the decisions he had earlier made.

What is so hard to get? The government will have no bearing on your decisions.

Actually, discussing this new "Obamacare" with my family doctor (and good friend) he made one statement that you have to wonder about. When the subject of rationed health care came up he said " That's already being done."

 

[SFC Ollie]

My Father had a living will. He insisted that he was not to be a burden to any of us and that he was to have no artificial prolonged life. When he decided not to eat (he was conscious and speaking) And the Hospital wanted to place him on life support and force feed him through a tube, we moved him from the Hospital to a Hospice. A week later he was eating and doing so much better we had to move him back to a full service assisted living. He died a week later from a blood clot. But the Government had no bearing on what actions we took or the decisions he had earlier made.

What is so hard to get? The government will have no bearing on your decisions.

My mom was in the hospital all last week for congestive heart failure. She's home now on oxygen 24/7, hospital bed in the den, nurse coming several times a week to check on her. The nurse was there on Friday when I got there. She told me that as of 1/1/11, due to the enactment of Obamacare, if you are hospitalized for xxx and need to be rehospialized for xxx within a month of release, Medicare will not pay for it. Medicare, which they have paid into their whole lives (my parents are 88 and 83), will not cover another hospital stay within a 30 day period. Now, you tell me . . . who made that decision? Certainly not my mom or her doctors.

Gee, I sure hope my mom doesn't need to go into the hospital twice in a 30 day period if the c.h.f. can't be managed at home.

I believe that nurse is WRONG.

 

[rdean]

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?

 

[Luissa]

My Father had a living will. He insisted that he was not to be a burden to any of us and that he was to have no artificial prolonged life. When he decided not to eat (he was conscious and speaking) And the Hospital wanted to place him on life support and force feed him through a tube, we moved him from the Hospital to a Hospice. A week later he was eating and doing so much better we had to move him back to a full service assisted living. He died a week later from a blood clot. But the Government had no bearing on what actions we took or the decisions he had earlier made.

What is so hard to get? The government will have no bearing on your decisions.

My mom was in the hospital all last week for congestive heart failure. She's home now on oxygen 24/7, hospital bed in the den, nurse coming several times a week to check on her. The nurse was there on Friday when I got there. She told me that as of 1/1/11, due to the enactment of Obamacare, if you are hospitalized for xxx and need to be rehospialized for xxx within a month of release, Medicare will not pay for it. Medicare, which they have paid into their whole lives (my parents are 88 and 83), will not cover another hospital stay within a 30 day period. Now, you tell me . . . who made that decision? Certainly not my mom or her doctors.

Gee, I sure hope my mom doesn't need to go into the hospital twice in a 30 day period if the c.h.f. can't be managed at home.

The nurse doesn't know what she is talking about.

 

[Luissa]

By the way Stephanie, I have many sob stories(shows how much you are), because I have actually provided end of life care for many people, and work in the health care field. Like I said, you have no clue what you are talking about.

you know what, you are an idiot.
go back and READ the article to find out wtf it is about.

I know exactly what it was about, and what happens during end of life care. How about you get a clue.

 

[Mr Natural]

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?

There's BIG difference between living and being alive.

The don't seem to get that.

 

[Granny]

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.

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.

"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.

By the way Stephanie, I have many sob stories(shows how much you are), because I have actually provided end of life care for many people, and work in the health care field. Like I said, you have no clue what you are talking about.

From the bitterness of some of your posts and your ignorance, I'm going to take a stab and say that you're a 3rd shift employee in a nursing home. Your attitude about the elderly is really shitty and you should find another profession.

As a matter of course, doctors generally DO explain to patients what their problem is and what the options are - and it's all inclusive in charges for his services. This is not a new thing to doctors. Unless you were actually present with a particular doctor you have no idea what options he discussed with his patient and/or family members. The government should have absolutely no say whatsoever in these personal matters. And as to Medicare or Medicaid paying doctors for doing this is absolutely absurd - and a waste of tax payer money. Doctors have been advising patients for years as a part of their medical care - and the co-pays and insurance pay for this as a matter of routine. Why the hell should the government dole out more money to doctors who have already been doing this for years?

 

[Stephanie]

SNIP:

Surprise! End-of-life advisory incentives return — through regulationShare40posted at 12:00 pm on December 26, 2010 by Ed Morrissey
printer-friendly Better get used to this process, because it’s how President Obama will be pushing his agenda on all fronts. The New York Times reports today that the White House will create incentives for doctors to discuss “options” for end of life care through regulation, after Congress removed the incentives from ObamaCare:
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.
The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.
Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.
While the new law does not mention advance care planning, the Obama administration has been able to achieve its policy goal through the regulation-writing process, a strategy that could become more prevalent in the next two years as the president deals with a strengthened Republican opposition in Congress.
There is nothing wrong with patients planning for contingencies through advance directives. There is also nothing wrong with doctors discussing those options with patients ahead of those decisions


SNIP:
There is, however, something at least vaguely disturbing about a government incentivizing doctors to do so as part of an expansive regulatory program that has, as one of its primary goals, cost reduction. The process used by Obama and Kathleen Sebelius to get this into ObamaCare is more disturbing, and in a very specific way. Congress made it clear that it didn’t want this incentive as part of the new law. However, thanks to the miles and miles of ambiguity in the final version of ObamaCare, with its repetitive the Secretary shall determine language, Congress has more or less passed a blank check for regulatory growth to Obama and Sebelius.
read it all and comments at.
Surprise! End-of-life advisory incentives return — through regulation Hot Air

 

[Zoom-boing]

Hmmm, perhaps the nurse was wrong. Looks like that won't happen until 2013.

The First Stick—
“Excessive Readmissions”
In addition to the financial incentives noted above, Healthcare Reform also contains financial reductions in Medicare payments as disincentives. For example, beginning in fiscal year 2013, if a hospital experiences “excessive readmissions” when compared to “expected” levels of readmissions for certain conditions, the hospital’s Medicare inpatient payments will be reduced. Healthcare Reform identifies three initial conditions to evaluate for “excessive readmissions”: (1) heart attack; (2) heart failure; and (3) pneumonia. The reduction in Medicare payments would be the larger of a floor adjustment factor established under the Healthcare Reform laws2 and the “excess readmissions ratio.”3 Beginning with fiscal year 2015, HHS is instructed to expand the list of applicable conditions beyond the three noted above to include the conditions identified by the Medicare Payment Advisory Commission in its report to Congress in June of 2007 and also include “other conditions and procedures as determined appropriate by [HHS].” HHS is also instructed to make all of the readmission rate information available to the public. Hospitals will be provided with the opportunity to review and comment on their hospital-specific data prior to this information being made public.

http://www.wahcnews.com/newsletters/whn-gsb0710.pdf

Isn't this saying that Medicare payments will be reduced if a patient is admitted excessively for heart attack, heart failure, or pneumonia? And this list will be expanded starting in 2015. Who is determining what is 'excessive'? The Medicare Payment Advisory Commission. Isn't that the government? Or am I reading this wrong?

 

[WillowTree]

Hmmm, perhaps the nurse was wrong. Looks like that won't happen until 2013.

The First Stick—
“Excessive Readmissions”
In addition to the financial incentives noted above, Healthcare Reform also contains financial reductions in Medicare payments as disincentives. For example, beginning in fiscal year 2013, if a hospital experiences “excessive readmissions” when compared to “expected” levels of readmissions for certain conditions, the hospital’s Medicare inpatient payments will be reduced. Healthcare Reform identifies three initial conditions to evaluate for “excessive readmissions”: (1) heart attack; (2) heart failure; and (3) pneumonia. The reduction in Medicare payments would be the larger of a floor adjustment factor established under the Healthcare Reform laws2 and the “excess readmissions ratio.”3 Beginning with fiscal year 2015, HHS is instructed to expand the list of applicable conditions beyond the three noted above to include the conditions identified by the Medicare Payment Advisory Commission in its report to Congress in June of 2007 and also include “other conditions and procedures as determined appropriate by [HHS].” HHS is also instructed to make all of the readmission rate information available to the public. Hospitals will be provided with the opportunity to review and comment on their hospital-specific data prior to this information being made public.

http://www.wahcnews.com/newsletters/whn-gsb0710.pdf

Isn't this saying that Medicare payments will be reduced if a patient is admitted excessively for heart attack, heart failure, or pneumonia? And this list will be expanded starting in 2015. Who is determining what is 'excessive'? The Medicare Payment Advisory Commission. Isn't that the government? Or am I reading this wrong?

Death Panels.

 

[WillowTree]

What is so hard to get? The government will have no bearing on your decisions.

My mom was in the hospital all last week for congestive heart failure. She's home now on oxygen 24/7, hospital bed in the den, nurse coming several times a week to check on her. The nurse was there on Friday when I got there. She told me that as of 1/1/11, due to the enactment of Obamacare, if you are hospitalized for xxx and need to be rehospialized for xxx within a month of release, Medicare will not pay for it. Medicare, which they have paid into their whole lives (my parents are 88 and 83), will not cover another hospital stay within a 30 day period. Now, you tell me . . . who made that decision? Certainly not my mom or her doctors.

Gee, I sure hope my mom doesn't need to go into the hospital twice in a 30 day period if the c.h.f. can't be managed at home.

The nurse doesn't know what she is talking about.

So, tell us what are the facts?

 

[Greenbeard]

Isn't this saying that Medicare payments will be reduced if a patient is admitted excessively for heart attack, heart failure, or pneumonia? And this list will be expanded starting in 2015. Who is determining what is 'excessive'? The Medicare Payment Advisory Commission. Isn't that the government? Or am I reading this wrong?

The payment amount for all hospital discharges is changing. So, for example, starting in FY 2013, reimbursements for hospital discharges at a given hospital will be either:

1. 99 percent of what they would've been in the absence of reform, or
2. 1 - (total payments for excess readmissions at that hospital/total payments for all discharges) percent of what they would've been in the absence of reform.

Payments to that hospital will be based on whichever of those two numbers is greater (i.e. somewhere between 99 and 100 percent of the base value). Excess readmissions are defined by looking at those three conditions identified by the National Quality Forum and the National Quality Forum will (and, in fact, already does) take the helm on deciding how to calculate expected readmissions mathematically.

This is very different than suggesting Medicare won't be paying for a particular patient to be readmitted. What they're doing is using payment, not for a particular patient with a particular condition but for every discharge, to encourage hospitals to get a handle on preventable readmissions.

 

[SFC Ollie]

Isn't this saying that Medicare payments will be reduced if a patient is admitted excessively for heart attack, heart failure, or pneumonia? And this list will be expanded starting in 2015. Who is determining what is 'excessive'? The Medicare Payment Advisory Commission. Isn't that the government? Or am I reading this wrong?

The payment amount for all hospital discharges is changing. So, for example, starting in FY 2013, reimbursements for hospital discharges at a given hospital will be either:

1. 99 percent of what they would've been in the absence of reform, or
2. 1 - (total payments for excess readmissions at that hospital/total payments for all discharges) percent of what they would've been in the absence of reform.

Payments to that hospital will be based on whichever of those two numbers is greater (i.e. somewhere between 99 and 100 percent of the base value). Excess readmissions are defined by looking at those three conditions identified by the National Quality Forum and the National Quality Forum will (and, in fact, already does) take the helm on deciding how to calculate expected readmissions mathematically.

This is very different than suggesting Medicare won't be paying for a particular patient to be readmitted. What they're doing is using payment, not for a particular patient with a particular condition but for every discharge, to encourage hospitals to get a handle on preventable readmissions.

Bullshit. I had 5 Angioplasties inside of 4 months. 5 different trips to the Hospital and 4 of them in an ambulance. This tells me I will not get the same care as I did 3 years ago.

 

[bigrebnc1775]

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]

 

[Cuyo]

My Father had a living will. He insisted that he was not to be a burden to any of us and that he was to have no artificial prolonged life. When he decided not to eat (he was conscious and speaking) And the Hospital wanted to place him on life support and force feed him through a tube, we moved him from the Hospital to a Hospice. A week later he was eating and doing so much better we had to move him back to a full service assisted living. He died a week later from a blood clot. But the Government had no bearing on what actions we took or the decisions he had earlier made.

What is so hard to get? The government will have no bearing on your decisions.

Actually, discussing this new "Obamacare" with my family doctor (and good friend) he made one statement that you have to wonder about. When the subject of rationed health care came up he said " That's already being done."

Well sure it is, in ER's and hospital triage centers. No big secret, is it?

 

[Cuyo]

My Father had a living will. He insisted that he was not to be a burden to any of us and that he was to have no artificial prolonged life. When he decided not to eat (he was conscious and speaking) And the Hospital wanted to place him on life support and force feed him through a tube, we moved him from the Hospital to a Hospice. A week later he was eating and doing so much better we had to move him back to a full service assisted living. He died a week later from a blood clot. But the Government had no bearing on what actions we took or the decisions he had earlier made.

To me, the provision does not seem to involve the government in the decision making process. It seems rather to give incentive to inform the patient of a multitude of options and realistic prognoses thereof, rather than just trying to sell the most profitable treatment...Which I think we can all agree is something that is now done.

 

[bigrebnc1775]

What is so hard to get? The government will have no bearing on your decisions.

Actually, discussing this new "Obamacare" with my family doctor (and good friend) he made one statement that you have to wonder about. When the subject of rationed health care came up he said " That's already being done."

Well sure it is, in ER's and hospital triage centers. No big secret, is it?

Wrong

 

[Cuyo]

Actually, discussing this new "Obamacare" with my family doctor (and good friend) he made one statement that you have to wonder about. When the subject of rationed health care came up he said " That's already being done."

Well sure it is, in ER's and hospital triage centers. No big secret, is it?

Wrong

Oh, how profound!

Anything informative to add to that, parasite?

Or maybe you just meant "Wrong, it IS a big secret?"