Section 1233, HR 3200 "End of Life Council/Euthenasia talk origins"

[Cecilie1200]

It's for them to record any official decision you choose to make. It's not for them to have any input in the decision, or to even have any input in the decision to make an official decision or not.

How'd you make that leap? Got your super sneakers on there, Sonic?

Make what leap? The government encouraging "end of life counseling" with a doctor? My doctor has no business having any input in my decision, beyond providing any information I ask him for, and the government has no business "encouraging" me to talk to him about it.

 

[veritas]

You're bootstrapping. I said end of life decisions, and deaths, have to be documented and recorded so therefore they are not personal issues.

I don't know who you're arguing with. Yourself maybe?

 

[AllieBaba]

you don't HAVE to have a living will or DNR order or medical power of attorney or any of that if you don't want to.

No you don't. This bill isn't making it mandatory either.

Yes it is. By making it mandatory to enroll, it's making it mandatory.

Figure it out.

 

[veritas]

you don't HAVE to have a living will or DNR order or medical power of attorney or any of that if you don't want to.

No you don't. This bill isn't making it mandatory either.

Yes it is. By making it mandatory to enroll, it's making it mandatory.

Figure it out.

You are systemically illogical. It's not mandatory. It's covered.

 

[Care4all]

It's for them to record any official decision you choose to make. It's not for them to have any input in the decision, or to even have any input in the decision to make an official decision or not.

How'd you make that leap? Got your super sneakers on there, Sonic?

Make what leap? The government encouraging "end of life counseling" with a doctor? My doctor has no business having any input in my decision, beyond providing any information I ask him for, and the government has no business "encouraging" me to talk to him about it.

you are being an ignoramus!!!

FIRST
IT IS NOT MANDATORY that we have this counceling....it was an OPTION for people like me, who would have wanted ALL OF THE INFORMATION on living wills and medical order forms that could have been useful to me and my husband in making OUR DECISIONS on ourselves....

SECOND
the bill was to make certain my insurance covered my counceling on my PERSONAL FRICKING WISHES for MY fricking medical care that I decided through my professional counseling and research decided to do FOR ME, once every 5 years!

To make this out as something else is nothing less than being intellectually DISHONEST.

you all, are really acting like the girl who cried wolf on ONE TOO MANY meaningless things in this bill, and when there REALLY IS, an issue in it that could be of REAL concern, NO ONE....and I mean NO ONE (other than maybe yourselves) will ever listen to you or believe you...and THAT could be a REAL problem down the road.

I have never in my life seen a bunch of over reacting, over absolutely nothing, nimrods!

does ANYONE ever really take the time to research what they are arguing over other than researching your own political leaning sites of your own favor...

Just the mention of "Life sustaining orders" in the bill MADE ME, say to myself immediately, "What does life sustaining orders mean?" before I could even go on with this thread, so I googled it, got my answer immediately, and realized you all have totally misrepresented what the term actually means and how each state has gyuidelines ALREADY on life sustaining orders and how to handle such, and a board that determines such... BUT NOOOOOOOO, YOU all have to make it out like this is OBAMA trying to KILL YOU...

WHAT A BUNCH OF LOONEY TOONS.

I truly do not understand WHY you wouldn't want to know the truth about each and every item you question and do some ACTUAL RESEARCH on it to find out precisely all about it and what it means?



Care

 

[veritas]

you are being an ignoramus!!!

At least she is consistent.

 

[Emma]

Read Sarah Palin's Facebook Notes on this. She does an excellent job of explaining how 'end of life counseling' will lead to rationing and that seniors have every right to be concerned about all of this.

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This 'end of life counseling' is a moot point now. They dropped this provision.

Sens. Drop End-of-Life Provision from Bill - CBS News

It's dropped from one of the Senate bills.

A health care bill passed by three House committees allows Medicare to reimburse doctors for voluntary counseling sessions about end-of-life decisions.

Too bad the Senators were pussies.

I wonder why they feel providers shouldn't be reimbursed for their services?

 

[Emma]

Actually, it doesn't. You run the risk of having your next-of-kin deciding something other than what you wanted, but you don't HAVE to have a living will or DNR order or medical power of attorney or any of that if you don't want to.

You're right about one thing. PEOPLE are responsible for it. They're responsible for deciding whether or not they want to be responsible. The government has no business stepping in and trying to legislate whether or not they do it.

Just because it's a good idea to do something doesn't necessarily mean it's a good idea for the government to make you do it.

There is NOTHING in the House bill that forces anyone to do anything.

Dear God.

As far as advance directives...

An advance directive can instruct your caregivers to do everything to keep you alive; it can instruct them to provide certain levels of care (tube feedings and antibiotics, for example). It doesn't even have to include a 'living will' portion at all. That's why it's called a directive.

And even if there is a living will declining CPR and life-support, that does NOT automatically make you a do-not-resuscitate. That ONLY happens upon the order of a physician. And it's all reversible, in part or in whole. Neither the advance directive NOR a DNR order is written in stone.

 

[Emma]

I can't help thinking this "end of life counseling" is going to end up being a lot like the "genetic counseling" I was given when I became pregnant at the age of 39. What it basically came down to was this woman sitting in a room, doing her best to scare the bejesus out of me about all the things that could be wrong with my baby and how difficult it would be to take care of a special-needs child, and trying to convince me to have an abortion should there be a problem. I would much have preferred to have waived the consultation, but the clinic refused to give me an amniocentesis unless I let them "counsel" me.

Maybe I'm cynical, but I see "end of life counseling" turning out to be some doctor trying to scare the bejesus out of old/sick people about how awful a lingering illness might be, how horrible for their families, how expensive, etc. and trying to convince them to "die with dignity" instead. As with the decision about keeping my baby (who was perfect in any case), I would prefer to make that decision with my husband and forego anyone else's "helpful" input unless I have a specific question.

That is why the bill includes specific guidelines as to what constitutes "advance care planning".

 

[Emma]

Make what leap? The government encouraging "end of life counseling" with a doctor? My doctor has no business having any input in my decision, beyond providing any information I ask him for, and the government has no business "encouraging" me to talk to him about it.

1. No one is encouraging anything.

2. Every health care provider has a plan of care for every patient.

 

[Emma]

Just a question for those opposed to this...

Why do you not want providers reimbursed for their services?

 

[PLYMCO_PILGRIM]

This is how you would cite the specific section you are referring to:

HR 3200
TITLE I--PROTECTIONS AND STANDARDS FOR QUALIFIED HEALTH BENEFITS PLANS
Subtitle G; Early Investments.
Section 163; Administrative simplification.


Replaces the Social Security Code Emma posted with:

‘SEC. 1173A. STANDARDIZE ELECTRONIC ADMINISTRATIVE TRANSACTIONS.

‘(a) Standards for Financial and Administrative Transactions-

‘(1) IN GENERAL- The Secretary shall adopt and regularly update standards consistent with the goals described in paragraph (2).

‘(2) GOALS FOR FINANCIAL AND ADMINISTRATIVE TRANSACTIONS- The goals for standards under paragraph (1) are that such standards shall--

‘(A) be unique with no conflicting or redundant standards;

‘(B) be authoritative, permitting no additions or constraints for electronic transactions, including companion guides;

‘(C) be comprehensive, efficient and robust, requiring minimal augmentation by paper transactions or clarification by further communications;

15
‘(D) enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;

1
‘(E) enable, where feasible, near real-time adjudication of claims;
1
‘(F) provide for timely acknowledgment, response, and status reporting applicable to any electronic transaction deemed appropriate by the Secretary;

1
‘(G) describe all data elements (such as reason and remark codes) in unambiguous terms, not permit optional fields, require that data elements be either required or conditioned upon set values in other fields, and prohibit additional conditions;
1
‘(H) harmonize all common data elements across administrative and clinical transaction standards.

The applicability section has to do with providers, not individuals.

Oh thats freaking good!!!!!!!!.

I have another thread now that I have to edit that claim off of.

Thank you VERY much for pointing that out.

 

[Navy1960]

Your end matters are not personal if people have to know what you want. What if you wanted to refuse another round of chemo, but had a stroke in the meantime and couldn't say you didn't want it and just wanted to be let go? How is anybody going to know? What if you have alzheimers?

It can't be that personal, it has to be documented and verified should the need arise if there is any contention. Your concerns are groundless. Death is a public happenstance. It's recorded. People are responsible for keeping track of these things. Not personal at all.

If a person get's into an accident, and has on their DL a listing that say's organ donor the Docotrs before harvesting that organ must seek permission from the family members to harvest that organ. If a family member has a stroke while having chemo those treating them will then get permission from family members as how to proceed with that person(s) treatement. If you had a long term condition like ALZ the same thing would apply. while death is a very personal matter, the estate side of death is a public matter, and I submit that to dismiss concerns as groundless is to catagorize death matters as simple matters of accounting that can be administered on a Governmental spreadsheet and I will continue to see this issue as very private matter that is supported by the fact that if death were as public as you say it were then the Govt. would be funding funerals and legislating the disposal, time, and place of mortal remains. If fact, perhaps this issue is both a public one when it comes to estate issues, and a private one when it comes to end of life issues, and at some point there is a little crossover as to how best to dispose of ones estate, I will grant you that. Still, if this matter is a state issue and no state lines are to be crossed, agian I see on this minor portion of the end of life matters where the Federal Govt., even has power to regulate , unless the estate crosses state lines. As for the planning itself, to dismiss this concern out of hand is not recognize the varied opinions , especially when it comes to end of life matters.

 

[veritas]

It has nothing to do with the estate. I don't know where you are getting this. It's about what one wants and if it is carried out. It's not about the funeral. It's about the people that are responsible for seeing that your wishes are carried out, the doctors, the nurses and the administrators, it's a very public, on the record sort of thing.

 

[Navy1960]

End-of-life self-medication ok; euthanasia by others not ok. (Apr 2008) Barack Obama;


Arizona:

36-3201 et seq. Living Wills and Health Care Directives
Life-Prolonging Acts Does not include comfort care or alleviation of pain but may include life-sustaining treatment artificially delaying the moment of death, CPR, drugs, electric shock, artificial breathing, artificially administered food and fluids
Legal Requirements for Valid Living Will (1) Adult; (2) in writing; (3) language clearly indicating intent to create a living will; (4) dated; (5) signed; (6) witnessed by at least one adult or a notary public
Revocation of Living Will Person may revoke health care directive or disqualify a surrogate by (1) written revocation; (2) orally notifying surrogate or health care provider; (3) making new health care directive; (4) any other act demonstrating specific intent to revoke
Validity from State-to-State Health care directive prepared in another state is valid in this state if it was valid where and at the time it was adopted to the extent it does not conflict with the criminal laws of Arizona
If Physician Unwilling to Follow Living Will Physician must effect prompt transfer to a physician willing to comply
Immunity for Attending Physician Health care provider making good faith decisions in reliance on apparently genuine health care directive or decision of a surrogate or living will is immune from criminal, civil, and professional discipline for that reliance (unless negligent)

Living wills are clearly state matters and are clearly matters of privacy and that are decisions that between a family member and their appointed surrogate. It is NOT a public matter. In fact if it were, a public matter other than on the estate side of the issue and that include the disposition of financial matters, then you would see a Federal Govt. standard applied to treating Doctors and not allowing them to deny end of life directives as in the Arizona law. Your correct in your assesment that htis issue impacts Doctors, nurses, and treatment professionals, however it has nothing at all to do with the Federal Govt. when it comes to end of life planning and Advanced Directives. If the Federal Govt. wished to promote these things then perhaps then , they should be in the business of promtion of Abortions, types of haircuts you should have, the list is endles. but they all have one thing in common they are all private matters that belong in the hands of an individual and need not be promoted by the Federal Govt. In fact the legal implementation and legislation living wills are a state issue and literally have nothing at all to do with the Federal Govt. and even the Federal Govt. has stated this in the PSDA

On November 5, 1990, Congress passed this measure as an amendment to the Omnibus Budget Reconciliation Act of 1990. It became effective on December 1, 1991. The PSDA requires many Medicare and Medicaid providers (hospitals, nursing homes, hospice programs, home health agencies, and HMO’s) to give adult individuals, at the time of inpatient admission or enrollment, certain information about their rights under state laws governing advance directives,
,

While the PSDA clearly shows any part of living wills as it applies to legislation belongs to to states the exectution of those belong to private hands of individuals and not the Federal Govt.

 

[PLYMCO_PILGRIM]

I just dont get why the govt wants to get involved in more than just coverage.

Coverage is the issue, not the quality of service or types of services.

 

[veritas]

Coverage is the issue, not the quality of service or types of services.

Types of services ARE coverage. Quality is less quantifiable except with respect to what is covered. The end of life counseling would be considered a consultation whereby you are informed of your situation and what options are available to you, just like any other information you would receive from your doctor about other things like diet and exercise and medications and potential procedures.

 

[Emma]

Coverage is the issue, not the quality of service or types of services.

Types of services ARE coverage. Quality is less quantifiable except with respect to what is covered. The end of life counseling would be considered a consultation whereby you are informed of your situation and what options are available to you, just like any other information you would receive from your doctor about other things like diet and exercise and medications and potential procedures.

Exactly. And again, this can also clarify that you want everything done, or specifically what you want done.

 

[Navy1960]

Coverage is the issue, not the quality of service or types of services.

Types of services ARE coverage. Quality is less quantifiable except with respect to what is covered. The end of life counseling would be considered a consultation whereby you are informed of your situation and what options are available to you, just like any other information you would receive from your doctor about other things like diet and exercise and medications and potential procedures.

Exactly. And again, this can also clarify that you want everything done, or specifically what you want done.

So given that then why not offer taxpayer funded cousel on abortion, or perhaps taxpayer funding on botox, or breast enhancements, because if you open the door under a healthcare bill to fund counsel matters for personal preference then you must open it for everything. The fact remains that this issue at best when legislation is invloved belongs in the hands of the states and the people that make it and not in the hands of the Federal govt. and especially not in a healthcare reform bill.

 

[veritas]

Types of services ARE coverage. Quality is less quantifiable except with respect to what is covered. The end of life counseling would be considered a consultation whereby you are informed of your situation and what options are available to you, just like any other information you would receive from your doctor about other things like diet and exercise and medications and potential procedures.

Exactly. And again, this can also clarify that you want everything done, or specifically what you want done.

So given that then why not offer taxpayer funded cousel on abortion, or perhaps taxpayer funding on botox, or breast enhancements, because if you open the door under a healthcare bill to fund counsel matters for personal preference then you must open it for everything. The fact remains that this issue at best when legislation is invloved belongs in the hands of the states and the people that make it and not in the hands of the Federal govt. and especially not in a healthcare reform bill.

MANDATORY "counseling" is already in place for abortions. Which, since Bush and the fundies took office, includes all sorts of religious BS and less medical info and should be redacted and amended. Abortions, botox and breast enhancements are all elective procedures. Death is not elective, we're all getting that condition at one point or another, so your argument is not logical.

Whenever you get any procedure, necessary or elective, the doctor is required to tell you what the possible risks and outcomes are and provide you with choices at the point before the service takes place. The "end of life" nonsense is just noise and it is getting tiresome belaboring the point that it is a non starter and only brain donors wish to make further issue of it.